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Biomedical subjects

J H Kelly

Publications and source records attributed to J H Kelly.

At least 55 records · Page 3Linked to original sources
PubMed1988

The effects of anesthesia on middle-ear effusions.

Surgeons occasionally note a discrepancy between preoperative assessment of middle-ear effusion and operative observation during the placement of ventilating tubes in children's ears. This study was designed to determine whether this variance is secondary to the effects of inhalation anesthesia or misinterpretation of the preoperative exam. Observations were recorded by three distinctly different methods of measurement: the surgeon, the MD-2 Impedance Analyzer, and the Acoustic Otoscope immediately before and after induction of anesthesia. These results were then analyzed and compared with the operative findings. Anesthetic induction was shown to cause alteration in the presence of middle-ear fluid in less than 10% of cases.

Acoustic Impedance Tests↗
PubMed1987

Growth and hepatospecific gene expression of human hepatoma cells in a defined medium.

The production of albumin, alpha-fetoprotein (AFP), and alpha-1 antitrypsin has been compared among human hepatoma cells cultured in medium containing serum, medium containing hormones and growth factors, and a basal medium containing selenium as the only supplement. Growth is sustained in all three media, and the expression of all three proteins was maintained for over 4 mo. in the various media. However, the quantitative production of albumin and AFP were dramatically different in the three media. Two hormones, insulin and triiodothyronine, influenced the level of secreted proteins. Triiodothyronine increases the amount of secreted albumin whereas insulin at 10 micrograms/ml reduced the level of total secreted protein.

Albumins↗
PubMed1986

Voice rehabilitation following laryngectomy. Myomucosal tracheoesophageal shunt.

Surgical procedures for speech rehabilitation following laryngectomy lack wide support owing to tumor recurrence, aspiration, stenosis of the fistula, and multiple surgical stages of limited usefulness in irradiated patients. The recent prostheses and their modifications have approximately a 70% success rate but similarly remain limited by the requisite maintenance and soilage. A mucosa-lined tracheoesophageal fistula with a functioning proximal muscle sphincter, created in one stage at laryngectomy, is described. This myomucosal unit can function with or without a prosthesis and potentially eliminates aspiration. Evolution of the flap design in an animal model is delineated and the clinical trial in six patients high-lighted. Five of the six have an excellent vocal quality without an associated air leak on phonation. Three function without a prosthesis.

Adult↗
PubMed1986

Inverted Y duplication of the ureter in association with ureterocele and bladder diverticulum.

We report a case of inverted Y duplication of the ureter in association with an obstructing ectopic ureterocele and paraureteral diverticulum. Preoperative radiological studies demonstrated the ureterocele and diverticulum but they failed to show the duplex distal ureter. The duplicated section of ureter was excised and a Cohen reimplantation was performed. The presence of a large ureterocele obstructing the bladder neck, a diverticulum, failure of reflux into the ectopic segment and poor function of the affected kidney all contributed to the difficulties in establishing a preoperative diagnosis.

Diverticulum↗
PubMed1986

Sudden hearing loss associated with piroxicam.

Tinnitus has been reported with use of piroxicam (Feldene) a nonsteroidal anti-inflammatory drug. Two cases of temporary hearing loss have also been reported. To the best of our knowledge the patient reported herein represents the first case of permanent hearing loss and tinnitus associated with use of the drug.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1985

Laryngopyocele as a cause of airway obstruction.

Symptomatic laryngoceles are unusual lesions. Laryngopyoceles are even more unusual, with a total of 32 cases reported in the world literature. Two cases of laryngopyocele presenting as airway obstruction are described along with a review of the anatomy, etiology, clinical course, and management of this lesion. An argument is made supporting the resection of the symptomatic laryngocele to prevent the rapid respiratory obstruction that may occur in the presence of a laryngopyocele.

Cysts↗
PubMed1984

Osteosclerotic plasmacytoma of maxillary bone (orbital floor).

