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Biomedical subjects

M Nyrop

Publications and source records attributed to M Nyrop.

13 recordsLinked to original sources
PubMed2000

Endoscopic CO2 laser therapy of Zenker's diverticulum--experience from 61 patients.

Endoscopic laser resection of hypopharyngeal diverticula has been used in the ENT Department, Odense, Denmark, since 1989. The outcome of treatment is reported in this presentation. Of the 61 patients, 32 (52%) were males. Age at operation was 72 years (median), range 37-94 years. The diagnosis in all patients was confirmed by barium radiography of the hypopharynx and the oesophagus. A Benjamin-Hollinger diverticuloscope was used for viewing the tissue bridge separating the diverticulum and the oesophagus. The tissue bridge was cut from the apex to the base using a CO2 laser. Perioperative complications were seen in 6 patients: Bleeding (1), subcutaneous emphysema without (3) or with (1) inflammation, inflammation without emphysema (1). The duration of postoperative nasogastric feeding was 2 days (median) (range 1-11 days). Fifty-four patients received prophylactic antibiotic treatment for a median of 3 days (range 0.5-13 days). The duration of postoperative hospitalization was 3 days (median) (range 2-14 days). The patients were routinely examined 2-3 months postoperatively. There were recurrences in 6 patients (10%), all successfully re-operated. A follow-up questionnaire was sent to patients who had finished their postoperative examination in March 1999. All 37 patients still alive responded. Median follow-up time was 37 months (range 3-96 months). Two patients reported recurrence at the time of follow-up and have been successfully re-operated. Eight patients reported minor and intermittent symptoms that did not indicate further evaluation. We conclude that laser resection of hypopharyngeal diverticula is an efficient therapy, which is applicable to and well tolerated in the great majority of patients. The rate of recurrence is low and re-operation can be performed without difficulty.

Adult↗
PubMed1999

Extensive and symptomatic cranial pneumatization: caused by frequent performance of Valsalva's manoeuvre?

Pneumocranium and spontaneous pneumocephalus are very rare disorders. We report a case in which the patient had suffered for some time from neck pain and neurological symptoms which originated from an extensively pneumatized cranium. The symptoms and the abnormal bone pneumatization disappeared after normalization of a high middle-ear pressure. The history and the findings suggest that the pathological pneumatization was caused by the patient's habit of frequently performing Valsalva's manoeuvre, in combination with the Eustachian tube functioning as a valve.

Adult↗
PubMed1997

Extensive cholesteatoma: long-term results of three surgical techniques.

During the years 1979-81, three different surgical techniques were used in the treatment of 87 ears with extensive cholesteatoma. All procedures were performed in one stage by the same surgeon. Ten to 13 years after the operations about 70 per cent of ears operated on by the canal wall up technique had developed a new cholesteatoma, which in most cases was recurrent, or a deep retraction pocket. A modification of this technique with mastoid obliteration resulted in a similar failure rate. In contrast, ears operated on by the canal wall down technique (in most cases with mastoid obliteration) had acceptable stability with a long-term recurrence rate of about 15 per cent. Most patients in the canal wall down group had a dry ear without significant cavity problems. Hearing in these patients was as least as good as hearing in patients with a preserved canal wall. We conclude that a meticulous one-stage canal wall down technique in ears with extensive cholesteatoma results in a high percentage of unproblematic, stable ears with satisfactory function. In contrast, if the posterior canal wall is preserved, recurrent cholestealoma is the rule more than the exception.

Adolescent↗
PubMed1994

Kimura's disease: case report and brief review of the literature.

Kimura's disease is a chronic inflammatory disease which often presents as a tumour-like swelling in the head and neck region with or without lymphadenopathy. Most cases have been described predominantly in Chinese and Japanese people. The lesion is benign, but it may easily be mistaken for a malignant tumour. Kimura's disease has been confused with angiolymphoid hyperplasia with eosinophilia (ALHE), from which it probably should be distinguished as a separate entity. The diagnosis may be suggested by a fine needle aspirate, but is established by a biopsy. The treatment of choice is surgical removal. A case of Kimura's disease in a Caucasian male of 12 years' duration is presented together with a brief review of the literature.

Aged↗
PubMed1994

Carcinoid tumor of the middle ear.

Carcinoid tumor of the middle ear is a very rare benign neoplasm, which may be mistaken for a malignant tumor. We present two new cases together with a review of 28 previously reported cases. Nearly all patients had progressive hearing loss, most often of the conductive type. About half of the patients complained of tinnitus and fullness of the ear. The typical otoscopic picture was erythema or lateral bulging of the tympanic membrane, which was intact in most patients. The tumor was most often localized to the middle ear with varying degree of extensions into neighboring areas. It often encapsulated the ossicles, which sometimes were eroded. Systemic symptoms were only reported in two cases. The tumor is clinically benign and total excision of the tumor and affected ossicles is an adequate treatment. The correct diagnosis, which should be considered in case of any adenomatous tumor of the middle ear, requires immunohistochemical and ultrastructural procedures.

Adult↗
PubMed1992

[Cyclosporin A treatment of adult patients with severe nephrotic syndrome].

This investigation is an assessment of the cyclosporin A-prednisone treatment which has been employed in all cases of therapy-resistant nephrotic syndrome in adults (n = 18) since January 1985 at the Department of Nephrology at the State University Hospital. Following an average duration of treatment of 20.7 months, five patients were in complete and eight in partial remission. All of the patients with minimal change disease (three patients) achieved complete remission. Recurrence after withdrawal of cyclosporin A occurred in three out of five patients. Cyclosporin A was withdrawn in five patients on account of suspected cyclosporin A nephrotoxicity. Hypertension, which was slight to moderate in the majority of cases, occurred frequently during treatment. Compared with the prognosis and frequency of complications in the untreated nephrotic syndrome and the frequency of side effects with the previously administered immunosuppressive treatment, the frequency of side effects with cyclosporin A treatment was acceptable. Until the indications are elucidated, adult patients with otherwise intractable nephrotic syndrome should be referred to special nephrological departments for possible cyclosporin A treatment.

