Repair of the injured facial nerve.
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Anastomosis, Surgical↗
Biomedical subjects
J Marais
Publications and source records attributed to J Marais.
Determination of glomerular filtration rate with radionuclide renography and direct urinary activity quantitation.
OBJECTIVE: The direct urinary activity quantitation method is quick (approximately 40 minutes), requires only a single blood sample, is performed as part of standard renal scanning and shows high accuracy compared with 24-hour creatinine clearance. The purpose was to evaluate the practical application and accuracy of this technique at our clinic. DESIGN: Direct urinary activity quantitation was done in patients scheduled for routine radionuclide renography and compared to standard multiple-blood-sample techniques by means of Cr-51-EDTA and Tc-99m-DTPA. SETTING: Academic Medical Complex, Department of Nuclear Medicine, Universitas Hospital, Bloemfontein. PARTICIPANTS: Fifteen patients scheduled for routine radionuclide renography (glomerular filtration rate (GFR) determination) were voluntarily enrolled in the study. The GFRs of selected patients varied over a wide range. Possible obstructive uropathy was excluded. MAIN OUTCOME MEASURES: GFRs obtained by the direct urinary method were compared with GFRs determined by multisample Cr-51-EDTA and Tc-99m DTPA. RESULTS: GFRs from the direct urinary method compared with multisample Tc-99m-DTPA showed differences from -19.85 to 22.95 ml/min with a mean of 0.2 (+/- 12.25) ml/min (r = 0.93). When compared with multisample Cr-51 EDTA, differences ranged from -34.35 to 21.05 ml/min with a mean of -4.25 (+/- 16.08) ml/min (r = 0.90). CONCLUSION: The direct urinary activity technique is CONCLUSION: The direct urinary activity technique is easily applied and highly accurate compared with previous standardised multisample radionuclide techniques for determination of GFR.
Adolescent↗
Nasoantral window assessment by acoustic rhinometry.
Twenty-five patients who had each had inferior meatal antrostomies performed were endoscopically examined and assessed with acoustic rhinometry six weeks and six months after surgery. No significant increase in nasal cross-sectional area could be demonstrated at the site of the antrostomy in the post-operative cases, although the nasoantral window was found to be patent in 44 of the 50 nasal cavities.
Acoustics↗
Minimal cross-sectional areas, nasal peak flow and patients' satisfaction in septoplasty and inferior turbinectomy.
Changes in minimal cross-sectional areas, measured by acoustic rhinometry as well as nasal peak flow fractions and linear analogue patients' satisfaction scores, were measured in two groups of eight patients each, undergoing septoplasty alone and septoplasty combined with trimming of the inferior turbinates, respectively. Patients who had both procedures performed showed the greatest increase in both minimal cross-sectional areas and peak flow fractions, and both of these parameters were closely correlated with patients' satisfaction, whether the patient was satisfied or not. Pre-operative nasal obstruction was worse in the dual-procedure group, but post-operative satisfaction was significantly greater in these patients. Both acoustic rhinometry and nasal peak flow fractions can be recommended as accurate and easy to perform pre-operative measurements in patients undergoing surgery for nasal obstruction.
Adolescent↗
Secretomotor rhinopathy after Le Fort I maxillary osteotomy. Case report.
Severe secretomotor (vasomotor) rhinopathy is a very uncommon nasal condition which is believed to result from marked autonomic neural imbalance to the nasal and lacrimal glands. It has not, to our knowledge, been reported after trauma or elective surgery. A patient is described who developed this condition after a Le Fort maxillary osteotomy. The clinical difficulties of establishing this diagnosis are highlighted, and contemporary management options are discussed.
Adult↗
Throat pain and pharyngeal packing: a controlled randomized double-blind comparison between gauze and tampons.
In order to determine whether patients having pharyngeal packing experience more or less post-operative throat pain when tampons were used, 80 patients were randomized into two groups to receive either gauze or tampon pharyngeal packing. A third control group of 40 patients were intubated but did not have any throat packs. Post-operative throat pain was subjectively rated at both 6 hours and at 24 hours by an independent observer. Thirty-eight per cent of patients had moderate or severe throat pain in the gauze group, whilst in the tampon and control groups these amounted to only 15% and 1% respectively. A significantly higher proportion of patients also had a moderate or severe sore throat at 24 hours in the former group. Intubation alone resulted in a sore throat post-operatively in 50% of patients, but 85% of those had a mild sore throat only. No differences in pain ratings in any group could be shown between men or women or between age groupings. Endotracheal intubation often causes post-operative throat pain which is exacerbated by the use of pharyngeal packing. The results presented suggest that tampons are a safe, effective alternative to gauze and result in less severe post-operative throat pain.
Double-Blind Method↗
Air-weapon crimes and accidents: a source of preventable injury.
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Accidents↗
A preliminary comparison of the effects of halothane and isoflurane on nasal mucosal blood flow.
The differing effects of halothane and isoflurane on nasal mucosal blood-flow was investigated by means of laser-doppler flowmetry in a total of fourteen patients who received one of these inhalational agents during anaesthesia. A trend towards lower nasal flux was seen in the halothane group but, due to insufficient numbers, significance could not be demonstrated. These changes in flux appeared not to be related to the falls in perfusion pressure which were seen in both groups of patients and were thought to be due to locally vasoactive effects.
