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Biomedical subjects

M May

Publications and source records attributed to M May.

At least 235 records · Page 13Linked to original sources
PubMed1978

Acoustic neurinoma in a child: a case study.

This case study reports the audiological and surgical findings for a nine-year-old boy with an acoustic neurinoma. He was suspected of having a right ear retrocochlear lesion following three audiological evaluations in four years. The initial evaluation indicated normal hearing ability. The second and third evaluations indicated a progressive right ear hearing loss, characterized by reduced word discrimination ability and absent acoustic reflexes. The patient had a 5 cm acoustic neurinoma compressing and adherent to the brain stem. The tumor was successfully removed following three operations employing an otoneurological and neurosurgical team approach through a retromastoid exposure. Postoperative recovery was uneventful. Facial nerve function was not disturbed, however attempts to preserve hearing on the involved side were not successful.

Child↗
PubMed1978

Gelfoam paste injection for vocal cord paralysis: temporary rehabilitation of glottic incompetence.

Vocal cord paralysis frequently results in open glottic incompetence with aspiration, an ineffective cough, and poor voice production. Glottic competence can be restored temporarily be injecting the true vocal cord with Gelfoam paste. This clinical use of Gelfoam for temporary rehabilitation is indicated in : 1) situations in which paralysis may be temporary, 2) patients for whom an open operative procedure must be delayed, and 3) circumstances in which it is desirable to determine the effect of vocal cord injection prior to placement of nonabsorbable material. The injection of Gelfoam paste results in minimal tissue reaction. Absorption is gradual over a period of six to ten weeks, allowing time for some glottic compensation. The injection may be repeated without adverse effects until the paralysis resolves or intervention of a permanent nature is indicated.

Gelatin Sponge, Absorbable↗
PubMed1978

Facial palsy: interpretation of neurologic findings.

A review of the otoneurologic findings in 500 patients with facial paralysis revealed their importance for diagnosis, prognosis, and understanding the pathophysiology of Bell's palsy. Diagnosis. The presence of simultaneous bilateral palsy, facial paralysis associated with lateral rectus palsy, slowly progressive facial weakness with or without hyperkinesis, and facial paralysis that showed no recovery after six months excluded Bell's palsy from the diagnosis. Ipsilateral recurrent palsies were another indication to suspect an underlying cause, since a tumor of the facial nerve caused the paralysis in 30% of the patients with this finding. Signs such as intact forehead movement, alterations in facial sensation, and corneal hypesthesia--although often associated with lesions in the cerebral cortex, cerebellopontine angle, or internal auditory canal--were also found in patients with Bell's palsy. Prognosis. A spontaneous complete recovery following Bell's palsy occurs in about 70% of the patients; but in the presence of a dry eye or dysacousis, the prognosis for a complete recovery drops 10 and 25%, respectively. Pathophysiology. It is proposed that the wide range of neurologic findings associated with Bell's palsy is due to a viral polyneuropathy. This is a disorder that primarily involves sensory nerves, and the facial motor deficit results from involvement of the sensory fibers carried with the facial nerve within the fallopian canal.

Cornea↗
PubMed1978

Resistance of SJL mice to immunosuppression by antibodies.

Immunosuppressive antisera that specifically inhibit induction of tuberculin-type delayed hypersensitivity in mice to the antigens chicken conalbumin and methylated human serum albumin were compared for activity in CF-1, CAF1, and SJL mice. These contrasensitizing antisera were effective in CF-1 and CAF1 mice of various ages. But in SJL mice they were ineffective if the animals were older than 8 weeks and were only moderately effective if the animals were younger. The antibodies of these antisera responsible for specific immunosuppression could be absorbed onto adherent peritoneal exudate cells taken from DAF1 but not SJL mice. They could be eluted from the CAF1 cells at 56 degrees C. These results and other data that are discussed suggest that SJL resistance to immunosuppression by contrasensitizing antibodies is related to a macrophage abnormality. The results also help explain earlier findings that SJL mice are unusually easy to sensitize and unusually resistant to tolerogenesis. This strain of mice should be especially useful for studying the mechanisms of afferent immunosuppression in immunologic enhancement-like forms of tolerance.

Aging↗
PubMed1977

Nasal obstruction from facial palsy.

Nasal obstruction due to a collapsed nasal ala occurred in 2% of our patients with facial paralysis. The denervated dilator nasal muscles allow the ala on the paralyzed side to collapse leading to increased resistance to inspiration. This symptom was further aggravated by preexisting external and nasoseptal obstructing deformities. Nasal obstruction from facial paralysis was corrected with septorhinoplasty techniques in three patients and by lateralization of the ala with a facial sling in another.

Facial Nerve↗
PubMed1977

Carcinogenicity of fibrous glass: pleural response in the rat in relation to fiber dimension.

