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Sample records for ear effusion mee

  1. Ultrasound characterization of middle ear effusion.

    PubMed

    Seth, Rahul; Discolo, Christopher M; Palczewska, Grazyna M; Lewandowski, Jan J; Krakovitz, Paul R

    2013-01-01

    To further enhance and assess the ability to characterize middle ear effusion (MEE) using non-invasive ultrasound technology. This is a prospective unblinded comparison study. Fifty-six children between the ages of 6 months and 17 years scheduled to undergo bilateral myringotomy with pressure equalization tube placement were enrolled. With the child anesthetized, the probe was placed into the external ear canal after sterile water was inserted. Ultrasound recordings of middle ear contents were analyzed by computer algorithm. Middle ear fluid was collected during myringotomy and analyzed for bacterial culture and viscosity. Ultrasound waveforms yielded a computer algorithm interpretation of middle ear contents in 66% of ears tested. When a result was obtained, the sensitivity and specificity for successfully characterizing middle ear fluid content as either void of fluid, thick fluid (mucoid), or thin fluid (serous or purulent) were at least 94%. Mucoid effusions had higher measured viscosity values (P=.002). Viscosity measures were compared to culture result, and those with low viscosity (thin consistency) had a higher likelihood of having a positive culture (P=.048). The device sensitivity and specificity for fluid detection were 94% or greater among interpretable waveforms (66% of those tested). Although this technology provides important information of the middle ear effusion presence and characteristic, further technological improvements are needed. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Ultrasound Characterization of Middle Ear Effusion

    PubMed Central

    Seth, Rahul; Discolo, Christopher M; Palczewska, Grazyna M; Lewandowski, Jan J; Krakovitz, Paul R

    2012-01-01

    Purpose To further enhance and assess the ability to characterize middle ear effusion (MEE) using non-invasive ultrasound technology. Materials and Methods This is a prospective unblinded comparison study. Fifty-six children between the ages of 6 months and 17 years scheduled to undergo bilateral myringotomy with pressure equalization tube placement were enrolled. With the child anesthetized, the probe was placed into the external ear canal after sterile water was inserted. Ultrasound recordings of middle ear contents were analyzed by computer algorithm. Middle ear fluid was collected during myringotomy and analyzed for bacterial culture and viscosity. Results Ultrasound waveforms yielded a computer algorithm interpretation of middle ear contents in 66% of ears tested. When a result was obtained, the sensitivity and specificity for successfully characterizing middle ear fluid content as either void of fluid, thick fluid (mucoid), or thin fluid (serous or purulent) was at least 94%. Mucoid effusions had higher measured viscosity values (P=0.002). Viscosity measures were compared to culture result, and those with low viscosity (thin consistency) had a higher likelihood of having a positive culture (P=0.048). Conclusion The device sensitivity and specificity for fluid detection was 94% or greater among interpretable waveforms (66% of those tested). Although this technology provides important information of the middle ear effusion presence and characteristic, further technological improvements are needed. PMID:23084430

  3. Non-invasive optical assessment of viscosity of middle ear effusions in otitis media.

    PubMed

    Monroy, Guillermo L; Pande, Paritosh; Shelton, Ryan L; Nolan, Ryan M; Spillman, Darold R; Porter, Ryan G; Novak, Michael A; Boppart, Stephen A

    2017-03-01

    Eustachian tube dysfunction can cause fluid to collect within the middle ear cavity and form a middle ear effusion (MEE). MEEs can persist for weeks or months and cause hearing loss as well as speech and learning delays in young children. The ability of a physician to accurately identify and characterize the middle ear for signs of fluid and/or infection is crucial to provide the most appropriate treatment for the patient. Currently, middle ear infections are assessed with otoscopy, which provides limited and only qualitative diagnostic information. In this study, we propose a method utilizing cross-sectional depth-resolved optical coherence tomography to noninvasively measure the diffusion coefficient and viscosity of colloid suspensions, such as a MEE. Experimental validation of the proposed technique on simulated MEE phantoms with varying viscosity and particulate characteristics is presented, along with some preliminary results from in vivo and ex vivo samples of human MEEs. In vivo Optical Coherence Tomography (OCT) image of a human tympanic membrane and Middle Ear Effusion (MEE) (top), with a CCD image of the tympanic membrane surface (inset). Below is the corresponding time-lapse M-mode OCT data acquired along the white dotted line over time, which can be analyzed to determine the Stokes-Einstein diffusion coefficient of the effusion. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Middle ear effusion in children and the indoor environment: an epidemiological study

    SciTech Connect

    Iversen, M.; Birch, L.; Lundqvist, G.R.

    Very low air infiltration rates have been found in new Danish day-care institutions built according to the energy conservation measures enforced in the Building Regulations. Complaints from staff in institutions have been numerous, e.g., mainly eyes and upper airways problems. Formaldehyde has been recognized as a causal factor in some cases. Extensive retrofitting has occurred in Denmark for energy conservation reasons. This will lower the air infiltration rates in dwellings and possibly create higher levels of pollutants produced indoors. A prospective study of 337 children was carried out during a 3-month period. The purpose of the study was to evaluatemore » the importance of indoor environmental factors in homes and day-care institutions for the incidence of middle ear effusion (MEE). The indoor environmental factors measured in institutions were carbon dioxide, temperature, and relative humidity. Conditions in the homes were assessed by a questionnaire. Middle ear effusion was measured by tympanometry. No relationship was found between indoor environmental factors and MEE, with the exception of parental smoking at home, which increased the frequency of MEE in children.« less

  5. Daily tympanometry for high-resolution measurement of the time between onset of cold-like illness and middle ear effusion.

    PubMed

    Doyle, William J; Winther, Birgit; Alper, Cuneyt M

    2008-06-01

    Tympanometry is a simple method to assess middle ear pressure (MEP) and the presence of middle ear effusion (MEE), a marker of otitis media (OM). To determine whether daily parental tympanometry and illness sign recording in their children can be used to define the time between onsets of cold-like illness (CLI) and MEE at high resolution. Prospective, longitudinal, 7 month, daily follow-up on 169 children aged 1 through 8.6 years. Tympanograms and illness were recorded daily by a parent. Tympanograms were examined, rejected if artifactual, and MEP data were entered into a database, with "flat tympanograms" coded as -400 mm H2O = MEE. The incidence and burden of CLIs (>2 days) were calculated, and for each CLI, the presence/absence of concurrent MEE (>2 days) was determined. For each child, the average MEP for CLI and nonCLI days was calculated. Paired CLI and tympanometric results were aligned and the days between event onsets determined. Stepwise regression was used to assign risk predictors for the measured outcomes. A total of 566 CLIs were recorded, and the average CLI burden/child was 16%. Age was a significant predictor of CLI incidence/child, and age, history of colds, and daily environment were predictors of CLI-burden/child. Of the 433 evaluable CLI episodes, MEE was a complication in 37%, and MEE with a CLI was predicted by age, OM history, and environment. MEP was significantly more negative during CLI episodes, and the magnitude was predicted by age, race, and OM history. The average difference in MEE-CLI onsets was 1.2 +/- 4.0 days; approximately 32% of MEEs occurred prior to CLI onset and 17% on the same day as CLI onset. CLIs adversely affect the middle ear-ambient pressure balance and are frequently associated with MEE episodes. The distribution in onsets between those events suggests that chemoprophylaxis of a child with a newly identified CLI to prevent MEE would have a low expected efficiency.

  6. The Impact of Otitis Media with Effusion on Infant Phonetic Perception

    ERIC Educational Resources Information Center

    Polka, Linda; Rvachew, Susan

    2005-01-01

    The effect of prior otitis media with effusion (OME) or current middle ear effusion (MEE) on phonetic perception was examined by testing infants' discrimination of "boo" and "goo" syllables in 2 test sessions. Middle ear function was assessed following each perception test using tympanometry. Perceptual performance was compared…

  7. An evidence based protocol for managing neonatal middle ear effusions in babies who fail newborn hearing screening.

    PubMed

    Weber, Brittany C; Whitlock, Scott M; He, Kaidi; Kimbrell, Blake S; Derkay, Craig S

    2018-04-12

    To evaluate the prevalence of middle ear disease in infants referred for failed newborn hearing screening (NBHS) and to review patient outcomes after intervention in order to propose an evidence-based protocol for management of newborns with otitis media with effusion (OME) who fail NBHS. 85 infants with suspected middle ear pathology were retrospectively reviewed after referral for failed NBHS. All subjects underwent a diagnostic microscopic exam with myringotomy with or without placement of a ventilation tube in the presence of a middle ear effusion and had intra-operative auditory brainstem response (ABR) testing or testing at a later date. At the initial office visit, a normal middle ear space bilaterally was documented in 5 babies (6%), 29/85 (34%) had an equivocal exam while 51/85 (60%) had at least a unilateral OME. Myringotomy with or without tube placement due to presence of an effusion was performed on 65/85 (76%) neonates. Normal hearing was established in 17/85 (20%) after intervention, avoiding the need for any further audiologic workup. Bilateral or unilateral sensorineural hearing loss (SNHL) or mixed hearing loss was noted in 54/85 (64%) and these children were referred for amplification. Initially observation with follow up outpatient visits was initiated in 27/85 (32%) however, only 3/27 (11%) resolved with watchful waiting and 24/27 (89%) ultimately required at least unilateral tube placement due to OME and 14/24 (59%) were found to have at least a unilateral mixed or SNHL. An effective initial management plan for children with suspected middle ear pathology and failed NBHS is diagnostic operative microscopy with placement of a ventilation tube in the presence of a MEE along with either intra-operative ABR or close follow-up ABR. This allows for the identification and treatment of babies with a conductive component due to OME, accurate diagnosing of an underlying SNHL component and for prompt aural rehabilitation. Copyright © 2018 Elsevier Inc

  8. The association of middle ear effusion with trigeminal nerve mass lesions in dogs.

    PubMed

    Wessmann, A; Hennessey, A; Goncalves, R; Benigni, L; Hammond, G; Volk, H A

    2013-11-09

    The trigeminal nerve is involved in the opening of the pharyngeal orifice of the Eustachian tube by operating the tensor veli palatini muscle. The hypothesis was investigated that middle ear effusion occurs in a more severe disease phenotype of canine trigeminal nerve mass lesions compared with dogs without middle ear effusion. Three observers reviewed canine MRIs with an MRI-diagnosis of trigeminal nerve mass lesion from three institutions. Various parameters describing the musculature innervated by the trigeminal nerve were scored and compared between dogs with and without middle ear effusion. Nineteen dogs met the inclusion criteria. Ipsilateral middle ear effusion was observed in 63 per cent (95% CI 48.4 per cent to 77.6 per cent) of the dogs. The size of the trigeminal nerve mass lesions was positively correlated with the severity of masticatory muscle mass loss (Spearman r=0.5, P=0.03). Dogs with middle ear effusion had a significantly increased generalised masticatory muscle mass loss (P=0.02) or tensor veli palatini muscle loss score (P=0.03) compared with those without. Larger trigeminal nerve mass lesions were associated with a greater degree of masticatory muscle mass loss. Masticatory muscle mass and, importantly, tensor veli palatini muscle mass was more severely affected in dogs with middle ear effusion suggesting an associated Eustachian tube dysfunction.

  9. Passive smoking, salivary cotinine concentrations, and middle ear effusion in 7 year old children.

    PubMed

    Strachan, D P; Jarvis, M J; Feyerabend, C

    1989-06-10

    To assess the contribution of passive exposure to tobacco smoke to the development of middle ear underpressure and effusion. Cross sectional observational study. One third of the primary schools in Edinburgh. 892 Children aged 6 1/2 to 7 1/2 were examined, and satisfactory tympanograms were obtained in 872. Results of assay of salivary cotinine concentrations were available for 770 children, and satisfactory tympanograms were available for 736 of these. Correlation of the prevalence of middle ear underpressure and effusion with concentrations of the marker of nicotine, cotinine, in the saliva of the children. Middle ear pressure and compliance were measured in both ears by impedance tympanometry. Salivary cotinine concentrations were assayed by gas-liquid chromatography. Cotinine concentrations increased with the number of smokers in the household. Girls had higher concentrations than boys, and children living in rented housing had higher concentrations than those living in housing owned by their parents. There was a trend towards more abnormal tympanometric findings with increasing cotinine concentration, the odds ratio for a doubling of the cotinine concentration being 1.14 (95% confidence interval 1.03 to 1.27). After adjustment for the sex of the child and housing tenure the odds ratio for a doubling of the cotinine concentration was 1.13 (1.00 to 1.28). The results of this study are consistent with those of case-control studies of children attending for an operation to relieve middle ear effusion. They indicate that the disease should be added to the list of recognised hazards associated with passive smoking. About one third of the cases of middle ear effusion in this study were statistically attributable to exposure to tobacco smoke.

  10. Middle Ear Effusion in Children: A Report of Treatment in 500 Cases

    PubMed Central

    Forquer, Brian D.; Linthicum, Fred H.

    1982-01-01

    Records were studied of 500 children younger than 9 years of age with middle ear effusion who had received one of three treatment strategies: (1) administration of medication, including decongestants, antihistamines or antibiotics (or a combination), (2) administration of medication for a limited time and then surgical therapy if effusion did not resolve or (3) myringotomy done immediately with insertion of ventilation tubes and, in some cases, removal of adenoids. Early surgical intervention resulted in significantly shorter delay in hearing restoration. It did not result in a lower recurrence rate and it did not reduce the number of occasions when thick fluid, as compared with thin fluid, was found at operation. Four children for whom medical and surgical treatment failed were considered candidates for mild gain, low maximum-power-output hearing aids. All other children had normal hearing after treatment. Medication was successful in achieving this goal in 48 percent of the cases. PMID:6184891

  11. Long-term evaluation of the effect of middle ear effusion on the vestibular system in children.

    PubMed

    Pazdro-Zastawny, Katarzyna; Pośpiech, Lucyna; Zatoński, Tomasz

    2018-06-01

    Otitis media with effusion (OME) is one of the most common clinical conditions in childhood. Fluid accumulation in the middle ear may impact inner ear. The purpose of this random sample cohort study was to investigate whether the past history of middle ear effusion has a long-term negative impact on the vestibular system in children. The study was carried out on 22 children aged 7-15 years who had undergone drainage of the middle ear 5 years before evaluation. The control group consisted of 29 healthy children aged 4-17 years. Vestibular function was examined using sway posturography and electronystagmography (ENG). The stabilogram parameters of the study group and the control group were compared. The field of developed area (FDA) and the average body sway velocity (ASV) were analyzed. Elevated stabilogram parameters of FDA and ASV, both with eyes open and eyes closed, were found in the study group. Statistically significant values (p < 0.05) were present for ASV with eyes open and with eyes closed. The ENG recordings were analyzed in both groups. In the study group, spontaneous nystagmus was observed in 40.9% of the children and positional nystagmus occurred in 63.6% of the children. According to tests, eye tracking test was impaired in 27.3% of cases. Rotatory chair testing revealed asymmetry in 18.2% of the children. The presence of effusion in the middle ear in the past has a negative impact on the vestibular part of the inner ear. Clinicians should be aware of the possible negative impact of middle ear effusion on the vestibular function in children with a history of otitis media with effusion. With seeimingly asymptomatic children clinicians should inquire parents about symptoms of dysequlibrium and imbalance. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. The expression and correlation of Hsp 70 and Hsp 27 in serous middle ear effusion fluids of pediatric patients-a preliminary study.

    PubMed

    Min, Hyun Jin; Choe, Ji Won; Chang, Moon Young; Kim, Kyung Soo; Lee, Sei Young; Mun, Seog-Kyun

    2017-10-01

    Several cytokines and innate immune-associated molecules are present in middle ear effusions, but damage-associated molecular patterns (DAMPs) in middle ear effusion have not been studied. Therefore, we evaluated the role of heat shock proteins (Hsps) in the development of otitis media with effusion (OME). Serous middle ear effusions from 22 pediatric patients who were diagnosed with OME and underwent ventilation tube insertion from June 2015 to March 2017 were evaluated in our study. The levels of Hsp 90, 70, 27, IL-8, and TNF-α in effusion fluids were evaluated by enzyme-linked immunosorbent assays. The associations between the levels of these molecules and the degree of tympanic membrane inflammation were statistically evaluated. Finally, the relationships among these molecules were also evaluated. Hsp 70 and Hsp 27 were detected in all middle ear effusions, but Hsp 90 was detected in only five effusion fluid samples. IL-8 was also detected in all middle ear effusions, but TNF-α was detected in only four effusion fluid samples. When we compared the degree of tympanic membrane inflammation with the levels of Hsp 70, Hsp 27, and IL-8, which were detected in all effusion fluids, we could not find statistical significance. However, Hsp 70, Hsp 27, and IL-8 were significantly associated with each other (p < 0.05). Hsp 70 and Hsp 27 were expressed in middle ear effusions. Furthermore, the levels of Hsp 70 and Hsp 27 were positively correlated with each other, and were also positively associated with the neutrophil chemoattractant, IL-8. Our findings suggested that Hsp 70 and Hsp 27 might be involved in the pathophysiology of pediatric OME. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Otopathogens Detected in Middle Ear Fluid Obtained during Tympanostomy Tube Insertion: Contrasting Purulent and Non-Purulent Effusions

    PubMed Central

    Holder, Robert C.; Kirse, Daniel J.; Evans, Adele K.; Whigham, Amy S.; Peters, Timothy R.; Poehling, Katherine A.; Swords, William E.; Reid, Sean D.

    2015-01-01

    Otitis media is a prominent disease among children. Previous literature indicates that otitis media is a polymicrobial disease, with Haemophilus influenzae, Streptococcus pneumoniae, Alloiococcus otitidis and Moraxella catarrhalis being the most commonly associated bacterial pathogens. Recent literature suggests that introduction of pneumococcal conjugate vaccines has had an effect on the etiology of otitis media. Using a multiplex PCR procedure, we sought to investigate the presence of the aforementioned bacterial pathogens in middle ear fluid collected from children undergoing routine tympanostomy tube placement at Wake Forest Baptist Medical Center during the period between January 2011 and March 2014. In purulent effusions, one or more bacterial organisms were detected in ~90% of samples. Most often the presence of H. influenzae alone was detected in purulent effusions (32%; 10 of 31). In non-purulent effusions, the most prevalent organism detected was A. otitidis (26%; 63 of 245). Half of the non-purulent effusions had none of these otopathogens detected. In purulent and non-purulent effusions, the overall presence of S. pneumoniae was lower (19%; 6 of 31, and 4%; 9 of 245, respectively) than that of the other pathogens being identified. The ratio of the percentage of each otopathogen identified in purulent vs. non-purulent effusions was >1 for the classic otopathogens but not for A. otitidis. PMID:26039250

  14. Pro-inflammatory interleukins in middle ear effusions from atopic and non-atopic children with chronic otitis media with effusion.

    PubMed

    Zielnik-Jurkiewicz, Beata; Stankiewicz-Szymczak, Wanda

    2016-06-01

    Chronic otitis media with effusion (OME) is associated with irreversible changes in the middle ear, sometimes leading to hearing loss and abnormal language development in children. While the pathogenesis of OME is not fully understood, inflammatory and allergic factors are thought to be involved. The study aimed to investigate the role of cytokines in the local development of chronic OME, and assess differences in the cytokine profiles between atopic and non-atopic children. 84 atopic and non-atopic children with chronic OME (mean age of 6 years 7 months) were studied. Age-matched children with hypertrophy of the adenoids and Eustachian tube dysfunction served as the control group. The number of past acute otitis media (AOM) episodes, their age, and the type of effusion were recorded for all children. Pro-inflammatory cytokine concentrations (TNF-α, IL-1β, IL-6 and IL-8) were determined and the presence of pathogenic bacteria in the patients' effusions was examined. High concentrations of TNF-α, IL-1β, IL-6 and IL-8 were found in the effusions in all children with chronic OME, with the highest levels observed in the non-atopic group. The atopic group showed persistently high IL-1β levels, while in the non-atopic children, IL-1β and TNF-α levels positively correlated with the patient's age and the number of past AOM episodes. Pathogenic bacteria were more frequently isolated from effusions in non-atopic children. In both atopic and non-atopic children, pro-inflammatory cytokines are found at high concentrations. This argues in favor of instituting anti-inflammatory management for treating OME, regardless of atopy.

  15. Ventilation time of the middle ear in otitis media with effusion (OME) after CO2 laser myringotomy.

    PubMed

    Sedlmaier, Benedikt; Jivanjee, Antonio; Gutzler, Rico; Huscher, Dörte; Jovanovic, Sergije

    2002-04-01

    The aim of this study was to investigate the transtympanic ventilation time, the healing course of the tympanic membrane, the early and late complications, and the recurrence rate of otitis media with effusion (OME) within 6 months after CO2 laser myringotomy with the CO2 laser otoscope Otoscan. Prospective clinical study. In this study, laser myringotomy was performed with the CO2 laser otoscope Otoscan in a patient population comprising 81 children (159 ears) with a history of otitis media with effusion (OME) associated with adenoidal and sometimes tonsillar hyperplasia. The procedure on the tympanic membrane was accordingly combined with an adenoidectomy, a CO2 laser tonsillotomy, or a tonsillectomy and therefore performed under insufflation anesthesia. In all ears, approximately 2 mm circular perforations were created in the lower anterior quadrants with a power of 12 to 15 W, a pulse duration of 180 msec, and a scanned area of 2.2 mm in diameter. None of the children showed postoperative impairment of cochleovestibular function such as sensorineural hearing loss or nystagmus. Otomicroscopic and videoendoscopic monitoring documented the closure time and healing pattern of tympanic membrane perforations. The mean closure time was found to be 16.35 days (minimum, 8 days; maximum, 34 days). As a rule, an onion-skin-like membrane of keratinized material was seen in the former myringotomy perforations at the time of closure. At the follow-up 6 months later, the condition of the tympanic membrane of 129 ears (81.1%) could be checked by otomicroscopy and videoendoscopy and the hearing ability by audiometry and tympanometry. The CO2 laser myringotomy sites appeared normal and irritation-free. Two of the tympanic membranes examined (1.6%) showed atrophic scar formation, and 1 (0.8%) had a perforation with a diameter of 0.3 mm. The perforation was seen closed in a control otoscopy 15 months postoperatively. OME recurred in 26.3% of the ears seen intraoperatively with

  16. Parent Versus Professional Views of the Developmental Impact of a Multi-Faceted Condition at School Age: Otitis Media with Effusion ("Glue Ear")

    ERIC Educational Resources Information Center

    Higgins, Josephine; Haggard, Mark

    2005-01-01

    Background: Several aspects of children's health and development are known from empirical studies to be associated with otitis media with effusion (OME; "glue ear"'). The "diffuse image" has been an obstacle to defining a core set of impacts about which inter-profession and parent-professional communication can be effective. Aims: The study…

  17. "Rabbit ear" scalp deformity caused by massive subdural effusion in infant following bilateral bur-hole drainage failure: successfully managed with subduro-peritoneal shunt.

    PubMed

    Satyarthee, Guru Dutta; Dawar, Pankaj; Sharma, Bhawani Shanker

    2013-11-01

    Subdural effusion in an infant is a rare clinical scenario which may be secondary to a variety of etiologies. Massive subdural effusion is an extremely rare complication of head injury. Authors report a rare case of progressive massive subdural effusion which, despite bilateral bur-hole placement and drainage, failed and presented with visual deterioration and massive bulge of the scalp at bur-hole sites, producing a rabbit ear appearance in a 10-month-old infant. Ultimately, cystoperitoneal shunt was carried out in a desperate attempt to prevent impending rupture of scalp sutures at sites of previous bur-hole placement. This was followed by not only complete resolution of hygroma but also visual recovery. The patient is doing well at 6 months following shunt, regaining normal vision and appropriate developmental milestones. A MRI scan of the brain was carried out at last follow-up, which revealed mild ventriculomegaly with the rest of the brain being unremarkable, and subduro-peritoneal shunt in situ. Such a case has not been reported in the literature till date. Subdural effusion usually runs a self-limiting course. Though neurosurgical intervention is occasionally needed, different methods of surgical procedure for management include bur hole alone, bur holes with subdural drain placement, twist drill craniotomy with drain, and even craniotomy. Various methods of management are discussed along with a review of pertinent literature.

  18. Chronological changes in microbial profiles in external and middle ear diseases: a 20-year study in Korea.

    PubMed

    Kim, Hantai; Choo, Oak-Sung; Jang, Jeong Hun; Park, Hun Yi; Choung, Yun-Hoon

    2017-03-01

    Microbial infection is one of the most significant causes of ear diseases, but microbial profiles are very diverse according to the diseases and change over time. The purpose of the study was to clarify differences and chronological changes in causative pathogens among infectious ear diseases over the last 20 years, and to identify antibiotic resistance. In total, 1191 isolates were included from patients diagnosed with chronic otitis media without cholesteatoma (COM), cholesteatomatous otitis media (Chole), middle ear effusion (MEE), including acute otitis media and otitis media with effusion, and external otitis (EO). Data were collected periodically for the years 1995, 2000, 2004, 2009, and 2013. Culture results and antibiotic resistance were assessed. The most common microorganism identified was S. aureus. The microbial profiles differed significant among the COM, Chole, and MEE groups (p < 0.001). In contrast, there was no distinct difference between COM and EO (p = 0.332). COM, Chole, and MEE also showed significant chronological changes in microbial profiles over time. The frequency of CNS increased markedly in COM and Chole (p = 0.029 and 0.028, respectively); however, S. pneumoniae infection decreased significantly in MEE (p = 0.016). Methicillin-resistant S. aureus (MRSA) demonstrated a constant trend (p = 0.564), whereas ciprofloxacin-resistant P. aeruginosa increased over time (p < 0.001). Microbial profiles have changed over a 20-year period. Increases in the frequency of coagulase-negative Staphylococcus (CNS) and bacterial resistance to ciprofloxacin, used widely in treating ear infections, are noteworthy.

  19. Ectopic Mineralization in the Middle Ear and Chronic Otitis Media with Effusion Caused by RPL38 Deficiency in the Tail-short (Ts) Mouse*

    PubMed Central

    Noben-Trauth, Konrad; Latoche, Joseph R.

    2011-01-01

    Inflammation of the middle ear cavity (otitis media) and the abnormal deposition of bone at the otic capsule are common causes of conductive hearing impairment in children and adults. Although a host of environmental factors can contribute to these conditions, a genetic predisposition has an important role as well. Here, we analyze the Tail-short (Ts) mouse, which harbors a spontaneous semi-dominant mutation that causes skeletal defects and hearing loss. By genetic means, we show that the Ts phenotypes arise from an 18-kb deletion/insertion of the Rpl38 gene, encoding a ribosomal protein of the large subunit. We show that Ts mutants exhibit significantly elevated auditory-brain stem response thresholds and reduced distortion-product otoacoustic emissions, in the presence of normal endocochlear potentials and typical inner ear histology suggestive of a conductive hearing impairment. We locate the cause of the hearing impairment to the middle ear, demonstrating over-ossification at the round window ridge, ectopic deposition of cholesterol crystals in the middle ear cavity, enlarged Eustachian tube, and chronic otitis media with effusion all beginning at around 3 weeks after birth. Using specific antisera, we demonstrate that Rpl38 is an ∼8-kDa protein that is predominantly expressed in mature erythrocytes. Finally, using an Rpl38 cDNA transgene, we rescue the Ts phenotypes. Together, these data present a previously uncharacterized combination of interrelated middle ear pathologies and suggest Rpl38 deficiency as a model to dissect the causative relationships between neo-ossification, cholesterol crystal deposition, and Eustachian tubes in the etiology of otitis media. PMID:21062742

  20. Effect of middle ear fluid on sound transmission and auditory brainstem response in guinea pigs.

    PubMed

    Guan, Xiying; Gan, Rong Z

    2011-07-01

    Combined measurements of middle ear transfer function and auditory brainstem response (ABR) in live guinea pigs with middle ear effusion (MEE) are reported in this paper. The MEE model was created by injecting saline into the middle ear cavity. Vibrations of the tympanic membrane (TM), the tip of the incus, and the round window membrane (RWM) were measured with a laser vibrometer at frequencies of 0.2-40 kHz when the middle ear fluid increased from 0 to 0.2 ml (i.e., full fill of the cavity). The click and pure tone ABRs were recorded as the middle ear fluid increased. Fluid introduction reduced mobility of the TM, incus and RWM mainly at high frequencies (f > 1 kHz). The magnitude of this reduction was related to the volume of fluid. The displacement transmission ratio of the TM to incus varied with frequency and fluid level. The volume displacement ratio of the oval window to round window was approximately 1.0 over most frequencies. Elevation of ABR thresholds and prolongation of ABR latencies were observed as fluid level increased. Reduction of TM displacement correlated well with elevation of ABR threshold at 0.5-8 kHz. Alterations in the ratio of ossicular displacements before and after fluid induction are consistent with fluid-induced changes in complex ossicular motions. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. Identification of Alloiococcus otitidis, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae in Children With Otitis Media With Effusion

    PubMed Central

    Farajzadah Sheikh, Ahmad; Saki, Nader; Roointan, Mitra; Ranjbar, Reza; Yadyad, Mohammad Jaafar; Kaydani, Abbas; Aslani, Sajad; Babaei, Mansoor; Goodarzi, Hamed

    2015-01-01

    Background: Based on many studies, otitis media with effusion (OME) is one of the major causes of childhood hearing loss, social malformation and medical costs. The pathogenesis still remains unclear, though it is known that this complication is closely related to bacterial infections. Alloiococcus otitidis, Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis are the most common bacterial pathogens isolated from middle ear effusions (MEEs). Objectives: Due to the prevalence of OME in children, we decided to investigate bacterial agents that cause diseases such as A. otitidis, H. influenzae, S. pneumonia and M. catarrhalis in these subjects. Patients and Methods: Forty-five children between one and 15 years of age were selected for this study. Seventy specimens were collected from MEE by myringotomy and inoculated in PBS buffer. Conventional culture and PCR methods were used for identification of bacterial agents. Results: The bacterial cultures in 8.6% of samples were positive by conventional culture, with A. otitidis, M. catarrhalis and S. pneumoniae present in 1.4%, 2.9% and 4.3% of samples, respectively. No H. influenzae was isolated. By the PCR method, A. otitidis was the most frequently isolated bacterium, found in 25.7% of samples, followed by S. pneumoniae, M. catarrhalis and H. influenzae, which were identified in 20%, 12% and 20% of samples, respectively. Overall, 55 out of 70 samples were positive by both the PCR and culture method. Conclusions: It can be concluded that A. otitidis was the major causative agent of MEE in children with OME. Therefore clinicians should be aware that bacterial infection plays an important role in the progression of acute otitis media to OME in children of our region. PMID:25861433

  2. Pneumatic low-coherence interferometry otoscope to quantify tympanic membrane mobility and middle ear pressure.

    PubMed

    Won, Jungeun; Monroy, Guillermo L; Huang, Pin-Chieh; Dsouza, Roshan; Hill, Malcolm C; Novak, Michael A; Porter, Ryan G; Chaney, Eric; Barkalifa, Ronit; Boppart, Stephen A

    2018-02-01

    Pneumatic otoscopy to assess the mobility of the tympanic membrane (TM) is a highly recommended diagnostic method of otitis media (OM), a widespread middle ear infection characterized by the fluid accumulation in the middle ear. Nonetheless, limited depth perception and subjective interpretation of small TM displacements have challenged the appropriate and efficient examination of TM dynamics experienced during OM. In this paper, a pneumatic otoscope integrated with low coherence interferometry (LCI) was adapted with a controlled pressure-generating system to record the pneumatic response of the TM and to estimate middle ear pressure (MEP). Forty-two ears diagnosed as normal (n = 25), with OM (n = 10), or associated with an upper respiratory infection (URI) (n = 7) were imaged with a pneumatic LCI otoscope with an axial, transverse, and temporal resolution of 6 µm, 20 µm, and 1 msec, respectively. The TM displacement under pneumatic pressure transients (a duration of 0.5 sec with an intensity of ± 150 daPa) was measured to compute two metrics (compliance and amplitude ratio). These metrics were correlated with peak acoustic admittance and MEP from tympanometry and statistically compared via Welch's t- test. As a result, the compliance represents pneumatic TM mobility, and the amplitude ratio estimates MEP. The presence of a middle ear effusion (MEE) significantly decreased compliance (p<0.001). The amplitude ratio of the OM group was statistically less than that of the normal group (p<0.01), indicating positive MEP. Unlike tympanometry, pneumatic LCI otoscopy quantifies TM mobility as well as MEP regardless of MEE presence. With combined benefits of pneumatic otoscopy and tympanometry, pneumatic LCI otoscopy may provide new quantitative metrics for understanding TM dynamics and diagnosing OM.

  3. Pneumatic low-coherence interferometry otoscope to quantify tympanic membrane mobility and middle ear pressure

    PubMed Central

    Won, Jungeun; Monroy, Guillermo L.; Huang, Pin-Chieh; Dsouza, Roshan; Hill, Malcolm C.; Novak, Michael A.; Porter, Ryan G.; Chaney, Eric; Barkalifa, Ronit; Boppart, Stephen A.

    2018-01-01

    Pneumatic otoscopy to assess the mobility of the tympanic membrane (TM) is a highly recommended diagnostic method of otitis media (OM), a widespread middle ear infection characterized by the fluid accumulation in the middle ear. Nonetheless, limited depth perception and subjective interpretation of small TM displacements have challenged the appropriate and efficient examination of TM dynamics experienced during OM. In this paper, a pneumatic otoscope integrated with low coherence interferometry (LCI) was adapted with a controlled pressure-generating system to record the pneumatic response of the TM and to estimate middle ear pressure (MEP). Forty-two ears diagnosed as normal (n = 25), with OM (n = 10), or associated with an upper respiratory infection (URI) (n = 7) were imaged with a pneumatic LCI otoscope with an axial, transverse, and temporal resolution of 6 µm, 20 µm, and 1 msec, respectively. The TM displacement under pneumatic pressure transients (a duration of 0.5 sec with an intensity of ± 150 daPa) was measured to compute two metrics (compliance and amplitude ratio). These metrics were correlated with peak acoustic admittance and MEP from tympanometry and statistically compared via Welch’s t-test. As a result, the compliance represents pneumatic TM mobility, and the amplitude ratio estimates MEP. The presence of a middle ear effusion (MEE) significantly decreased compliance (p<0.001). The amplitude ratio of the OM group was statistically less than that of the normal group (p<0.01), indicating positive MEP. Unlike tympanometry, pneumatic LCI otoscopy quantifies TM mobility as well as MEP regardless of MEE presence. With combined benefits of pneumatic otoscopy and tympanometry, pneumatic LCI otoscopy may provide new quantitative metrics for understanding TM dynamics and diagnosing OM. PMID:29552381

  4. Pleural effusion

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000086.htm Pleural effusion To use the sharing features on this page, please enable JavaScript. A pleural effusion is a buildup of fluid between the layers ...

  5. The microbiome of otitis media with effusion.

    PubMed

    Chan, Chun Ling; Wabnitz, David; Bardy, Jake Jervis; Bassiouni, Ahmed; Wormald, Peter-John; Vreugde, Sarah; Psaltis, Alkis James

    2016-12-01

    The adenoid pad has been considered a reservoir for bacteria in the pathogenesis of otitis media with effusion. This study aimed to characterize the middle ear microbiota in children with otitis media with effusion and establish whether a correlation exists between the middle ear and adenoid microbiota. Prospective, controlled study. Middle ear aspirates adenoid pad swabs were collected from 23 children undergoing ventilation tube insertion. Adenoid swabs from patients without ear disease were controls. Samples were analyzed using 16S rRNA sequencing on the Illumina MiSeq platform. Thirty-five middle ear samples were collected. The middle ear effusion microbiota was dominated by Alloiococcus otitidis (23% mean relative abundance), Haemophilus (22%), Moraxella (5%), and Streptococcus (5%). Alloiococcus shared an inverse correlation with Haemophilus (P = .049) and was found in greater relative abundance in unilateral effusion (P = .004). The microbiota of bilateral effusions from the same patient were similar (P < .001). However, the otitis media with effusion microbiota were found to be dissimilar to that of the adenoid (P = .01), whereas the adenoid microbiota of otitis media with effusion and control patients were similar (P > .05) (permutational multivariate analysis of the variance). Dissimilarities between the local microbiota of the adenoid and the middle ear question the theory that the adenoid pad is a significant reservoir to the middle ear in children with otitis media with effusion. A otitidis had the greatest cumulative relative abundance, particularly in unilateral effusions, and shares an inverse correlation with the relative abundance of Haemophilus. NA Laryngoscope, 126:2844-2851, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  6. Ear Infection (Middle Ear)

    MedlinePlus

    ... secretions from the middle ear Swelling, inflammation and mucus in the eustachian tubes from an upper respiratory ... your baby for at least six months. Breast milk contains antibodies that may offer protection from ear ...

  7. Periorbital edema and mees' lines in systemic lupus erythematosus.

    PubMed

    Jarek, M J; Finger, D R; Gillil, W R; Giandoni, M B

    1996-06-01

    There are many cutaneous findings that have been described in systemic lupus erythematosus (SLE). These include disease-specific and nonspecific lesions. Periorbital edema in the absence of proteinuria or hypoalbuminemia has been only rarely described. We report three patients who developed marked periorbital edema in association with a flare of SLE. All patients were without proteinuria or significant hypoalbuminemia, and no other etiology for the periorbital swelling was identified. This occurred despite all three taking antimalarial therapy, but the edema resolved promptly and completely with glucocorticoids. One of these patients also had transverse leukonychia, or Mees' lines, present on several fingernails, that appeared to correspond with previous SLE flares.Mees' lines and periorbital edema may represent two additional nonspecific but disease-related dermatologic manifestations of SLE. Whereas periorbital edema usually develops in concert with other clinical evidence of a lupus flare and is easily treated, Mees' lines appear to serve as a time line for previous SLE activity.

  8. Ear Disorders

    MedlinePlus

    ... most common illness in infants and young children. Tinnitus, a roaring in your ears, can be the ... problems in your inner ear; its symptoms include tinnitus and dizziness. Ear barotrauma is an injury to ...

  9. Swimmer's Ear

    MedlinePlus

    ... Eardrum Taking Care of Your Ears Can Loud Music Hurt My Ears? Your Ears What's Earwax? How Do Pain Relievers Work? View more About Us Contact Us Partners Editorial Policy Permissions Guidelines Privacy Policy & Terms of Use Notice ...

