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R Mai

Publications and source records attributed to R Mai.

At least 37 records · Page 2Linked to original sources
PubMed2000

The irony of being Oscar: the legendary life and death of Oscar Wilde.

In this second in a series of famous historic personages who suffered from ear disease (see Yardley M, Rutka J. Troy, Mycenae, and the Otologic Demise of Herr Heinrich Schliemann. J Otolaryngol 1998; 27:217-221), we review the life and otology-related death of the legendary playwright Oscar Wilde. In his time, Wilde ridiculed the social hypocrisy of the Victorian age, championed the individual, and pleaded for a more tolerant and forgiving society in his many books, plays, and letters. Very much the acerbic and iconoclastic wit, Wilde's private and later very public affair de coeur with Lord Alfred Douglas, the son of the Marquis of Queensberry, still continues to interest and paradoxically shock our sensitivities. Wilde's ultimate demise from an otogenic bacterial meningitis appears all the more ironic when one considers the role his father, Sir William Wilde, played as one of the founding fathers of modern otology.

Drama↗
PubMed2000

The success of 6-month stenting in endonasal frontal sinus surgery.

The ultimate success or failure of frontal sinus surgical procedures, whether they be endonasal or external, is determined essentially by the rate of restenosis of the frontal sinus outflow tract or neo-ostium postoperatively. Long-term stenting for a period of several months significantly reduces the rate of restenosis, particularly in difficult cases. We retrospectively reviewed the cases of 12 patients who received 21 frontal nasal stents, which were left in place for 6 months. Based on outcomes measures that included endoscopy or radiologic findings and patients' self-evaluations, we conclude that frontal nasal stents that are left in place for 6 months are more effective than stents that are removed earlier. We recommend that this type of management be considered in difficult revision cases and before performing an external operation.

Adult↗
PubMed1999

Evaluation of the dizzy patient: experience from a multidisciplinary neurotology clinic.

In 1993 a multidisciplinary neurotology clinic was established at the Toronto Hospital, University of Toronto, where patients with symptoms of dizziness were assessed by both otolaryngologists and neurologists. The results from the first 400 patients seen in consultation are described. The disease pathologies identified in this patient population with dizziness showed some significant differences from other published series, which we believe reflects the specialized tertiary nature of referrals to this clinic. A model for the collaborative investigation of the dizzy patient is provided consistent with the current trend towards multidisciplinary approaches in medicine.

Adolescent↗
PubMed1999

Taylor's cortical dysplasia: a confocal and ultrastructural immunohistochemical study.

In the present report we describe the neuropathological characteristics of tissue surgically resected from three patients affected by intractable epilepsy secondary to cortical dysplasia. Common features, suggestive of a focal cortical dysplasia of Taylor, were observed in all specimens. Immunocytochemical procedures were performed using neuronal and glial markers and the sections were observed at light traditional and confocal microscopes. This part of the investigation pointed out: 1. cortical laminar disruption; 2. very large neurons displaying a pyramidal or round shape; 3. ballooned cells; 4. decrease of calcium binding proteins immunoreactivity; 5. abnormal nets of parvalbumin- and glutamic acid decarboxylase-positive puncta around giant neurons but not around ballooned cells. Ultrastructural investigation on the same material provided evidence of a high concentration of neurofilaments in giant neurons and of glial intermediate filaments in ballooned cells. In addition, immunolabeled GABAergic terminals clustered around giant neurons were not found to establish synapses on their cell bodies. The present data, derived from a limited sample of patients but showing very consistent features, suggest that in Taylor's type of cortical dysplasia a disturbance of migratory events could be paralleled by a disruption of cell differentiation and maturation and by an impairment of synaptogenesis. This latter mechanism seemed to affect especially the inhibitory elements, and could account for the hyperexcitability of this tissue and thus for the high epileptogenicity of Taylor's dysplasia.

Adult↗
PubMed1999

Research perspectives in cortical dysplasia and associated epilepsies.

Our understanding of cortical alterations and related epilepsies has grown enormously in the last decade thanks to the explosion of basic information from laboratory neuroscience combined with advances in diagnostic tools, therapeutic approaches and surgical techniques. In the present paper, we briefly review the most important advances in these fields from the point of view of the clinician concerned with cortical malformation-related epilepsies. We propose that a highly effective way forward, expected not only to widen knowledge of the basic mechanisms of seizure generation, but also to improved the management of patients, would be to promote interdisciplinary research programmes on resected human cortex that involve neurosurgeons, neurologists and laboratory neuroscientists.

