A silent pseudocholinesterase gene. Marked suxamethonium sensitivity in a person heterozygous for the atypical and silent pseudocholinesterase genes.
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Apnea↗
Biomedical subjects
E Ostfeld
Publications and source records attributed to E Ostfeld.
Acquired irreversible sensorineural hearing loss associated with otitis media with effusion.
The development of irreversible sensorineural hearing loss (SNHL) in three patients having chronic otitis media with effusion of the serous or mucoid type is described. Anamnestic, clinical, and laboratory investigations revealed no evidence of known etiologic factors, diseases, or conditions that could have induced inner ear damage. It seems that the pathogenetic mechanism of this complication of chronic otitis media with effusion is penetration of infectious agents or their toxic products from the middle ear to the inner ear through the round window membrane. The SNHL may be of different types and degrees, from a high-tone hearing loss to complete anacusis. The development of SNHL was not prevented or influenced by the insertion of tympanostomy tubes.
Adult↗
Micromethod for determination of middle ear gas composition.
This is a microchromatographic method for simultaneous determinations of O2, N2, CO2 and N2O in gas samples of 40-100 microliters. A Packard 836 U gas chromatograph with a thermal conductivity detector and helium gas as carrier was used. The combination of Porapak and 5A molecular sieve column system was found adequate and is described in detail. The fidelity of this method was proved by a high constancy of the retention time, the linearity of the response and the reproducibility of results. The present method proved to be reliable for determination of all middle ear gases in man and experimental animals during general anesthesia with N2O.
Anesthesia, General↗
Acute gram-negative bacillary infections of middle ear and mastoid.
Thirty-three patients with acute purulent otitis media and mastoiditis caused by Gram-negative bacilli are presented. The main features of the disease include: predilection for young male infants, a high rate of complications that include sepsis, mastoiditis and osteomyelitis of the base of the skull. Patients that are diagnosed early respond well to drainage and ventilation of the infected middle ear combined with in vitro effective antibacterial therapy. Patients that receive prior inappropriate antibacterial therapy tend to have prolonged courses and require mastoid surgery. It is suggested that early myringotomy and bacterial cultures be performed in all patients with acute middle ear infections.
Acute Disease↗
Middle ear gas composition during nitrous oxide-oxygen ventilation.
The middle ear gas composition during 180 minutes ventilation with nitrous oxide-oxygen mixture was determined in 12 mongrel dogs. The mean relative concentration of N2O in the middle ear (ME) rose to 12,26.4 and 29.3% after 60, 120 and 180 minutes respectively. During this period, the relative concentration of N2 dropped from a mean of 83.2% in the air-ventilated dogs to 54.8%, without an essential change in the concentrations of O2 or CO2. The elimination of N2O from the ME during 30 minutes of postanesthetic ventilation with O2 was incomplete, an average of 11.4% N2O remaining in the ME. At the same time, the mean relative concentration of O2 reached 19%, higher than the O2 relative concentration normally present in the ME. The results indicate that gas diffusion may occur across the ME mucosa for N2O as well as for O2, producing selective changes in the middle ear gas composition.
Animals↗
Evaluation of countercurrent immunoelectrophoresis as a diagnostic tool in bacterial otitis media.
The diagnostic efficiency of countercurrent immunoelectrophoresis (CIE) and correlation of clinical and bacteriological data were studied in 184 middle ear effusions (MEE) from 125 patients diagnosed as acute primary, acute recurrent otitis media, and chronic MEE. Significant differences between stage of otitis media (OM), patient age and type of MEE were found. Streptococcus pneumoniae was isolated in 22% of the overall MEE, 26% in the acute primary and 26% in acute recurrent OM. Among the S. pneumoniae isolates, 82.5% were detected by CIE and culture, 15% only by culture and 2.5% only by CIE. Most S. pneumoniae isolates identified by culture and CIE were in a purulent MEE (64%) while those identified by culture only were in a mucoid MEE (67%). Haemophilus influenzae overall incidence was 29%; 13% of them produced beta-lactamase and only 4% were serotype b. The H. influenzae serotype b strains were detected by culture as well as CIE, so the overall effectiveness of CIE for S. pneumoniae and H. influenzae serotype b was 19.5% and 22 to 23% for acute primary and recurrent OM. Sterile cultures were obtained in 37.5% of the overall MEE. The CIE seems to be a useful screening test, culture remaining the method for definitive bacterial identification in MEE.
Bacterial Infections↗
Peripheral blood T and B lymphocyte subpopulations in Bell's palsy.
