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Biomedical subjects

Y Finkelstein

Publications and source records attributed to Y Finkelstein.

At least 91 records · Page 5Linked to original sources
PubMed1992

The riddle of the uvula.

Since ancient times, the uvula has been a subject of interesting and contradictory observations. On the one hand, it was regarded as having a functional role in speech and in immunology, but on the other hand it was regarded as a potentially hazardous organ, possibly responsible for sudden infant death syndrome. None of these hypotheses, however, has been proved. In a previous study on patients undergoing uvulopalatopharyngoplasty, we suggested that the most important function of the uvula is connected with the muscularis uvula. Its function could be related to drinking while bending over. This previous assumption was that the uvula is a phylogenetic remnant from mammals that drink while bending their neck downward. In the present study, the soft palate of eight different mammals was macroscopically and microscopically studied and compared. Of all animals in the study, a small underdeveloped uvula was found only in two baboons. We found that the human uvula consists of an intermix of serous and seromucous glandular masses, muscular tissue, and large excretory canals. The serous and seromucous glands are absent in the other mammals. Thus, the uvula is a highly sophisticated structure, capable of producing a large quantity of fluid saliva that can be excreted in a short time. Both uvula and speech serve to differentiate human beings from animals. Our conclusion is that the uvula is possibly an accessory organ of speech, and may be another marker of human evolution that differentiates man from other mammals.

Animals↗
PubMed1992

Effects of acute negative middle ear pressure on hearing. New answers to old questions and a review of the literature.

The magnitude of hearing loss caused by negative middle ear pressure is a controversial issue. We present a clinical, prospective and controlled study on the effect of negative middle ear pressure on hearing in human ears. Sixty-two ears of patients undergoing uvulopalatopharyngoplasty were examined pre- and postoperatively. The test group consisted of 31 ears in which negative postoperative middle ear pressure ranging between -150 and -400 mmH2O had developed. The control group consisted of 31 ears in which no middle ear pressure change was recorded after the same operation. Bone conduction hearing loss up to 20 dB (with a mean of 11 dB) at 250 Hz, up to 25 dB (with a mean of 13.1 dB) at 500 Hz and up to 10 dB (with a mean of 7.6) at 1,000 Hz was the dominant finding. An additional air-bone gap up to 15 dB (with a mean of 4.3 dB) was found only at 250 Hz. Basic theories about the acoustic response of the ear are discussed and new theories proposed.

Adult↗
PubMed1992

Auditory brainstem evoked response in patients undergoing carotid endarterectomy.

Auditory brainstem evoked response-(ABR) may be affected by changes in cerebral blood flow. Apart from its primary indications for prevention of stroke and transient ischemic attacks-(TIA's), internal carotid endarterectomy-(ICE) has been shown to improve cognitive function and cause diminution of tinnitus and vertigo. A one-week postoperative ABR previous study of patients undergoing ICE demonstrated no change in ABR recordings. In order to evaluate possible late changes, we have conducted a prospective study of the delayed effects of ICE on ABR in 13 patients. No initial pathology was noted and no significant change found in any of the absolute and interpeak latencies of ABR waves.

Acoustic Stimulation↗
PubMed1991

Impulsive artistic creativity as a presentation of transient cognitive alterations.

A 27-year-old right-handed male mosaic artisan who had not shown any interest in drawing or artistic activity was admitted to the Department of Neurology for attacks of bizarre behavior and convulsive disorder. The patient reported feeling "waves" engulfing him during the attacks, leaving him floating helplessly. During some attacks, the patient impulsively initiated drawing activity. Interictal sleep-deprivation EEG showed a left frontotemporal focus of paroxysmal discharge. Brain tomography with SPECT showed low 99Tc-HMPAO uptake in the left frontoparietal region. Psychodiagnostic tests gave evidence of dysfunction of the left frontal region, with preference of the right hemisphere. It is suggested that the attacks of altered cognitive state were, in this case, provoked by spreading depression of the left hemisphere, while the integrative functions of the right hemisphere remained intact. Thus, the impulsive artistic creativity during the attacks may represent a "release phenomenon" of the complex visuospatial skills of the right (subdominant) hemisphere. This symptomatology of transient cognitive alterations is unique and, to the best of our knowledge, has not been previously reported.

Adult↗
PubMed1991

Squamous and basal cell cancers directly invading major salivary glands.

Epidermoid carcinoma of the skin of the head and neck may uncommonly involve the parotid gland by either direct extension or metastases to the parotid lymph nodes. The parotid gland contains a rich network of superficial and deep nodes, draining a large area of the facial region, with the preauricular, cheek, ear, and eyelid dominating. Few patients with direct parenchymal invasion of the parotid gland by a simultaneously existing squamous or basal cell carcinoma were reported. We could find no report discussing direct tumoral invasion into the submandibular salivary gland. Three patients with squamous cell carcinomas and 2 with basal cell carcinomas of the skin directly involving the underlying salivary glands are presented. The few authors discussing this subject concur that treatment should include resection of the primary tumor along with parotidectomy. Elective neck dissection and irradiation are proposed. The course of disease, treatment, and survival of our patients are discussed.

Adult↗
PubMed1991

Syndrome of inappropriate antidiuretic hormone secretion in cancer of the head and neck.

The syndrome of inappropriate secretion of arginine vasopressin (AVP) known as the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by hyponatremia that results from water retention attributable to persistent AVP release. It may occur in a variety of malignant and nonmalignant lesions, with small cell or oat cell carcinoma of the lung by far responsible for the largest number of these cases. Cancer of the head and neck may be a rare cause of SIADH, and only a few such cases have been reported. We describe four patients with advanced cancer of the head and neck region with coexisting SIADH. Diagnosis and treatment are reported and the literature is reviewed. The possible occurrence of SIADH in the head and neck surgical practice should be kept in mind. Since SIADH is usually transient, water restriction and parenteral sodium chloride may be sufficient in overcoming the acute phase.