Adult↗
Otolaryngological indicator operations: one year's experience.
One year's experience of otolaryngological indicator operations is presented. Of 59 myringoplasties, 47 (79%) were successful; trainees performed 44 (74%) of the procedures. Seventy patients undergoing septal surgery reported significant improvements in nasal obstruction (P < 0.001), catarrh and facial pain (P < 0.005). Seventeen laryngectomies were performed for stage III and IV disease. The median operative time of 3.1 h rose to 5.1 h with a concomitant neck dissection. Eleven complications ensued, and the median stay for an uncomplicated laryngectomy was 16 days and 30 days following complications. Forty-one parotidectomies, 19 submandibular gland excisions and 10 ductal procedures were performed with 5 wound complications and 5 minor temporary facial nerve weaknesses. We have established a baseline for comparison of our practice with others and concluded that septal surgery gives good symptomatic relief, trainees perform reasonable numbers of myringoplasties, and improvements remain to be made in our outpatient septal surgery data collection.
Adolescent↗
Solitary plasmacytoma of the skull base.
Plasmacytomas involving the skull base are rare lesions that may be well advanced by the time of diagnosis. Because of their anatomic site they may produce a variety of signs and symptoms, some of which may be vague, often resulting in delays in presentation and in appropriate investigations. We present such a patient, discuss the diagnosis and management, and give a review of the literature.
Diplopia↗
Cochleotoxicity due to Mianserin hydrochloride.
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Adult↗
Comparison of cocaine alone or with adrenaline on nasal mucosal blood flow.
Cocaine is commonly used in ENT practice for its vasoconstrictor and anaesthetic properties. It is sometimes combined with adrenaline. The laser Doppler Flowmeter was used to compare the effect of 5 per cent cocaine alone or with adrenaline (1 in 1,000) on nasal mucosal blood flow. The results show an average fall in blood flow of 76.7 per cent for cocaine with adrenaline, compared to 61.2 per cent with cocaine alone. The difference is significant (P less than 0.05). The time taken for the blood flow to fall was an average of 131 s and 160 s respectively. These differences are not significant.
Adult↗
The effect of ice packs upon nasal mucosal blood flow.
The effect on nasal mucosal blood flow of ice packs on the forehead and ice packs within the mouth was investigated in 16 healthy subjects. The laser Doppler flowmeter was used to record changes in blood flow to the inferior turbinate, as measured by change in the flux. Ice packs within the mouth produced a significant decrease in nasal mucosal blood flow (p less than 0.05). The average fall was 23% (SEM 5.9) compared with the control measurements. No significant change was recorded following the application of ice packs to the forehead. The results of this study question the scientific rationale behind the use of forehead ice packs in clinical practice.
Adult↗
Comparative mucosal microvasculature of the mammalian stomach.
The comparative morphology of the gastric mucosal microvasculature was investigated using the corrosion casting technique. The vascular pattern consisted of a hexagonally arranged capillary plexus surrounding the gastric glands and terminating in venules running perpendicular to the mucosal axis. Vessels of the pyloric antrum demonstrated an acute angle between capillaries and venules, whereas vessels of the gastroduodenal junction changed from a honeycomb pattern to a leaf-like arrangement.
Animals↗
Peripheral vascularization of the dermal laminae of the equine hoof.
The vascular architecture of the dermal laminae was studied by scanning electron microscopy of vascular corrosion casts. Ultrastructurally, the laminar vasculature consisted of arterioles, capillaries, venules and veins, arranged in a sheet-like network. Through the laminae, arterioles ran parallel to the solar surface and branched at two levels to form a continuous arteriolar arcade, parallel to the hoof wall. Capillaries originating from these arcades formed hairpin loops joining the marginal vein prior to forming an axially situated venous network. Additional capillaries were also given off by the arterioles, forming an abaxially arranged capillary plexus.
Animals↗
Microvasculature of the foal metacarpus.
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Animals↗
Microvasculature of the feline stomach.
The feline gastric microvasculature was studied by corrosion of the injected vascular bed, which allowed evaluation of the vascular pattern of the different tunics. The serosal pattern consisted of numerous interconnected capillary vessels, forming a delicate network. Submucosal arteries supplied the muscular tunic through numerous anastomosing vessels that followed the direction of the smooth muscle fibers. The entire mucosal tunic was supplied by arterioles derived from the submucosal plexus; these gave rise to capillaries that surrounded the gastric glands and terminated in a diffuse, anastomosing subepithelial capillary network. Venules coursed through the mucosa in a perpendicular manner, forming submucosal veins.
Animals↗
Microcirculation of the coronary band of the equine hoof.
Scanning-electron-microscopic examination of corrosion casts was used to investigate the microcirculation of the coronary border of the equine hoof. Numerous peg-shaped capillary plexuses derived from arterioles extended distally from the dorsal branches of the digital arteries parallel to the hoof wall. The plexuses varied in length and consisted of a fine network of interconnected capillaries that converged to join a centrally situated venule. These centrally situated venules within the papillary plexuses gave rise to a vast venous plexus deep to the coronary band.
Animals↗