Biomedical subjects

M Tos

Publications and source records attributed to M Tos.

At least 289 records · Page 16Linked to original sources

PubMed1977

Tubal function in chronic secretory otitis media in children.

In 100 children (150 ears) with chronic secretory otitis media the function of the Eustachian tube during treatment with grommet was investigated by air equalisation methods. Tubal function proved poor in the great majority at the beginning of the treatment, but towards its completion there was some improvement. After extrusion of the grommet, tubal function was investigated on the same material by tympanometry. 34% had normal middle-ear pressure initially, and 43% 12-18 months after closure of the perforation. There was no relation between tubal function shown by air equalisation methods and by tympanometry, and the air equalisation methods proved of less value than tympanometry in assessing the course and prognosis of secretory otitis. The pathogenetic theories - the ex vacuo and the secretory theory - are discussed in relation to the chronic tubal dysfunction found to be the most common direct cause of the disease.

Acoustic Impedance Tests↗

PubMed1977

Combined grafts in total reconstruction of old radical cavities.

93 patients with an old, infected and discharging radical cavity were subjected to total reconstruction of the middle ear, especially to obtain a permanently dry ear. The cavity was obliterated and the auditory meatus reconstructed by various muscle grafts and large pieces of fascia (41 ears), by combined grafts consisting of tragal cartilage, pieces of bone, homologous septal cartilage, and muscle grafts (40 ears). In the 12 prognostically most favourable ears the cavity was repneumatized. The functional results were the same in all three groups, namely a functional success in 72%. At follow-up 1-6 years after the operation there was functional success in 62%, but 94% of the ears were dry. Obliteration of the cavity by combined grafts was at long sight more solid than obliteration by muscle. It is discussed whether, in reconstructing radical cavities, repneumatization of the cavity is preferable to obliteration, and it is concluded that at long sight a solid obliteration must afford a more stable ear than repneumatization.

Cartilage↗

PubMed1977

Mucous glands in the developing human rhinopharynx.

In 42 fetuses and prematures, the entire mucosa from the rhinopharynx was stained by various whole-mount methods. The development, growth, spread, distribution, situation, and size of the glands were determined. The development starts in the 11th week below the tubal orifice, whence the glands spread to the entire rhinopharynx. The number increases gradually by about 60-70 glands a week. By the 23rd week, there are 1,100-1,200 glands in the rhinopharynx. After that juncture, there is presumably no further new formation. The density and size of the glands were at a maximum in Rosenmüller's recess, below the tubal orifice, and in the salpingopharyngeal fold, least anterior to the tubal orifice and at the junction to the pharynx. The role of the sero-mucous glands in the rhinopharynx under normal and abnormal conditions is dicussed.

Female↗

PubMed1977

Middle ear ventilation after acute otitis media.

The investigation includes 43 children (82 ears) with acute otitis media who were treated with paracentesis and antibiotics. The middle ear pressure was measured 7 days, 14 days, 1 month, and 2 months after the otitis. A follow-up examination was performed 4-12 months after the otitis. The normalization process was extremely slow: 3 months after the otitis only 37% of the ears had a pressure between 0 and -50 mm H2O, and 24% had flat curves and chronic secretory otitis. 3-12 months after, 49% of the ears had a normal pressure. A discussion on whether the middle ear ventilation had been reduced before the present otitis, or whether the slow normalization process is due to the changes in the mucous membrane is presented. The first assumption seems to be more probable. The significance of poor ventilation in the occurrence of recurrency is emphasized. Tympanometry is recommended 1-3 months after otitis, especially in recurrent otitis media.

Acute Disease↗

PubMed1977

Density of goblet cells on normal adult nasal turbinates.

On the basis of 10 middle and 10 inferior turbinates from autopsies on normal adults, a quantitative study of the goblet cells was performed, using the whole-mount method. There was quite some increase in density into the posterior direction, with a generally higher density on the inferior than on the middle turbinate. The results are related to the current of air in the nose.

Age Factors↗

PubMed1977

Density of goblet cells in the normal adult human nasal septum.

On ten adult septal mucous membranes, stained by the PAS-alcian blue whole-mount method, the density of goblet cells was determined in 12 localities distributed on the entire septum. The median density proved to be slightly, but significantly increasing into the anteroposterior direction, there being 4,800 in the anterior and 6,200 cells per mm2 in the posterior quarter of the septum. There was a tendency to higher density in the lower than in the middle and upper thirds. However, these differences were not statistically significant. Interindividual variations in density and variations within different segments of the same septum were relatively pronounced. This goes to show that the assessment of goblet cell density on the basis of sections, so often seen in the literature, can only be taken with the utmost reserve.

