PubMed Health⌕ Search

Biomedical subjects

A Abela

Publications and source records attributed to A Abela.

11 recordsLinked to original sources
PubMed2001

Nontuberculous mycobacterial adenitis of the head and neck in children: experience from a tertiary care pediatric center.

OBJECTIVE: To describe our experience with the diagnosis, surgical treatment, and outcome of nontuberculous mycobacterial (NTM) adenitis of the head and neck in children, and to present a preliminary report about the use of NTM skin tests in our institution. STUDY DESIGN: Retrospective study. METHODS: The medical records of all children diagnosed with cervicofacial NTM adenitis were retrospectively reviewed for the period from January 1, 1995, through December 31, 2000. We also examined the use of intradermal skin tests for the diagnosis of NTM infection. RESULTS: Fifty patients were diagnosed with NTM cervicofacial adenitis. Pertinent demographic information, clinical presentation, investigation, and type of diagnostic procedures were documented. Surgical procedures, complications, and relapses were also noted. One unusual case of retropharyngeal adenitis is illustrated. All patients were treated with complete excision of their lesion at the first operation. No major complications were noted. Only one patient relapsed and required a second operation. Forty-one children were skin-tested with NTM antigens. Of these, 30 patients were dual-tested with Purified Protein Derivative (PPD) also. No adverse reactions were noted with the use of skin tests. Sensitivity of NTM antigens alone is 87%. Sensitivity of dual testing is 78%. No patient had a PPD-dominant reaction. CONCLUSION: Surgical excision is the treatment of choice of NTM adenitis because of the high cure rate with a single procedure, the excellent cosmetic result, and the low complication rate. NTM skin tests are safe and could be useful in early diagnosis of the infection but further investigation is needed.

Biopsy↗
PubMed2001

Anterior and posterior middle ear congenital cholesteatomas in children.

Congenital cholesteatomas arise from embryonic epithelial cell rests in the middle ear cleft. We report our series of 19 cases observed in 18 children between 1985 and 1990. Clinical data and surgical observations are analyzed. In regard to the location of the lesions, our findings are consistent with most of what has been reported in the literature. Sixty-eight percent of the lesions originated from the anterosuperior part of the mesotympanum. Only 10% were posterosuperiorly located. Pathogenic mechanisms are discussed with respect to the lesion's primary site.

Audiometry↗
PubMed1997

Lymphangiomas in children: percutaneous sclerotherapy with an alcoholic solution of zein.

PURPOSE: To determine the efficacy of percutaneous sclerotherapy with an alcoholic solution of zein in lymphangiomas in pediatric patients. MATERIALS AND METHODS: Fourteen patients with macrocystic and mixed lymphangiomas were treated with use of Ethibloc as a sclerosing agent. The procedure was performed with ultrasonographic and/or fluoroscopic guidance. Follow-up clinical and sequential computed tomographic examinations were performed to evaluate regression of the lesion. RESULTS: Regression was excellent in nine (64%) of the 14 lesions: Regression was complete in four lymphangiomas and was to less than 5% of the initial volume in five. Satisfactory results were obtained in the remaining five (36%) of 14 lesions. The most frequent complication was leakage of Ethibloc without important sequelae in 10 of the 14 lymphangiomas. CONCLUSION: Percutaneous sclerotherapy with Ethibloc was a safe and effective procedure in the treatment of macrocystic and mixed lymphangiomas.

Adolescent↗
PubMed1995

Endonasal dacryocystocele of the newborn.

The true incidence of endonasal dacryocystocele in the newborn is probably underestimated; the number of cases in the last few years has increased with better imaging techniques and diagnostic tools. Although infrequent, it must be considered in the differential diagnosis of neonatal respiratory distress and nasal obstruction. These children typically present an endonasal mass under the inferior turbinate, most often associated with inner canthal swelling. This series of four patients represents one of the largest to be reported since the first publication on the subject by Goralowna in 1979.

Dacryocystitis↗
PubMed1994

Neural and myogenic effects of leukotrienes C4, D4, and E4 on canine bronchial smooth muscle.