Plasma cell neoplasms have been classified as multiple myeloma, solitary plasmacytoma and extramedullary plasmacytoma. They are usually considered as osteolytic lesions of bone except for the rare occurrence of osteosclerotic lesions. This paper describes the first reported osteosclerotic plasmacytoma of the maxillary bone and orbital floor. The difficulties in establishing a diagnosis and the relationship to other plasma cell neoplasms are discussed. Osteosclerotic plasmacytomas are a rare variant of plasma cell tumors which usually produce osteolytic lesions rather than bony sclerosis. Sixty-eight patients with the osteosclerotic variant have appeared in the world literature, with an overall incidence of about 1 per cent in a large series of plasma cell neoplasms (Dreidger and Pruzanski, 1979). There have been only six previous cases of solitary osteosclerotic plasmacytomas reported (Morley and Schweiger, 1964; Roberts et al., 1974; Rodriguez et al. 1976; Rushton, 1965; Schneinker, 1938; Brigham Medical Review, 1961) involving spine, sternum, or rib. None have previously been reported in the head and neck area. Plasma cell tumors have been classified into multiple myeloma, solitary plasmacytomas of bone, and extramedullary plasmacytomas. Multiple myeloma is a disseminated plasma cell malignancy characterized by the production of homogeneous immunoglobulins (whole or fragments) which appear in the serum and urine. Plasma cell tumors can also occur as solitary plasmacytomas, usually in bone, but also in soft tissue. With time, most solitary plasmacytomas develop disseminated disease with all the characteristics of multiple myeloma (Wiltshaw, 1976). Extramedullary plasmacytomas arise in soft tissue rather than bone, and primarily occur in the head and neck region. Clinically, they remain localized and less frequently develop into disseminated myeloma.

Female↗
PubMed1984

Pseudomonas rhinosinusitis.

Although rare in the otherwise healthy patient, pseudomonas rhinosinusitis is encountered most frequently in the immunocompromised host or severely traumatized patient. Intravenous antibiotic therapy in conjunction with aggressive surgical drainage is required. Two cases are documented that are typical of this philosophy. A third patient with isolated nasal involvement, because of multiple medical disabilities, was treated with local debridement and topical therapy alone and responded.

Female↗
PubMed1984

Methods of diagnosis and documentation.

The foregoing represent only the most frequently used methods of assessing laryngeal disease. Many other methods show promise and are being evaluated in a few centers. Future laryngologists will be more sophisticated in diagnosing laryngeal lesions, including the use of computer analysis of methods in current use. As with all testing, the laryngologist should "tailor" the procedure to the individual patient and choose the diagnostic test that will incur minimal expense, time, discomfort, and danger to the patient.

Acoustics↗
PubMed1983

Development of speech-audiometric materials for native Spanish-speaking adults.

The lack of valid and reliable Spanish speech audiometry materials constitutes an important clinical problem. Such tests necessitate the construction of appropriate materials. Analysis of English and Spanish literature on speech audiometry led to the identification of guidelines for new test materials in the Spanish language. Test lists were devised, recorded and used to evaluate 10 normal-hearing native Spanish-speaking subjects. The results obtained led to a final set of recorded lists. Boston College Auditory Test lists may be used successfully with Spanish-speaking patients. The current study should provide the impetus and sufficient guidelines upon which speech stimuli in other languages may be constructed.

Adult↗
PubMed1982

Surgical update on nasal dermoids.

A one-stage surgical procedure describing the removal of the necessary nasal bones for complete eradication of nasal dermoids, with subsequent replacement of the intact bones, is discussed herein. This technique has proved to be invaluable in two patients who underwent this procedure. Extensive meticulous dissection often is necessary to extirpate this cystic lesion to prevent its recurrence. Extensive surgery, however, need not result in a notable cosmetic deformity that requires secondary restorative measures. Using this technique, replaced nasal bone segments effect immediate reconstruction. A 20-year review of the cases of nasal dermoids from the Children's Hospital Medical Center, Boston, also is presented.

Child, Preschool↗
PubMed1982

Ludwig's angina: an update.

Despite a reduction in preantibiotic mortality rates that exceeded 50%, Ludwig's angina remains a potentially lethal entity primarily because of rapidly progressive airway obstruction. Since the reports of several large series in the 1940's, there have been put sporadic case reports because of widespread use of antibiotics in orodental infection, improved dental care, as well as adherence to strict diagnostic criteria. Since this entity is now uncommon, unnecessary delay in diagnosis and management may occur and may result in serious complications. This presentation will consist of an historical review, discussion of pathogenesis followed by clinical presentation, bacteriology and treatment, as well as a detailed analysis of our most recent 20 cases. There were no complications and no deaths. The infection resolved with medical therapy in 11 patients, while 9 patients required surgical procedures. Penicillin, clindamycin or chloramphenicol were started initially in all cases. Four of these 9 patients developed a localized abscess, while on antibiotics, which required drainage. Tracheotomy or intubation was necessary in 7 patients. Early and aggressive use of appropriate antibiotics and protection of the airway are the mainstays of a successful treatment regimen. Judicious surgical intervention is indicated in those patients who develop localized abscesses while on antibiotics or are unresponsive to medical management.

Abscess↗