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J Haapaniemi

Publications and source records attributed to J Haapaniemi.

18 recordsLinked to original sources
PubMed2001

The effect of promontorial bone on laser light transmission in measuring capillary blood flow in vivo.

Use of laser Doppler flowmetry (LDF) to assess cochlear blood flow (CBF) in experimental animals has elucidated the complex mechanisms in CBF regulation. Some attempts have been made to measure CBF in humans, although earlier studies produced confusing data about the physical possibility of LDF penetrating the human tympanic cavity promontory. In this study, we used LDF in an attempt to observe capillary blood flow in vivo through the intact human promontory in order to develop a method for measuring CBF in human patients. Temporal bones from six human cadavers were removed and the promontory overlying the basal turn of the cochlea was drilled off and fixed in 10% formalin. Perpendicular bone thickness was measured at the site of the stria vascularis. Seven young rats were anesthetized and the carotid artery was cannulated for blood pressure recording. Capillary flow was registered with LDF from two sites, the kidney and the plantar area of a hind limb, using a custom-designed probe with 632.8 nm and 780 nm wavelengths. Intravenous epinephrine was used to evoke blood flow changes. The same measurements were repeated through the promontorial bone. The light attenuation induced by the promontorial bone was 79+/-28% for the 632.8 nm wavelength, and 22+/-15 to 65+/-13% for the 780 nm wavelength, depending on the thickness of the bone. The sensitivity in detecting minute changes was 78% and 91-96%, respectively, for the 632.8 nm and 780 nm wavelengths. This study indicates that it is possible to detect minute changes in capillary blood flow through the intact human promontory at the site of the stria vascularis.

Adult↗
PubMed2001

Ultrasound and antral lavage in the examination of maxillary sinuses.

Two hundred and ninety maxillary sinuses in 206 patients, suspected of having acute or prolonged maxillary sinusitis, were examined using ultrasound (US) and then irrigated with isotonic saline. The results of the antral lavage and the US were compared and various US recording variables were analyzed. The sensitivity of US examination to find maxillary sinus secretion was 77% and the specificity 49%. The distance from the initial echo to the back wall echo (BWE) and the ratio of the echo-free area to the distance from the initial echo to the BWE were sensitive indicators of the presence of maxillary sinus secretion. The results suggest that US is a relatively sensitive method also in the diagnosis of prolonged maxillary sinus inflammations. However, its low specificity weakens its value in clinical work. The usability of US in the diagnosis of maxillary sinusitis can be increased by intermittently controlling US findings by sinus puncture. This is of particular importance for general practitioners, but also for specialists.

Adolescent↗
PubMed2000

Cochleovestibular symptoms related to the site of vestibular schwannoma.

The purpose of the investigation was to study the symptoms that may provide clues to the early diagnosis of vestibular schwannoma (VS). The symptoms associated with VS in 41 patients were compared with the tumour locations detected by magnetic resonance imaging (MRI). There were 9 (22%) mainly intracanalicular and 32 (78%) mainly extracanalicular tumours. MRI visualized the enhancement of the intracanalicular nerve in 27 of 32 extracanalicular schwannomas. Hearing impairment was found as an initial symptom equally frequently in patients with intra- or extracanalicular VS. Tinnitus was reported as the first symptom more often in patients with extracanalicular VS and dizziness more often in patients with intracanalicular tumours. At the time of diagnosis, unilateral hearing loss was present in 98% of patients, independent of tumour location. Likewise, dizziness was found equally frequently in both patient groups. Instead, tinnitus was found almost significantly more frequently in patients with intracanalicular VS (p = 0.07). Although statistically insignificantly so, neurological symptoms were more common in patients with extracanalicular VS (p = 0.45).

Cochlea↗
PubMed2000

Treatment of severe tinnitus.

In 1995-96 we selected a group of 26 patients who were suffering from severe invalidating idiopathic tinnitus (IT) in order to evaluate the efficacy of rehabilitation and some alternative therapies. All patients were assessed thoroughly by means of audiology and radiology regarding any objective cause for the symptom. In order to help patients control their symptom by increasing knowledge and adding supportive elements, they were given basic education (presentations of the anatomy and physiology of the ear and hearing system, psychological and social aspects of IT, guided and non-guided group discussions, relaxation therapy, physiotherapy, music therapy) for 4 months, comprising one 2-h session bi-weekly. This type of group therapy was found to be extremely helpful, although no objective evaluation revealed effects on IT sensation (VAS) or psychometric measures (SLC-90). In a second limb of the study, the same patients attended a 6-day intensive course in a spa. The purpose was to evaluate the possible usefulness of the widely recommended alternative therapies for IT. All patients had an opportunity to sample the treatments. Six months later only a few had tried any of these treatments, but all reported that the lessons were the most helpful in association with supportive group discussions. The results indicated that none of these therapies can be recommended, based on rational medical practise.

Humans↗
PubMed2000

Transtympanic versus tympanic membrane electrocochleography in examining cochleovestibular disorders.

