Biomedical subjects
Publications and source records attributed to J A Annis.
A case of an unilateral sensorineural hearing loss of sudden onset, due to an osteoma in the internal auditory canal is presented. As far as the authors are aware an osteoma at this site associated with a hearing loss occurring within a few hours has not previously been reported.
Recent research on inflammatory sinus disease has implicated a central role for the ethmoid labyrinth, which may influence changes in the maxillary and frontal sinuses. CT can provide excellent definition of the paranasal sinuses and particularly the ethmoids, which is a prerequisite for endoscopic surgery. We describe a prospective series of 110 coronal CT scans performed on patients with a clinical diagnosis of sinusitis who had undergone diagnostic nasal endoscopies and medical treatment prior to surgery. 86% of the scans showed abnormal mucosal thickening. The ethmoids were affected in 73% and the maxillary sinus in 64%. Pneumatization of the middle turbinate was a common variant and when present was associated with anterior ethmoid disease in 60% of patients. Anterior ethmoid inflammatory changes were demonstrable in 95% of patients with maxillary sinus disease. Direct coronal CT can readily demonstrate disease in the infundibulum, frontal recess and posterior ethmoids in the same orientation confronting the endoscopist, and helps in the planning of ethmoidal surgery. Following surgery the sinuses can be directly inspected in outpatients which reduces the need for any further plain radiographs. It is important that the diagnosis of sinusitis is not based on CT findings alone as isolated areas of mucosal thickening are common in the normal population.
Insertion of a sound amplification device into the round window niche (extracochlear implant) or into the coils of the cochlea (intracochlear implant) can give significant benefits to some carefully selected, severely deaf patients. Imaging has an essential role in selective and pre-operative assessment. Severe otosclerosis and post-meningitic labyrinthitis ossificans are common causes of deafness in these patients and can be demonstrated by computed tomography (CT). The most suitable side for operation can be assessed. We describe our experiences with 165 patients, 69 of whom were found suitable for implants. Thin (1 mm) section CT in axial and coronal planes is the best imaging investigation of the petrous temporal bones but the place of magnetic resonance scanning to confirm that the inner ear is fluid-filled and polytomography to show a multichannel implant in the cochlea is discussed. No implants were used for congenital deformities, but some observations are made of this type of structural deformity of the inner ear.
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This study reviews the radiographs and clinical case notes of 897 patients who attended the Accident and Emergency (A & E) Department of Leicester Royal Infirmary, over an 8-month period, for whom radiographs of the cervical spine were requested. The radiological interpretations by the casualty officers and junior radiologists in training were compared with those by a consultant radiologist and large discrepancies were observed. There was a predominance of fractures and subluxations at the levels of C1 and C2, and at C7 and T1. A study of the adequacy of the radiographs has shown that 90% of the lateral radiographs included C7 but only 57% included T1. Through-the-mouth views were adequate for interpretation in 67% of cases. The practice of the A & E and radiology departments at the Leicester Royal Infirmary is briefly described. The poor performance of the casualty officers and junior radiologists is discussed and suggestions made which might improve the accuracy of the radiological diagnosis of cervical-spine injuries in the A & E department.
A method is shown for deducing the surface area of a pendant drop from the same profile photograph as is normally used to determine interfacial tension. Manipulation of such drops by a micrometer syringe then enables the pendant drop to be used as a surface balance for studying adsorption from bulk solutions. Results are given for the compression of films from solutions of albumin, gamma-globulin, fibrinogen, albumin-gamma-globulin mixture and albumin-gamma-globulin-fibrinogen mixture, and from serum, plasma, and blood at the isooctane-buffer interface. It is suggested that gamma-globulin and fibrinogen films are unfolded at the interface but that albumin films are different in that they consist of an inner, unfolded layer and an outer, globular layer. A film from serum resembles that from gamma-globulin alone, and not that from albumin-gamma-globulin mixture, whereas a film from plasma resembles that of fibrinogen at low compression and that of albumin-gamma-globulin-fibrinogen mixture at high compression. A film from blood is shown to resemble that from plasma.
An apparatus is described for the study of foam formation in double contrast preparations in vitro. Antifoaming agents are shown to be of considerable benefit to the double contrast technique, silicone and silicone-free antifoamers being equally effective. Silicone antifoamers are preferred because of their wide clinical acceptability. Antifoamer formulation and concentration are found to be critical factors in determining efficacy of foam suppression, and may lead to erroneous results in the clinic.