  10. Role of Laryngopharyngeal Reflux in the Pathogenesis of Otitis Media with Effusion.

    PubMed

    Doğru, Mehmet; Kuran, Gökhan; Haytoğlu, Süheyl; Dengiz, Ramazan; Arıkan, Osman Kürşat

    2015-04-01

    To determine whether there is an association between otitis media with effusion and laryngopharyngeal reflux in children. This study included 31 children with otitis media with effusion. The pepsinogen level in the middle ear fluid of all patients was measured by sandwich enzyme-linked immunosorbent assay. Each patient's middle ear fluid was investigated for Helicobacter pylori (H. pylori) using the Campylobacter-like organism (CLO) test. The middle ear pepsinogen levels were compared with those in the serum. The correlation between pepsinogen levels and H. pylori positivity in the middle ear fluid was investigated. The mean middle ear pepsinogen level (211.69 ng/mL) was significantly higher than that in the serum (24.18 ng/mL) in patients with otitis media with effusion. The middle ear aspirates of six patients (19%) were positive for H. pylori, and the correlation between H. pylori positivity and increased pepsinogen levels in the middle ear fluid was statistically significant in patients with otitis media with effusion. We detected higher pepsinogen levels and H. pylori positivity rates in the middle ear fluid than in the serum of patients with otitis media with effusion. These results support the role of laryngopharyngeal reflux in the pathogenesis of otitis media with effusion.

  11. Ear wax

    MedlinePlus

    See your provider if your ears are blocked with wax and you are unable to remove the wax. Also call if you have an ear wax blockage and you develop new symptoms, such as: Drainage from the ear Ear pain Fever Hearing loss that continues after you clean the wax

  12. Ear Pieces

    ERIC Educational Resources Information Center

    DiJulio, Betsy

    2011-01-01

    In this article, the author describes an art project wherein students make fanciful connections between art and medicine. This project challenges students to interpret "ear idioms" (e.g. "blow it out your ear," "in one ear and out the other") by relying almost entirely on realistic ear drawings, the placement of them, marks, and values. In that…

  13. Ear discharge

    MedlinePlus

    ... swabs or other small objects into the ear Middle ear infection Other causes of ear discharge include: Eczema ... tube surgery - what to ask your doctor Images Ear anatomy Eardrum repair - series References Bauer CA, Jenkins HA. Otologic symptoms and syndromes. In: Flint PW, Haughey BH, Lund V, et ...

  14. Middle-ear velocity transfer function, cochlear input immittance, and middle-ear efficiency in chinchilla

    PubMed Central

    Ravicz, Michael E.; Rosowski, John J.

    2013-01-01

    The transfer function HV between stapes velocity VS and sound pressure near the tympanic membrane PTM is a descriptor of sound transmission through the middle ear (ME). The ME power transmission efficiency (MEE), the ratio of sound power entering the cochlea to power entering the middle ear, was computed from HV measured in seven chinchilla ears and previously reported measurements of ME input admittance YTM and ME pressure gain GMEP [Ravicz and Rosowski, J. Acoust. Soc. Am. 132, 2437–2454 (2012); J. Acoust. Soc. Am. 133, 2208–2223 (2013)] in the same ears. The ME was open, and a pressure sensor was inserted into the cochlear vestibule for most measurements. The cochlear input admittance YC computed from HV and GMEP is controlled by a combination of mass and resistance and is consistent with a minimum-phase system up to 27 kHz. The real part Re{YC}, which relates cochlear sound power to inner-ear sound pressure, decreased gradually with frequency up to 25 kHz and more rapidly above that. MEE was about 0.5 between 0.1 and 8 kHz, higher than previous estimates in this species, and decreased sharply at higher frequencies. PMID:24116422

  15. Middle-ear velocity transfer function, cochlear input immittance, and middle-ear efficiency in chinchilla.

    PubMed

    Ravicz, Michael E; Rosowski, John J

    2013-10-01

    The transfer function H(V) between stapes velocity V(S) and sound pressure near the tympanic membrane P(TM) is a descriptor of sound transmission through the middle ear (ME). The ME power transmission efficiency (MEE), the ratio of sound power entering the cochlea to power entering the middle ear, was computed from H(V) measured in seven chinchilla ears and previously reported measurements of ME input admittance Y(TM) and ME pressure gain G(MEP) [Ravicz and Rosowski, J. Acoust. Soc. Am. 132, 2437-2454 (2012); J. Acoust. Soc. Am. 133, 2208-2223 (2013)] in the same ears. The ME was open, and a pressure sensor was inserted into the cochlear vestibule for most measurements. The cochlear input admittance Y(C) computed from H(V) and G(MEP) is controlled by a combination of mass and resistance and is consistent with a minimum-phase system up to 27 kHz. The real part Re{Y(C)}, which relates cochlear sound power to inner-ear sound pressure, decreased gradually with frequency up to 25 kHz and more rapidly above that. MEE was about 0.5 between 0.1 and 8 kHz, higher than previous estimates in this species, and decreased sharply at higher frequencies.

  16. Parapneumonic pleural effusion

    MedlinePlus

    Pleural effusion - pneumonia ... Pneumonia, most commonly from bacteria, causes parapneumonic pleural effusion. ... Antibiotics are prescribed to treat the pneumonia. If the person ... be used to drain the fluid. If better drainage of the fluid is ...

  17. Tympanostomy Tubes: A Rational Clinical Treatment for Middle Ear Disease.

    ERIC Educational Resources Information Center

    Roland, Peter S.; Brown, Orval

    1990-01-01

    The use of tympanostomy tubes to treat middle ear disease including otitis media is discussed with sections on the eustachian tube; acute otitis media; persistent effusion; changes in the tympanic membrane; special populations; and complications. (DB)

  18. Airplane Ear

    MedlinePlus

    ... to severe hearing loss Ringing in your ear (tinnitus) Spinning sensation (vertigo) Vomiting resulting from vertigo Bleeding ... complications may include: Permanent hearing loss Ongoing (chronic) tinnitus Prevention Follow these tips to avoid airplane ear: ...

  19. Ear examination

    MedlinePlus

    ... ear anatomy Otoscopic exam of the ear References King EF, Couch ME. History, physical examination, and the ... commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer ...

  20. Elephant ear

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002867.htm Elephant ear poisoning To use the sharing features on this page, please enable JavaScript. Elephant ear plants are indoor or outdoor plants with ...

  1. Your Ears

    MedlinePlus

    ... Protect your hearing by wearing earplugs at loud music concerts and around noisy machinery, like in wood ... More on this topic for: Kids Can Loud Music Hurt My Ears? What Is an Ear Infection? ...

  2. Ear Tubes

    MedlinePlus

    ... of the ear drum or eustachian tube, Down Syndrome, cleft palate, and barotrauma (injury to the middle ear caused by a reduction of air pressure, ... specialist) may be warranted if you or your child has experienced repeated ... fluid in the middle ear, barotrauma, or have an anatomic abnormality that ...

  3. Ear Problems

    MedlinePlus

    ... may have OTITIS MEDIA, an infection of the middle ear. Self CareSee your doctor. Many ear infections will ... half-alcohol, half-white vinegar solution in the ear before and after swimming or ... JOINT (TMJ) SYNDROME, a disorder that affects the jaw joint, may ...

  4. Values Range of Tympanometric Gradient in Otitis Media With Effusion.

    PubMed

    Duzer, Sertac; Sakallioglu, Oner; Akyigit, Abdulvahap; Polat, Cahit; Cetiner, Hasan; Susaman, Nihat

    2017-05-01

    The aim of this study was to establish how reliable a given tympanogram is in predicting the presence or absence of a middle ear effusion, and to provide new views for the diagnostic information of tympanometry. The use of tympanometric gradient in addition to static admittance is the focus of this study. The authors enrolled 146 female and 129 male patients. The participants were allocated into groups as follow: Group A1 consisted of 50 healthy children. Group A2 consisted of 86 children with otitis media with effusion. Group B1 consisted of 85 healthy adults. Group B2 consisted of 54 adults with otitis media with effusion. All diagnostic otoscopic examination and tympanometry were performed in both ears. The authors analyzed the distribution of tympanograms in patients with otitis media with effusion and healthy controls. When the right and left ear canal volume of either children or adults with otitis media with effusion compared with healthy controls, no statistically significant different was observed (P > 0.05). On the other hand, the statistically significant difference was detected for the values of compliance, pressure and gradient of either children or adults with otitis media with effusion compared with healthy controls (P < 0.05). The authors found the values range from 0.01 to 1.52 mL gradients (mean least value 0.15 mL) in adults and the values range from 0.01 to 0.93 mL gradients (mean least value 0.10 mL) in children in the presence of otitis media with effusion. The authors think that tympanometric gradient may be useful to detect the otitis media with effusion.

  5. Cilia and Ear.

    PubMed

    Piatti, Gioia; De Santi, Maria Margherita; Torretta, Sara; Pignataro, Lorenzo; Soi, Daniela; Ambrosetti, Umberto

    2017-04-01

    To investigate the prevalence of otological complications derived from primary ciliary dyskinesia (PCD) in adulthood. Twenty-three patients with diagnosed PCD underwent medical history aimed at recording the presence of ear, nose, and throat manifestations (ENT) and any surgical treatments. The ENT objectivity was annotated, and then patients were subjected to audiometric test, tympanometry, registration of otoacoustic emission, and vestibular evaluation. Otitis media with chronic middle ear effusion (OME) during childhood was reported in 52% of the subjects, no patient had undergone ear surgery, and only 2 patients had an episode of otitis in the last year. Eleven of 23 patients showed normal hearing, 11 had a conductive hearing impairment, and 1 showed a severe sensorineural hearing loss unrelated to the syndrome. The bilateral stapedial reflex was only found in all cases of normoacusia and type A tympanogram, distortion product otoacoustic emissions (DPOAE) were present in 8 patients, and no patient had vestibular alterations. Our study confirms a very frequent prevalence of OME in PCD during childhood. Careful monitoring of otological complications of the syndrome is always desirable, also given the high presence in adults of other manifestations in the upper airways, such as chronic rhinosinusitis and nasal polyposis.

  6. Ear wax

    PubMed Central

    2008-01-01

    Introduction Ear wax only becomes a problem if it causes a hearing impairment or other ear-related symptoms. Ear wax is more likely to accumulate and cause a hearing impairment when normal extrusion is prevented — for example, by the use of hearing aids, or by the use of cotton buds to clean the ears. Ear wax can visually obscure the ear drum, and may need to be removed for diagnostic purposes. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of methods to remove ear wax? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2007 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found nine systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: ear syringing; manual removal (other than ear syringing); and wax softeners (alone or prior to syringing). PMID:19450340

  7. Otitis media with effusion

    MedlinePlus

    OME; Secretory otitis media; Serous otitis media; Silent otitis media; Silent ear infection; Glue ear ... Kerschner JE, Preciado D. Otitis media. In: Kliegman RM, Stanton BF, St. ... of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016: ...

  8. Ear Tubes

    MedlinePlus

    ... 1/20th of an inch) that could allow water to enter the middle ear, research studies show no benefit in keeping the ears dry and current guidelines do not recommend routine water precautions. Therefore, you do not need to restrict ...

  9. Passage of albumin from the middle ear to the inner ear in otitis media in the chinchilla

    SciTech Connect

    Goldberg, B.; Goycoolea, M.V.; Schleivert, P.M.

    1981-08-01

    A study of the permeability of the middle ear-inner ear interface for macromolecules was carried out in chinchillas with open and obstructed eustachian tubes utilizing tritiated human serum albumin and immunoelectrophoresis. Tritiated albumin was placed in the round window niche area or normal animals and animals in which the eustachian tubes had been obstructed for 24 hours or 14 days. The tritiated albumin was allowed to remain in the middle ear cavity for 24 hours, Samples of middle ear effusion, perilymph, blood and cerebrospinal fluid were collected and measured for radioactivity. Radioactivity was demonstrated in the perilymph. Samples of middlemore » ear effusions and perilymph were also studied by immunoelectrophoresis with goat antihuman albumin. Albumin placed in the round window niche of an experimental animal could be recovered unchanged in the perilymph. The results suggest a pathophysiologic explanation for the association of otitis media and sensorineural hearing loss or endolymphatic hydrops.« less

  10. Ear tag

    MedlinePlus

    ... an ear tag or pit are: An inherited tendency to have this facial feature A genetic syndrome ... Elsevier Churchill Livingstone; 2016:chap 19. Review Date 4/24/2017 Updated by: Liora C Adler, MD, ...

  11. Swimmer's ear

    MedlinePlus

    ... often gets better with the proper treatment. Possible Complications The infection may spread to other areas around the ear, including the skull bone. In older people or those who have diabetes, the infection may become severe. This condition is ...

  12. Ear Infections

    MedlinePlus

    ... but they are less common. The infection usually affects the middle ear and is called otitis media. ... become clogged with fluid and mucus. This can affect hearing, because sound cannot get through all that ...

  13. Pierced Ears

    MedlinePlus

    ... weeks. Then you can start enjoying your pierced ears again! Reviewed by: Steven Dowshen, MD Date reviewed: September ... All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, ...

  14. Ear emergencies

    MedlinePlus

    ... and ruptured eardrums can be caused by: Inserting cotton swabs, toothpicks, pins, pens, or other objects into ... The person will have severe pain. Place sterile cotton gently in the outer ear canal to keep ...

  15. Surgical considerations and safety of cochlear implantation in otitis media with effusion.

    PubMed

    Cevizci, Rasit; Dilci, Alper; Celenk, Fatih; Karamert, Recep; Bayazit, Yildirim

    2018-06-01

    To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications. Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group. Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (p<0.05). Granulation tissue and edematous middle ear and mastoid mucosa were observed in all cases of otitis media with effusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p>0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation. There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Swimmer's Ear (For Parents)

    MedlinePlus

    ... scratching the ear canal, vigorous ear cleaning with cotton swabs, or putting foreign objects like bobby pins ... Also, never put objects into kids' ears, including cotton-tipped swabs. How Is Swimmer's Ear Treated? Treatment ...

  17. [Audiological characteristics of young children with otitis media with effusion].

    PubMed

    Wang, Qiu-ju; Shi, Wei; Lan, Lan; Wang, Da-yong; Zhang, Ya-mei

    2008-12-01

    To characterize the audiological features in the infants with otitis media with effusion (OME) and to investigate the utility of variety of objective audiometry methods in diagnosis and intervention on OME. Fifty six infants (40 males and 16 females) were investigated, who were referred to our clinic at the General Hospital of Chinese People's Liberation Army by the other hospitals from December 2004 to June 2007 when the infants were diagnosed or highly suspected of OME. The ages at the initial diagnosis ranged from 42 days to three years, with an average of five months. The infants, after receiving the conventional otolaryngological exams, were subjected to the tests of auditory brainstem response (ABR), otoacoustic emission (OAE), tympanometry (226 Hz and 1000 Hz) and behaviors audiometry. Among 56 affected infants, 87 ears were diagnosed with OME, of which 31 infants were affected bilateral and 25 with monaural. For the 49 infants who received hearing screening at birth, 36 infants were referred at the initial screening. For the 52 infants who received repeated screening, all subjects were referred. Six infants without receiving hearing screening came to clinic when their parents observed their kids' hearing impairment. Among the 52 cases (104 ears) who received tympanometry test, 20 subjects (28 ears) showed B or C type tympanometry curve. Thirty-nine cases (78 ears) were given tympanometry test at 1000 Hz, of which 38 cases (55 ears) showed abnormal hearing. Among 56 infants (112 ears) with ABR test, 49 subjects (74 ears) exhibited prolonged ABR type I curve. All 56 infants (112 ears) received OAE test, of which 55 subjects (81 ears) were referred. Four infants (8 ears) accepted the behavior test and all of them showed A-B Gap. The combined tympanometry test at both 226 Hz and 1000 Hz, ABR latency or threshold test, infant's behavior test and OAE, used jointly, enable characterizing better OME in infants, thus helping early diagnosis of this hearing disorder.

  18. Tuberculous Pleural Effusion

    PubMed Central

    Cohen, Leah A.; Light, Richard W.

    2015-01-01

    When a patient presents with new pleural effusion, the diagnosis of tuberculous (TB) pleuritis should be considered. The patient is at risk for developing pulmonary or extrapulmonary TB if the diagnosis is not made. Between 3% and 25% of patients with TB will have TB pleuritis. The incidence of TB pleuritis is higher in patients who are human immunodeficiency virus (HIV)-positive. Pleural fluid is an exudate that usually has a predominance of lymphocytes. The easiest way to diagnose TB pleuritis in a patient with lymphocytic pleural effusion is to demonstrate a pleural fluid adenosine deaminase level above 40 IU/L. The treatment for TB pleuritis is the same as that for pulmonary TB. Tuberculous empyema is a rare occurrence, and the treatment is difficult. PMID:29404070

  19. Diagnostic Tools of Pleural Effusion

    PubMed Central

    2014-01-01

    Pleural effusion is not a rare disease in Korea. The diagnosis of pleural effusion is very difficult, even though the patients often complain of typical symptoms indicating of pleural diseases. Pleural effusion is characterized by the pleural cavity filled with transudative or exudative pleural fluids, and it is developed by various etiologies. The presence of pleural effusion can be confirmed by radiological studies including simple chest radiography, ultrasonography, or computed tomography. Identifying the causes of pleural effusions by pleural fluid analysis is essential for proper treatments. This review article provides information on the diagnostic approaches of pleural effusions and further suggested ways to confirm their various etiologies, by using the most recent journals for references. PMID:24920946

  20. Combined Effect of Fluid and Pressure on Middle Ear Function

    PubMed Central

    Dai, Chenkai; Wood, Mark W.; Gan, Rong Z.

    2008-01-01

    In our previous studies, the effects of effusion and pressure on sound transmission were investigated separately. The aim of this study is to investigate the combined effect of fluid and pressure on middle ear function. An otitis media with effusion model was created by injecting saline solution and air pressure simultaneously into the middle ear of human temporal bones. Tympanic membrane displacement in response to 90 dB SPL sound input was measured by a laser vibrometer and the compliance of the middle ear was measured by a tympanometer. The movement of the tympanic membrane at the umbo was reduced up to 17 dB by the combination of fluid and pressure in the middle ear over the auditory frequency range. The fluid and pressure effects on the umbo movement in the fluid-pressure combination are not additive. The combined effect of fluid and pressure on the umbo movement is different compared with that of only fluid or pressure change in the middle ear. Negative pressure in fluid-pressure combination had more effect on middle ear function than positive pressure. Tympanometry can detect the middle ear pressure of the fluid-pressure combination. This study provides quantitative information for analysis of the combined effect of fluid and pressure on tympanic membrane movement. PMID:18162348

  1. Effect of Otitis Media with Effusion on Comodulation Masking Release in Children.

    ERIC Educational Resources Information Center

    Hall, Joseph W.; Grose, John H.

    1994-01-01

    This study investigated comodulation masking release (CMR) in 42 children (ages 5 to 10) with a history of otitis media with effusion (OME) and 19 control children with no history of ear disease. Results indicated that monotic CMRs were reduced in children with hearing loss due to OME and these CMRs remained abnormally small for several months.…

  2. External Otitis (Swimmer's Ear)

    MedlinePlus

    ... Debris removal, antibiotic ear drops, keeping water and cotton swabs out of the ear, and pain relievers ... Injuring the ear canal while cleaning it (using cotton swabs) or getting water or irritants, such as ...

  3. Ear Injuries (For Parents)

    MedlinePlus

    ... Inserting something into the ear. Things like a cotton swab, fingernail, or pencil can scratch the ear ... Never stick anything in their ears — not even cotton swabs or their fingers. Regular bathing should be ...

  4. Pleural Effusion in Multiple Myeloma.

    PubMed

    Wang, Zhuo; Xia, Guoguang; Lan, Ling; Liu, Fayong; Wang, Yanxun; Liu, Baoyue; Ding, Yi; Dai, Li; Zhang, Yunjian

    2016-01-01

    Pleural effusion is rarely observed in patients with multiple myeloma (MM). Myeloma cell infiltration or invasion to the pleura is very rare. This study aimed to investigate the clinical characteristics of pleural effusion in patients with MM. We retrospectively reviewed the medical records of patients diagnosed with pleural effusion, MM, and pleural effusion with MM between 2004 and 2014 at Beijing Jishuitan Hospital. The present study included patients with pleural effusion who underwent cytological, bacteriological, biochemical and other testing. The cytopathology of abnormal pleural effusion cells was not diagnostic, thus flow cytometry was performed. MM was defined using the diagnosis standard of NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) 2014 for MM. This study included 3,480 pleural effusion patients and 319 MM patients. There were 34 patients with both MM and pleural effusion (17 men and 17 women). The average age was 63 years (range, 48-84 years). Pleural effusion with MM was caused by congestive heart disease, chronic renal failure, hypoalbuminemia, pulmonary infarctions, cirrhosis, pulmonary arterial hypertension, parapneumonic effusion, tuberculous pleural effusion, and myelomatous pleural effusion (MPE). The diagnosis of MPE was confirmed by the detection of myeloma cells in the pleural fluid using flow cytometric analyses. There were only 2 MPE cases in our study. The first MPE case was a woman. The first clinical manifestation was pleural effusion, and the diagnosis was non-secretory MM, DSS stage IIIA (Durie-Salmon staging system); ISS stage I (the International Staging System). The second MPE case was a man who was diagnosed with MM IgA-κ, DSS stage IIIA; ISS stage II. The detection rate of MPE was very low. MPE tended to present with yellow exudates and the lack of physical and chemical characteristics. Furthermore, patients with MPE exhibited many yellow nodules on the pleura. These nodules were lobulated and had abundant

  5. [Ten questions about pericardial effusion].

    PubMed

    Imazio, Massimo; Lazaros, George; Brucato, Antonio

    2018-06-01

    Although a new or worsening pericardial effusion is a diagnostic criterion for pericarditis, in clinical practice the presence of pericardial effusion does not necessarily imply the evidence of pericarditis. Up to 40-50% of cases of pericarditis do not show the presence of pericardial effusion (dry pericarditis). The clinician should first evaluate any related symptoms and signs (symptomatic vs asymptomatic), its size and hemodynamic impact, then rule out pericarditis and the presence of an underlying disease (e.g. cancer, systemic inflammatory diseases, renal failure, hypothyroidism). If no cause is apparent ("idiopathic effusion"), the decision to tap should be individualized and based on symptoms. A large, chronic pericardial effusion may have a good long-term prognosis even without routine drainage.In this paper, we will try to clarify common doubts and outline evidence-based approaches to diagnosis, therapy and follow-up of these patients, also addressing the possible complications and outcomes.

  6. Treatment options in otitis media with effusion.

    PubMed

    Upadhya, Ila; Datar, J

    2014-01-01

    Secretary Otitis media with effusion (OME) is the accumulation of mucus in the middle ear and sometimes in the mastoid air cell system. The main etiological factor is alteration in mucociliary system of middle ear secondary to ET malfunction which may be primary or secondary. OME is the cause of concern due to its occurance in paediatric age group, highest at 2 years of age, presenting as impairment of hearing leading to delayed speech and language development, poor academic performance and behavioral problems. In spite of this there are no confirmed guidelines of treatment to overcome. Many treatment options are available medical as well as surgical. Prospective study conducted to evaluate various treatment options revealed that auto inflation of ET is the main stay of treatment. If the ET malfunction is due to any reasons like adenoids, deviated nasal septum, hypertrophied turbinates or any other cause surgical intervention of the same gives 100% results. Medical management gives good results but recurrence is equally common.

  7. Issues of Importance to Urban Youth Service Providers. MEE Report Update.

    ERIC Educational Resources Information Center

    MEE Productions Inc., Philadelphia, PA. Research Div.

    What Motivational Educational Entertainment (MEE) has learned about popular urban youth culture and the "hip-hop generation" is updated and expanded, focusing on substance use and abuse, violence, and sexuality. Qualitative focus groups were used to obtain the opinions of former high school dropouts who were enrolled in General…

  8. The Enculturation of BoMee: Looking at the World through Deaf Eyes.

    ERIC Educational Resources Information Center

    Wilcox, Sherman; Corwin, Joanne

    1990-01-01

    This paper presents a cultural model of deafness, describing the experiences of a deaf child as enculturation into a deaf world. The implications of this view on social, cognitive, and linguistic development are explored through description of BoMee, an adopted Korean deaf child being raised in a multilingual, multicultural environment.…

  9. [Sarcoid pleural effusion].

    PubMed

    Rodríguez-Núñez, Nuria; Rábade, Carlos; Valdés, Luis

    2014-12-09

    Pleural effusion (PE) is a very uncommon manifestation of sarcoidosis. It is equally observed in men and women, can appear at any age and in all radiologic stages, though it is more common in stages i and ii. Effusions have usually a mild or medium size and mainly involve the right side. Various mechanisms can be implicated. PE will be a serous exudate if there is an increase in the capillary permeability due to direct involvement of the pleural membrane, a chylothorax if mediastinum lymph nodes compress the thoracic duct and/or the lymphatic drainage from the pleural cavity, an hemothorax if granuloma compress or invade pleural small vessels or capillaries, and even a transudate if there is compression of the inferior vena cava, atelectasis due to complete bronchial obstruction or when the resolution of the PE is incomplete with chronic thickening of visceral pleura (trapped lung). It manifests biochemically as a pauci-cellular exudate with a predominance of lymphocytes, though there can be a preponderance of eosinophils or neutrophils. Protein concentrations are usually proportionately higher than lactate dehidrogenase, adenosine deaminase is normally low and it is possible to find increased levels of CA-125 in women. The tuberculin test is negative and pleural or lung biopsies yield the diagnosis by confirming the presence of non-caseating granulomata. These PE can have a favorable self-limited outcome, even though in most cases treatment with corticosteroids is needed, while surgery is required in a few cases. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  10. Association of Gel-Forming Mucins and Aquaporin Gene Expression With Hearing Loss, Effusion Viscosity, and Inflammation in Otitis Media With Effusion.

    PubMed

    Samuels, Tina L; Yan, Justin C; Khampang, Pawjai; Dettmar, Peter W; MacKinnon, Alexander; Hong, Wenzhou; Johnston, Nikki; Papsin, Blake C; Chun, Robert H; McCormick, Michael E; Kerschner, Joseph E

    2017-08-01

    Persistent, viscous middle ear effusion in pediatric otitis media (OM) contributes to increased likelihood of anesthesia and surgery, conductive hearing loss, and subsequent developmental delays. Biomarkers of effusion viscosity and hearing loss have not yet been identified despite the potential that such markers hold for targeted therapy and screening. To investigate the association of gel-forming mucins and aquaporin 5 (AQP5) gene expression with inflammation, effusion viscosity, and hearing loss in pediatric OM with effusion (OME). Case-control study of 31 pediatric patients (aged 6 months to 12 years) with OME undergoing tympanostomy tube placement and control individuals (aged 1 to 10 years) undergoing surgery for cochlear implantation from February 1, 2013, through November 30, 2014. Those with 1 or more episodes of OM in the previous 12 months, immunologic abnormality, anatomical or physiologic ear defect, OM-associated syndrome (ie, Down syndrome, cleft palate), chronic mastoiditis, or history of cholesteatoma were excluded from the study. All patients with OME and 1 control were recruited from Children's Hospital of Wisconsin, Milwaukee. The remainder of the controls were recruited from Sick Kids Hospital in Toronto, Ontario, Canada. Two to 3 middle ear biopsy specimens, effusions, and preoperative audiometric data (obtained <3 weeks before surgery) were collected from patients; only biopsy specimens were collected from controls. Expression of the mucin 2 (MUC2), mucin 5AC (MUC5AC), mucin 5B (MUC5B), and AQP5 genes were assayed in middle ear biopsy specimens by quantitative polymerase chain reaction. One middle ear biopsy specimen was sectioned for histopathologic analysis. Reduced specific viscosity of effusions was assayed using rheometry. Of the 31 study participants, 24 patients had OME (mean [SD] age, 50.4 [31.9] months; 15 [62.5%] male; 16 [66.7%] white) and 7 acted as controls (mean [SD] age, 32.6 [24.4] months; 2 [26.6%] male; 6 [85.7%] white

  11. The comparative anatomy of the pig middle ear cavity: a model for middle ear inflammation in the human?

    PubMed Central

    PRACY, J. P.; WHITE, A.; MUSTAFA, Y.; SMITH, D.; PERRY, M. E.

    1998-01-01

    This study was undertaken to develop a functional model of otitis media with effusion (OME) in the pig (Sus scrofa), with the purpose of investigating the origin of lymphocytes populating the middle ear during the course of an inflammatory process. The relevance of the model to the human condition of OME is to a large extent dependent on the anatomical and physiological similarities between the middle ear cavity and the pharyngeal lymphoid tissue of the pig and man. Anatomical specimens were collected from 7 young Large White pigs to determine the gross anatomy of the middle ear cavity and the histological characteristics of the middle ear mucosa. It was found that the anatomy of the 3 parts of the middle ear cavity in man and in the pig is broadly similar, although some minor differences were observed. The porcine eustachian tube was seen to be cartilaginous throughout its length in contrast to the part osseous, part cartilaginous structure found in man; the porcine ossicles were slightly different in shape to those of man and the air cell system was situated inferior to the tympanic cavity in the pig as opposed to posteriorly in man. This paper describes the structure and morphology of the pig middle ear cavity and compares and contrasts it with that of man. The minor differences observed are of anatomical importance but do not diminish the usefulness of the pig middle ear cleft as a potential model for human middle ear disorders. PMID:9688502

  12. A short-wave infrared otoscope for middle ear disease diagnostics (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Carr, Jessica A.; Valdez, Tulio; Bruns, Oliver; Bawendi, Moungi

    2016-02-01

    Otitis media, a range of inflammatory conditions of the middle ear, is the second most common illness diagnosed in children. However, the diagnosis can be challenging, particularly in pediatric patients. Otitis media is commonly over-diagnosed and over-treated and has been identified as one of the primary factors in increased antibiotic resistance. We describe the development of a short-wave infrared (SWIR) otoscope for objective middle ear effusion diagnosis. The SWIR otoscope can unambiguously detect the presence of middle ear fluid based on its strong light absorption in the SWIR. This absorption causes a stark, visual contrast between the presence and absence of fluid behind the tympanic membrane. Additionally, when there is no middle ear fluid, the deeper tissue penetration of SWIR light allows the SWIR otoscope to better visualize middle ear anatomy through the tympanic membrane than is possible with visible light. We demonstrate that in healthy, adult human ears, SWIR otoscopy can image a range of middle ear anatomy, including landmarks of the entire ossicular chain, the promontory, the round window niche, and the chorda tympani. We suggest that SWIR otoscopy can provide valuable diagnostic information complementary to that provided by visible pneumotoscopy in the diagnosis of middle ear effusions, otitis media, and other maladies of the middle ear.

  13. Interaction Between Allergy and Middle Ear Infection.

    PubMed

    Oh, Jeong-Hoon; Kim, Woo Jin

    2016-09-01

    Recent studies have attempted to identify interactions among the causes of otitis media with effusion (OME). This review discusses the interaction between allergy and infection with regard to host and environmental factors in terms of the development of OME. Protection of the upper airway against microbial invasion requires active interaction between the defense mechanisms of the respiratory epithelium, including innate and adaptive immunity, and mechanical factors. The impairment of these defenses due to allergy and/or increased bacterial resistance may lead to increased susceptibility to infectious organisms in the respiratory tract and middle ear mucosa. Recent genetic studies have provided valuable information about the association of Toll-like receptor signaling variations with clinical phenotypes and the risk of infection in the middle ear. Among the causal factors of OME, allergy not only induces an inflammatory reaction in the middle ear cavity but also facilitates the invasion of infectious pathogens. There is also evidence that allergy can affect the susceptibility of patients to infection of the upper respiratory tract, including the middle ear cavity.

  14. Ear infection - chronic

    MedlinePlus

    Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... Chole RA. Chronic otitis media, mastoiditis, and petrositis. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. ...

  15. Ear drainage culture

    MedlinePlus

    ... needed. Your health care provider will use a cotton swab to collect the sample from inside the ... Using a cotton swab to take a sample of drainage from the outer ear is not painful. However, ear pain may ...

  16. Swimmer's Ear (External Otitis)

    MedlinePlus

    ... t help, your doctor might prescribe a stronger pain reliever. You'll use this only for a short time — until the ear drops and antibiotics begin to work. To protect your ear while it heals, your ...

  17. Taking Care of Your Ears

    MedlinePlus

    ... Audiologist Perforated Eardrum What's Hearing Loss? Can Loud Music Hurt My Ears? What Is an Ear Infection? Swimmer's Ear Your Ears What's Earwax? View more About Us Contact Us Partners Editorial Policy Permissions Guidelines Privacy Policy & Terms of Use Notice ...

  18. High-resolution computed tomography of the middle ear and mastoid. Part II. Tubotympanic disease

    SciTech Connect

    Swartz, J.D.; Goodman, R.S.; Russell, K.B.

    1983-08-01

    Of more than 200 patients who underwent high-resolution computed tomography (CT) of the middle ear, the vast majority had tubotympanic disease in one of its forms: middle ear effusion, tympanosclerosis, granulation tissue, tympanic membrane retractions, or acquired cholesteatoma. The CT appearance of each of these conditions is discussed and illustrated. Emphasis is placed on the differential diagnosis of tubotympanic disease by determining dependent from nondependent soft-tissue opacity using two CT projections.

  19. In vivo imaging of middle-ear and inner-ear microstructures of a mouse guided by SD-OCT combined with a surgical microscope

    PubMed Central

    Cho, Nam Hyun; Jang, Jeong Hun; Jung, Woonggyu; Kim, Jeehyun

    2014-01-01

    We developed an augmented-reality system that combines optical coherence tomography (OCT) with a surgical microscope. By sharing the common optical path in the microscope and OCT, we could simultaneously acquire OCT and microscope views. The system was tested to identify the middle-ear and inner-ear microstructures of a mouse. Considering the probability of clinical application including otorhinolaryngology, diseases such as middle-ear effusion were visualized using in vivo mouse and OCT images simultaneously acquired through the eyepiece of the surgical microscope during surgical manipulation using the proposed system. This system is expected to realize a new practical area of OCT application. PMID:24787787

  20. Pleuropericardial effusion associated with minoxidil administration

    PubMed Central

    Webb, D. B.; Whale, R. J.

    1982-01-01

    A patient on minoxidil developed pericardial and pleural effusions with a high protein content. This finding is not compatible with the view that such effusions in patients taking minoxidil are transudates. PMID:7111124

  1. [Pleural effusion: diagnosis and management].

    PubMed

    Pastré, J; Roussel, S; Israël Biet, D; Sanchez, O

    2015-04-01

    Pleural effusion management is a common clinical situation associated with numerous pulmonary, pleural or extra-pulmonary diseases. A systematic approach is needed to enable a rapid diagnosis and an appropriate treatment. Pleural fluid analysis is the first step to perform which allows a presumptive diagnosis in most cases. Otherwise, further analysis of the pleural fluid or thoracic imaging or pleural biopsy may be necessary. This review aims at highlighting the important elements of the work-up required by a pleural effusion. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  2. Expression of CXCL4 and aquaporin 3 and 10 mRNAs in patients with otitis media with effusion.

    PubMed

    Jin, Zhe; Cha, Sung Ho; Choi, Yong-Sung; Kim, Young Il; Choi, Sun A; Yeo, Seung Geun

    2016-02-01

    Bacterial infections in children with underdeveloped Eustachian tubes are a major cause of otitis media with effusion (OEM), and persistent effusion in the middle ear in these patients is a major cause of surgical intervention. CXCL4 is associated with bacterial infection, and aquaporins 3 and 10 are associated with water metabolism. This study assessed the expression of mRNAs encoding CXCL-4 and aquaporins 3 and 10 in the effusion of pediatric OME patients, and the association of this expression with clinical manifestations. Levels of CXCL4 and aquaporin 3 and 10 mRNA were assayed by real-time RT-PCR in the middle ear effusion of 38 pediatric patients with OME requiring ventilation tube insertion. The relationships of these mRNA levels with the presence of bacteria; concomitant diseases such as allergic rhinitis, sinusitis, and adenoid disease; recurrence of OME; and number of ventilation tube insertions were evaluated. CXCL4 and aquaporin 3 and 10 mRNAs were expressed in middle ear effusion of all OME patients. CXCL-4 mRNA levels were significantly lower when bacteria were present and in patients with concomitant diseases (p<0.05 each). Levels of all three mRNAs were unrelated to OME recurrence or number of ventilation tube insertions (p>0.05 each). The levels of CXCL4 and aquaporin 10 mRNAs were significantly correlated (p<0.05). Expression of CXCL4 and aquaporin 3 and 10 mRNAs in middle ear effusion is associated with the pathophysiology of OME. CXCL4 mRNA levels are significantly lower in patients with than without concomitant diseases or bacterial infections. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Aetiology and pathology of otitis media with effusion in adult life.

    PubMed

    Mills, R; Hathorn, I

    2016-05-01

    To gather and analyse information concerning the aetiology and pathology of otitis media with effusion in adults. A review of the English language literature from 1970 to the present was conducted. The available evidence suggests that otitis media with effusion in adult life is best viewed as a syndrome with a number of causes, including: infiltration of the eustachian tube by nasopharyngeal carcinoma and other local malignancies; changes in the middle ear and eustachian tube induced by radiotherapy; and systemic disease. There is now a body of evidence specifically related to the aetiology and pathology of otitis media with effusion in adult life. However, further research is required to fill in the gaps in our knowledge and understanding of this condition.

  4. Relationship between Eustachian tube dysfunction and otitis media with effusion in radiotherapy patients.

    PubMed

    Akazawa, K; Doi, H; Ohta, S; Terada, T; Fujiwara, M; Uwa, N; Tanooka, M; Sakagami, M

    2018-02-01

    This study evaluated the relationship between radiation and Eustachian tube dysfunction, and examined the radiation dose required to induce otitis media with effusion. The function of 36 Eustachian tubes in 18 patients with head and neck cancer were examined sonotubometrically before, during, and 1, 2 and 3 months after, intensity-modulated radiotherapy. Patients with an increase of 5 dB or less in sound pressure level (dB) during swallowing were categorised as being in the dysfunction group. Additionally, radiation dose distributions were assessed in all Eustachian tubes using three dose-volume histogram parameters. Twenty-two of 25 normally functioning Eustachian tubes before radiotherapy (88.0 per cent) shifted to the dysfunction group after therapy. All ears that developed otitis media with effusion belonged to the dysfunction group. The radiation dose threshold evaluation revealed that ears with otitis media with effusion received significantly higher doses to the Eustachian tubes. The results indicate a relationship between radiation dose and Eustachian tube dysfunction and otitis media with effusion.

