Search PubMed⌕ Search

Biomedical subjects

J J Manni

Publications and source records attributed to J J Manni.

At least 55 records · Page 3Linked to original sources
PubMed1998

Click-evoked oto-acoustic emission measurement in preterm infants.

UNLABELLED: Click-evoked oto-acoustic emissions (CEOAE) are acoustic responses produced by the inner ear, reflecting functional auditory integrity. We studied both the success rate of the CEOAE method and the CEOAE presence in preterm infants during their stay at the Neonatal Intensive Care Unit (NICU), by analysis of the results of longitudinal CEOAE measurements in 19 preterm infants. The CEOAE method proved to be feasible in the majority of the population under study; the CEOAE measurement failed in 8% of the total of 226 attempts. Within the range of 30-40 weeks post-conceptional age (PCA) the CEOAE presence increased from about 50% to 80%. These results show the possible clinical application of CEOAE in a NICU for the monitoring of cochlear function during treatment of preterm infants. CONCLUSION: Bedside CEOAE measurement in preterm infants in a NICU is feasible at a PCA as low as 30 weeks.

Feasibility Studies↗
PubMed1998

Retrograde approach to pharyngo-esophageal obstruction.

BACKGROUND: The entrance of the esophagus has to be identified for treatment of a pharyngo-esophageal obstruction. If transoropharyngeal identification is unsuccessful, a retrograde approach might be indicated. METHODS: By way of a mini-laparotomy and gastrotomy, a flexible gastroscope can be passed into the esophagus. In one patient with a Zenker's diverticulum, a guidewire was inserted through the accessory channel of the gastroscope and passed through a stenosis, caused by marked hypertrophy of the cricopharyngeal muscle, into the oral cavity. Thereafter antegrade dilatation and laser assisted myotomy could be performed. In another patient with a membranous obstruction of the esophageal entrance due to radiotherapy, the occlusion was perforated transoropharyngeally and bluntly dilatated guided by the light from the gastroscope. RESULTS: In both cases the esophageal passage was restored. No complications occurred as a result of the procedures. CONCLUSIONS: The retrograde approach may be a good alternative when antegrade identification of the esophageal entrance fails.

Aged↗
PubMed1998

A prospective study of speech and voice rehabilitation after total laryngectomy with the low-resistance Groningen, Nijdam and Provox voice prostheses.

In a prospective study the Groningen, Nijdam, and Provox voice prostheses were evaluated with respect to speech and voice rehabilitation. At approximately 1, 4, and 10 months after operation, patients were submitted to a standardized speaking task to evaluate phonatory skills (phrase length, phonation duration, dynamics on tone, dynamics on sentence, speech rate and availability of sound), speech quality (fluency and overall intelligibility), voice quality and stoma technique (stoma noise). Tracheoesophageal speech rehabilitation proved to be successful in 94-100% of patients, as measured at approximately 10 months after operation. Furthermore, no significant overall differences were found between the three prostheses. There was a significant improvement in time for speech rate and stoma noise. As for the time effects (e.g. improvement in performance over time) no differences between the three prostheses were found.

Humans↗
PubMed1997

[The maxillary sinus and odontogenic cysts].

An unilateral maxillary sinusitis is frequently caused by dental pathology. An odontogenic cyst in the maxillary sinus usually lacks accompanying symptoms of infection. In three patients, a 35-year-old man and two women aged 16 and 28, an odontogenic cyst in the maxillary sinus was diagnosed. Consultation of a maxillofacial surgeon is needed because orthopantomographic imaging is diagnostically most helpful. In these patients combined treatment by an ENT surgeon and a maxillofacial surgeon is important.

Adolescent↗
PubMed1997

Detection of chromosomal aberrations in cytologic brush specimens from head and neck squamous cell carcinoma.

