摘要:

AbstractA rabbit auricular amputation model was used to study the relative effects of arterial insufficiency (AI) and venous congestion (VC) on composite graft survival. The percentage of graft survival was significantly greater for the AI group (45.8%) than for the VC group (15.9%) 2 weeks postoperatively. The percentage of graft survival at 3 weeks for the VC, AI, and no‐ligation groups were not statistically different. All three groups were statistically different from the control group, which had both the central artery and vein ligated. The VC group also exhibited significantly more graft edema, as measured by maximal graft thickness, than the other three groups.The impact of AI and VC on composite graft survival is investigated and discussed. These results suggest that venous congestion is more detrimental to early graft survival than arterial insufficienc

ISSN:0023-852X    

DOI:10.1288/00005537-199506000-00001

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractOcclusion of the maxillary ostium is considered to be a key factor in the pathogenesis of maxillary sinusitis. In this study, the authors determined the effect of ostial occlusion on pressure in the rabbit maxillary sinus which, like most humans, has only one ostium. We compared pressures in the normal and occluded maxillary sinus and the nasal cavity during spontaneous breathing in anesthetized adult animals. Serial pressure measurements were obtained from sinuses with patent ostia in nasal‐breathing rabbits and with occluded ostia in both nasal‐breathing and tracheotomized animals.Sinuses with patent ostia showed pressure curves synchronous with the respiratory cycle. Inspiratory and expiratory pressures in the nasal cavity and the sinus were isobaric. Sinuses with occluded ostia initially developed a positive pressure followed by a negative pressure that reached a subatmospheric plateau of‐28.2 ± 7.3 mm H2O (mean ± standard deviation [SD]) within 20 to 50 minutes.This is the first quantitative study of sinus pressures using the rabbit as an animal model. The findings may contribute to a better understanding of the role of ostial occlusion in the pathogenesis of maxillary sinusitis in

ISSN:0023-852X    

DOI:10.1288/00005537-199506000-00002

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractSeventy‐five patients who had advanced cervical metastasis with possible invasion of the deep muscles or carotid artery were approached with aggressive resection and intraoperative radiotherapy (IORT). All metastatic nodes were greater than 3 cm, 65% were fixed on clinical examination, and 35% involved the carotid artery. Forty‐six (61%) of the patients had previously received irradiation. Fifteen of the patients required extended neck dissections with carotid resections and grafting. After the resection an average single dose of 2000 cGy of electron beam IORT was delivered.At 2 years, the local control rate within the IORT port was 68% and the absolute survival rate was 45%. Local control rates for close and microscopic margins (76% and 73%, respectively) were significantly better than the control rate for gross residual disease (25%,P<.05).The combination of extended neck dissection, including carotid artery resection if necessary, and IORT appears to offer improved cont

ISSN:0023-852X    

DOI:10.1288/00005537-199506000-00003

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractVarious diagnostic tools were used in 26 patients with parotid masses to determine their value in preoperative malignant or benign categorization. These tools were positron emission tomography (PET), clinical examination, fine‐needle aspiration biopsy (FNAB), computed tomography (CT), and magnetic resonance imaging (MRI). PET identified all 26 lesions and all 12 malignant lesions, but made the correct categorization in only 69% of cases. Thus, it was not as good as the more conventional diagnostic methods, their correct categorizations being 85% (clinical), 87% (CT/MRI), and 78% (FNAB) in the same patient

ISSN:0023-852X    

DOI:10.1288/00005537-199506000-00004

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractContact granuloma of the vocal folds has been associated with abnormal use of the voice, and acid reflux may exacerbate the inflammatory process. Treatments have included voice therapy and antireflux measures. Surgical excision is considered in patients who do not respond to medical management.Localized injections of botulinum toxin type A (BOTOX®) have been effective in patients with disorders of muscular control in the head and neck. In this study, granulomas resolved in six patients who underwent injection of the affected vocal folds. Botulinum toxin type A is probably successful because it prevents forceful closure of the arytenoids during phonation and coughing. Localized injection of this neurotoxin is promising both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy or who are poor surgical candidates