  5. Equivalent Ear Canal Volumes in Children Pre- and Post-Tympanostomy Tube Insertion.

    ERIC Educational Resources Information Center

    Shanks, Janet E.; And Others

    1992-01-01

    Evaluation of preoperative and postoperative equivalent ear canal volume measures on 334 children (ages 6 weeks to 6.7 years) with chronic otitis media with effusion found that the determination could be made very accurately for children 4 years and older. Criterion values for tympanic membrane perforation and preoperative and postoperative…

  6. Feasibility and Acceptability of Mobile Epilepsy Educational System (MEES) for People with Epilepsy in Malaysia

    PubMed Central

    Neni, Widiasmoro Selamat

    2012-01-01

    Abstract Background: Telemedicine innovations, including short message service (SMS), have been used to address a range of health concerns in a variety of settings. Practical, safe, and cost-effective, this simple tool can also potentially improve patients' understanding toward their own diseases via knowledge enhancement. This study was designed to develop and assess the feasibility and acceptability of an SMS-based epilepsy educational program for epilepsy patients. Subjects and Methods: This was a prospective randomized interventional study. Epilepsy outpatients from three general hospitals in East Coast Peninsular Malaysia received the SMS-based mobile epilepsy educational system (MEES) for a 3-month period. Results: In total, 51 patients completed the study (median age, 25.0 years; 51.0% female; 92.2% Malay; 56.9% single; education level, 70.6% ≤SPM/Cambridge O-level equivalent; 25.5% supportive workers; monthly income, 58.8% ≤MYR 500.0/USD 158.5). Approximately 86.0% of the patients owned at least a mobile phone. The total cost of SMS delivery was economically affordable (MYR 3.08/USD 0.98 per patient). Overall, 74.0% agreed that MEES was either very or quite useful. It is encouraging that the majority of patients have offered positive comments and favorable opinions specifically toward epilepsy education (94.0%), drug-taking reminder (90.0%), and clinic appointment reminder (88.0%). It was also reported that 88.2% of the participants would recommend MEES to other people with epilepsy. Conclusions: The current study adds to the growing evidence suggesting that a greater investment in telemedicine programs involving SMS would be both feasible and well received by patients and could be a potentially valuable approach to increase access and effectiveness of epilepsy care. PMID:23078181

  7. Feasibility and acceptability of mobile epilepsy educational system (MEES) for people with epilepsy in Malaysia.

    PubMed

    Lua, Pei Lin; Neni, Widiasmoro Selamat

    2012-12-01

    Telemedicine innovations, including short message service (SMS), have been used to address a range of health concerns in a variety of settings. Practical, safe, and cost-effective, this simple tool can also potentially improve patients' understanding toward their own diseases via knowledge enhancement. This study was designed to develop and assess the feasibility and acceptability of an SMS-based epilepsy educational program for epilepsy patients. This was a prospective randomized interventional study. Epilepsy outpatients from three general hospitals in East Coast Peninsular Malaysia received the SMS-based mobile epilepsy educational system (MEES) for a 3-month period. In total, 51 patients completed the study (median age, 25.0 years; 51.0% female; 92.2% Malay; 56.9% single; education level, 70.6% ≤SPM/Cambridge O-level equivalent; 25.5% supportive workers; monthly income, 58.8% ≤MYR 500.0/USD 158.5). Approximately 86.0% of the patients owned at least a mobile phone. The total cost of SMS delivery was economically affordable (MYR 3.08/USD 0.98 per patient). Overall, 74.0% agreed that MEES was either very or quite useful. It is encouraging that the majority of patients have offered positive comments and favorable opinions specifically toward epilepsy education (94.0%), drug-taking reminder (90.0%), and clinic appointment reminder (88.0%). It was also reported that 88.2% of the participants would recommend MEES to other people with epilepsy. The current study adds to the growing evidence suggesting that a greater investment in telemedicine programs involving SMS would be both feasible and well received by patients and could be a potentially valuable approach to increase access and effectiveness of epilepsy care.

  8. Physiology of breathlessness associated with pleural effusions

    PubMed Central

    Thomas, Rajesh; Jenkins, Susan; Eastwood, Peter R.; Lee, Y.C. Gary; Singh, Bhajan

    2015-01-01

    Purpose of review Pleural effusions have a major impact on the cardiorespiratory system. This article reviews the pathophysiological effects of pleural effusions and pleural drainage, their relationship with breathlessness, and highlights key knowledge gaps. Recent findings The basis for breathlessness in pleural effusions and relief following thoracentesis is not well understood. Many existing studies on the pathophysiology of breathlessness in pleural effusions are limited by small sample sizes, heterogeneous design and a lack of direct measurements of respiratory muscle function. Gas exchange worsens with pleural effusions and improves after thoracentesis. Improvements in ventilatory capacity and lung volumes following pleural drainage are small, and correlate poorly with the volume of fluid drained and the severity of breathlessness. Rather than lung compression, expansion of the chest wall, including displacement of the diaphragm, appears to be the principle mechanism by which the effusion is accommodated. Deflation of the thoracic cage and restoration of diaphragmatic function after thoracentesis may improve diaphragm effectiveness and efficiency, and this may be an important mechanism by which breathlessness improves. Effusions do not usually lead to major hemodynamic changes, but large effusions may cause cardiac tamponade and ventricular diastolic collapse. Patients with effusions can have impaired exercise capacity and poor sleep quality and efficiency. Summary Pleural effusions are associated with abnormalities in gas exchange, respiratory mechanics, respiratory muscle function and hemodynamics, but the association between these abnormalities and breathlessness remains unclear. Prospective studies should aim to identify the key mechanisms of effusion-related breathlessness and predictors of improvement following pleural drainage. PMID:25978627

  9. Physiology of breathlessness associated with pleural effusions.

    PubMed

    Thomas, Rajesh; Jenkins, Susan; Eastwood, Peter R; Lee, Y C Gary; Singh, Bhajan

    2015-07-01

    Pleural effusions have a major impact on the cardiorespiratory system. This article reviews the pathophysiological effects of pleural effusions and pleural drainage, their relationship with breathlessness, and highlights key knowledge gaps. The basis for breathlessness in pleural effusions and relief following thoracentesis is not well understood. Many existing studies on the pathophysiology of breathlessness in pleural effusions are limited by small sample sizes, heterogeneous design and a lack of direct measurements of respiratory muscle function. Gas exchange worsens with pleural effusions and improves after thoracentesis. Improvements in ventilatory capacity and lung volumes following pleural drainage are small, and correlate poorly with the volume of fluid drained and the severity of breathlessness. Rather than lung compression, expansion of the chest wall, including displacement of the diaphragm, appears to be the principle mechanism by which the effusion is accommodated. Deflation of the thoracic cage and restoration of diaphragmatic function after thoracentesis may improve diaphragm effectiveness and efficiency, and this may be an important mechanism by which breathlessness improves. Effusions do not usually lead to major hemodynamic changes, but large effusions may cause cardiac tamponade and ventricular diastolic collapse. Patients with effusions can have impaired exercise capacity and poor sleep quality and efficiency. Pleural effusions are associated with abnormalities in gas exchange, respiratory mechanics, respiratory muscle function and hemodynamics, but the association between these abnormalities and breathlessness remains unclear. Prospective studies should aim to identify the key mechanisms of effusion-related breathlessness and predictors of improvement following pleural drainage.

  10. Cauliflower ear dissection.

    PubMed

    Fujiwara, Masao; Suzuki, Ayano; Nagata, Takeshi; Fukamizu, Hidekazu

    2011-11-01

    Cauliflower ear (CE) is caused by repeated direct trauma to the external ear. Surgical correction of an established CE is one of the most challenging problems in ear reconstruction. However, no reports have clarified the dissection of an established CE in detail. In this report, the dissection of a CE is described based on macroscopic, microscopic and imaging features. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. Role of pepsin and pepsinogen: linking laryngopharyngeal reflux with otitis media with effusion in children.

    PubMed

    Luo, Hua-Nan; Yang, Qi-Mei; Sheng, Ying; Wang, Zheng-Hui; Zhang, Qing; Yan, Jing; Hou, Jin; Zhu, Kang; Cheng, Ying; Wang, Bo-Tao; Xu, Ying-Long; Zhang, Xiang-Hong; Ren, Xiao-Yong; Xu, Min

    2014-07-01

    To analyze the relationship between laryngopharyngeal reflux (LPR) represented by pepsin and pepsinogen, and pathogenesis of otitis media with effusion (OME). Prospective case-control study. Children with OME who required adenoidectomy and tympanostomy/tympanostomy tubes placement were enrolled in OME group, whereas children with adenoid hypertrophy (AH) who required adenoidectomy and individuals who required cochlear implantation (CI) were enrolled in AH and CI groups, respectively. Pepsinogen mRNA and protein levels were assessed by real-time fluorescence-based quantitative polymerase chain reaction and immunohistochemistry in adenoid specimens from the OME and AH groups. Pepsin and pepsinogen concentrations were evaluated by enzyme-linked immunosorbent assay in middle ear fluid and plasma from the OME and CI groups. The levels of pepsinogen protein expressed in cytoplasm of epithelial cells and clearance under epithelial cells in adenoid specimens from the OME group were significantly higher than those in the AH group. Furthermore, the concentrations of pepsin and pepsinogen in the OME group were 51.93±11.58 ng/mL and 728±342.6 ng/mL, respectively, which were significantly higher than those in the CI group (P<.001). In addition, the concentrations of pepsin in dry ears were significantly lower than those in serous and mucus ears in the OME group (F=22.77, P<.001).Finally, the concentration of pepsinogen in middle ear effusion was positively correlated with the expression intensity of pepsinogen protein in cytoplasm of epithelial cells (r=0.73, P<.05) in the OME group. Pepsin and pepsinogen in middle ear effusion are probably caused by LPR and may be involved in the pathogenesis of OME. 3b. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Mucosal pathology of an experimental otitis media with effusion after X-ray irradiation

    SciTech Connect

    Ohashi, Y.; Nakai, Y.; Ikeoka, H.

    1987-07-01

    Ten guinea pigs were irradiated with 30 Gy of x-radiation. Five were killed on the eighth day after irradiation, and the remainder were killed at the sixteenth day after irradiation. At the time of death, examination was made of the ciliary activity and the fine structure of the middle ear mucosa. Serous effusion was found in each tympanic cavity of all animals. It was shown also that the guinea pig, when irradiated with 30 Gy of x-radiation, exhibits pathologic abnormalities similar to those in humans with otitis media with effusion: degeneration of cilia or ciliated cells and changes in themore » vascular system (capillary injury and increased capillary permeability). Functional examinations showed that x-ray irradiation has delayed effects on ciliary activity, and the effects are much greater at the sixteenth day than at the eighth day. We speculate that the accumulation of effusion can be, at least partially, a consequence of ciliary dysfunction. The induction of sterile effusion by the use of x-ray irradiation provides a unique animal model for chronic otitis media with effusion of the serous type.« less

  13. "Reaching the Hip-Hop Generation." The MEE Symposium (New York, New York, March 1-2, 1993). Final (Symposium Proceedings) Report.

    ERIC Educational Resources Information Center

    MEE Productions Inc., Philadelphia, PA. Research Div.

    This final report attempts to capture the work and atmosphere of the recent symposium convened by Motivational Educational Entertainment, Inc. (MEE), a black-owned communications research, consulting, and video production company. In its commitment to helping urban youth, MEE conducted a study of the "hip-hop" generation and its…

  14. Ear tube insertion

    MedlinePlus

    ... eardrum may cause some hearing loss. But most children do not have long-term damage to their hearing or speech, even when the ... not go away with treatment, or if a child has many ear infections ... or that damages nearby nerves Injury to the ear after sudden ...

  15. Inner ear disorders.

    PubMed

    Smouha, Eric

    2013-01-01

    To present a framework for the diagnosis and treatment of inner ear disorders, with an emphasis on problems common to neuro-rehabilitation. Disorders of the inner ear can cause hearing loss, tinnitus, vertigo and imbalance. Hearing loss can be conductive, sensorineural, or mixed; conductive hearing loss arises from the ear canal or middle ear, while sensorineural hearing loss arises from the inner ear or auditory nerve. Vertigo is a hallucination of motion, and is the cardinal symptom of vestibular system disease. It should be differentiated from other causes of dizziness: gait imbalance, disequilibrium, lightheadedness (pre-syncope). Vertigo can be caused by problems in the inner ear or central nervous system. The diagnosis of inner ear disorders begins with a targeted physical examination. The initial work-up of hearing loss is made by audiometry, and vertigo by electronystagmography (ENG). Supplemental tests and MRI are obtained when clinically indicated. The clinical pattern and duration of vertigo are the most important clinical features in the diagnosis. Common inner ear causes of vertigo include: vestibular neuritis (sudden, unilateral vestibular loss), Meniere's disease (episodic vertigo), benign paroxysmal positional vertigo (BPPV), and bilateral vestibular loss. Common central nervous system causes of vertigo include: post concussion syndrome, cervical vertigo, vestibular migraine, cerebrovascular disease, and acoustic neuroma. A basic knowledge of vestibular physiology, coupled with a understanding of common vestibular syndromes, will lead to correct diagnosis and treatment in most cases.

  16. Effectiveness of Ear Splint Therapy for Ear Deformities

    PubMed Central

    2017-01-01

    Objective To present our experience with ear splint therapy for babies with ear deformities, and thereby demonstrate that this therapy is an effective and safe intervention without significant complications. Methods This was a retrospective study of 54 babies (35 boys and 19 girls; 80 ears; age ≤3 months) with ear deformities who had received ear splint therapy at the Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University Hospital between December 2014 and February 2016. Before the initiation of ear splint therapy, ear deformities were classified with reference to the standard terminology. We compared the severity of ear deformity before and after ear splint therapy by using the physician's ratings. We also compared the physician's ratings and the caregiver's ratings on completion of ear splint therapy. Results Among these 54 babies, 41 children (58 ears, 72.5%) completed the ear splint therapy. The mean age at initiation of therapy was 52.91±18.26 days and the treatment duration was 44.27±32.06 days. Satyr ear, forward-facing ear lobe, Darwinian notch, overfolded ear, and cupped ear were the five most common ear deformities. At the completion of therapy, the final physician's ratings of ear deformities were significantly improved compared to the initial ratings (8.28±1.44 vs. 2.51±0.92; p<0.001). There was no significant difference between the physician's ratings and the caregiver's ratings at the completion of ear splint therapy (8.28±1.44 vs. 8.0±1.61; p=0.297). Conclusion We demonstrated that ear splint therapy significantly improved ear deformities in babies, as measured by quantitative rating scales. Ear splint therapy is an effective and safe intervention for babies with ear deformities. PMID:28289646

  17. Pericardial Effusion and Pericardiocentesis: Role of Echocardiography

    PubMed Central

    2012-01-01

    Pericardial effusion can develop from any pericardial disease, including pericarditis and several systemic disorders, such as malignancies, pulmonary tuberculosis, chronic renal failure, thyroid diseases, and autoimmune diseases. The causes of large pericardial effusion requiring invasive pericardiocentesis may vary according to the time, country, and hospital. Transthoracic echocardiography is the most important tool for diagnosis, grading, the pericardiocentesis procedure, and follow up of pericardial effusion. Cardiac tamponade is a kind of cardiogenic shock and medical emergency. Clinicians should understand the tamponade physiology, especially because it can develop without large pericardial effusion. In addition, clinicians should correlate the echocardiographic findings of tamponade, such as right ventricular collapse, right atrial collapse, and respiratory variation of mitral and tricuspid flow, with clinical signs of clinical tamponade, such as hypotension or pulsus paradoxus. Percutaneous pericardiocentesis has been the most useful procedure in many cases of large pericardial effusion, cardiac tamponade, or pericardial effusion of unknown etiology. The procedure should be performed with the guidance of echocardiography. PMID:23236323

  18. Antiphospholipid syndrome complicated by unilateral pleural effusion.

    PubMed

    Mitamura, Yasutaka; Takahara, Masakazu; Ito, Takamichi; Nakano, Misa; Moroi, Yoichi; Furue, Masutaka

    2013-05-01

    Antiphospholipid syndrome (APS) with pleural effusion is extremely rare. A 75-year-old man was admitted to our hospital for spreading erythema on his trunk and extremities, as well as dyspnea. One year before admission, he had visited us with a 1-year history of erythema and purpura on his legs and occasional fever. Given the diagnosis of APS, we initiated a combination therapy of aspirin and warfarin, but the skin lesions had gradually worsened. A biopsy specimen revealed marked thrombosis in the dermal and subcutaneous small vessels. In addition, chest X-ray and computed tomography demonstrated a large pleural effusion in the left lung. He underwent repeated drainage of the pleural effusion but the effusion recurred. We added oral prednisolone 30 mg daily to his prior anticoagulant therapy. The skin lesions and pleural effusion rapidly improved and disappeared without any complication. Corticosteroids might be a choice of treatment for intractable pleural effusion in APS patients.

  19. [Mediastinal Pancreatic Pseudocyst with Pancreatic Pleural Effusion].

    PubMed

    Sasajima, Motoko; Kawai, Hideki; Suzuki, Yohei; Saito, Yoshitaro; Eto, Takeshi

    2017-06-01

    A 72-year-old man with chronic alcohol related pancreatitis was admitted for dyspnea and pain at the upper body. Chest X-ray showed right massive pleural effusion. Chest and abdominal contrast enhanced thin slice computed tomography revealed the route from the pancreatic head reaching the right thoracic cavity via the esophagus hiatus and the communication between the cystic lesion and main pancreatic duct. We drained the pleural effusion that showed abnormally high amylase activity. We diagnosed his illness as mediastinal pancreatic pseudocyst with pancreatic pleural effusion. Endoscopic Nasopancreatic Drainage catheter was placed in the main pancreatic duct, and the pleural effusion disappeared.

  20. Efficacy of amoxicillin with and without decongestant-antihistamine for otitis media with effusion in children. Results of a double-blind, randomized trial.

    PubMed

    Mandel, E M; Rockette, H E; Bluestone, C D; Paradise, J L; Nozza, R J

    1987-02-19

    In a randomized, double-blind, placebo-controlled trial involving 518 infants and children who had otitis media with effusion ("secretory" otitis media), we evaluated the efficacy of a two-week course of amoxicillin (40 mg per kilogram of body weight per day) with and without a four-week course of an oral decongestant-antihistamine combination. Among the 474 subjects who were evaluated at the four-week end point, the rate of resolution of middle-ear effusion was twice as high in those treated with amoxicillin, either with or without the decongestant-antihistamine, as in those who received placebo (P less than 0.001), but 69.8 percent of the amoxicillin-treated subjects still had effusion. Among both the amoxicillin-treated subjects and the placebo-treated subjects, resolution was more likely in those with initially unilateral effusion, in those who had had effusion for eight weeks or less, and in those without an upper respiratory tract infection at the four-week end point. Side effects were reported more often in subjects who received decongestant-antihistamine than in those who did not. Among the subjects without effusion at the four-week end point, recurrent effusion developed in approximately half those in both the amoxicillin and placebo groups during the subsequent three months. We conclude that in infants and children with otitis media with effusion, amoxicillin treatment increases to some extent the likelihood of resolution.

  1. Pleurodesis for malignant pleural effusions.

    PubMed

    Shaw, P; Agarwal, R

    2004-01-01

    Approximately half of all patients with metastatic cancer develop a malignant pleural effusion which is likely to lead to a significant reduction in quality of life secondary to symptoms such as dyspnoea and cough. The aim of pleurodesis in these patients is to prevent re-accumulation of the effusion and thereby of symptoms, and avoid the need for repeated hospitalization for thoracocentesis. Numerous clinical studies have been performed to try to determine the optimal pleurodesis strategy, and synthesis of the available evidence should facilitate this. The aims of this review were to ascertain the optimal technique of pleurodesis in cases of malignant pleural effusion; to confirm the need for a sclerosant; and to clarify which, if any, of the sclerosants is the most effective. The Cochrane Central Register of Controlled Trials was searched for studies on 'pleurodesis'. Studies for inclusion were also identified from MEDLINE (1980 to June 2002) and EMBASE (1980 to May 2002). No language restriction was applied. RCTs of adults subjects undergoing pleurodesis for pleural effusion in the context of metastatic malignancy (or a malignant process leading to pleural effusion) were included. Two reviewers independently selected studies for inclusion in the review, and extracted data using a standard data collection form. Primary outcome measures sought were effectiveness of pleurodesis as defined by freedom from recurrence of effusions, and mortality after pleurodesis. Secondary outcomes were adverse events due to pleurodesis. Dichotomous data were meta-analysed using a fixed effect model and expressed as relative risk. The number-needed-to-treat (NNT) was calculated for pleurodesis efficacy. In addition, for adverse events, the overall percentage of patients across studies exhibiting a particular adverse effect such as fever, pain, or gastrointestinal symptoms was calculated. A total of 36 RCTs with 1499 subjects were eligible for meta-analysis. The use of sclerosants

  2. Infrared absorption cross-sections, radiative efficiency and global warming potential of HFC-43-10mee

    NASA Astrophysics Data System (ADS)

    Le Bris, Karine; DeZeeuw, Jasmine; Godin, Paul J.; Strong, Kimberly

    2018-06-01

    HFC-43-10mee (C5H2F10) is a substitute for CFC-113, HCFC-141b and methyl chloroform, as well as an alternative to perfluorocarbons with high radiative efficiencies. Recent observations have shown that the global mean tropospheric abundance of HFC-43-10mee has increased steadily from the 1990s to reach 0.211 ppt in 2012. To date, the emission of this compound is not regulated. The radiative efficiency (RE) of HFC-43-10mee has recently been re-evaluated at 0.42 W m-2 ppb-1, giving a 100-year time horizon global warming potential (GWP100) of 1650. However, the initial RE, from which the new values were derived, originated from an unpublished source. We calculated a new RE of 0.36 W m-2 ppb-1 and a GWP100 of 1410 from laboratory absorption cross-section spectra of a pure vapour of HFC-43-10mee. Acquisitions were performed in the 550-3500 cm-1 spectral range using Fourier transform spectroscopy. The results were compared with the broadened spectra from the Pacific Northwest National Laboratory (PNNL) database and with theoretical calculations using density functional theory.

  3. The constricted ear.

    PubMed

    Paredes, Alfredo A; Williams, J Kerwin; Elsahy, Nabil I

    2002-04-01

    The constricted ear may be described best as a pursestring closure of the ear. The deformity may include lidding of the upper pole with downward folding, protrusion of the concha, decreased vertical height, and low ear position relative to the face. The goals of surgical correction should include obtaining symmetry and correcting the intra-auricular anatomy. The degree of intervention is based on the severity of the deformity and may range from simple repositioning, soft tissue rearrangement, or manipulation of the cartilage. Multiple surgical techniques are described.

  4. Red ear syndrome.

    PubMed

    Purdy, R Allan; Dodick, David W

    2007-08-01

    The red ear syndrome is a rare syndrome originally described by Lance in 1994. It involves pain in and around the ear and associated autonomic phenomena, the most significant of which is cutaneous erythema of the ear ipsilateral to the pain and obvious to the patient and examiner during the attack. It may well represent an auriculo-autonomic cephalgia and/or be part of the group of disorders recognized as trigeminal autonomic cephalalgias. As a syndrome, it still lacks specificity in regard to etiology, mechanisms, and treatment but is important to recognize clinically because of its associations.

  5. [Analysis of related factors of recurrent otitis media with effusion in children].

    PubMed

    Zhu, Z; Zheng, G X; Li, Q; Shi, Q L; Zhou, H G; Fang, R P

    2017-08-05

    Objective: To investigate the influencing factors of recurrent episodes of otitis media with effusion in children. Method: A retrospective summary of the clinical data of 210 cases of children with otitis media with effusion, 75 cases of recurrence after treatment, 135 cases were recovered, the recurrence of the related factors and after symptomatic treatment effect is analyzed. Result: Logistic regression analysis results found that adenoid hypertrophy (Ⅲ°, Ⅳ°), tonsil hypertrophy (Ⅳ°) and sinusitis (including choanal polyp), a positive allergens, upper respiratory tract infection, the stomach esophagus regurgitation, cleft palate, younger age has significant effect on recurrence of otitis media with effusion, have significant difference ( P < 0.05). And the influence of duration, gender, passive smoking history and previous medical history of otitis media with effusion has no obvious statistical significance ( P > 0.05). Through the comparison among different age groups, adenoidectomy Ⅲ °, Ⅳ ° hypertrophy tract infections in > 3-6 years old group has significant effect ( P < 0.05), recurrent respiratory tract infections in less than 3 years old group and the group of children aged > 3-6 years OME recurrence has significant effect ( P < 0.05). By tympanocentesis or tympanostomy tube insertion and according to different conditions to take symptomatic treatment, 75 cases (123 ears) were cured 96 ears (78.05%), 19 ears were improved (15.45%), the total effective rate was 93.50%, ineffective in 8 ears (6.50%). Conclusion: Adenoid hypertrophy (Ⅲ°, Ⅳ°), tonsil hypertrophy (Ⅳ°), sinusitis, nasal polyps, allergic diseases and upper respiratory tract infection gastroesophageal reflux, cleft palate and younger age may be adverse factors related to recurrent otitis media with effusion in children, the clinical doctors should pay attention to these symptoms, according to different causes, adopt individualized treatment plan, make children get the best

  6. Cosmetic ear surgery

    MedlinePlus

    ... ear reduction. In: Rubin JP, Neligan PC, eds. Plastic Surgery: Volume 2: Aesthetic Surgery . 4th ed. Philadelphia, ... Tang Ho, MD, Assistant Professor, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and ...

  7. Complications of ear rings.

    PubMed

    Lane, Jennifer C E; O'Toole, Gregory

    2012-06-01

    In this paper the complications of ear piercing are considered and the treatment of resultant deformities is described. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Ear infection - acute

    MedlinePlus

    ... more than 6 children) Changes in altitude or climate Cold climate Exposure to smoke Family history of ear infections ... Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Internal review and update ...

  9. EAR Program Research Results

    DOT National Transportation Integrated Search

    2013-01-01

    The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for longterm improvements to transportation systems-improvements in planning, building, renewing, and operating safe, congesti...

  10. Middle Ear Infections (For Parents)

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español Middle Ear Infections KidsHealth / For Parents / Middle Ear Infections What's ... en español Infecciones del oído medio What Are Middle Ear Infections? Ear infections happen when viruses or bacteria ...

  11. Beta-trace protein in ascites and pleural effusions: limits of CSF leakage detection.

    PubMed

    Dietzel, Joanna; Krebs, Alexander; Böttcher, Dominique; Sieb, Manuela; Glocker, Michael O; Lüdemann, Jan; Roser, Markus; Dressel, Alexander

    2012-06-10

    Rhino- and/or otoliquorrhea can be diagnosed by detecting beta-trace protein (β-TP) in nasal or ear secretions, as β-TP is found in high concentrations in cerebrospinal fluid (CSF) but not in serum. CSF fistulae following trauma or surgery can also occur at other anatomical sites, resulting in CSF leakage into the thoracic and abdominal cavities. By analogy, determination of ß-TP has also been used to diagnose CSF admixture in pleural effusions and ascites. However, no systematic study has yet evaluated the concentrations of β-TP in such fluids in the absence of CSF. To determine the validity of β-TP determination as a marker for the presence of CSF, we investigated β-TP concentrations in pleural effusions and ascites without CSF admixture. Patients from whom samples of ascites or pleural effusion and a paired plasma sample were available were investigated. One hundred sixty-four patients were prospectively recruited. ß-TP concentrations were determined by nephelometry. Mass spectrometric proteome analysis confirmed the presence of ß-TP in the samples. Median β-TP concentrations detected in ascites and pleural effusions (range, 0.014-26.5 mg/L, median 2.29 mg/L) exceeded the corresponding plasma concentrations 2.6-fold. According to cutoffs published to diagnose rhino- and otoliquorrhea, between 6.1% and 95.7% of the specimens would have been erroneously rated CSF-positive. Protein analysis confirmed the presence of β-TP in pleural effusion and ascites. Ascites and pleural effusion contain high concentrations of β-TP that exceed the levels in corresponding plasma. Therefore, β-TP is not a specific marker for the presence of CSF in these fluids.

  12. Pleural effusion: diagnosis, treatment, and management

    PubMed Central

    Karkhanis, Vinaya S; Joshi, Jyotsna M

    2012-01-01

    A pleural effusion is an excessive accumulation of fluid in the pleural space. It can pose a diagnostic dilemma to the treating physician because it may be related to disorders of the lung or pleura, or to a systemic disorder. Patients most commonly present with dyspnea, initially on exertion, predominantly dry cough, and pleuritic chest pain. To treat pleural effusion appropriately, it is important to determine its etiology. However, the etiology of pleural effusion remains unclear in nearly 20% of cases. Thoracocentesis should be performed for new and unexplained pleural effusions. Laboratory testing helps to distinguish pleural fluid transudate from an exudate. The diagnostic evaluation of pleural effusion includes chemical and microbiological studies, as well as cytological analysis, which can provide further information about the etiology of the disease process. Immunohistochemistry provides increased diagnostic accuracy. Transudative effusions are usually managed by treating the underlying medical disorder. However, a large, refractory pleural effusion, whether a transudate or exudate, must be drained to provide symptomatic relief. Management of exudative effusion depends on the underlying etiology of the effusion. Malignant effusions are usually drained to palliate symptoms and may require pleurodesis to prevent recurrence. Pleural biopsy is recommended for evaluation and exclusion of various etiologies, such as tuberculosis or malignant disease. Percutaneous closed pleural biopsy is easiest to perform, the least expensive, with minimal complications, and should be used routinely. Empyemas need to be treated with appropriate antibiotics and intercostal drainage. Surgery may be needed in selected cases where drainage procedure fails to produce improvement or to restore lung function and for closure of bronchopleural fistula. PMID:27147861

  13. Otitis media with effusion: experiences of children with cleft palate and their parents.

    PubMed

    Tierney, Stephanie; O'Brien, Kevin; Harman, Nicola L; Sharma, Ravi K; Madden, Colm; Callery, Peter

    2015-01-01

    To explore the views of children with cleft palate and their parents about daily life with otitis media with effusion and associated hearing loss. A qualitative study. Semistructured interviews were used to collect data from parents. Participatory techniques, including activities on a tablet computer, were used to collect data from children. Framework analysis was applied to interview transcripts. Two English cleft units. A purposive sample of parents of 37 children aged 0 to 11 years with experience of otitis media with effusion. Their children also took part if aged 6 to 11 years (n = 22). Themes related to the following: (1) emotions (frustration, anger, sadness, happiness, anxiety), (2) educational experiences (struggling at school, having to sit at the front of the class, requiring extra support, missing lessons for appointments or due to ear infections), (3) social interactions (isolation, communication, reliance on siblings, participation in activities). A number of areas of interviewees' everyday life were affected by the presence of otitis media with effusion. Parents may need to be forewarned about the possible ongoing nature of this condition and its impact on a child's social and emotional experiences. Children may also benefit from age-appropriate information about otitis media with effusion and its treatment, including information on hearing tests, to help reduce any anxiety.

  14. Diode laser myringotomy for chronic otitis media with effusion in adults.

    PubMed

    Zanetti, Diego; Piccioni, Michela; Nassif, Nader; Campovecchi, Chiara; Redaelli de Zinis, Luca O

    2005-01-01

    To analyze the closure time of diode laser-assisted myringotomies, the incidence of complications, and the hearing results in comparison with the "cold" procedure in adults with otitis media with effusion (OME). Prospective case-control study. Tertiary referral center, university hospital. Twenty-eight adult patients (39 ears), 13 men and 15 women, age 13 to 76 years (mean, 51.9). Inclusion criteria included 3 months (or more) history of OME resistant to medical therapy. Twenty-two control patients (34 ears) underwent cold myringotomies with knife and ventilation tubes (VT). Diode laser myringotomy performed in an office setting under local anesthesia with topical EMLA ointment. Timing of closure of the myringotomy, hearing results, incidence of complications, recurrence of OME. No intra- or postoperative pain nor complications were observed. Otomicroscopic daily monitoring documented the healing patterns of the tympanostomies, which remained patent for 7 to 25 days (average, 15.6 +/- 4.8 days). Immediate improvement of hearing was achieved in every patient. Recurrence of OME was observed in 36 ears (92.3%) within 1 month from healing. In the control group with VTs, healing of the eardrum was observed between 126 and 301 days (average, 183.2 +/- 44.8 days), and recurrence of OME was observed in 8 ears (23.5%) (p < 0.001). One month after healing, the air-bone gap was retained within 10 dB in 10.3% (4/39) of the diode laser group and in 50% (17/34) of the standard procedure group (p=0.0001). Diode laser myringotomy is a straightforward, painless procedure simplified by the thin fiberoptic cables available. Functional benefit is comparable to conventional tympanostomies plus VTs, but the duration of patency is too short to achieve long-term clearance of the effusion in "glue" ears of adult patients. Selected indications could be acute or recurrent otitis media or the prevention of barotraumas in tubal dysfunction.

  15. The human otitis media with effusion: a numerical-based study.

    PubMed

    Areias, B; Parente, M P L; Santos, C; Gentil, F; Natal Jorge, R M

    2017-07-01

    Otitis media is a group of inflammatory diseases of the middle ear. Acute otitis media and otitis media with effusion (OME) are its two main types of manifestation. Otitis media is common in children and can result in structural alterations in the middle ear which will lead to hearing losses. This work studies the effects of an OME on the sound transmission from the external auditory meatus to the inner ear. The finite element method was applied on the present biomechanical study. The numerical model used in this work was built based on the geometrical information obtained from The visible ear project. The present work explains the mechanisms by which the presence of fluid in the middle ear affects hearing by calculating the magnitude, phase and reduction of the normalized umbo velocity and also the magnitude and phase of the normalized stapes velocity. A sound pressure level of 90 dB SPL was applied at the tympanic membrane. The harmonic analysis was performed with the auditory frequency varying from 100 Hz to 10 kHz. A decrease in the response of the normalized umbo and stapes velocity as the tympanic cavity was filled with fluid was obtained. The decrease was more accentuated at the umbo.

  16. Management of malignant pleural effusion.

    PubMed

    Chen, Hongbin; Brahmer, Julie

    2008-07-01

    Malignant pleural effusion (MPE) often presents in patients with cancer at an advanced stage and thus carries a poor prognosis. This review updates the current knowledge on the management of MPE, focusing on recent literature about the efficacy and safety of the most common methods, including pleurodesis by either thoracoscopy with talc insufflation or thoracostomy with talc slurry, use of an indwelling pleural catheter, and intrapleural chemotherapy. Talc remains the agent of choice in pleurodesis, although the use of alternative agents continues to be explored. The choice of procedure to achieve pleurodesis depends on careful patient selection based on predictive factors and individual characteristics. Talc pleuro-desis is relatively well tolerated and safe, as is an indwelling pleural catheter, in an appropriate patient population. Because MPE is a common problem in cancer patients, future research with more randomized, prospective designs and innovative interventions is needed.

  17. Knee joint effusion following ipsilateral hip surgery.

    PubMed

    Christodoulou, A G; Givissis, P; Antonarakos, P D; Petsatodis, G E; Hatzokos, I; Pournaras, J D

    2010-12-01

    To correlate patellar reflex inhibition with sympathetic knee joint effusion. 65 women and 40 men aged 45 to 75 (mean, 65) years underwent hip surgery. The surgery entailed dynamic hip screw fixation using the lateral approach with reflection of the vastus lateralis for pertrochantric fractures (n = 49), and hip hemiarthroplasty or total hip replacement using the Watson-Jones approach (n = 38) or hip hemiarthroplasty using the posterior approach (n = 18) for subcapital femoral fractures (n = 28) or osteoarthritis (n = 28). Knee joint effusion, patellar reflex, and thigh circumference were assessed in both legs before and after surgery (at day 0.5, 2, 7, 14, 30, and 45). Time-sequence plots were used for chronological analysis, and correlation between patellar reflex inhibition and knee joint effusion was tested. In the time-sequence plot, the peak frequency of patellar reflex inhibition (on day 0.5) preceded that of the knee joint effusion and the thigh circumference increase (on day 2). Patellar reflex inhibition correlated positively with the knee joint effusion (r = 0.843, p = 0.035). These 2 factors correlated significantly for all 3 surgical approaches (p < 0.0005). All 3 approaches were associated with patellar reflex inhibition on day 0.5 (p = 0.033) and knee joint effusion on day 2 (p = 0.051). Surgical trauma of the thigh may cause patellar reflex inhibition and subsequently knee joint effusion.

  18. Mast cells mediate malignant pleural effusion formation.

    PubMed

    Giannou, Anastasios D; Marazioti, Antonia; Spella, Magda; Kanellakis, Nikolaos I; Apostolopoulou, Hara; Psallidas, Ioannis; Prijovich, Zeljko M; Vreka, Malamati; Zazara, Dimitra E; Lilis, Ioannis; Papaleonidopoulos, Vassilios; Kairi, Chrysoula A; Patmanidi, Alexandra L; Giopanou, Ioanna; Spiropoulou, Nikolitsa; Harokopos, Vaggelis; Aidinis, Vassilis; Spyratos, Dionisios; Teliousi, Stamatia; Papadaki, Helen; Taraviras, Stavros; Snyder, Linda A; Eickelberg, Oliver; Kardamakis, Dimitrios; Iwakura, Yoichiro; Feyerabend, Thorsten B; Rodewald, Hans-Reimer; Kalomenidis, Ioannis; Blackwell, Timothy S; Agalioti, Theodora; Stathopoulos, Georgios T

    2015-06-01

    Mast cells (MCs) have been identified in various tumors; however, the role of these cells in tumorigenesis remains controversial. Here, we quantified MCs in human and murine malignant pleural effusions (MPEs) and evaluated the fate and function of these cells in MPE development. Evaluation of murine MPE-competent lung and colon adenocarcinomas revealed that these tumors actively attract and subsequently degranulate MCs in the pleural space by elaborating CCL2 and osteopontin. MCs were required for effusion development, as MPEs did not form in mice lacking MCs, and pleural infusion of MCs with MPE-incompetent cells promoted MPE formation. Once homed to the pleural space, MCs released tryptase AB1 and IL-1β, which in turn induced pleural vasculature leakiness and triggered NF-κB activation in pleural tumor cells, thereby fostering pleural fluid accumulation and tumor growth. Evaluation of human effusions revealed that MCs are elevated in MPEs compared with benign effusions. Moreover, MC abundance correlated with MPE formation in a human cancer cell-induced effusion model. Treatment of mice with the c-KIT inhibitor imatinib mesylate limited effusion precipitation by mouse and human adenocarcinoma cells. Together, the results of this study indicate that MCs are required for MPE formation and suggest that MC-dependent effusion formation is therapeutically addressable.