BACKGROUND: Detection of genetic changes in the mucosa of the upper aerodigestive tract may provide a target for the screening of cytologic specimens to identify premalignant transformation in this region. In this pilot study, the feasibility of the fluorescence in situ hybridization (FISH) technique to detect genetically aberrant cells in brush specimens was evaluated. METHODS: Brush specimens taken from the tumors of 20 patients with head and neck squamous cell carcinoma (HNSCC) and from the normal mucosa of 8 control patients were analyzed by FISH using DNA probes for the chromosomes 1 and 7. The FISH results were compared with DNA flow cytometry and FISH results of the solid tumor specimens. RESULTS: The results of this study showed that 15 of the 20 tumor brush specimens contained numeric chromosomal aberrations in at least 5% of the cells collected. Chromosomal aberrations were detected in all brush specimens taken from tumors that were DNA aneuploid and showed aneusomy. The presence of these aberrations correlated well with the classification "suspicious for malignancy," which was based on Papanicolaou stained slides of the same specimens. In the control group the percentage of chromosomally aberrant cells did not exceed 2%; in addition, no suspiciously malignant cells were observed in this group. CONCLUSIONS: This study reveals that the FISH technique can be applied diagnostically to brush specimens of HNSCC. The presence of chromosomal aberrations in > 5% of the cells in these specimens can be considered as a marker for malignancy.

Adult↗
PubMed1997

Cytokeratin and vimentin expression in normal epithelium and squamous cell carcinomas of the larynx.

The immunohistochemical expression patterns of cytokeratin polypeptides and vimentin were investigated in normal epithelia and squamous cell carcinomas of the larynx with special emphasis on tumor grading. During malignant transformation of epithelial cells, the cytokeratin expression patterns changed, depending on the differentiation grade of the carcinomas. In low-grade carcinomas, the expression patterns were close to those of the normal epithelium. With increasing tumor grade, there was decreased expression of stratification cytokeratins and increased expression of basal cell, simple cell and hyperproliferation-related cytokeratins. Increasing tumor grade was also associated with the expression of vimentin, a cytoskeletal protein of mesenchymal cells. No relationship was found between vimentin expression and the presence of lymph-node metastases.

Biomarkers, Tumor↗
PubMed1997

Aerodynamic characteristics of the Nijdam voice prosthesis in relation to tracheo-esophageal wall thickness.

Tracheo-esophageal speech using various prostheses is currently the most successful form of voice and speech rehabilitation for laryngectomies. Main inter-device differences are durability and trans-device pressure loss during speech. The valveless indwelling Nijdam voice prosthesis is a new voice prosthesis. A barrier mechanism is created by a combination of the esophageal mucosa and the umbrella-like "hat" of the prosthesis that covers the esophageal side of the tracheo-esophageal fistula. The Nijdam prosthesis can be used clinically for longer periods of time when compared to such other indwelling voice prostheses as the Provox prosthesis and the low-resistance Groningen prosthesis. However, transdevice pressure loss during speech has been unknown. Adjustment of the shft length of the Nijdam voice prosthesis to tracheo-esophageal wall thickness was expected to affect trans-device pressure loss during speech. We report the results of in vitro tests to quantify the effect of tracheo-esophageal wall thickness on trans-device pressure loss. In the present study pressure loss was measured at different air flow rates in relation to tracheo-esophageal wall thickness. Findings demonstrated that when shaft length of the Nijdam prosthesis corresponded exactly to tracheo-esophageal wall thickness, trans-device pressure loss was comparable to that of the Provox prosthesis. If a relatively shorter Nijdam prosthesis was chosen to prevent aspiration from occurring, the pressure loss across the prosthesis increased to that of the low-resistance Groningen prosthesis.

Esophagus↗
PubMed1997

Frequency shift of individual spontaneous otoacoustic emissions in preterm infants.

In adults, spontaneous otoacoustic emissions (SOAE) have shown a considerable frequency stability. In preterm infants, however, the SOAE proved to show an apparent and consistent upward shift of frequency at increasing postconceptional age (PCA). In 25 ears of 14 preterm infants (PCA, 29.1-41.3 wk) a total of 66 SOAE frequencies were monitored, ranging from 1611 to 5774 Hz. All but one of the SOAE frequencies shifted toward higher frequency. The SOAE frequency shift rate in Hertz per week was proportionally constant relative to the SOAE frequency. The mean shift rate was 0.74 +/- 0.39%/wk. At increasing PCA, the SOAE frequency shift rate tended to slow down. A linear fit through the data predicted the SOAE frequency to stop at about 45-50-wk PCA. The frequency dependence and time course of the SOAE frequency shift strongly suggest cochlear maturation during the last period of gestation.

Acoustic Stimulation↗
PubMed1997

In vivo aerodynamic characteristics of the Nijdam voice prosthesis.

