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Biomedical subjects

J Kronenberg

Publications and source records attributed to J Kronenberg.

At least 73 records · Page 4Linked to original sources
PubMed1994

Peritonsillar abscess: repeated needle aspiration versus incision and drainage.

The study evaluates the management of peritonsillar abscess (PTA) by comparing needle aspiration versus incision and drainage of the abscess. Twenty-four of 86 patients treated by needle aspiration underwent a single aspiration, and 38 had 2, 19 had 3, and 5 had 4 aspirations before the abscess resolved. A significant amount of pus, up to 8, 5, and 3 mL, respectively, was detected in the subsequent aspirations. Recurrent PTA was noted in 20 patients (23.26%). In 9 of these patients (10.47%) the recurrent episode occurred immediately (in less than 1 month) and was considered residual disease. Seventy-four patients were treated by incision and drainage, and none had an immediate recurrence. Only 3 (4.05%) patients developed a late recurrent episode. The difference in the recurrence rate between the two groups is statistically significant. A history of recurrent tonsillitis prior to abscess formation did not show a significant influence on the recurrence rate. A high incidence of streptococcal infections was noted in both groups, with anaerobes detected in only 15% of samples. There was a good response to penicillin-resistant organisms. Although needle aspiration is a tempting modality for treating PTA in community clinics, one should be aware of the risks of a higher incidence of residual and recurrent disease in comparison to incision and drainage, as well as the need for repeated aspirations.

Adolescent↗
PubMed1994

The effect of prostaglandins E2 and F2a on brain and tracheal ciliary activity.

Prostaglandins E2 and F2a have a mild stimulatory effect (+11% to 18% from baseline) on the in vitro ciliary beat frequency in tracheal rings, which contain mucus-producing cells, and in brain slices, which are devoid of mucus. Results are compared with previous studies and the merits of the used experimental models are discussed.

Animals↗
PubMed1994

Acute mastoiditis--revisited.

The clinical course and causative organisms were studied in 18 patients with acute mastoiditis, 13 of whom (72%) had no previous history of middle ear disease. Their age ranged from 5 months to 21 years, and duration of middle ear symptoms immediately prior to admission ranged from 1 to 45 days (average 9.7 days). None had undergone a myringotomy prior to admission, while 13 (72%) had been receiving antibiotic treatment for acute otitis media. Three were admitted with intracranial complications. Bacteria were isolated in 10 of the 16 patients in whom samples were available for bacterial culture, and included Streptococcus pneumonia (2), Streptococcus pyogenes (2), Staphylococcus aureus (2), Staphlococcus coagulase negative (2), Klebsiella pneumonia (1), and Pseudomonas aeruginosa (1). Of the 17 patients treated by us, 11 received surgery. Acute otitis media, secretory otitis media, acute mastoiditis, subacute mastoiditis and masked mastoiditis create a continuum. Antibiotic treatment for acute otitis media cannot be considered as an absolute safeguard against acute mastoiditis. When antibiotics are prescribed for acute mastoiditis before culture result is available, an anti-staphylococcal agent should be included. At least some patients with acute mastoiditis develop a primary infection of the bony framework of the middle ear cleft. The prevalence of the intracranial complications in acute mastoiditis is still high and may appear soon after or concomitant with the first sign of acute mastioditis.

Acute Disease↗
PubMed1994

Familial occurrence of Warthin's tumour.

A rare occurrence of Warthin's tumour in the parotid glands of three brothers is presented. The only two reports of familial Warthin's tumour are mentioned and pathophysiologic mechanisms are suggested.

Adenolymphoma↗
PubMed1994

Boundaries during adolescence.

This essay looks at the period of adolescence through the dimension of boundaries and examines how adolescence and boundaries affect one another. During adolescence external physical and internal psychological boundaries are blurred. The climate and milieu are well defined and having the environment provide clear boundaries facilitates the passage of this developmental stage.

Adolescent↗
PubMed1993

[Auditory achievements of cochlear implantation].

The cochlear implant, which stimulates the auditory nerve electrically, is a rehabilitative solution for the severely deaf who cannot benefit from a hearing aid. The implant enables them to rejoin the world of sound from which they were disconnected. We present the process of auditory diagnosis which determines the patient's suitability for cochlear implantation, the implant's tuning program and the rehabilitation process it entails. Each of the 22 implanted electrodes is checked through a computer program, and the specifications of the electrical stimulation are established to provide the most comfortable hearing level for the implanted device. These stimulation specifications determine the number of active electrodes and the ideal stimulation model. During the 8-week hearing-training program which follows implantation, the patients acquaint themselves with the new world of sound through which they will communicate with their environment. Of the 16 implanted patients 7 heard only via the implant, without the aid of lipreading, a result which is considered excellent. These patients are able to talk on the telephone with the aid of the implant. 1 patient refused to use the implant, while the others have had good to moderate results. Noteworthy is the fact that even those with only moderate results greatly benefit from the implant, and are not willing to function without it for even a single day.

