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Biomedical subjects

M Strome

Publications and source records attributed to M Strome.

At least 73 records · Page 4Linked to original sources
PubMed1984

Cryotherapy of subglottic hemangioma.

The natural history of the hemangioma is spontaneous regression; therefore, most lesions require no treatment. The large occlusive subglottic hemangioma which presents before the age of 6 months, however, may be life-threatening. Two infants with subglottic hemangiomas with complete upper airway obstruction were treated successfully with cryotherapy, after tracheostomy. In each case the cryoprobe was placed transbronchoscopically on the subglottic hemangioma at -80 degrees C. for 30 to 45 seconds, the freezing interval varying with the age of the patient. One infant is asymptomatic and has had the tracheostomy tube removed. The other infant, after successful cryosurgical treatment, died from an unrelated illness. The histopathology of the larynx 3 1/2 months after cryotherapy of the hemangioma showed tracheal reepithelialization, active regeneration of cartilage with maintenance of luminal diameter, minimal submucosal fibrosis, and minimal residual hemangioma. Cryotherapy for subglottic hemangiomas offers many advantages including hemostasis, controlled local surgical injury, subsequent rapid healing of tissues with minimal fibrosis, and preservation of lumen without stricture. Previous forms of therapy which have been supplanted include radiotherapy, injection of sclerosing substances, systemic steroids, and surgical excision. Carbon dioxide laser is an effective therapeutic modality that we reserve for selected smaller hemangiomatis lesions of the subglottic area.

Cryosurgery↗
PubMed1984

Osteosclerotic plasmacytoma of maxillary bone (orbital floor).

Plasma cell neoplasms have been classified as multiple myeloma, solitary plasmacytoma and extramedullary plasmacytoma. They are usually considered as osteolytic lesions of bone except for the rare occurrence of osteosclerotic lesions. This paper describes the first reported osteosclerotic plasmacytoma of the maxillary bone and orbital floor. The difficulties in establishing a diagnosis and the relationship to other plasma cell neoplasms are discussed. Osteosclerotic plasmacytomas are a rare variant of plasma cell tumors which usually produce osteolytic lesions rather than bony sclerosis. Sixty-eight patients with the osteosclerotic variant have appeared in the world literature, with an overall incidence of about 1 per cent in a large series of plasma cell neoplasms (Dreidger and Pruzanski, 1979). There have been only six previous cases of solitary osteosclerotic plasmacytomas reported (Morley and Schweiger, 1964; Roberts et al., 1974; Rodriguez et al. 1976; Rushton, 1965; Schneinker, 1938; Brigham Medical Review, 1961) involving spine, sternum, or rib. None have previously been reported in the head and neck area. Plasma cell tumors have been classified into multiple myeloma, solitary plasmacytomas of bone, and extramedullary plasmacytomas. Multiple myeloma is a disseminated plasma cell malignancy characterized by the production of homogeneous immunoglobulins (whole or fragments) which appear in the serum and urine. Plasma cell tumors can also occur as solitary plasmacytomas, usually in bone, but also in soft tissue. With time, most solitary plasmacytomas develop disseminated disease with all the characteristics of multiple myeloma (Wiltshaw, 1976). Extramedullary plasmacytomas arise in soft tissue rather than bone, and primarily occur in the head and neck region. Clinically, they remain localized and less frequently develop into disseminated myeloma.

Female↗
PubMed1984

Choanal atresia. Clinical considerations for management.

Taking cognizance of the embryology and newer diagnostic techniques, the transpalatal route is strongly recommended as the optimal surgical procedure for the management of choanal atresia. It should be performed as soon as general anesthesia can be safely administered. In selected instances, but particularly when a patient is at increased surgical risk, necessitating surgical brevity, the endonasal puncture technique should be considered as the initial procedure. Parents must be appraised of the potential for subsequent growth deficiencies, mental retardation, and crossbite.

Abnormalities, Multiple↗
PubMed1984

Pseudomonas rhinosinusitis.

Although rare in the otherwise healthy patient, pseudomonas rhinosinusitis is encountered most frequently in the immunocompromised host or severely traumatized patient. Intravenous antibiotic therapy in conjunction with aggressive surgical drainage is required. Two cases are documented that are typical of this philosophy. A third patient with isolated nasal involvement, because of multiple medical disabilities, was treated with local debridement and topical therapy alone and responded.

Female↗
PubMed1984

Interferon and natural killing of human lymphoma cell lines after induction of the Epstein Barr viral cycle by superinfection.

