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G Exarchakos

Publications and source records attributed to G Exarchakos.

17 recordsLinked to original sources
PubMed2004

Subdural empyema and cerebellar abscess due to chronic otitis media.

The infratentorial variety of the subdural empyema, with or without coexisting cerebellar abscess, is a rare clinical entity that carries a high mortality rate. We briefly describe the case of a 49-year-old man presented with severe debility, fever and an obviously neglected chronic otitis media. The patient had refused surgical treatment several months ago. After admission, his level of consciousness began to deteriorate, and the radiological studies showed infratentorial subdural suppuration extending into the right cerebellar hemisphere, along with chronic pyogenic infection of the middle ear and the mastoid process. Radical mastoidectomy was performed first, followed by extensive right posterior fossa craniectomy. The two subdural collections and the cerebellar abscess were successfully evacuated. Subsequently, he received post-operative antibiotic treatment for 6 weeks. At follow-up, 10 months after surgery, his neurological recovery was complete except for a minor residual cerebellar dysfunction on the right. This unusual case highlights that in patients presented with severe intracranial complications of chronic otitis media, early diagnosis and radical surgical intervention may be life saving.

Abscess↗
PubMed2003

Lipoprotein (a) and acute-phase response in patients with vestibular neuronitis.

BACKGROUND: Vestibular neuronitis (VN) is a relatively common condition characterized by the acute onset of vertigo, nausea and vomiting, in the absence of auditory or central nervous system involvement. The exact aetiology (inflammatory, viral or vascular?) remains obscure. Lipoprotein (a) [Lp(a)] is an atherogenic particle. Its serum levels are mainly genetically determined and vary widely between individuals. Whether Lp(a) is consistently a positive acute-phase reactant is controversial. PURPOSE: We evaluated the alterations in lipidaemic parameters and serum biological markers (including acute-phase reactants) in adult patients presenting acutely with VN. SUBJECTS AND METHODS: A total of 34 consecutive VN patients (24 men and 11 women) and 37 apparently healthy controls (25 men and 12 women) were studied. Laboratory evaluation was performed during the acute episode and 6 months later (stable state). RESULTS: Serum Lp(a) concentrations were significantly lower at the time of presentation (median value 6.4 vs. 16.4 mg dL-1 in the stable state, P < 0.001), whereas fibrinogen levels were significantly higher during the acute episode than in the stable state (median value 293.0 vs. 202.0 mg dL-1, respectively, P < 0.0001). During the acute episode, plasma fibrinogen correlated with CRP levels (Spearman r = 0.84, P < 0.0001). By contrast, inverse correlations were noted between Lp(a) levels and CRP (Spearman r = -0.47, P = 0.007) as well as between Lp(a) and fibrinogen levels (Spearman r = -0.35, P = 0.05). CONCLUSION: Vestibular neuronitis episodes are associated with evidence of an acute inflammatory response as reflected by significant elevations in plasma fibrinogen and CRP concentrations, whereas Lp(a) behaves as a negative acute-phase reactant.

Acute Disease↗
PubMed2003

Solitary extramedullary plasmacytoma of the maxillary sinus. Case report.

Solitary extramedullary plasmacytomas are rare tumors that often affect head and neck region. Because of the non-specific associated symptomatology, they frequently are misdiagnosed. We briefly describe a 69-year-old woman who developed solitary plasmacytoma in the left maxillary sinus and was initially treated as having sinusitis. We also report the diagnostic work-up that is necessary to establish a correct diagnosis in such cases. This case highlights that an appropriate investigation for neoplastic disease should be performed in patients presenting with persistent symptoms that resemble those of sinusitis, especially if these do not resolve after conservative medical treatment.

Aged↗
PubMed2002

Ramsay Hunt syndrome presenting as a cranial polyneuropathy.

Ramsay Hunt syndrome (RHS) is herpes zoster of the facial nerve, frequently associated with VIII cranial nerve involvement, but on rare occasions other cranial nerves are affected as well. We present the case of a 63-year-old woman with RHS with involvement of V, VII, VIII, IX, and XII cranial nerves. The patient showed significant improvement after treatment with acyclovir and prednisolone. RHS should be recognized as a polycranial neuritis characterized by damage to sensory and motor nerves, including the facial nerve and the auditory-vestibular apparatus. Early institution of treatment with antiviral agents may help hasten healing. Involvement of the XIIth cranial nerve has not been reported previously.

Cranial Nerve Diseases↗
PubMed2001

Hearing loss in progressive systemic sclerosis patients: a comparative study.

OBJECTIVE: To investigate the middle and inner ear involvement in patients with progressive systemic sclerosis (PSS). STUDY DESIGN AND SETTINGS: We prospectively evaluated 34 PSS patients. All patients underwent a complete ear-nose-throat physical examination and audiological evaluation with pure tone, impedance, and speech audiometry. In addition, systemic manifestations of the disease and drug therapy were recorded. Finally, all patients were tested for the presence of autoantibodies. The results were compared with those of 45 age-matched healthy subjects. RESULTS: We found a sensorineural hearing loss in 20% and mixed type hearing loss in 3.3% of the patients. There was no correlation of hearing loss with age, systemic manifestations of the disease, presence of autoantibodies, and drug therapy. Ten percent of the patients had patulous eustachian tubes. CONCLUSION: One fourth of PSS patients had a hearing loss affecting the middle and mainly the high frequencies. This is a lower percentage than that reported by other investigators. A significant prevalence of bilateral patulous eustachian tubes was noticed as well. Further investigation is needed for a better understanding of the mechanism of ear damage in PSS patients.

