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Biomedical subjects

D McShane

Publications and source records attributed to D McShane.

At least 37 records · Page 2Linked to original sources
PubMed1995

The radio-opacity of fishbones: a cadaveric study.

Lateral neck radiographs performed to localize impacted fishbones have a low sensitivity. The differing radio-opacities of the bones of various fish species may be a reason for this. A cadaver head and neck and the rib bones of 10 species of fish were used in this study. A laryngoscope was used to introduce a fishbone into the vallecula and then into the hypopharynx of the cadaver. A lateral radiograph was taken in each case. Ten control films were taken. The radiographs were independently reviewed by a consultant radiologist and otolaryngologist. The presence and position of any bone seen was noted. There was no inter-observer variation. All species of fishbone were visible. One bone was not seen by either observer. Visualization of fishbones is more dependent on position than their degree of radio-opacity. Routine radiography is recommended.

Animals↗
PubMed1994

Localized, late-onset, high-grade lymphoma following bone marrow transplantation: response to combination chemotherapy.

Non-Hodgkin's lymphoma is the commonest secondary cancer following bone marrow transplantation (BMT). We report the case of a 42-year-old man who developed a laryngeal high-grade B-cell lymphoma 5 years following a matched T depleted BMT for CML. Polymerase chain reaction (PCR) analysis using the microsatellite marker Cyp 19 demonstrated the donor origin of involved tissue. Epstein-Barr virus (EBV) genomic sequences were identified by PCR. Although EBV related B-cell lymphoproliferative disorders (BLPD) post BMT are difficult to treat, there was a complete remission in this patient following three courses of chemotherapy (CHOP) administered with G-CSF. This case of late-onset BLPD appears clinically distinct from the well-defined, aggressive, early post-transplant BLPD.

Adult↗
PubMed1992

Intracellular glutathione levels in T cell subsets decrease in HIV-infected individuals.

The authors have shown previously that intracellular glutathione (GSH) plays an important role in the regulation of human immunodeficiency virus (HIV) transcription and replication in vitro, through modulation of signal transduction by inflammatory cytokines. Moreover, intracellular GSH levels are known to regulate T-lymphocyte function. In multiparameter FACS studies presented here, we show that relative GSH levels in CD4+ and CD8+ T cells from HIV+ individuals are significantly lower than in corresponding subsets from uninfected controls. These studies define the relative intracellular glutathione (GSH) levels in CD4+ T cells, CD8+ T cells, B cells, and monocytes from 134 HIV-infected individuals and 31 uninfected controls. The greatest decreases in intracellular GSH occur in subsets of T cells in individuals in the later stages of the HIV infection. In AIDS patients, GSH levels are 63% of normal in CD4+ T cells (p less than 0.0001) and are 62% of normal in CD8+ T cells (p less than 0.0001). Similarly, in AIDS-related complex (ARC) patients, GSH levels are 66% of normal in CD4+ T cells (p less than 0.003) and are 69% of normal in CD8+ T cells (p less than 0.003). These findings suggest that low intracellular GSH levels may be an important factor in HIV infection and in the resulting immunodeficiency.

AIDS-Related Complex↗
PubMed1991

Head and neck cancer localization with indium labelled carcinoembryonic antigen: a pilot project.

Antibodies reacting with cancer cells are playing an increasing role in cancer detection. Most antibodies under study are directed at onco-fetal proteins, principally carcino-embryonic antigen (CEA). In terms of imaging, most work has concentrated on the abdominal and pelvic regions. Although the majority of primary head and neck cancers are amiable to clinical identification, detection of regional metastases and recurrences following radiotherapy can be difficult. Antibody to CEA was radiolabelled with Indium-111 and used to identify proven head and neck tumors by external imaging. In seven patients with squamous cell tumors, five of five primary sites and two of three secondary sites were imaged satisfactory. Comparison with conventional scanning showed good correlation. There were no false positive scans, no consistent relationship between serum or tissue CEA levels and the success of imaging was evident. The success of this pilot study should encourage the search for more tumor-specific antigens, and further studies of external scintigraphic techniques in the localization of head and neck cancers.

Aged↗
PubMed1990

Hearing aid usage in occupational hearing loss claimants.

Between 1980 and 1986, the Department of Otolaryngology at Mount Sinai Hospital, Toronto, evaluated 3,509 occupational hearing loss claimants for the Workers' Compensation Board of Ontario. Detailed information about work, medical and audiologic findings for each claimant was entered into the departmental database system. The goals of this retrospective analysis were to examine some demographic characteristics and to describe the aural rehabilitation status of this population. Most claimants had bilateral mild or moderate hearing loss but all degrees and patterns of loss occurred. Of 2,657 first-time, reliable claimants, 881 (33.2%) arrived with a hearing aid, typically a monaural, behind-the-ear fitting. Twenty percent with bilateral mild loss owned an aid whereas 38% of claimants with bilateral severe loss did not have one. Ninety percent of aid owners reported that their device was of some help. This level of satisfaction was not affected by age, degree of loss, or speech discrimination ability. Substantial usage was reported for non-work situations. Hearing aids were especially helpful for TV and in small group situations. Ultimately, 81% of all claimants were determined to be hearing aid candidates.

