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Biomedical subjects

C Gysin

Publications and source records attributed to C Gysin.

13 recordsLinked to original sources
PubMed1999

The role of a graded profile analysis in determining candidacy and outcome for cochlear implantation in children.

Assessment of candidacy for cochlear implantation in children continues to present a challenge to cochlear implant programs. The efficacy of implantation depends on a number of factors and as a result a multidisciplinary approach has been adopted. At the Cochlear Implant Program at The Hospital for Sick Children, Toronto, we use a graded profile analysis (GPA) which has been adapted from the Children's Implant Profile (CHIP) developed by Hellman (S.A. Hellman, P.M. Chute, R.E. Kretschmer, M.E., Nevins, S.C. Parisier, L.C. Thurston, The development of a Children's Implant Profile, Am. Ann. Deaf. 136 (1991) 77-81). This structured assessment allows each potential candidate to be 'scored' in each category of assessment giving a potential range of -14 to +14. In this retrospective study of 109 candidates we examine the relationship between GPA scores and decision to implant. For those patients who were implanted, the relationship between GPA score and speech perception outcomes was also evaluated. Three distinct groups of children emerged from the analysis. The first group had scores less than 5 and were not considered to be suitable for implantation. Within the second group who scored between 5 and 8, there was no clear relationship between decision to implant and score. The last group, who scored 9-14, was considered to be generally suitable for implantation provided that there were no medical contraindications and the parents consented to implantation. There was a significant association between rate of improvement of speech perception and GPA score. Those patients with scores of 9 to +14 improved at a faster rate than group 5-8 (P < 0.05). The implications of these findings are discussed.

Adolescent↗
PubMed1999

Percutaneous or surgical tracheostomy: a meta-analysis.

OBJECTIVE: To compare percutaneous with surgical tracheostomy using a meta-analysis of studies published from 1960 to 1996. DATA SOURCES: Publications obtained through a MEDLINE database search with a Boolean combination (tracheostomy or tracheotomy) and complications, with constraints for human studies and English language. STUDY SELECTION: Publications addressing all peri- and postoperative complications. Studies limited to specific tracheostomy complications or containing insufficient details were excluded. Two authors independently selected the publications. DATA EXTRACTION: A list of relevant surgical variables and complications was compiled. Complications were divided into peri- and postoperative groups and further subclassified into severe, intermediate, and minor groups. Because most studies of percutaneous tracheostomy were published after 1985, surgical tracheostomy studies were divided into two periods: 1960 to 1984 and 1985 to 1996. The articles were analyzed independently by three investigators, and rare discrepancies were resolved through discussion and data reexamination. DATA SYNTHESIS: Earlier surgical tracheostomy studies (n = 17; patients, 4185) have the highest rates of both peri- (8.5%) and postoperative (33%) complications. Comparison of recent surgical (n = 21; patients, 3512) and percutaneous (n = 27; patients, 1817) tracheostomy trials shows that perioperative complications are more frequent with the percutaneous technique (10% vs. 3%), whereas postoperative complications occur more often with surgical tracheotomy (10% vs. 7%). The bulk of the differences is in minor complications, except perioperative death (0.44% vs. 0.03%) and serious cardiorespiratory events (0.33% vs. 0.06%), which were higher with the percutaneous technique. Heterogeneity analysis of complication rates shows higher heterogeneity in older and surgical trials. CONCLUSIONS: Percutaneous tracheostomy is associated with a higher prevalence of perioperative complications and, especially, perioperative deaths and cardiorespiratory arrests. Postoperative complication rates are higher with surgical tracheostomy.

Adult↗
PubMed1999

Frey syndrome before Frey: the correct history.

OBJECTIVE: To review the chronology of publications on gustatory sweating before Frey's landmark publication. METHODS: Reports on Frey syndrome were reviewed, and all references given to publications before 1950 were obtained and examined. References to prior publications in the obtained articles were similarly reviewed. The cases described in these publications were analyzed for their compatibility with the accepted clinical symptoms of Frey syndrome. RESULTS: Despite numerous references, the case described by Duphenix in 1757 is most probably a traumatic parotid fistula. The first reported case of Frey syndrome should be attributed to Baillarger in 1853.

Eponyms↗
PubMed1999

Review of objective topographic facial nerve evaluation methods.

OBJECTIVE: This study is a critical review of the described methods for objective topographic evaluation of facial nerve function to identify areas of consensus and point to future research topics. SOURCES AND STUDY SELECTION: Original research articles on the subject were identified through the Medline database and reference cross-checking. DATA EXTRACTION AND SYNTHESIS: The articles were grouped according to the methodology used for topographic facial nerve evaluation. The advantages and shortcomings of each method are evaluated. The results obtained in each publication are presented in light of the method used. CONCLUSION: Measurements localized around the facial area under investigation show maximal displacement, whereas other sites exhibit much smaller displacements. Large displacements in these locations can be used to assess synkinesis and contractures. Large intersubject variability of the same measure is found. Both linear measurement and image-subtracting techniques hold promise. but until comparative studies are performed, the best method will remain controversial. Simple systems, accurately evaluating facial motor function, are yet to be developed.

Anthropometry↗
PubMed1997

Microscopic tonsillectomy: a double-blind randomized trial.

