摘要:

AbstractA new and highly promising adjunctive modality for the diagnosis and therapy of malignancies is under development using lasers and tumor targeting dyes. To reach the eventual goal of clinical treatment, several current “fantasies and fallacies” regarding laser applications in medicine must be identified and their problems clearly outlined. A multidisciplinary scientific approach is also required to enable the clinical practicality of this laser targeting approach. Many new dyes and laser wavelengths are being tested to improve specific tumor uptake and/or retention, lower systemic toxicity, increase tissue penetration, and identify fluorochromes with synergistic properties to further enhance laser tumoricidal effects. Rapid technological advancements in magnetic resonance imaging may now provide an extremely sensitive way to detect and monitor laser‐tissue effects, and allow efficient interstitial laser phototherapy of deep and sometimes inaccessible tumors. The current and future prospectives of the emerging field of laser phototherapy are desc

ISSN:0023-852X    

DOI:10.1288/00005537-199107000-00026

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractPrenatal and perinatal correlates of abnormal auditory brainstem responses in neonates have been studied extensively. In contrast, vestibular function during the first year of life has received sparse attention. Using a specially modified vestibular test battery, 65 infants (17 low‐risk, 48 high‐risk) were initially evaluated during their first 6 months of life. Results revealed normal vestibular function in 46 infants (13 low‐risk, 33 high‐risk) and abnormal findings at either 3 or 6 months in 19 infants (4 low‐risk, 15 high‐risk). Correlations between vestibular results and variables such as auditory brainstem response results, birth history, and postnatal course in the neonatal intensive care unit were analyzed statistically. While some differences were mildly significant, none were highly significant. The lack of significant correlation between abnormal auditory brainstem response and vestibular results is of particul

ISSN:0023-852X    

DOI:10.1288/00005537-199107000-00001

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe vestibulo‐ocular reflex (VOR) is usually evaluated by whole‐body rotary chair oscillation in darkness, but is limited to ambulatory patients. In order to develop a portable method of VOR assessment, eye movements from 10 normal subjects were studied under three conditions:1. whole‐body rotary chair oscillation in the dark and in the light with a head mounted blank field,2. passive head‐on‐body rotation in the light with a blank field, and 3. active head‐on‐body rotation in the light with a blank field. The influence of visual fixation, neck rotation, and volition on VOR gain was to be assessed. Head oscillations were maintained at 0.5 and 1.0 Hz, 50°/s peak velocity.Mean VOR gains with blank field testing were indistinguishable from those obtained in darkness during whole‐body rotation. In addition, there were no significant differences in the mean gain between whole‐body, passive head rotation or active head rotation. Two vestibulopathic patients (absent calorics bilaterally and oscillopsia) were also studied to illustrate potential clinical utility of the methods. Rotations under all conditions revealed low but variable gains.The evaluation of the VOR in the light with a blank visual surround and passive or active head rotation is a potentially useful clinical method of bedside ass

ISSN:0023-852X    

DOI:10.1288/00005537-199107000-00002

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractA series of varying types of surgical injuries to the recurrent laryngeal nerve, including half section, double crush, suture ligation, and complete section of the nerve, was investigated in dogs by correlating clinical and electromyographic findings. The state of recovery from palsy was evaluated by recording the electromyography from the affected laryngeal muscles as well as by observing the movements of the vocal cords.Six electromyography patterns were recorded from the affected muscles following injuries to the recurrent laryngeal nerve. There is a close relationship between the electromyography patterns and the types of nerve injuries.Within 3 months after injuries of the recurrent laryngeal nerve, the electromyography motor unit potentials in the involved intrinsic laryngeal muscles and vocal cord movements on the side of the nerve injury were back to normal in the groups of dogs in which the recurrent laryngeal nerves were partially sectioned and doubly crushed; the electromyography potentials and vocal cord motion on the affected side did not return to normal in the group of dogs in which the recurrent laryngeal nerves were permanently ligated with suture. In the group of dogs which had had a complete section of the recurrent laryngeal nerve, no recovery of both electromyography and vocal cord function on the affected side was observed 6 months after injury of the recurrent laryngeal nerve.This study showed that the frequency of the regenerated potentials recorded from the affected muscles is related to the types and degrees of injuries to the recurrent laryngeal nerve. Recovery from recurrent laryngeal nerve palsy is complete within 3 months after nerve impairment if over half of the nerve fibers of the impaired nerve are maintained intact without degeneration. Moreover, the period from onset to complete recovery from palsy was remarkably short, less than 2 months. The most appropriate time for the electromyography examination to evaluate the degrees of the nerve injury and to anticipate the prognosis of recurrent laryngeal nerve palsy was proposed.