Interferon (IFN) production during natural killer (NK) cell assays with Raji, an EBV-carrying human lymphoma-derived cell line, was studied to determine whether IFN generated by effectors in vitro acted in target cell lysis. In 4-hr tests, Raji is insensitive to NK but becomes susceptible after superinfection with the P3HR-1 strain of EBV. IFN was not detectable by bioassay in supernatants from 4-hr assays, and the addition of antibody to IFN did not prevent the lysis of the superinfected Raji cells. In 18-hr tests the NK sensitivity of the superinfected Raji cells was markedly elevated, and a percent of the normal Raji cells was also killed. IFN alpha was found in supernatants from 18-hr tests. Antibody to IFN alpha markedly reduced the killing of superinfected Raji and slightly reduced cytotoxicity against control Raji in 18-hr tests. Taken together these results indicate that what is referred to as natural killing has IFN-related and IFN-nonrelated components.

Antibodies↗
PubMed1984

Bilateral congenital middle ear cholesteatomas.

Congenital middle ear cholesteatomas remain of interest because of their relative rarity and unknown origin. A 4-month-old child presenting with bilateral congenital middle ear cholesteatomas forms the basis for this report. The nature of the epithelial debris found suggests an external origin. An extended transcanal tympanotomy approach for removal, based upon an operative experience of 11 similar ears, will be discussed.

Child, Preschool↗
PubMed1983

Rehabilitative surgery for aspiration. A clinical analysis.

Operative intervention for refractory aspiration necessitates an understanding of its prognostic implications. The closure procedures most often performed are evaluated, comparing and rating technical difficulty, degree of closure, reversibility, and vocalization, both immediately and after reconstruction. The epiglottic over-sew was shown to have merit. Its distinctive features include the potential for postclosure phonation as well as the opportunity for sequential reversal. Both of these features make mastering the technique worthwhile.

Epiglottis↗
PubMed1983

Development of speech-audiometric materials for native Spanish-speaking adults.

The lack of valid and reliable Spanish speech audiometry materials constitutes an important clinical problem. Such tests necessitate the construction of appropriate materials. Analysis of English and Spanish literature on speech audiometry led to the identification of guidelines for new test materials in the Spanish language. Test lists were devised, recorded and used to evaluate 10 normal-hearing native Spanish-speaking subjects. The results obtained led to a final set of recorded lists. Boston College Auditory Test lists may be used successfully with Spanish-speaking patients. The current study should provide the impetus and sufficient guidelines upon which speech stimuli in other languages may be constructed.

Adult↗
PubMed1983

Self-stimulating growth factor production by B-cell lines derived from Burkitt's lymphomas and other lines transformed in vitro by Epstein-Barr virus.

Kinetics of cell growth of human B-lymphocyte lines derived from Burkitt's lymphomas and lines derived from the Epstein-Barr virus transformation of normal adult lymphocytes were studied. Cells seeded at high densities (5 X 10(4)/ml) grew in an exponential manner; those seeded at low densities (5 X 10(3) to 1 X 10(4) began to grow exponentially only after a lag period of 3 to 4 days. Transfer of stationary low-density cell populations into filtered media from growing high-density cultures (conditioned media) stimulated cell growth, as determined both by increased cell numbers and [3H]thymidine incorporation. Enhanced cell growth occurred in conditioned media at all cell seeding concentrations that grew in normal media. Furthermore, cultures seeded at very low cell concentrations that do not grow in normal media proliferated in conditioned media. Media from a series of B-cell lines tested with one exception were autostimulatory. Reciprocal cell transfer experiments showed that media from B-cell lines cross-stimulated cells in other B-cell lines. Media from the non-B-cell lines tested were not autostimulatory and did not stimulate growth of the B-cell lines, and conversely these non-B-cell lines were not growth enhanced by the conditioned media. Absorption of growth-enhancing media with preincubated cell lines seeded at low density removed the enhancing capacity. These results demonstrate that B-cell lines from Burkitt's lymphomas and B-cells transformed in vitro by Epstein-Barr virus produce absorbable growth-enhancing factor(s) that may be essential to the development of perpetual growth in culture.

Absorption↗
PubMed1983

Increased sensitivity to natural killing in Raji cells is due to effector recognition of molecules appearing on target cell membranes following EBV cycle induction.

