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Biomedical subjects

G Marshak

Publications and source records attributed to G Marshak.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

Congenital granular cell epulis causing polyhydramnios.

We report a case of an extremely large granular cell epulis situated on the maxillary alveolar ridge of a newborn. It obstructed the infant's mouth and caused polyhydramnios. The lesion was detected in utero by ultrasonography and removed after birth in the delivery room, with satisfactory results. It is evident that the epulis increased in size during the last phase of pregnancy. The literature concerning this peculiar lesion is reviewed and theories of histogenesis are discussed.

Adult↗
PubMedDate not supplied

Granulomatous reaction in lymph nodes draining laryngeal carcinoma.

Presented are two cases of simultaneous occurrence of epithelioid granulomas and metastatic squamous cell carcinoma in cervical lymph nodes draining supraglottic carcinoma. Laboratory tests and radiological and clinical findings ruled out sarcoidosis, as well as mycotic, mycobacterial, or other bacterial infection. Upon finding of epithelioid granulomas in cervical lymph nodes, a malignant tumor of the head and neck region should be considered as a differential diagnostic possibility. Uncritical acceptance of a diagnosis based solely on the histological appearance may lead to erroneous treatment.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Success of stapedectomy performed by residents.

A retrospective study of 240 stapedectomies for otosclerosis performed in a teaching department during the last 10 years was done. The results and complications in patients operated on by residents and faculty were compared. Strict criteria for evaluating the surgical outcome were used. "Satisfactory" results obtained by residents during their entire training (79 per cent) were significantly poorer (P greater than 0.05) than those achieved by the faculty (90 per cent). In the second period of residency, however, the residents' success rate (89 per cent) was equal to that of the faculty. There was no statistically significant difference in the complication rate between residents and faculty. Two essential conditions are responsible for good stapedectomy results by residents: experience with sufficient numbers of patients requiring middle-ear surgery (including otosclerosis and chronic middle-ear disease) and close supervision by the faculty in the operating room.

Adult↗
PubMedDate not supplied

Acute mastoiditis: a 10-year review.

PURPOSE: To study how antibiotic treatment and an early decision to aspirate subperiosteal abscesses can reduce hospitalization periods and costs in patients with acute mastoiditis. PATIENTS AND METHODS: During a 10-year period, 134 patients were diagnosed with acute mastoiditis at the Department of Ear, Nose, and Throat and Head and Neck Surgery (Kaplan Medical Center, Rehovot, Israel). The diagnoses was based on physical findings of retroauricular swelling and erythema and tenderness, with protrusion of the auricle forward and downward. The majority of patients (77) reached medical treatment during the first 3 days of their disease. Wide myringotomy and intravenous antibiotic treatment, aspiration, and complete cortical mastoidectomy were the treatment options. RESULTS: With the administration of wide myringotomy and intravenous antibiotic treatment, 115 patients recovered; nine received aspiration and did not need surgery; and only 15 patients who received the antibiotic treatment needed a complete cortical mastoidectomy. CONCLUSION: With the wise use of antibiotics and early decision to aspirate subperiosteal abscesses, the hospitalization period, the cost, and the need for surgery can be reduced.

Acute Disease↗
PubMedDate not supplied

Airway obstruction in a hemophiliac child.

The hemophiliac patient is in constant danger of death from hemorrhage. The danger of bleeding into the submucosal areas of the upper aerodigestive tract, however, does not primarily lie in the blood loss but rather is due to compression and edema of the upper airway. The treatment of choice, in addition to the direct treatment for the specific clotting factor deficiency, is elective nasotracheal intubation, since in most cases this interstitial bleeding, resulting in airway compromise, recedes in four to five days.

Airway Obstruction↗
PubMedDate not supplied

Adenoidectomy versus tympanostomy in chronic secretory otitis media.

Fifty-eight consecutive charts of children suffering from mucoid middle ear effusion proven by myringotomy who were followed for two years were reviewed. Half of the group underwent adenoidectomy and the other half, with similar age distribution, had tympanostomy. Only 20.7% of the adenoidectomized children had normal hearing and aerated middle ears during the two-year follow-up, whereas 59% had normal hearing following tympanostomy. Adenoidectomy had no additional beneficial effect on the cure rate obtained by tympanostomy, which proved to be more effective in all age groups, and in the nonallergic child. In the atopic child, however, both modalities yielded similarly poor results.

