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Biomedical subjects

J B Jacobs

Publications and source records attributed to J B Jacobs.

At least 37 records · Page 2Linked to original sources
PubMed1995

Safe and effective infundibulotomy technique.

The ostiomeatal complex has been identified as an important anatomic region in the pathogenesis of sinusitis. Functional endoscopic techniques rely on removal of mucosal disease from this site to improve drainage and aeration. Structural variations and the use of a sharp blade to create the infundibulotomy can result in inadvertent injury to the orbit. To avoid orbital penetration we perform the infundibulotomy with a curved, blunt dental elevator and displace the uncinate with its medial and lateral mucosa toward the middle turbinate. This stretches the infundibulum to reveal the maxillary ostium at its depth. The remaining mucosal attachments of the uncinate process are then incised under direct vision, and the complex is resected, creating an initial wide antrostomy. This technique has avoided orbital penetration in 700 cases in patients with early or late stages of mucosal disease.

Endoscopy↗
PubMed1994

[Psychosocial treatment of tinnitus].

After all medical and audiological treatments have failed, tinnitus patients often get the advise to "learn to live with it". The aim of psycho-social treatment is assisting patients in the identification of tinnitus aggravating factors and teaching them various coping skills. Treating these problems is primarily recommended for patients suffering from other disorders, even related to tinnitus. Motivation for psycho-social treatment depends on the ability of patients to accept tinnitus as a fundamental fact in their existence.

Adaptation, Psychological↗
PubMed1993

Comparison of functional endoscopic sinus surgery under local and general anesthesia.

We present a retrospective comparison of intravenous sedation and general anesthesia techniques employed at New York University-Bellevue Medical Center for functional endoscopic sinus surgery. Some authors have stressed the use of local anesthesia with intravenous sedation in order to avoid complications and reduce blood loss. We have reviewed 232 patients who underwent 401 consecutive ethmoidectomies and maxillary antrostomies. Local anesthesia, employed in 64% of patients, carried an estimated blood loss of 23 mL per side. General anesthesia was associated with an average blood loss of 58 mL per side. The rate of operative complications for local anesthesia was 8.7% per patient, with a 1.6% rate of major complications per side. General anesthesia carried an overall complication rate of 2.4% per patient, with no major complications. General anesthesia is a relatively safe and viable option for endoscopic sinus surgery that in selected cases may be preferable to local anesthesia.

Adolescent↗
PubMed1991

Staphylococcus aureus nasal carriage in patients with rhinosinusitis.

Toxic shock syndrome has been associated with rhinologic surgery and medical devices, and it has been linked to a circulating exotoxin of a toxogenic strain of Staphylococcus aureus. One hundred forty patients with rhinosinusitis were studied. Nasal cultures were obtained. The microbiological characteristics are described. The carrier rate for Staphylococcus aureus was 35%. Thirty percent of patients selected for surgery were Staphylococcus aureus carriers. Toxin-capable isolates were identified in 40% of those tested. Users of cocaine, topical decongestants, and steroid sprays had a statistically higher rate of Staphylococcus aureus carriage compared to nonusers. It is hoped that by identifying the population at risk and defining the factors associated with the development of toxic shock syndrome, a cogent policy of prevention can be established.

Adolescent↗
PubMed1989

Pulmonary hypoplasia and osteogenesis imperfecta type II with defective synthesis of alpha I(1) procollagen.

Perinatal lethal osteogenesis imperfecta (OI type II), a heritable disorder of connective tissue occurs approximately once in 60,000 live births. Phenotypic characteristics include defective cranial ossification and severe skeletal deformity due to intrauterine rib and long bone fractures. Lethal OI may be associated with intracranial hemorrhage or severe respiratory insufficiency. Pulmonary hypoplasia has been previously observed in OI type II, but has not been defined clinically. The infant described herein was born with OI type II and pulmonary hypoplasia. Pathological examination of airway branching patterns indicated that lung development had progressed to only the 10 week stage with immature acinar development. Investigation type I collagen synthesis by cultured dermal fibroblasts revealed the presence of electrophoretically abnormal alpha 1(I) polypeptides. These findings suggest that biochemically regulated processes, as well as mechanical factors, may impeded pulmonary development in similar cases of OI type II.

Culture Techniques↗
PubMed1989

Rhinomanometric evaluation of two nasal steroid sprays in rhinitis.

A prospective, randomized study comparing the effectiveness of two nasal steroid sprays, flunisolide and beclomethasone dipropionate, in the treatment of nasal obstruction associated with allergic or vasomotor rhinitis has been conducted at New York University Medical Center-Bellevue Hospital. All patients underwent routine history and physical examinations and a modified radioallergosorbent test. Paranasal sinus films were used to exclude patients with sinusitis. The Rhinotest microprocessor rhinomanometer was used to quantify pretreatment and posttreatment total nasal air flow and resistance during a period of 2 months. These findings were assessed in conjunction with the patients' subjective complaints. Results demonstrated that anterior rhinomanometric assessment of the nasal airway during inhalant therapy correlated well with the patients' own subjective impressions of nasal air flow. Both steroid inhalants were effective; however, flunisolide provided for earlier and more substantial symptomatic relief. Beclomethasone dipropionate had milder side effects.

Adult↗
PubMed1988

Congenital progressive hydronephrosis in mice: a new recessive mutation.