Adult↗
PubMed1989

Hemispheric specialization for speech and non-verbal stimuli in Chinese and French Canadian subjects.

Dichotic speech (CV syllables) and non-verbal stimuli (melodies, tones and triple tones) were presented to 20 French Canadian (10 men, 10 women) and 19 Chinese (10 men, 9 women) right-handed university students to investigate cultural and sexual differences in auditory functional asymmetry. Analyses of variances on correct scores showed a REA in the perception of speech and a LEA in the perception of melodies and triple tones for both groups. Cross-cultural effects were observed for speech only, indicating a better overall performance on the part of French Canadian students. Moreover, women were better than men in the perception of tones and triple tones, suggesting that women may attend more to intonational information. Finally, the results for both ethnic groups showed the same pattern of interhemispheric functional asymmetry for speech and non-speech material.

Adult↗
PubMed1989

Dermoids ('hairy polyps') of the oro-nasopharynx.

Dermoids, or hairy polyps, are rare lesions affecting the head and neck region. To date approximately 120 cases have been recorded. They arise during early embryogenesis and are invariably benign. Unlike the more differentiated types of teratoma, hairy polyps are derived from only two germinal layers, ectoderm and mesoderm. Most originate in the oro-nasopharyngeal region, either as pedunculated or sessile masses. They usually present at, or soon after, birth with signs of upper aerodigestive tract obstruction. Treatment consists of surgical removal. In young children with airway compromise, the expertise of an experienced paediatric anaesthetist is essential. Three new cases of hairy polyp are described to add to the present literature. Two originated in the nasopharynx and one in the oropharynx. Interestingly, one patient, a neonate, also suffered from severe osteopetrosis. All lesions were removed by simple surgical excision under general anaesthesia. There were no operative or post-operative complications.

Aged↗
PubMed1989

Bacterial tracheitis.

Bacterial tracheitis is the term used to describe a severe infraglottic infection characterized by toxicity, brassy cough, inspiratory stridor, subglottic oedema and the presence of copious mucopurulent secretions in the trachea. It is an uncommon condition that requires prompt diagnosis and intensive medical therapy if significant morbidity and mortality are to be avoided. Since the condition was first described in 1979 approximately one hundred cases have been reported. In this paper we present four children with bacterial tracheitis to add to the current literature. Interestingly, one child was admitted on two separate occasions with the disease, an event not previously recorded. All patients underwent endoscopy which revealed findings typical of bacterial tracheitis in each case. None required tracheostomy though three required nasotracheal intubation. Post-endoscopy all were managed in the Intensive Care Unit. There were no fatalities or significant morbidity. The average duration of hospitalization was seven days.

Bacterial Infections↗
PubMed1989

Treatment of combined subglottic and critically low tracheal stenoses secondary to burn inhalation injury.

We report a case of combined severe subglottic and lower tracheobronchial stenoses after an inhalation burn injury. The patient was successfully treated by the insertion of a bifurcated silicone rubber stent. The proximal limb of the silicone tube was used to stent the subglottic stenosis after it had been resected, a treatment option not previously reported. It is speculated that the diffuse airway damage resulted from a combination of thermal injury, mechanical trauma and infection. The relatively late symptomatic presentation of the lower tracheal stricture is stressed and the treatment options discussed.

Burns, Inhalation↗
PubMed1989

Transhiatal esophagectomy with gastric transposition for pharyngolaryngeal malignant disease.

Between 1981 and 1988, 41 patients underwent pharyngolaryngoesophagectomy with transhiatal gastric transposition and primary pharyngogastrostomy for hypopharyngeal, laryngeal, and cervical esophageal carcinoma. All patients had squamous cell carcinoma. Twenty-one patients had been treated initially by high-dose radiotherapy, but the tumor had either persisted or recurred. Four patients had previously received high-dose local radiotherapy to the neck for unrelated diseases, and in 16 patients no preoperative radiotherapy was given. There was one operative death. Anastomotic leaks developed in nine previously irradiated patients and three required flap reconstructions. Thirty patients had satisfactory swallowing postoperatively and three swallowed poorly. Delayed gastric emptying was a serious problem in two patients, necessitating pyloric bag dilatation in one and pyloroplasty in another. The average postoperative stay was 31 days. Thirty-seven percent survived longer than 12 months and 15% longer than 24 months. The probability of survival after 2 years is 35%. All deaths from recurrent disease occurred within 412 days postoperatively. At present, pharyngolaryngoesophagectomy with gastric transposition and primary pharyngogastric anastomosis offers the best chance for cure or palliation with acceptable morbidity and function for selected patients with advanced hypopharyngeal and laryngeal tumors.

Adult↗
PubMed1988

An analysis of mental health research with American Indian youth.