The use of electrocochleography (EcoG) is considered to be of clinical value in otological diagnosis. Non-invasive ear canal (EC) and tympanic membrane (TM) EcoG recording techniques, and invasive transtympanic (TT) technique are the methods used for objective assessment of cochlear function. In this study, eight adults (16 ears) with suspected Meniere's disease were examined using a newly designed, disposable tympanic electrode and a traditional, thin transtympanic needle. The amplitudes of the TT electrode responses were 4-6-fold larger than those produced by the TM electrode. The morphology of the waveforms for the two recording techniques was nearly identical. The mean amplitudes of the action potential (AP) obtained with the TM electrode were 2.39-3.73 microV, and with the TT electrode 14.08-19.60 microV, depending on the stimulus intensity. For the summating potential (SP), the TM and TT electrodes had mean amplitudes of 0.82-1.60 microV and 3.53-5.81 microV respectively. The SP/AP ratios were larger with the TM electrode than with the TT electrode. They were inconsistent in four ears (25%) when measured with the TM and TT electrodes. All patients were more satisfied with the TT examination, since it was quite painless, unlike the TM examination. The authors recommend the use of the TT recording technique as a painless examination in which the electrode is close to the inner ear, allowing a good signal-to-noise ratio and large amplitudes. Diagnostic interpretations are easier and more reliable with the TT electrode than with the TM electrode.

Adult↗
PubMed1998

Bronchioloalveolar carcinoma: diagnostic pitfalls and immunocytochemical contribution.

Because bronchioloalveolar carcinoma (BAC) commonly displays bland cytologic appearance, there is a good potential for misinterpretation. The aim of this study was twofold: one was to identify the most reproducible cytomorphologic features to distinguish BAC from conventional lung adenocarcinoma (CLA) on fine-needle aspiration (FNA), and the other was to investigate the staining characteristics of these two variants of lung carcinoma with P53 tumor suppressor gene immunostain and their potential value in the distinction between the two entities. Cytology records of 13 histologically documented BACs was retrieved: 7 FNA, 3 bronchial washing/bronchial brushing (BW/ BB), and 3 scraping smears of surgical specimens. Two cases had both FNA and BW/BB material. Immunostains for P53 protein, carcinoembryonic antigen (CEA), and Ki67(MIB-1) monoclonal antibodies were performed on 13 BACs (FNA cell blocks and tissue) and on 11 FNA cell blocks of CLA. Cytologically, BAC showed uniform cells with abundant, lacy cytoplasm, and bland, folded nuclei arranged singly, in papillary clusters, and sheets. Immunocytochemically, one BAC and one CLA were technically unacceptable. Of the 12 remaining BAC cases, 10 were reactive with CEA, 9 reactive with Ki67 (> 5%), and 4 reactive with P53. Of the 10 remaining CLAs, 9 were positive with CEA, 9 were reactive with Ki67 (> 5%), and 8 were reactive with P53. We conclude that BAC demonstrates distinctive cytologic features, but difficulty may be encountered with well-differentiated CLA, metastatic adenocarcinoma, and other lesions. Immunocytochemically, CEA and Ki67 do not appear to be discriminate, but P53 may be of value in distinguishing BAC from CLA. Attention to subtle nuclear changes, characteristic grouping, cellular arrangement, and P53 reactivity could enable cytopathologists to accurately diagnose BAC.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1997

Comparison of ultrasound and X-ray maxillary sinus findings in school-aged children.

A total of 663 unselected 7-, 10- and 14-year-old school children were examined for both ultrasound and X-ray maxillary sinus findings. Ultrasound and X-ray findings were normal in 84.5% and 83.9% of the children, respectively. In a comparison of the findings, the sensitivity of ultrasound examination compared to abnormal maxillary sinus X-ray findings was low. However, a negative ultrasound finding was a sound basis for excluding the disease. According to the results of the present study, it is perhaps justified to say that a negative ultrasound finding excludes the occurrence of radiographic sinusitis, whereas a positive ultrasound finding has little or minor significance.

Adolescent↗
PubMed1995

The 6 kHz acoustic dip in school-aged children in Finland.

In the present study, pure-tone audiometry was used in 687 Finnish school children, aged 6-15 years, to determine the prevalence of a 6 kHz acoustic dip and related factors among three age groups. Trained audiometricians tested air conduction thresholds in a sound-proof room. A total of 57 children (8.3%) had a clear-cut dip of at least 20 dB at 6 kHz. This dip was more pronounced in older children and in boys. A thorough case history was obtained by questionnaire, with logistic regression analysis showing that low birth weight (< 2500 g) and childhood measles were the only factors associated with occurrence of the 6 kHz dip in school-aged children.

Adolescent↗
PubMed1995

Tympanic membrane changes in school-aged children.

A comprehensive otolaryngologic examination, including otomicroscopy, was performed for 687 school children for morphologically to study the distribution of normal and abnormal tympanic membrane findings and the association of different factors with the abnormal TM finding in 6 to 15-year-old children. Two-thirds of the children had completely healthy tympanic membranes without any visible pathological change. The findings were more often normal the older the child. In the total population, individual tympanic membrane findings were normal as follows: color 90.7%, position 93.8%, mobility 93.7%, structure 91.8% and position of pars flaccida 88.5%. Contrary to normal findings, tympanic membrane abnormalities were not in general associated with each other. The study provides new information on the occurrence of tympanic membrane changes among school-aged children.

