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Biomedical subjects

P Karma

Publications and source records attributed to P Karma.

At least 19 recordsLinked to original sources
PubMed1992

Magnetic facial nerve stimulation in Bell's palsy.

The transcranial magnetic stimulation (TMS) technique makes it possible to stimulate the intracranial part of the facial nerve. In a total of 51 patients with acute Bell's palsy, TMS was performed, and the responses were compared with those elicited by conventional extracranial electric stimulation (EES). Clinical recovery was evaluated at 258-539, mean 410, days from the beginning of the palsy. With both techniques the motor evoked potentials (MEPs) could always be elicited on the healthy side, the mean latency being 4.7 ms with TMS and 3.7 ms with EES. In the acute phase, TMS elicited MEPs on the paralyzed side in 47% of the patients, and EES in 98%. The patients with TMS elicitable MEPs during the first 4 days of the palsy had significantly better recovery than those without response (p less than 0.05). The difference in recovery between patients with or without elicitable TMS responses on days 5-8 and 9-14 was not significant. In EES, the amplitude difference between the two sides within the first 4 days was not significantly (p greater than 0.05) different. On days 9-14 the patients with a less than 80% difference between the two sides recovered significantly (p less than 0.05) better than those with a difference of greater than or equal to 80%, So, TMS may be of help in the early prognosis of Bell's palsy.

Adolescent↗
PubMed1992

Magnetic facial nerve stimulation in normal subjects. Three groups of responses.

Magnetic stimulation provides a method to stimulate the facial nerve transcranially. With this method, the stimulation can be directed to the intracranial part of the facial nerve, whereas conventional electric stimuli are delivered to a more peripheral part of the nerve. In 40 healthy subjects, ipsilateral responses with latencies of 4.5 +/- 0.4 ms were recorded on the nasolabial folds. The latencies were 1.1 ms longer than those elicited at the stylomastoid foramen by electric stimulation. Furthermore, a response with a mean latency of 12 ms (range 10-16 ms) appeared in 6 out of 10 healthy subjects and a polyphasic response with a mean latency of 32 ms in 9 out of 10 of these subjects. Transcranial magnetic stimulation seems to allow the examination of motor conduction through the proximal part of the facial nerve. In addition, the method may give further information concerning the facial activation mechanisms possibly by other central pathways.

Adult↗
PubMed1991

Azithromycin concentrations in sinus fluid and mucosa after oral administration.

The concentrations of azithromycin in sinus fluid and mucosal tissue were determined in a total of 23 patients with acute or chronic sinusitis. Five patients with acute sinusitis and four with chronic sinusitis were administered a five-day course of oral azithromycin (500 mg on day 1, 250 mg on days 2-5, all as single doses), and the remaining 14 patients, all with chronic sinusitis, received single oral doses of azithromycin (500 mg). With the five-day regimen, the mean levels of azithromycin in sinus fluid were markedly higher in patients with acute sinusitis (1.34 micrograms/ml) than in patients with chronic sinusitis (0.25 micrograms/ml) 24 h after the first dose. The levels of azithromycin in the sinus fluid increased from the first to the last dose in both patient groups; the mean levels of azithromycin 24 h after the last dose were 2.33 micrograms/ml in acute sinusitis patients and 0.38 micrograms/ml in chronic sinusitis patients. In chronic sufferers, the mean levels of azithromycin in the sinus fluid following a single oral dose were 0.25, 0.41, 0.57 and 0.22 micrograms/ml at 24, 48, 72 and 96 h, respectively, after administration. In these patients the mean sinus drug concentrations were much greater in the mucosal tissue (1.23 micrograms/g) than in the sinus fluid (0.41 micrograms/ml) 48 h after administration of the single dose. There were no treatment-related changes in laboratory function tests, and side effects were described as mild to moderate (five patients complained of nausea, abdominal pain or headache).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1991

The comparative efficacy and safety of clarithromycin and amoxycillin in the treatment of outpatients with acute maxillary sinusitis.