Adult↗
PubMed1999

Epidermal growth factor receptor expression in primary laryngeal cancer: an independent prognostic factor of neck node relapse.

Specimens of laryngeal squamous cell carcinoma (LSCC) were examined for epidermal growth factor receptor (EGFR) content using a radioreceptor method; 140 untreated consecutive patients with primary LSCC undergoing initial surgical resection were followed up for a median of 49 months (range 2-84 months) after surgery. Cox univariate regression analysis using EGFR as a continuous variable showed that EGFR levels were directly associated with the risk of lymph node metastasis. A significant relationship between EGFR status and cervical node metastasis was observed. The cutoff value of 20 fmol/mg protein was the best prognostic discriminator. The 5-year metastasis-free survival (MFS) was 66% for patients with EGFR- tumors compared with 15% for patients with EGFR+ tumors. By multivariate analysis, the EGFR status appeared to be a significant independent prognostic factor for MFS. Our results suggest that the assessment of EGFR status at the time of diagnosis may identify a subset of LSCC patients highly susceptible to neck node metastases thus defining therapy accordingly.

Analysis of Variance↗
PubMed1992

Perceptive bilateral deafness following clinical tetanus to a neonate.

A rare case of bilateral perceptive deafness following clinical tetanus is reported. The patient was a 15-day-old neonate. The clinical tetanus was treated with tetanus antitoxin (human gamma globulins) and penicillin. The exact mechanism of auditory nerve damage associated clinical tetanus and treatment with human tetanus antitoxin and penicillin is still not clearly known. We believe that the damage of the hearing organ can be attributed to the tetanus toxin and not to the human gamma globulins (tetanus antitoxin).

Audiometry, Pure-Tone↗
PubMed1992

[Norrie-Wardburg syndrome].

We describe a case of a 25-year old patient with typical Norrie-Warburg Syndrome. From the first year of his life he was found to be blind, with bilateral sensorineural loss of hearing. Audiological examination showed symmetrical moderate bilateral sensorineural hearing loss. His hearing loss was refractory to treatment for the last eight years. Because of timely diagnosis of hearing loss and timely fitting of a hearing aid, the patient could study at school and graduate from university education. Disease carriers who are clinically healthy can be identified only via chromosome analysis.

Adult↗
PubMed1991

[Cerebral anoxia with fatal outcome caused by aspiration of an air-filled balloon].

We report an 11-year-old child who aspirated a toy balloon causing death by asphyxia. Children who chew balloons while running and who breathe deeply or laugh at the same time are under great risk. The saliva which smears the balloon makes it easier to slide into the airway. Therefore chewing of balloons by children must be avoided because of the danger of aspiration.

Airway Obstruction↗
PubMed1978

Topical noxythiolin in colonic healing.

Rats were subjected to division and anastomosis of the colon just proximal to the rectum to study the healing of colonic anastomoses. The effect of noxythiolin irrigation of the divided colon before and after anastomosis was investigated and compared with controls. Healing was assessed using five variables--macroscopic and microscopic inspection, bursting pressure and tensile strength estimations and angiography for new vessel formation. The study shows that noxythiolin irrigation of the colon in the rat significantly increases the chance of a sound anastomosis without interfering with healing. Furthermore, it inhibits the formation of adhesions.

Administration, Topical↗
PubMed1978

Colonic anastomosis healing. The effect of topical povidone-iodine.

The effect of povidone-iodine (0.1% available iodine) irrigation on colonic anastomosis healing was investigated in 196 Sprague-Dawley rats. Each end of the divided colon was irrigated with 5 ml of povidone-iodine solution or with an equal volume of normal saline before anastomosis and again after the anastomosis had been completed. Healing was assessed at 2, 4, 6, 8, 10, and 14 days after operation: macroscopically, mechanically, histologically and angiigraphically. Povidone-iodine irrigation did not impair healing in any way.

Administration, Topical↗
PubMed1976

An experimental study of gastric healing following scalpel and diathermy incisions.

To date there has been no reliable information available which compares gastric healing following incisions made by scalpel and diathermy. Standard incisions were made in rat stomachs, half with a scalpel and half with diathermy, following which they were closed in a standard fashion. Healing was assessed at intervals by bursting and tensile strength measurements, angiography, and histology. All incisions were healed by the tenth day. The only significant difference discovered was that histologically there was a definite lag in healing up to the fifth day in those incisions made by diathermy. It is suspected that this is due to mucosa having been dragged into the wound edges by adherence to the diathermy knife.

Animals↗
PubMed1976

Gastric mucosal contraction.

In this study the role that contraction plays in the healing of gastric wounds is explored experimentally. Superficial gastric mucosal defects made in the columnar part of rat stomachs were found to close rapidly, compared to defects carried down into the muscle layer. The collagen was packed tightly at the edges of the defects and no other factors appeared to have played a part in the closure. It is surmised that the decrease in size of the defect is due to fibroblastic activity causing contraction. It would seem likely that the myofibroblast, as described by other investigators, would be the unique cell causing this action. Further studies are required to confirm or refute this hypothesis.

Animals↗
PubMedDate not supplied

[Surgical management of varicocele with vein-to-vein anastomosis].

The authors mention the technique of Koichi Ishigami, relative to 15 cases. This involves the anastomosis of the spermatic vein with the long saphenous vein. The authors use phlebography to show the permeability of this venovenostomy, and emphasize the quality of their results.

Humans↗