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Biomedical subjects

J A Kirchner

Publications and source records attributed to J A Kirchner.

At least 55 records · Page 3Linked to original sources
PubMed1977

The effect of tracheostomy on the laryngeal closure reflex.

The clinical observation of aspiration following prolonged tracheostomy prompted a neurophysiologic investigation of the glottic closure reflex in dogs longitudinally evaluated after permanent tracheostomy. The data support significant alterations in the central organization of the protective closure reflex heretofore considered phylogenetically primitive and therefore physiologically stable over wide ranges of functional demand. The data indicate that chronic upper airway bypass results in: 1. increased threshold of the evoked adductor response; 2. random shifts in its latency; 3. rapid attenuation of the primary evoked response to repetitive SLN stimulation; and 4. reduced after-discharge activity, all of which contribute to a weakened, ill-coordinated closure respons.

Action Potentials↗
PubMed1975

Misdiagnosis complicating acupuncture.

A 33-year-old man, profoundly deaf since the age of 5 from meningitis, received 25 acupuncture treatments at a center in western Massachusetts. Subsequent hearing evaluation at the Yale New Haven Medical Center again confirmed his profound deafness. He also was found to have cerumen (rock-hard and long standing) in both ear canals. Final removal of the cerumen one week later permitted inspection of a normal eardrum on the right and a debris-filled retraction pocket on the left. The diagnosis of cholesteatoma was confirmed at surgery. Representatives of the medical profession should accept responsibility for adequate examination and diagnosis before starting treatment.

Acupuncture Therapy↗
PubMed1975

Preoperative laminagraphic evaluation of the sphenoid sinus for transsphenoidal surgery.

In recent years the transethmoidal and transnasal approaches to the pituitary gland have become increasingly popular. In each case, detailed preoperative analysis of the anatomy of the sphenoid sinus and its boundaries is crucial in facilitating entry to the pituitary fossa and in reducing intraoperative complications. Certain operative difficulties and complications are the result of the marked variability in the anatomy of the sphenoid bone and its sinus. These include: loss of orientation within a capacious sinus; perforation of the carotid artery or cavernous sinus; injury to the optic nerve or ophthalmic artery; and violation of the subarachnoid space with resultant pneumocephalus or cerebrospinal fluid rhinorrhea. Pneumatization develops originally within the presphenoid, beginning anteriorly and proceeding posteriorly. Around the time of puberty the pneumatization usually penetrates up to the spheno-occipital synchondrosis. Dense bony septa remain within the sinus along the plane of fusion of the various sphenoidal segments. Preoperative laminagraphy of these ridges and septa is extremely helpful in planning the safest and most direct route to the sella. Laminagraphy is preferable to routine skull films because the septal detail is unobscured by overlying facial structures. Pleuridirectional laminagraphic motion (circular or hypocycloidal) is preferred to linear motion because of the clarity and detail that they provide.

Humans↗
PubMed1975

Anterior commissure cancer--a clinical and laboratory study of 39 cases.

Of 13 anterior commissure cancers treated by radiation therapy and reported in 1970, eight had residual or recurrent cancer at the primary site and required total laryngectomy. All but one of the 13 had been treated prior to 1958 by Orthovoltage radiation. A total of 19 patients with anterior commissure lesions were treated at the Yale-New Haven Hospital using a 2MEV Van de Graaf generator between mid 1958 when this supervoltage source first became available and December 1971. None was lost to follow-up and thus all are available for evaluation after more than two years. Results in this group have been compared with 20 glottic carcinomas with involvement of the anterior commissure treated surgically during the same period of time. Thirteen of the resulting 20 surgical specimens have been studied by serial section.

Epiglottis↗