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Biomedical subjects

M Wake

Publications and source records attributed to M Wake.

At least 73 records · Page 4Linked to original sources

Spontaneous perforation of the pharynx/esophagus.

Spontaneous perforation of the pharynx/esophagus is an unusual and probably under-diagnosed condition. This small series of patients demonstrating consistent clinical and radiological evidence of this condition suggests that it may be more common than has previously been supposed. It appears that in the majority of cases where the site of rupture occurs in the pharynx or upper esophagus that a self resolving clinical picture normally occurs.

Adult↗

Effect of nasogastric tubes on eustachian tube function.

The Eustachian tube acts as pressure equalizing tube between the nasopharynx and the middle ear. It also functions as a conduit for removal of secretions from the middle ear and mastoid air cell system into the post nasal space. Eustachian tube function may be assessed objectively using tympanometric measurements. (Brooks, 1968, Lutman, 1987). The post-operative use of nasogastric Ryles tubes is associated with reduced peak middle ear pressure (mmH2O) and reduced peak compliance volumes (ml) as assessed by tympanometry. In addition changes in the appearance of the tympanic membrane may occur with the protracted use of Ryles tubes. This phenomenon is a transient one. Nasogastric tube-induced Eustachian tube dysfunction is a previously unreported entity.

Aged↗

Audit of blood transfusion policy in head and neck surgery.

There is current concern about the possible adverse affects of blood transfusion on patient survival after cancer surgery. In addition, blood transfusion is associated with a low incidence of morbidity and mortality in any patient. 100 patient records have been examined retrospectively to outline the problems with blood transfusion policy in head and neck surgery. The current situation lacks standardization on a scientific basis and represents an area of resource over-utilization. A new approach to this subject in head and neck surgery is proposed and a recommended 'new policy' suggested.

Blood Grouping and Crossmatching↗

Adenoid cystic carcinoma: a comparison between CT, MR and Gd MR imaging techniques.

Nasopharyngeal carcinoma continues to be a difficult diagnostic problem in many patients. It is well known that amongst the many and varied manifestations of this disease, a unilateral middle ear effusion in an adult should be regarded with suspicion. Such a case in a 42-year-old patient is presented. In this case the benefit of Gadolinium enhanced magnetic resonance imaging over and above computerized tomography is demonstrated.

Adult↗

Guillotine and dissection tonsillectomy compared.

One hundred children and twenty adults were randomly allocated to guillotine or dissection tonsillectomy operations. The study was prospective and double-blind. In the children, the guillotine technique had demonstrable advantages over the dissection technique in terms of duration of operation, blood loss and post-operative pain. There was no significant morbidity in either group. In the adults, the random allocation of patients into these groups was found to be technically unsatisfactory and this arm of the study was abandoned after twenty patients.

Adolescent↗

[A case of coronary spasm during general anesthesia successfully treated with nitroglycerin and verapamil].

We had a patient without history of angina, who repetitively showed transient elevation of ST-segment during general anesthesia. Coronary spasm was suspected, but no triggering factors could be detected; the spasm being observed under deep and stable anesthesia and at this point no surgical stimulations were interposed. It was treated successfully with intravenous administrations of nitroglycerin and verapamil and no further elevations of ST-segment could be observed.

Aged↗

Spontaneous perforation of the pharynx/oesophagus.

A single case of spontaneous perforation of the pharynx/oesophagus is reported. This case is exceptional with regard to its idiopathic nature and self-resolving clinical course. Other reported cases of this rare condition generally have a clearly identifiable aetiology and are associated with a high morbidity and mortality. The diagnostic label of spontaneous perforation' has been used inappropriately in previously reported cases.

Adult↗

Ectopic production of beta-human chorionic gonadotropin by inverted papilloma of the nose.

A series of 19 inverted papillomas (transitional type or Schneiderian papillomas) of the nose were examined using an immunogold-silver (IGS) technique and an indirect immunoperoxidase technique. We demonstrated beta-HCG production in all 19 specimens with both methods. The staining demonstrated by the IGS technique was of a greater intensity and in a larger number of cells than that observed by the indirect immunoperoxidase method.