We describe a new autosomal recessive mutation, congenital progressive hydronephrosis (cph), that arose in the C57BL/6J inbred mouse strain. The clinical, histopathological, biochemical and radiographic characteristics, and the genetic linkage of this new mutation are discussed. Our studies indicate that the homozygous mutant mice have progressive bilateral upper urinary tract obstruction leading to azotemia and death of renal failure. The anatomical site of obstruction appears to be at the level of the ureteropelvic junction. Genetic mapping studies have localized the cph gene to the distal half of chromosome 15. The cph mouse strain provides a reproducible model for analysis of the onset and development of obstructive uropathic conditions in the neonatal period.

Animals↗
PubMed1988

Anti-Fx1A produces complement-dependent cytotoxicity of glomerular epithelial cells.

Glomerular injury in passive Heymann nephritis (PHN) in rats is mediated by the C5b-9 membrane attack complex (MAC) and is associated with morphologic changes in glomerular visceral epithelial cells (GEC). We determined if the nephritogenic antibody of PHN (gamma 1 sheep anti-Fx1A IgG) directs insertion of the MAC into GEC plasma membranes with consequent cytotoxicity. Antibody-sensitized GEC were exposed to various sera serving as sources of complement. Loss of cell viability was determined by trypan blue uptake and/or by release of cellular lactate dehydrogenase (LDH). Incubation of antibody-sensitized primary and passaged GEC in fresh human serum (FHS) resulted in sigmoidal relationships between cytotoxicity and complement dose (r = 0.97 and 0.94, respectively) such that cytolysis approached 100% with FHS (10% vol/vol). Cytotoxicity was not evident if C8-deficient (C8D) plasma was substituted for FHS, but was restored in a dose-dependent manner by reconstitution with purified rat C8. Sublytic injury was demonstrated by wide separation between simultaneous release curves of cell-incorporated biscarboxyethyl carboxyfluorescein (BCECF; mol wt approximately equal to 520) and LDH at limiting doses of complement (at 2% FHS, BCECF release was 51.1 +/- 0.6% of maximum vs. 3.2 +/- 1.3% for LDH; N = 3) and by blebbing of the plasma membrane on electron microscopy. Thus, the pathogenic antibody of PHN produces complement-mediated sublytic as well as lytic cytotoxicity of GEC.

Animals↗
PubMed1988

MR imaging in patients with intracranial aneurysm clips.

Four patients with intracranial aneurysm clips made from a variety of alloys were studied without incidence by MR imaging at field strengths ranging from 0.35 to 0.6 T. Knowledge of the type of alloy used in the manufacturing of an aneurysm clip is important in determining whether the clip will or will not deflect in a magnetic field. Ferromagnetic clips show deflection and torque in a magnetic field and have the potential to dislodge from the aneurysm. Nonferromagnetic or weakly ferromagnetic aneurysm clips such as the Sugita (Elgiloy), Yasargil (316 LVM stainless steel), Heifetz (Elgiloy), Yasargil (Phynox), and Vari-Angle McFadden (MP35N) do not deflect or deflect weakly in the magnetic field and therefore would not be expected to dislodge during MR. The option of imaging many patients with intracranial aneurysm clips with MR extends the usefulness of the technique to a previously excluded population.

Adult↗
PubMed1987

Toxic shock syndrome in nasal surgery: a physiochemical and microbiologic evaluation of Merocel and NuGauze nasal packing.

A prospective comparison of the microbiologic safety of Merocel versus NuGauze nasal packing in 119 surgical patients is presented. Presurgical and postsurgical nasal cultures were obtained, analyzed, and compared. The importance of a preoperative nasal culture isolate of Toxic Shock Syndrome Toxin Number 1 (TSST-1) producing Staphylococcus aureus in predicting postoperative toxigenic S. aureus isolation and Toxic Shock Syndrome symptomatology is demonstrated. An in vitro comparison of the ability of NuGauze and Merocel to amplify TSST-1 production was performed.

Adolescent↗
PubMed1986

Correlation of fine needle aspiration biopsy and CT scanning of parotid masses.

Preoperative evaluation of parotid tumors still poses difficult problems for the head and neck surgeon. The complex anatomy of the parotid space leads to difficulty in localizing these tumors. In addition, physical examination will rarely determine whether a parotid lesion is benign or malignant. High resolution CT scanning with contrast and fine needle aspiration can provide enough preoperative information to enable the surgeon to counsel his patient concerning possible risks and the extent of surgery that may be indicated. We are able to determine tumor location, multiple or bilateral masses, associated adenopathy, and often specific tumor histology. Forty-two parotid aspirates and 26 CT scans were reviewed and correlated with their postoperative pathology specimen. Parotid aspiration cytology was found to be a highly accurate and safe procedure for preoperative determination of parotid pathology. However, the CT scan was specific only in defining the anatomic localization and extent of a parotid mass.

Biopsy, Needle↗
PubMed1985

Properties and characterization of vesicles released by young and old human red cells.

We have presently demonstrated morphologic differences between young and senescent red cells following 18 h of metabolic depletion in vitro. Young and old red cells both form echinocytes, whereas only young cells demonstrated myelin forms or microspheres. Furthermore, vesicles were released in greater quantities into the cell-free supernatant from young cells. Isolated vesicles from both young and old red cells contained lipids, intrinsic membrane proteins (especially band 3), and haemoglobin, and they were also enriched in acetylcholinesterase (AChE). Young cells produced more vesicles than old cells but the composition of the low density vesicles was similar except that haemoglobin-spectrin complex was found exclusively in vesicles from young cells. Oxidation of young red cells prior to metabolic depletion prevented both myelin formation and vesicle release.

Acetylcholinesterase↗