OBJECTIVE: To evaluate microsurgical bipolar cautery tonsillectomy (TEmic) by comparing it with traditional blunt dissection tonsillectomy (TEtrad). DESIGN: A double-blind prospective randomized trial with stratification in two age groups. PATIENTS: 200 consecutive patients undergoing tonsillectomy for tonsillar hypertrophy, or recurrent or chronic tonsillitis. OUTCOME MEASURES: Duration of surgery, intraoperative bleeding, daily postoperative pain and otalgia, postoperative bleeding episodes. METHODS: Duration of surgery and operative bleeding were evaluated by the anesthesiologist. The patients were instructed to record daily pain and otalgia. Final postoperative evaluation was done by a different physician, blinded to the surgical technique. RESULTS: Mean intraoperative bleeding was 12 ml for TEmic and 36 ml for TEtrad (P < 0.001). Mean duration of surgery was 37 minutes for TEmic and 36 minutes for TEtrad (NS). Otalgia was present in 41% of TEmic patients and 69% of TEtrad patients (p < 0.001). Daily postoperative pain was lower in the TEmic group than it was in the TEtrad group for the entire study period (10 days). Postoperative hemorrhage was present in three TEmic patients (3%) and in eight TEtrad patients (8%), a difference that did not reach significance (p > 0.1). CONCLUSION: Microsurgical bipolar cautery tonsillectomy compares favorably with traditional techniques in terms of intraoperative bleeding, postoperative pain, otalgia, and hemorrhage. This technique combines the hemostatic advantage of cautery dissection, the excellent visualization achieved by a microscope, and, with the use of a video, greatly improves the physician's ability to teach how to perform a tonsillectomy.

Biological Products↗
PubMed1978

Stereological study of the zona fasciculata of the adrenal cortex in stress situations (hypothermia, catabolism).

The ultrastructure of the rat fasciculata cells in stress situations, such as catabolism and hypothermia was compared descriptively and quantitatively by stereological methods with that of the nonstimulated rat fasciculata cell. The volume and surface densities are expressed per cm3 of cytoplasm, mitochondria and smooth endoplasmic reticulum. Furthermore, absolute values are given. In both stress situations the volume density of the mitochondria compared to the controls is enlarged significantly (H: 37% CA: 50%). The significant increase of the average single mitochondrium of the fasciculata cell (H: 58% CA: 58%) shows a real growth of the mitochondria in these stress situations. Also the surface density of the mitochondrial inner membranes--the mitochondrial enzymes for steroid genesis are partly located in these membranes--shows a significant increase (H: 31%, CA: 84%). Whereas the volume density of the smooth endoplasmic reticulum remains unchanged, the surface density is significantly raised (H: 44%, CA: 60%). An attempt was made to draw up a relationship between stereological and known biochemical data of steroid genesis within the fasciculata cell. An activation in both stress situations could be observed. The stereological data reflect a subcellular reaction pattern, which is similar to exogenous ACTH administration, thus indicating an endogenous ACTH liberation due to these stress conditions.

Adrenal Cortex↗
PubMed1976

Stereology of liver biopsies from healthy volunteers.

The stereological model and the base-line data of normal human liver needle biopsy-specimens are presented. Four reference systems were introduced: 1 cm3 of liver tissue, 1 cm3 of hepatocyte, 1 cm3 of hepatocytic cytoplasm and the volume of an average "mononuclear" hepatocyte. The sampling was done at three levels of magnification (1,000 X, 5,000 X and 10,000 X). A lobular differentiation was not considered. The baseline data show strikingly small variations (s.e. less than 10%) within the individual biopsy specimen and within the group of four biopsies. There is no principal difference between human beings presented here, rats, mice and dogs. Only the mean individual volume of human hepatocytes is clearly larger than in rodents. The problems and limitations of stereological work on liver biopsy specimens are discussed.

Animals↗
PubMedDate not supplied

Deoxyribonucleic acid (DNA) content of morphologically different sperm types from normal and subfertile human males.

20 male patients (G2), affected by idiopathic oligozoospermia, and 10 normal fertile males (G1) were investigated. The DNA content of 50 Feulgen stained sperm heads per subject was determined, using single cell photometry. In a second step area, circumference, length, and width of the same heads were measured, using a semi-automatic image analysis system. Considering only morphologically normal heads, the mean DNA content is only slightly smaller in G2 than in G1. On the contrary, the DNA variation is strongly higher in G2 than in G1. Unfortunately, morphologically defect heads show an increased DNA variation, too. Thus, determining the DNA variation of a semen, containing many morphologically defect heads, a combined determination of the DNA content and head morphology is necessary. This can only be achieved by single cell cytophotometry, which is therefore superior to flow cytophotometry as regards this problem. Many heads with a strongly abnormal DNA content do not show any morphological abnormalities. These subcellular changes can only be detected by the determination of the DNA content.

DNA↗
PubMedDate not supplied

Local injection therapy in 107 patients with myofascial pain syndrome of the head and neck.

Myofascial pain syndrome of the head and neck is a frequent cause of facial pain and is characterized by tender trigger points. In a double-blind study of 107 patients, local injection therapy using one of three solutions was applied at the trigger points by intracutaneous injection of 0.3 ml solution followed by deep infiltration of the site. Results using bupivacaine 0.25%, lignocaine 1% and saline 0.9% were compared. There was no significant difference among groups with respect to reduction of pain and overall rating by patients of the therapeutic benefits. Fifty-three patients (49%) were free of symptoms after treatment, 40 patients (38%) reported substantial relief and in 14 patients (13%) symptoms remained unchanged. The findings suggest that relief of pain is mainly due to reflex mechanisms rather than to the pharmacological effects of the injected solutions. Physiological saline solution is recommended for use in local injection therapy.

Analysis of Variance↗