Adenoidectomy↗
PubMedDate not supplied

Pharmacokinetics of cefaclor in chronic middle ear effusions.

Fifty children aged 1 to 13 years with chronic or recurrent otitis media with effusion received a single dose of cefaclor (15 mg/kg body weight) by the oral route 30 minutes to seven hours before the removal of middle ear effusion and insertion of tympanostomy tubes. Serum and middle ear aspirate concentrations of the antibiotic were determined employing a microbiological assay technique by a disk diffusion method. Middle ear specimens were also cultured for aerobic bacteria. The mean peak serum concentration level (8.49 +/- 7.89 micrograms/ml) was observed after 30 minutes, whereas the middle ear peak level (0.47 +/- 0.78 micrograms/ml) occurred after one hour. Of the 87 middle ear specimens, 37 had cefaclor concentrations which were detectable within the resolution of the bioassay method (greater than 0.16 micrograms/ml). There was no correlation between the type of middle ear effusion (mucoid or serous) and the concentration of cefaclor in the middle ear. Only 18% of the middle ear cultures were positive for aerobic bacteria; Hemophilus influenzae was the most common organism.

Adolescent↗
PubMedDate not supplied

Longitudinal study of the efficacy of ampicillin in the treatment of pneumococcal otitis media in a chinchilla animal model.

A chinchilla animal model was used to determine the effects of early antibiotic treatment with ampicillin or the local and systemic protective mechanisms during pneumococcal acute otitis media with effusion (AOME). The right bullae of 74 chinchillas were inoculated with 170 colony-forming units (CFU) of Streptococcus pneumoniae type 7F, and animals were randomly assigned to 1 of 2 groups: early (24 hours postinoculation) and late (12 days postinoculation) initiation of ampicillin treatment. During the first challenge, 52 chinchillas died within a 1-month period, apparently from suppurative complications of AOME. Following the resolution of AOME in their right ears, all surviving animals were challenged for the second time by bilateral bullar inoculations using 130 CFU of the same organism. All 10 animals in the early ampicillin treatment group developed severe bilateral AOME, whereas only 3 of the 12 animals in the late ampicillin treatment group developed a recurrence of AOME in the right ear. Significantly, 8 of the 12 animals in this group developed severe left AOME. These findings suggest the presence of a local middle ear defense system and support the results of previous similar studies in which S pneumoniae types 3 and 6A were used. The results of the present study also suggest that in the chinchilla the early administration of a systemic antibiotic (ampicillin) interferes with this defense mechanism.

Ampicillin↗
PubMedDate not supplied

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↗
PubMedDate not supplied

Acute mastoiditis: a review of 69 cases.

Sixty-nine cases of acute mastoiditis were managed at the Kaplan Hospital in Israel during a 10-year period. About two thirds (68%) recovered with conservative therapy consisting of wide myringotomy and intravenous antimicrobial therapy, usually ampicillin and cloxacillin. One third (22 patients) were managed surgically by complete mastoidectomy. Indications for surgery were subperiosteal abscess, based on clinical findings in 20 patients; one had septic fever that did not respond to antimicrobial therapy, and one had signs of meningeal irritation. Mastoid radiographs played no role in the decision to operate. Four cases of unsuspected epidural abscess were found, two behind intact tegmental bone. Acute mastoiditis develops mostly in ears that have not been immune to previous infections; thus the mucosal barrier is broken easily and osteitis occurs. Although with the advent of antimicrobial therapy the presentation and course of the disease are milder, the disease is still serious and potentially lethal.

Abscess↗
PubMedDate not supplied

Effects of elevated intranasal temperature on subjective and objective findings in perennial rhinitis.

The effects of elevated intranasal temperature on symptoms and signs of perennial rhinitis were studied in 78 patients by a double-blind, randomized, placebo-controlled clinical trial. Patients were subjected to two treatments separated by a 1-week interval. Each treatment consisted of three 30-minute sessions, during which the patient's intranasal temperature was raised by inhalation of saturated hot air (42 degrees C to 44 degrees C). Subjective response was recorded on a daily symptom score card during the week following treatment. Nasal patency was determined before and after treatment by measuring maximal nasal expiratory and inspiratory airflow and by measuring the area covered with vapor formed by the exhaled air on a plate. Highly reproducible results were obtained by using these three objective methods. Elevation of intranasal temperature resulted in amelioration of rhinitis symptoms and in objective evidence of increased nasal patency in a significant percentage of patients compared to the placebo-treated group.

Adult↗