Adult↗
PubMed1991

Uvulopalatopharyngoplasty: evaluation of postoperative complications, sequelae, and results.

A study of 71 patients with obstructive sleep apnea syndrome was performed to evaluate the effectiveness, complications, and late sequelae of uvulopalatopharyngoplasty. Postoperative immediate complications were of minor importance. In 96% of the patients, the snoring was improved; it was completely resolved in 48%. The postoperative apnea index remained pathologic in all patients who underwent postoperative polysomnography, although mild improvement was noted. Seventy-four percent of our patients felt a subjective postoperative improvement which was not always confirmed by the polysomnographic examination. A record of improvement was obtained in 64% of the operated patients. Our results establish the beneficial effect of uvulopalatopharyngoplasty, which is the recommended surgical procedure for obstructive sleep apnea syndrome.

Adult↗
PubMed1991

Study of the normal and insufficient velopharyngeal valve by the "Forced Sucking Test".

A thorough assessment of the velopharyngeal (VP) closure dynamics is important for therapeutic planning in patients with nasal speech. An additional diagnostic tool to the standard endoscopic examination of the VP valve, the "Forced Sucking Test" (FST) is presented. In this study, 110 patients with a normal VP valve and 40 patients with VP insufficiency were subjected to a comprehensive endoscopic examination. When existent, Passavant's ridge clearly appears in 80% of these cases during the FST. This is advantageous, since the ridge is often unseen during routine nasendoscopy. Passavant's ridge appears indistinguishable in shape and level during speech and FST. During FST, the bulge of the uvular ridge is clearly seen on the flat or concave nasal surface of the velum. In cases of diastasis of the velar musculature, the midline V-defect of the velum is clearly seen. The test is particularly important in children with concomitant adenoid hypertrophy. The findings are discussed in terms of their implications for the anatomy and physiology of the VP valve. FST is recommended as an additional and complementary part of the endoscopic examination of the VP valve.

Adult↗
PubMed1991

Barotrauma-induced hearing loss.

With the current increase in commercial, military and sports diving to deeper depths, cases of middle and inner ear barotrauma are more frequently noted. Although most of the literature up to the late 1960s has emphasized middle ear barotrauma (MEBT), inner ear barotrauma (IEBT) is reported more frequently than before. MEBT and IEBT are major causes of diving induced hearing loss. MEBT should be treated by prevention and symptomatically when occurring. A labyrinthine window fistula necessitating surgical repair may be caused by IEBT. Although reports of IEBT are relatively few, this entity should be kept in mind and differentiated from other causes of diving-induced hearing loss. The relevant literature is reviewed and diagnosis and treatment are discussed.

Atmospheric Pressure↗
PubMed1991

Decompression sickness induced hearing loss. A review.

Otologic manifestations of decompression sickness (DCS) occur only rarely. However, with more frequent exposures to deeper depths in recent years, several reports of hearing loss due to DCS have appeared. Nevertheless, the scant literature directly discussing the subject establishes otologic DCS as an important cause of diving-induced hearing loss. When hearing impairment with or without vestibular symptoms is a solitary manifestation of DCS type II, it may be difficult to distinguish from middle and inner ear barotrauma resulting in labyrinthine window fistula. Once a diagnosis is established, immediate recompression treatment with hyperbaric oxygen may result in complete recovery. The pathologic mechanism is discussed and the pertinent literature reviewed.

Atmospheric Pressure↗
PubMed1990

Nasopharyngeal pressure gradients during non-phonetic activities of the velopharyngeal valve. Part I.

The phonetic activity of the velopharyngeal valve has been the subject of electromyographic, radiological, ultrasonic, endoscopic, and of various acoustic and aeromechanical investigations. The subject of the present study was the non-phonetic activities of the velopharyngeal valve. Ten patients were assessed by nasendoscopic examinations of the velopharyngeal valve. The pressure gradients in the nasopharynx during these activities were recorded. Typical individual nasopharyngeal pressure patterns were revealed inducing a development of a special technique and tests for a further study of the non-phonetic activities of the velopharyngeal valve in correlation with its abnormality and pathological speech activities.

Adult↗
PubMed1990

Nasopharyngeal pressure gradients during non-phonetic activities of the velopharyngeal valve. Part II.

The subject of our study is the non-phonetic activities of the velopharyngeal valve (VPV). The VPVs of 10 patients were assessed by nasendoscopic examinations. The nasopharyngeal pressure fluctuations were recorded by catheters placed into the nasopharynx. Simultaneous pressure created in the oral cavity was measured as well. In Part I we discussed the swallowing activities and here we describe sucking and blowing activities. The pressure wave tracings and measurements with the nasendoscopic examination provide us with new information which permits a further study of the non-phonetic activity of the VPV and a correlation with its abnormal speech activity.

Adult↗
PubMed1990

Cell membrane activities and regeneration mechanisms as therapy mediators in moxibustion and acupuncture treatments: theoretical considerations.

Needling by acupuncture or heating by moxibustion, the major Chinese medicine modalities, include tissue destruction or increased permeability of cell membrane. Both action potential activities and the release of cellular metabolites responsible for regeneration occurs. These phenomena are eventually abolished by local and systemic inhibitory elements being metabolites or neurogenic. The inhibitory effect induced by the acupuncture and moxibustion and directed to the manipulation site of these modalities may affect other anatomical sites and reduce or prevent neoplastic growth and neuromuscular or cardiac membrane activity disturbances.

Acupuncture Therapy↗