ISSN:0023-852X    

DOI:10.1288/00005537-199107000-00003

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe toxic effects on the stria vascularis of treatment with cisplatin alone and combined with the aminoglycoside antibiotic, gentamicin, were studied in guinea pigs. The toxicity induced in albino and pigmented guinea pigs was investigated morphologically with light and transmission electron microscopy, and functionally by brainstem‐evoked response audiometry. The results of hearing thresholds were variable, ranging from no change in one ear in some of the animals to a hearing loss of 20 dB in one or both ears when treated with low‐dose cisplatin alone or in combination with gentamicin. Bilateral deafness resulted from high‐dose cisplatin combined with gentamicin. The combined treatment produced prominent structural damage in the stria vascularis. The results should be considered when aminoglycoside therapy is required in conjunction with cisp

ISSN:0023-852X    

DOI:10.1288/00005537-199107000-00004

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractExperiments leading to the development and use of a biomaterial based on reconstituted collagen for use in tympanoplasty are presented. A stable, even membrane with optimal strength and an organized matrix of collagen protein strands has been obtained. Biocompatibility was documented by subcutaneous implantation, cytotoxicity with agar overlay, cell contact, and cell‐growth inhibition studies. Experimental grafting in chinchillas with perforated tympanic membranes demonstrated that the collagen membrane performed well in all cases. Histopathological studies in chinchillas showed that the collagen membrane compared favorably with fascia grafts. Of significance is that:1. The membrane has a matrix of microperforations that enhance tissue ingrowth, allow stable anchoring, and permit aeration of the middle ear cavity.2.The membranes obtained are not exposed to aldehyde cross‐linking; therefore, tissue reaction due to aldehydes is avoi

ISSN:0023-852X    

DOI:10.1288/00005537-199107000-00005

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe development of a new device that consists of a biodegradable support incorporating a thera‐peutically releasable amount of ampicillin is presented. This device is in an insertable shape that allows placement into the middle ear via a myringot‐omy incision. Once in the middle ear cavity, it expands, contacts the walls, and provides extended release of ampicillin. In vitro studies (3 months) documented the consistent release of therapeutic levels of ampicillin. In vivo efficacy was demonstrated in otitis‐induced chinchillas (bacterial inoculation). The device compared favorably with topical and systemic treatment and prophylaxis of otitis media. The device was also efficient in repeated bacterial challenges. Topical extended middle ear drug delivery can become a significant form of treatment for middle ear disease, and has the potential of being useful as a source for inner ear drug del

ISSN:0023-852X    

DOI:10.1288/00005537-199107000-00006

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractToxic shock syndrome has been associated with rhinologic surgery and medical devices, and it has been linked to a circulating exotoxin of a toxogenic strain ofStaphylococcus aureus. One hundred forty patients with rhinosinusitis were studied. Nasal cultures were obtained. The microbiological characteristics are described. The carrier rate forStaphylococcus aureuswas 35%. Thirty percent of patients selected for surgery wereStaphylococcus aureuscarriers. Toxin‐capable isolates were identified in 40% of those tested. Users of cocaine, topical decongestants, and steroid sprays had a statistically higher rate ofStaphylococcus aureuscarriage compared to non‐users. It is hoped that by identifying the population at risk and defining the factors associated with the development of toxic shock syndrome, a cogent policy of prevention can be establis

ISSN:0023-852X    

DOI:10.1288/00005537-199107000-00007

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractAn objective, noninvasive method for the diagnosis and monitoring of pathology referable to the temporomandibular joint is presented.A computerized temporomandibular joint analyzer was developed to obtain data from the patient's temporomandibular joint area to provide an objective record of clinical symptoms and signs. This data, used in conjunction with a complete history and physical examination, aids in the diagnosis and decision‐making process for therapy.Fifty patients with temporomandibular complaints were evaluated. Diagnoses made using the temporomandibular joint analyzer in conjunction with complete histories and physical examinations were confirmed in 81% of the patients by further examinations with x‐ray studies, computed tomography scans, magnetic resonance imaging, and ar‐throscopy.Patients' progress during treatment was monitored using the temporomandibular joint analyzer. Results of the temporomandibular joint analyzer were compatible with patients' progress as reported subjectively and with clinical evaluation in 97% of the cases.The temporomandibular joint analyzer can be used to reduce time and expense as well as to minimize the discomfort involved in the evaluation of temporomandibular joint diso

ISSN:0023-852X    

DOI:10.1288/00005537-199107000-00008

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY

摘要:

AbstractAn efficacious treatment has not been available to patients with aberrant regeneration of the facial nerve as a result of Bell's palsy or after acoustic neuroma excision. This prospective controlled trial examines the efficacy of electromyographic feedback versus mirror feedback as treatment strategies for patients suffering from long‐standing (18 months minimum) facial nerve paresis. Twenty‐five patients were randomly assigned to electromyography with mirror feedback or mirror feedback alone. Seven rural patients who did not undergo treatment served as controls. At 0,6, and 12 months, facial motor function was objectively quantified by linear measurement of facial movement, visual assessment of voluntary movement, and electrical measurement of facial nerve response to maximal stimulation. Statistically significant improvements were noted in both electromyography and mirror‐feedback groups with respect to symmetry of voluntary movement (P<.03) and linear measurement of facial expression (P<.01). The positive results of this controlled trial demonstrate that feedback training in combination with a structured home rehabilitation program is a clinically efficacious treatment for patients with facial nerve pa

ISSN:0023-852X    

DOI:10.1288/00005537-199107000-00009

出版商:John Wiley&Sons, Inc.    

年代:1991

数据来源: WILEY