  19. Mast cells mediate malignant pleural effusion formation

    PubMed Central

    Giannou, Anastasios D.; Marazioti, Antonia; Spella, Magda; Kanellakis, Nikolaos I.; Apostolopoulou, Hara; Psallidas, Ioannis; Prijovich, Zeljko M.; Vreka, Malamati; Zazara, Dimitra E.; Lilis, Ioannis; Papaleonidopoulos, Vassilios; Kairi, Chrysoula A.; Patmanidi, Alexandra L.; Giopanou, Ioanna; Spiropoulou, Nikolitsa; Harokopos, Vaggelis; Aidinis, Vassilis; Spyratos, Dionisios; Teliousi, Stamatia; Papadaki, Helen; Taraviras, Stavros; Snyder, Linda A.; Eickelberg, Oliver; Kardamakis, Dimitrios; Iwakura, Yoichiro; Feyerabend, Thorsten B.; Rodewald, Hans-Reimer; Kalomenidis, Ioannis; Blackwell, Timothy S.; Agalioti, Theodora; Stathopoulos, Georgios T.

    2015-01-01

    Mast cells (MCs) have been identified in various tumors; however, the role of these cells in tumorigenesis remains controversial. Here, we quantified MCs in human and murine malignant pleural effusions (MPEs) and evaluated the fate and function of these cells in MPE development. Evaluation of murine MPE-competent lung and colon adenocarcinomas revealed that these tumors actively attract and subsequently degranulate MCs in the pleural space by elaborating CCL2 and osteopontin. MCs were required for effusion development, as MPEs did not form in mice lacking MCs, and pleural infusion of MCs with MPE-incompetent cells promoted MPE formation. Once homed to the pleural space, MCs released tryptase AB1 and IL-1β, which in turn induced pleural vasculature leakiness and triggered NF-κB activation in pleural tumor cells, thereby fostering pleural fluid accumulation and tumor growth. Evaluation of human effusions revealed that MCs are elevated in MPEs compared with benign effusions. Moreover, MC abundance correlated with MPE formation in a human cancer cell–induced effusion model. Treatment of mice with the c-KIT inhibitor imatinib mesylate limited effusion precipitation by mouse and human adenocarcinoma cells. Together, the results of this study indicate that MCs are required for MPE formation and suggest that MC-dependent effusion formation is therapeutically addressable. PMID:25915587

  20. Effusion plate using additive manufacturing methods

    DOEpatents

    Johnson, Thomas Edward; Keener, Christopher Paul; Ostebee, Heath Michael; Wegerif, Daniel Gerritt

    2016-04-12

    Additive manufacturing techniques may be utilized to construct effusion plates. Such additive manufacturing techniques may include defining a configuration for an effusion plate having one or more internal cooling channels. The manufacturing techniques may further include depositing a powder into a chamber, applying an energy source to the deposited powder, and consolidating the powder into a cross-sectional shape corresponding to the defined configuration. Such methods may be implemented to construct an effusion plate having one or more channels with a curved cross-sectional geometry.

  1. Complete spontaneous avascular necrosis of the adult navicula associated with Mee's growth arrest lines of the great and second toenails.

    PubMed

    Singh, Dishan; Ferrerro, Andrea

    2014-03-01

    Spontaneous total avascular necrosis of the tarsal navicula has been well documented in children (Kohler's disease) but is uncommon in adults where partial necrosis is usually seen after trauma or in Müller-Weiss disease. A case of spontaneous complete navicular osteonecrosis in a 46 year old female is described; she had accompanying Mee's leuchonychial lines in the toenails of the great and second toes only; the lines resolved after 9 months. She has been treated with an excision of the navicula and interpositional iliac crest bone graft talo-cuneiform fusion with resolution of her pain. It is postulated that the combination of the Mee's lines and avascular necrosis of the navicula indicates an occlusion of the dorsalis pedis in a predisposed individual. Copyright © 2013 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  2. Middle Ear Infections and Ear Tube Surgery (For Parents)

    MedlinePlus

    ... Infection? Swimmer's Ear Perforated Eardrum Hearing Impairment Swimmer's Ear (External ... All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, ...

  3. Listening to the ear

    NASA Astrophysics Data System (ADS)

    Shera, Christopher A.

    Otoacoustic emissions demonstrate that the ear creates sound while listening to sound, offering a promising acoustic window on the mechanics of hearing in awake, listening human beings. That window is clouded, however, by an incomplete knowledge of wave reflection and transmission, both forth and back within the cochlea and through the middle ear. This thesis "does windows," addressing wave propagation and scattering on both sides of the middle ear. A summary of highlights follows. Measurements of the cochlear input impedance in cat are used to identify a new symmetry in cochlear mechanics-termed "tapering symmetry" after its geometric interpretation in simple models-that guarantees that the wavelength of the traveling wave changes slowly with position near the stapes. Waves therefore propagate without reflection through the basal turns of the cochlea. Analytic methods for solving the cochlear wave equations using a perturbative scattering series are given and used to demonstrate that, contrary to common belief, conventional cochlear models exhibit negligible internal reflection whether or not they accurately represent the tapering symmetries of the inner ear. Frameworks for the systematic "deconstruction" of eardrum and middle-ear transduction characteristics are developed and applied to the analysis of noninvasive measurements of middle-ear and cochlear mechanics. A simple phenomenological model of inner-ear compressibility that correctly predicts hearing thresholds in patients with missing or disarticulated middle-ear ossicles is developed and used to establish an upper bound on cochlear compressibility several orders of magnitude smaller than that provided by direct measurements. Accurate measurements of stimulus frequency evoked otoacoustic emissions are performed and used to determine the form and frequency variation of the cochlear traveling-wave ratio noninvasively. Those measurements are inverted to obtain the spatial distribution of mechanical

  4. Listening to the Ear

    NASA Astrophysics Data System (ADS)

    Shera, Christopher Alan

    Otoacoustic emissions demonstrate that the ear creates sound while listening to sound, offering a promising acoustic window on the mechanics of hearing in awake, listening human beings. That window is clouded, however, by an incomplete knowledge of wave reflection and transmission, both forth and back within the cochlea and through the middle ear. This thesis "does windows," addressing wave propagation and scattering on both sides of the middle ear. A summary of highlights follows. Measurements of the cochlear input impedance in cat are used to identify a new symmetry in cochlear mechanics--termed "tapering symmetry" after its geometric interpretation in simple models--that guarantees that the wavelength of the traveling wave changes slowly with position near the stapes. Waves therefore propagate without reflection through the basal turns of the cochlea. Analytic methods for solving the cochlear wave equations using a perturbative scattering series are given and used to demonstrate that, contrary to common belief, conventional cochlear models exhibit negligible internal reflection whether or not they accurately represent the tapering symmetries of the inner ear. Frameworks for the systematic "deconstruction" of eardrum and middle-ear transduction characteristics are developed and applied to the analysis of noninvasive measurements of middle-ear and cochlear mechanics. A simple phenomenological model of inner-ear compressibility that correctly predicts hearing thresholds in patients with missing or disarticulated middle-ear ossicles is developed and used to establish an upper bound on cochlear compressibility several orders of magnitude smaller than that provided by direct measurements. Accurate measurements of stimulus -frequency evoked otoacoustic emissions are performed and used to determine the form and frequency variation of the cochlear traveling-wave ratio noninvasively. Those measurements are inverted to obtain the spatial distribution of mechanical

  5. [Basics of Ear Surgery].

    PubMed

    Lailach, S; Zahnert, T

    2016-12-01

    The present article about the basics of ear surgery is a short overview of current indications, the required diagnostics and surgical procedures of common otologic diseases. In addition to plastic and reconstructive surgery of the auricle, principles of surgery of the external auditory canal, basics of middle ear surgery and the tumor surgery of the temporal bone are shown. Additionally, aspects of the surgical hearing rehabilitation (excluding implantable hearing systems) are presented considering current study results. Georg Thieme Verlag KG Stuttgart · New York.

  6. Ear - blocked at high altitudes

    MedlinePlus

    ... ears; Flying and blocked ears; Eustachian tube dysfunction - high altitude ... to the eardrum) and the back of the nose and upper throat. ... down from high altitudes. Chewing gum the entire time you are ...

  7. What Is an Ear Infection?

    MedlinePlus

    ... Hearing Loss? Taking Care of Your Ears Swimmer's Ear Perforated Eardrum What's Earwax? View ... All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, ...

  8. External ear anomalies and hearing impairment in Noonan Syndrome.

    PubMed

    van Trier, Dorothée C; van Nierop, Josephine; Draaisma, Jos M Th; van der Burgt, Ineke; Kunst, Henricus; Croonen, Ellen A; Admiraal, Ronald J C

    2015-06-01

    This is the first cohort in which hearing impairment and external ear anomalies in Noonan Syndrome are described extensively. Retrospective analysis of the otorhinolaryngological and clinical genetic data from 97 Noonan Syndrome (NS) patients. Forty-four NS patients were seen by an otorhinolaryngologist for the analysis of hearing impairment. In our cohort 80 of the 97 patients were genetically tested. In 71 of these mutations were found: in 48 patients a mutation in PTPN11, in 10 patients in SOS1, in 5 patients in SHOC2, in 5 patients in RAF1, in 1 patient in MAP2K2, in 1 patient in KRAS and in 1 patient in A2ML1. External ear anomalies were reported in 75 NS patients (77%). In 69 patients the ears were low-set, 28 patients had posteriorly rotated ears, 14 patients showed protruding ears and 18 had thickened helices. Hearing impairment was detected in 34 NS patients. Nine patients had sensorineural hearing impairment, two a permanent conductive hearing impairment, two other patients had mixed hearing impairment and 20 patients had conductive hearing impairment in the past, caused by otitis media with effusion. Their temporary conductive hearing impairment resolved between the ages of 2 and 18 years. Sensorineural hearing impairment varied between mild high-frequency hearing impairment and profound (uni- and bilateral) hearing impairment and was progressive in three patients. Four NS patients received cochlear implants for their severe sensorineural hearing impairment. The cohort is small for genotype-phenotype correlations, but sensorineural hearing impairment, especially the bilateral severe hearing impairment, was only seen in patients with a PTPN11 mutation. NS is characterized by dysmorphic external ear anomalies and both sensorineural and conductive hearing impairment. Audiological examinations are recommended in all patients with Noonan Syndrome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Pleural effusion leading to right atrial collapse.

    PubMed

    Khouzam, Rami N; Yusuf, Jawwad

    2014-01-01

    Rapid accumulation of pericardial fluid can lead to tamponade, resulting in cardiac chambers' collapse, which can lead to hemodynamic and clinical instability, potentially needing emergent pericardiocentesis. Pleural effusion should also be considered as a potential, if rare, cause of cardiac chambers' collapse and possibly cardiac tamponade. This phenomenon has clinical implications because hemodynamically unstable patients with moderate to large pleural effusion may actually need thoracentesis instead of massive volume resuscitation, inotropic agents, or pericardiocentesis. Copyright © 2013 Wiley Periodicals, Inc.

  10. Pleural effusions and diseases of the pleura.

    PubMed

    Noone, K E

    1985-09-01

    There are four factors that govern fluid movement to or from the pleural space: hydrostatic pressure, colloid osmotic pressure, filtration coefficient, and lymphatic function. When any of these factors are altered, fluid accumulates within the pleural space. Congestive heart failure, pancreatitis, neoplasia, hypoalbuminemia, and pulmonary thromboembolism can evoke pleural effusions by altering normal fluid transport mechanisms. This approach to pleural effusion helps to explain fluid accumulation. Chylothorax, hemothorax, and empyema are also covered in the article.

  11. From Ear to Brain

    ERIC Educational Resources Information Center

    Kimura, Doreen

    2011-01-01

    In this paper Doreen Kimura gives a personal history of the "right-ear effect" in dichotic listening. The focus is on the early ground-breaking papers, describing how she did the first dichotic listening studies relating the effects to brain asymmetry. The paper also gives a description of the visual half-field technique for lateralized stimulus…

  12. Ear-protector ratings.

    DOT National Transportation Integrated Search

    1973-12-01

    Twenty-one brands of ear protectors, including custom-molded, wearer-molded, and pre-molded types, were evaluated according to American-standard procedures. Earplugs are described and are listed in the order of their low-frequency (below 1000 Hz) att...

  13. Ear surgery - slideshow

    MedlinePlus

    ... Otolaryngology – Head and Neck Surgery, The University of Texas Medical School at Houston, Houston, TX. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Ear Disorders ...

  14. Dehydration of Traditional Dried Instant Noodle (Mee Siput) Using Controlled Temperature & Humidity Dryer

    NASA Astrophysics Data System (ADS)

    Mamat, K. A.; Yusof, M. S.; Yusoff, Wan Fauziah Wan; Zulafif Rahim, M.; Hassan, S.; Rahman, M. Qusyairi. A.; Karim, M. A. Abd

    2017-05-01

    Drying process is an essential step to produce instant noodles. Yet, the industries especially Small and Medium Enterprises (SMEs), is seeking for an efficient method to dry the noodles. This paper discusses the performance of an invented drying system which employed heating and humidifying process. The drying system was tested using 30 kilogram of the raw noodle known as “Mee Siput”. Temperature controlled system were used in the study to control the temperature of the drying process and prevent the dried noodles from damage by maintaining the temperature of lower than 80°C. The analysis shows that the system was drastically decreased the humidity from 80% to 40% just after 200 minutes of the drying process. The complete dehydration time of noodle has also decreased to only 4 hours from 16 hours when using traditional drying system without sacrificed the good quality of the dried noodle. In overall, the invented system believed to increase the production capacity of the noodle, reduce cost of production which would highly beneficial for Small Medium Industries (SMEs) in Malaysia.

  15. Acute myeloid leukemia with leukemic pleural effusion.

    PubMed

    Chang, Hung

    2013-10-01

    Acute myeloid leukemia (AML) may be associated with extramedullary tumor growth, which is commonly known as myeloid sarcoma. Although AML with leukemic pleural effusion is considered rare, the true incidence is not clear. We report three cases of AML involving pleural effusion in this study. The cases were encountered in a single institute within two years, suggesting that leukemic effusion is more common than previously reported. Leukemic cells showed evidence of monocytic differentiation in all cases. Two patients presented with advanced AML. Both had concurrent myeloid sarcoma. Both were ineligible for intensive treatment and died soon after diagnosis of myeloid sarcoma. The third patient had pleural effusion upon diagnosis of AML. Remission was achieved and the effusion disappeared after treatment. We conclude leukemic effusion may become more common in an era of improved care and prolonged survival for AML patients. The prognostic impact is unclear and patients should be given standard AML treatment whenever possible. Copyright © 2012 Wiley Periodicals, Inc., a Wiley company.

  16. Chylous pericardial effusion after pulmonary lobectomy.

    PubMed

    Yang, Weixiong; Luo, Canqiao; Liu, Zhenguo; Cheng, Chao

    2017-07-01

    Chylous pericardial effusion is a rarely reported complication of lung cancer surgery. Here, we report a case of an elderly man who suffered chylous pericardial effusion after radical right upper lung resection for cancer. The massive chylous effusion first occurred in the pericardium, drained to the right chest after the drainage of the hydropericardium and subsequently moved back to the pericardium again. Lymphoscintigraphy examination indicated that a chylous fistula was present in the plane of the tracheal carina. After failure to control the chylous effusion with conservative medical treatment, the patient underwent video-assisted thoracic surgery through the left chest for thoracic duct ligation and pericardial fenestration. The patient was ultimately discharged without recurrence of the effusion after surgical treatment. This case report discusses the possible mechanism of chylopericardium after lung cancer surgery and suggests some strategies to prevent postoperative chylous pericardial effusion. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  17. A simple solution for complicated pleural effusions.

    PubMed

    Murthy, Sudish C; Okereke, Ikenna; Mason, David P; Rice, Thomas W

    2006-09-01

    Complicated pleural effusions are difficult to manage with conventional strategies. In this study, we review the safety, efficacy, and durability of PleurX catheters (Denver Biomedical, Golden, CO) for managing complicated pleural effusions and describe a patient population who might benefit. From July 1999 to February 2003, 63 PleurX catheters were placed in 58 symptomatic patients (an additional five had bilateral catheters) to manage complicated pleural effusions. Patients selected for catheter placement tended to have poor performance status (Eastern Cooperative Oncology Group < or =2) or had failed standard therapies. Of the 63 catheters, 52 (83%) were placed because of malignant complicated pleural effusions. A registry of patients was constructed, and data were obtained from review of medical records. Nonparametric estimates of freedom from reintervention and overall survival were obtained by the Kaplan-Meier method. Catheter-related complications were noted in four of 58 patients (7%) and included one each of pneumothorax, seroma, empyema, and pain syndrome. Freedom from reintervention for effusion management was 95%. Of the patients, 86% (50 of 58) experienced dyspnea relief. There were no procedure-related mortalities. Catheters remained functional up to 330 days, and four of 63 (6%) required one-time thrombolysis with tissue plasminogen activator. PleurX catheters are safe, effective, and durable solutions for complicated pleural effusions and seem to provide an attractive alternative for patients who have few other palliative options. We consider the catheters as first-line therapy for these patients.

  18. Ear Infections and Language Development.

    ERIC Educational Resources Information Center

    Roberts, Joanne E.; Zeisel, Susan A.

    Ear infections in infants and preschoolers can cause mild or moderate temporary hearing loss, which may in turn affect a child's ability to understand and learn language. Noting that providing children with proper medical treatment for ear infections or middle ear fluid is important in preventing possible problems with language development, this…

  19. Ear Scaffold Reconstruction Using Ultrasonic Aspirator for Cauliflower Ear.

    PubMed

    Hao, Scarlett; Angster, Kristen; Hubbard, Fleesie; Greywoode, Jewel; Vakharia, Kalpesh T

    2018-04-01

    Untreated auricular hematomas from ear trauma can result in an ear deformation known as cauliflower ear, secondary to fibrosis and new cartilage overgrowth. Cauliflower ear reconstruction has traditionally utilized tools such as a drill or a scalpel in order to improve auricular cosmesis. We present a case report utilizing an ultrasonic aspirator to recontour the fibrosed cartilage of a cauliflower ear. The ultrasonic aspirator has advantages over traditional tools in its ability to provide finely controlled bone removal without damage to surrounding soft tissue. The patient in this case report underwent multistage reconstruction using the ultrasonic aspirator with excellent cosmetic result and patient satisfaction.

  20. Clinical implications of magnetic resonance imaging in temporomandibular disorders patients presenting ear fullness.

    PubMed

    Lee, Sang Yeon; Park, Ji Woon; Park, Seo Eun; Nam, Dong Woo; Lim, Hyun Jung; Kim, Young Ho

    2017-12-14

    The aim of this study was to investigate whether findings detected by temporomandibular joint magnetic resonance imaging (TMJ-MRI) can provide pathognomonic evidence of temporomandibular disorders (TMD) in patients with nonspecific ear fullness (EF). The association of nonspecific EF with clinical characteristics of TMD based on TMJ-MRI findings was examined. Retrospective analysis. Thirty-four subjects (42 ears) who had no detectable otologic problems as a cause of EF were enrolled in this study. Each subject underwent TMJ-MRI to identify pathology of the TMJ as a possible cause of nonspecific EF. All subjects participated in the re-evaluation process following TMD treatment. Anatomical abnormalities in TMJ-MRI, irrespective of TMD signs, were observed in 34 of the 42 ears (80.9%), such as degenerative change of the TMJ (16 ears), articular disc displacement (11 ears), and joint effusion (seven ears). Specific abnormalities of the TMJ were associated with nonspecific EF, and this symptom showed improvement following individualized TMD treatment in those with internal derangement and/or effusion of the TMJ. However, abnormal TMJ-MRI findings were also observed in seven of nine ears with no TMD signs, and there was no significant association between the presence of TMD signs and abnormal TMJ-MRI findings (χ 2 = 0.075, P = .784). Patients presenting with nonspecific EF may have TMD, which can be effectively diagnosed using TMJ-MRI. The present study revealed the causal relationship between nonspecific EF and abnormal TMJ findings based on MRI. Individualized TMD treatments based on TMJ-MRI led to improved treatment outcomes with special regard to nonspecific EF LEVEL OF EVIDENCE: 4 Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  1. Evaluation of the protective effect of Botulinum toxin type A injection on otitis media with effusion.

    PubMed

    Çalım, Ömer Faruk; Yıldırım, Yavuz Selim; Doğan, Remzi; Tuğrul, Selhattin; Gedik, Özge; Özturan, Orhan

    2017-09-01

    This study makes an analysis of the effect of Botulinum toxin type A on otitis media with effusion in rats. As part of the study, 24 male Wistar Albino rats were divided into three groups: Group 1: Botulinum toxin Type A and Histamıne (intratympanic 0.2 ml = 20 unit BTA); Group 2: Saline and Histamine (intratympanic 0.2 ml 0.9%); Group 3: Histamine (intratympanic 0.2 ml). Histamine (intratympanic 0.2 ml) was administered into the right ear for all groups. DPOAE and ABR tests were carried out on days 5, 10, 15 and 20 from the beginning of the study. There was no significant difference between DPOAE and ABR scores of the groups. In each group, the DPOAE scores for the right ear significantly decreased on day 5 when compared to the basal scores. In each group, there was no significant difference between days 5, 10 and 15 for the right ear. Botulinum toxin type A blocked the secretion of glands in the middle ear and showed no effect to prevent the formation of serous otitis. In addition, it was found out that Botulinum toxin did not lead to any morphological change in the cochlea.

  2. Ear Infections - Multiple Languages

    MedlinePlus

    ... Cantonese dialect) (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Nepali (नेपाली) Russian (Русский) ... हिन्दी (Hindi) Bilingual PDF Health Information Translations Japanese (日本語) Expand Section Middle Ear Infection - 日本語 (Japanese) ...

  3. Clinical Importance of Angiogenic Cytokines, Fibrinolytic Activity and Effusion Size in Parapneumonic Effusions

    PubMed Central

    Chung, Chi-Li; Hsiao, Shih-Hsin; Hsiao, George; Sheu, Joen-Rong; Chen, Wei-Lin; Chang, Shi-Chuan

    2013-01-01

    Objective To investigate the relationship among angiogenic cytokines, fibrinolytic activity and effusion size in parapneumonic effusion (PPE) and their clinical importance. Methods From January 2008 through December 2010, 26 uncomplicated (UPPE) and 38 complicated (CPPE) PPE were studied. Based on chest ultrasonography, there were non-loculated in 30, uni-loculated in 12, and multi-loculated effusions in 22 patients. The effusion size radiological scores, and effusion vascular endothelial growth factor (VEGF), interleukin (IL)-8, plasminogen activator inhibitor type-1 (PAI-1) and tissue type plasminogen activator (tPA) were measured on admission. Treatment outcome and pleural fibrosis, defined as radiological residual pleural thickening (RPT), were assessed at 6-month follow-up. Results The effusion size and effusion VEGF, IL-8 and PAI-1/tPA ratio were significantly higher in CPPE than in UPPE, and significantly higher in multi-loculated PPE than in non-locualted and uni-loculated PPE, respectively. VEGF (cutoff value 1975 pg/ml) and IL-8 (cutoff value 1937 pg/ml) seemed best to discriminate between UPPE and CPPE. VEGF, IL-8 and effusion size correlated positively with PAI-1/tPA ratio in both UPPE and CPPE. Moreover, the level of VEGF, but not IL-8, correlated positively with effusion size in all patients (r = 0.79, p<0.001) and in UPPE (r = 0.64, p<0.001) and CPPE (r = 0.71, p<0.001) groups. The patients with higher VEGF or greater effusion were prone to have medical treatment failure (n = 10; VEGF, odds ratio 1.01, p = 0.02; effusion size, odds ratio 1.26, p = 0.01). Additionally, ten patients with RPT had larger effusion size and higher levels of VEGF and PAI-1/tPA ratio than did those without. Conclusions In PPE, VEGF and IL-8 levels are valuable to identify CPPE, and higher VEGF level or larger effusion is associated with decreased fibrinolytic activity, development of pleural loculation and fibrosis, and higher risk of medical

  4. Impact of Sulphurous Water Politzer Inhalation on Audiometric Parameters in Children with Otitis Media with Effusion

    PubMed Central

    Mirandola, Prisco; Gobbi, Giuliana; Malinverno, Chiara; Carubbi, Cecilia; Ferné, Filippo M.; Artico, Marco; Vitale, Marco

    2013-01-01

    Objectives The positive effects of spa therapy on ear, nose, and throat pathology are known but robust literature in this field, is still lacking. The aim of this study was to assess through a retrospective analysis, the effects on otitis media with effusion of Politzer endotympanic inhalation of sulphurous waters in children aged 5-9 years. Methods A cohort of 95 patients was treated with Politzer insufflations of sulphurous water: 58 patients did a cycle consisting of a treatment of 12 days per year for three consecutive years; 37 patients followed the same procedure for 5 years consecutively. The control population was represented by untreated, age-matched children. A standard audiometric test was used before and after each cycle of treatment. Results One cycle of Politzer inhalation of sulphur-rich water improved the symptoms. Three cycles definitively stabilized the improvement of hearing function. Conclusion Our results show that otitis media with effusion in children can be resolved by an appropriate non-pharmacological treatment of middle ear with sulphur-rich water. PMID:23524467

  5. Impact of sulphurous water politzer inhalation on audiometric parameters in children with otitis media with effusion.

    PubMed

    Mirandola, Prisco; Gobbi, Giuliana; Malinverno, Chiara; Carubbi, Cecilia; Ferné, Filippo M; Artico, Marco; Vitale, Marco; Vaccarezza, Mauro

    2013-03-01

    The positive effects of spa therapy on ear, nose, and throat pathology are known but robust literature in this field, is still lacking. The aim of this study was to assess through a retrospective analysis, the effects on otitis media with effusion of Politzer endotympanic inhalation of sulphurous waters in children aged 5-9 years. A cohort of 95 patients was treated with Politzer insufflations of sulphurous water: 58 patients did a cycle consisting of a treatment of 12 days per year for three consecutive years; 37 patients followed the same procedure for 5 years consecutively. The control population was represented by untreated, age-matched children. A standard audiometric test was used before and after each cycle of treatment. One cycle of Politzer inhalation of sulphur-rich water improved the symptoms. Three cycles definitively stabilized the improvement of hearing function. Our results show that otitis media with effusion in children can be resolved by an appropriate non-pharmacological treatment of middle ear with sulphur-rich water.

  6. Polygenicity and Epistasis Underlie Fitness-Proximal Traits in the Caenorhabditis elegans Multiparental Experimental Evolution (CeMEE) Panel.

    PubMed

    Noble, Luke M; Chelo, Ivo; Guzella, Thiago; Afonso, Bruno; Riccardi, David D; Ammerman, Patrick; Dayarian, Adel; Carvalho, Sara; Crist, Anna; Pino-Querido, Ania; Shraiman, Boris; Rockman, Matthew V; Teotónio, Henrique

    2017-12-01

    Understanding the genetic basis of complex traits remains a major challenge in biology. Polygenicity, phenotypic plasticity, and epistasis contribute to phenotypic variance in ways that are rarely clear. This uncertainty can be problematic for estimating heritability, for predicting individual phenotypes from genomic data, and for parameterizing models of phenotypic evolution. Here, we report an advanced recombinant inbred line (RIL) quantitative trait locus mapping panel for the hermaphroditic nematode Caenorhabditis elegans , the C. elegans multiparental experimental evolution (CeMEE) panel. The CeMEE panel, comprising 507 RILs at present, was created by hybridization of 16 wild isolates, experimental evolution for 140-190 generations, and inbreeding by selfing for 13-16 generations. The panel contains 22% of single-nucleotide polymorphisms known to segregate in natural populations, and complements existing C. elegans mapping resources by providing fine resolution and high nucleotide diversity across > 95% of the genome. We apply it to study the genetic basis of two fitness components, fertility and hermaphrodite body size at time of reproduction, with high broad-sense heritability in the CeMEE. While simulations show that we should detect common alleles with additive effects as small as 5%, at gene-level resolution, the genetic architectures of these traits do not feature such alleles. We instead find that a significant fraction of trait variance, approaching 40% for fertility, can be explained by sign epistasis with main effects below the detection limit. In congruence, phenotype prediction from genomic similarity, while generally poor ([Formula: see text]), requires modeling epistasis for optimal accuracy, with most variance attributed to the rapidly evolving chromosome arms. Copyright © 2017 by the Genetics Society of America.

  7. Polygenicity and Epistasis Underlie Fitness-Proximal Traits in the Caenorhabditis elegans Multiparental Experimental Evolution (CeMEE) Panel

    PubMed Central

    Noble, Luke M.; Chelo, Ivo; Guzella, Thiago; Afonso, Bruno; Riccardi, David D.; Ammerman, Patrick; Dayarian, Adel; Carvalho, Sara; Crist, Anna; Pino-Querido, Ania; Shraiman, Boris; Rockman, Matthew V.; Teotónio, Henrique

    2017-01-01

    Understanding the genetic basis of complex traits remains a major challenge in biology. Polygenicity, phenotypic plasticity, and epistasis contribute to phenotypic variance in ways that are rarely clear. This uncertainty can be problematic for estimating heritability, for predicting individual phenotypes from genomic data, and for parameterizing models of phenotypic evolution. Here, we report an advanced recombinant inbred line (RIL) quantitative trait locus mapping panel for the hermaphroditic nematode Caenorhabditis elegans, the C. elegans multiparental experimental evolution (CeMEE) panel. The CeMEE panel, comprising 507 RILs at present, was created by hybridization of 16 wild isolates, experimental evolution for 140–190 generations, and inbreeding by selfing for 13–16 generations. The panel contains 22% of single-nucleotide polymorphisms known to segregate in natural populations, and complements existing C. elegans mapping resources by providing fine resolution and high nucleotide diversity across > 95% of the genome. We apply it to study the genetic basis of two fitness components, fertility and hermaphrodite body size at time of reproduction, with high broad-sense heritability in the CeMEE. While simulations show that we should detect common alleles with additive effects as small as 5%, at gene-level resolution, the genetic architectures of these traits do not feature such alleles. We instead find that a significant fraction of trait variance, approaching 40% for fertility, can be explained by sign epistasis with main effects below the detection limit. In congruence, phenotype prediction from genomic similarity, while generally poor (r2<10%), requires modeling epistasis for optimal accuracy, with most variance attributed to the rapidly evolving chromosome arms. PMID:29066469

  8. Antibiotics for otitis media with effusion in children.

    PubMed

    van Zon, Alice; van der Heijden, Geert J; van Dongen, Thijs M A; Burton, Martin J; Schilder, Anne G M

    2012-09-12

    Otitis media with effusion (OME) is characterised by an accumulation of fluid in the middle ear behind an intact tympanic membrane, without the symptoms or signs of acute infection. In approximately one in three children with OME, however, a bacterial pathogen is identified in the middle ear fluid. In most cases, OME causes mild hearing impairment of short duration. When experienced in early life and when episodes of (bilateral) OME persist or recur, the associated hearing loss may be significant and have a negative impact on speech development and behaviour. Since most cases of OME will resolve spontaneously, only children with persistent middle ear effusion and associated hearing loss potentially require treatment. Previous Cochrane reviews have focused on the effectiveness of ventilation tube insertion, adenoidectomy, autoinflation, antihistamines, decongestants, and oral and topical intranasal steroids in OME. This review focuses on the effectiveness of antibiotics in children with OME. To assess the effects of antibiotics in children up to 18 years with OME. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the search was 22 February 2012. Randomised controlled trials comparing oral antibiotics with placebo, no treatment or therapy of unproven effectiveness. Our primary outcome was complete resolution of OME at two to three months. Secondary outcomes included resolution of OME at other time points, hearing, language and speech, ventilation tube insertion and adverse effects. Two authors independently extracted data using standardised data extraction forms and assessed the quality of the included studies using the Cochrane 'Risk of bias' tool. We presented dichotomous results as risk differences as well as

  9. Toxocariasis: An unusual cause of pleural effusion.

    PubMed

    Vallentin, Blandine; Carsin, Ania; Dubus, Jean-Christophe

    2015-10-01

    Toxocara canis, one of the most frequent parasites worldwide, rarely triggers respiratory symptoms. We report the case of a 5-year-old girl hospitalized for a unilateral eosinophilic pleural effusion due to Toxocara canis. Besides the fact that she was living in a squat, no other medical condition was reported. There was no other site of infection caused by the parasite and she was successfully treated with albendazole. This case report is obviously unique as very few cases of pleural effusion due to Toxocara canis are reported in literature, all in adult patients. © 2015 Wiley Periodicals, Inc.

  10. The ear: Diagnostic imaging

    SciTech Connect

    Vignaud, J.; Jardin, C.; Rosen, L.

    1986-01-01

    This is an English translation of volume 17-1 of Traite de radiodiagnostic and represents a reasonably complete documentation of the diseases of the temporal bone that have imaging manifestations. The book begins with chapters on embryology, anatomy and radiography anatomy; it continues with blood supply and an overview of temporal bone pathology. Subsequent chapters cover malformations, trauma, infections, tumors, postoperative changes, glomus tumors, vertebasilar insufficiency, and facial nerve canal lesions. A final chapter demonstrates and discusses magnetic resonance images of the ear and cerebellopontine angle.

  11. Lack of efficacy of a decongestant-antihistamine combination for otitis media with effusion ("secretory" otitis media) in children. Results of a double-blind, randomized trial.

    PubMed

    Cantekin, E I; Mandel, E M; Bluestone, C D; Rockette, H E; Paradise, J L; Stool, S E; Fria, T J; Rogers, K D

    1983-02-10

    In a double-blind, randomized trial of 553 infants and children who had otitis media with effusion ("secretory" otitis media), we compared the efficacy of a four-week course of an oral decongestant-antihistamine combination (pseudoephedrine hydrochloride, 4 mg per kilogram of body weight per day, and chlorpheniramine maleate, 0.35 mg per kilogram per day) with that of placebo. Among patients with initially unilateral disease, resolution of middle-ear effusion occurred at four weeks in 38 per cent of those treated with placebo and 34 per cent of those treated with drug (P = 0.74). Among patients with initially bilateral disease the corresponding proportions were 19 and 21 per cent, respectively (P = 0.67). Side effects were reported more often among drug-treated than placebo-treated patients. Decongestant-antihistamine combinations do not appear to be indicated for the treatment of otitis media with effusion in infants and children.

  12. Cilia distribution and polarity in the epithelial lining of the mouse middle ear cavity

    PubMed Central

    Luo, Wenwei; Yi, Hong; Taylor, Jeannette; Li, Jian-dong; Chi, Fanglu; Todd, N. Wendell; Lin, Xi; Ren, Dongdong; Chen, Ping

    2017-01-01

    The middle ear conducts sound to the cochlea for hearing. Otitis media (OM) is the most common illness in childhood. Moreover, chronic OM with effusion (COME) is the leading cause of conductive hearing loss. Clinically, COME is highly associated with Primary Ciliary Dyskinesia, implicating significant contributions of cilia dysfunction to COME. The understanding of middle ear cilia properties that are critical to OM susceptibility, however, is limited. Here, we confirmed the presence of a ciliated region near the Eustachian tube orifice at the ventral region of the middle ear cavity, consisting mostly of a lumen layer of multi-ciliated and a layer of Keratin-5-positive basal cells. We also found that the motile cilia are polarized coordinately and display a planar cell polarity. Surprisingly, we also found a region of multi-ciliated cells that line the posterior dorsal pole of the middle ear cavity which was previously thought to contain only non-ciliated cells. Our study provided a more complete understanding of cilia distribution and revealed for the first time coordinated polarity of cilia in the epithelium of the mammalian middle ear, thus illustrating novel structural features that are likely critical for middle ear functions and related to OM susceptibility. PMID:28358397

  13. Knee effusion after total knee replacement.

    PubMed Central

    Cameron, H. U.

    1993-01-01

    The various causes of effusions in artificial knees can be divided into four groups: implant related, technique related, interface problems, and infection. Diagnosis can be made from the patient's history and a clinical examination. Treatment is usually surgical revision. Images Figure 1 p1110-a Figure 5 Figure 6 Figure 7 PMID:8499791

  14. Effusion cytomorphology of small round cell tumors.

    PubMed

    Ikeda, Katsuhide; Tsuta, Koji

    2016-01-01

    Small round cell tumors (SRCTs) are a group of tumors composed of small, round, and uniform cells with high nuclear/cytoplasmic (N/C) ratios. The appearance of SRCT neoplastic cells in the effusion fluid is very rare. We reported the cytomorphological findings of SRCTs in effusion cytology, and performed statistical and mathematical analyses for a purpose to distinguish SRCTs. We analyzed the cytologic findings of effusion samples from 40 SRCT cases and measured the lengths of the nuclei, cytoplasms, and the cell cluster areas. The SRCT cases included 14 Ewing sarcoma (EWS)/primitive neuroectodermal tumor cases, 5 synovial sarcoma cases, 6 rhabdomyosarcoma cases, 9 small cell lung carcinoma (SCLC) cases, and 6 diffuse large B-cell lymphoma (DLBL) cases. Morphologically, there were no significant differences in the nuclear and cytoplasmic lengths in cases of EWS, synovial sarcoma, and rhabdomyosarcoma. The cytoplasmic lengths in cases of SCLC and DLBL were smaller than those of EWS, synovial sarcoma, and rhabdomyosarcoma. The nuclear density of the cluster in SCLC was higher than that in other SRCTs, and cases of DLBL showed a lack of anisokaryosis and anisocytosis. We believe that it might be possible to diagnose DLBL and SCLC from cytologic analysis of effusion samples but it is very difficult to use this method to distinguish EWS, synovial sarcoma, and rhabdomyosarcoma. Statistical and mathematical analyses indicated that nuclear density and dispersion of nuclear and cytoplasmic sizes are useful adjuncts to conventional cytologic diagnostic criteria, which are acquired from experience.

  15. Detection and mapping of trace explosives on surfaces under ambient conditions using multiphoton electron extraction spectroscopy (MEES).

    PubMed

    Tang, Shisong; Vinerot, Nataly; Fisher, Danny; Bulatov, Valery; Yavetz-Chen, Yehuda; Schechter, Israel

    2016-08-01

    Multiphoton electron extraction spectroscopy (MEES) is an analytical method in which UV laser pulses are utilized for extracting electrons from solid surfaces in multiphoton processes under ambient conditions. Counting the emitted electrons as a function of laser wavelength results in detailed spectral features, which can be used for material identification. The method has been applied to detection of trace explosives on a variety of surfaces. Detection was possible on dusty swabs spiked with explosives and also in the standard dry-transfer contamination procedure. Plastic explosives could also be detected. The analytical limits of detection (LODs) are in the sub pmole range, which indicates that MEES is one of the most sensitive detection methods for solid surface under ambient conditions. Scanning the surface with the laser allows for its imaging, such that explosives (as well as other materials) can be located. The imaging mode is also useful in forensic applications, such as detection of explosives in human fingerprints. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Viability and virulence of pneumolysin, pneumococcal surface protein A, and pneumolysin/pneumococcal surface protein A mutants in the ear.

