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Biomedical subjects

T Palva

Publications and source records attributed to T Palva.

At least 109 records · Page 6Linked to original sources
PubMed1978

Use of lyophilized dura in aural surgery.

Lyophilized dura was utilized in chronic ear surgery to cover raw promontory surfaces, to stabilize the reconstructed ossicles, to raise the posterior insertion point of the grafted drum after canal wall removal, and to fortify the soft posterior canal wall. In 3 guinea pigs, lyodura was also placed in the bulla and studied 6, 12 and 16 months later. In 6 months of time, lyodura had become covered with normal epithelium and in 12 months of time, the greatest part of the lyodura was resorbed from the middle ear, normal epithelium having developed. In the canal wall area, resorption is slower and collagenic dural network is clearly recognizable even after a period of 24 months. Lyophilized dura contains no irritating material and is considered to be a versatile and useful material in chronic ear surgery.

Animals↗
PubMed1977

The morphology of the vestibular nerve in a patient with normal vestibular function and in patients with Ménière's disease.

The morphology of the vestibular nerve was studied in three fresh nerve specimens obtained by surgery from two patients with Ménière's disease and one patient with tinnitus after an attack of sudden deafness. The number of nerve fibres appeared light microscopically normal. The vestibular ganglion cells of the Ménière-specimens showed, as a characteristic finding advanced vesiculation of the cytoplasm. This change was confirmed by electron microscopy and the vacuoles appeared to consist of widened endoplasmic reticulum cisternae. Numerous primary lysosomes and lipofuscin granules were observed in all vestibular ganglion cells but their number appeared increased in the specimens from Ménière-patients. Some of the vestibular ganglion cells of these patients showed a filamentous appearance and the number of glycogen granules seemed reduced in all of them. All vestibular ganglion cells observed were unmyelinated. The degenerative changes observed might explain the typical elevation of the threshold for vestibular stimulation in Ménière's disease.

Adult↗
PubMed1977

Evaluation of patients with bronchial carcinoma.

Results of diagnostic procedures are presented on 259 successive patients with bronchial cancer at Päivärinne Chest Hospital during the period 1967-73. The most common tumours were epidermoid (56%), 'small cell' (20.5%) and adenocarcinoma (9.5%). In 106 patients (41%) chest radiography suggested a tumour, though bronchoscopy was normal, and in 22 cases (8.5%) the radiograph was normal but bronchoscopy revealed a tumour. In 10 (4%) both the radiological and the bronchoscopic findings were normal. A definite histopathological diagnosis was reached by bronchoscopy in 144 patients (44%), by mediastinoscopy in 14 (5%), by fine needle biopsy in 28 (11%) and operatively in 103 (40%). Using all methods of treatment prognosis was significantly better in the group that had been diagnosed by mass miniature radiography, or accidentally (29% alive) as compared with those who had symptoms of the disease (6%).

Adult↗
PubMed1977

Bronchial findings in pulmonary tuberculosis.

A total of 297 bronchoscopies were performed on 238 patients with pulmonary tuberculosis at the Paivarinne Chest Hospital during the period 1967--1973. The tuberculous process was deemed active in 172 patients and inactive in 66. Active endobronchial tuberculosis was diagnosed in 20 patients, 11.6% of the active cases, whereas inactive sequelae of endobronchial tuberculosis appeared in 7% of the total material. Bronchography was performed on 163 patients; a normal bronchogram was obtained in 54% of the cases with minimal changes, 35% of the moderately advanced cases, 13% of the far advanced and 23% of the inactive cases. Sputum samples were more often positive for tubercle bacilli than the bronchial aspirates, and bacterial cultures from sputum samples were less reliable indicators of infection than were cultures from bronchial aspirates. Cytological smears revealed no difference between these two sampling methods.

Adult↗
PubMed1977

Haemoptysis. A bronchological evaluation.

A series of 342 patients with haemoptysis, who underwent bronchological examination at Päivärinne Chest Hospital during the period 1967-73, is presented. The most frequent cause of haemoptysis was bronchial carcinoma (86 cases, 25%), with chronic bronchitis in 73 cases (21.5%, inactive pulmonary tuberculosis in 33 (9.5%), bronchiectasis in 22 (t.5%), active pulmonary tuberculosis in 21 (6%) and pneumonia in 17 (5%). The cause of bleeding remained unkown in 73 cases (21.5%). Bronchoscopic findings were normal in 86 patients (25%) and only inflammatory mucosal changes were found by bronchoscopy in 181 patients (53%). A bleeding bronchial carcinoma was identified in 42 patients. The exact bleeding point was observed in the mucosa in 10 patients, and bleeding could be traced to the segmental bronchus in 18 patients, to the lobar bronchus in 2 and to the main bronchus in 3. One attack of haemoptysis, in a case of tuberculosis ended fatally. In all cases in which bleeding was still present at the time of bronchoscopy the bleeding point could be traced at least to the segmental bronchus.