The Nijdam voice prosthesis is an indwelling valveless voice prosthesis for postlaryngectomy voice rehabilitation. The in vitro aerodynamic characteristics are reported to be comparable to that of the low-resistance Groningen voice prosthesis. Owing to the design of the prosthesis the airflow resistance depends on the shaft length of the voice prosthesis in relation to the thickness of the tracheo-oesophageal wall. As tissue characteristics of the patient's oesophageal mucosa could also be of importance, an in vivo study was found necessary. To assess in vivo characteristics the following parameters were recorded in 10 patients: intratracheal pressure, intraoesophageal pressure and airflow during phonation. At an airflow of 0.15 1/sec the transdevice pressure loss varied from 0.5 up to 7 kPa (mean 3.9 kPa). With an artificial increase of the tracheo-oesophageal wall thickness, transdevice pressure losses up to 13 kPa were found. Significant interindividual as well as intraindividual differences were noted. The airflow resistance of the Nijdam voice prosthesis in relation to the thickness of the tracheo-oesophageal wall was compared with the airflow resistance reported for various other voice prostheses. The in vivo aerodynamic characteristics of the Nijdam voice prosthesis found in this study indicate the need to modify the present design in order to improve its airflow resistance and to eliminate the influence of the thickness and tissue characteristics of the tracheo-oesophageal wall.

Airway Resistance↗
PubMed1997

Endolymph flow.

Explore the source record for details and available documents.

Ear, Inner↗
PubMed1996

The Blom-Singer tracheostoma valve as a valuable addition in the rehabilitation of the laryngectomized patient.

Prosthesis-assisted tracheo-esophageal speech has proven its value in post-laryngectomy voice rehabilitation, although manual occlusion of the tracheostoma during speech is necessary. In contrast a tracheostoma valve enables hands-free speech. We have now had experience with 30 patients using the Blom-Singer tracheostoma valve for more than 6 months and have found that most patients prefer prosthesis-assisted speech with the tracheostoma valve. Measurement of several speech parameters with digital and valve occlusion of the tracheostoma did not show any significant differences between the two speaking conditions. Problems included maintenance of an airtight seal, outward forcing of the valve diaphragm during forced expiration and subjective increased airflow resistance.

Adult↗
PubMed1996

Disease-specific survival and locoregional control in tonsillar carcinoma.

In a nationwide survey on oropharyngeal carcinoma in the Netherlands (1986-1990), 380 patients with a tonsillar carcinoma were retrospectively studied. The records of 268 (71%) men and 112 (29%) women with a median age of 59 yr (range 31-91), who had squamous cell carcinoma (272 patients, 98%) or undifferentiated carcinoma (8 patients, 2%) were reviewed with respect to treatment, disease-specific survival and locoregional control. Distribution by stage according to the UICC'92 system was: 27 patients (7%) stage I, 59 (15%) stage II, 99 (26%) stage III, 182 (48%) stage IV and 13 patients (3%) unknown stage. Using a previously reported revised staging system the following distribution was obtained: 118 patients (31%) stage I, 120 (31%) stage II, 67 (18%) stage III, 54 (14%) stage IV and 21 patients (6%) with an unknown stage. Treatment consisted of radiotherapy alone in 231 patients (61%), surgery and radiotherapy in 101 (27%), surgery alone in 30 (8%), chemotherapy in 5 (2%) and 13 patients (3%) did not receive any treatment. At 5-yr the overall survival was 32%, the disease-specific survival 42% and the locoregional control 61%. In patients treated with radiotherapy alone the disease-specific survival was 39%, for surgery and radiotherapy 53% and for surgery alone 83%. The disease-specific survival according to UICC'92 stage was 71% in stage I, 59% in II, 50% in III and 32% in stage IV (P < 0.0001). In the revised staging the survival figures were 63% in stage I, 43% in II, 31% in III and 9% in IV (P < 0.0001). The two staging systems appeared to be comparable in prognostic discrimination; the clinical relevance of the revised stage might, however, be slightly superior to the UICC'92 version. The difference in results after radiotherapy alone and surgery + radiotherapy remained significant, also after adjusting for stage (P < 0.0001).

Carcinoma↗
PubMed1996

Regional metastasis in head and neck squamous cell carcinoma: revised value of US with US-guided FNAB.