The efficacy and safety of clarithromycin and amoxycillin in the treatment of acute maxillary sinusitis were compared in a single-blind, multicentre outpatient study. Fifty patients were randomly assigned to receive either clarithromycin 500 mg 12-hourly or amoxycillin 500 mg 8-hourly orally. Clinical signs and symptoms, sinus culture and blood and urine laboratory profiles were assessed prior to treatment, at four to six days during treatment, and within 48 h of the end of therapy (usually 9-11 days). Patients from whom beta-lactamase producing strains were isolated were excluded from the study. Both antibiotics achieved a clinical success rate of 91% within 48 h post-treatment; radiological resolution or improvement was observed in 91% of patients treated with clarithromycin and 89% of patients who received amoxycillin. Bacteriological cure was achieved in 88% and 91% of evaluable patients for clarithromycin and amoxycillin, respectively. Adverse events were reported for 16% of patients in the clarithromycin group compared to 26% in the amoxycillin group. Gastrointestinal disturbance was the most commonly occurring adverse event in both groups. The results of this study suggest that clarithromycin is as effective and well tolerated as amoxycillin in the treatment of acute maxillary sinusitis.

Acute Disease↗
PubMed1991

A clinical research form for use in the documentation of middle ear effusion.

A form for use in both the clinical and research setting for documenting the presence and course of otitis media with effusion by pneumatic otoscopy has been developed. The form is based on the data obtained in a large Finnish study on pneumatic otoscopy signs and findings at myringotomy (Karma P, Penttilä M, Sipilä M, & Kataja M, Int J Pediatr Otorhinlaryngol 1989). The rationale for development and the clinical and research applications of the form are discussed.

Air↗
PubMed1991

Transcranial facial nerve stimulation by magnetic stimulator in normal subjects.

Magnetic stimulation provides a new method to stimulate facial nerve transcranially. Stimulation can be directed to the intracranial part of the facial nerve, whereas the conventional electric stimuli are delivered extracranially to a more peripheral part of the nerve. Fourty healthy volunteers were examined to determine the normal responses for transcranial facial nerve stimulation. The center of the inducing coil ring was located so that its center was 3 cm posterior and 6 cm lateral to the vertex. Responses were recorded on the nasolabial fold. Latencies were 4.5 +/- 0.4 ms on both sides, being 1.1 ms longer than those elicited by electric stimulation of the nerve at the stylomastoid foramen. Amplitudes with magnetic stimuli were equal to those obtained with electric stimuli. The transcranial magnetic stimulation seems to be an accurate and promising method to examine the facial nerve.

Adult↗
PubMed1979

Bacteria in chronic maxillary sinusitis.

Sixty-one chronically inflamed maxillary sinuses produced 131 bacterial strains from mucosal pieces that were taken during a Caldwell-Luc operation and cultured aerobically and anaerobically. Sinus secretions showed only 62 and nasal secretions 106 bacterial strains. Fourteen mucosal strains, including 11 Haemophilus influenzae, grew heavily. None of 24 mucosal anaerobes showed heavy growth. Of 52 antral mucosae with culturable bacteria, 37 disclosed mixed and 15 pure growth. The bacteriological characteristics of the diseased sinus and the nose did not correlate. The duration or extent of the disease, the macroscopic appearance of the diseased sinus, or the presence or absence of allergy were unrelated to bacteriological findings, except that H influenzae was concentrated in purulent sinuses. Intraoperative culture of antral mucosa seems to give the most reliable picture of the bacteriological condition in chronic maxillary sinusitis.

Adult↗
PubMed1979

T cells as marked with acid alpha-naphthyl acetate esterase staining in secretory otitis media.