Cerebral Cortex↗
PubMed1998

Quantitative electroencephalography in amyotrophic lateral sclerosis.

OBJECTIVES: The authors evaluated quantitative EEG (QEEG) in patients with amyotrophic lateral sclerosis (ALS), in order to see if the confined cortical degeneration found in anatomical and functional examinations of central (rolandic) regions could give rise to abnormalities of cortical electrical activity. MATERIAL AND METHODS: Eighteen patients with ALS were compared with 14 control subjects comparable for age and sex. The QEEG analysis was blind to the clinical data. Frequency analysis of 30 EEG epochs, each of 2.6 s duration, was performed. RESULTS: QEEG in ALS patients showed a significant well-localized decrease of alpha activity only in the central regions, while theta and delta relative power did not show any difference from controls. CONCLUSION: We suggest that QEEG is able to show evidence of subtle EEG changes probably due to loss of cells in the somatomotor cortex selectively affecting the generator sites.

Adult↗
PubMed1997

Conjugal amyotrophic lateral sclerosis: toxic clustering or change?

We describe a southern Italian couple, married for 28 years, who developed amyotrophic lateral sclerosis (ALS) within 30 months of each other. They had drunk water taken from an artesian well for nearly thirty years. Samples of the water were investigated in the search for heavy metals and pesticides using high performances liquid chromatography, gas chromatography and absorption spectrometry. No heavy metals, pesticides or known environmental toxic substances were found in significant concentration. This would seem to support the view that conjugal ALS in Caucasians is due to mere coincidence.

Amyotrophic Lateral Sclerosis↗
PubMed1997

Motor evoked potentials and disability in secondary progressive multiple sclerosis.

BACKGROUND: To investigate the mechanisms underlying disability in multiple sclerosis (MS), 40 patients with the relapsing-remitting form of the disease and 13 patients with secondary progressive MS underwent multimodal evoked potential (EP), motor evoked potential (MEP), and spinal motor conduction time evaluation. Clinical disability was evaluated by the expanded disability status scale (EDSS) and functional system scales. In secondary progressive MS patients, magnetic resonance imaging (MRI) was used to obtain a semiquantitATive estimate of the total lesion load of the brain. RESULTS: Spinal motor conduction time was significantly longer in secondary progressive MS patients than controls (p < 0.001) and relapsing-remitting MS patients (p < 0.05), but did not differ between relapsing-remitting patients and controls. Spinal motor conduction times also correlated directly with EDSS scores (p < 0.001) and pyramidal functional system scores (p < 0.001). Brain lesion load (4960.3 +/- 3719.0 mm2) and the total number of lesions (67.7 +/- 37.0) in secondary progressive MS did not correlate with disability scores. For the following EPs, the frequencies of abnormalities were significantly higher in secondary progressive MS patients than relapsing-remitting patients: visual evoked potentials (p < 0.05), somatosensory evoked potentials and upper limb motor evoked potentials (p < 0.01), and brainstem auditory evoked potentials, lower limb somatosensory evoked potentials and lower limb motor evoked potentials (p < 0.001). CONCLUSIONS: These findings suggest that disability in secondary progressive MS patients is mainly due to progressive involvement of corticospinal tract in the spinal cord.

Adult↗
PubMed1996

[Diagnostic value of color Doppler ultrasound in addition to B-image ultrasound in predicting underweight newborn infants].

In 74 pregnancies suspected for a small-for-gestational age (SGA) fetus by ultrasound measurement of the abdominal circumference, Doppler measurements of the fetal aorta and umbilical artery were performed. The renal and middle cerebral arteries were studied by color flow mapping. 47 infants were indeed growth retarded. The resistance- (RI) and pulsatility-indices (PI) of all vessels and their ratios were calculated. The superior parameter evaluated by receiver operating characteristic was the ratio of the PI of the middle cerebral artery in comparison to the PI of the umbilical artery at a threshold value of 1.6. An additional diagnostic value of Doppler sonography was only seen in cases of normal amniotic fluid volume and fetal symmetry, but not in cases of oligohydramnion and fetal asymmetry.

Brain↗
PubMed1996

[Clinical characteristics critical for patients "recovered" after surgical treatment for temporal lobe epilepsy].