ISSN:0023-852X    

DOI:10.1288/00005537-199506000-00005

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractOtoacoustic emissions (OAEs) are low‐level acoustic sounds of cochlear origin that can be recorded from the external auditory canal under well‐controlled conditions. They are a natural by‐product of normal auditory physiology and may be divided into two general categories: spontaneous and evoked emissions. These emissions provide an objective, non‐invasive measurement of cochlear function that is accurate, rapid, and simple to perform. The clinical utility of OAEs has been extensively described in both normally hearing subjects and subjects with sensori‐neural hearing loss. The primary clinical applications of these emissions appear to be in neonatal screening and ototoxic monitoring.In this study, the effects of middle ear effusion on the production of evoked OAEs in children were assessed using preoperative tympanometric and otoacoustic emissions testing. The study subjects were children with a history of chronic otitis media who had otoscopic findings suggestive of middle ear effusion. An attempt was made to correlate the type of middle ear effusion found at surgery with the presence or absence of preoperative otoacoustic emissions.Statistical analysis indicated that the type of effusion in the middle ear does affect the presence or absence of emissions. These results tend to refute previous notions that OAEs are not measurable if the tympanogram is abnormal or fluid is present in the middle ear space. A review of the pertinent literature in included, along with a general description of the types of OAEs and their clinical sig

ISSN:0023-852X    

DOI:10.1288/00005537-199506000-00006

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe neural generators of the brainstem auditory evoked potentials (BAEPs) in humans are not completely known. Attempts to identify the anatomical location of the neural generators of the human BAEP based on the results of studies in animals commonly used in auditory experimentation have been difficult because of the considerable anatomical differences between the ascending auditory pathways in humans and animals.The authors of this study compared recordings obtained from different locations on the lateral side of the brainstem in six patients undergoing micro vascular decompression surgery for a cranial nerve disorder affecting the fifth cranial nerve (i.e., trigeminal neuralgia). Ipsilateral click stimulation evoked prominent responses from the caudal aspect of the pons up to the junction between the pons and the midbrain, but all components of the responses with latencies shorter than 8 msec had smaller amplitudes when recorded at more rostral locations. Components with latencies in the range of peak V elicited by contralateral click stimulation had their largest amplitudes when recorded from the lateral brainstem at the level of the fourth cranial nerve (thus, close to the inferior colliculus). Earlier components of the contralateral responses (latencies in the range of the latency of peak III) had their largest amplitudes when recorded from the caudal lateral brainstem.The results of this study indicate that the part of the uncrossed auditory pathway that is located rostral to the cochlear nucleus contributes little to the farfield potentials (i.e., BAEP), and it is doubtful whether the contralateral response that can be recorded at the level of the cochlear nucleus contributes noticeably to the BAEP.

ISSN:0023-852X    

DOI:10.1288/00005537-199506000-00007

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe charts of 258 patients undergoing tonsillectomy with or without adenoidectomy between June 1991 and June 1993 were reviewed. One hundred sixty‐nine of these patients received ketorolac tromethamine during the perioperative period as a nonnar‐cotic alternative for postoperative pain management. The incidence of postoperative hemorrhage among patients who received ketorolac tromethamine was 10.1%, compared to 2.2% in those patients who received narcotic analgesia only. The average time to adequate oral intake and discharge was evaluated. Ketorolac appeared to moderately decrease the time to adequate oral intake. The use of ketorolac did not significantly alter the time to discharge.The increased incidence of postoperative hemorrhage in patients receiving ketorolac should be considered before this medication is used in the perioperative period. The risk/benefit ratio of ketorolac use as a postoperative analgesic may be better demonstrated in a prospective st

ISSN:0023-852X    

DOI:10.1288/00005537-199506000-00008

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractAfter the detection of epidermal growth factor and transforming growth factor alpha in various body fluids and human saliva the current study aimed to investigate the presence of basic fibroblast growth factor (bFGF) in human saliva. Basic FGF is stimulating the proliferation of cells of mesodermal and neuroectodermal origin and is highly angioge‐netic. After ELISA technique was established, saliva was collected from eight healthy individuals. Run in duplicate, 14 (87.5%) of the 16 samples investigated contained measurable amounts of bFGF. In the samples containing bFGF the concentration varied between 0.1 pg/mL and 8.4 pg/mL (mean concentration, 3.8 pg/mL; SD, 3.5). There was no correlation between age and sex and bFGF concentrations. It is therefore concluded that bFGF is present in human saliva and may even constitute a constant component. The physiological importance of this finding is discusse

ISSN:0023-852X    

DOI:10.1288/00005537-199506000-00009

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractUsher's syndrome, type 3 (USH3) is characterized by progressive hearing loss. Usher's syndrome, type 3 has been supposed to be rare, occurring in 2% to 4% of all patients with Usher's syndrome. In a nationwide study we collected data on 229 patients with Usher's syndrome in Finland. Definite cases of USH3 were found in 30 (13%) of the 229 patients. An additional 61 patients had clinical evidence of earlier progression of their hearing impairment. We suggest that 91 (40%) of the 229 patients with Usher's syndrome represent cases of USH3.

ISSN:0023-852X    

DOI:10.1288/00005537-199506000-00010

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY