[An infected radicular cyst--a rare cause for facial cellulitis].
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Adult↗
Biomedical subjects
L Ertama
Publications and source records attributed to L Ertama.
Velopharyngeal insufficiency following palatine tonsillectomy.
Although adenotonsillectomy is usually considered a minor operation, numerous uncommon but severe complications have been described. Even tonsillectomy alone can cause velopharyngeal insufficiency (VPI). We describe two cases in which severe VPI was noted after palatine tonsillectomy was performed because of recurrent peritonsillar abscesses. The patients underwent clinical examination, nasalance measurements, videonasopharyngoscopy and videofluoroscopy. Findings in both patients were consistent with lesions of branches of the vagus and glossopharyngeal nerves through lingual rami, while one of the patients probably also had a lesion of the hypoglossal nerve. Endoscopic and videofluoroscopic examinations demonstrated essential differences in the patients' preoperative state of velopharyngeal anatomy. Findings demonstrate the value of careful postoperative endoscopic and videofluoroscopic examination in cases with VPI after tonsillectomy to identify factors affecting subsequent VPI and to design possible treatment.
Cineradiography↗
[Videofluorography as a method of evaluating hypernasality].
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Child↗
Globus pharyngis, commonly associated with esophageal motility disorders.
OBJECTIVES: To evaluate the role of gastrointestinal and psychiatric etiology in globus sensation. METHODS: The study population consisted of 32 consecutive patients with globus sensation without dysphagia referred to the Department of Otorhinolaryngology in Helsinki University Hospital. Eleven patients were excluded from the study: two because of advanced age, one prisoner, and six patients refused further studies. Only two patients (6%) were found to have abnormal otorhinolaryngological status. These patients were also excluded from the study. Esophagogastroduodenoscopy, 24-h pH recording, esophageal manometry, and Bernstein acid perfusion test were carried out in 21 patients (13 females, eight males, mean age 49 yr). Psychiatric evaluation was done in 20 patients; one patient refused the psychiatric consultation. RESULTS: Abnormal endoscopy was found in 12/21 (57%) of the patients, with antral gastritis and hiatal hernia being the most common findings. Two patients had esophagitis. Sixty-seven percent demonstrated abnormalities in esophageal manometry, the most frequent finding being a nonspecific esophageal motility disorder (29%). pH monitoring was normal in 16/21 of patients (76%), whereas the Bernstein test showed positive results in 13/21 (62%). With DSM IIIR as the diagnostic tool, five of 20 patients (25%) received a psychiatric diagnosis. CONCLUSIONS: Globus sensation has a multiple etiology, and local reasons are rare but should first be ruled out. Abnormalities in esophageal motility are commonly found, and these patients seem to be sensitive to esophageal acidity. Esophageal manometry and ambulatory 24-h pH recording should be included in the evaluation of a globus patient. The number of psychiatric disorders does not differ from that in the general population. Treatment of globus sensation should be directed toward the abnormality found behind the symptom.
Conversion Disorder↗
The role of alcohol in accidental falls.
Fifty-three percent of patients injured in accidental falls in the evening in Helsinki and 15% of time-, site- and sex-matched control pedestrians were alcohol-involved. Relative risk of injury, if 1.0 at zero BAC, was 3 at BACS 60-100 mg/100 ml, 10 at 101-150 mg/100 ml and about 60 at BACS above that.
Accident Proneness↗
Role of drugs in traffic accidents.
Serum samples from 201 drivers who presented at emergency departments within six hours after being injured in a road accident and 325 control drivers selected randomly at petrol stations were screened for drugs by combined thin-layer and gas chromatography. Blood alcohol concentrations were also measured, and a questionnaire on the subjects' state of health and use of drugs administered. At interview 30 patients (15%) and 44 controls (13%) said that they had taken drugs in the previous 24 hours. Four patients (2%) and six controls (2%) said that they had taken psychotropic drugs, but serum analysis detected psychotropic drugs in 10 patients (5%) and eight controls (2.5%). Diazepam was found in 16 of the 18 subjects in whom psychotropic drugs were detected. Alcohol was detected in 30 patients (15%) and three controls (1%). Drug use appeared to be somewhat lower in Finland than in other Western countries, and illness to be a more important traffic hazard than drugs in general. Interview was not a reliable method of establishing whether drivers had taken psychotropic drugs. Taking diazepam may increase the risk of being involved in a traffic accident, but alcohol was the most powerful risk factor.
Accidents, Traffic↗
The poor reactivity of retinal vessels to systemic administration of vasoactive agents in pentobarbital anesthetized rats.
The responsiveness of retinal vasculature to i.v. administration of several potent vasoactive agents was studied in pentobarbital anesthetized rats by taking fundus photographs. Since cerebral vasculature had been claimed to react in a similar manner but less liably than retinal vessels to some vasoactive substances, the findings were applied to the problem of reactivity of brain vessels. Sublethal doses of noradrenaline, adrenaline, 5-hydroxytryptamine, angiotensin amide and arginine orlysine vasopressin caused no marked acute ( less than or equal to 2 min) vasoconstriction in retinal vessels. Nor did any of these agents or bradykinin elicit vasodilatation. The late vasoconstriction (greater than 2 min) found in succumbing animals was most likely unspecific, since it did not occur until severe toxic symptoms appeared. The findings support the concept that intracerebral vessels are quite resistant to the direct action of many vasoactive agents given i.v.
Animals↗
A case-control study on alcohol as a risk factor in pedestrian accident. A preliminary report.
Alcohol as a risk factor in pedestrian accidents was studied so that the BACs were measured by gas chromatography in 341 accident patients and by ASD-breathalyzers in 682 sex-, site-, and time-matched pedestrians not involved in accidents. Alcohol was found in the blood in 53% of the accident cases and in 15% of the controls. The RR, if 1.0 at zero BAC, was 0.59 at BAC 0.3-0.5, 2.2 at 0.6-1.0, 6.8 at 1.1-1.5, 13 at 1.6-2.0, and 29 at BACs of over 2.0 g/l.
Accidents, Traffic↗