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Biomedical subjects

A F Drake

Publications and source records attributed to A F Drake.

96 records · Page 6Linked to original sources
PubMedDate not supplied

Eikenella corrodens as a cause of recurrent and persistent infections of the head and neck.

Four patients had Eikenella corrodens infections involving the head and neck in different ways. The organism is discussed as a pathogen in mixed infections and as the predominant organism in other processes. As part of the resident microflora of mucous membrane surfaces, it is an important potential pathogen in a number of otolaryngologic clinical settings. Careful microbiological culturing and susceptibility testing reveal the causative organism and guide the antibiotic therapy.

Adolescent↗
PubMedDate not supplied

Evaluation and management of a carcinoma arising in a thyroglossal duct cyst.

Thyroglossal duct remnants are the most common congenital cystic lesions of the neck; however, a carcinoma arising in these structures is rare. Two new cases of a papillary adenocarcinoma arising in a thyroglossal duct cyst are presented. Preoperative evaluation, operative management, and postoperative care are discussed. Initial evaluation consisting of a thorough head and neck examination, palpation of the thyroid gland, thyroid function tests, and selective use of thyroid imaging is recommended. Removal of the cyst and tract in the manner described by Sistrunk is advocated. If an adenocarcinoma is found in the cyst and if a carcinoma is found in the thyroid gland or a thyroid scan reveals a nodule, a total thyroidectomy is recommended. A modified neck dissection and total thyroidectomy is advocated for cervical metastases. Postoperatively, thyroid suppression and long-term follow-up are encouraged. A squamous cell carcinoma arising in a thyroglossal duct remnant appears more aggressive and requires complete excision and, for confirmed cervical metastases, radical neck dissection and postoperative radiation therapy.

Adenocarcinoma, Papillary↗
PubMedDate not supplied

Frequency dependence of effective nasal resistance.

Forced random noise techniques were used to characterize the effective resistance of the nasal passages in normal subjects and subjects who were candidates for surgical correction of nasal obstruction. The slope of the effective resistance curve was characterized by the average resistances over 3 to 5 Hz and 13 to 15 Hz. Subjects with nasal obstruction had effective nasal resistance curves which were more frequency-dependent than those of normal subjects (p less than 0.05). A mathematical model consisting of two series resistance-inertance elements in parallel was used to simulate the nasal passages. With this model we were able to generate effective resistance curves similar to those measured in both normal and obstructed subjects. The forced random noise technique may be a convenient, noninvasive technique for studying the fluid mechanical properties of airflow in the nasal passages and the effects of pharmacological and surgical interventions on nasal resistance.

Acoustics↗
PubMedDate not supplied

Clinical nasal obstruction and objective respiratory mode determination.

Nasal obstruction represents a considerable portion of the symptoms addressed by the otolaryngologist. It has received widespread interest in the orthodontic literature as well, because of the presumed relation between nasal obstruction and facial growth, especially vertical maxillary excess. The range of normal variation in oral versus nasal breathing has not been defined. This study attempted to correlate patient symptoms with respiratory mode. A sample of 20 symptomatic adult subjects presenting with nasal obstruction was compared to a control sample of 20 asymptomatic adults by means of SNORT (Simultaneous Nasal and Oral Respirometric Technique). Nasal resistance was significantly different between the two groups, but percent nasality (that proportion of the total volume of air breathed nasally) was a more consistent and significant finding. The relevance of these results to both clinical and basic physiology is discussed.

Adult↗
PubMedDate not supplied

Perceptual and physiologic effects of histamine challenge on nasal breathing.

The purpose of this study is to determine the effect of histamine-induced nasal congestion on nasal airflow and the perception of externally applied resistance to nasal breathing. Nasal cross-sectional area and nasal airflow during free breathing were measured in 15 adult subjects before and after histamine challenge. The threshold for perception of resistance to nasal breathing was determined using a dynamic perturbator device, with both free breathing and controlled nasal air-flow. The average threshold for perception of nasal resistance was 0.383 Pa/cm3/s at baseline. After histamine application, there was a significant decrease in nasal cross-sectional area (p = 0.0001), associated with a decrease in nasal airflow (r = 0.6). The average threshold of perception increased to 1.373 Pa/cm3/s (p < 0.0001). When nasal airflow was controlled at the baseline rate, the threshold of perception improved to 0.638 Pa/cm3/s (p = 0.024). These findings indicate that nasal congestion causes a reduction in both nasal airflow and the perception of resistance to nasal breathing. The ability to detect nasal airway impairment is improved with increased nasal airflow. An improved understanding of the physiology of the subjective perception of nasal patency may lead to innovative methods for the treatment of nasal obstruction.

Adult↗