The leukotrienes (LTs), referred to as the slow-reacting substance of anaphylaxis (SRS-A), are reported to have little or no activity in the canine airway. The objective of this study was to determine whether LTC4, LTD4, and LTE4 (10(-10)-10(-7) M) play a role in neuromuscular control of third- to fifth-order canine bronchi. In the presence of 1 microM indomethacin (Indo), canine bronchial smooth muscle contracted and was depolarized in a concentration-dependent manner by LTC4 or LTD4 but not by LTE4. LTC4 and LTD4 concentration-response curves were not significantly affected when conducted in the presence of any of the following: 10(-7) M propranolol (beta-adrenoceptor antagonist), 10(-6) M chlorpheniramine (H1-receptor antagonist), 10(-6) M ketanserin (nonselective 5-hydroxytryptamine receptor antagonist), 10(-7) M atropine (muscarinic receptor antagonist), and 10(-6) M tetrodotoxin (sodium channel blocker). LTC4 and LTD4 also potentiated electrical field-stimulated (EFS) excitatory junction potentials (EJPs), suggesting a possible prejunctional enhancement of acetylcholine release. In the absence of Indo, no postjunctional responses to LTC4 and LTD4 occurred. Endogenous prostaglandin E2 (PGE2) and 6-keto-PGF1 alpha (a stable metabolite of PGI2) levels from canine bronchi were significantly reduced by Indo. In the presence of Indo, addition of > or = 10(-8) M of PGE2 suppressed contractions to LTC4 and LTD4. These data suggest that the decrease in PGE2 and PGI2 production by Indo is sufficient to unmask the excitatory postjunctional actions of LTC4 and LTD4 on bronchial smooth muscle. Serine borate (45 mM; an inhibitor of gamma-glutamyl transpeptidase, which prevents the conversion of LTC4 to LTD4) increased selectively the contractile activity of LTC4. L-Cysteine (3 mM; an inhibitor of an aminopeptidase, which prevents the conversion of LTD4 to LTE4) enhanced the contractile responses to LTD4. Serine borate increased the amplitude and duration of EFS contractions and potentiated the amplitude of EFS EJPs; the last effects were prevented by nordihydroguaiaretic acid. These and other studies suggest that LTs are synthesized by canine bronchi and have receptors on canine bronchial smooth muscle but that contractions to LTC4 and LTD4 in the canine airway are usually not observed because of the presence of inhibitory prostanoids (PGE2 and PGI2). We suggest that decreases in PGE2 and PGI2 in models of airway disease in combination with increases in LTC4, LTD4, and thromboxane A2 may contribute to airway hyperresponsiveness in vitro.

6-Ketoprostaglandin F1 alpha↗
PubMed1992

The internal calcium store in airway muscle: emptying, refilling and chloride. Possible new directions for drug development.

This review examines the ionic mechanisms underlying acetylcholine (Ach) depolarization of airway smooth muscle and suggests that multiple mechanisms are involved. Increased chloride and nonspecific cation conductance, and decreased or rapidly inactivating potassium conductances seem to be involved. Chloride ions also seem to play an important role in determining whether Ca2+ remains inside or is replenished in the sarcoplasmic reticulum (SR). The physiological role of Ach-induced depolarization is analysed and is suggested to be the promotion of the refilling of Ca2+ stores, partly through a direct refilling of SR-Ca2+ stores by way of an L-type Ca2+ channel. This refilling is promoted by Ca2+ channel agonists and is independent of the transmembrane potential. Ca(2+)-release by a variety of agonists leads to depolarization and stable membrane oscillations which depend on the action of the Ca(2+)-store uptake mechanisms in order to function. These oscillations may play a role in prolonged bronchoconstriction. Better knowledge of the control mechanisms of Cai2+ is likely to reveal new targets for the therapy of asthma and provide a better understanding of the function of airway smooth muscle.

Acetylcholine↗
PubMed1991

The large vestibular aqueduct syndrome and sensorineural hearing loss in the pediatric population.

Sensorineural hearing loss, associated with a dilated vestibular aqueduct, is often described as progressive. Since 1982, computed tomography of the mastoids has become part of the routine investigation of deaf children at Sainte-Justine Hospital. Using clinical, audiometric and radiological material from 130 patients with sensorineural hearing loss, we identified 18 patients with enlarged vestibular aqueducts. The large vestibular aqueduct population was then compared to the normal vestibular aqueduct patients in regard to the degree and evolution of the sensorineural hearing loss. Progression of hearing loss was noted in 46% of patients in the presence of large vestibular aqueducts as compared to 35% in the absence of this anomaly. Normal radiographic findings did not exclude the possibility of further hearing loss.

Child↗
PubMed1987

Myeloperoxidase deficiency with extensive candidal osteomyelitis of the base of the skull.

A 6-year-old girl had a 7-month history of headaches and painful torticollis. A CT scan of the mastoids showed extensive bone destruction of the base of the skull and C-1. Biopsies of the retropharyngeal area and of the anterior aspect of C-1 were performed: histopathologic findings were suggestive of mycotic infection and cultures were positive for Candida albicans. The child was treated successfully with amphotericin B. The immunologic evaluation demonstrated the absence of myeloperoxidase in the neutrophils.

Candidiasis↗
PubMed1985

Dermoid cyst of the Eustachian tube.

A case of congenital dermoid cyst of the Eustachian tube is reported. Only seven similar cases have been found in our review of the literature. The embryology and usual mode of presentation of these cysts are discussed. Finally, a new surgical approach using a combined retro-auricular and protympanic route is presented.

Dermoid Cyst↗
PubMed1984

Post-myringotomy care: a prospective study.

Children with tympanostomy tubes have always been considered somewhat handicapped in regard to swimming and bathing. Their parents had to maintain constant surveillance to prevent then from getting water in their ears. A prospective study involving more than 1,000 children was conducted between June 1981 and August 1982 on two groups of randomly selected patients to determine the prevalence of suppurative otitis media and its relationship to bathing and swimming. One group had to follow strict rules to prevent water entering the ear (bathing caps, earplugs) whereas the other group was allowed to bathe and swim without any precaution upon the condition of using a polymyxin B/gramicidin ear drop combination at bedtime on the day they swam. The study shows no increase in prevalence of suppurative otitis media in the "open canal" group as compared to the "closed canal" group. Furthermore, the monthly distribution of infections shows a relatively evan distribution throughout the year. This study implies that swimming and bathing are safe for the vast majority of children with tympanostomy tubes and thus simplifies enormously the post-myringotomy care for the child, the parents, and the physician.

Baths↗