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Biomedical subjects

G A Gates

Publications and source records attributed to G A Gates.

At least 91 records · Page 5Linked to original sources
PubMed1987

Quantitation of pneumatic otoscopy.

Pneumatic otoscopy has long been espoused as an easily and rapidly used, inexpensive method for routine evaluation of the tympanic membrane and middle ear. This widely used technique, however, has not been explored in a quantitative manner. Therefore, we measured the differential pressure and frequency of the pressure pulse used by a group of experienced otoscopists during routine pneumatic otoscopic examination. We found the pressure pulse varied from 170 to 520 mm H2O and the frequency varied from 2.2 to 4.9 pulses per second. We used a pneumatic pump to deliver a controlled pressure pulse--at a frequency of 4.0/sec--to the pneumatic otoscope. This device was used to measure the minimum pressure pulse necessary for the experienced otoscopist to merely detect tympanic membrane movement in normal ears. The threshold for visible movement ranged from 10 to 15 mm H2O. Thus, even the most gentle otoscopist used a pressure pulse an order of magnitude higher than the threshold for detection of visible movement in normal ears. The gap between the pressure pulse at threshold for visual detection of movement and that which is routinely used offers the possibility of increased sensitivity and specificity for this commonly used diagnostic tool. Preliminary data are presented from this study in which the pressure pulses required for visual detection of tympanic membrane movement in diseased ears were determined.

Ear Diseases↗
PubMed1987

Facial paralysis.

This article discusses peripheral facial paralysis of nontraumatic origin. The term idiopathic facial paralysis is used generically, in place of the often ambiguous term, Bell's palsy, to indicate all types of peripheral facial palsy/paralysis for which no cause is apparent. Included is a brief resumé of the pertinent anatomy and pathophysiology, a synopsis of etiologic considerations, and a discussion of current therapeutic options. This article is aimed at practitioners of otolaryngology, neurology, and neurosurgery with the hope that it will be of value to them in caring for their patients.

Facial Paralysis↗
PubMed1986

Estrogen receptors in the temporomandibular joint of the baboon (Papio cynocephalus): an autoradiographic study.

Using an autoradiographic method, the temporomandibular joint (TMJ) complex of five aged female baboons was studied for the presence of receptors for estradiol-17 beta. The study was performed in an effort to learn more of the pathophysiology of this joint and in an attempt to provide a scientific basis to explain the reported preponderance of women who seek and undergo treatment for signs and symptoms referable to the TMJ. This experiment revealed that the TMJ complex contains numerous cells with receptors for estrogen, particularly the articular surface of the condyle, articular disk, and capsule. Muscles of mastication contained relatively fewer receptors. As a result, one may postulate a role for the sex steroid hormones in the maintenance, repair, and/or pathogenesis of the TMJ. Additional studies are necessary to fully determine the significance of hormone receptors in this site and any correlation between diseases of the TMJ and the endocrine status of affected patients.

Aging↗
PubMed1986

Medical treatment of chronic otitis media with effusion (secretory otitis media).

To determine whether antimicrobial therapy is of value in the treatment of chronic otitis media with effusion (secretory otitis media), we treated 1,429 4- to 8-year-old children--2224 affected ears--with a fixed regimen of an antibiotic mixture (Pediazole) for 10 days and a decongestant (Novafed) for 30 days. We observed the children monthly to determine the rate of clearance. Validity of diagnosis was greater than 90% with an algorithm of pneumatic otoscopy and tympanometry. Medication compliance was not measured. At 1 month, 45% of the children (48% of the ears) had cleared and at 2 months, 60% of the children (63% of the ears) had cleared. Factors such as sex and prior treatment in the preceding 3 months were no different in the cured vs. the uncured groups. Age significantly influenced the cure rate (P less than 0.0001); the older the child, the higher the clearance rate. Tympanograms type 5, 8, and 12-14 were significantly more prevalent in the uncleared group (P = 0.0001). The clear rate for unilateral cases was 76% and for bilateral cases, 47% (P less than 0.0001). Children with chronic otitis media with effusion are most likely to be cured by medical therapy/time if they are older, have unilateral disease, or a peaked tympanogram. Surgery should be withheld in these children for 2 or more months to permit the highest rate of spontaneous resolution.