Aged↗

PubMed1977

Quantitative histology of the maxillary sinus.

The entire mucosa from 10 normal maxillary sinuses was removed post-mortem and stained by the PAS-alcian blue whole-mount method. The density of goblet cells and of mucous glands was investigated. The median density of goblet cells was 170 cells/field, corresponding to 9,600 cells per mm2, with wide individual variations, but there were no significant differences in density between the various walls. The density of goblet cells was somewhat higher than in the nose. Glands were very scarce and small in the maxillary sinus. Their median density in most walls was 0.15-0.20 gland/mm2, but in the medial wall significantly higher, 0.5 gland/mm2. The lower density of glands in the maxilly sinus than in the nose, where it is 8-9 glands/mm2, is in complete agreement with lesser requirement of the antral mucosa for moistening, cleaning, and warming of the air. Quantitative histological studies of normal mucosa will form the basis for studies of abnormal mucosa.

Aged↗

PubMed1977

Nasal glands in newborn infants.

The entire mucosa of the nasal septum from four newborn infants was removed, stained by the PAS-alcian blue whole-mount method, and the density of mucous glands was determined in 12 different localities. The interindividual median density was 30.7 glands/mm2 and the median count 13,500 glands. The glands were regularly distributed over the entire respiratory region, but with a significant decrease in density in the posterior half. It has been demonstrated that all glands are laid down before birth, that their density decreases with increasing age until it reaches 8.4 glandss/mm2 at an adult age, and that acute or recurrent acute catarrhal or inflammatory changes of the nose do not lead to the newformation of glands.

Acute Disease↗

PubMed1977

Pathogenesis of nasal polyps.

On the basis of studies on the glands of the nasal mucosa and polyps as well as the structure of the latter, some previous pathogenetic theories are analysed. The authors advance their own theory of polyp formation: Infiltration and oedema in the nasal mucosa result in rupture of the epithelium and formation of granulations which gradually become lined with pseudostratified columnar epithelium. During growth of the polyp there occurs formation of mucous glands which owing to growth of the polyps become long and stretched.

Adult↗

PubMed1977

Surgery of acoustic neuromas. Preliminary experience with a translabyrinthine approach.

Inspired by the works of William House, the authors formed an otoneurosurgical team in order to improve the results after surgery for acoustic neuromas. This paper deals with the preliminary results obtained with the translabyrinthine approach in 13 patients with acoustic neuromas. In 9 patients it was possible to remove the tumor totally with this approach, in 4 patients a second suboccipital operation was necessary to secure total removal. One small, 7 medium and 5 large tumors were encountered. The facial nerve was preserved in 83 per cent of the patients. One patient with a large tumor died after the second suboccipital operation. The relation between size of the tumor and the outcome of the operation is stressed, and in order to reduce the number of large tumors it is suggested that all patients with unilateral hearing loss should be suspected of having a neuroma, until the diagnosis has been disproved. It is concluded that the surgery for acoustic neuromas is otologic-neurosurgical teamwork, and that the treatment should be centralized.

Adult↗

PubMed1976

Density of mucous glands in the normal adult nasal septum.

The entire mucosa from 13 normal nasal septa was stained by the PAS-alcian blue whole-mount method, and the mean density of glandular orifices in 13 localities was determined quantitatively by counts in 4 mm2 fields. The median density within the entire material was 8.4 glands/mm2, with an interindividual variation of +/- 1 gland/mm2. The median number was 15,900 glands, range 10,800-21,800. The distribution of the glands is regular, with little variation between the localities. Density is somewhat, but significantly lower in the posterior quarter of the septum, and there was a significant increase in density into the infero-superior direction.

Aged↗

PubMed1976

Goblet cell density in Eustachian tube of children.

In 13 clinically normal infants and children between the ages of 9 days and 14 years, the entire mucosa from the Eustachian tube was dissected and stained by the PAS-Alcian blue whole-mount method, and the density of goblet cells was determined in 360 counting fields. This disclosed an extreme dispersion of median density in the various parts, due to a physiological increase through childhood, an increase in the osseous or cartilaginous part, and in the entire Eustachian tube due to pathologic actions such as tubal occlusion, recurrent or protracted catarrhal conditions, regurgitations, and duodenal intubation. After the pathologic stimulation has ceased, the density falls, presumably to the limit normal for the age concerned.

Adolescent↗

PubMed1976

Secretory otitis media. Late results of treatment with grommets.

