Hidradenoma papilliferum of the external auditory canal.
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Biomedical subjects
Publications and source records attributed to E Ostfeld.
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Technetium99m Methylene Diphosphate bone scintigraphy (BS) of the skull was performed in three patients with malignant external otitis (MEO). Pathological uptake of the radioisotope in the mastoid region was found during the early stages of MEO updating radiologic findings. The extent of the radioisotope accumulation during the early stages of MEO indicates that the actual tissue damage exceeds the clinical estimation. The follow-up BS findings correlate well with the clinical course of MEO indicating either healing or extension to the base of skull.
The histopathologic changes during the early stage of malignant external otitis (MEO) were studied in two patients, one a non-diabetic. The specimens were obtained by an en bloc excision of the diseased tissue of the external ear canal through a retroauricular approach. The most prominent histologic features of the early stage of MEO consist of a thick layer of almost acellular, partly degenerated, collagen extending from the cartilage into the dermis, which most likely existed prior to the penetration of the microorganism. This finding supports our concept that MEO is a disease which develops as a results of invasion of opportunistic organisms into tissue previously devitalized, probably due to vascular compromise and that these latter features constitute the basic mechanism of the entire disease process.
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A rare case of solitary Kaposi sarcoma of the base of the tongue is presented. After excision-biopsy the treatment consisted of radio-therapy. A follow-up of two years shows no recurrence.
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Necrotizing external otitis in an infant receiving cytostatic therapy for neuroblastema has been described. The disease is characterized by invasion and necrosis of the skin and cartilage of the external ear. P aeruginosa is the usual pathogen isolated in this infection. The disease should be suspected in infants with severe underlying conditions and who have external otitis that does not respond to local therapy. Vigorous antibiotic therapy and possible surgical intervention are indicated.
Pregnancy sera were found to react differently when screened simultaneously with adenoid and peripheral blood lymphocytes (PBL) obtained from the same individual. Some of the reactions were attributed to the higher sensitivity of adenoid lymphocytes to a low titer HLA or Ia antibody, while others were shown to be due to the expression of DRw (Ia-like) antigens on both T and B lymphocytes separated from adenoids. Positive reactions specific to adenoid lymphocytes, or manifested only following anti-beta2-microglobulin (a-beta2-m) treatment, suggest the presence of antigens other than HLA or Ia on the cell membrane. Unmasking of antigenic sites by the a-beta2-m capping process and rearrangement of the membrane structure may also contribute to the observed phenomena.
Pre and one year postoperative bone conduction (b.c.) thresholds were compared for 50 ears of 48 patients, ranging in age from 14 to 42 years, in whom successful tympanic grafts resulted in at least an average improvement of 10 db for 500 to 4000 Hz. While pre and postoperative data are included for all ears and test frequencies, significant BC improvement is seen only at those frequencies, in each case, where the pre-op BC thresholds were worse than 10 db. Normal pre-op BC thresholds cannot show substantial improvement because of audiometric limitations. The amount of BC shift at each frequency for those with pre-op BC thresholds that were subnormal averaged 6 db at 500 Hz, 13.3 db at 1000 Hz, 13.8 db at 2000 Hz and 9 db at 4000 Hz, all highly significant statistically. There were no significant postoperative BC shifts related either to duration of the disease process, length of postoperative period before final test (all were more than one year) or whether the surgical procedure was tympanoplasty type I or myringoplasty.
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Rhinoscleroma may present a diagnostic problem when encountered outside endemic region. Two young men from Gaza with tumor-like masses of scleroma in the nasal cavities and the nasopharynx are described. Histological examination of biopsy material from the nasal lesions showed pathognomonic Mikulicz cells, and cultures grew Klebsiella rhinoscleromatis. Both patients responded well to antibiotic treatment.
The effect of antibiotic therapy and hospitalization on the external ear canal flora was investigated in 131 children. Fifty-eight percent of the patients receiving antibiotic therapy had Gram-negative bacilli or yeasts in their external ear canal, compared with 17% of the patients who were hospitalized for ten days or longer and only 3% of the patients who were hospitalized for short periods. Antibiotic therapy is the major factor in determining the colonization rate of the external ear canal with potentially pathogenic flora. Children under 1 year of age seem to be the most susceptible group to this shift of flora.
Fungal infections occurred in 3 of 22 renal transplants (13.6%). Two patients developed rhinocerebral phycomycosis, and Rhizopus arrhizus was isolated from cultures of the nasal conchae. Both patients were treated with systemic amphotericin B. Three-and-a-half months after transplantation the third patient developed an acute ureteral obstruction secondary to infection with Aspergillus nidulans; this necessitated removal of the graft. There was no immediate mortality associated with these fungal infections but there was immediate loss of the grafts in the two patients.
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