Biomedical subjects
Publications and source records attributed to T Leng.
OBJECTIVE: To improve the level of diagnosis and treatment of malignant external otitis (MEO). METHOD: Four cases with MEO were reported. RESULT: Three in four cases were followed up. One patient was cured, and the others died of intracranial infection. CONCLUSION: Early diagnosis of MEO is very important for treatment. The patients of MEO with diabetes often died of intracranial infection.
OBJECTIVE: To evaluate the influence of pavulon (muscle relaxant) on facial nerve monitoring for patient with middle ear-mastoid operation during general anesthesia. METHOD: Intraoperative monitoring of the facial nerve (FNM) was done in 45 ears (44 case). For patient with middle ear-mastoid disease, 38 ears underwent inhaled-intravenous anesthesia with muscle relaxant pavulon (group of general anesthesia), 7 ears underwent local anesthesia (group of local anesthesia). Accelography (ACCG) was used in 10 case for testing the correlation between of FNM and the various degree of recovery from ulnar nerve-musculor blockade. RESULT: FNM could be elicited during different periods of recovery with values of T4/T1 varying from 10%-98%. Pavulon could be used to eliminate muscular vibration from disturbing FNM. Electromyography (EMG) potentials were successfully recorded in 34 ears (89.4%). Anesthesia was uneventful and it may be controled satisfactority. CONCLUSION: Considering the advantage of pavulon. It can be used for general anesthesia during intraoperative monitoring of the facial nerve for children or adults suffering from local complicated diseases.
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The prevention of facial nerve injury in otoplasty for ear malformation is important. This paper analysed 519 cases of ear malformation collected during 10 years from 1985 to 1995. The hearing of 428 cases was improved, of which the hearing of 221 cases did recover to available level. A long-term follow-up of 198 cases showed that 152 cases had kept the same hearing level as that immediately after surgery. In 130 cases with single middle ear malformation the malformation rate of facial nerve was 60.8%(79/130), and that for chorda tympani 5.4% (7/130). In 75 cases of middle ear malformation with stricture of external acoustic meatus the malformation rate of facial nerve was 60.0% (45/75), and that for chorda tympani 13.3%(10/75). In 314 cases of middle ear malformation with atresia of external acoustic meatus the malformation rate of facial nerve was 42.5%(142/314), and that for chorda tympani nerve 100.0%(314/314). Two cases(0.4%) were of surgical facial nerve paralysis. For protection of facial nerve, it was important to master the anatomy of temporal bone and have a high-resolution computed tomographic scanning to identify facial nerve. It was also important to use electroneurographic monitoring when necessary.
One hundred and fifty-eight patients with congenital microtia and atresia were treated with simultaneous total ear reconstruction and hearing rehabilitation including meatoplasty, tympanoplasty as well as fenestration. Using this operation, the authors have reconstructed 160 auricles and simultaneously restored their auditory function. After the operation, the hearing gain reached 20-45 dB in 132 cases (82.5%). The success rate of the reconstructed ear was 158/160 (98.2%). Most of the reconstructed ears were of excellent appearance.
The Source of infectious bacteria is the first problem in provension of infection considered by the medical workers. In this paper, with the method of bacteria plasmid analysis, chromosome DNA restriction fragment length polymorphism analysis, drug resistance experiment (antibacterial drug, sterilizing drug) and so on. We confirmed that staphylococci of nosocomi is mainly from air; but the gram-negative bacteria is mainly from the patient's pharyngeal portion; and cause hospital infection indirectly. The drug resistance of gram-negative from air was lower than the same gram-negative bacilli's isolated from the patient. Moreover, kill bacteria the infectious strain is same strain in air. Above-mentioed results provided the important basis for control of the hoslpital infection.
Obliteration of the external lymphatic space on 18 guinea pigs was performed. The lymphatic space of the horizontal semicircular canal was blocked by fascia. Auditory (ABR) and vestibular functions were tested before and after the surgical obliteration. Morphologic changes in the cochlea and vestibule were observed under light microscope. It was found that there was no significant difference in the threshold of ABR before and after the operation. However, the sustained time of nystagmus was significantly decreased after the operation. Our results indicate that this surgical procedure may damage vestibular function, but produce no evident damage to the cochlear function.
The purpose of this paper is to present a surgical method for microtia(small auricle, small external audiotory meatus and small tympanic membrane). 7 cases received fenestration of semicircular canal. During the operation it was found that the patients had congenital absence of oval windows and stapes, significant low position of horizontal facial canal covering the oval windows. It was impossible to perform labyrinthotomy in these patients. The only choice of operation is fenestration of semicircular canal. 7 ears underwent the operation as described. 6 weeks-21 months follow-up showed that all of the 7 ears achieved good hearing results. Range of hearing gain was 35-40 dB and bone-air gap was 25-30 dB.
A total of 762 cases of viral hepatitis admitted to the two teaching hospitals of the Third Military Medical College were used for study. They were divided into two groups depending upon whether corticoid treatment was given. As the result of cRR = 6.06, chi 2 = 174.16, P < 0.01, it is obvious that the corticoid therapy is a risk factor for the secondary infection in patients suffered from viral hepatitis. For getting rid of the interference of confounding factor and interaction a stratified analysis was performed. These patients were again divided into severe type and moderate type according to the severity of the disease. The results of stratified analysis were aRR (F) = 3.05 and aRR (F) = 1.48, cRR > aRR. These findings demonstrated that the degree of severity of patients played a primary role in the secondary infection of hepatitis and showed that the confounding factor was present. On the other hand, the result of aRR (F) not equal to aRR (F) indicated that the interaction also existed simultaneously. This study suggests that special attention should be paid to maintain and increase the level of immunological defence function in patients with hepatitis. And, it is necessary to restrict the indiscriminate usage of corticoids, particularly in severe patients, for preventing nosocomial infection.
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The cumulative streptococcal pyoderma and pharyngitis rates of 491 children followed over a period of three years were 19.8 and 15.7% respectively. Streptococcal infections occurred more commonly in Malays, in children from families with monthly household incomes of less than $500/- and in those living in attap/zinc-roofed houses. During the three years, streptococcal pyoderma and pharyngitis rates varied from 1.6-5.3 and 0.4-4.3% respectively. Skin sores occurred most frequently on lower limbs. About one in six acquisitions of streptococci in throats was accompanied by clinical manifestations of respiratory infections. 90.9% of pyoderma cases responded to penicillin therapy. Penicillin was effective in eradicating group A streptococci from the throats of 84.6% of 136 children with previous positive cultures. The treatment schedule implemented for School C did not seem to reduce the streptococcal infection and carrier rates in that school to a great extent.
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