    PubMed

    Schachern, Patricia A; Tsuprun, Vladimir; Goetz, Sarah; Cureoglu, Sebahattin; Juhn, Steven K; Briles, David E; Paparella, Michael M; Ferrieri, Patricia

    2013-09-01

    Understanding how pneumococcal proteins affect the pathology of the middle ear and inner ear is important for the development of new approaches to prevent otitis media and its complications. To determine the viability and virulence of Streptococcus pneumoniae mutants deficient in pneumolysin (Ply-) and pneumococcal surface protein A (PspA-) in the chinchilla middle ear. Bullae of chinchillas were inoculated bilaterally with wild-type (Wt), Ply-, PspA-, and Ply-/PspA- strains. Bacterial colony-forming units (CFUs) in middle ear effusions were counted at 48 hours. The CFUs of the PspA- group were also counted at 6 to 36 hours after inoculation. Temporal bone histopathological results were compared. Twenty-seven chinchillas in an academic research laboratory. Chinchilla middle ears were inoculated with S pneumoniae to produce sufficient volumes of effusions and noticeable histopathological changes in the ears. The CFU counts in the middle ear effusions and histopathological changes were compared to determine the effect of pneumococcal protein mutations on chinchilla ears. At 48 hours, CFUs in middle ears were increased for the Wt and Ply-/PspA- strains, but Ply- remained near inoculum level. No bacteria were detected in the PspA- group. The CFUs of PspA- decreased over time to a low level at 30 to 36 hours. In vitro, PspA- in Todd-Hewitt broth showed an increase in bacterial growth of 2 logs at 43 hours, indicating PspA- susceptibility to host defenses in vivo. The PspA- and Ply- groups had fewer pathologic findings than the Wt or Ply-/PspA- groups. Histopathological analysis showed significant differences in the number of bacteria in the scala tympani in the Wt group compared with the Ply-, PspA-, and Ply-/PspA- groups. The PspA- strain was the least virulent. The PspA- mutant was much less viable and less virulent in the ear than the Wt, Ply-, and Ply-/PspA- strains. There was no significant attenuation in the viability and virulence of the Ply-/PspA- mutant

  17. Surgical correction of cauliflower ear.

    PubMed

    Yotsuyanagi, T; Yamashita, K; Urushidate, S; Yokoi, K; Sawada, Y; Miyazaki, S

    2002-07-01

    We have classified the cauliflower ear into different types according to the zone and the degree of deformity. One major group is deformity without change in the outline of the ear, and this is divided into four subgroups according to the zone. All of these subgroups can be treated by shaving the deformed cartilage through suitable incision lines. For deformities accompanied by a skin deficit, a postauricular skin flap should be used. The other major group is deformity accompanied by a change in the outline of the ear, which is divided into two subgroups. If the ear is rigid, a conchal cartilage graft is used. If the structural integrity of the ear is poor, costal cartilage is used to provide rigidity.

  18. [Sarcoidosis related pleural effusion: 6 case reports and literatures review].

    PubMed

    Wang, Feng; Tong, Zhaohui; Wang, Zhen; Wang, Xiaojuan; Xu, Lili

    2015-02-01

    To summarize the clinical features and the diagnosis-treatment points of sarcoidosis related pleural effusion. Six typical sarcoidosis related pleural effusion cases with pathological evidence were reviewed, and the clinical data of these cases were retrospectively analyzed and the related literatures were reviewed. The literature review was carried out respectively with "sarcoidosis", "pleural disease" and "pleural effusion" as the keywords in CNKI and PubMed database by January 2014. Six cases, including 1 male and 5 females, with sarcoidosis related pleural effusions were reported. 3 cases had bilateral effusions, 2 cases had left effusion and 1 case had right effusion. The pleural effusion routine test had a low specificity, which demonstrated that the fluid was exudate and consisted with large number of lymphocytes. 3 of these cases were diagnosed by medical thoracoscopy. Medical thoracoscopy revealed that pleural involvement was variable with multiple nodulespresent in some cases and subtle change in others. A total of 28 literatures and 92 cases with pleural involvement in sarcoidosis were retrieved from CNKI and PubMed database (time range: 2004.1-2014.1), including 59 cases of pleural effusion, 29 cases of pleural thickening, 3 cases of pneumothorax and 1 case of nodules in pleura. Pleural involvement in sarcoidosis was often misdiagnosed or mistreated as tuberculous pleurisy because the routine tests regarding pleural effusion usually had a low specificity. Medical thoracoscopy could provide clinicians with important clues to assist differentiation of the cause for non-conclusive pleural effusion in this situation.

  19. Profiling pleural effusion cells by a diffraction imaging method

    NASA Astrophysics Data System (ADS)

    Al-Qaysi, Safaa; Hong, Heng; Wen, Yuhua; Lu, Jun Q.; Feng, Yuanming; Hu, Xin-Hua

    2018-02-01

    Assay of cells in pleural effusion (PE) is an important means of disease diagnosis. Conventional cytology of effusion samples, however, has low sensitivity and depends heavily on the expertise of cytopathologists. We applied a polarization diffraction imaging flow cytometry method on effusion cells to investigate their features. Diffraction imaging of the PE cell samples has been performed on 6000 to 12000 cells for each effusion cell sample of three patients. After prescreening to remove images by cellular debris and aggregated non-cellular particles, the image textures were extracted with a gray level co-occurrence matrix (GLCM) algorithm. The distribution of the imaged cells in the GLCM parameters space was analyzed by a Gaussian Mixture Model (GMM) to determine the number of clusters among the effusion cells. These results yield insight on textural features of diffraction images and related cellular morphology in effusion samples and can be used toward the development of a label-free method for effusion cells assay.

  20. Sinuclean Nebules treatment in children suffering from otitis media with effusion.

    PubMed

    Varricchio, A; De Lucia, A; Varricchio, A M; Della Volpe, A; Mansi, N; Pastore, V; Ciprandi, G

    2017-03-01

    Otitis media with effusion (OME) is an ear disorder defined by the presence of fluid in the middle ear without signs or symptoms of acute infection. The current randomized, double-blind, controlled study aimed to evaluate whether Sinuclean Nebules treatment, administered by nasal douche (Rinowash), could induce ear healing better than isotonic saline in children with OME. The study was randomized, double-blind, and controlled. Group A (30 children) was treated with Sinuclean Nebules 45 and Group B (31 children) was treated with isotonic saline; both compounds were administered by nasal nebulization with Rinowash nasal douche twice/day in the morning and in the evening for 10 days, followed by a one-week suspension, and after by a second course as the first. Tympanogram and audiometry were performed at baseline and after treatment. Considering the global evaluation of the treatment: in Group A, 28 (93.3%) patients had complete resolution and 2 (6.7%) had partial resolution; in Group B, all patients had failure of treatment. There was a significant difference between groups (p < 0.0001). The current randomized-controlled study demonstrated that Sinuclean Nebules was effective and in the treatment of children with OME. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Pinna abnormalities and low-set ears

    MedlinePlus

    ... Pinna abnormalities; Genetic defect - pinna; Congenital defect - pinna Images Ear abnormalities Pinna of the newborn ear References Haddad J, Keesecker S. Congenital malformations. In: Kliegman RM, Stanton BF, ...

  2. Anomalies of the middle and inner ear.

    PubMed

    Rodriguez, Kimsey; Shah, Rahul K; Kenna, Margaret

    2007-02-01

    The development of the middle and inner ear highlights the intricacy of embryology. As early as 3 weeks after fertilization, the inner ear begins taking form. This process, along with development of the middle ear, continues throughout gestation. At birth, the middle ear, inner ear, and associated structures are almost adult size. An understanding of the embryologic development of the ear serves as a foundation for evaluating and managing congenital malformations of these structures. The focus of this article is the normal, abnormal, and arrested development of the middle and inner ear, with a clinical emphasis on malformed middle and inner ear structures and a discussion of associated syndromes.

  3. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children.

    PubMed

    Browning, George G; Rovers, Maroeska M; Williamson, Ian; Lous, Jørgen; Burton, Martin J

    2010-10-06

    Otitis media with effusion (OME; 'glue ear') is common in childhood and surgical treatment with grommets (ventilation tubes) is widespread but controversial. To assess the effectiveness of grommet insertion compared with myringotomy or non-surgical treatment in children with OME. We searched the Cochrane ENT Disorders Group Trials Register, other electronic databases and additional sources for published and unpublished trials (most recent search: 22 March 2010). Randomised controlled trials evaluating the effect of grommets. Outcomes studied included hearing level, duration of middle ear effusion, language and speech development, cognitive development, behaviour and adverse effects. Data from studies were extracted by two authors and checked by the other authors. We included 10 trials (1728 participants). Some trials randomised children (grommets versus no grommets), others ears (grommet one ear only). The severity of OME in children varied between trials. Only one 'by child' study (MRC: TARGET) had particularly stringent audiometric entry criteria. No trial was identified that used long-term grommets.Grommets were mainly beneficial in the first six months by which time natural resolution lead to improved hearing in the non-surgically treated children also. Only one high quality trial that randomised children (N = 211) reported results at three months; the mean hearing level was 12 dB better (95% CI 10 to 14 dB) in those treated with grommets as compared to the controls. Meta-analyses of three high quality trials (N = 523) showed a benefit of 4 dB (95% CI 2 to 6 dB) at six to nine months. At 12 and 18 months follow up no differences in mean hearing levels were found.Data from three trials that randomised ears (N = 230 ears) showed similar effects to the trials that randomised children. At four to six months mean hearing level was 10 dB better in the grommet ear (95% CI 5 to 16 dB), and at 7 to 12 months and 18 to 24 months was 6 dB (95% CI 2 to 10 dB) and 5 d

  4. Association of microRNA 146 with middle ear hyperplasia in pediatric otitis media.

    PubMed

    Samuels, Tina L; Yan, Justin; Khampang, Pawjai; MacKinnon, Alexander; Hong, Wenzhou; Johnston, Nikki; Kerschner, Joseph E

    2016-09-01

    Toll-like receptor signaling activated by bacterial otitis media pathogens in the middle ear has been shown to play a key role in OM susceptibility, pathogenesis and recovery. Recent studies implicate microRNA 146 (miR-146) in regulation of inflammation via negative feedback of toll-like receptor signaling (TLR) in a wide variety of tissues, however its involvement in otitis media is unknown. Human middle ear epithelial cells were stimulated with proinflammatory cytokines, interleukin 1 beta or tumor necrosis factor alpha, for two to twenty-four hours. Middle ear biopsies were collected from children with otitis media with effusion (n = 20), recurrent otitis media (n = 9), and control subjects undergoing cochlear implantation (n = 10). miR-146a, miR-146b expression was assayed by quantitative PCR (qPCR). Expression of miR-146 targets involved in TLR signaling, IRAK1 and TRAF6, was assayed by qPCR in middle ear biopsies. Middle ear biopsies were cryosectioned and epithelial thickness measured by a certified pathologist. Proinflammatory cytokines induced expression of miR-146 in middle ear epithelial cells in vitro. Middle ear miR-146a and miR-146b expression was elevated in otitis media patients relative to control subjects and correlated with middle ear epithelial thickness. A trend towards inverse correlation was observed between miR-146 and TRAF6 expression in the clinical population. This report is the first to assess miRNA expression in a clinical population with OM. Findings herein suggest miR-146 may play a role in OM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Factors Affecting Loss of Tympanic Membrane Mobility in Acute Otitis Media Model of Chinchilla

    PubMed Central

    Guan, Xiying; Chen, Yongzheng; Gan, Rong Z.

    2014-01-01

    Recently we reported that middle ear pressure (MEP), middle ear effusion (MEE), and ossicular changes each contribute to the loss of tympanic membrane (TM) mobility in a guinea pig model of acute otitis media (AOM) induced by S. pneumoniae (Guan and Gan, 2013). However, it is not clear how those factors vary along the course of the disease and whether those effects are reproducible in different species. In this study, a chinchilla AOM model was produced by transbullar injection of Haemophilus influenzae. Mobility of the TM at the umbo was measured by laser vibrometry in two treatment groups: 4 days (4D) and 8 days (8D) post inoculation. These time points represent relatively early and later phases of AOM. In each group, the vibration of the umbo was measured at three experimental stages: unopened, pressure-released, and effusion-removed ears. The effects of MEP and MEE and middle ear structural changes were quantified in each group by comparing the TM mobility at one stage with that of the previous stage. Our findings show that the factors affecting TM mobility do change with the disease time course. The MEP was the dominant contributor to reduction of TM mobility in 4D AOM ears, but showed little effect in 8D ears when MEE filled the tympanic cavity. MEE was the primary factor affecting TM mobility loss in 8D ears, but affected the 4D ears only at high frequencies. After the release of MEP and removal of MEE, residual loss of TM mobility was seen mainly at low frequencies in both 4D and 8D ears, and was associated with middle ear structural changes. Our findings establish that the factors contributing to TM mobility loss in the chinchilla ear were similar to those we reported previously for the guinea pig ears with AOM. Outcomes did not appear to differ between the two major bacterial species causing AOM in these animal models. PMID:24406734

  6. The effect of caffeic acid phenethyl ester and thymoquinone on otitis media with effusion in rats.

    PubMed

    Gülmez, Mehmet İhsan; Okuyucu, Şemsettin; Dokuyucu, Recep; Gökçe, Hasan

    2017-05-01

    In this study, we aimed to investigate the effect of CAPE and thymoquinone in experimental rat otitis media with effusion (OME) model. Intraoral approach of eustachian tube orifice cauterization were administered to 36 of 40 rats participating the study. After application of exclusion criterias, 22 rats with appropriate conditions were determined. Totally 26 rats (44 otitis model ears and 8 normal ears) were randomly divided into 5 groups. While group I was consisted of healthy rats, the other groups were consisted of rats with otitis model. Group I (saline + control group; n = 8 normal ears) and group II (saline + otitis model; n = 10 otitis model ears) received intraperitoneally saline solution. CAPE was given intraperitoneally to group III (CAPE + otitis model; n = 12 otitis model ears) at a concentration of 10 mg/kg for treatment of otitis media. Group IV (thymoquinone + otitis model; n = 12 otitis model ears) was treated orally with 10 mg/kg of thymoquinone. Group V (methylprednisolone + otitis model; n = 10 otitis model ears) was treated intraperitoneally with 1 mg/kg of methylprednisolone. Tympanic bulla samples were excised after 10th day of treatment and examined under light microscopy. Submucosal neutrophil leukocyte count of group I was significantly lower than other groups (II, IV, V) (respectively p < 0,0001, p < 0,001, p < 0,0001, Tukey test), while it was not significantly different from group III (p = 0,056, Tukey test). Submucosal neutrophil leukocyte count of group III was significantly lower than group II and group V (p = 0.029 ve p = 0.03, Tukey test). There was no significant difference between group IV and group V (p = 0,28, Tukey test). Based on these findings, it could be suggested that CAPE, anti inflammatory properties proven in the literature, plays an important role in OME treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Polycystic liver disease with right pleural effusion

    NASA Astrophysics Data System (ADS)

    Anggreini, A. Y.; Dairi, L. B.

    2018-03-01

    Polycystic liver disease (PCLD) is a condition in which multiple cysts form in the hepatic parenchyma. The polycystic liver disease is also an autosomal dominant disorder (ADPLD) caused by a mutation in a gene that encodes a protein hepatocystin. PCLD has a prevalence count of 1:200,000 people in the people of America. PCLD occurs ± 24% of patients in the third decade of age to 80% by the sixth decade. Women tend to get larger cysts and more and correlated with the number of pregnancies. The following case report of a woman, 51-years-old who was treated at Haji Adam Malik hospital Medan with a diagnosis of polycystic liver disease with right pleural effusion. Some literature has reported complications of the polycystic liver disease but rarely reported with pleural effusion presentation. The patient had already undergone a puncture of pleural fluid and after three weeks of treatment condition of the patient improved and permitted to be outgoing patient.

  8. Impact of Staphylococcus epidermidis lysates on middle ear epithelial proinflammatory and mucogenic response.

    PubMed

    Val, Stéphanie; Mubeen, Humaira; Tomney, Amarel; Chen, Saisai; Preciado, Diego

    2015-02-01

    Chronic otitis media with effusion (COME) develops after sustained inflammation and is characterized by secretory middle ear epithelial metaplasia and effusion, most frequently mucoid. Staphylococcus epidermidis, typically considered a commensal organism, is very frequently recovered in chronic middle ear fluid and in middle ear biofilms. Although it has been shown to drive inflammation in sinonasal epithelium, the impact of S. epidermidis on COME is markedly understudied. The goal of this study was to examine the in vitro effects of S. epidermidis lysates on murine and human middle ear epithelial cells. Staphylococcus epidermidis lysates were generated and used to stimulate submerged and differentiated human and murine epithelial cells (MEECs) for 24 to 48 hours. Quantitative real time-polymerase chain reaction, Western blot, enzyme-linked immunosorbent assay, and immunocytochemistry techniques were performed to interrogate the mucin gene MUC5AC and MUC5B expression and protein production, chemokine response, as well as NF-κB activation. Luciferase reporter assays were performed to further evaluate nuclear factor κB (NF-κB) activation and query specific promoter responses after S. epidermidis exposure. Staphylococcus epidermidis induced a time- and dose-dependent MUC5AC and MUC5B overexpression along with a parallel overexpression of Cxcl2 in mouse MEEC and IL-8 in human MEEC. Further investigations in mMEEC showed a 1.3 to 1.5 induction of the MUC5AC and MUC5B promoters. As potential mechanisms for these responses, induction of an oxidative stress marker, along with early nuclear translocation and activation of NF-κB, was found. Finally, chronic exposure induced marked epithelial thickening of cells differentiated at the air liquid interface. Staphylococcus epidermidis lysates activate a proinflammatory response in MEEC, including mucin gene expression and protein production. Although typically considered a nonpathogenic commensal organism in the ear, these

  9. Clinical Relevance of Pleural Effusion in Patients with Pulmonary Embolism.

    PubMed

    Choi, Sun Ha; Cha, Seung-Ick; Shin, Kyung-Min; Lim, Jae-Kwang; Yoo, Seung-Soo; Lee, Shin-Yup; Lee, Jaehee; Kim, Chang-Ho; Park, Jae-Yong; Lee, Deok Heon

    2017-01-01

    Data regarding pleural effusion due to pulmonary embolism (PE) are limited. The aim of this study was to investigate the clinical characteristics of PE patients with pleural effusion caused by PE. Patients with PE were retrospectively analyzed and divided into 2 groups based on computed tomography: a group with pleural effusion due to PE (effusion group) and a group without pleural effusion (control group). Clinical characteristics were compared between the 2 groups. The study population consisted of the effusion group (n = 127) and the control group (n = 651). Serum C-reactive protein (CRP) level was significantly higher in the effusion group than in the control group. The percentages of high-risk Simplified PE Severity Index (57 vs. 47%, p = 0.008), central PE (84 vs. 73%, p = 0.013), right ventricular dilation (45 vs. 36%, p = 0.053), and pulmonary infarction (40 vs. 8%, p < 0.001) were higher in the effusion group than in the control group. Multivariate analysis demonstrated that pulmonary infarction (odds ratio [OR] 6.20, 95% confidence interval [CI] 3.49-10.91, p < 0.001) and CRP level (OR 1.05, 95% CI 1.101-1.09, p = 0.023) were independent predictors of pleural effusion due to PE. The presence of pleural effusion was not a predictor of short-term outcomes or length of hospital stay. Patients with more severe PE are likely to have pleural effusion caused by PE. However, pleural effusion was not a proven predictor of short-term outcome or length of hospital stay. Pulmonary infarction and CRP levels were independent risk factors for the development of pleural effusion. © 2017 S. Karger AG, Basel.

  10. Chemical pleurodesis for malignant pleural effusions.

    PubMed

    Walker-Renard, P B; Vaughan, L M; Sahn, S A

    1994-01-01

    To provide information about available agents for chemical pleurodesis. A MEDLINE search (1966 to October 1992) was conducted using the terms malignant pleural effusion and pleurodesis. All articles containing references to patients with recurrent, symptomatic, malignant pleural effusions treated with chemical pleurodesis were selected and reviewed for pleurodesis regimen, number of patients treated, success rate (complete response), and adverse effects. The agents studied included doxycycline, minocycline, tetracycline, bleomycin, cisplatin, doxorubicin, etoposide, fluorouracil, interferon-beta, mitomycin-c, Corynebacterium parvum, methylprednisolone, and talc. Independent extraction by three observers. Studies including a total of 1168 patients with malignant pleural effusions were reviewed for efficacy of the pleurodesis agent and studies including 1140 patients were reviewed for toxicity. Chemical pleurodesis produced a complete response in 752 (64%) of 1168 patients. The success rate of the pleurodesis agents varied from 0% with etoposide to 93% with talc. Corynebacterium parvum, the tetracyclines, and bleomycin had success rates of 76%, 67%, and 54%, respectively. The most commonly reported adverse effects were pain (265 of 1140, 23%) and fever (220 of 1140, 19%). Doxycycline and minocycline, with success rates of 72% and 86%, respectively, appear to be effective tetracycline-replacement agents in the few patients studied. Talc appears to be the most effective and least expensive agent; however, insufflation has the disadvantages of the expense of thoracoscopy and the usual need for general anesthesia. Bleomycin appears to be less effective than talc and the tetracyclines and is substantially more expensive.

  11. [Interdisciplinary Cooperation as a Characteristic of Successful Rehabilitation Facilities--Results from the Project MeeR].

    PubMed

    Kleineke, V; Stamer, M; Zeisberger, M; Brandes, I; Meyer, T

    2015-08-01

    To determine if there is a difference between successful and less successful rehabilitation facilities concerning their extent and quality of interdisciplinary cooperation? This analysis is part of the project MeeR, that aims to identify characteristics of rehabilitation facilities related to successful rehabilitation. 6 facilities were recruited based on a quantitative analysis; 3 facilities that ranked as above average and 3 as below average in terms of their success in rehabilitating patients. Comprehensive qualitative data were collected on these 6 facilities. In above average rehabilitation facilities, the extent of interdisciplinary cooperation was higher than in below average facilities; the position of the medical profession was less dominant and there was a wider access to team meetings. Promotion of interdisciplinary cooperation is an important component for the improvement of the success of rehabilitation facilities. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Penicillin treatment accelerates middle ear inflammation in experimental pneumococcal otitis media.

    PubMed Central

    Kawana, M; Kawana, C; Giebink, G S

    1992-01-01

    Most Streptococcus pneumoniae strains are killed by very low concentrations of penicillin and other beta-lactam antibiotics, yet middle ear inflammation and effusion persist for days to weeks after treatment in most cases of pneumococcal otitis media. To study the effect of beta-lactam antibiotic treatment on pneumococci and the middle ear inflammatory response during pneumococcal otitis media, we measured concentrations of pneumococci, inflammatory cells, and lysozyme in middle ear fluid (MEF) by using the chinchilla model. Procaine penicillin G given intramuscularly 12 and 36 h after inoculation of pneumococci into the middle ear caused a significant acceleration in the MEF inflammatory cell concentration compared with that in untreated controls, with a significant peak in the inflammatory cell concentration 24 h after pneumococcal inoculation. The lysozyme concentration in MEF also increased more rapidly in treated than in control animals. Viable pneumococci were not detected in MEF after the second dose of penicillin, but the total pneumococcal cell concentration remained unchanged for at least 45 days. Therefore, penicillin treatment accelerated middle ear inflammation while killing pneumococci, but treatment did not accelerate clearance of the nonviable pneumococcal cells from MEF. Further studies will need to define the contribution of these responses to acute and chronic tissue injury. PMID:1563782

  13. Classification of Newborn Ear Malformations and their Treatment with the EarWell Infant Ear Correction System.

    PubMed

    Daniali, Lily N; Rezzadeh, Kameron; Shell, Cheryl; Trovato, Matthew; Ha, Richard; Byrd, H Steve

    2017-03-01

    A single practice's treatment protocol and outcomes following molding therapy on newborn ear deformations and malformations with the EarWell Infant Ear Correction System were reviewed. A classification system for grading the severity of constricted ear malformations was created on the basis of anatomical findings. A retrospective chart/photograph review of a consecutive series of infants treated with the EarWell System from 2011 to 2014 was undertaken. The infants were placed in either deformation or malformation groups. Three classes of malformation were identified. Data regarding treatment induction, duration of treatment, and quality of outcome were collected for all study patients. One hundred seventy-five infant ear malformations and 303 infant ear deformities were treated with the EarWell System. The average age at initiation of treatment was 12 days; the mean duration of treatment was 37 days. An average of six office visits was required. Treated malformations included constricted ears [172 ears (98 percent)] and cryptotia [three ears (2 percent)]. Cup ear (34 ears) was considered a constricted malformation, in contrast to the prominent ear deformity. Constricted ears were assigned to one of three classes, with each subsequent class indicating increasing severity: class I, 77 ears (45 percent); class II, 81 ears (47 percent); and class III, 14 ears (8 percent). Molding therapy with the EarWell System reduced the severity by an average of 1.2 points (p < 0.01). Complications included minor superficial excoriations and abrasions. The EarWell System was shown to be effective in eliminating or reducing the need for surgery in all but the most severe malformations. Therapeutic, IV.

  14. Ototoxicity (Ear Poisoning) (For Parents)

    MedlinePlus

    ... never change the dose or stop giving your child a medicine without talking to your doctor first. Reviewed by: Robert C. ... Hearing Loss? Can Loud Music Hurt My Ears? Going to the Audiologist Hearing ...

  15. Principles of endoscopic ear surgery.

    PubMed

    Tarabichi, Muaaz; Kapadia, Mustafa

    2016-10-01

    The aim of this review is to study the rationale, limitations, techniques, and long-term outcomes of endoscopic ear surgery. The article discusses the advantages of endoscopic ear surgery in treating cholesteatoma and how the hidden sites like facial recess, sinus tympani, and anterior epitympanum are easily accessed using the endoscope. Transcanal endoscopic approach allows minimally invasive removal of cholesteatoma with results that compare well to traditional postauricular tympanomastoidectomy.

  16. Surgical correction of constricted ear combined with Stahl's ear.

    PubMed

    Bi, Ye; Lin, Lin; Yang, Qinhua; Pan, Bo; Zhao, Yanyong; He, Leren; Jiang, Haiyue

    2015-07-01

    Constricted ear combined with Stahl's ear is a rare ear deformity, which is a kind of complex congenital auricular deformity. From 1 January 2007 to 1 January 2014, 19 patients with constricted ear combined with Stahl's ear (Spock ear) were enrolled in this study, most of which were unilaterally deformed. To correct the deformity, a double Z-shaped skin incision was made on the posterior side of the auricle, with the entire layer of cartilage cut parallel to the helix traversing the third crus to form a fan-shaped cartilage flap. The superior crura of the antihelix were shaped by the folding cartilage rim. The cartilage of the abnormal third crus was made part of the new superior crura of antihelix, and the third crus was eliminated. The postoperative aesthetic assessment of the reshaped auricle was graded by both doctors and patients (or their parents). Out of the 19 patients, the number of satisfying cases of the symmetry, helix stretch, elimination of the third crus, the cranioauricular angle, and the substructure of the reshaped ears was 14 (nine excellent and five good), 16 (six excellent and 10 good), 17 (eight excellent and nine good), 15 (five excellent and 10 good), and 13 (two excellent and 11 good), respectively. With a maximum of a 90-month follow-up, no complication was observed. The results of the study suggested that this rare deformity could be corrected by appropriate surgical treatment, with a satisfied postoperative appearance. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Primary tuberculosis of the eustachian tube causing otitis media with effusion.

    PubMed

    Oh, Se-Joon; Yi, Keun-Ik; Lee, Chang-Hoon; Cho, Kyu-Sup

    2015-01-01

    Eustachian tube (ET) dysfunction may cause pathological changes in the middle ear, including recurrent acute otitis media and otitis media with effusion (OME). Mechanical obstruction of the ET may be caused by primary tumor-like lesions arising from ET or secondary ET infiltration due to nasopharyngeal and parapharyngeal space tumor. Tuberculosis is known to affect almost every organ in the body, and it should be a concern of each and every medical practitioner. However, tuberculosis of the ET has not been reported in the literature previously. This article reports primary tuberculosis arising in the ET that presented as aural fullness and hearing disturbance in a patient with OME. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Otitis Media with Effusion: Its Significance in the Deaf Student.

    DTIC Science & Technology

    1982-06-01

    Otitis media with effusion currently ranks as the most common cause of hearing loss in children of preschool and school age. Otitis media with...makes the difference between usable auditory input and useless noise. The etiology of otitis media with effusion is uncertain. Its educational...paper explores the extent of otitis media with effusion, its effects, what methods are available for detection, current and future methods of medical

  19. Proteomic study of benign and malignant pleural effusion.

    PubMed

    Li, Hongqing; Tang, Zhonghao; Zhu, Huili; Ge, Haiyan; Cui, Shilei; Jiang, Weiping

    2016-06-01

    Lung adenocarcinoma can easily cause malignant pleural effusion which was difficult to discriminate from benign pleural effusion. Now there was no biomarker with high sensitivity and specificity for the malignant pleural effusion. This study used proteomics technology to acquire and analyze the protein profiles of the benign and malignant pleural effusion, to seek useful protein biomarkers with diagnostic value and to establish the diagnostic model. We chose the weak cationic-exchanger magnetic bead (WCX-MB) to purify peptides in the pleural effusion, used matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) to obtain peptide expression profiles from the benign and malignant pleural effusion samples, established and validated the diagnostic model through a genetic algorithm (GA) and finally identified the most promising protein biomarker. A GA diagnostic model was established with spectra of 3930.9 and 2942.8 m/z in the training set including 25 malignant pleural effusion and 26 benign pleural effusion samples, yielding both 100 % sensitivity and 100 % specificity. The accuracy of diagnostic prediction was validated in the independent testing set with 58 malignant pleural effusion and 34 benign pleural effusion samples. Blind evaluation was as follows: the sensitivity was 89.6 %, specificity 88.2 %, PPV 92.8 %, NPV 83.3 % and accuracy 89.1 % in the independent testing set. The most promising peptide biomarker was identified successfully: Isoform 1 of caspase recruitment domain-containing protein 9 (CARD9), with 3930.9 m/z, was decreased in the malignant pleural effusion. This model is suitable to discriminate benign and malignant pleural effusion and CARD9 can be used as a new peptide biomarker.

  20. VEGF correlates with inflammation and fibrosis in tuberculous pleural effusion.

    PubMed

    Bien, Mauo-Ying; Wu, Ming-Ping; Chen, Wei-Lin; Chung, Chi-Li

    2015-01-01

    To investigate the relationship among angiogenic cytokines, inflammatory markers, and fibrinolytic activity in tuberculous pleural effusion (TBPE) and their clinical importance. Forty-two patients diagnosed with TBPE were studied. Based on chest ultrasonography, there were 26 loculated and 16 nonloculated TBPE patients. The effusion size radiological scores and effusion vascular endothelial growth factor (VEGF), interleukin- (IL-) 8, plasminogen activator inhibitor type-1 (PAI-1), and tissue type plasminogen activator (tPA) were measured. Treatment outcome and pleural fibrosis, defined as radiological residual pleural thickening (RPT), were assessed at 6-month follow-up. The effusion size and effusion lactate dehydrogenase (LDH), VEGF, IL-8, PAI-1, and PAI-1/tPA ratio were significantly higher, while effusion glucose, pH value, and tPA were significantly lower, in loculated than in nonloculated TBPE. VEGF and IL-8 correlated positively with LDH and PAI-1/tPA ratio and negatively with tPA in both loculated and nonloculated TBPE. Patients with higher VEGF or greater effusion size were prone to develop RPT (n=14; VEGF, odds ratio 1.28, P=0.01; effusion size, odds ratio 1.01, P=0.02), and VEGF was an independent predictor of RPT in TBPE (receiver operating characteristic curve AUC=0.985, P<0.001). Effusion VEGF correlates with pleural inflammation and fibrosis and may be targeted for adjunct therapy for TBPE.

  1. VEGF Correlates with Inflammation and Fibrosis in Tuberculous Pleural Effusion

    PubMed Central

    Bien, Mauo-Ying; Wu, Ming-Ping; Chen, Wei-Lin; Chung, Chi-Li

    2015-01-01

    Objective. To investigate the relationship among angiogenic cytokines, inflammatory markers, and fibrinolytic activity in tuberculous pleural effusion (TBPE) and their clinical importance. Methods. Forty-two patients diagnosed with TBPE were studied. Based on chest ultrasonography, there were 26 loculated and 16 nonloculated TBPE patients. The effusion size radiological scores and effusion vascular endothelial growth factor (VEGF), interleukin- (IL-) 8, plasminogen activator inhibitor type-1 (PAI-1), and tissue type plasminogen activator (tPA) were measured. Treatment outcome and pleural fibrosis, defined as radiological residual pleural thickening (RPT), were assessed at 6-month follow-up. Results. The effusion size and effusion lactate dehydrogenase (LDH), VEGF, IL-8, PAI-1, and PAI-1/tPA ratio were significantly higher, while effusion glucose, pH value, and tPA were significantly lower, in loculated than in nonloculated TBPE. VEGF and IL-8 correlated positively with LDH and PAI-1/tPA ratio and negatively with tPA in both loculated and nonloculated TBPE. Patients with higher VEGF or greater effusion size were prone to develop RPT (n = 14; VEGF, odds ratio 1.28, P = 0.01; effusion size, odds ratio 1.01, P = 0.02), and VEGF was an independent predictor of RPT in TBPE (receiver operating characteristic curve AUC = 0.985, P < 0.001). Conclusions. Effusion VEGF correlates with pleural inflammation and fibrosis and may be targeted for adjunct therapy for TBPE. PMID:25884029

  2. Validation of equations for pleural effusion volume estimation by ultrasonography.

    PubMed

    Hassan, Maged; Rizk, Rana; Essam, Hatem; Abouelnour, Ahmed

    2017-12-01

    To validate the accuracy of previously published equations that estimate pleural effusion volume using ultrasonography. Only equations using simple measurements were tested. Three measurements were taken at the posterior axillary line for each case with effusion: lateral height of effusion ( H ), distance between collapsed lung and chest wall ( C ) and distance between lung and diaphragm ( D ). Cases whose effusion was aspirated to dryness were included and drained volume was recorded. Intra-class correlation coefficient (ICC) was used to determine the predictive accuracy of five equations against the actual volume of aspirated effusion. 46 cases with effusion were included. The most accurate equation in predicting effusion volume was ( H  +  D ) × 70 (ICC 0.83). The simplest and yet accurate equation was H  × 100 (ICC 0.79). Pleural effusion height measured by ultrasonography gives a reasonable estimate of effusion volume. Incorporating distance between lung base and diaphragm into estimation improves accuracy from 79% with the first method to 83% with the latter.

  3. Evaluation of pleural and pericardial effusions by magnetic resonance imaging.

    PubMed

    Tscholakoff, D; Sechtem, U; de Geer, G; Schmidt, H; Higgins, C B

    1987-08-01

    MR examinations of 36 patients with pleural and/or pericardial effusions were retrospectively evaluated. The purpose of this study was to determine of MR imaging is capable of differentiating between pleural and pericardial effusions of different compositions using standard electrocardiogram (ECG)-gated and non-gated spin echo pulse sequences. Additional data was obtained from experimental pleural effusions in 10 dogs. The results of this study indicate that old hemorrhages into the pleural or pericardial space can be differentiated from other pleural or pericardial effusions. However, further differentiation between transudates, exudates and sanguinous effusions is not possible on MR images acquired with standard spin echo pulse sequences. Respiratory and cardiac motion are responsible for signal loss, particularly on first echo images. This was documented in experiments in dogs with induced effusions of known composition; "negative" T2 values consistent with fluid motion during imaging sequences were observed in 80% of cases. However, postmortem studies of the dogs with experimental effusions showed differences between effusions with low protein concentrations and higher protein concentrations. We conclude from our study that characterization of pleural and pericardial effusions on standard ECG-gated and non-gated MR examinations is limited to the positive identification of hemorrhage. Motion of the fluid due to cardiac and respiratory activity causes artifactual and unpredictable changes in intensity values negating the more subtle differences in intensity associated with increasing protein content.

  4. Pleural effusion segmentation in thin-slice CT

    NASA Astrophysics Data System (ADS)

    Donohue, Rory; Shearer, Andrew; Bruzzi, John; Khosa, Huma

    2009-02-01

    A pleural effusion is excess fluid that collects in the pleural cavity, the fluid-filled space that surrounds the lungs. Surplus amounts of such fluid can impair breathing by limiting the expansion of the lungs during inhalation. Measuring the fluid volume is indicative of the effectiveness of any treatment but, due to the similarity to surround regions, fragments of collapsed lung present and topological changes; accurate quantification of the effusion volume is a difficult imaging problem. A novel code is presented which performs conditional region growth to accurately segment the effusion shape across a dataset. We demonstrate the applicability of our technique in the segmentation of pleural effusion and pulmonary masses.

  5. Prevertebral space effusion caused by the breaking of swollen lymphonodi retropharynici in nasopharyngeal carcinoma: A case report.

    PubMed

    Liu, Lian-Hua; Yang, Xiao-Feng

    2016-06-01

    A 20-year-old male presented to hospital with blood in the mucus, which had occurred for 6 months, and was diagnosed with nasopharyngeal carcinoma (NPC). Due to passive smoking, the patient developed a constant and violent cough, pain behind the right ear and swelling of the retropharynx. The results of a computed tomography scan, which was performed during re-examination of the patient, revealed that the right lymphonodi retropharynici had decreased in size and the hypodense shadow of the prevertebral space had become clear. Therefore, the retropharyngeal pressure was suspected to be increased due to the violent cough. Consequently, the increased pressure may have caused the swollen lymph nodes on the right side of the pharynx to break, which allowed the necrotic liquid to seep into the prevertebral space and result in effusion. Subsequent to 5 days of treatment with methylprednisolone (40 mg ivgtt qd, d1-5), the results from the cone bean computed tomography examination, which had been performed prior to radiotherapy, indicated that the retropharyngeal swelling had improved and the prevertebral space had returned to normal. To the best of our knowledge, the present study is the first reported case of effusion in the prevertebral space caused by the breaking of swollen lymphonodi retropharynici in NPC. The present study acts as a reminder of the possible delays in the treatments for head and neck tumor patients that demonstrate swollen retropharyngeal lymph nodes due to the occurrence of effusion in the prevertebral space.