Adolescent↗
PubMed1977

Acquired tracheobronchomalacia.

In a series of 2150 patients subjected to bronchoscopy 94 (4.5%) were found to have tracheobronchomalacia. Tracheomalacia alone was diagnosed in 21 patients (22%), tracheobronchomalacia in 59 (63%) and bronchomalacia alone in 14 (15%). Mild malacic changes were noted in 44 patients (47%), moderate in 38 (40.5%) and severe in 12 (12.5%). The main symptoms were dyspnoea (63%), chronic cough with expectoration (49%) and haemoptysis (33%), and the most frequent concurrent diseases chronic bronchitis (53%), bronchial cancer (27.5%) and pulmonary tuberculosis (19%). Bronchoscopy performed under local anaesthesia enabled the dynamics of the tracea and bronchi to be observed during spontaneous breathing and during coughing, and it is the best available diagnostic procedure. Histologically the number of longitudinal elastic fibres in the pars membranacea was clearly reduced throughout the whole tracheal area in one patient with tracheomalacia but no differences were found in the amount of collagen, mucopolysaccharides and elastin in the cartilages of trachea and bronchi. This disease seems to be associated with chronic obstructive pulmonary diseases such as chronic bronchitis, and it apparently shares the same aetiological factors.

Aged↗
PubMed1976

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↗
PubMed1976

Immediate and short-term complications of chronic ear surgery.

Complications of chronic ear surgery in a series of 2,192 operations are reported. Inadvertent opening of the inner ear occurred in 18 cases, leading to deafness in six ears. Four ears became deaf without apparent cause, for a total of ten (0.5%). High-tone sensorineural losses resulted in 3% of the ears. Facial nerve paralysis occurred in ten ears; in one of these, a graft was employed during primary surgery. All patients had a good recovery. It is stressed that to keep the number of complications at a minimum, strict rules must be followed and sufficient supervision offered in chronic ear surgery in teaching institutions.

Deafness↗
PubMed1976

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↗
PubMed1976

Chronic bronchitis. A bronchologic evaluation.

214 patients with chronic bronchitis were subjected to bronchial studied at Päivärinne Chest Hospital during the period 1967-1973. Bronchoscopy alone gave a frequency of 30% for bronchiectases while the information from bronchography increased this figure to 44%. In addition, 24% of the patients showed bronchographic changes in the form of naked filling or mucus obstrcution. Sputum specimens were less reliable indicators of infection than bronichial aspirates in patients with chronic bronchitis. Tracheobroncho-malacia was found in 50 patients and greatly increased the gravity of the disease.

Adolescent↗
PubMed1976

Middle ear effusions -- complications of disease and treatment.

The results of treatment of secretory otitis media with commonly found disease in Finland is described. Treatment includes adenoidectomy and/or insertion of tympanostomy tubes with mastoidectomy in selected cases. Tympanostomy tube treatment results in an increased amount of visible tympanic membrane scar formation and tympanosclerosis, but these are of no major functional importance. In about 10 per cent of the glue ears a mastoid disease process complicates the disease. Here thorough mastoidectomy at an early stage is the treatment of choice. Cholesteatoma formation appears in about two per cent, but in the majority of cases this is not related to tympanostomy treatment but is due to the disease process itself.

Adenoidectomy↗
PubMed1975

Staged surgery in ears with excessive disease of tympanum.

Results regarding tympanic healing and hearing improvement are reported in a series of 84 one-stage operations on the middle ear, using thin silicone elastomer sheeting, and of 76 two-stage operations using temporary filling of the middle ear with paraffin wax, and of ten with silicone elastomer sponge. All epithelium was removed from the tympanic cleft at the primary operation. Staging of the operation gave better hearing results and resulted in fewer adhesive middle ears. Middle ear mucosal biopsies from ears with mucus production around the paraffin showed an increased number of glands and secreting epithelial cells, much as in glue ears. Residual or recurrent cholesteatoma appeared in only 2.4%, which is attributed to resection of the posterior canal wall in cases of cholesteatoma, as contrasted with the intact canal wall technique.

Air↗
PubMed1975

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↗
PubMed1975

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↗
PubMed1975

Re-mediastinoscopy.

In a series of 1,188 mediastinoscopies, six re-mediastinoscopies (0.5%) were made. The indications for repeated mediastinal exploration can be made more lenient since the adhesions between the innominate artery and the trachea need not always be extensive; if they are, an alternative paratracheal route can be used. Caution should be used, keeping possible vascular complications in mind, but we believe that an earlier mediastinoscopy does not contraindicate a repeated procedure.

Adult↗