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Biomedical subjects

M Harell

Publications and source records attributed to M Harell.

At least 19 recordsLinked to original sources
PubMed1994

Non-explosive blast injury of the ear.

Non-explosive blast injury of the ear refers to the otological trauma caused by a blow to the ear that seals the external auditory meatus. It results in a sudden increase of air pressure within the ear canal that strikes the tympanic membrane. The present study portrays the various aspects of middle and inner ear damage in 91 patients resulting from an assault we entitled a 'non-explosive blast injury' to the ear. Sixty cases were caused by a slap or a fist, 13 patients suffered sport accidents, mostly in ball games, and 18 patients were injured during swimming and water sports activities. The common symptoms were hearing loss, earache, tinnitus, vertigo and otorrhoea. All 91 patients presented with acute perforations of their eardrums. The mean conductive hearing loss was 11.2 dB. A high tone sensorineural hearing loss was detected in only 20 per cent of the patients. A spontaneous closure of the perforation with a conservative management approach was observed in 94.8 per cent of the patients. Healing of the perforation was always associated with closure of the air-bone gap, while the results of the sensorineural hearing loss recovery were less favourable.

Adolescent↗
PubMed1990

Typing of Pseudomonas aeruginosa ear infections related to outcome of treatment.

Of 142 patients with Pseudomonas aeruginosa (PSA) ear infections, 88 (62 per cent) had chronic otitis media and 54 (38 per cent) external otitis. Following serotyping and pyocin typing of their bacteria, and relating the type to outcome, patients could be divided into three groups: (1) 120 patients who had no recurrence with isolation of only one PSA strain, (2) 13 patients who had recurrent infections and in whom the same PSA strain was isolated in repeated cultures, and (3) nine patients who had recurrent disease, but who had a change in their PSA strains. Most of the PSA strains isolated from patients in groups (1) and (2) were stable to pyocin, and resistent to gentamicin. Patients in the first group were all cured initially by medical management. Of the nine patients in group (3) who had a different serotype on repeated cultures, medical treatment was successful in eight (89 per cent), but of the 13 patients in group (2) who had the same Pseudomonas aeruginosa serotype cultured, medical therapy failed in six (46 per cent) and mastoid surgery was required. Serotyping of Pseudomonas aeruginosa otitis may be helpful in predicting the type of management in patients who have recurrent infections.

Adolescent↗
PubMed1990

Nasal transit time in normal subjects and pathologic conditions.

A radionuclide method using Tc-99m was used to measure the nasal transit time in 43 patients, including normal smokers and nonsmokers and those with various nasal or paranasal pathologies. The technique described was slightly modified from that already in use in various centers in order to enable more precise measurement. Measurement of transit time of a droplet of Tc-99m phytate on the nasal mucosa appears to differentiate patients with immotile cilia syndrome from normal controls. A positive test, however, can occur also in smokers and in patients with other nasal and paranasal problems. The test is reproducible, cost-effective, and noninvasive, enabling the clinician to make a more appropriate selection of patients needing further investigation.

Adolescent↗
PubMed1990

[Epiglottitis in adults].

Acute epiglottitis in the child is an emergency, well known to pediatricians, that requires rapid diagnosis and treatment. Aggressive treatment in recent years has markedly decreased mortality (17). Acute epiglottitis in adults has been thought to be rare, but lately numerous studies have shown an increase in the disease. We present 19 older patients, aged 13-72 (mean 44.7 years), with acute epiglottitis. A most important finding was the relatively long time from onset of symptoms until diagnosis, averaging 2.5 days. All the blood and throat cultures were negative, except for a single throat culture which yielded Pseudomonas aeruginosa. The most common presenting symptoms were severe sore-throat and dysphagia; half presented with some respiratory distress. Diagnosis was usually made on indirect laryngoscopy, but lateral X-ray of the soft tissues of the neck was found to be highly reliable. Treatment was usually conservative, including antibiotics, rehydration and steroids to alleviate edema. All patients were under strict observation for the first 48 hours, but only 1 required intubation. There were no deaths.

Acute Disease↗
PubMed1989

[Well-differentiated thyroid carcinoma].

18 cases of well-differentiated thyroid carcinoma are described, of which 5 were papillary or mixed carcinomas and 3 were follicular. In 12 of 14 in whom radio-isotope scanning was performed, a cold or indeterminate nodule was found. Fine needle aspiration was positive and concordant with the operative histological findings in half the cases examined. In 4 hemithyroidectomy was performed, and in 14 total thyroidectomy. Thyroid remnants were found on scanning in all of the 14. These remnants were ablated with radioactive iodine (131I). An ablative dose of 30 millicurie was insufficient in almost all cases and a second dose was required. 3 cases with regional spread of the tumor were reoperated, and large ablative doses of 131I(150-170 mCi) were given. In 14 cases clinical remission was achieved. Followup included ultrasonography and total body 131I scans.