In 108 children (184 ears) with chronic secretory otitis treated with grommets, the condition at one-to-five years follow-up was compared with that at five-to-eight years follow-up. At the latter time, hearing was extremely good, 97.5% of the ears having a speech reception threshold (SRT) of 20 dB or less. However, only 67% of patients could be classified as cured by normal tympanometry. The remaining ears showed a negative middle-ear pressure of 100 to 300 mm H2O (25%), recurrent accumulation of secretion (1.6%), adhesive otitis (3.3%), perforation (1.7%), or cholesteatoma (1%). The eardrum was normal in 44% of patients, while in 25% it was diffusely atrophic, lax, or retracted.

Adenoidectomy↗

PubMed1976

Secretory otitis. Histopathology and goblet-cell density in the Eustachian tube and middle ear in children.

The histological changes in the middle ear of four children with incipient or mild chronic secretory otitis are described. They consist in vascular dilatation and proliferation, round-cell infiltration, epithelial metaplasia into pseudostratified, columnar, ciliated epithelium posteriorly in the middle ear, formation of abnormal mucous tubular glands, and an increase in goblet-cell density in the osseous tube and middle ear. The causes of these changes were presumably long-lasting tubal occlusion due to a permanent nasogastric tube and protracted catarrhal diseases. The density of goblet cells was determined in various parts of the Eustachian tube and middle ear. The findings were analysed statistically and compared with the density in prematures and newborns, normal children, and normal adults. In the tympanic orifice and in the osseous Eustachian tube the goblet-cell density was greatly increased, whereas the increase in the middle ear varied individually, but was in conformity with the other findings. These cases illustrate that the histopathological changes in the middle-ear mucosa in secretory otitis must be regarded not only from a qualitative, but certainly also from a quantitative point of view.

Adult↗

PubMed1976

Routine procedure for determining goblet cell density in the mucosa of the respiratory tract.

In two normal nasal septa, fine-dissected and stained by PAS-alcian blue whole-mount methods, counts of goblet cells were done in eight different localities in 1, 2, 5, 10, 20, 30, 50, and 100 fields measuring 0.01768 mm2. The median density and range of goblet cells by each mode of counting were compared and the mean deviation determined. Even as little as 2-5 blindly placed counts, which do not take much time, afford in a 4 mm2 area a fairly reliable orientation regarding density, considerably more reliable than an estimate of the density in sections, so often reported in the literature. Determination of the goblet cell density can be included as a routine method in the histopathological diagnosis of mucosal diseases of the upper and lower respiratory tract.

Aged↗

PubMed1976

Goblet cell density in the eustachian tube in prematures and in newborn infants.

In order to determine the goblet-cell pattern in a completely normal mucosa, the entire mucosa from the Esutachian tube of 14 prematures and newborns was dissected and stained in toto by the PAS-alcian blue whole-mount method. Goblet cells were counted in many localities and the results analysed statistically. The density proved very low, but uniform in the entire Eustachian tube, 10 cells per field, corresponding to 565 cells per mm2. These findings were compared with those from a normal adult autopsy material in which the density in the pharyngeal orifice was high, but gradually decreased towards the tympanic orifice where it was as low as in prematures. It is concluded that a marked postnatal increase in the density in the tubal orifice is abnormal, whereas a physiological increase in density may be expected in the pharyngeal part of the tube. One premature, intubated for three days, exhibited a very high density in the Eustachian tube, presumably as a consequence of sudden tubal occlusion.

Cell Count↗

PubMed1976

[The density of the mucous glands in the fetal nose (author's transl)].

In 50 fetuses and premature infants between the ages of 11 and 23 weeks the entire nasal mucosa was dissected free and stained by the Osmium, the PAS or the PAS-alcian blue whole-mount method after which the nasal mucous glands were studied with special reference to density. In front on the septum and in the lateral wall density increases evenly and is by the 23rd week 28 glands per square mm. In the middle and at the back of the septum, where the glands develope later, the density is somewhat smaller by the 23rd week. Through the entire period, and also after the 23rd week, new glands continue to develop a fact which is of importance for the understanding of the distribution of the glands since the first glands to develop form a glandular layer deep in the lamina propria and the last glands to develop a superficial layer.

Female↗

PubMed1976

[Goblet cells in nasal allergy (author's transl)].

After staining of the whole nasal mucosa from a patient with nasal allergy by the PAS-alcian-blue whole mount method, the density of goblet cells was determined quantitatively. In most sections of the nasal septum and of the inferior and middle nasal concha, the density of goblet cells was found to be considerably lower than in normal subjects. While in some sections, in particular posteriorly, the density was the same as in normal subjects, it was nowhere higher. The low density may be due to metaplastic changes of the epithelium which had thickened and lost ciliary cells. Previous statements that the density of goblet cells is increased in nasal allergy could not be confirmed quantitatively, but investigation of larger materials is called for before any conclusions may be drawn.

Adult↗