We analyse subjective and objective clinical manifestations, in 33 patients, among the 63 with "pure" temporal lobe epilepsy, for which we obtained at least a video-EEG or video-stereo-EEG ictal recording. We compared video-EEG recordings (103 seizures, mean 3.9; min 1, max. 23) and video-stereo-EEG recordings (77 seizures, mean 3.2; min 1, max. 13) with anamnestical data, in order to define the degree of reliability of patient and relatives reports. Overall agreement between anamnestic and video-recorded informations is excellent for subjective symptoms, and fairly good for objective signs. Subjective manifestations (reported in 90.1% of this group) are described in detail as well as the objective ones, these latter split divided into early and late manifestations.

Electroencephalography↗
PubMed1996

[EEG video recording].

We analyse EEG data from video-EEG recordings of 24 patients, selected among the 63 with "pure" temporal lobe epilepsy. As to interictal EEG features, 62.5% of patients show a less regular background activity on the affected side, in 70% of patients slow waves are either localised or lobar, while in 58% are spikes. Slow waves and spikes have the same well-defined localisation in 37.5% of the patients. Ictal recordings show an initial EEG pattern with high localising value (low-voltage fast activity, flattening or slow waves interruption) in 74/121 seizures (61%). Five out of these 24 patients were operated on without invasive recordings on the basis of ictal video-EEG data. In the 19 patients left, video-EEG ictal informations were used for the planning of the stereo-EEG exploration.

Electroencephalography↗
PubMed1996

[Surgical treatment of temporal lobe epilepsy: reality and prospectives].

This chapter provides a synthetic overview of the topics treated in this issue. Presurgical diagnostic procedures are schematically described and an analysis of surgical results is made in comparison with those obtained from other epilepsy surgery groups. Surgical complications linked both to invasive presurgical diagnostic procedures and therapeutic surgical acts are described. Finally, the creation of new epilepsy surgery centres is suggested on the basis of epidemiological data, which demonstrate the discrepancy among the patients operated on at present and those who could benefit from the surgical treatment.

Decision Making↗
PubMed1995

Color flow mapping of the middle cerebral artery in 23 hydrocephalic fetuses.

Color flow mapping was performed on 23 fetuses with hydrocephaly. The measurements on the middle cerebral artery posed no problem. We found end-diastolic frequencies in all cases. The pulsatility-indices were raised in only 4 cases. Color Doppler sonography gave no extra information about diagnosis or prognosis.

Blood Flow Velocity↗
PubMed1995

[Efficacy of high-frequency cinematography in diagnosis of dysphagia].

Dysphagia is a common symptom in clinical practice. Due to the broad spectrum of underlying diseases many disciplines are involved in the therapy and diagnosis of dysphagia, where radiology plays a central role. The radiologist is confronted with different diagnostic problems and has to choose the most appropriate type of investigation. In many cases no organic disorder can be demonstrated by clinical examination, endoscopy or conventional radiological techniques. In this setting cineradiography is an outstanding tool for finding functional or structural changes in the swallowing chain. This study underlines the efficiency of cineradiography in the diagnosis of dysphagia.

Adult↗
PubMed1994

Metaanalysis of prophylactic drug treatment in the prevention of postoperative bleeding.

Prophylactic drug treatment is one of several strategies to reduce postoperative blood loss and potentially limit homologous blood use in open heart surgery. A computerized MEDLINE search supplemented with manual bibliography reviews was performed for randomized clinical trials published in peer-reviewed English-language journals from January 1980 to June 1993. A metaanalysis was conducted of trials evaluating desmopressin (group DD, n = 13), epsilon-aminocaproic acid or tranexamic acid (group EA, n = 4), and aprotinin (group AP, n = 16). Eligible studies used placebo controls and administered the drug in a prophylactic manner. The primary study end point was postoperative chest tube loss (mL, mean +/- standard deviation). There was a significant reduction in postoperative chest tube loss detected for each of the active treatments versus the placebo (DD versus controls: percent reduction 0.11, p = 0.0021; EA versus controls: percent reduction 0.30, p < 0.0001; and AP versus controls: percent reduction 0.36, p < 0.0001). Therapy with EA or AP was associated with a greater reduction in chest tube loss than DD (EA versus DD, p = 0.0033, and AP versus DD, p < 0.0001). Secondary study end points were transfusion requirements, chest reexploration, and perioperative mortality. The volume of postoperative red cell transfusion (mean +/- standard deviation) was reduced with EA (p < 0.0001) or AP treatment (p < 0.0001) compared with a placebo or DD, whereas the proportion of patients given transfusions was limited only in the AP-treated patients (odds ratio 0.23; 95% confidence interval, 0.16 to 0.33; p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Aminocaproic Acid↗