Adenocarcinoma↗
PubMed1988

Acute acoustic trauma: dynamics of hearing loss following cessation of exposure.

The natural history of individuals with acute acoustic trauma who ceased to be exposed to impact noise was examined. Retrospective follow-up was carried out for 4 years on patients who were qualified as disabled following acoustic trauma with permanent threshold shift. Eight hundred forty-one individuals (1682 ears) were examined, of which 1514 ears with acoustic trauma were included in the study group; 150 individuals (300 ears) who continued to be exposed to impact noise even after discovery of acoustic trauma comprised the control group. In the latter, as long as exposure to gunfire continued, the severity of acoustic trauma increased. In the study group, during the first year after injury, changes were observed in hearing, whether improvement or deterioration; after this period, hearing loss appeared to be final. We suggest that, after 1 year following acute acoustic trauma, the associated hearing loss be considered as final, provided there is no further exposure to noise. This finding holds great importance from the medicolegal standpoint, an aspect that is unclear in the literature. It clarifies that beyond the period of 1 year after initial exposure, the pathologic process ceases (as long as there is no additional exposure to noise or gunfire). Further hearing deterioration beyond this period is not related to the initial acoustic trauma but rather to other factors.

Acute Disease↗
PubMed1987

Diffuse idiopathic skeletal hyperostosis with dysphagia (a review).

Dysphagia due to cervical osteophytes is not common. However, diffuse idiopathic skeletal hyperostosis (DISH) with cervical involvement which causes dysphagia is even rarer. The otolaryngologist is not generally familiar with this entity. The diagnosis can be made by plain cervical X-ray films, a barium swallowing esophagogram and or a CT scan of the neck. When doubt still exists, further extra-axial X-ray films can be helpful. Although most patients have been treated surgically, there may be a role for conservative therapy initially, as surgery in elderly DISH patients is often morbid and even fatal. A 79-year-old patient with DISH (Forestier's disease) is reported. Non-steroidal anti-inflammatory therapy was successfully implemented. DISH is compared with other disorders of the cervical spine which may cause dysphagia.

Aged↗
PubMed1986

Auditory brain stem responses in schizophrenic patients.

Auditory brain stem responses (ABR) were recorded from 20 schizophrenic patients, of whom ten were medicated and ten were unmedicated. A matched control group consisted of ten normal subjects. A statistically significant difference in the latencies of N3 and N5 recordings was found among the three groups. The results suggest that unmedicated schizophrenics have a delayed latency for peaks N3 and N5, and that medication (with neuroleptic drugs) shortens these delayed latencies back to the normal range.

Adult↗
PubMed1982

Toxic shock syndrome: otolaryngologic presentations.

Toxic shock syndrome is a recently discovered and widely publicized disease found to occur in young menstruating women and thought to be associated with the use of vaginal tampons. To this date, there has been no known report of a similar disease being caused by nasal or sinus packing. The following is a discussion of the toxic shock syndrome (TSS) and a presentation of two cases that demonstrated a striking similarity to that disease.

Adult↗
PubMed1978

Management of tinnitus aurium with lidocaine and carbamazepine.

At present there are two methods of management of tinnitus: one old, by masking with a noise generator, and one new, by biofeedback. Neither of these methods is convenient and neither gets at the heart of the problem. A third method, using intravenous lidocaine as a test and oral carbamazepine therapy, was developed in the Pain Clinic of the Auckland General Hospital in New Zealand. This paper will report our brief experience with these drugs in the management of tinnitus and other similar disorders. Twenty-seven patients with intractable tinnitus had a significant reduction from a test dose of intravenous lidocaine and were treated with oral carbamazepine. Of this group 1 patient (4%) had complete relief, 21 patients (78%) had partial relief, and 5 patients (18%) had no relief. Complications were few and not serious, and either disappeared spontaneously or when the carbamazepine was stopped. One patient with palatal myoclonus, refractory to all other forms of treatment, had complete relief on a small dose of carbamazepine. It may be that palatal myoclonus, hemifacial spasm, and other such clonic convulsive disorders will be amenable to the same treatment.

Administration, Oral↗
PubMed1978

Ventilation of the atelectatic ear.

The absorption of gas from the middle ear--mastoid air cell system causes an average pressure decrease of 5 cm water per hour. Interference with the normal opening of the Eustachian tube causes increased negative pressure build-up, which stops gas absorption from the middle ear. High carbon dioxide tension is associated with metaplastic changes of mucosal stem cells into mucus producing cells. Ventilation of the middle ear is necessary for removal of the negative pressure as well as of the excess carbon dioxide. The problems associated with longterm ventilation tubes are reviewed, and some future prospects of permanent ventilation tubes are discussed.

Biocompatible Materials↗