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Biomedical subjects

T V McCaffrey

Publications and source records attributed to T V McCaffrey.

At least 91 records · Page 5Linked to original sources
PubMed1988

The use of fibrin glue for the repair of experimental CSF rhinorrhea.

Surgical repair of cerebrospinal fluid rhinorrhea requires the production of a seal able to resist cerebrospinal fluid pressure during the period of healing. Direct suturing, packing with muscle and fat grafts, and coverage with mucosal or muscle flaps have been effective in repairing most CSF leaks. Fibrin glue may enhance the results of a CSF leak repair by providing better adhesion of the graft and improving the initial seal during healing. A study was performed on 36 rats to assess the effectiveness of fibrin glue in repairing experimentally produced CSF leaks. CSF rhinorrhea was produced by creating a defect in the anterior cranial fossa through the region of the cribriform plate. There were four treatment groups: 1. no treatment control; 2. fibrin adhesive alone; 3. muscle packing alone; and 4. fibrin glue with muscle packing. The CSF leaks were evaluated 3 weeks after operation. Persistent CSF leakage was noted in 89% of group 1, 55% of group 2, 33% of group 3, and 22% of group 4. The reduced CSF leakage in the muscle plus fibrin glue group suggests that fibrin glue, by its adhesive sealing properties, enhances the results of muscle packing alone for the treatment of cerebrospinal fluid rhinorrhea.

Animals↗
PubMed1988

Intraoperative electrophysiologic monitoring of laryngeal muscle during thyroid surgery.

A technique is described for intraoperative electrophysiologic monitoring of laryngeal muscles. This technique has been used to identify the laryngeal nerves during surgery for recurrent tumors of the thyroid gland, when direct visualization of the nerves is difficult or impossible. Laryngeal muscle electrical activity is monitored with endoscopically placed wire-hook electrodes inserted into the vocal folds bilaterally. Neurotonic discharges are detected when the recurrent laryngeal nerves are manipulated during surgical dissection. Precise localization of the recurrent nerves is possible using a hand-held bipolar stimulator.

Adenocarcinoma, Papillary↗
PubMed1987

Surgical treatment of invasion of the upper aerodigestive tract by well-differentiated thyroid carcinoma.

Forty-eight patients with well-differentiated thyroid carcinoma invading upper aerodigestive tract structures have been described. Age at diagnosis was found to be a negative prognostic factor, and duration of disease before invasion was found to be a positive prognostic factor. Treatment with radical surgery and adjuvant therapy provided no improvement in survival over treatment with near-total (skeletonizing) excisions combined with adjuvant therapy. All patients treated with partial debulking procedures, with or without tracheotomy, died from disease. We believe that partial resection of upper aerodigestive tract structures without sacrifice of voice, normal breathing, or swallowing should be considered in patients with well-differentiated thyroid carcinoma.

Adenocarcinoma↗
PubMed1987

Migration of Teflon after vocal cord injection.

Each of eight mongrel dogs received a 0.5 ml injection of polytef paste into the right vocal fold. These dogs were killed at 1 week, 1 month, 3 months, and 6 months after injection, and a number of organs were examined. Polarizing microscopy was used to examine the upper cervical lymph nodes, lower cervical lymph nodes, mediastinal lymph nodes, abdominal lymph nodes, cerebral cortex, brainstem, lung, liver, spleen, and kidney to determine if migration of polytef had occurred. Examination of these organs revealed that there was consistent migration of polytef particles into the cervical lymph nodes, with the highest incidence occurring in upper cervical lymph nodes on the side of injection. There was no evidence of migration of polytef particles to distant sites. The study shows that polytef particles may migrate to cervical lymph nodes after injection into the larynx; however, there is no evidence of distant migration.

Animals↗
PubMed1987

The effect of systemic triamcinolone acetonide on nerve repair.

The effects of timed-release pellets of triamcinolone acetonide on sciatic nerve regeneration were studied. Bilateral nerve defects were created in 18 rats. One defect was sutured primarily, while the contralateral side was grafted with a 1 cm autogenous graft. Nerve regeneration was assessed at 20 weeks by muscle-twitch strength and compound action potential parameters measured proximal and distal to the repair site. Conduction velocity and regenerative index (ratio of distal to proximal compound action potential area) were calculated. Significant improvement of the regenerative index and twitch strength occurred in animals treated with a 0.5 mg 21-day-release pellet. Improvement occurred in animals treated with 0.5 mg 60-day pellets, but the difference was not significant. The findings suggest that regeneration was enhanced as a result of increased numbers of axons that made distal connections in the animals that received 21-day-release triamcinolone systemically. Corticosteroid therapy may benefit motor nerve repair.

Action Potentials↗
PubMed1987

Reflex control of nasal blood vessels.

The effect of stimulation of vagal afferent fibers on nasal blood vessels was studied in 36 cats. Volume change of the nasal capacitance vessels was measured by plethysmographic balloons inserted into the nose. Electrical stimulation of the vagus nerve produced a vasodilatation of nasal mucosa. Pulmonary stretch receptor stimulation by veratridine alkaloid and progressive lung inflation in open-chest cats also produced a vasodilatation of the nasal mucosa. These reflexes were abolished by sectioning the vagus nerves. These results suggest a reflex arc between the lung and nasal capacitance vessels which arises from pulmonary stretch receptors.

Airway Resistance↗
PubMed1986

The beneficial effect of triamcinolone acetonide on nerve repair with autogenous grafts.