A prospective clinical, virological and immunological study was performed on 25 consecutive Bell's palsy (BP) patients. Multiple cranial nerve involvement was found in 15 patients. A significant decrease in the peripheral blood T lymphocyte percentage as well as an increase in B lymphocyte percentage (p less than 0.001) were found in 13 of the BP patients during the first 24 days from the clinical onset of the paralysis. No correlation was found between the peripheral blood lymphocyte subpopulations and the patient's age, sex, degree of paralysis or recovery rate. No changes were detected in the levels of immunoglobulins (IgG, IgM), complement (C3, C4) and antiviral antibodies to herpes simplex and zoster, EBV, cytomegalic virus, adenovirus, influenza and mumps. The clinical and immunological data of BP show a similar pattern to those of Guillain-Barre syndrome suggesting that BP may be an antoimmune demyelinating cranial polyneuritis which may be caused by a preceding viral infection.
Adolescent↗
Gas scavenging during bronchoscopy under general anesthesia.
Prevention of exposure of the endoscopist to high levels of anesthetic gases during bronchoscopy was attempted experimentally in dogs by a scavenging system. Results were compared with exposure during the conventional technique of anesthetic gas administration for clinical bronchoscopy using the rigid open ventilating bronchoscope. The scavenging system consisted of a vacuum pump applied to the open ventilating rigid bronchoscope sidearm connection during intratracheal administration of nitrous oxide, , oxygen, and halothane gas mixture. Gas samples were taken from the trachea, the proximal end of the bronchoscope, and the endoscopist's breathing zone, and analyzed by gas chromatography. Findings indicate that halothane anesthesia for bronchoscopy administered by conventional techniques is a source of air pollution in the operating room and exposes the endoscopist to subanesthetic levels of halothane that may affect psychomotor functioning. The use of the gas scavenging system lowered the concentrations of halothane and nitrous oxide at the endoscopist's breathing zone to a level at which inhalation for short periods has no clinical effects, while the concentrations of the anesthetics and oxygen in the trachea were maintained at a satisfactory level.
Air Pollutants, Occupational↗
The middle ear gas composition in air-ventilated dogs.
The middle ear gas composition has been examined in 5 air-ventilated dogs under sodium thiopentone anesthesia. The gas samples were obtained by transtympanic puncture and analysed by gas chromatography. The following mean +/- S.D. gas composition was obtained: N2 83.2 +/- 5.0; O2 12.1 +/- 2.2; and CO2 4.7 +/- 0.7.
Anesthesia, General↗
Bone scintigraphic diagnosis in acute frontal sinusitis.
The diagnostic value of Technetium 99m Methylene Diphosphate bone scintigraphy was evaluated in 21 patients, 10 of them with acute frontal sinusitis and a "fluid level" on sinus radiography. Pathologic accumulation of the radioisotope over the region corresponding to the diseased frontal sinus was observed in 9 of these 10 patients, 5 of them having a marked accumulation. The patients with marked accumulation of the bone-seeking radioisotope had a more severe clinical course of the disease than those who had a moderate or no accumulation of the radioisotope. Marked accumulation of the radioisotope was also found in a patient with "inflammatory pseudotumor of the orbit". The radioisotope did not accumulate over the frontal sinus of patients with mucosal swelling or cellulitis of face, or in control patients with mastoid disease. Based on our findings, we recommend bone scintigraphy be performed routinely for diagnosis of acute frontal sinusitis. A marked accumulation of Tc99m MDP indicates inflammatory metabolic changes of the sinus bony walls, predicting a severe clinical course and the necessity of aggressive treatment.
Adult↗
Interferon anti-viral system in Bell's palsy.
Thirty-two consecutive Bell's palsy patients were examined clinically and virologically. All the patients were assayed for serum interferon (IFN) levels at onset of the disease and most of them had repeated IFN assays during the course of the disease. In 15 patients the peripheral blood mononuclear cells (PBMC) were also evaluated for the presence of an anti-viral state (AVS). In viral infections, blood IFN levels are invariably increased, and the PBMC are usually in an AVS. Twenty-three patients (72%) had increased serum IFN values or were in an AVS. The mean serum IFN level was 95 U/ml (normal less than or equal to 16 U/ml) during the first 3 days following onset of the disease, declining later to normal values from the seventh day onwards. No patient had increased antibody titers to herpes simplex and varicella-zoster viruses. The increased blood IFN levels and the AVS of blood cells are compatible with an acute viral infection. It is concluded that the etiology of Bell's palsy is most likely an acute viral infection, possibly due to an unidentified or unusual virus, or to reactivation of a latent virus.
Facial Paralysis↗
Temporal bone collections in Europe and the United States.
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Acute Disease↗