Adolescent↗
PubMed1993

Management of penetrating wounds of the neck.

Management policies for penetrating wounds of the neck vary from mandatory surgical exploration to selective surgical exploration following extensive or minimal imaging investigation. In order to review the treatment protocol at Sheba Medical Center, Tel Hashomer, Israel, we retrospectively studied 21 patients who were treated between the years 1984 and 1989. Thirteen had gunshot injuries and eight had stab wounds. Eight patients had undergone immediate exploration of the neck. Four patients had died, but all of these latter patients had evidence for significant bleeding that could have been detected within a short time of admission. On the basis of our findings and previous studies, we conclude that: presenting features of neck injuries should be differentiated into two basic categories: immediately life-threatening and not immediately life-threatening. Immediately life-threatening features include overt massive bleeding, expanding hematoma, non-expanding hematoma in the presence of hemodynamic instability, hemomediastinum, hemothorax, and hypovolemic shock. In all of these cases, immediate surgical exploration is mandatory. Non-life-threatening features include any signs of vascular complication in a hemodynamically stable patient, signs of upper aerodigestive tract lesions (when initial treatment has already relieved respiratory distress) and peripheral neurological deficits. These patients should undergo thorough imaging investigations on the basis of which the need for and the nature of possible surgical intervention can be determined.

Adolescent↗
PubMed1993

Cerebrospinal fluid (CSF) otorhinorrhoea following vestibular schwannoma surgery treated by extended subtotal petrosectomy with obliteration.

Extended subtotal petrosectomy as a treatment for persistent cerebrospinal fluid (CSF) otorhinorrhoea is presented. Four patients were successfully operated on by this technique, all previously having undergone suboccipital removal of vestibular schwannoma: other interventions used had failed to seal the fistulae. The internal auditory canal was the usual pathway for CSF leakage as well as retrosigmoid, retrolabyrinthine, retro- or perifacial cells. Total exenteration of middle ear and mastoid cell tracts, skeletonization of sigmoid sinus, jugular bulb and facial nerve, drilling out of semicircular canals, vestibule, and cochlea, and skeletonization of the internal auditory canal, followed by obliteration, are the main steps of this approach.

Cerebrospinal Fluid Otorrhea↗
PubMed1993

Conversion deafness.

Conversion deafness is very rarely encountered among adults. This report will illustrate two cases of this somatoform disorder following different traumatic experiences. It emphasizes the difficulties in establishing the diagnosis and reviews various aspects of treatment.

Accidents, Traffic↗
PubMed1993

Perforated tympanic membrane after blast injury.

The rate of spontaneous healing of tympanic membrane perforations in relation to time after blast injury, size, and location of perforations, was evaluated in 147 patients (210 ears). In 46 patients a paper patch was placed over the perforation. Spontaneous healing was seen in 155 ears (74%), 131 (62%) healed within the first 3 months and 145 ears (69%) healed within 10 months. Large and central kidney-shaped perforations had the least tendency to heal and usually required surgical intervention. Tympanoplasty was performed on 33 ears (15%), ossiculoplasty on 5 and mastoidectomy on 10. Intervention is recommended when the tympanic membrane remains unhealed for at least 10 months.

Adolescent↗
PubMed1992

[Cochlear implantation].

Since the Israeli cochlear implant program was started in June 1989, 74 candidates have been evaluated for implantation. The main causes for hearing loss were meningitis (16 patients), aminoglycoside toxicity (9), congenital (6), viral (e.g. mumps) (6), and middle ear infection. Candidates were rejected mainly due to psychosocial factors (40%) and audiological parameters (30%). 16 postlingual deaf were implanted. In 7 of them (43.7%) the results were excellent, in 4 (25.0%) good, in 3 (18.7%) fair; 1 case is currently in a training program and 1 is a failure. There were 2 major complications: facial nerve palsy which necessitated surgical decompression, and insertion of the electrodes into the hypotympanic air cells, corrected by reoperation.

Cochlear Implants↗
PubMed1992

Nasal ciliary motility in retinitis pigmentosa.

Normal in-vitro ciliary beat frequency is reported in a patient with retinitis pigmentosa. The significance of electromicroscopic ciliary defects in this condition is appraised.

Ciliary Motility Disorders↗
PubMed1992

Vasoactive therapy versus placebo in the treatment of sudden hearing loss: a double-blind clinical study.

Twenty-seven patients suffering from sudden sensorineural hearing loss (SHL) were randomly assigned to one of two groups: a treatment group (n = 13) receiving intravenous procaine and low-molecular-weight dextran, and a placebo control group (n = 14). The effect of treatment was analyzed by means of an analysis of variance and covariance procedures. Results indicated nonsignificant differences between the groups on all outcome indices measured. Sex, age, time since the onset of symptoms to the initiation of therapy, audiogram configuration, and initial severity of hearing loss did not significantly affect the results. These findings suggest that the therapeutic effects of this vasodilator are not superior to a placebo.

Adult↗