  6. Symptomatic pericardial effusion after chemoradiation therapy in esophageal cancer patients.

    PubMed

    Fukada, Junichi; Shigematsu, Naoyuki; Takeuchi, Hiroya; Ohashi, Toshio; Saikawa, Yoshiro; Takaishi, Hiromasa; Hanada, Takashi; Shiraishi, Yutaka; Kitagawa, Yuko; Fukuda, Keiichi

    2013-11-01

    We investigated clinical and treatment-related factors as predictors of symptomatic pericardial effusion in esophageal cancer patients after concurrent chemoradiation therapy. We reviewed 214 consecutive primary esophageal cancer patients treated with concurrent chemoradiation therapy between 2001 and 2010 in our institute. Pericardial effusion was detected on follow-up computed tomography. Symptomatic effusion was defined as effusion ≥grade 3 according to Common Terminology Criteria for Adverse Events v4.0 criteria. Percent volume irradiated with 5 to 65 Gy (V5-V65) and mean dose to the pericardium were evaluated employing dose-volume histograms. To evaluate dosimetry for patients treated with two-dimensional planning in the earlier period (2001-2005), computed tomography data at diagnosis were transferred to a treatment planning system to reconstruct three-dimensional plans without modification. Optimal dosimetric thresholds for symptomatic pericardial effusion were calculated by receiver operating characteristic curves. Associating clinical and treatment-related risk factors for symptomatic pericardial effusion were detected by univariate and multivariate analyses. The median follow-up was 29 (range, 6-121) months for eligible 167 patients. Symptomatic pericardial effusion was observed in 14 (8.4%) patients. Dosimetric analyses revealed average values of V30 to V45 for the pericardium and mean pericardial doses were significantly higher in patients with symptomatic pericardial effusion than in those with asymptomatic pericardial effusion (P<.05). Pericardial V5 to V55 and mean pericardial doses were significantly higher in patients with symptomatic pericardial effusion than in those without pericardial effusion (P<.001). Mean pericardial doses of 36.5 Gy and V45 of 58% were selected as optimal cutoff values for predicting symptomatic pericardial effusion. Multivariate analysis identified mean pericardial dose as the strongest risk factor for symptomatic

  7. Large pericardial effusion induced by minoxidil.

    PubMed

    Çilingiroğlu, Mehmet; Akkuş, Nuri; Sethi, Salil; Modi, Kalgi A

    2012-04-01

    A 53-year-old male admitted with increased shortness of breath. In the physical examination, he had dyspnea, tachycardia and tachypnea. An echocardiogram showed large pericardial effusion (PE) as well as significant pulmonary hypertension. He had been started recently on minoxidil for blood pressure control. PE was reported to occur with minoxidil treatment both in patients undergoing dialysis and those with normal renal function. Pulmonary hypertension has been reported to affect the cardiac tamponade physiology. Because of significant pulmonary hypertension in our patient, a right heart catheterization was also done, which prevented cardiac tamponade. He was treated conservatively without any intervention, and PE resolved spontaneously after discontinuation of minoxidil.

  8. Prognostic impact of pleural effusion in acute pulmonary embolism.

    PubMed

    Kiris, Tuncay; Yazıcı, Selçuk; Koc, Ali; Köprülü, Cinar; Ilke Akyildiz, Zehra; Karaca, Mustafa; Nazli, Cem; Dogan, Abdullah

    2017-07-01

    Background Pulmonary embolism (PE) is a common and life-threatening condition associated with considerable morbidity and mortality. Pleural effusion occurs in about one in three cases; however, data on its prognostic value are scarce. Purpose To investigate the association between pleural effusion and both 30-day and long-term mortality in patients with acute PE. Material and Methods We retrospectively evaluated 463 patients diagnosed with acute PE using computed tomography pulmonary angiography (CTPA). Echocardiographic, demographic, and laboratory data were collected. The study population was divided into two groups: patients with and without pleural effusions. Pleural effusion detected on CT was graded as small, moderate, and large according to the amount of effusion. The predictors of 30-day and long-term total mortality were analyzed. Results Pleural effusions were found in 120 patients (25.9%). After the 30-day follow-up, all-cause mortality was higher in acute PE patients with pleural effusions than in those without (23% versus 9%, P < 0.001). Also, patients with pleural effusions had significantly higher incidence of long-term total mortality than those without pleural effusions (55% versus 23%, P < 0.001). In a multivariate analysis, pleural effusion was an independent predictor of 30-day and long-term mortality (odds ratio [OR], 2.154; 95% confidence interval [CI], 1.186-3.913; P = 0.012 and OR, 1.591; 95% CI, 1.129-2.243; P = 0.008, respectively). Conclusion Pleural effusion can be independently associated with both 30-day and long-term mortality in patients with acute PE.

  9. 3D Printed Bionic Ears

    PubMed Central

    Mannoor, Manu S.; Jiang, Ziwen; James, Teena; Kong, Yong Lin; Malatesta, Karen A.; Soboyejo, Winston O.; Verma, Naveen; Gracias, David H.; McAlpine, Michael C.

    2013-01-01

    The ability to three-dimensionally interweave biological tissue with functional electronics could enable the creation of bionic organs possessing enhanced functionalities over their human counterparts. Conventional electronic devices are inherently two-dimensional, preventing seamless multidimensional integration with synthetic biology, as the processes and materials are very different. Here, we present a novel strategy for overcoming these difficulties via additive manufacturing of biological cells with structural and nanoparticle derived electronic elements. As a proof of concept, we generated a bionic ear via 3D printing of a cell-seeded hydrogel matrix in the precise anatomic geometry of a human ear, along with an intertwined conducting polymer consisting of infused silver nanoparticles. This allowed for in vitro culturing of cartilage tissue around an inductive coil antenna in the ear, which subsequently enables readout of inductively-coupled signals from cochlea-shaped electrodes. The printed ear exhibits enhanced auditory sensing for radio frequency reception, and complementary left and right ears can listen to stereo audio music. Overall, our approach suggests a means to intricately merge biologic and nanoelectronic functionalities via 3D printing. PMID:23635097

  10. 3D printed bionic ears.

    PubMed

    Mannoor, Manu S; Jiang, Ziwen; James, Teena; Kong, Yong Lin; Malatesta, Karen A; Soboyejo, Winston O; Verma, Naveen; Gracias, David H; McAlpine, Michael C

    2013-06-12

    The ability to three-dimensionally interweave biological tissue with functional electronics could enable the creation of bionic organs possessing enhanced functionalities over their human counterparts. Conventional electronic devices are inherently two-dimensional, preventing seamless multidimensional integration with synthetic biology, as the processes and materials are very different. Here, we present a novel strategy for overcoming these difficulties via additive manufacturing of biological cells with structural and nanoparticle derived electronic elements. As a proof of concept, we generated a bionic ear via 3D printing of a cell-seeded hydrogel matrix in the anatomic geometry of a human ear, along with an intertwined conducting polymer consisting of infused silver nanoparticles. This allowed for in vitro culturing of cartilage tissue around an inductive coil antenna in the ear, which subsequently enables readout of inductively-coupled signals from cochlea-shaped electrodes. The printed ear exhibits enhanced auditory sensing for radio frequency reception, and complementary left and right ears can listen to stereo audio music. Overall, our approach suggests a means to intricately merge biologic and nanoelectronic functionalities via 3D printing.

  11. 3D finite element model of the chinchilla ear for characterizing middle ear functions

    PubMed Central

    Wang, Xuelin; Gan, Rong Z.

    2016-01-01

    Chinchilla is a commonly used animal model for research of sound transmission through the ear. Experimental measurements of the middle ear transfer function in chinchillas have shown that the middle ear cavity greatly affects the tympanic membrane (TM) and stapes footplate (FP) displacements. However, there is no finite element (FE) model of the chinchilla ear available in the literature to characterize the middle ear functions with the anatomical features of the chinchilla ear. This paper reports a recently completed 3D FE model of the chinchilla ear based on X-ray micro-computed tomography images of a chinchilla bulla. The model consisted of the ear canal, TM, middle ear ossicles and suspensory ligaments, and the middle ear cavity. Two boundary conditions of the middle ear cavity wall were simulated in the model as the rigid structure and the partially flexible surface, and the acoustic-mechanical coupled analysis was conducted with these two conditions to characterize the middle ear function. The model results were compared with experimental measurements reported in the literature including the TM and FP displacements and the middle ear input admittance in chinchilla ear. An application of this model was presented to identify the acoustic role of the middle ear septa - a unique feature of chinchilla middle ear cavity. This study provides the first 3D FE model of the chinchilla ear for characterizing the middle ear functions through the acoustic-mechanical coupled FE analysis. PMID:26785845

  12. Predictive Factors and Treatment Outcomes of Tuberculous Pleural Effusion in Patients With Cancer and Pleural Effusion.

    PubMed

    Lee, Jaehee; Lee, Yong Dae; Lim, Jae Kwang; Lee, Deok Heon; Yoo, Seung Soo; Lee, Shin Yup; Cha, Seung Ick; Park, Jae Yong; Kim, Chang Ho

    2017-08-01

    Patients with cancer are at an increased risk of tuberculosis. As pleural effusion has great clinical significance in patients with cancer, the differential diagnosis between tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) is important. However, the predictive factors and treatment outcomes of TPE in patients with cancer have rarely been studied. Confirmed TPE cases identified at cancer diagnosis and during anticancer management from 2008-2015 were retrospectively investigated. Patients in the study included coexisting TPE and cancer (n = 20), MPE (n = 40) and TPE without cancer (n = 40). Control groups were patients with MPE, and patients with TPE without cancer. Clinical, laboratory and pleural fluid characteristics were compared among groups. Treatment outcomes were compared between patients with TPE with and without cancer. In the final analysis, serum C-reactive protein (S-CRP) ≥3.0mg/dL and pleural fluid adenosine deaminase (ADA) ≥40U/L were independent predictors for identifying TPE in patients with cancer having pleural effusion. The combination of S-CRP with pleural fluid ADA using an "or" rule achieved a sensitivity of 100%, whereas both parameters combined in an "and" rule had a specificity of 98%. Treatment outcomes were not different between the TPE groups with and without cancer. S-CRP and pleural fluid ADA levels may be helpful for predicting TPE in patients with cancer with pleural effusion. The combination of these biomarkers provides better information for distinguishing between TPE and MPE in these patients. Treatment outcomes of TPE in patients with cancer are comparable to those in patients without cancer. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  13. Unclassified congenital deformities of the external ear.

    PubMed

    Vathulya, Madhubari

    2018-01-01

    Congenital ear deformities are a common entity. They are found in isolation or as a part of syndrome in patients. They may involve the external, middle or inner ear or in any of these combinations. Three patients of different ages presented with deformities including mirror image duplication of the superior auricle, unclassified deformities of ear lobule (wavy lobule) and deformity of superior auricle with unclassified variety of lateral ear pit. This article highlights that there are further cases of ear deformities that are noticed in the general population who come for cosmetic correction, and hence, there is a need for further modifying the classification of ear deformities.

  14. Learning to perform ear reconstruction.

    PubMed

    Wilkes, Gordon H

    2009-08-01

    Learning how to perform ear reconstruction is very difficult. There are no standardized teaching methods. This has resulted in many ear reconstructions being suboptimal. Learning requires a major commitment by the surgeon. Factors to be seriously considered by those considering performing this surgery are (1) commitment, (2) aptitude, (3) training methods available, (4) surgical skills and experience, and (5) additional equipment needs. Unless all these factors are addressed in a surgeon's decision to perform this form of reconstruction, the end result will be compromised, and patient care will not be optimized. It is hoped that considering these factors and following this approach will result in a higher quality of aesthetic result. The future of ear reconstruction lies in the use of advanced digital technologies and tissue engineering. Copyright Thieme Medical Publishers.

  15. [Surgical procedures in 156 cases of pleural effusion. Immediate results].

    PubMed

    Cicero-Sabido, Raúl; Páramo-Arroyo, Rafael F; Navarro-Reynoso, Francisco Pascual; Pimentel-Ugarte, Lorenzo

    2006-01-01

    Pleural effusion is a common clinical entity. Proper diagnosis and management are important for successful treatment. We undertook this study to evaluate immediate results of the procedures used in a group of cases with pleural effusion. Of 2589 patients at first consultation, 787 were hospitalized and 156 had pleural effusion. Diagnostic and therapeutic procedures used were evaluated. With thoracentesis and evacuation of liquid, 23 nonneoplastic cases had resolution. Chest tube drainage with water seal was performed in 133 patients. This procedure suppressed the effusion in 109 patients, but in 24 patients another approach was necessary. In this group there were 35 neoplastic and 96 nonmalignant cases, the latter 36 were provoked by iatrogenic management. Twenty two cases of pneumothorax considered as gaseous effusion and 10 cases of chronic empyema sequelae of pleural effusions were also studied. Proportion comparison demonstrated significant differences between neoplastic and nonneoplastic effusions (p =0.001) and in cases managed with minimally invasive procedures and chest tube drainage (p =0.001). The performance of pleurodesis and thoracoscopy is discussed. In chronic cases, indications of open window thoracostomy and myoplasty are elucidated. In pleural effusion, opportune diagnosis and proper management are essential. Drainage tube can solve the majority of cases. Pneumothorax must be treated in the same way. In chronic empyema, open window thoracostomy and myoplasty are indicated. Careless patient management and poor treatment lead to iatrogenic complications.

  16. A case of young woman with recurrent right pleural effusion.

    PubMed

    Mehta, Asmita A; Gupta, Amit; Venkitakrishnan, Rajesh

    2015-01-01

    Endomterisois is usually found in women of child-bearing age. A case is presented of massive right-sided pleural effusion caused by endometriosis. The final diagnosis was made by thoracoscopic pleural biopsy. Physicians should be aware of this potentially treatable cause of pleural effusion having excluded other possibilities such as malignancy and tuberculosis.

  17. Pregnancy with bilateral tubercular pleural effusion: challenges.

    PubMed

    Ahuja, Vanita; Gombar, Satinder; Kumar, Navneet; Goyal, Nitika; Gupta, Kanika

    2014-04-01

    Pulmonary tuberculosis (TB) during pregnancy mimics some of the physiological changes that occur during pregnancy. Diagnosis is challenging, especially when the patient presents with acute respiratory distress. The incidence of pleural effusion in TB is 3-25% and in the majority of patients, is unilateral. We describe the intensive care management of a 27-year-old pregnant woman admitted to our hospital with life threatening respiratory distress and circulatory shock. She continued to have severe metabolic and respiratory acidosis with shock in spite of the resuscitative measures undertaken. At that point, a bedside lung ultrasonography showed bilateral pleural effusion which was followed with therapeutic thoracocentesis of the right side. This resulted in the stabilization of the respiratory mechanics and haemodynamics of the patient. The pleural fluid culture tested positive for acid fast bacilli after 4 weeks in the intensive care unit. Anti-TB therapy was started and she made a rapid recovery with liberation from mechanical ventilation. The early use of bedside lung ultrasonography was instrumental in the successful management of this patient.

  18. [Current treatment strategy in malignant pleural effusion].

    PubMed

    Türler, A; Walter, M; Schmitz-Rixen, T

    1996-01-01

    Malignant pleural effusions are a grave consequence of advanced cancer disease. The successful suppression of pleural fluid reaccumulation can make a major contribution to the management and palliative care of patients with disseminated cancer. Many treatment concepts have been reported in the literature. The recommended therapy in malignant pleural effusions consists of intrapleural instillation of a sclerotic agent to produce pleurodesis. Different substances have been used, including tetracyclines, cytostatic agents, fibrin, talc, Corynebacterium parvum, cytokines and others. We reviewed the most frequently used techniques of pleurodesis in order to define the most effective treatment concept. In 15 prospective randomized trials the success rates varied from 13% with bleomycin to 100% with talc or Corynebacterium parvum. Talc was superior to other agents in 6 of 6, Corynebacterium parvum in 3 of 4 and bleomycin or tetracycline only in 3 of 8 studies. Adverse effects were frequently observed with cytostatic agents, but were very rare in the case of talc or fibrin instillation. Comparing the recently published data pleurodesis with talc appears to be the most effective treatment strategy, followed by Corynebacterium parvum, bleomycin and tetracycline.

  19. Massive pericardial effusion associated with hypothyroidism.

    PubMed

    Ionescu, Simona Daniela; Tănase, Daniela Maria; Ouatu, Anca; Ambăruş, V; Dosa, Anca; Arsenescu-Georgescu, Cătălina

    2014-01-01

    The diagnosis of hypothyroidism is difficult because hypothyroidism in adults and especially the elderly, classic, has an insidious onset with a range of nonspecific symptoms which may delay diagnosis for months or even years. Old age seems to represent trigger factor for autoimmune diseases, including hypothyroidism. Clinical features in hypothyroidism, such as weight gain, fatigue, cold intolerance, constipation, dry skin, edema and muscle weakness, and decreased osteo-tendinous reflexes are usually subtle and can be overlooked. Thyroid dysfunction may be associated with a negative impact on the cardiovascular system. Pericardial, pleural and peritoneal effusions are common findings in hypothyroidism. This case report represents a typical primary hypothyroidism (autoimmune) and shows the clinical features of this disease. Basically we talked about a severe myxedema with the involvement of internal organs in an elderly woman and the euthyroidism restoration, under thyroid replacement therapy, was correlated with the clinical improvement and cardiovascular and neurological status, with radiographic remission and regression to extinction of pericardial effusion at repeated echocardiographic evaluations.

  20. Infectious pleural effusion status and treatment progress

    PubMed Central

    Yang, Wei; Zhang, Ze-Ming

    2017-01-01

    Pleural cavity infection continuously seriously threatens human health with continuous medical progress. From the perspective of pathophysiology, it can be divided into three stages: exudative stage, fibrin exudation and pus formation stage, and organization stage. Due to the pathogenic bacteria difference of pleural cavity infection and pulmonary infection, it is very important for disease treatment to analyze the bacteria and biochemical characteristics of the infectious pleural effusion. Most prognoses of patients have been relatively good, while for some patients, the complicated parapneumonic effusion or empyema could be evolved. Antibiotic treatment and sufficient drainage are the foundation for this treatment. No evidence can support the routine use of a fibrin agent. However, it has been reported that the plasminogen activator and deoxyribonuclease can be recommended to be applied in the pleural cavity. In case of failure on conservative medical treatment, operative treatment can be applied such as thoracoscopy and pleural decortication. According to the clinical characteristics of these patients, it is a key to research prognosis, as well as early evaluation and stratification, in the future. PMID:29268539

  1. [Eosinophilic pleural effusion possibly induced by fibrin sealant].

    PubMed

    Kambayashi, Takatoyo; Suzuki, Takashi

    2012-02-01

    A 74-year-old man underwent right upper lobectomy for the lung cancer and bullectomy of right lower lobe. Fibrin sealant was used for sealing the excision line. The increase of the pleural effusion with increasing C-reactive protein( CRP) and eosinophilia was noted at the 17th day after the operation. The pleural effusion was transparent and yellowish colored suggesting transudatory liquid. The eosinophil in the pleural effusion was as high as 14%. The drainage of the pleural effusion was performed for 2 days resulting in disappearing the abnormal accumulation without any additional treatment. The cause of pleural effusion was supposed to be fibrin sealant by a positive result of the drug lymphocyte stimulation test.

  2. Inner Ear Drug Delivery for Auditory Applications

    PubMed Central

    Swan, Erin E. Leary; Mescher, Mark J.; Sewell, William F.; Tao, Sarah L.; Borenstein, Jeffrey T.

    2008-01-01

    Many inner ear disorders cannot be adequately treated by systemic drug delivery. A blood-cochlear barrier exists, similar physiologically to the blood-brain barrier, which limits the concentration and size of molecules able to leave the circulation and gain access to the cells of the inner ear. However, research in novel therapeutics and delivery systems has led to significant progress in the development of local methods of drug delivery to the inner ear. Intratympanic approaches, which deliver therapeutics to the middle ear, rely on permeation through tissue for access to the structures of the inner ear, whereas intracochlear methods are able to directly insert drugs into the inner ear. Innovative drug delivery systems to treat various inner ear ailments such as ototoxicity, sudden sensorineural hearing loss, autoimmune inner ear disease, and for preserving neurons and regenerating sensory cells are being explored. PMID:18848590

  3. Middle ear infection (otitis media) (image)

    MedlinePlus

    Otitis media is an inflammation or infection of the middle ear. Acute otitis media (acute ear infection) occurs when there is ... which causes production of fluid or pus. Chronic otitis media occurs when the eustachian tube becomes blocked ...

  4. Physiological functioning of the ear and masking

    NASA Technical Reports Server (NTRS)

    1984-01-01

    The physiological functions of the ear and the role masking plays in speech communication are examined. Topics under investigation include sound analysis of the ear, the aural reflex, and various types of noise masking.

  5. Quality of questionnaires for the assessment of otitis media with effusion in children.

    PubMed

    Gan, R W C; Daniel, M; Ridley, M; Barry, J G

    2018-04-01

    Audiometric tests provide information about hearing in otitis media with effusion (OME). Questionnaires can supplement this information by supporting clinical history-taking as well as potentially providing a standardized and comprehensive assessment of the impact of the disease on a child. There are many possible candidate questionnaires. This study aimed to assess the quality and usability of parent / child questionnaires in OME assessment. Fifteen, published questionnaires, commonly used in audiological departments (Auditory Behaviour in Everyday Life (ABEL), Children's Auditory Performance Scale (CHAPS), Children's Home Inventory for Listening Difficulties (CHILD), Children's Outcome Worksheets (COW), Evaluation of Children's Listening and Processing Skills (ECLiPS), Early Listening Function (ELF), Fisher's Auditory Problem Checklist (FAPC), Hearing Loss 7 (HL-7), Listening Inventory for Education- Revised (LIFE-R Student), Listening Inventory for Education UK Individual Hearing Profile (LIFE-UK IHP), LittlEARS Auditory Questionnaire (LittlEARS), Listening Situations Questionnaire (LSQ), Otitis Media 6 (OM-6), Quality of Life in Children's Ear Problems (OMQ-14), Parents' Evaluation of Aural/Oral Performance of Children (PEACH) were assessed according to the following 8 criteria: conceptual clarity, respondent burden, reliability, validity, normative data, item bias, ceiling/ floor effects, and administrative burden. ECLiPS, LittlEARS and PEACH scored highest overall based on the assessment criteria established for this study. None of the questionnaires fully satisfied all 8 criteria. Although all questionnaires assessed issues considered to be of at least adequate relevance to OME, the majority had weaknesses with respect to the assessment of psychometric properties, such as item bias, floor/ceiling effects or measurement reliability and validity. Publications reporting on the evaluation of reliability, validity, normative data, item bias and ceiling

  6. 21 CFR 870.2710 - Ear oximeter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear oximeter. 870.2710 Section 870.2710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2710 Ear oximeter. (a) Identification. An ear...

  7. Immunologic Disorders of the Inner Ear.

    ERIC Educational Resources Information Center

    Kinney, William C.; Hughes, Gordon B.

    1997-01-01

    Immune inner ear disease represents a series of immune system mediated problems that can present with hearing loss, dizziness, or both. The etiology, presentation, testing, and treatment of primary immune inner ear disease is discussed. A review of secondary immune inner ear disease is presented for comparison. (Contains references.) (Author/CR)

  8. 21 CFR 870.2710 - Ear oximeter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ear oximeter. 870.2710 Section 870.2710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2710 Ear oximeter. (a) Identification. An ear...

  9. Treating "cauliflower ear" with silicone mold.

    PubMed

    Gross, C G

    1978-01-01

    Acute hematoma of the ear (cauliflower ear) can be satisfactorily treated with aspiration and the use of the silicone mold to prevent reaccumulation of the blood or serum in the ear. Advantages of the silicone mold over other dressings appears to be ease of application, patient acceptance, and prevention of reoccurrence of reaccumulation of the hematoma.

  10. Can Loud Music Hurt My Ears?

    MedlinePlus

    ... Videos for Educators Search English Español Can Loud Music Hurt My Ears? KidsHealth / For Kids / Can Loud Music Hurt My Ears? Print en español La música ... up? Oh! You want to know if loud music can hurt your ears . Are you asking because ...

  11. Mutant KRAS promotes malignant pleural effusion formation

    PubMed Central

    Αgalioti, Theodora; Giannou, Anastasios D.; Krontira, Anthi C.; Kanellakis, Nikolaos I.; Kati, Danai; Vreka, Malamati; Pepe, Mario; Spella, Μagda; Lilis, Ioannis; Zazara, Dimitra E.; Nikolouli, Eirini; Spiropoulou, Nikolitsa; Papadakis, Andreas; Papadia, Konstantina; Voulgaridis, Apostolos; Harokopos, Vaggelis; Stamou, Panagiota; Meiners, Silke; Eickelberg, Oliver; Snyder, Linda A.; Antimisiaris, Sophia G.; Kardamakis, Dimitrios; Psallidas, Ioannis; Μarazioti, Antonia; Stathopoulos, Georgios T.

    2017-01-01

    Malignant pleural effusion (MPE) is the lethal consequence of various human cancers metastatic to the pleural cavity. However, the mechanisms responsible for the development of MPE are still obscure. Here we show that mutant KRAS is important for MPE induction in mice. Pleural disseminated, mutant KRAS bearing tumour cells upregulate and systemically release chemokine ligand 2 (CCL2) into the bloodstream to mobilize myeloid cells from the host bone marrow to the pleural space via the spleen. These cells promote MPE formation, as indicated by splenectomy and splenocyte restoration experiments. In addition, KRAS mutations are frequently detected in human MPE and cell lines isolated thereof, but are often lost during automated analyses, as indicated by manual versus automated examination of Sanger sequencing traces. Finally, the novel KRAS inhibitor deltarasin and a monoclonal antibody directed against CCL2 are equally effective against an experimental mouse model of MPE, a result that holds promise for future efficient therapies against the human condition. PMID:28508873

  12. Quantification of pleural effusion on CT by simple measurement.

    PubMed

    Hazlinger, Martin; Ctvrtlik, Filip; Langova, Katerina; Herman, Miroslav

    2014-01-01

    To find the simplest method for quantifying pleural effusion volume from CT scans. Seventy pleural effusions found on chest CT examination in 50 consecutive adult patients with the presence of free pleural effusion were included. The volume of pleural effusion was calculated from a three-dimensional reconstruction of CT scans. Planar measurements were made on CT scans and their two-dimensional reconstructions in the sagittal plane and at three levels on transversal scans. Individual planar measurements were statistically compared with the detected volume of pleural effusion. Regression equations, averaged absolute difference between observed and predicted values and determination coefficients were found for all measurements and their combinations. A tabular expression of the best single planar measurement was created. The most accurate correlation between the volume and a single planar measurement was found in the dimension measured perpendicular to the parietal pleura on transversal scan with the greatest depth of effusion. Conversion of this measurement to the appropriate volume is possible by regression equation: Volume = 0.365 × b(3) - 4.529 × b(2) + 159.723 × b - 88.377. We devised a simple method of conversion of a single planar measurement on CT scan to the volume of pleural effusion. The tabular expression of our equation can be easily and effectively used in routine practice.

  13. Long-term Outcome of Patients With Undiagnosed Pleural Effusion.

    PubMed

    Gunluoglu, Gulsah; Olcmen, Aysun; Gunluoglu, Mehmet Zeki; Dincer, Ibrahim; Sayar, Adnan; Camsari, Gungor; Yilmaz, Veysel; Altin, Sedat

    2015-12-01

    The cause of exudative pleural effusion cannot be determined in some patients. The longterm outcomes of patients with undiagnosed pleural effusion were analyzed. Patients with exudative pleural effusion whose diagnostic procedures included pleural biopsy using video-assisted thoracoscopic surgery carried out between 2008 and 2012 were evaluated retrospectively. Patients diagnosed with non-specific pleuritis were included. Fifty-three patients with available follow-up data were included in the study. Forty men and 13 women (mean age 53.9±13.9 years) were included. Median follow-up time was 24 months. No diagnosis was given in 27 patients (51%), and a clinical diagnosis was given in 26 patients (49%) during the follow-up period. Malignant disease (malignant mesothelioma) was diagnosed in 2 (3.7%) patients. Other diseases were parapneumonic effusion in 12, congestive heart failure in 8, and miscellaneous in 4 patients. Volume of effusion at the time of initial examination and re-accumulation of fluid after video-assisted thoracoscopic surgery were associated with malignant disease (P=.004 and .0001, respectively). Although the probability is low, some patients with exudative pleural effusion undiagnosed after pleural biopsy via video-assisted thoracoscopic surgery may have malignant disease. Patients with an initially large volume of effusion that re-accumulates after examination should be closely monitored. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  14. Endoscopic ultrasound-guided transesophageal thoracentesis for minimal pleural effusion.

    PubMed

    Rana, Surinder Singh; Sharma, Ravi; Gupta, Rajesh

    2018-06-19

    Pleural effusion is a common finding both in patients with benign and malignant diseases of pleura and lung with diagnostic thoracentesis establishing the diagnosis in the majority of cases. The diagnostic thoracentesis can be done either blindly or under the guidance of ultrasound or computed tomography. However, minimal pleural effusion is difficult to sample even under image guidance. Endoscopic ultrasound (EUS) is known to detect smaller volume of pleural effusion and, thus, can help in guiding thoracentesis. To analyze the safety and efficacy of EUS-guided diagnostic thoracentesis in patients with undiagnosed minimal pleural effusion retrospectively. Retrospective analysis of the data of patients with minimal pleural effusion, who underwent EUS-guided transesophageal diagnostic thoracentesis over last 2 years, was performed. Thirteen patients (11 male; mean age 46.7 ± 16.2 years) with undiagnosed minimal pleural effusion underwent successful EUS-guided transesophageal diagnostic thoracentesis using a 22-G needle. Seven (53%) patients had fever on presentation whereas two presented with cough and loss of appetite. Eight to 54 mL fluid was aspirated with an attempt to completely empty the pleural cavity. There were no complications of the procedure. EUS-guided diagnostic thoracentesis is a safe and effective alternative for evaluating patients with minimal pleural effusion.

  15. Methimazole associated eosinophilic pleural effusion: a case report.

    PubMed

    Gaspar-da-Costa, Pedro; Duarte Silva, Filipa; Henriques, Júlia; do Vale, Sónia; Braz, Sandra; Meneses Santos, João; M M Victorino, Rui

    2017-03-21

    Adverse reactions associated to anti-thyroid drugs include fever, rash, arthralgia, agranulocytosis and hepatitis that are thought to be hypersensitivity reactions. Five cases of pleural effusion associated to thionamides have also been reported, two with propylthiouracil and three with carbimazole. We report here a case of a 75-year-old man admitted because of unilateral pleural effusion. The patient had a recent diagnosis of hyperthyroidism and 6 days after starting methimazole complained of pleuritic chest pain. He had elevated C-reactive protein and erythrocyte sedimentation rate and normal white blood cell count and liver enzymes. Chest radiography showed a moderate right pleural effusion and the ultrasound revealed a loculated effusion that was shown to be an eosinophilic exudate. The temporal relationship between methimazole intake and the development of pleural effusion combined with the extensive exclusion of alternative causes, namely infectious, neoplastic and primary auto-immune diseases, led to the diagnosis of hypersensitivity reaction to methimazole. The thionamide was stopped and corticosteroid was started with complete resolution of the pleural effusion in 3 months. Awareness of this rare adverse reaction of anti-thyroid drugs is important and methimazole can be added to the list of possible etiologies of drug-induced eosinophilic pleural effusion.

  16. Tuberculous pleural effusions: advances and controversies

    PubMed Central

    Allwood, Brian W.; Diacon, Andreas H.; Koegelenberg, Coenraad F. N.

    2015-01-01

    On a global scale, tuberculosis (TB) remains one of the most frequent causes of pleural effusions. Our understanding of the pathogenesis of the disease has evolved and what was once thought to be an effusion as a result of a pure delayed hypersensitivity reaction is now believed to be the consequence of direct infection of the pleural space with a cascade of events including an immunological response. Pulmonary involvement is more common than previously believed and induced sputum, which is grossly underutilised, can be diagnostic in approximately 50%. The gold standard for the diagnosis of tuberculous pleuritis remains the detection of Mycobacterium tuberculosis in pleural fluid, or pleural biopsy specimens, either by microscopy and/or culture, or the histological demonstration of caseating granulomas in the pleura along with acid fast bacilli (AFB). In high burden settings, however, the diagnosis is frequently inferred in patients who present with a lymphocytic predominant exudate and a high adenosine deaminase (ADA) level, which is a valuable adjunct in the diagnostic evaluation. ADA is generally readily accessible, and together with lymphocyte predominance justifies treatment initiation in patients with a high pre-test probability. Still, false-negative and false-positive results remain an issue. When adding closed pleural biopsy to ADA and lymphocyte count, diagnostic accuracy approaches that of thoracoscopy. The role of other biomarkers is less well described. Early pleural drainage may have a role in selected cases, but more research is required to validate its use and to define the subpopulation that may benefit from such interventions. PMID:26150911

  17. Pericarditis and pericardial effusion: management update.

    PubMed

    Sparano, Dina M; Ward, R Parker

    2011-12-01

    Prompt recognition of the signs and symptoms of pericardial disease is critical so that appropriate treatments can be initiated. Acute pericarditis has a classical presentation, including symptoms, physical examination findings, and electrocardiography abnormalities. Early recognition of acute pericarditis will avoid unnecessary invasive testing and prompt therapies that provide rapid symptom relief. Non-steroidal anti-inflammatory drugs (NSAIDs) remain first-line therapy for uncomplicated acute pericarditis, although colchicine can be used concomitantly with NSAIDS as the first-line approach, particularly in severely symptomatic cases. Colchicine should be used in all refractory cases and as initial therapy in all recurrences. Aspirin should replace NSAIDS in pericarditis complicating acute myocardial infarction. Systemic corticosteroids can be used in refractory cases or in those with immune-mediated etiologies, although generally should be avoided due to a higher risk of recurrence. Pericardial effusions have many etiologies and the approach to diagnosis and therapy depends on clinical presentation. Pericardial tamponade is a life-threatening clinical diagnosis made on physical examination and supported by characteristic findings on diagnostic testing. Prompt diagnosis and management is critical. Treatment consists of urgent pericardial fluid drainage with a pericardial drain left in place for several days to help prevent acute recurrence. Analysis of pericardial fluid should be performed in all cases as it may provide clues to etiology. Consultation of cardiac surgery for pericardial window should be considered in recurrent cases and may be the first-line approach to malignant effusions, although acute relief of hemodynamic compromise must not be delayed. Constrictive pericarditis is associated with symptoms that mimic many other cardiac conditions. Thus, correct diagnosis is critical and involves identification of pericardial thickening or calcification in

  18. [Parapneumonic pleural effusion: difficulties in making therapeutic decisions].

    PubMed

    Chudzicka, Aleksandra; Chciałowski, Andrzej

    2007-01-01

    Pneumonia is the second most common cause of pleural effusion. The presence of pleural fluid makes the prognosis in patients with pneumonia worse and causes a higher mortality rate. This is why it is very important to undertake suitable treatment as soon as possible. Most parapneumonic pleural effusions resolve with antibiotic alone, but sometimes more invasive treatment is necessary. Therapeutic decisions are based on different criteria. For many years determining biochemical fluid characteristics has been used for this purpose. Presentlythe usefullness of new parameters is being evaluated. Their application in diagnostics was possible thanks to better knowledge of mechanisms that participate in the development of parapneumonic pleural effusion.

  19. Thermal Effusivity of Vegetable Oils Obtained by a Photothermal Technique

    NASA Astrophysics Data System (ADS)

    Cervantes-Espinosa, L. M.; de L. Castillo-Alvarado, F.; Lara-Hernández, G.; Cruz-Orea, A.; Hernández-Aguilar, C.; Domínguez-Pacheco, A.

    2014-10-01

    Thermal properties of several vegetable oils such as soy, corn, and avocado commercial oils were obtained by using a photopyroelectric technique. The inverse photopyroelectric configuration was used in order to obtain the thermal effusivity of the oil samples. The theoretical equation for the photopyroelectric signal in this configuration, as a function of the incident light modulation frequency, was fitted to the experimental data in order to obtain the thermal effusivity of these samples. The obtained results are in good agreement with the thermal effusivity reported for other vegetable oils. All measurements were done at room temperature.

  20. [A classical but unknown cause of peritoneal effusion disclosed by echography. Typhoid fever].

    PubMed

    Judet, O; Rouveix, E; Verderi, D; Bismuth, V

    1989-01-01

    Two cases of peritoneal effusion discovered by sonography in patients with typhoid fever are reported. These peritoneal effusions have no pejorative value; only clinical findings can differentiate these simple effusions from a perforative thyphoid peritonitis, which is exceptional nowadays. Typhoid fever, among other febrile diseases should be considered when ultrasounds shows an isolated peritoneal effusion.

  1. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children.

    PubMed

    Lous, J; Burton, M J; Felding, J U; Ovesen, T; Rovers, M M; Williamson, I

    2005-01-25

    Otitis media with effusion (OME), or 'glue ear', is very common in children, especially between the ages of one and three years with a prevalence of 10% to 30% and a cumulative incidence of 80% at the age of four years. OME is defined as middle ear effusion without signs or symptoms of an acute infection. OME may occur as a primary disorder or as a sequel to acute otitis media. The functional effect of OME is a conductive hearing level of about 25 to 30 dB associated with fluid in the middle ear. Both the high incidence and the high rate of spontaneous resolution suggest that the presence of OME is a natural phenomenon, its presence at some stage in childhood being a normal finding. Notwithstanding this, some children with OME may go on to develop chronic otitis media with structural changes (tympanic membrane retraction pockets, erosion of portions of the ossicular chain and cholesteatoma), language delays and behavioural problems. It remains uncertain whether or not any of these findings are direct consequences of OME. The most common medical treatment options include the use of decongestants, mucolytics, steroids, antihistamines and antibiotics. The effectiveness of these therapies has not been established. Surgical treatment options include grommet (ventilation or tympanostomy tube) insertion, adenoidectomy or both. Opinions regarding the risks and benefits of grommet insertion vary greatly. The management of OME therefore remains controversial. To assess the effectiveness of grommet insertion compared with myringotomy or non-surgical treatment in children with OME. The outcomes studied were (i) hearing level, (ii) duration of middle ear effusion, (iii) well-being (quality of life) and (iv) prevention of developmental sequelae possibly attributable to the hearing loss (for example, impairment in impressive and expressive language development (measured using standardised tests), verbal intelligence, and behaviour). We searched the Cochrane Central Register of

  2. [Detection of antibodies against Legionella pneumophila from pleural effusion--a case report of Legionnaire's pneumonia with pleural effusion].