Adult↗
PubMed1991

[Cardiovascular manifestations of hypothyroidism].

On the basis of a case history, the clinical and paraclinical manifestations of hypothyroidism are reviewed. Exertion dyspnoea without signs of cardiac insufficiency occurs frequently. The minute and stroke volume and heart rate are reduced. The blood pressure may rise (reversible) and hypertension may occur. The function of the left ventricle is reversibly reduced. A tendency to formation of exudates has been observed. X-ray of the thorax may revial massive relatively asymptomatic pleural exudates and cardiomegaly. Pericardial exudate occurs frequently and is demonstrated best by echocardiography. Inter- and intracellular deposits, infiltrations and fibroses have been demonstrated in the myocardium and these probably contribute to some of the non-specific, reversible ECG changes (low voltage, flattening/inversion of T waves, sinus bradycardia). The plasma concentrations of several different enzymes (including creatine kinase (CK), CK-MB and LDH) may be raised in myxoedema. The reason for this is perhaps compromized membrane function in the skeletal muscle cells. The diagnosis of myocardial infarction in myoedema requires that CK-MB constitutes at least 6% of the total CK and that the increase is transient. In patients with coronary sclerosis, substitution treatment should be initiated carefully because the risk of ischaemic symptoms is otherwise considerably increased. It is not elucidated whether the hypothyroidism per se can increase atheroma formation.

Aged↗
PubMed1991

Anaesthetic equipment for a developing country.

A development aid project to Malawi is described. This involved the development of a suitable anaesthetic machine for use in under-developed countries and the selection of a suitable oxygen concentrator to provide it with air and oxygen. All government hospitals were provided with anaesthetic equipment and personnel were trained to keep it regularly serviced. Follow up testing of reliability was undertaken. The cost benefit to the country amounted to 234,084 pounds (sterling) per year. This is the first instance of widespread use of standardized anaesthetic equipment which includes oxygen concentrators.

Anesthesiology↗
PubMed1990

The model Malawi.

Explore the source record for details and available documents.

Anesthesiology↗
PubMed1990

Cyclosporin A treatment of severe steroid resistant nephrotic syndrome in adults.

Ten adult patients with a severe nephrotic syndrome resistant to conventional immunosuppression were treated with cyclosporin A (CyA) for a mean period of 11 months. CyA was effective in all but two patients, as evaluated by 24-h urine protein excretion and clinical appearance. In general the best effect of CyA was seen in patients with minimal change disease and in those who had normal kidney function before CyA was initiated. CyA-induced nephrotoxicity was observed in four patients. There was no correlation with the duration of CyA therapy. Hypertension was accentuated and required multidrug treatment in five patients. This side-effect tended to be most pronounced among patients with reduced kidney function at onset of CyA therapy. In conclusion, CyA is effective in the treatment of severe steroid resistant adult nephrotic syndrome. For most patients in the present study, CyA reduced proteinuria by at least 70% to less than 3.5 g of protein per day in 8 of 10 patients; only two patients were unresponsive to CyA treatment.

Adult↗
PubMed1989

[Platelet function, hypertension and ischemic heart disease].

Treatment of mild to moderate hypertension does not result in any obvious reduction in the frequency of coronary heart disease (CDH) whereas the frequency of cerebrovascular disease is reduced. Platelet activation assumes a central role in the development of arteriosclerosis which is presumed to be the basis of coronary heart disease. Platelet activation may occur at sites of damaged endothelium (eg in the arteriosclerotic plaque) and by means of influencing specific thrombocyte receptors. The receptors may also be activated in vitro, which may be utilized experimentally. By means of stratification of material from the literature, it appears possible that patients with high mean arterial blood pressures (MAP) (over approximately 120 mmHg) have an increased tendency to platelet aggregation for ADP and adrenalin. This hyper-aggregability appears to be related to the blood pressure as it is normalized when MAP is reduced by treatment to values around 120 mmHg. If MAP is under 120 mmHg already, no further decrease in the tendency to platelet aggregation occurs. Some investigations suggest an effect on ischaemic heart disease on treatment of the most hypersensitive patients. The observations quoted in the present article are in agreement with the theory that thrombocyte aggregation may be of significance for development of CDH.

Adenosine Diphosphate↗
PubMed1988

Platelet aggregation in hypertension and the effects of antihypertensive treatment.

The major findings of a review of the literature on platelet aggregation in hypertensive human subjects and the effects of antihypertensive agents were as follows: (1) There is an increased platelet aggregatory response to epinephrine and ADP in hypertensives with MAP greater than 120 mmHg. (2) Treatment with propranolol decreases the aggregatory response to ADP, but it may enhance the response to epinephrine. (3) Treatment with calcium blockers in normotensives decreases the aggregatory response to epinephrine. Further work needs to be done to answer the questions raised by this review. Since the major goal, yet unachieved, of antihypertensive therapy is reduction of the incidence of CHD, the anti-thrombotic or thrombotic potential of antihypertensive agents must be known. Future clinical trials of drug therapy for hypertension should be designed to include at least a determination of platelet aggregation in response to both ADP and epinephrine.

Adrenergic beta-Antagonists↗