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Biomedical subjects

J J Shea

Publications and source records attributed to J J Shea.

142 records · Page 8Linked to original sources
PubMedDate not supplied

Enchondral cartilage rests collagen-induced autoimmunity: a possible pathogenetic mechanism of otosclerosis.

Collagen autoimmunity has been suggested as one etiologic mechanism to otosclerosis. Although substantial studies relating this disease to collagen autoimmunity have been reported, a basic understanding of the pathogenic mechanism involved is lacking. Some otosclerosis patients have a high level of antibody to type II collagen. In addition, complement and antibody were deposited in the stapes from otosclerosis patients. Furthermore, the otic capsule and stapes have been found to contain type II collagen by immunohistologic studies and biochemical analysis. Otospongiosis-like lesions have also been produced in rats by immunizing them with type II collagen. This finding led us to postulate a hypothesis of an autoimmunity to type II collagen as an etiopathogenesis of this illness. Our initial hypothesis has been updated to incorporate new findings in the field of cell biology. The role of interleukin 1, osteoclasts, osteoblasts, bone resorption, and other factors such as minor collagens, calcitonin, vitamin D, parathyroid hormone, collagenase, and prostaglandins are incorporated in this updated hypothesis.

Animals↗
PubMedDate not supplied

Stapedectomy - long-term report.

The long-term results with large fenestra stapedectomy with vein graft and Teflon piston are compared with results with the small fenestra stapedectomy with teflon piston directly into the vestibule. There were 1,943 operations in the former group and 2,155 in the latter when compared in 1970. One hundred consecutive patients from the beginning of each group with follow-up to present were compared. Results were generally the same with no great change in 15 and 20 years as compared to those at 5 years. The complication of perilymph fistula was caused by creating an opening in the footplate much larger than the prosthesis and was eliminated by interposing a living oval window seal if the opening was much larger than the prosthesis and a flap of lining membrane from the promontory when it was not. Other factors that influence a good result are discussed, including the type and the diameter of the piston used, the type of living oval window seal and the method of attachment to the incus. The small fenestra operation was found to be superior to the large, not only for the hearing gain achieved, but the case of performance and the freedom from complications due to migration of the prosthesis and/or the oval window seal. At present we have done about all that can be done for the conductive components. What remains is the sensorineural component which our studies indicate may be due to an autoimmune response.

Cochlear Implants↗
PubMedDate not supplied

The supratubal recess in cholesteatoma surgery.

Acquired attic retraction cholesteatoma involving the anterior epitympanum is infrequently encountered and even less frequently discussed in the literature. The lack of cholesteatoma in this region is mostly due to a ridge of bone extending inferiorly from the tegmen tympani, just anterior to the cochleariform process. The term "cog" was coined and popularized to refer to this bony ridge. Erosion of the cog by cholesteatoma matrix allows extension of cholesteatoma into the supratubal recess. A number of vital structures including the facial nerve, cochlea, middle fossa dura, and internal carotid artery are intimately related to the supratubal recess. A clear three-dimensional understanding of these structures is necessary to remove disease safely from this area regardless of whether the posterior canal wall is left up or taken down. We present a series of dissection illustrations of the supratubal recess and discuss the possible routes of cholesteatoma extension. A series of patients with varying degrees of involvement of the supratubal recess and related structures is presented, and the pitfalls and management of cholesteatoma in this area are discussed.

Adolescent↗
PubMedDate not supplied

Treatment of sudden hearing loss with diatrizoate meglumine (Hypaque).

Between March and November 1976, 30 patients with sudden hearing loss (SHL) were treated with vasodilators and diatrizoate meglumine (Hypaque). Nine (30%) of the patients had a good response, 7 (23%) had a moderate response, and 14 (47%) had no response to treatment. Most of the patients who responded were treated within the first month and had no vertigo associated on their onset of SHL. Their hearing loss was also less than 90 dB for any of the frequencies tested. Using the criteria of SHL of less than one month's duration, no vertigo associated with onset, and a loss less than 90 dB, seven patients were treated with vasodilator plus Hypaque during the period between January and August 1977. Six (86%) of the seven patients had return of serviceable hearing.

Adult↗
PubMedDate not supplied

Treatment of tinnitus with tocainide hydrochloride.

Intravenous (IV) injection of lidocaine was used in patients with tinnitus for combined treatment with oral anticonvulsants carbamazepine (Tegretol) and primidone (Mysoline). In most cases, the high complication rate with these drugs precluded their long-term use. Tocainide hydrochloride (HCl), a primary amine analog of lidocaine, can be taken orally and was evaluated for the use in the treatment of tinnitus. A double-blind study in which one group received 200 mg tocainide HCl four times a day and one group received a placebo revealed no significant differences in tinnitus relief between the two groups. A single-blind study in which 600 mg tocainide HCl four times a day was administered showed 80% to 98% tinnitus relief in five of the six patients who tolerated the drug. Tocainide HCl treatment of tinnitus is promising.

Adult↗