Non-specific acid alpha-naphthyl acetate esterase (ANAE) activity of the lymphocytes was investigated in smears made of middle ear secretions and peripheral blood from 61 children with secretory otitis media. On the average, 20.1% (right ear) and 2.1% (left ear) of the lymphocytes in the ear samples showed distinctive ANAE-positive spots in their cytoplasms, by the method used. The mean percentage of ANAE-positive cells in the blood was 47.8 and it was significantly (P less than 0.001) higher than the respective percentages of the ear samples. In normal childrne, 54.9% of the lymphocytes, on the average, were ANAE-positive. This difference in blood between patients and control group was significant (P less than 0.001). Consequently, the present study suggests that the relationship of T- and non-T-lymphocytes, as a marked with ANAE, are disturbed in children suffering from secretory otitis media. The importance of this finding and the validity of the method are discussed.

Child↗
PubMed1978

T lymphocytes in the effusions of secretory otitis media.

Smears were made from 39 middle ear effusions in 29 children with secretory otitis media (SOM) and stained with acid alpha-naphthyl acetate esterase (ANAE) to demonstrate T lymphocytes. The effusions showed on the average 21% of the lymphocytes to be ANAE positive, while simultaneously drawn peripheral blood revealed the proportion of ANAE positive cells to be 53% (P less than 0.001, the Student's t-test). Our finding suggests that T cell dependent defence mechanisms may be locally disturbed in SOM.

Child↗
PubMed1978

Access of metronidazole into the chronically inflamed middle ear with reference to anaerobic bacterial infections.

Strictly anaerobic bacteria were found in about one third of 138 consecutive cases of active chronic otitis media. These infections were always mixed involving aerobes as well. In 79 cases only aerobes were found and 16 cultures were sterile. To provide a basis for possible clinical trials, the penetration of metronidazole into the ear was studied after an oral dose of 2.4 g to patients with chronic otitis media. Significant amounts of biologically active metronidazole were found in 8 of 12 middle ear discharges at 2--4 h, the concentrations varying between 9.4 and 65.0 microgram/ml. Between 2 and 13 h after administration, significant drug concentrations all exceeding the highest reported bactericidal ones were found in the middle ear mucosa in 6 cases of the 8 in which the determinations were possible. Neither the mucosal nor the discharge concentrations correlated with the simultaneous serum levels of metronidazole, which were high in all 23 patients studied.

Administration, Oral↗
PubMed1977

Cholesteatoma in children.

The 65 cholesteatomas operated on in children showed a more expansive and rapid growth than those in adults. In one fifth of the cases cholesteatoma filled the whole air-cell area, which was wide in half of the children. Fifty-two ears of these children had an attic or a posterosuperior perforation. One case was complicated by a fistula in the horizontal semicircular canal, and the ossicular chain was unbroken in 23 cases (35%). Thus, the findings support the idea of the primary soft-tissue spread of cholesteatoma in children. Five ears (8%) discharged postoperatively, and three ears (5%) were reoperated on and showed residual tympanal cholesteatoma. Cavity obliteration with canal wall down technique proved safe, even in the cases of the most extensive and active cholesteatoma.

Adolescent↗
PubMed1977

Anaerobic bacteria in chronic otitis media.

The bacteriology of 70 consecutive cases of active chronic otitis media was studied. Using appropriate technology, anaerobic bacteria were recovered in 33%, Bacteroides species accounting for one half of them. They were always found in mixed infections involving the average of 3.8 bacteria, 1.9 anaerobic, and 1.9 facultative species. The bacteriology was relatively stable from one ear to the other in the ten bilateral cases studied. The results were alike in the groups differing with respect to local antimicrobial therapy or appearance of the middle ear discharge. The cases with chronic otitis in spite of previous radical surgery presented more often with anaerobic infection than the unoperated ones, and none of them yielded sterile cultures. The recognition of anerobic middle ear infections may be clinically significant because the susceptibilities of the organisms to antimicrobial agents and to air are characteristically different from those of aerobic or facultative bacteria.

Administration, Topical↗
PubMed1977

Congenital epulis. Report of a case.

The clinical characteristics and histogenesis of congenital epulis, the tumour often confused with granular cell myoblastoma, are discussed and a case of our own is presented.

Female↗