Seventeen fibrous glasses of diverse type or dimensional distribution induced different incidences of malignant mesenchymal neoplasms when implanted in the pleurae of female Osborne-Mendel rats for periods of more than 1 year. Neoplastic response correlated well with the dimensional distribution of fibers. Fibers less than or equal to 1.5 mu in diameter and greater than 8 mu in length yielded the highest probability of pleural sarcomas, and probability trends suggested that pleural sarcoma incidence increased with increasing lengths of fibers with diameters of less than 1.5 mu, Morphologic observations indicated that fibers less than or equal to 8 mu in length were inactivated by phagocytosis. In fibers greater than 8 mu in length, the correlation of carcinogenicity witth increasing length was difficult to explain. Since neoplastic response to a variety of types of durable fibers, particularly asbestos fibers, was similar, our experiments reinforce the idea that the carcinogenicity of fibers depends on dimension and durability rather than physicochemical properties and emphasize that all respirable fibers be viewed with caution.

Animals↗
PubMed1977

Nasofrontal-ethmoidal injuries.

Our experiences in managing 17 patients with nasofrontal-ethmoidal injuries is reviewed. The treatment of frontal injuries, cerebrospinal fluid leaks, and pseudohypertelorism is discussed.

Adolescent↗
PubMed1976

Natural history of bell's palsy: the salivary flow test and other prognostic indicators.

Fifty-one patients with Bell's palsy were evaluated within two days of onset and followed for six months without surgical intervention or effective medical treatment in order to observe the natural history of the disease. Sixty-three percent had a complete return while 37 percent had incomplete return. Age, the presence of pain, and taste alterations had no prognostic value. The progression of the palsy, response to maximal stimulation and salivary flow testing were approximately 80 percent accurate in predicting outcome. The salivary flow test was the most useful prognostic indicator since salivary flow became reduced within two days of onset in the patients likely to develop denervation while the other tests did not become altered until 3 to 14 days after onset. In patients with Bell's palsy, the salivation test seems to be the only method capable of predicting denervation before it begins; therefore, it should be ideal for selecting patients for appropriate treatment.

Adult↗
PubMed1976

The use of steroids in Bell's palsy: a prospective controlled study.

A prospective, controlled, double-blind study was designed to evaluate the effect of steroid treatment on the natural history of Bell's palsy. Fifty-one patients were included in the study between 1972 and 1974. The patients were evaluated and started on treatment within two days of onset of Bell's palsy and followed for six months. Treatment was given in randomized double-blind fashion and consisted of either vitamins or a total of 410 mg of prednisone plus vitamins in descending doses over 10 days. The recovery of facial motor function was determined by three physicians who had no knowledge of the treatment received by the patients. They examined photographs of the patients taken six months after onset of paralysis in eight positions of facial function and categorized them as to complete fair, or poor recovery of facial function. These results of this evaluation were submitted to the biostatistician who broke the treatment code. The results of this study demonstrate no statistically significant beneficial effect of steroid therapy upon recovery from Bell's palsy. Factors considered included the patients' age, sex, the presence of pain, ageusia, hyperacusis, diabetes, hypertension, the progression and degree of palsy, the results of nerve excitability and salivary flow tests, and the time at which recovery was first noted or became complete. Bell's palsy remains without a proven efficacious treatment.

Adult↗
PubMed1976

Red chorda tympani nerve in Herpes Zoster oticus.

A red chorda tympani nerve was previously reported as a finding limited to patients with Bell's palsy. This is a report of red chorda tympani nerve observed in 3 of 10 patients with Herpes Zoster oticus in whom the chorda tympani was visible. It is speculated that the red discoloration is due to a viral inflammatory process and, therefore, when this sign is present in a patient with idiopathic peripheral facial paralysis, a viral neuropathy should be suspected.

Chorda Tympani Nerve↗
PubMed1976

Penetrating wounds of the neck in civilians.

The management of penetrating neck wounds can be approached in a logical manner. The priorities in saving life are to ensure an airway and to maintain cardiocerebral perfusion. The initial evaluation and heroic life saving measure often rest upon the most inexperienced person, the house officer, who may be handicapped by the lack of experienced support personnel and sophisticated diagnostic and therapeutic equipment required for total management of these most challenging problems. It is hoped that this presentation provides the necessary guidelines for meeting this challenge. The pathophysiology, diagnostic approaches, and therapeutic measures are reviewed in the order in which they would be handled when the patient is brought to the emergency room, taken for special radiographic studies, and then subjected to surgical exploration. Special emphasis is placed upon diagnosis and management of traumatic arterial injuries, since these are the most challenging and most difficult to manage, as well as the most common causes of death following cervical penetrating wounds. Late vascular defects and associated injuries to the lymphatic, neural, airway, and foodway systems complete the discussion.

Angiography↗
PubMed1976

Neck masses in children: diagnosis and treatment.

Neck masses in children most often represent benign lymphadenitis due to infection. The involved lymph nodes are usually small, shotty, diffusely distributed, and superficial. They may be tender and associated with an acute upper respiratory infection or with chronic infection of the tonsils and adenoids. Enlargement of the jugulodigastric node is most often associated with tonsillitis, and the spinal accessory group of nodes with adenoiditis. Acute viral diseases may be associated with lymphadenopathy; mononucleosis is the most striking example. The differential diagnosis must include deep neck-space abscesses, congenital cysts, and benign as well as malignant neoplasms. A diagnosis can be derived from a consideration of the history and physical findings, the age of the patient, and the location, size, and consistency of the mass. A careful otolaryngologic exam--including the nasopharynx, a chest radiograph, and appropriate blood studies--should be routine. When malignancy is suspected, a biopsy of the mass is indicated.

Abscess↗