Bilateral nerve cable graft repairs were made in the sciatic nerves of Wistar rats. One group of repairs was treated locally with triamcinolone acetonide (0.5 mg), one group was exposed to the systemic effects of the drug, and one group was left untreated. Nerve regeneration was measured by nerve-stimulated muscle twitch strength, as well as several electrophysiologic parameters of the compound action potential conducted through the graft. Results suggest that nerve regeneration through an autogenous graft is significantly improved by local treatment with triamcinolone acetonide. Further studies are indicated to determine appropriate dosage necessary to maximize the beneficial local effects.

Action Potentials↗
PubMed1985

Nerve grafting. Functional results after primary vs delayed repair.

The finding of heightened metabolic activity in nerve cell bodies after axonal injury has led to speculation that delaying motor nerve repair would be beneficial. Using a sciatic nerve model, 100 rats were grouped based on nerve autograft donor and recipient site variables. Animals were subjected to electrophysiologic testing at 3, 6, 9, and 12 weeks after grafting. Twitch force and nerve compound action potential parameters were calculated and compared using two-way analysis of variance. Previous studies have suggested interaction between donor and recipient variables. We cannot support these findings. Our data revealed no significant difference between immediate or delayed nerve repair or between fresh or predegenerated nerve grafts.

Action Potentials↗
PubMed1985

Effect of maturation on the sensitivity of laryngeal resistance to chemoreceptor stimulation in the dog.

The respiratory system undergoes many changes with maturation, resulting in increased capacity and efficiency. In an effort to determine the effects of maturation on airway control, laryngeal airway resistance was studied from infancy to adulthood in dogs. Reflex regulation of laryngeal airway resistance in response to chemoreceptor stimulation was found in puppies 1 day of age and older. Chemoreceptor-mediated laryngeal reflexes were qualitatively similar in all age groups. However, a significant quantitative difference was found. With maturation, an increase in the sensitivity of both central and peripheral chemoreceptors regulating laryngeal resistance is realized.

Aging↗
PubMed1985

Normal nasal resistance.

Eighty normal adults without nasal symptoms were studied to determine normal nasal resistance values and the variation of nasal resistance in normal adults. A microprocessor-based system for collection and analysis of transnasal pressure and flow was used to obtain nasal resistance values. Unilateral and total transnasal pressure and flow values were determined before and after decongestion of the nose with 1% phenylephrine spray. The distribution of the 80 resistance values was found to be skewed to the right. Log transformation of the resistance values was the best method to normalize their distribution. The mean and variation of normal nasal resistance are reported at flows of 0.1 and 0.2 L/sec, at pressures of 0.5 and 1 cm H2O, and at radii of 1, 2, and 3 on the pressure-flow curve.

Adult↗
PubMed1984

Life-threatening neck infections. Early diagnosis to forestall crisis.

Infections of the neck become life-threatening with airway or systemic involvement. The first step in successful management is early recognition by the initial examiner. Patient evaluation includes a thorough history and physical examination, laboratory studies, and if the patient's condition is stable, roentgenographic studies. With early diagnosis of neck infections, serious complications such as spread to vital structures, toxicity, airway compromise, and sepsis can be prevented.

Abscess↗
PubMed1984

Role of the nasal airway in regulation of airway resistance during hypercapnia and exercise. Second-Place Resident Award at 1982 Research Forum.

Posterior mask rhinomanometry was used to measure nasal resistance during exercise and hypercapnia in 10 healthy adult volunteers. Exercise was produced by peddling a stationary bicycle at three loads. Hypercapnia was produced by breathing O2 mixtures containing 5%, 6%, and 8% CO2. The results showed that nasal resistance decreases linearly as expired CO2 levels and exercise levels increase, minute ventilation increases linearly as expired CO2 levels and exercise levels increase, and nasal resistance varies inversely with minute ventilation during both hypercapnia and exercise. The constant relationship between nasal resistance and minute ventilation during hypercapnia and exercise suggests that nasal resistance is regulated by the respiratory center to match the level of respiratory demand.

Adult↗
PubMed1984

Objective evaluation of anterior septal surgical reconstruction.

Fifty patients who underwent nasal septal reconstruction for anterior septal deformities were examined preoperatively and postoperatively with anterior mask rhinomanography. A high degree of correlation was found between the reduction in nasal resistance after operation and the patients' subjective assessment of improvement. Those patients who improved subjectively had a mean decrease in nasal resistance of 1.2 cm H2O/L/sec, whereas those patients who indicated no improvement had a mean increase in nasal resistance of 0.2 cm H2O/L/sec.

Airway Resistance↗
PubMed1984

Animal model for peripheral nerve grafting.

We propose an animal model from which it is possible to follow nerve-muscle unit recovery after a nerve graft easily, consistently, and relatively inexpensively. The model is also compatible with subsequent histologic or histochemical analysis. We document the recovery of a group of animals after nerve grafting to demonstrate the flexibility of the model.

Action Potentials↗
PubMed1984

Life-threatening soft-tissue infections of the neck.

Four adult patients had life-threatening soft-tissue infections of the neck. One had Hemophilus influenzae infection, one had Streptococcus pyogenes infection, and two had polymicrobial mixed aerobic and anaerobic infections. Three of the four patients died despite appropriate antimicrobial therapy and surgical intervention. These cases demonstrate the spectrum of serious soft-tissue infections of the neck in both the compromised and the uncompromised host. Soft-tissue infections of the neck may be necrotizing or nonnecrotizing. Cellulitis secondary to H. influenzae and beta-hemolytic streptococci is usually non-necrotizing, whereas necrotizing infections are caused most commonly by synergistic organisms. Potential complications include septic shock, disseminated intravascular coagulation, acute renal failure, adult respiratory distress syndrome, mediastinitis, and pericarditis. Early recognition with aggressive medical and surgical therapy is essential to reduce the mortality.

Adult↗