    PubMed

    Xu, L; Wang, P; Chen, S

    1994-06-01

    Using TAT and ELISA, 50 samples of pleural effusion and sera from patients infected with non-Legionella pneumophila were detected for antibodies against Legionella pneumophila serogroups 1 and 6, respectively. The average titre and upper limit value (99%, mean + 2.326S) calculated. In addition, a pleural effusion and a serum from a patient with Legionnaire's pneumonia were also detected by TAT and ELISA. The result showed that the titre of this antibody in his pleural effusion was not only over the upper limit, but also higher than that in his serum.

  3. Antibiotics for otitis media with effusion in children.

    PubMed

    Venekamp, Roderick P; Burton, Martin J; van Dongen, Thijs M A; van der Heijden, Geert J; van Zon, Alice; Schilder, Anne G M

    2016-06-12

    Otitis media with effusion (OME) is characterised by an accumulation of fluid in the middle ear behind an intact tympanic membrane, without the symptoms or signs of acute infection. Since most cases of OME will resolve spontaneously, only children with persistent middle ear effusion and associated hearing loss potentially require treatment. Previous Cochrane reviews have focused on the effectiveness of ventilation tube insertion, adenoidectomy, nasal autoinflation, antihistamines, decongestants and corticosteroids in OME. This review, focusing on the effectiveness of antibiotics in children with OME, is an update of a Cochrane review published in 2012. To assess the benefits and harms of oral antibiotics in children up to 18 years with OME. The Cochrane ENT Information Specialist searched the ENT Trials Register; Central Register of Controlled Trials (CENTRAL 2016, Issue 3); PubMed; Ovid EMBASE; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 14 April 2016. Randomised controlled trials comparing oral antibiotics with placebo, no treatment or therapy of unproven effectiveness in children with OME. We used the standard methodological procedures expected by Cochrane. Twenty-five trials (3663 children) were eligible for inclusion. Two trials did not report on any of the outcomes of interest, leaving 23 trials (3258 children) covering a range of antibiotics, participants, outcome measures and time points for evaluation. Overall, we assessed most studies as being at low to moderate risk of bias.We found moderate quality evidence (six trials including 484 children) that children treated with oral antibiotics are more likely to have complete resolution at two to three months post-randomisation (primary outcome) than those allocated to the control treatment (risk ratio (RR) 2.00, 95% confidence interval (CI) 1.58 to 2.53; number needed to treat to benefit (NNTB) 5). However, there is

  4. Rapidly progressive effusive constrictive pericarditis caused by methicillin sensitive Staphylococcus aureus (MSSA). samraakhtar@hotmail.com.

    PubMed

    Akhtar, Naveed; Khalid, Ayesha; Ahmed, Waqas; Rasheed, Khalid

    2010-04-01

    Effusive-constrictive pericarditis is a clinical syndrome characterized by concurrent pericardial effusion and pericardial constriction, where constrictive hemodynamics are persistent after effusion is drained. It may present at any point along the clinical course, from the occurrence of an effusion to the development of chronic pericardial constriction. We refer an unusual case of effusive constrictive pericarditis developing rapidly within days, following purulent pericarditis secondary to chest trauma.

  5. Ionizing Radiation and the Ear

    SciTech Connect

    Borsanyi, Steven J.

    The effects of ionizing radiation on the ears of 100 patients were studied in the course of treatment of malignant head and neck tumors by teleradiation using Co 60. Early changes consisted of radiation otitis media and a transient vasculitis of the vessels of the inner ear, resulting in hearing loss, tinnitus, and temporary recruitment. While no permanent changes were detected microscopically shortly after the completion of radiation in the cochlea or labyrinth, late changes sometimes occurred in the temporal bone as a result of an obliterating endarteritis. The late changes were separate entities caused primarily by obliterating endarteritis andmore » alterations in the collagen. Radiation affected the hearing of individuals selectively. When hearing threshold shift did occur, the shift was not great. The 4000 cps frequency showed a greater deficit in hearing capacity during the tests, while the area least affected appeared to be in the region of 2000 cps. The shift in speech reception was not significant and it was correlated with the over-all change in response to pure tones. Discrimination did not appear to be affected. Proper shielding of the ear with lead during radiation, when possible, eliminated most complications. (H.R.D.)« less

  6. Pathogenesis of Middle Ear Cholesteatoma

    PubMed Central

    Yamamoto-Fukuda, Tomomi; Hishikawa, Yoshitaka; Shibata, Yasuaki; Kobayashi, Toshimitsu; Takahashi, Haruo; Koji, Takehiko

    2010-01-01

    Middle ear cholesteatoma is characterized by enhanced proliferation of epithelial cells with aberrant morphological characteristics. To investigate the origin of the cholesteatoma cells, we analyzed spontaneously occurring cholesteatomas associated with a new transplantation model in Mongolian gerbils (gerbils). Cholesteatomas were induced in gerbils with a transplanted tympanic membrane by using the external auditory canal (EAC) ligation method. After the pars flaccida of the tympanic membranes were completely removed from male gerbils, corresponding portions of tympanic membranes of female gerbils were transplanted to the area of defect, and then we ligated the EAC (hybrid-model group). As a control group, the EAC of normal male and female gerbils was ligated without myringoplasty. In all ears of each group, the induced cholesteatomas were seen. In situ PCR was then performed to detect the mouse X chromosome-linked phosphoglycerate kinase-1 (pgk-1) gene on the paraffin sections. One pgk-1 spot in the epithelial nuclei was detected in male cholesteatoma, and two pgk-1 spots were detected in female cholesteatoma, respectively. On the other hand, in the hybrid-model group, we detected not only one but also two pgk-1 spots in the epithelial nuclei of cholesteatoma. These results strengthened the evidence that the origin of epithelial cells in cholesteatoma is the tympanic membrane in this model, but not the residential middle ear epithelial cells or the skin of the EAC. PMID:20413684

  7. Sarcoidosis presenting with pleurisy and bilateral pleural effusions.

    PubMed Central

    Johnson, N. M.; Martin, N. D.; McNicol, M. W.

    1980-01-01

    A patient with acute sarcoidosis is described who presented with pleurisy and bilateral pleural effusions, but no other abnormalities on examination or chest X-ray. This presentation of sarcoidosis is unusual and is discussed. Images Fig. 1 PMID:7433329

  8. Eosinophilic Pleural Effusion: A Rare Manifestation of Hypereosinophilic Syndrome

    PubMed Central

    Okafor, Ndubuisi C.; Oso, Ayodeji A.; Oranu, Amanke C.; Wolff, Steven M.; Murray, John J.

    2009-01-01

    Several causes of eosinophilic pleural effusions have been described with malignancy being the commonest cause. Hypereosinophilic syndrome (HES) is a rare disease and very few cases have been reported of HES presenting as eosinophilic pleural effusion (EPE). We report a case of a 26-year-old male who presented with shortness of breath. He had bilateral pleural effusions, generalized lymphadenopathy, splenomegaly, and leukocytosis with marked peripheral blood eosinophilia. The pleural fluid was exudative, with 25%–30% eosinophilis, and absence of neoplastic cells. Hypereosinophilic syndrome was diagnosed after other causes of eosinophilia were excluded. He continued to be dyspneic with persistent accumulation of eosinophilic pleural fluid, even after his peripheral eosinophil count had normalized in response to treatment. This patient represents a very unusual presentation of HES with dyspnea and pleural effusions and demonstrates that treatment based on response of peripheral eosinophil counts, as is currently recommended, may not always be clinically adequate. PMID:20111739

  9. Eosinophilic pleural effusion: a rare manifestation of hypereosinophilic syndrome.

    PubMed

    Okafor, Ndubuisi C; Oso, Ayodeji A; Oranu, Amanke C; Wolff, Steven M; Murray, John J

    2009-01-01

    Several causes of eosinophilic pleural effusions have been described with malignancy being the commonest cause. Hypereosinophilic syndrome (HES) is a rare disease and very few cases have been reported of HES presenting as eosinophilic pleural effusion (EPE). We report a case of a 26-year-old male who presented with shortness of breath. He had bilateral pleural effusions, generalized lymphadenopathy, splenomegaly, and leukocytosis with marked peripheral blood eosinophilia. The pleural fluid was exudative, with 25%-30% eosinophilis, and absence of neoplastic cells. Hypereosinophilic syndrome was diagnosed after other causes of eosinophilia were excluded. He continued to be dyspneic with persistent accumulation of eosinophilic pleural fluid, even after his peripheral eosinophil count had normalized in response to treatment. This patient represents a very unusual presentation of HES with dyspnea and pleural effusions and demonstrates that treatment based on response of peripheral eosinophil counts, as is currently recommended, may not always be clinically adequate.

  10. Malignant and Tuberculous Pleural Effusions: Immunophenotypic Cellular Characterization

    PubMed Central

    de Aguiar, Lucia Maria Zanatta; Antonangelo, Leila; Vargas, Francisco S.; Zerbini, Maria Cláudia Nogueira; Sales, Maria Mirtes; Uip, David E.; Saldiva, Paulo Hilário Nascimento

    2008-01-01

    INTRODUCTION AND OBJECTIVES Tuberculosis and cancer are the main causes of pleural effusion. Pleural involvement is associated with migration of immune cells to the pleural cavity. We sought to characterize the immunophenotype of leukocytes in the pleural effusion and peripheral blood of patients with tuberculosis or malignancy. METHODS Thirty patients with tuberculosis (14) or malignancy (16) were studied. A control group included 20 healthy blood donors. RESULTS Malignant phycoerythrin pleural effusions showed higher percentages of CD3, CD4, CD3CD45RO, and CD20CD25 lymphocytes and lower percentages of CD3CD25 and CD20HLA-DR when compared to PB lymphocytes. Compared to PB, tuberculous effusions had a higher percentage of lymphocytes that co-expressed CD3, CD4, CD3CD45RO, CD3TCRαβ, CD3CD28, and CD20 and a lower percentage of CD14, CD8 and CD3TCRγδ-positive lymphocytes. Malignant effusions presented higher expression of CD14 whereas tuberculous effusions had higher expression of CD3 and CD3CD95L. Peripheral blood cells from tuberculosis patients showed higher expression of CD14, CD20CD25 and CD3CD95L. Compared with the control cells, tuberculosis and cancer peripheral blood cells presented a lower percentage of CD3CD4 and CD3CD28-positive cells as well as a higher percentage of CD3CD8, CD3CD25 and CD3CD80-positive cells. CONCLUSIONS Tuberculous and malignant peripheral blood is enriched with lymphocytes with a helper/inducer T cell phenotype, which are mainly of memory cells. CD14-positive cells were more frequently found in malignant effusions, while CD3-positive cells expressing Fas ligand were more frequently found in tuberculous effusions. PMID:18925324

  11. The clinical characteristics of pleural effusion in scrub typhus.

    PubMed

    Kim, Hyung Ho; Chung, Jong-Hoon; Kim, Dong-Min; Yun, Na Ra; Lee, Jun; Kwon, Yong Eun; Yoon, Sung Ho; Lee, Seung Il; Han, Mi Ah

    2016-06-11

    The aim of this study is to identify the factors associated with the occurrence of pleural effusion and to investigate the characteristics of pleural effusion in scrub typhus. We conducted a retrospective analysis of the medical records of scrub typhus patients between January 2004 and December 2011 at Chosun University Hospital in South Korea. A total of 445 scrub typhus patients were divided into the following two groups: without (n = 352) or with pleural effusion (n = 93). The data of 18 scrub typhus patients who underwent thoracentesis were summarized. Multivariate analysis demonstrated that the following factors were associated with the occurrence of pleural effusion in scrub typhus: older age (odds ratio [OR] = 1.029, P = 0.037, confidence interval [CI] = 1.002-1.056); male gender (OR = 1.924, P = 0.020, CI = 1.109-3.340); presence of heart failure (OR = 2.628, P = 0.039, CI = 1.052-6.565); and lower albumin (OR = 0.107, P ≤ 0.001, CI = 0.058-0.196). Most pleural effusion presentations were bilateral (88 %) and small (91 %). The effusion had transudate characteristics in 7 patients and exudate characteristics in 11 patients based on Light's criteria. This study provided the first data regarding the following four independent risk factors associated with the occurrence of pleural effusion: older age; male gender; the presence of heart failure; and lower albumin. The pleural effusion presentations in scrub typhus patients were bilateral and small in most cases, with transudate and/or exudate characteristics.

  12. A Case of Massive Pleural Effusion: Pleurodesis by Bleomycin.

    PubMed

    Hasan, R; Khan, O S; Aftabuddin, M; Razzaque, A M; Chowdhury, G A

    2016-04-01

    Malignant pleural effusion is a common complication of primary and metastatic pleural malignancies. Pleurodesis for the management of malignant pleural effusion is intended to achieve symphysis between parietal and visceral pleura, and to prevent relapse of pleural effusion. Many chemical agents are tried to induce inflammation and damage of the pleural mesothelial layer to achieve this symphysis. Hemorrhagic pleural effusion, especially in the right hemithorax commonly occurs as presentation of primary and metastatic pleural malignancies. This case reports massive right-sided hemorrhagic pleural effusion as the sole manifestation of primary lung cancer in a 45 year old man. Patient attended our department of thoracic surgery complaining of cough, shortness of breath and right sided chest pain. A chest X-ray and chest computer tomography (CT) radiograph shows right sided massive pleural effusion. Right sided tube thoracotomy done. Pleural fluid study was done. Fluid for cytopathology was positive for malignant cell. Computed tomography guided fine needle aspiration cytology from right lung lesion was also done. Diagnosis was as small cell carcinoma. Pleural effusion resolved after 9(th) post operative day of chest tube insertion. Bleomycin pleurodesis was done. Day after pleurodesis intra thoracic tube was removed and patient was discharged from hospital on 10(th) Post operative day with an advice to attend the oncology department for further treatment. The protocol of tube thoracostomy and chemical pleurodesis was almost always successful in giving symptomatic relief of respiratory distress for a considerable period of time. However, chemical pleurodesis is not possible in all cases of malignant pleural effusion because it has got potential complication including death.

  13. Acute Effusive Pericarditis due to Horse Chestnut Consumption

    PubMed Central

    Edem, Efe; Kahyaoğlu, Behlül; Çakar, Mehmet Akif

    2016-01-01

    Patient: Male, 32 Final Diagnosis: Pericardial effusion related to the consumption of herbal product Symptoms: Dyspnea Medication: Horse chestnut (Aesculus hippocastanum L) Clinical Procedure: Pericardial and pleural effusions were drained through a pericardiopleural window Specialty: Cardiology Objective: Unusual clinical course Background: There are many well-known causes of pericardial effusion, such as cancer metastasis, bacterial or viral pericarditis, and uremic pericarditis; however, no reports exist in the literature demonstrating a pericardial effusion that led to cardiac tamponade following consumption of an herbal remedy. Case Report: A 32-year-old male patient was referred to our cardiology outpatient clinic with a complaint of dyspnea. The patient’s medical history was unremarkable; however, he had consumed 3 boxes of horse chestnut (Aesculus hippocastanum L) paste over the previous 1.5 months. His chest x-ray examination revealed an enlarged cardiac shadow and bilateral pleural effusion. On transthoracic echocardiographic examination, his ejection fraction was found to be 55% with circumferentially extended pericardial effusion that reached 3.9 cm at its maximal thickness. No growth had been detected in the pericardial and pleural biopsies or blood samples; there was no evidence of an infectious process in the physical examination. Based on this information, we diagnosed pericarditis resulting from the use of herbal remedies. This is the first report to demonstrate that herbal remedy consumption may cause this type of clinical condition. Conclusions: Besides other well-known causes, pericardial effusion related to the consumption of herbal remedies should always be considered when treating patients with pericardial effusion caused by unclear etiologies. PMID:27141926

  14. Novel joint cupping clinical maneuver for ultrasonographic detection of knee joint effusions.

    PubMed

    Uryasev, Oleg; Joseph, Oliver C; McNamara, John P; Dallas, Apostolos P

    2013-11-01

    Knee effusions occur due to traumatic and atraumatic causes. Clinical diagnosis currently relies on several provocative techniques to demonstrate knee joint effusions. Portable bedside ultrasonography (US) is becoming an adjunct to diagnosis of effusions. We hypothesized that a US approach with a clinical joint cupping maneuver increases sensitivity in identifying effusions as compared to US alone. Using unembalmed cadaver knees, we injected fluid to create effusions up to 10 mL. Each effusion volume was measured in a lateral transverse location with respect to the patella. For each effusion we applied a joint cupping maneuver from an inferior approach, and re-measured the effusion. With increased volume of saline infusion, the mean depth of effusion on ultrasound imaging increased as well. Using a 2-mm cutoff, we visualized an effusion without the joint cupping maneuver at 2.5 mL and with the joint cupping technique at 1 mL. Mean effusion diameter increased on average 0.26 cm for the joint cupping maneuver as compared to without the maneuver. The effusion depth was statistically different at 2.5 and 7.5 mL (P < .05). Utilizing a joint cupping technique in combination with US is a valuable tool in assessing knee effusions, especially those of subclinical levels. Effusion measurements are complicated by uneven distribution of effusion fluid. A clinical joint cupping maneuver concentrates the fluid in one recess of the joint, increasing the likelihood of fluid detection using US. © 2013 Elsevier Inc. All rights reserved.

  15. [The diagnostic value of medical thoracoscopy for unexplained pleural effusion].

    PubMed

    Jiang, Shu-juan; Mu, Xiao-yan; Zhang, Song; Su, Li-li; Ma, Wei-xia

    2013-05-01

    To explore the endoscopic features of patients with unexplained pleural effusion, and to evaluate the diagnostic value of medical thoracoscopy. A retrospective analysis of 2380 patients with unexplained pleural effusion (1320 males and 1060 females; age 15-94 years) in Shandong Provincial Hospital from 1992 to 2011 were performed .The diagnosis was confirmed by medical thoracoscopy. The endoscopic findings of malignant pleural effusion mostly showed nodules of varying sizes. The nodules could be grape-like, cauliflower-like, fused into masses, or diffused small nodules . The appearance of cancerous nodules was more diversified compared to tuberculous nodules. Tuberculous pleurisy was manifested as diffuse pleural congestion and miliary changes, multiple small gray-white nodules, fibrin deposition and adhesion in the pleural cavity, pleural thickening and loculation . The pathological diagnosis was as follows: pleural metastases in 899 (37.8%), primary pleural mesothelioma in 439 (18.4%), tuberculous pleurisy in 514 (21.6%), non-specific inflammation in 226 (9.5%), empyema in 190 (8.0%), hepatic pleural effusion in 36 (1.5%) and pleural effusion of unknown causes in 76 (3.2%) cases. The diagnostic positive rate of medical thoracoscopy was 96.8%. No serious complications were observed. Medical thoracoscopy is a relatively safe procedure and has an important application value in the diagnosis of unexplained pleural effusion.

  16. Acute Effusive Pericarditis due to Horse Chestnut Consumption.

    PubMed

    Edem, Efe; Kahyaoğlu, Behlül; Çakar, Mehmet Akif

    2016-05-04

    There are many well-known causes of pericardial effusion, such as cancer metastasis, bacterial or viral pericarditis, and uremic pericarditis; however, no reports exist in the literature demonstrating a pericardial effusion that led to cardiac tamponade following consumption of an herbal remedy. A 32-year-old male patient was referred to our cardiology outpatient clinic with a complaint of dyspnea. The patient's medical history was unremarkable; however, he had consumed 3 boxes of horse chestnut (Aesculus hippocastanum L) paste over the previous 1.5 months. His chest x-ray examination revealed an enlarged cardiac shadow and bilateral pleural effusion. On transthoracic echocardiographic examination, his ejection fraction was found to be 55% with circumferentially extended pericardial effusion that reached 3.9 cm at its maximal thickness. No growth had been detected in the pericardial and pleural biopsies or blood samples; there was no evidence of an infectious process in the physical examination. Based on this information, we diagnosed pericarditis resulting from the use of herbal remedies. This is the first report to demonstrate that herbal remedy consumption may cause this type of clinical condition. Besides other well-known causes, pericardial effusion related to the consumption of herbal remedies should always be considered when treating patients with pericardial effusion caused by unclear etiologies.

  17. A morphometric study of the human ear.

    PubMed

    Alexander, K Skaria; Stott, David J; Sivakumar, Branavan; Kang, Norbert

    2011-01-01

    We examined variations in the shape of the human ear according to age, sex and ethnic group with particular attention to ear prominence. 420 volunteers were recruited. Measurements included; head height and length, ear height and axis, antihelix taken off angle, earlobe length and width, ear width at the helical root and tragus. Prominence was measured at the helical root and tragus (conchomastoid angle, conchal bowl depth and helical-mastoid distance). Good symmetry was shown for all measurements. Ethnically Indian volunteers had the largest ears (both length and width), followed by Caucasians, and Afro-Caribbeans. This trend was significant in males (p<0.001), but not significant in females (p=0.087). Ears increased in size throughout life. Subjectively, only 2% of volunteers felt their ears were prominent compared to 10% in the opinion of the principal investigator. No objective measurements were identified that accurately predicted subjective perceptions of prominence. We found consistent trends in ear morphology depending on ethnic group, age and sex. Our study was unable to define an objective method for assessing ear prominence. Decisions about what constitutes a prominent ear should be left to personal and aesthetic choice. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Ear canal dynamic motion as a source of power for in-ear devices

    NASA Astrophysics Data System (ADS)

    Delnavaz, Aidin; Voix, Jérémie

    2013-02-01

    Ear canal deformation caused by temporomandibular joint (jaw joint) activity, also known as "ear canal dynamic motion," is introduced in this paper as a candidate source of power to possibly recharge hearing aid batteries. The geometrical deformation of the ear canal is quantified in 3D by laser scanning of different custom ear moulds. An experimental setup is proposed to measure the amount of power potentially available from this source. The results show that 9 mW of power is available from a 15 mm3 dynamic change in the ear canal volume. Finally, the dynamic motion and power capability of the ear canal are investigated in a group of 12 subjects.

  19. Prevention and management of vascular complications in middle ear and cochlear implant surgery.

    PubMed

    Di Lella, Filippo; Falcioni, Maurizio; Piccinini, Silvia; Iaccarino, Ilaria; Bacciu, Andrea; Pasanisi, Enrico; Cerasti, Davide; Vincenti, Vincenzo

    2017-11-01

    The objective of this study is to illustrate prevention strategies and management of vascular complications from the jugular bulb (JB) and internal carotid artery (ICA) during middle ear surgery or cochlear implantation. The study design is retrospective case series. The setting is tertiary referral university hospital. Patients were included if presented pre- or intraoperative evidence of high-risk anatomical anomalies of ICA or JB during middle ear or cochlear implant surgery, intraoperative vascular injury, or revision surgery after the previous iatrogenic vascular lesions. The main outcome measures are surgical outcomes and complications rate. Ten subjects were identified: three underwent cochlear implant surgery and seven underwent middle ear surgery. Among the cochlear implant patients, two presented with anomalies of the JB impeding access to the cochlear lumen and one underwent revision surgery for incorrect positioning of the array in the carotid canal. Subtotal petrosectomy was performed in all cases. Anomalies of the JB were preoperatively identified in two patients with attic and external auditory canal cholesteatoma, respectively. In a patient, a high and dehiscent JB was found during myringoplasty, while another underwent revision surgery after iatrogenic injury of the JB. A dehiscent ICA complicated middle ear effusion in one case, while in another case, a carotid aneurysm determined a cholesterol granuloma. Rupture of a pseudoaneurysm of the ICA occurred in a child during second-stage surgery and required permanent balloon occlusion without neurological complications. Knowledge of normal anatomy and its variants and preoperative imaging are the basis for prevention of vascular complications during middle ear or cochlear implant surgery.

  20. The point prevalence of otitis media with effusion among primary school children in Western Sicily.

    PubMed

    Martines, Francesco; Bentivegna, Daniela; Di Piazza, Fabiola; Martinciglio, Gioacchino; Sciacca, Vincenzo; Martines, Enrico

    2010-05-01

    The objective of this study is to identify the prevalence of otitis media with effusion (OME) in primary school children and to value the possible predisposing factors focusing on relationship between allergy and OME in Western Sicily. 2,097 children attending primary school were screened from September 2006 to June 2007 in Sciacca. Children underwent pneumatic otoscopy, skin tests, tympanogram and acoustic reflex tests. Audiogram was performed if the child had a type B or a type C tympanogram. The criteria for diagnosis of OME were: documented persistent middle ear effusion by otoscopic examination for a minimum of 3 months, presence of B or C tympanogram, absence of ipsilateral acoustic reflex and a conductive hearing loss greater than 25 dB at any one of the frequencies from 250 Hz to 4 kHz. OME was identified in 143 children, in 61 of whom OME was unilateral and in 82 of whom it was bilateral. The overall prevalence of OME was 6.8%, with a maximum prevalence of 12.9% between 5 and 6 years of age. By increasing age, the prevalence of OME decreased. Also, we found a higher prevalence rate of OME in children with positive skin tests (62.9%) than those with negative skin tests (37.1%). The present study evidences the high social impact of OME, whose prevalence is directly correlated to age and atopy. Moreover, our finding supports the literature data that climatic and environmental factors may also have a role in the occurrence of OME.

  1. Measurement of Cefaclor and Amoxicillin-Clavulanic Acid Levels in Middle-Ear Fluid in Patients with Acute Otitis Media

    PubMed Central

    Scaglione, F.; Caronzolo, D.; Pintucci, J. P.; Fraschini, F.

    2003-01-01

    Concentrations of cefaclor (CFC) or amoxicillin-clavulanic acid (AMX/CA) in middle-ear fluid collected preserving the stability and clearing the cell contents has been compared to those obtained using the traditional method. Sixty-seven children with effusive otitis media were treated orally with CFC (20 mg/kg of body weight) or AMX/CA (20 mg/kg) (4:1 ratio). The concentrations in cell-free fluid (C−) appear higher than those in the total fluid (C+) (as assayed traditionally). PMID:12937009

  2. Vascular endothelial growth factor and protein level in pleural effusion for differentiating malignant from benign pleural effusion.

    PubMed

    Wu, Da-Wei; Chang, Wei-An; Liu, Kuan-Ting; Yen, Meng-Chi; Kuo, Po-Lin

    2017-09-01

    Pleural effusion is associated with multiple benign and malignant conditions. Currently no biomarkers differentiate malignant pleural effusion (MPE) and benign pleural effusion (BPE) sensitively and specifically. The present study identified a novel combination of biomarkers in pleural effusion for differentiating MPE from BPE by enrolling 75 patients, 34 with BPE and 41 with MPE. The levels of lactate dehydrogenase, glucose, protein, and total cell, neutrophil, monocyte and lymphocyte counts in the pleural effusion were measured. The concentrations of interleukin (IL)-1β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-α, interferon γ, transforming growth factor-β1, colony stimulating factor 2, monocyte chemoattractant protein-1 and vascular endothelial growth factor (VEGF) were detected using cytometric bead arrays. Protein and VEGF levels differed significantly between patients with BPE and those with MPE. The optimal cutoff value of VEGF and protein was 214 pg/ml and 3.35 g/dl respectively, according to the receiver operating characteristic curve. A combination of VEGF >214 pg/ml and protein >3.35 g/dl in pleural effusion presented a sensitivity of 92.6% and an accuracy of 78.6% for MPE, but was not associated with a decreased survival rate. These results suggested that this novel combination strategy may provide useful biomarkers for predicting MPE and facilitating early diagnosis.

  3. CSF otorhinorrhea in a child with inner ear dysplasia: diagnosis with T2-weighted and intrathecal contrast-enhanced MR cisternography.

    PubMed

    Mehdi, Elnur; Alkan, Alpay; Yetis, Huseyin; Aralasmak, Ayse; Ozdemir, Huseyin

    2014-07-01

    During the follow-up of recurrent pneumonia in a 9-month-old girl, rhinorrhea with discharge of a positional and intermittent nature was discovered. Radiological assessment was requested to detect any skull base openings and cerebrospinal fluid (CSF) leakage. T2-weighted MR cisternography showed bilateral inner ear dysplasia, communication of the internal auditory canal with the vestibule, and effusion in the right middle ear. Intrathecal contrast-enhanced MR cisternography revealed a CSF fistula from the right internal auditory canal to the Eustachian tube. The patient was operated upon on the right side, and the presence of a CSF leak near the oval window was confirmed. No adverse effects were seen during the short-term and long-term follow-up. Diagnosing this case required special attention, careful examination, and relevant investigations to find the site of CSF leakage in this patient with bilateral inner ear dysplasia.

  4. Malignant pleural effusion from papillary thyroid carcinoma diagnosed by pleural effusion cytology: A case report.

    PubMed

    Kosmas, Konstantinos; Tsonou, Anna; Mitropoulou, Georgia; Salemi, Eufrosyni; Kazi, Danai; Theofanopoulou, Ageliki

    2018-02-01

    Papillary thyroid carcinoma (PTC) is by far the most common thyroid malignancy (over 85%) of all the thyroid cancers. It has excellent prognosis and 10-year survival rate in most of the cases (95%). Most of the tumors are indolent and do not recur or metastasize after removal. However, widespread metastases to lung, skeleton, central nervous system and, occasionally, other organs may be observed. In rare instances, this disease may metastasize to the pleura and manifest as a malignant pleural effusion (MPE) and portend poor prognosis. This article reports the cytomorphologic and immunocytochemical findings of a female patient with a symptomatic pleural effusion resulting from PTC metastatic to the pleura. Pleural fluid cytology revealed abundant papillary clusters with relatively nuclear pleomorphism, intranuclear cytoplasmic inclusions and nuclear grooves, small and distinct nucleoli as well as small discrete vacuoles. Psammoma bodies were not seen. Immunocytochemical staining was positive for TGB, EMA, Ber-EP4, CK19, and negative for TTF-1. Metastasis of PTC to pleural fluid is extremely rare and diagnosing the disease by cytology is challenging and requires medical expertise as well as knowledge of clinical context and immunocytochemical staining. Additionally, a cytologic diagnosis of MPE due to PTC provides important treatment information and plays an important role in prognosis. © 2017 Wiley Periodicals, Inc.

  5. Molecular Mechanisms of Inner Ear Development

    PubMed Central

    Wu, Doris K.; Kelley, Matthew W.

    2012-01-01

    The inner ear is a structurally complex vertebrate organ built to encode sound, motion, and orientation in space. Given its complexity, it is not surprising that inner ear dysfunction is a relatively common consequence of human genetic mutation. Studies in model organisms suggest that many genes currently known to be associated with human hearing impairment are active during embryogenesis. Hence, the study of inner ear development provides a rich context for understanding the functions of genes implicated in hearing loss. This chapter focuses on molecular mechanisms of inner ear development derived from studies of model organisms. PMID:22855724

  6. Molecular mechanisms of inner ear development.

    PubMed

    Wu, Doris K; Kelley, Matthew W

    2012-08-01

    The inner ear is a structurally complex vertebrate organ built to encode sound, motion, and orientation in space. Given its complexity, it is not surprising that inner ear dysfunction is a relatively common consequence of human genetic mutation. Studies in model organisms suggest that many genes currently known to be associated with human hearing impairment are active during embryogenesis. Hence, the study of inner ear development provides a rich context for understanding the functions of genes implicated in hearing loss. This chapter focuses on molecular mechanisms of inner ear development derived from studies of model organisms.

  7. Listening to Nature's orchestra with peculiar ears

    NASA Astrophysics Data System (ADS)

    Yager, David D.

    2003-04-01

    Insects use hearing for the crucial tasks of communicating with conspecifics and avoiding predators. Although all are based on the same acoustic principles, the diversity of insect ears is staggering and instructive. For instance, a South African grasshopper demonstrates that hearing conspecific calls is possible over distances 1 km with ears that do not have tympana. Actually, these creatures have six pairs of ears that play different roles in behavior. In numerical contrast, praying mantises have just a single ear in the ventral midline. The ear is very effective at detecting ultrasonic bat cries. However, the bioacoustics of sound transduction by two tympana facing each other in a deep, narrow slit is a puzzle. Tachinid flies demonstrate that directional hearing at 5 kHz is possible with a pair of ears fused together to give a total size of 1 mm. The ears are under the fly's chin. Hawk moths have their ears built into their mouthparts and the tympanum is more like a hollow ball than the usual membrane. As an apt last example, cicada ears are actually part of the orchestra: their tympana function both in sound reception and sound production.

  8. An Effective 3D Ear Acquisition System

    PubMed Central

    Liu, Yahui; Lu, Guangming; Zhang, David

    2015-01-01

    The human ear is a new feature in biometrics that has several merits over the more common face, fingerprint and iris biometrics. It can be easily captured from a distance without a fully cooperative subject. Also, the ear has a relatively stable structure that does not change much with the age and facial expressions. In this paper, we present a novel method of 3D ear acquisition system by using triangulation imaging principle, and the experiment results show that this design is efficient and can be used for ear recognition. PMID:26061553

  9. Could ionizing radiation forestall cauliflower ear?

    PubMed

    Hwang, K; Kim, C W; Lee, S I; Park, I S; Kim, W C; Loh, J J

    2001-02-01

    Repeated trauma to the ear very often results in "cauliflower ear." Many methods have been suggested to prevent an injured ear from demonstrating a cauliflowerlike deformity. The principles of treatment are evacuation of the hematoma, control of the reaccumulation of fluid, and maintenance of the cartilage contour. The authors studied the effect of ionizing radiation on deformed rabbit ears induced by repeated trauma. Twenty ears (10 rabbits) were used in the experiment. The animals were divided into four groups (control, preradiation, low dose, and high dose). Hematoma was produced by pounding the lateral side of the auricle 10 times with a 50-g weight at a height of 15 cm. The thickness of the injured and uninjured sites was measured, and histological analysis was performed for each group. The thickness of the ears of the irradiated groups was significantly less than the control group. The authors think that radiation treatment of repeatedly injured ears could prevent ear deformity, and could possibly be an adjunctive form of management of cauliflower ear in addition to hematoma evacuation and compression therapy.

  10. An Effective 3D Ear Acquisition System.

    PubMed

    Liu, Yahui; Lu, Guangming; Zhang, David

    2015-01-01

    The human ear is a new feature in biometrics that has several merits over the more common face, fingerprint and iris biometrics. It can be easily captured from a distance without a fully cooperative subject. Also, the ear has a relatively stable structure that does not change much with the age and facial expressions. In this paper, we present a novel method of 3D ear acquisition system by using triangulation imaging principle, and the experiment results show that this design is efficient and can be used for ear recognition.

  11. CT of the ear in Pendred syndrome.

    PubMed

    Goldfeld, Moshe; Glaser, Benjamin; Nassir, Elias; Gomori, John Moshe; Hazani, Elitsur; Bishara, Nassir

    2005-05-01

    To prospectively determine the structural anomalies of the inner ear by using thin-section computed tomography (CT) in an extended family with Pendred syndrome. Ethics committee approved the study, and informed consent was obtained from every patient or from parents of patients under legal age. Twelve patients (three females and nine males aged 7-47 years) with Pendred syndrome (all from the same ethnic isolate and with the same mutation in the PDS gene) were evaluated for inner-ear malformation at thin-section CT. Both ears were evaluated. Presence or absence of interscalar septum between upper and middle turns of the cochlea was evaluated, and vestibule and vestibular aqueduct were examined for enlargement. Modiolus was determined to be present or absent (modiolar deficiency). CT scans were evaluated in consensus by two radiologists (M.G., J.M.G.). All patients had inner ear malformation on both sides. Modiolus was absent and vestibule was enlarged on both sides in all 12 patients. Interscalar septum was absent in 18 (75%) of 24 ears. In eight patients, interscalar septum was absent in both ears, whereas in two patients, it was absent on only one side. Aqueduct was enlarged in 20 (80%) of 24 ears. In nine patients, both ears had enlarged aqueducts, while in two patients, only one side was abnormal. Inner ear malformation is an invariable finding in Pendred syndrome. Modiolus deficiency and vestibular enlargement were the most consistent anomalies in this population with Pendred syndrome. (c) RSNA, 2005.

  12. [Otitis media with effusion in children younger than 1 year].

    PubMed

    Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael

    2016-06-01

    To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2,500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  13. Comparison of cefuroxime axetil and amoxicillin-clavulanate suspensions in treatment of acute otitis media with effusion in children.