Age Factors↗
PubMed1986

Post-tympanostomy otorrhea.

Otorrhea is the most common complication of surgical drainage of the tympanum for the treatment of chronic secretory otitis media. Otorrhea present at the first postoperative visit may be due to the operative procedure, the underlying disease process, or both. After analyzing data from 525 operations on 1045 ears of 396 children with chronic secretory otitis media, and finding an over-all incidence of immediate postoperative otorrhea of 3.4%, we conclude that preparations of the ear canal with povidone iodine and the postoperative prophylactic use of an antimicrobial-corticosteroid topical preparation provides optimal control of postoperative wound infection. Sporadic increases in the incidence of postoperative otorrhea may be due to extrinsic factors such as outbreaks of upper respiratory infection.

Adenoidectomy↗
PubMed1986

Management of neonatal subglottic stenosis.

When considering management of subglottic stenosis, all conservative efforts to establish a satisfactory airway must be considered prior to surgical reconstruction. However, the approach which allows for the earliest possible decannulation is the one which is sought because of high morbidity and mortality of tracheostomy in the pediatric population.

Animals↗
PubMed1985

Changes in the nuclear uptake and retention of 3H-estrogen in gonadotrophs and lactotrophs as a function of age.

A quantitative autoradiographic immunocytochemical study was performed in which the nuclear uptake and retention of 3H-estradiol (3H-E2) by luteinizing hormone (LH) and prolactin (PRL) cells was examined in 19-21-year-old baboons. 3H-E2 concentrating cells were found in all of the three lobes of the pituitary in varying percentages (38.7%, pars distalis; 17.1%, pars intermedia; 6.3%, pars nervosa). Approximately 80% of PRL cells and nearly 100% of LH cells were labeled. A count of the number of silver grains over nuclei revealed a marked variation of the accumulation of 3H-E2 by LH cells and to a lesser extent in PRL cells. These results suggest functional heterogeneity among LH and PRL cells. The present results are discussed in relation to the physiological state of old animals.

Aging↗
PubMed1985

Cartilage of the baboon contains estrogen receptors.

Castrated-adrenalectomized aged female baboons were injected with 3H-estradiol-17 B (E2) and killed one hour later. Specimens from all regions of the larynx and oral cavity were taken and processed for autoradiography. A consistent and heavy uptake of 3H-E2 by the perichondrium and cartilage was found in all laryngeal sections with cartilage present and in the articular cartilage of the condyle of the mandible. These data provide evidence that cartilage contains receptors for estrogen. These data along with data already present in the literature suggest that circulating estrogen may act directly on cartilage to modulate collagen synthesis and further that the loss in circulating estrogen associated with menopause might in part explain the large sexual dimorphism associated with the incidence of osteoarthritis.

Aging↗
PubMed1984

Infectious diseases of the sphenoid sinus.

Thirty-one patients with sphenoid sinusitis were treated from 1978-1982. Twenty patients had infections contiguous with other paranasal sinus disease. Five of these patients had fungal sinusitis. Eleven patients were seen with isolated sphenoid sinusitis; 3 were secondary to trauma and 8 were due to nontraumatic causes. Possible etiologies include upper respiratory infections, developmental abnormalities, and water forced into the nasal cavity during swimming. The immunocompromised patient is more likely to present with minimal symptoms with a fungal infection, and aggressive diagnostic and therapeutic measures should be undertaken. Because the symptoms of headache, nasal stuffiness, proptosis, ptosis and decreased visual acuity may be interpreted as an intracranial, neurological, or vascular problem, a misdiagnosis may be made. A high index of suspicion for sphenoiditis should be maintained. Therapy involves a combination of medical (antimicrobial agent) and surgical (sinus drainage and marsupialization) management.

Bacterial Infections↗