Adult↗

Craniofacial surgery.

Craniofacial surgery is concerned with the treatment of congenital and acquired conditions affecting the head, face and jaws (Tessier, 1971a). Previously these were treated individually by plastic, neurological and faciomaxillary surgeons. This type of surgery was associated with a high risk of morbidity and mortality (Goldin, 1975). Following the pioneering work of Dr Paul Tessier in Paris during the mid-1960s, using a multidisciplinary team approach has allowed for more radical treatment of these abnormalities with an acceptable morbidity rate within established craniofacial units (Munro, 1975).

Adolescent↗

Mechanisms of long and short term immunity to plague.

Long and short term immunity to plague was produced in normal mice by using, respectively, an antibiotic resistant Yersinia pestis and Yersinia pseudotuberculosis. Both immunogens were used live. Passive serum transfer experiments, together with assays for the bactericidal activity of macrophages and delayed hypersensitivity tests, showed that the short term immunity was of a humoral nature and the long term immunity was cell mediated. The plague virulence markers of the two immunogens were: Y. pestis VW- F1+ P1+ P+; Y. pseudotuberculosis VW+ F1- P1- P-. The challenge organism was Y. pestis VW+ F1+ P1+ P+.

Animals↗

Parents' Evaluation of Developmental Status in the Australian day-care setting: developmental concerns of parents and carers.

OBJECTIVE: To trial the Parents' Evaluation of Developmental Status (PEDS) as an instrument for reporting developmental concerns for Australian preschool children. METHOD: A cross-sectional survey of parents and carers of 262 children attending five day-care centres and two kindergartens in Melbourne was conducted between October and November 1999. Parents and carers completed the written PEDS questionnaire, comprising 10 questions eliciting concerns about learning, development and behaviour, and answered questions about the acceptability and use of the PEDS. RESULTS: Of 445 children, 389 were eligible for inclusion. Complete parent and carer PEDS data were available for 262 children (67% response: 47% boys; 53% girls) aged from 18 months to 5 years, 9 months. Most parents found the PEDS questionnaire easy to complete (98%) and likely to be useful to health professionals (89%). Twenty-four children (9%) were classified as being at high-risk of disabilities and 49 (19%) were classified as being at medium-risk of disabilities. Parents of 125 children (48%) reported no concerns. The prevalence of parental concerns was similar to the USA norming sample. Carers reported similar prevalences of concerns. Although overall agreement was high, parent/carer kappa-values were modest, being highest for the gross motor (kappa = 0.40) and social-emotional (kappa = 0.37) domains. CONCLUSIONS: The PEDS is acceptable to parents of Australian preschool children, with a prevalence of significant concerns (i.e. children at high- and medium-risk of developmental problems) that is similar to those in the USA. Further research is needed to assess what factors differentially influence whether a concern is felt in a particular domain for a particular child.

Adult↗

Degeneration of spiral ganglion cells in the chinchilla after inner hair cell loss induced by carboplatin.

The anticancer drug carboplatin has been used to generate inner hair cell (IHC) lesions in the cochlea of chinchillas. This has provided a valuable model for the study of the relative roles of IHCs and outer hair cells (OHCs). In the present study, we examined the pathological and temporal relationships between the degeneration of the cochlear IHCs and type I spiral ganglion cells (SGCs). A single intravenous dose of 200 mg/m2 carboplatin produced extensive IHC loss with no apparent effect on the OHCs. The auditory brainstem response threshold was significantly elevated by 2 weeks following treatment and remained stable through 12 weeks. Elevated thresholds were well correlated with morphological lesions. On the other hand, the SGC population progressively decreased from 2 to 12 weeks after treatment, to about half of the control density values. A positive correlation existed between the density of SGC and the number of surviving IHCs. These results indicate that selective damage to IHCs causes a distinct loss of SGCs.

Animals↗