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Biomedical subjects

P Karma

Publications and source records attributed to P Karma.

At least 91 records · Page 5Linked to original sources

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↗

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↗

Secretory otitis media in chronic lymphatic leukaemia. A temporal bone report of a case treated for seven months with tympanostomy tubes.

Serially sectioned temporal bones were studied from a patient with chronic lymphatic leukaemia with submucosal infiltration of the nasopharynx, the resulting secretory otitis having been treated with tympanostomy tubes for 7 months. The initially serous sterile secretion turned mucoid, and a low grade infection supervened. For the last 3 months the tympanostomy tubes were open and the ears dry. In the sections, the mastoid air cells showed leukaemic infiltrations and contained AB- and PAS-positive secretion. The drum openings were without reaction and there was no epithelial ingrowth around the margins. The posterior tympanum in both ears contained organizing fibrous tissue extending from the inner surface of the drum to the promontory. In the tympanum the mucosa was flat or columnar and without glands. Distinct AB and PAS-positive mucus film and secretory cells appeared on the promontory epithelium and the inner surface of the drum. In the tubo-tympanic recess some AB- and PAS-positive subepithelial glands appeared and in the tympanic orifice of the tube the secretory cells were prominent and the lumen full of AB-positive mucus. The case reported represents an intermediate stage in the healing of secretory otitis media, most of the glands having disappeared but the intraepithelial secretory elements being still active.

Aged↗

Histochemistry of normal middle ear mucosa.

Mucosal biopsy specimens were taken from the middle ear in 19 patients with otosclerosis and stained by Alcan blue and PAS. They were also stained for hydrolytic and oxidative enzymes. In additon, 11 temporal bones from patients without any previous ear disease were serially sectioned for mucopolysaccharides. In otosclerosis, both acid and neutral mucopolysaccharides were present in the mucosa, but not to the same extent as in the temporal bone specimens. Acid phosphatase, lactate malate dehydrogenases, and nonspecific esterase were demonstrated even in very thin epithelium, providing a potential basis for the appearance of these enzymes in large amounts in various inflammatory middle ear diseases.

Acid Phosphatase↗

Mastoid Obliteration. Histopathologucal Study of Three Temporal Bones.

Three temporal bones were serially sectioned to study the postoperative fate of the meatally based postauricular musculoperiosteal flap. In all three ears, the flap sealed off the middle ear effectively from the mastoid cavity and in one, with resected canal wall, formed a new soft posterior wall with good meatus. All flaps contained viable muscle, fat, collagen, reticulin, and elastin, and were richly vascularized. In two flaps, small granulating foci of infection were noted. In two temporal bones, from a child with hypogammaglobulinemia, small cholesterol cysts formed behind the falp during the delayed healing of the mastoid wounds.

Adolescent↗

Middle ear mucosa and chronic ear disease. III. Enzyme studies of thick noncholesteatomous epithelium.

Thick mucosa removed from the promontory in cases with chronic otitis media showed prominent PAS-positive glands and epithelial secretory cells. Alcian blue positivity was less pronounced, contrary to the mucosa from glue ears. Enzyme activity in the epithelium and propria was comparable to that in glue ears, with some increase in alkaline phosphatase and some decrease in proprial lactate dehydrogenase and malate dehydrogenase activity. Removal of thick, permanently altered mucoas is recommended even in the absence of squamous epithelium. Steps should be taken to allow regrowth of thin, normal middle ear epithelium on the promontory.

Acid Phosphatase↗

Prevention of otitis media in children by pneumococcal vaccination.

A total of 3,340 infants, 95 per cent of them 7 to 9 months old, were randomly vaccinated in a double-blind fashion with either the 14-valent pneumococcal (Pn) polysaccharide vaccine or a saline placebo in three urban areas in Finland. The second dose of the vaccine was given 5 months later. Age and sex distribution, recruitment of infants, and their otitis-related treatment and follow-up were similar in the study areas. Side effects after vaccination were mild and fewer than among older children. Antibody responses to vaccine polysaccharides varied from type to type, but were generally poor, especially to types most prevalent in otitis media. After the first dose of vaccine, the occurrence of otitis visits among the Pn-vaccinated, as compared with controls, showed inter-area differences, but ranged from not more than a 30 per cent reduction at its best to an increase in some areas and in some clinical categories. The respective figures for children with acute otitis media were similar between the vaccination groups and the study areas. The effect of the vaccine on acute otitis media caused by specific Pn types/groups represented in the vaccine was variable but generally poor. Group 6 attacks especially seemed to behave problematically. The second dose of the vaccine did not give additional benefit serologically or clinically. The efficacy of currently available pneumococcal vaccine against otitis media seemed poor in infants.

Antibodies, Bacterial↗

A study of the pneumococcal vaccine in prevention of clinically acute atttacks of recurrent otitis media.

A total of 827 infants and children three months to six years of age were vaccinated randomly after an attack of otitis media, with either the 14-valent pneumococcal vaccine or a control vaccine against Hemophilus influenzae type b. Clinically acute attacks of otitis media that occurred greater than or equal to 14 days after vaccination were analyzed by culture of the middle ear fluid. Children who had received the pneumococcal vaccine at the age of seven to 83 months experienced within the first six months after vaccination significantly fewer attacks of otitis media caused by Streptococcus pneumoniae than did children in the control group (50% overall reduction, p less than 0.01). The reduction of attacks was specific to those pneumococcal types/groups present in the vaccine that induced a good serum antibody response; the specific protection indicated for vaccine types/groups other than 6 (to which the antibody response was very poor) was 67% (P less than 0.001). No or very little protection was seen in infants younger than seven months or in any children later than six months after vaccination.

Acute Disease↗

Clinical applications of and experiences with a portable, unlimited text-to-speech synthesizer.

An unlimited, portable, text-to-speech synthesizer, Synte 2, is introduced. Since 1977, it has been applied and tested to the rehabilitation of the deaf and others unable to speak as well as to the rehabilitation of the blind. It has been shown to be beneficial to those people. With this system, it seems possible to markedly increase the concept capacity of the deaf. In audiology, it provides a new way to produce objective, everlasting, and ever-repeatable ordinary and sensitized speech tests. Further, the apparatus has innumerable applications in audiological and speech pathological research. This kind of speech synthesizer has come to stay in clinical use. General principles of the use of the synthesizer and experiences over 3 years in rehabilitation and medical research are discussed.

Adult↗