Previous studies demonstrated that NK resistant Epstein-Barr virus (EBV) carrying human lymphoblastoid cell lines become sensitive to NK cell-mediated destruction following induction of the viral cycle by superinfection with the P3HR-1 substrain of EBV or chemicals. In the present report we analysed the cellular membrane changes that were related to the development of sensitivity to NK activity in Raji cells with metabolic inhibitors. NK sensitivity does not develop in P3HR-1 superinfected Raji cells that are cultured in the presence of the RNA synthesis inhibitor actinomycin D and drops to half the amount usually detected in superinfected cells that are grown with the protein synthesis inhibitor cyclohexamide. In experiments with cyclohexamide blocks removed after 24 h, the target cell sensitivity to NK returns to normal levels. Control Raji cells cultured with the same inhibitors for up to 72 h do not develop any sensitivity to NK cell activity. These findings suggest that the development of sensitivity to NK destruction in Raji cells following superinfection is due to the addition to the cell membrane of a virally promoted molecule(s) that requires active RNA and protein synthesis.

Burkitt Lymphoma↗
PubMed1982

Surgical update on nasal dermoids.

A one-stage surgical procedure describing the removal of the necessary nasal bones for complete eradication of nasal dermoids, with subsequent replacement of the intact bones, is discussed herein. This technique has proved to be invaluable in two patients who underwent this procedure. Extensive meticulous dissection often is necessary to extirpate this cystic lesion to prevent its recurrence. Extensive surgery, however, need not result in a notable cosmetic deformity that requires secondary restorative measures. Using this technique, replaced nasal bone segments effect immediate reconstruction. A 20-year review of the cases of nasal dermoids from the Children's Hospital Medical Center, Boston, also is presented.

Child, Preschool↗
PubMed1982

Air volumes during connected speech of normal-hearing and hearing-impaired adults.

Aerodynamic characteristics were investigated in connected discourse of normal-hearing and orally trained hearing-impaired adults. Subjects read sentences of various lengths and produced a spontaneous speech sample. Utterances were sensed by a pneumotachograph and recorded oscillographically and by audiotape. Inspiratory and expiratory volumes and expiratory time were measured. Word intelligibility was judged. Hearing-impaired subjects displayed greater ranges of air volumes and expiratory time. From sentence to spontaneous conditions, intelligibility varied systematically with expiratory volume.

Adolescent↗
PubMed1982

Advances in management of laryngeal and subglottic stenosis.

The introduction of cryotherapy and the refinement of surgical techniques has promoted progress in the care of infants and children with previously unresponsive intraluminal lesions of the larynx and subglottic area. Three cases illustrate the pluralistic approach that often must be brought to and individualized for these difficult cases before a measure of success can be assured. One case, stenotic since intubation required when the child was less than 1 k, was treated with fulguration, cryotherapy, and prolonged stenting. The severe stenosis from the tracheotomy site to the vocal cords eventually required open repair with anterior and posterior cricoid splits and a hyoid pedicled bone graft, followed by prolonged stenting. A method of internal stenting through the cords with percutaneous fixation was effective for long-term (3-6 mo) therapy. Another patient with severe stenosis was managed with multiple cryotherapy procedures followed by prolonged internal stenting. A third patient with subglottic stenosis secondary to an inhalation burn, was treated with cryotherapy without stenting. This presentation discusses the techniques of internal stenting with percutaneous fixation, cryotherapy, and open repair with combined anterior and posterior cricoid split, considering the indications and idiosyncracies of each technique.

Child↗
PubMed1982

Ludwig's angina: an update.

Despite a reduction in preantibiotic mortality rates that exceeded 50%, Ludwig's angina remains a potentially lethal entity primarily because of rapidly progressive airway obstruction. Since the reports of several large series in the 1940's, there have been put sporadic case reports because of widespread use of antibiotics in orodental infection, improved dental care, as well as adherence to strict diagnostic criteria. Since this entity is now uncommon, unnecessary delay in diagnosis and management may occur and may result in serious complications. This presentation will consist of an historical review, discussion of pathogenesis followed by clinical presentation, bacteriology and treatment, as well as a detailed analysis of our most recent 20 cases. There were no complications and no deaths. The infection resolved with medical therapy in 11 patients, while 9 patients required surgical procedures. Penicillin, clindamycin or chloramphenicol were started initially in all cases. Four of these 9 patients developed a localized abscess, while on antibiotics, which required drainage. Tracheotomy or intubation was necessary in 7 patients. Early and aggressive use of appropriate antibiotics and protection of the airway are the mainstays of a successful treatment regimen. Judicious surgical intervention is indicated in those patients who develop localized abscesses while on antibiotics or are unresponsive to medical management.

Abscess↗