Adolescent↗
PubMed1979

Massive hemoptysis secondary to flow-directed thermodilution catheters.

Hemoptysis is an unusual complication of flow-directed (Swan-Ganz) catheters. Over-inflation of the balloon with a shearing-induced rupture of a small pulmonary artery, and the spear effect of the catheter tip appear to be the mechanisms in the two cases presented. Diligent care to avoid overinflation of the balloon in the pulmonary capillary wedge position by observation of the pressure waveform is critical. The spear effect that is frequently seen during insertion may be eliminated by deflating the balloon at the first appearance of the pulmonary artery waveform and gradual advancement of the catheter five to eight cm, when the balloon is then reinflated to obtain the wedge.

Aged↗
PubMed1979

Deep neck infections.

From January 1967 to August 1978, 65 patients with cervical abscesses were referred to the ENT Clinic of Turku University Hospital. The origin of these deep neck infections was odontogenic in 19, tonsillitis or tonsillectomy in 14, trauma in seven, salivary glands in five and branchiogenic cysts in five and other known causes in three cases. In 12 cases the origin was unknown. The cervical abscesses of odontogenic origin were located mostly in the submandibular space (11/19). The rest of the deep cervical infections were mostly found in the parapharyngeal space (25/46). Etiological factors and treatment of these severe infections are discussed.

Abscess↗
PubMedDate not supplied

Radical meatoplasty in the treatment of severe chronic external otitis.

In the beginning, external otitis is an inflammation of the skin of the external ear canal. Partial or total obliteration of the meatus causes cleaning problems, which worsen the obliteration, and hence, the infection. Immunosuppressive medication or illness, certain dermatological problems or frequent infections may lead to irreversible changes and to the malignant form of external otitis with life-threatening sequelae. Conservative treatments in the beginning are aimed at regaining the normal skin functions by helping the cleaning process and curing the acute infection with repeated irrigation, proper antibacterial medication and corticosteroids and anti-inflammatory analgesics. In rare prolonged cases, surgical procedures are needed to help the cleaning process by removing the irreversibly thickened skin and bone affections, and using grafts. On the basis of our experience, even the removal of the diseased skin and enlarging of the external ear canal are insufficient procedures in the most difficult cases. In the present paper, we describe a new surgical method that we have performed to treat chronic bilateral obliterative external otitis in 2 patients, with favorable results.

Anti-Infective Agents↗
PubMedDate not supplied

Aspiration biopsy cytology of malignant hemangiopericytoma metastatic to the lungs. Cytomorphologic and immunocytochemical study of a case.

BACKGROUND: Hemangiopericytoma (HP) is an uncommon, slowly growing tumor that originates in "pericyte" cells. Biologically it can be benign or malignant; however, it is difficult to predict tumor behavior based on histomorphology alone. The cytomorphology of this tumor has been described only rarely. Other spindle cell mesenchymal tumors can mimic HP on fine needle aspiration biopsy (FNAB). CASE: A 60-year-old man presented with cough and a left lung mass on chest roentgenography and multiple smaller bilateral lung nodules on computed tomographic scan. FNAB of the dominant left lung mass showed a moderately cellular aspirate with clusters and single spindle-shaped cells morphologically similar to those of hemangiopericytoma excised from the posterior part of the neck 11 years previously. With immunocytochemical studies, the tumor cells were negative for cytokeratin, factor VIII-related antigen, S-100 protein and HHF35 but positive for vimentin and CD34. CONCLUSION: FNAB is a valuable tool in evaluating nonepithelial metastatic lung tumors. In the appropriate clinical setting, it is possible to render a diagnosis of HP on FNAB in patients with previously documented HP based on morphologic comparison and ancillary studies, especially immunocytochemical stains.

Antigens, CD34↗
PubMedDate not supplied

Clinical efficacy and tolerance of bacampicillin and amoxycillin suspensions in children with acute otitis media.

A total of 97 children with acute otitis media were entered into a single-blind, parallel-group study to compare the efficacy and tolerance of suspensions of bacampicillin, given twice daily, with amoxycillin, given three times daily. The daily dosage was about 40 mg/kg body weight in each case and the duration of treatment was 10 days. Patients were examined before the start of treatment, at an early follow-up visit within 2-3 weeks after the start of treatment and at a late follow-up visit 4-6 weeks after the start of treatment. The initial bacteriology revealed a relatively high proportion of Branhamella catarrhalis and a low incidence of pneumococci. In total, 92 patients were evaluated for efficacy at early follow-up, where both bacampicillin and amoxycillin showed equal and good treatment results in approximately 90% of cases. Evaluation at the last valid visit showed that 80-90% of the patients were either cured or improved. The failure frequency tended to be somewhat higher with amoxycillin.

Acute Disease↗