To evaluate the role of conservation surgical treatment of inverted papillomas of the nose and paranasal sinuses, the clinical course of 46 patients treated during a 10-year period was evaluated. Twelve patients were noted to have either invasive squamous cell carcinoma or carcinoma in situ and were excluded from analysis. Of the remaining 34 patients, 19 had previous treatment for inverted papilloma. Subsequently, 20 patients were treated with lateral rhinotomy and medial or partial maxillectomy. Fourteen patients were treated with conservation surgical therapy. There were 5 recurrences (15%), which all occurred in the conservation-treated group. Four of six (66%) patients treated with an intranasal procedure recurred but only 1 of the 8 (12%) patients treated with a Caldwell-Luc approach combined with an intranasal procedure. Successful treatment was achieved in all patients undergoing salvage surgery for recurrence. The role of conservation treatment in the management of inverted papillomas of the nose and paranasal sinuses is discussed.

Female↗

PubMedDate not supplied

Soluble multimeric Alzheimer beta(1-40) pre-amyloid complexes in dilute solution.

Aqueous solutions of beta(1-40) peptide spontaneously associate to form pentameric/hexameric complexes that can be demonstrated by SDS-PAGE following treatment with glutaraldehyde and borohydride reduction. Under amyloidogenic conditions of pH and high peptide concentration these aggregates can further associate to form pentameric/hexameric complexes that can be demonstrated by SDS-PAGE following treatment with glutaraldehyde and borohydride reduction. Under amyloidogenic conditions of pH and high peptide concentration these aggregates can further associate to form sedimentable and filterable structures with beta-sheet amyloid characteristics of Thioflavine T fluorescence. The presence of such preamyloid structures at low peptide concentration suggests a mechanism by which amyloid plaques can accrete additional material by a cooperative rather than monomeric growth. The existence of a monomer<==>multimer equilibrium may partly explain the divergence of biological consequences with respect to neurotoxicity.

Amino Acid Sequence↗

PubMedDate not supplied

A field method for the determination of lead in glass used for shielding television receiver components.

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Colorimetry↗

PubMedDate not supplied

Epiglottic laryngoplasty for complicated laryngeal stenosis.

The technique of epiglottic laryngoplasty, previously described for reconstruction following near total laryngectomy for glottic carcinoma, has been used in selected patients with severe glottic and subglottic stenosis. Our experience in four patients suggests that it is useful for 1) laryngeal stenosis in which there is loss or collapse of the external cartilaginous framework, and 2) laryngeal stenosis which is refractory to the usual forms of therapy. The technique is a technically simple, one-stage procedure which provides its own endolaryngeal mucosal lining, as well as autogenous cartilaginous support. It has been successful in restoring adequate airway and preserving voice without interfering with deglutition or laryngeal competence in most patients.

Adult↗

PubMedDate not supplied

Factors influencing choice between tracheostomy and prolonged translaryngeal intubation in acute respiratory failure: a prospective study.

One of the problems of prolonged ventilatory therapy in acute respiratory failure (ARF) is the need to choose between tracheostomy after 48 to 72 hours of translaryngeal (TL) tracheal intubation or the continuous use of the TL tube for a period of 10 days. Too often the choice has been based on retrospective studies or personal preference. To investigate this problem prospectively, 52 adults in ARF were divided sequentially into 2 groups on their 3rd day of TL intubation. Patients in group I (G-I) retained the TL tube for a total of 11 days; those in group II (G-II) were tracheostomized on the 3rd day. The following factors ere used to evaluate the efficiency and complications in each group: patient's epidemiologic variables, daily pulmonary functions, severity of respiratory infections, and scores of post-intubation airway lesions. No consistent statistically significant differences between the two procedures were seen in the pulmonary functions or the range of individual patient variables. However, with an early tracheostomy, there was an eightfold greater incidence of contamination of the airway by new organisms, airway lesions were more frequent and severe, and the need for the tracheal tube was extended. To identify the epidemiologic variables and the pulmonary functions that discriminate between patients with serious airway lesions and those with mild lesions, and to evaluate the ability of these variables to differentiate the patients who died from those who survived, the distribution of all factors was compared in the two categories. The epidemiologic variables separated the patients according to their airway lesions only, while the difference in pulmonary functions was statistically significant only between the patients who died and those who survived.

Acute Disease↗

PubMedDate not supplied

Administration of ketamine or Innovar by the microdrip technic: a double blind study.

This study of 40 healthy adults undergoing elective gynecologic procedures was undertaken to evaluate the microdrip technic of administering ketamine or Innovar slowly to induce anesthesia and to supplement N2O anesthesia. All patients were managed by the same anesthetist and surgeons and received 10 mg of diazepam and 0.4 mg of atropine IM for premedication. After injection of 10 mg of diazepam, anesthesia was induced by infusions containing either ketamine (2 mg/ml) or Innovar (0.1 ml/ml), at an average rate of 10 ml/min. The infusions were assigned to the patients randomly and their nature was disguised from the staff. After tracheal intubation, ventilation was mechanically supported and anesthesia maintained with N2O-O2 (2:1), by drip at a rate adjusted to the patient's vital signs, and by intermitten injections of 3 to 6 mg of d-tubocurarine. Special forms coded to suit computer use were used to collect data during induction, maintenance, and recovery, and standard mathematical tests were used for analysis. Results showed that (a) ketamine effects could not be differentiated clinically from those of Innovar; (b) ketamine dosage could be reduced to 0.3 to 0.5 the recommended bolus dosage; (c) pulse rates and incidence of mental aberrations during induction or recovery were equal in both groups; (d) blood pressure showed a modest but significant increase (10% from basal values) until 20 minutes of tracheal intubation only in the ketamine group; (e) mean Pao2 determined 30 minutes after tracheal intubation was significantly higher in the ketamine group; (f) ketamine administration by the slow (20 mg/min) microdrip technic reduces the incidence of side effects.

Anesthesia, Intravenous↗

PubMedDate not supplied

Your child--health. Helping your child sleep soundly.

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Child Welfare↗

PubMedDate not supplied

Radiography of posttraumatic syringomyelia.

Posttraumatic syringomyelia was studied in 15 patients. Gas myelography in 12 patients showed a definite spinal cord swelling in 10 and a probable cord enlargement in two. Plain spinal computed tomography (CT) in four patients demonstrated intramedullary radiolucent zones in three. After intrathecal injection of metrizamide in 10 patients, cysts were opacified in eight. Postoperative CT in two patients demonstrated collapse of the cyst in one. Gas myelography shows the extent and site of maximal dilatation of the cyst where a shunt can be placed. CT is less invasive and provides a definitive diagnosis.

Adult↗