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A Mudry

Publications and source records attributed to A Mudry.

26 records · Page 2Linked to original sources

A history of otology through the development of scientific and medical thought.

The story of the development of civilisation and of humanity is at the base of science, medicine and otology in particular. The evolution of knowledge is better understood by dividing the story into chronological periods. Through primitive, archaic, hellenistic, byzantine, arabian, monastic, scholastic, Renaissance, modern and finally contemporary medicine, otology has progressively found its way. The key to progress is within man, in his conception of life and of the world around him. Otology will be affected by these different trends of thought and will find its place in medicine during the XIX Century, the XX Century being its most prolific period.

Byzantium↗

Risk of transmission of human immunodeficiency virus infection during tympano-ossicular homograft: an experimental study.

It is generally agreed that middle ear reconstructive surgery performed with tympano-ossicular homografts produces superior functional results compared with prosthetic material, especially with respect to extrusion rate. The use of homografts, though, has been seriously hampered recently by the fear of transmission of human immunodeficiency virus (HIV) infection. In HIV-infected patients, the virus is primarily found in the cells of the lymphoid and monocytic lineage. The nature of the tissues in the eardrum and ossicles, mostly fibrous tissue and compact bone without marrow, suggests that little virus load should be found in homografts. Indeed, culturing minced homograft tissue from two HIV-infected donors with acquired immune deficiency syndrome (AIDS) in a sensitive culture system with PHA-stimulated lymphoblasts produced no virus. Before use, homografts undergo a fixation procedure in 5% formaldehyde and then are kept in a solution containing Cialit as a preservative. The authors therefore examined the capacity of formaldehyde and Cialit to reduce the infectivity of HIV in models of infected tissue as measured in vitro. The reduction of in vitro infectivity due to these treatments was at least 10(5)-fold and 10(2)-fold, respectively. Coupled with the low virus burden in tympano-ossicular tissue, our data suggests that the fixation procedure affords such a reduction in infectivity that the risk of HIV transmission, even from an HIV-infected donor, is vanishingly low.

Culture Techniques↗

The use of the covered Wallstent for the palliative treatment of inoperable tracheobronchial cancers. A prospective, multicenter study.

STUDY OBJECTIVE: To investigate the safety, efficacy, and tolerance of the covered Wallstent for the palliative treatment of inoperable tracheobronchial cancer. DESIGN: An 8-month prospective study employing either a rigid bronchoscope or a flexible delivery system for prosthesis insertion. SETTING: Multicentric setting involving four teaching hospitals in Switzerland and Germany. PATIENTS: Forty patients (29 men, 11 women), average age of 62 years, presenting with an inoperable tracheobronchial cancer. INTERVENTIONS: After partial airway recanalization with an Nd-YAG laser, the covered Wallstent was inserted 23 times using a rigid bronchoscope (Rigidstep device), and 27 times using a flexible delivery system (Telestep device) under fluoroscopic and endoscopic visualization. RESULTS: Clinical and endoscopic examination at 1, 30, and 90 days showed improvement in the bronchial lumen and in the dyspnea index. No serious complication (death, perforation, hemorrhage, inability to remove an improperly placed prosthesis) was observed during surgery. Late complications included migration (12%), inflammatory granulations or tumor regrowth at the tip of the prosthesis (36%), and symptomatic retention of secretion (38%). CONCLUSIONS: Compared with other tracheobronchial prostheses, notably the Dumon stent, the covered Wallstent presents the following advantages: insertion with visual guidance, treatment of extrinsic compressions and esophagobronchial fistulas, and little chance of migration when the prosthesis diameter is chosen correctly. The following disadvantages can be noted: high price; both repositioning and extraction of the released stent are more difficult, though certainly possible; and risk of granulations at the tips of the prosthesis and retention of secretions. Suggestions are made for potential improvements to the stent and insertion system that may result in a significant decrease in early and late complications.

Adult↗

[Anatomy of the pharyngo-laryngeal crossing].

The anatomy of the pharyngo-laryngeal region can be considered from different points of view. The anesthetist should be aware of some important details that will help him during the intubation maneuvers. The anatomist and the ENT surgeon will guide him through the following landmarks: the basis of the tongue, the epiglottis, the arytenoids and the vocal cords.

Anesthesiology↗