A comprehensive search and review of literature, documents, publications and other material written since 1970, relevant to American Indian mental health research, was completed in order to generate a list of research and of training needs. A content analysis of this literature enabled a synthesis which describes important biopsychosocial issues faced by American Indian communities, gaps in past and current research efforts, specific problems in past research, and recommendations in each of these areas with regards to future research possibilities and needs. The portion of the analysis presented in this paper deals with American Indian infants, preschoolers, children and adolescents. In order of presentation, the specific issue domains dealt with include: otitis media, fetal alcohol syndrome, abuse and neglect, failure-to-thrive/autism/enuresis, which are examined together (early development) in terms of research gaps; and neurosensory disorders/developmental disabilities/handicapping conditions/school-related problems, foster care and adoption, self-concept/identity, conduct disorders/delinquency, drug and alcohol use, and suicide and depression, which are examined (school-age children and adolescents) in relation to research gaps and needs.

Adolescent↗
PubMed1987

Mental health and North American Indian/Native communities: cultural transactions, education, and regulation.

Critical issues in the delivery of mental health services to North American Indians/Natives residing in rural areas are discussed by describing Indian populations/communities; briefly summarizing available literature concerning the nature of mental health problems within Indian communities; examining Indian belief systems relevant to participation in mental health service delivery processes; exploring community expectations for structuring participatory interactions which may inhibit utilization of mental health services; and describing transactions between Indian consumers and non-Indian professionals which have become typical over time. The rural context was examined as it interacts with individual and community characteristics to affect Indian mental health. Relations between geography and culture, important in understanding the mental health problems of Indian people, are discussed in regard to expanding community healing resources through empowerment, and viewing "education as transformation" as a key concept in enhancing community healing processes.

Acculturation↗
PubMed1986

Nonspecific chronic inflammatory bowel disease and AIDS.

A male patient with a 14-year history of UC (ulcerative colitis) had a helper-suppressor ratio (H/S) of 0.25 during a suspected exacerbation of chronic colitis. Prednisone and sulfasalazine were administered. Despite a transient clinical response he developed AIDS (acquired immune deficiency syndrome) and KS (Kaposi's sarcoma) within 3 months of initiating therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Malignant external otitis.

Malignant external otitis was first identified by Chandler in 1968 as a significant otologic entity. Since then its mortality rate has steadily declined. This is due to increased awareness, earlier diagnosis and appropriate antibiotic therapy. A review of five years' experience with this condition at Mount Sinai Hospital, Toronto, is presented. The use of radionuclide scanning in diagnosis and determining duration of therapy is stressed.

Aged↗
PubMed1986

Schwannoma of the intrasternomastoid portion of the spinal accessory nerve: sophisticated preoperative CT diagnosis and appropriate surgical management.

Neurogenic tumors of the cervical portion of the cranial nerves are rare, and hence frequently misdiagnosed and mismanaged. A unique case of an isolated schwannoma of the spinal accessory nerve was correctly diagnosed by the constellation of signs demonstrated on a CT examination. This led to appropriate surgical removal with full motor nerve preservation. The primary purpose of this manuscript is to demonstrate the qualitative and quantitative radiologic signs indicative of the diagnosis and the surgical management resulting therefrom. The second more subtle purpose is to demonstrate the sophisticated clinical implications which can result from effective high-technology imaging.

Accessory Nerve↗
PubMed1984

Differences in cerebral asymmetries related to drinking history and ethnicity. A computerized axial tomography (CAT) scan study.

Normal computerized axial tomography scans of 179 American Indian, black, and white subjects were examined for cerebral asymmetry patterns. Information concerning the drinking history of each subject was also obtained. Results indicated that alcohol use history was associated with differences in asymmetry patterns, above and beyond differences associated with ethnicity. In subjects without a history of alcohol use, more whites were more likely to have left asymmetry of both occipital length and width, as compared to American Indians and blacks. In subjects with a history of alcohol use, all subjects closely resembled one another, regardless of ethnicity. In the total sample, alcohol users were more likely to show greater right occipital width.

Black or African American↗
PubMed1983

Neurocranial form: differentiating four ethnic populations using a simple CT scan measure.

Measurements of the cranial vault were obtained at the frontal and occipital poles, using computerized tomographic scans of 192 White, American Indian, Black and Oriental subjects. Significant differences were found in relation to the skull distance measurement (SDM) at the occipital pole for those subjects whose occipital SDM was greater than the frontal SDM (F less than O), as compared to other subjects who displayed equal frontal-occipital SDM (F = O) or frontal greater than occipital (F greater than O) SDM. With respect to these three relationships between frontal and occipital SDM, most American Indian subjects displayed the F = O pattern, most Black subjects the F less than O pattern and most Orientals the F greater than O pattern. White subjects distributed themselves equally among the three patterns. The importance of this new measurement is considered in relation to various areas of current neurological, psychological and anthropological investigations.

Adolescent↗