PURPOSE: To verify the acclaimed accuracy of ultrasound (US) combined with US-guided fine-needle aspiration biopsy (FNAB) in the detection of lymph node metastasis in the neck and to evaluate the interobserver variability. MATERIALS AND METHODS: In a prospective, multicenter study of 185 patients with head and neck squamous cell carcinoma, US (n=238 neck sides) with US-guided FNAB (n=178 neck sides) was used for evaluation of the lymph node status of the neck. Findings were correlated with those of histopathologic examination in 238 neck sides. RESULTS: US with US-guided FNAB had a sensitivity of 77% and a specificity of 100%. Nineteen of 178 aspirations were nondiagnostic. There were no significant differences between the four participating hospitals or the individual sonologists (P>.05). CONCLUSION: Sensitivity of US with US-guided FNAB was slightly lower compared with previous reports. Specificity was similar to previous reports. Interobserver variability appeared to be low. The validity of US with US-guided FNAB is high and warrants widespread use of the procedure for evaluation of the neck.

Adult↗
PubMed1996

The Groningen, Nijdam and Provox voice prostheses: a prospective clinical comparison based on 845 replacements.

The Groningen, Nijdam and Provox voice prostheses (VP) are all low-pressure, indwelling voice prostheses. Although there are differences concerning the valve mechanism, they have a similar design and are therefore interchangeable. In a prospective study, 845 consecutive replacements were evaluated in 158 patients. Average device lifetime differed significantly from 13 weeks for the Provox VP and 15.8 weeks for the Groningen VP, to 19 weeks for the Nijdam device. Leakage through or around a voice prosthesis was the main replacement indication. Leakage occurred significantly more often with the Provox VP (80.2%) than with the Groningen VP (58.8%) or the Nijdam VP (55%). Increased airflow resistance as a replacement indication occurred significantly more often with the Groningen VP (45.4%) and the Nijdam VP (45.9%) than with the Provox VP (22.7%). Complications during the replacement procedure were rare and usually mild. Replacement was usually an easy outpatient procedure; general anaesthesia was only necessary in 3.0% of 845 replacements, without any significant difference between the three devices. Granulation tissue and hypertrophic scar tissue formation were the most frequent local complications. They occurred in less than 10% of our patients but were significantly more common in patients with a Nijdam VP.

Airway Resistance↗
PubMed1996

Cytokeratin and vimentin expression in normal epithelium and benign lesions of the vocal cords.

The expression of cytokeratins and vimentin was studied immunohistochemically in normal epithelium and 12 benign lesions of the vocal cord with the use of a broad panel of monoclonal antibodies against cytokeratins and vimentin. Histology showed that the various lesions contained hyperkeratotic, hyperplastic and atrophic epithelium, irrespective of their clinical appearance. Especially the Ck profile of the (hyper)keratotic lesions was changed in comparison with the native epithelium. Increased expression of the keratinization marker Ck 10 was associated with decreased expression of the stratification markers Cks 4 and 13. Expression of the basal cell marker Ck 14 and hyperproliferation-associated Cks 16 and 17 was increased in all the benign lesions, except in atrophic epithelium. These expression patterns differ from those observed in malignant epithelial lesions. The latter show a marked expression of simple cell Cks and vimentin and more pronounced expression of hyperproliferation-associated markers than the benign lesions.

Antibodies, Monoclonal↗
PubMed1996

The Nijdam voice prosthesis: a self-retaining valveless voice prosthesis for vocal rehabilitation after total laryngectomy.

Voice prosthesis-assisted speech rehabilitation after total laryngectomy has proven to be successful in the majority of patients and exceeds the results of traditional oesophageal speech. Nevertheless 10-30% failure rates are still reported. In part this is due to prosthesis-related problems, in particular ingrowth of Candida species in the valve-bearing parts of the devices. A new indwelling, low-resistance and valveless voice prosthesis is described; the Nijdam voice prosthesis. The device has an average device lifetime of 19 weeks which appears to be superior to other indwelling voice prostheses. Replacement indications mainly comprise leakage or increased airflow resistance. Most frequent local complications are granulation tissue and hypertrophic scar tissue formation. These occur in 12% of the patients and can easily be treated. Replacement is a simple outpatient procedure. The prosthesis is interchangeable with other types of indwelling voice prosthesis.

Equipment Design↗