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Biomedical subjects

C Reams

Publications and source records attributed to C Reams.

5 recordsLinked to original sources
PubMed1991

Neurotologic disease in four patients with normal audiometric findings.

Clinical suspicion remains an underlying diagnostic clue in the evaluation of patients with unconfirmed acoustic neuromas. This is particularly true when initial otologic and audiologic evaluations are equivocal. This paper summarizes a series of four patients each who demonstrated normal audiometric (pure-tone and conventional speech audiometry) and/or ABR findings in the presence of surgically confirmed intracanalicular or cerebellopontine angle tumors. Three of the patients presented with evidence of "classical" acoustic tumors, whereas the fourth patient revealed a benign internal auditory canal capillary hemangioma. Audiologic evaluation, ABR measures, and MRI scanning demonstrate the relationships observed in each of the four patients. Diagnostic strategies illustrate the importance of cross-check principles (audiologic, electrophysiologic, and imaging techniques) in the diagnosis of posterior fossa tumors. The presence of normal pure-tone thresholds should not discourage the pursuit of additional diagnostic measures if clinical suspicion remains a factor in comprehensive patient management.

Adult↗
PubMed1989

Uvulopalatopharyngoplasty: postoperative management and evaluation of results.

Since the earliest report of success with the uvulopalatopharyngoplasty (UPPP) operation, several authors have reported less than optimal results in their experience with the procedure. Part of the difficulty in evaluating the objective results of postoperative sleep studies has been the variations in reporting data. In addition, no standard of postoperative care, including analgesia, and immediate postoperative monitoring has been described. Our experience with 42 UPPP patients (34 studied with preoperative and postoperative polysomnography) indicates a 76% response (56% successes, and an additional 20% with limited success) with use of the more stringent criteria described recently. We discuss our management of these cases, including postoperative oxygen saturation monitoring and avoidance of narcotic analgesia as necessary factors for success with this operation.

Female↗
PubMedDate not supplied

Human tympanic membrane--malleus attachment. Preliminary study.

The relationship between the malleus handle and the tympanic membrane in humans has been studied with primary attention being directed to the fibrous layer of the tympanic membrane and its method of attachment to the malleus. This attachment is most intimate at the level of the umbo and becomes progressively more tenuous as the short process is approached. The long process of the malleus, comprised of a bony core, has a definite sleeve of cartilage surrounding its entire length. This cartilage is surrounded by a perichondrial layer which has previously been termed a periosteum. In the lower third, the fibrous lamina propria appears to split equally and the fibers then blend imperceptively with those of the perichondrial layer surrounding the manubrium. At high levels, the attachment is less intimate, most of the fibers appearing to pass lateral to the malleus handle. The embryologic development of the tympanic membrane-malleus junction has been considered and the anatomical features of this area have been considered in relation to functional requirements.

Ear Ossicles↗
PubMedDate not supplied

How to assess a patient's support system and personal abilities prior to liver transplantation.

Most liver transplant programs have come to accept the importance of evaluating the psychosocial status of potential liver transplant recipients prior to liver transplantation. The goal is to utilize a thorough assessment of the candidate's support system and personal abilities in order to predict post-transplantation compliance and overall medical-surgical outcome. To achieve this goal, it has been necessary to include a large number of multidisciplinary specialists including social workers, nurses, and psychologists as well as physicians in the evaluation process. Each disclipline contributes to the overall assessment and management of these candidates prior to and following liver transplantation. The purpose of this report is to describe how one spectrum of issues relating to a potential candidate's strengths and vulnerabilities are assessed in the liver transplant program at the University of Kentucky.

Adaptation, Psychological↗