Biomedical subjects
Publications and source records attributed to N Uri.
Herpes zoster oticus produces facial paralysis with a low recovery rate. Acyclovir, a specific virostatic drug, was given intravenously in five herpes zoster oticus patients, and in three of them was followed by oral therapy. In follow-ups of 1 to 24 months, one patient had grade I recovery, three patients grade II, and one grade III. These good results encourage the use of acyclovir in herpes zoster oticus patients.
Qualitative technetium Tc 99m bone scintigraphy using phosphate compounds and gallium 67 scintigraphy were described as a helpful means in diagnosing necrotizing external otitis (NEO). They were, however, claimed to be nonspecific. Quantitative Tc 99m methylene diphosphonate bone scintigraphy and gallium 67 scintigraphy were performed in eight patients with NEO and in 20 patients with severe external otitis, in order to prove usefulness of scintigraphy in the diagnosis of NEO. Ratios of lesion to nonlesion for bone scintigraphy were 1.67 +/- 0.16 in patients with NEO and 1.08 +/- 0.09 in patients with severe external otitis, and for gallium 67 scintigraphy they were 1.35 +/- 0.24 in NEO patients and 1.05 +/- 0.03 in patients with severe external otitis. There was no difference in uptake between diabetic patients with severe external otitis and nondiabetic patients. The scintigraphic studies were also evaluated using a qualitative scoring method (scores 0 to +4), according to the intensity of the radiopharmaceutical uptake. This method was found to be inferior in the diagnosis of NEO compared with the quantitative method. We conclude that lesion-to-nonlesion ratios greater than 1.5 and 1.3 on bone and gallium 67 scintigraphy, respectively, are indicative of NEO. Quantitative bone scintigraphy, which is quicker to perform, may be used as a single imaging modality for the diagnosis of NEO.
Neuroendocrine carcinoma (carcinoid), is a rare laryngeal malignancy with aggressive behavior. The 5-year survival rate is only about 10%, mainly because of distant metastases. We describe a patient with neuroendocrine carcinoma of the larynx, large cell type, without evidence of regional or distant metastases. Treatment included total laryngectomy and adjuvant radiotherapy to the neck. There was no evidence of disease at 6-month follow-up.
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Ingestion of a foreign body rarely produces symptoms. We report a patient who presented with oculosympathetic paresis. We believe this is a previously unrecorded manifestation of foreign body ingestion.
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Auditory brainstem evoked potentials (ABEP) were recorded to determine whether children who suffered in the past, or suffered at time of examination from Secretory otitis media (S.O.M.), exhibited slowed conduction along their auditory brainstem. Five groups of subjects were examined: children with active S.O.M. during the examination, children with S.O.M. in the past who were treated non-surgically and recovered, children with S.O.M. in the past who were treated surgically and recovered, children who were treated by insertion of ventilating tubes (V.T.), and had S.O.M. during the examination (recurrent S.O.M.), and a control group of neurologically and audiologically normal, age-matched children with no history of S.O.M. 205 ears were tested in all. Each of the groups was subdivided according to the severity of hearing loss, duration and type of treatment. These parameters were evaluated within and between groups, and in relation to the control group. Significant increases of interpeak latency differences (IPLD) between peaks V and III as well as V to I were found in the S.O.M. groups compared to the control group. The duration of the disease was found to be the dominant factor slowing central conduction. These findings confirm the suggestion that attenuation in auditory stimulation at an early age affects central conduction.
Twelve normal adults were evaluated to determine their capacity to suppress caloric-induced nystagmus by visual fixation. Fixation suppression (FS) was assessed four times during the routine Fitzgerald-Hallpike caloric procedure. The results were characterized by large inter-subject as well as intra-subject variability. It is cautioned that diagnostic categories should not be inferred on the basis of absolute numeric values of FS.
In order to assess the extent of the underlying pathology in Bell's palsy, the vestibular function of 24 patients was evaluated within the first week from the onset of facial paralysis. Seven patients had pathological findings by ENG and an additional three had subjective vestibular signs; four of these ten patients also showed abnormal auditory brain stem evoked potentials. There was no correlation between the severity of the paralysis or the prognosis for recovery and the presence of vestibular abnormalities.
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Congenital middle ear encephalocele (CMEE) is a rare entity, previously reported in only 29 patients. It might originate from dehiscence of the tegmen tympani or antri or the bony plate of the posterior fossa. The common presenting symptoms are spontaneous cerebrospinal fluid (CSF) otorrhea and/or rhinorrhea, persistent "serious otitis media," conductive hearing loss, and, occasionally, recurrent meningitis. We report a case of CMEE initially seen with progressive facial paresis, review the previously reported cases of CMEE, and discuss the pathogenesis and surgical management.