    PubMed Central

    McLinn, S E; Moskal, M; Goldfarb, J; Bodor, F; Aronovitz, G; Schwartz, R; Self, P; Ossi, M J

    1994-01-01

    Two hundred sixty-three pediatric patients from the ages of 3 months to 11 years were enrolled in a randomized, investigator-blinded, multicenter study comparing the clinical and bacteriological efficacies and safety of cefuroxime axetil suspension (CAE) with those of amoxicillin-clavulanate suspension (AMX-CL) in the treatment of acute otitis media with effusion. Patients received CAE at 30 mg/kg of body weight per day (n = 165) in two divided doses or AMX-CL at 40 mg/kg/day (n = 98) in three divided doses for 10 days. The primary pathogens among 200 isolates from pretreatment cultures of middle ear fluid were identified as follows: Haemophilus influenzae (39%), over a third of which were beta-lactamase positive; Streptococcus pneumoniae (34%); and Moraxella catarrhalis (16%). Pathogens were eradicated or presumed to be eradicated from 81% (95 of 118) and 76% (50 of 66) of bacteriologically evaluable patients in the CAE and AMX-CL groups, respectively. A satisfactory clinical response (cure or improvement with or without resolution of effusion) occurred in 113 (77%) of 146 clinically evaluable patients in the CAE group and in 66 (74%) of 89 evaluable patients in the AMX-CL group. Clinical failure or recurrence (within 2 weeks following the completion of treatment) occurred in 22 and 26% of CAE- and AMX-CL-treated patients, respectively. Drug-related adverse events occurred in 18% of CAE-treated patients, whereas they occurred in 39% of AMX-CL-treated patients (P < 0.001); diarrhea or loose stools was the most commonly reported adverse event (CAE, 12%; AMX-CL, 31%; P < 0.001). These results indicate that CAE given twice daily is as effective as AMX-CL given three times daily in the treatment of acute otitis media with effusion in pediatric patients, but CAE was associated with significantly fewer drug-related adverse events. PMID:8192458

  14. Otitis media with effusion in an allergic animal model: A functional and morphological study.

    PubMed

    Kim, Dong-Kee; Park, Hyu Eun; Back, Sang-A; Park, Hyang Rim; Kim, Soo Whan; Park, Yooyeon; Yeo, Sang Won; Park, Shi-Nae

    2016-05-01

    Allergy is considered as one of important etiologic factor of otitis media with effusion (OME). In present study, we evaluated the causal effect of allergy on OME in an animal model, and investigated the secondary effect of bacterial infection. Allergy and control animals were subdivided into groups with and without intratympanic injection of lipopolysaccharide (IT-LPS). Allergic otitis media was induced via intraperitoneal ovo-albumin injection with intranasal challenge. We assessed the occurrence of OME in allergic animals and the effect of IT-LPS on allergic otitis media. We also investigated the Th1 and Th2 responses in the middle-ear mucosa. Hearing of the animals was measured by ABR and DPOAE. OME was observed in 75% of the allergic animals. After IT-LPS, 100% of the control and allergy groups showed otitis media. Light microscopy revealed that the middle-ear mucosa of animals of both groups also was significantly increased after IT-LPS, and the Th1 response (IL-2 and IFN-γ) and Th2 response (IL-5 and IL-13) cytokines were expressed at higher levels in the allergy group with IT-LPS than in control group with IT-LPS. Hearing tests between the allergy and control group with IT-LPS did not reveal any differences. Our findings may be direct evidence of an allergic causal effect on OME. Th2 response cytokines were strongly expressed in allergic OME, and the inflammatory reaction to LPS was more intense in the allergic group, which indicates that otitis media related to allergy can be severely aggravated by an inflammatory reaction to bacterial infection. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Measurement of neutrino mixing angle θ13 and mass difference Δ mee2 from reactor antineutrino disappearance in the RENO experiment

    NASA Astrophysics Data System (ADS)

    Kim, Soo-Bong

    2016-07-01

    RENO (Reactor Experiment for Neutrino Oscillation) made a definitive measurement of the smallest neutrino mixing angle θ13 in 2012, based on the disappearance of reactor electron antineutrinos. The experiment has obtained a more precise value of the mixing angle and the first result on neutrino mass difference Δ mee2 from an energy and baseline dependent reactor neutrino disappearance using ∼500 days of data. Based on the ratio of inverse-beta-decay (IBD) prompt spectra measured in two identical far and near detectors, we obtain sin2 ⁡ (2θ13) = 0.082 ± 0.009 (stat .) ± 0.006 (syst .) and | Δ mee2 | = [2.62-0.23+0.21 (stat.)-0.13+0.12 (syst .) ] ×10-3 eV2. An excess of reactor antineutrinos near 5 MeV is observed in the measured prompt spectrum with respect to the most commonly used models. The excess is found to be consistent with coming from reactors. A successful measurement of θ13 is also made in an IBD event sample with a delayed signal of neutron capture on hydrogen. A precise value of θ13 would provide important information on determination of the leptonic CP phase if combined with a result of an accelerator neutrino beam experiment.

  16. A case of Riedel's thyroiditis with pleural and pericardial effusions.

    PubMed

    Erdoğan, Murat Faik; Anil, Cüneyd; Türkçapar, Nuran; Ozkaramanli, Demet; Sak, Serpil Dizbay; Erdoğan, Gürbüz

    2009-06-01

    Riedel's thyroiditis (RT) is a rare type of chronic thyroiditis of unproven etiology and definite treatment. It can be associated with retroperitoneal, mediastinal, orbital, and hepatic fibrosis. Symptoms arise mainly due to compression of neighboring structures. Surgery is usually required for a definite diagnosis and decompression to relieve the symptoms. Glucocorticoids and tamoxifen are commonly used agents for the pharmacotherapy. We hereby describe the development of pleural and pericardial effusions during the clinical course of an RT case. A 39-year-old woman suffering from neck compression symptoms was admitted to the hospital. After a decompression isthmectomy, RT was diagnosed. She responded well to glucocorticoid therapy after surgery. However, symptoms reoccurred shortly after glucocorticoid withdrawal and the disease process extended to the mediastinum. Tamoxifen was started and the neck and mediastinal mass regressed and her symptoms disappeared considerably for more than 6 months. However, she was readmitted with severe dyspnea and chest pain. Further investigation revealed an exudative pleural and pericardial effusion and mediastinal enlargement. A thorough evaluation of the patient's effusions did not disclose any specific etiological insult. The patient was symptom-free with a considerable reduction of the soft tissue mass and no effusions, and treated successfully with colchicine, azathioprine, and glucocorticoids. To the best of our knowledge, this is the first case reported in the literature as an RT presenting with pleuropericardial effusions.

  17. Mechanics of the canine diaphragm in pleural effusion.

    PubMed

    De Troyer, André; Leduc, Dimitri; Cappello, Matteo; Gevenois, Pierre Alain

    2012-09-01

    Pleural effusion is a complicating feature of many diseases of the lung and pleura, but its effects on the mechanics of the diaphragm have not been assessed. In the present study, radiopaque markers were attached along muscle bundles in the midcostal region of the diaphragm in anesthetized dogs, and the three-dimensional location of the markers during relaxation before and after the stepwise introduction of liquid into the left or right pleural space and during phrenic nerve stimulation in the same conditions was determined using computed tomography. From these data, accurate measurements of diaphragm muscle length and displacement were obtained, and the changes in pleural and abdominal pressure were analyzed as functions of these parameters. The effect of liquid instillation on the axial position of rib 5 was also measured. The data showed that 1) liquid leaked through the dorsal mediastinal sheet behind the pericardium so that effusion was bilateral; 2) effusion caused a caudal displacement of the relaxed diaphragm; 3) this displacement was, compared with passive lung inflation, much larger than the cranial displacement of the ribs; and 4) the capacity of the diaphragm to generate pressure, in particular pleural pressure, decreased markedly as effusion increased, and this decrease was well explained by the decrease in active muscle length. It is concluded that pleural effusion has a major adverse effect on the pressure-generating capacity of the diaphragm and that this is the result of the action of hydrostatic forces on the muscle.

  18. Waste Heat Recovery and Recycling in Thermal Separation Processes: Distillation, Multi-Effect Evaporation (MEE) and Crystallization Processes

    SciTech Connect

    Emmanuel A. Dada; Chandrakant B. Panchal; Luke K. Achenie

    Evaporation and crystallization are key thermal separation processes for concentrating and purifying inorganic and organic products with energy consumption over 1,000 trillion Btu/yr. This project focused on a challenging task of recovering low-temperature latent heat that can have a paradigm shift in the way thermal process units will be designed and operated to achieve high-energy efficiency and significantly reduce the carbon footprint as well as water footprint. Moreover, this project has evaluated the technical merits of waste-heat powered thermal heat pumps for recovery of latent heat from distillation, multi-effect evaporation (MEE), and crystallization processes and recycling into the process. Themore » Project Team has estimated the potential energy, economics and environmental benefits with the focus on reduction in CO2 emissions that can be realized by 2020, assuming successful development and commercialization of the technology being developed. Specifically, with aggressive industry-wide applications of heat recovery and recycling with absorption heat pumps, energy savings of about 26.7 trillion Btu/yr have been estimated for distillation process. The direct environmental benefits of this project are the reduced emissions of combustible products. The estimated major reduction in environmental pollutants in the distillation processes is in CO2 emission equivalent to 3.5 billion lbs/year. Energy consumption associated with water supply and treatments can vary between 1,900 kWh and 23,700 kWh per million-gallon water depending on sources of natural waters [US DOE, 2006]. Successful implementation of this technology would significantly reduce the demand for cooling-tower waters, and thereby the use and discharge of water treatment chemicals. The Project Team has also identified and characterized working fluid pairs for the moderate-temperature heat pump. For an MEE process, the two promising fluids are LiNO3+KNO3+NANO3 (53:28:19 ) and LiNO3+KNO3+NANO2

  19. Clinical features and survival of lung cancer patients with pleural effusions.

    PubMed

    Porcel, Jose M; Gasol, Ariadna; Bielsa, Silvia; Civit, Carme; Light, Richard W; Salud, Antonieta

    2015-05-01

    The clinical relevance of pleural effusions in lung cancer has seldom been approached systematically. The aim of this study was to determine the prevalence, causes and natural history of lung cancer-associated pleural effusions, as well as their influence on survival. Retrospective review of clinical records and imaging of 556 consecutive patients with a newly diagnosed lung cancer over a 4-year period at our institution. Lung cancer comprised 490 non-small cell and 66 small cell types. About 40% of patients with lung cancer developed pleural effusions at some time during the course of their disease. In half the patients, the effusions were too small to be tapped. These effusions did not progress to require a pleural intervention. Patients with minimal effusions had a worse prognosis compared to patients without pleural effusions (median survival of 7.49 vs 12.65 months, P < 0.001). Less than 20% of the 113 patients subjected to a diagnostic thoracentesis had benign causes for their effusions. Palliative pleural procedures (like therapeutic thoracenteses, pleurodesis or tunnelled pleural catheters) were conducted in 79 (84%) of the 94 malignant effusions. An effusion's size equal to or greater than half of the hemithorax was a strong predictor of the need for a palliative procedure. Overall survival of patients with malignant effusions was 5.49 months. Malignant pleural effusions are a poor prognostic factor in the setting of lung cancer, which includes minimal effusions not amenable to tapping. © 2015 Asian Pacific Society of Respirology.

  20. Playing by Ear: Foundation or Frill?

    ERIC Educational Resources Information Center

    Woody, Robert H.

    2012-01-01

    Many people divide musicians into two types: those who can read music and those who play by ear. Formal music education tends to place great emphasis on producing musically literate performers but devotes much less attention to teaching students to make music without notation. Some would suggest that playing by ear is a specialized skill that is…

  1. The ideal ear position in Caucasian females.

    PubMed

    Broer, P Niclas; Thiha, Aung; Ehrl, Denis; Sinno, Sammy; Juran, Sabrina; Szpalski, Caroline; Ng, Reuben; Ninkovic, Milomir; Prantl, Lukas; Heidekrueger, Paul I

    2018-03-01

    Ear position contributes significantly to facial appearance. However, while objective measurements remain the foundation for esthetic evaluations, little is known about how an ear should ideally be positioned regarding its rotational axis. This study aimed to further evaluate whether there exists a universally applicable ideal ear axis, and how sociodemographic factors impact such preferences. An interactive online survey was designed, enabling participants to change the axis of a female model's ear in terms of its forward and backward rotation. The questionnaire was sent out internationally to plastic surgeons and the general public. Demographic data were collected and analysis of variance was used to investigate respective preferences. A total of 1016 responses from 35 different countries (response rate: 18.5%) were gathered. Overall, 60% of survey takers chose the minus 10 or 5° angles to be most attractive. Significant differences were found regarding sex, ethnicity, country of residence, profession and respective ear axis preferences. Across multiple countries and ethnicities, an ear position in slight reclination of minus 5-10° is considered most pleasing in Caucasian females. However, sociodemographic factors significantly impact individual ear axis preferences and should be taken into consideration when performing reconstructive ear surgery. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Stem Cell Therapy for the Inner Ear

    PubMed Central

    Okano, Takayuki

    2012-01-01

    In vertebrates, perception of sound, motion, and balance is mediated through mechanosensory hair cells located within the inner ear. In mammals, hair cells are only generated during a short period of embryonic development. As a result, loss of hair cells as a consequence of injury, disease, or genetic mutation, leads to permanent sensory deficits. At present, cochlear implantation is the only option for profound hearing loss. However, outcomes are still variable and even the best implant cannot provide the acuity of a biological ear. The recent emergence of stem cell technology has the potential to open new approaches for hair cell regeneration. The goal of this review is to summarize the current state of inner ear stem cell research from a viewpoint of its clinical application for inner ear disorders to illustrate how complementary studies have the potential to promote and refine stem cell therapies for inner ear diseases. The review initially discusses our current understanding of the genetic pathways that regulate hair cell formation from inner ear progenitors during normal development. Subsequent sections discuss the possible use of endogenous inner ear stem cells to induce repair as well as the initial studies aimed at transplanting stem cells into the ear. PMID:22514095

  3. Is Attention Shared Between the Ears?1

    PubMed Central

    Shiffrin, Richard M.; Pisoni, David B.; Castaneda-Mendez, Kicab

    2012-01-01

    This study tests the locus of attention during selective listening for speech-like stimuli. Can processing be differentially allocated to the two ears? Two conditions were used. The simultaneous condition involved one of four randomly chosen stop-consonants being presented to one of the ears chosen at random. The sequential condition involved two intervals; in the first S listened to the right ear; in the second S listened to the left ear. One of the four consonants was presented to an attended ear during one of these intervals. Experiment I used no distracting stimuli. Experiment II utilized a distracting consonant not confusable with any of the four target consonants. This distractor was always presented to any ear not containing a target. In both experiments, simultaneous and sequential performance were essentially identical, despite the need for attention sharing between the two ears during the simultaneous condition. We conclude that selective attention does not occur during perceptual processing of speech sounds presented to the two ears. We suggest that attentive effects arise in short-term memory following processing. PMID:23226838

  4. 21 CFR 878.3590 - Ear prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear prosthesis. 878.3590 Section 878.3590 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An...

  5. 21 CFR 878.3590 - Ear prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ear prosthesis. 878.3590 Section 878.3590 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An...

  6. 21 CFR 878.3590 - Ear prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ear prosthesis. 878.3590 Section 878.3590 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An...

  7. 21 CFR 878.3590 - Ear prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ear prosthesis. 878.3590 Section 878.3590 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An...

  8. 21 CFR 878.3590 - Ear prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ear prosthesis. 878.3590 Section 878.3590 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3590 Ear prosthesis. (a) Identification. An...

  9. INNER EAR EMBRYOGENESIS: GENETIC AND ENVIRONMENTAL DETERMINANTS

    EPA Science Inventory

    The anatomy and developmental molecular genetics of the inner ear from establishment of the otic placode to formation of the definitive cochlea and vestibular apparatus will be reviewed and the complex 3-D structural changes that shape the developing inner ear will be illustrated...

  10. Middle Ear Infection (Chronic Otitis Media) and Hearing Loss

    MedlinePlus

    ... You Middle Ear Infection (Chronic Otitis Media) and Hearing Loss Middle Ear Infection (Chronic Otitis Media) and ... loss. How does otitis media affect a child’s hearing? All children with middle ear infection or fluid ...

  11. Ciliochoroidal effusion with persistent hypotony after trabectome surgery

    PubMed Central

    Osman, Essam A; AlMobarak, Faisal

    2015-01-01

    The trabectome is a novel form of ab interno trabeculectomy that ablates and remove the trabecular meshwork and the inner wall of Schlemm's canal and subsequently expose the natural drainage pathway (the collector channels) to aqueous humor. Complications associated with the trabectome are few and among them is transient hypotony. We report a case of a prolonged ciliochoroidal effusion with hypotony after ab interno trabeculectomy using the trabectome with cyclodialysis cleft detected by 80 MHz ultrasound biomicroscopy in a previously neither nonoperated nor traumatized eye. Transient hypotony has been reported after the trabectome surgery. Very few cases were associated with inadvertent intraoperative cyclodialysis, but there are no cases of prolonged hypotony with ciliochoroidal effusion with cyclodialysis. In our case, associated transient intraoperative and postoperative hypotony with a history of chronically high pressure along with the possible contribution of low-grade postoperative inflammation may have precipitated the ciliochoroidal effusion with prolonged hypotony associated with cyclodialysis. PMID:25971178

  12. Ear asymmetries in middle-ear, cochlear, and brainstem responses in human infants

    PubMed Central

    Keefe, Douglas H.; Gorga, Michael P.; Jesteadt, Walt; Smith, Lynette M.

    2008-01-01

    In 2004, Sininger and Cone-Wesson examined asymmetries in the signal-to-noise ratio (SNR) of otoacoustic emissions (OAE) in infants, reporting that distortion-product (DP)OAE SNR was larger in the left ear, whereas transient-evoked (TE)OAE SNR was larger in the right. They proposed that cochlear and brainstem asymmetries facilitate development of brain-hemispheric specialization for sound processing. Similarly, in 2006 Sininger and Cone-Wesson described ear asymmetries mainly favoring the right ear in infant auditory brainstem responses (ABRs). The present study analyzed 2640 infant responses to further explore these effects. Ear differences in OAE SNR, signal, and noise were evaluated separately and across frequencies (1.5, 2, 3, and 4 kHz), and ABR asymmetries were compared with cochlear asymmetries. Analyses of ear-canal reflectance and admittance showed that asymmetries in middle-ear functioning did not explain cochlear and brainstem asymmetries. Current results are consistent with earlier studies showing right-ear dominance for TEOAE and ABR. Noise levels were higher in the right ear for OAEs and ABRs, causing ear asymmetries in SNR to differ from those in signal level. No left-ear dominance for DPOAE signal was observed. These results do not support a theory that ear asymmetries in cochlear processing mimic hemispheric brain specialization for auditory processing. PMID:18345839

  13. Biometric recognition using 3D ear shape.

    PubMed

    Yan, Ping; Bowyer, Kevin W

    2007-08-01

    Previous works have shown that the ear is a promising candidate for biometric identification. However, in prior work, the preprocessing of ear images has had manual steps and algorithms have not necessarily handled problems caused by hair and earrings. We present a complete system for ear biometrics, including automated segmentation of the ear in a profile view image and 3D shape matching for recognition. We evaluated this system with the largest experimental study to date in ear biometrics, achieving a rank-one recognition rate of 97.8 percent for an identification scenario and an equal error rate of 1.2 percent for a verification scenario on a database of 415 subjects and 1,386 total probes.

  14. Hearing loss in children with otitis media with effusion: a systematic review.

    PubMed

    Cai, Ting; McPherson, Bradley

    2017-02-01

    Otitis media with effusion (OME) is the presence of non-purulent inflammation in the middle ear. Hearing impairment is frequently associated with OME. Pure tone audiometry and speech audiometry are two of the most primarily utilised auditory assessments and provide valuable behavioural and functional estimation on hearing loss. This paper was designed to review and analyse the effects of the presence of OME on children's listening abilities. A systematic and descriptive review. Twelve articles reporting frequency-specific pure tone thresholds and/or speech perception measures in children with OME were identified using PubMed, Ovid, Web of Science, ProQuest and Google Scholar search platforms. The hearing loss related to OME averages 18-35 dB HL. The air conduction configuration is roughly flat with a slight elevation at 2000 Hz and a nadir at 8000 Hz. Both speech-in-quiet and speech-in-noise perception have been found to be impaired. OME imposes a series of disadvantages on hearing sensitivity and speech perception in children. Further studies investigating the full range of frequency-specific pure tone thresholds, and that adopt standardised speech test materials are advocated to evaluate hearing related disabilities with greater comprehensiveness, comparability and enhanced consideration of their real life implications.

  15. COMPARISON BETWEEN COMPUTED TOMOGRAPHIC CHARACTERISTICS OF THE MIDDLE EAR IN NONBRACHYCEPHALIC AND BRACHYCEPHALIC DOGS WITH OBSTRUCTIVE AIRWAY SYNDROME.

    PubMed

    Salgüero, Raquel; Herrtage, Michael; Holmes, Mark; Mannion, Paddy; Ladlow, Jane

    2016-01-01

    Prevalence of subclinical middle ear lesions in dogs that undergo computed tomography (CT) and magnetic resonance imaging of the head has been reported up to 41%. A predisposition in brachycephalics has been suggested, however evidence-based studies are lacking. Aims of this retrospective cross-sectional study were to compare CT characteristics of the middle ear in groups of nonbrachycephalic and brachycephalic dogs that underwent CT of the head for conditions unrelated to ear disease, and test associations between thickness of the soft palate and presence of subclinical middle ear lesions. One observer recorded CT findings for each dog without knowledge of group status. A total of 65 dogs met inclusion criteria (25 brachycephalic, 40 nonbrachycephalic). Brachycephalic dogs had a significantly thicker bulla wall (P = 2.38 × 10(-26)) and smaller luminal volume (P = 5.74 × 10(-20)), when compared to nonbrachycephalic dogs. Soft palate thickness was significantly greater in the brachycephalic group (P = 2.76 × 10(-9)). Nine of 25 brachycephalic dogs had material in the lumen of the tympanic cavity, compared to zero of 45 of nonbrachycephalics. Within the brachycephalic group, a significant difference in mean soft palate thickness was identified for dogs with material in the middle ear (12.2 mm) vs. air-filled bullae (9 mm; P = 0.016). Findings from the current study supported previous theories that brachycephalic dogs have a greater prevalence of subclinical middle ear effusion and smaller bulla luminal size than nonbrachycephalic dogs. Authors recommend that the bulla lumen volume formula previously developed for mesaticephalic dogs, (-0.612 + 0.757 [lnBW]) be adjusted to 1/3(-0.612 + 0.757 [lnBW]) for brachycephalic breeds. © 2016 American College of Veterinary Radiology.

  16. Primary Intestinal Lymphangiectasia Manifested as Unusual Edemas and Effusions

    PubMed Central

    Wang, Xuefeng; Jin, Hong; Wu, Weilu

    2016-01-01

    Abstract Primary intestinal lymphangiectasia (PIL) is a rare disorder of unknown etiology characterized by diffuse or localized dilation and eventual rupture of the enteric lymphatic vessels in mucosa, submucosa, and/or subserosa. Lymph, rich in all kinds of proteins and lymphocytes, leaks into the gastrointestinal tract via the affected lymphatic vessels causing hypoproteinemia and lymphopenia. The main symptom is variable degrees of pitting edemas of bilateral lower limbs. But edemas of any other parts of body, and mild serous effusions may also occur sometimes. PIL occurs in conjunction with a right hemifacial edema, a right upper limb lymphedema, asymmetric bilateral calves edemas, and a unilateral massive pleural effusion seems never to be reported before. In addition, increased enteric protein loss that may cause severe hypoproteinemia usually get overlooked, and the lymphatic system disorders always put the diagnoses in a dilemma. We described a case of a 17-year-old Chinese girl with a history of gradually progressive swellings of right-sided face, right upper limb, and bilateral calves since 3 to 4 months of age. A right-sided massive pleural effusion, a moderate pericardial effusion, and a mild ascites have been proved unchanged by a series of computerized tomography (CT) scans since 5 years ago. The diagnosis of PIL was finally confirmed by severe hypoproteinemia, endoscopic changes, and histology of jejunum biopsy. Further lymphoscintigraphy and lymphangiography also identified lymph leakage in her bowel and several abnormal lymphatic vessels. A high-protein, low-fat diet supplemented with medium-chain triglycerides (MCT) showed some benefit. This case suggested that PIL was a rare but important etiology of hypoproteinemia, effusions, and edemas. PIL, effusions, and lymphedema can be the features of multisegmental generalized lymphatic dysplasia. In addition, both lymphoscintigraphy and intranodal lymphangiography could be considered when lymphatic

  17. A new diagnostic approach for bilious pleural effusion.

    PubMed

    Saraya, Takeshi; Light, Richard W; Sakuma, Sho; Nakamoto, Yasuo; Wada, Shoko; Ishida, Manabu; Inui, Toshiya; Koide, Takashi; Ishii, Haruyuki; Takizawa, Hajime

    2016-09-01

    Bilious pleural effusion is an extremely rare condition associated with liver diseases, subphrenic or subhepatic abscess formation, biliary peritonitis, and invasive procedures (i.e., percutaneous biliary drainage or liver biopsy). The current diagnostic test is based on the measurement of the ratio of pleural total bilirubin to serum total bilirubin, which is greater than 1 in patients with bilious pleural effusion. Given the low incidence of bilious pleural effusion, the precise diagnostic yield of this ratio based test has not been evaluated. We retrospectively reviewed the medical records of our institution and searched the PubMed database for reports of bilious pleural effusion. We identified a total of 12 cases of bilious pleural effusion (9 from 8 Pubmed reports and 3 from our institutional records). The factors causing this condition were broadly classified into three categories based on the pathophysiology: 1) liver diseases (echinococcosis, tuberculosis and amebiasis); 2) subhepatic/subphrenic abscess or biliary peritonitis, with or without biliary tract obstruction; and 3) iatrogenic disease after percutaneous biliary drainage and/or liver biopsy. The sensitivity of detection was 76.9% when the ratio of pleural total bilirubin to serum total bilirubin was greater than 1. The sensitivity increased to 100% when a combination test including pleural glycoholic acid was adopted. This study demonstrates the high diagnostic yield for bilious pleural effusion using a combination of two test criteria; a ratio of pleural total bilirubin to serum total bilirubin greater than 1 and the presence of pleural glycoholic acid. Copyright © 2016 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  18. Detection of pneumothorax and pleural effusion with horizontal beam radiography.

    PubMed

    Lynch, Katherine C; Oliveira, Cintia R; Matheson, Jodi S; Mitchell, Mark A; O'Brien, Robert T

    2012-01-01

    Forty-seven patients with a known history of thoracic trauma or clinical suspicion of pneumothorax were selected for thoracic imaging. The patient population was composed of 42 dogs and five cats. Standard vertical beam (VB) left and right lateral and ventrodorsal/dorsoventral (VD/DV) projections were obtained for each patient, and at least one horizontal beam (HB) projection (VD projection made in lateral recumbency). A total of 240 images were reviewed. Subjective assessment for the presence and degree of pneumothorax and pleural effusion was made more confidently with HB projections. Pneumothorax was identified in at least one projection in 26 patients (26 dogs) and pleural effusion in 21 patients (19 dogs and two cats). Pneumothorax and pleural effusion were present concurrently in 17 dogs. Pneumothorax and pleural effusion were graded for each image as absent, mild, moderate, or severe. Right (P < 0.001) and left (P < 0.05) lateral HB VD projections and the standard VB left lateral projection (P < 0.05) were significantly more likely to detect and grade pneumothorax severely than the VB VD/DV views. The right lateral HB projection had the highest rate of detection and gradation of severity for pneumothorax compared with other views. VD/DV projections had the lowest sensitivity for detection of the pneumothorax and gradation of severity for pneumothorax and pleural effusion. No significant difference in diagnosis (P = 0.9149) and grade (P = 0.7757) of pleural effusion were seen between views, although the left lateral HB had both the highest rate of detection and grade of severity.

  19. Seronegative rheumatoid arthritis: a rare cause of effusive-constrictive pericarditis requiring pericardiectomy.

    PubMed

    Soo, Alan; Graham, Alastair

    2012-04-01

    Effusive-constrictive pericarditis is a rare condition. In this report, we describe a case of effusive-constrictive pericarditis caused by seronegative rheumatoid arthritis which was successfully treated with surgical pericardiectomy.

  20. Microbiomes of the normal middle ear and ears with chronic otitis media.

    PubMed

    Minami, Shujiro B; Mutai, Hideki; Suzuki, Tomoko; Horii, Arata; Oishi, Naoki; Wasano, Koichiro; Katsura, Motoyasu; Tanaka, Fujinobu; Takiguchi, Tetsuya; Fujii, Masato; Kaga, Kimitaka

    2017-10-01

    The aim of this study was to profile and compare the middle ear microbiomes of human subjects with and without chronic otitis media. Prospective multicenter cohort study. All consecutive patients undergoing tympanoplasty surgery for chronic otitis media or ear surgery for conditions other than otitis media were recruited. Sterile swab samples were collected from the middle ear mucosa during surgery. The variable region 4 of the 16S rRNA gene in each sample were amplified using region-specific primers adapted for the Illumina MiSeq sequencer (Illumina, CA, USA)). The sequences were subjected to local blast and classified using Metagenome@KIN (World Fusion, Tokyo, Japan). In total, 155 participants were recruited from seven medical centers. Of these, 88 and 67 had chronic otitis media and normal middle ears, respectively. The most abundant bacterial phyla on the mucosal surfaces of the normal middle ears were Proteobacteria, followed by Actinobacteria, Firmicutes, and Bacteroidetes. The children and adults with normal middle ears differed significantly in terms of middle ear microbiomes. Subjects with chronic otitis media without active inflammation (dry ear) had similar middle ear microbiomes as the normal middle ears group. Subjects with chronic otitis media with active inflammation (wet ear) had a lower prevalence of Proteobacteria and a higher prevalence of Firmicutes than the normal middle ears. The human middle ear is inhabited by more diverse microbial communities than was previously thought. Alteration of the middle ear microbiome may contribute to the pathogenesis of chronic otitis media with active inflammation. 2b. Laryngoscope, 127:E371-E377, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  1. Study of immunoglobulins in pleura and pleural effusions.

    PubMed Central

    Telvi, L; Jaubert, F; Eyquem, A; Andreux, J P; Labrousse, F; Chrétien, J

    1979-01-01

    The protein concentration of 35 pleural effusions was compared with that in the serum. The ratio of the pleural and serum concentration of albumin, IgG, IgA, and IgM is always below unity and appears to have no diagnostic value. However, the ratio of the concentration of these proteins was inversely related to their molecular weight. The underlying mechanism in malignant and inflammatory effusions appear similar and is in keeping with a diffusion process. Immunofluorescent staining of the pleura suggests the intercellular passage of the proteins through the mesothelial barrier. Images PMID:384578

  2. Middle ear tuberculosis: diagnostic criteria.

    PubMed

    Jesić, Snezana; Stosić, Svetlana; Milenković, Branislava; Nesić, Vladimir; Dudvarski, Zoran; Jotić, Ana; Slijepcević, Nikola

    2009-01-01

    Tuberculous otitis is a diagnostic problem due to the difficulty to obtain microbiological, histomorphological and cytological confirmation of the disease. Our objective was to compare clinical and radiological characteristic and development of otogenic complications in patients with tuberculous otitis and otitis with cholesteatoma as the most destructive form of chronic nonspecific otitis in the purpose of establishing the diagnostic criteria for tuberculous otitis. Medical records of 12 patients with tuberculous otitis and 163 patients with cholesteatoma treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery in Belgrade during the eight-year period were analyzed. All of the patients underwent otomicroscopic, audiological and radiological examination of the thorax and temporal bone, microbiological examination of the secretion and histomorphological examination of the tissue taken during middle ear surgery. Statistical analysis was done using chi2 test with Yates correction. Otogenic complication as facial palsy and sensorineural hearing loss were more frequent in tuberculous otitis patients, than in cholesteatoma. Also, fistulas of the labyrinth and facial canal bone destruction were also more frequent in tuberculous otitis than in cholesteatoma. A larger extent of temporal bone destruction was noticed on CT scans of the temporal bone in half of the patents with tuberculous otitis. Coexistence with miliary pulmonary tuberculosis was detected in one third of the patients. There were no microbiological or histomorphological confirmations of the disease, except in one case with positive ZiehI-Neelsen staining. Tuberculous otitis media should be considered in patients with serious otogenic complications and with shorter duration of ear discharge, and in association with diagnosed miliary pulmonary tuberculosis and extensive temporal bone destruction. Polymerase chain reaction still is not reliable for diagnosis.

  3. Numerical analysis of ossicular chain lesion of human ear

    NASA Astrophysics Data System (ADS)

    Liu, Yingxi; Li, Sheng; Sun, Xiuzhen

    2009-04-01

    Lesion of ossicular chain is a common ear disease impairing the sense of hearing. A comprehensive numerical model of human ear can provide better understanding of sound transmission. In this study, we propose a three-dimensional finite element model of human ear that incorporates the canal, tympanic membrane, ossicular bones, middle ear suspensory ligaments/muscles, middle ear cavity and inner ear fluid. Numerical analysis is conducted and employed to predict the effects of middle ear cavity, malleus handle defect, hypoplasia of the long process of incus, and stapedial crus defect on sound transmission. The present finite element model is shown to be reasonable in predicting the ossicular mechanics of human ear.

  4. Gastroesophageal reflux disease in children with chronic otitis media with effusion.

    PubMed

    Yüksel, Fatih; Doğan, Mansur; Karataş, Duran; Yüce, Salim; Şentürk, Mehmet; Külahli, Ismail

    2013-03-01

    We aimed to evaluate a possible relation between gastroesophageal reflux disease and middle ear effusion in children. Children who came to ear, nose, and throat (ENT) department with the symptoms of hearing loss or aural fullness and diagnosed as OME by examination and tympanometry were included into the study. Children were reviewed gastroesophageal reflux disease symptoms including the following: (a) airway symptoms: stridor, frequent cough, recurrent croup, wheezing, nasal congestion, obstructive apnea, hoarseness, and throat clearing; (b) feeding symptoms: frequent emesis, dysphagia, choking: gagging, sore throat, halitosis, food refusal, regurgitation, pyrosis, irritability, failure to thrive, and anemia. Diagnosis is made with at least one positive test of radionuclide gastroesophageal scintigraphy or 24 h pH probe in the patients with reflux. ENT findings were also examined between gastroesophageal reflux disease positive and gastroesophageal reflux disease negative groups. Approximately 39 (54.9%) of 71 children had at least 1 positive test for gastroesophageal reflux disease. Between the gastroesophageal reflux disease-positive and gastroesophageal reflux disease-negative groups, symptoms of reflux were not significantly different. Two pooled variables were created: airway complex (stridor, frequent cough, throat clearing), and feeding complex (irritability, pyrosis, failure to thrive). Percentage of positive symptom complexes were no statistically different between gastroesophageal reflux disease-positive and gastroesophageal reflux disease-negative groups (>0.05). Ear, nose, and throat disorders (including rhinitis/sinusitis, adenoid hypertrophy, tonsillitis/pharyngitis, and laryngitis) were more frequent in gastroesophageal reflux disease-positive group. Tonsillitis/pharyngitis was significantly different between the gastroesophageal reflux disease positive and gastroesophageal reflux disease-negative groups. Upper respiratory tract infections were seen

  5. Uremic pleuritis: A case report and review of recurrent exudative pleural effusions in children.

    PubMed

    McGraw, Matthew D; Galambos, Csaba; Stillwell, Paul C

    2017-09-01

    Despite similar mechanisms driving pleural fluid accumulation, the causes of pleural effusions in children differ significantly from that of adults. When a pleural effusion re-occurs in an adult, literature recommends early thoracentesis, and consideration for pleuroscopy with biopsy to guide the diagnostic evaluation. In children, there is a paucity of literature for guiding management of recurrent exudative pleural effusion. We present an unusual pediatric case of uremic pleuritis with recurrent pericardial and exudative pleural effusions. © 2017 Wiley Periodicals, Inc.

  6. Pericardial Effusion with Cardiac Tamponade as a form of presentation of Primary Hypothyroidism.

    PubMed

    Agarwal, Arun; Chowdhury, Nikhil; Mathur, Ankit; Sharma, Samiksha; Agarwal, Aakanksha

    2016-12-01

    Hypothyroidism is a rare cause of pericardial effusion (PE). Pericardial effusion secondary to hypothyroidism remains a diagnostic challenge for clinicians because of its inconsistency between symptoms and amount of pericardial effusion. We report an atypical case that presented with ascites and was diagnosed to have cardiac tamponade secondary to primary hypothyroidism. Besides repeated pericardiocentesis she eventually required surgical management and optimization of medical therapy to manage the massive pericardial effusion. © Journal of the Association of Physicians of India 2011.

  7. Characteristic pattern of pleural effusion in electrical impedance tomography images of critically ill patients.

    PubMed

    Becher, T; Bußmeyer, M; Lautenschläger, I; Schädler, D; Weiler, N; Frerichs, I

    2018-06-01

    Electrical impedance tomography (EIT) is increasingly used for continuous monitoring of ventilation in intensive care patients. Clinical observations in patients with pleural effusion show an increase in out-of-phase impedance changes. We hypothesised that out-of-phase impedance changes are a typical EIT finding in patients with pleural effusion and could be useful in its detection. We conducted a prospective observational study in intensive care unit patients with and without pleural effusion. In patients with pleural effusion, EIT data were recorded before, during, and after unilateral drainage of pleural effusion. In patients with no pleural effusion, EIT data were recorded without any intervention. EIT images were separated into four quadrants of equal size. We analysed the sum of out-of-phase impedance changes in the affected quadrant in patients with pleural effusion before, during, and after drainage and compared it with the sum of out-of-phase impedance changes in the dorsal quadrants of patients without pleural effusion. We included 20 patients with pleural effusion and 10 patients without pleural effusion. The median sum of out-of-phase impedance changes was 70 (interquartile range 49-119) arbitrary units (a.u.) in patients with pleural effusion before drainage, 25 (12-46) a.u. after drainage (P<0.0001) and 11 (6-17) a.u. in patients without pleural effusion (P<0.0001 vs pleural effusion before drainage). The area under the receiver operating characteristics curve was 0.96 (95% limits of agreement 0.91-1.01) between patients with pleural effusion before drainage and those without pleural effusion. In patients monitored with EIT, the presence of out-of-phase impedance changes is highly suspicious of pleural effusion and should trigger further examination. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  8. Untargeted mass spectrometry-based metabolomic profiling of pleural effusions: fatty acids as novel cancer biomarkers for malignant pleural effusions.

    PubMed

    Lam, Ching-Wan; Law, Chun-Yiu

    2014-09-05

    Untargeted mass spectrometry-based metabolomic profiling is a powerful analytical method used for broad-spectrum identification and quantification of metabolites in biofluids in human health and disease states. In this study, we exploit metabolomic profiling for cancer biomarker discovery for diagnosis of malignant pleural effusions. We envisage the result will be clinically useful since currently there are no cancer biomarkers that are accurate enough for the diagnosis of malignant pleural effusions. Metabolomes of 32 malignant pleural effusions from lung cancer patients and 18 benign effusions from patients with pulmonary tuberculosis were analyzed using reversed-phase liquid chromatography tandem mass spectrometry (LC-MS/MS) using AB SCIEX TripleTOF 5600. MS spectra were analyzed using XCMS, PeakView, and LipidView. Metabolome-Wide Association Study (MWAS) was performed by Receiver Operating Characteristic Curve Explorer and Tester (ROCCET). Insignificant markers were filtered out using a metabolome-wide significance level (MWSL) with p-value < 2 × 10(-5) for t test. Only compounds in Human Metabolome Database (HMDB) will be used as cancer biomarkers. ROCCET analysis of ESI positive and negative MS spectra revealed free fatty acid (FFA) 18:1 (oleic acid) had the largest area-under-ROC of 0.96 (95% CI = 0.87-1.00) in malignant pleural effusions. Using a ratio of FFA 18:1-to-ceramide (d18:1/16:0), the area-under-ROC was further increased to 0.99 (95% CI = 0.91-1.00) with sensitivity 93.8% and specificity 100.0%. Using untargeted metabolomic profiling, the diagnostic cancer biomarker with the largest area-under-ROC can be determined objectively. This lipogenic phenotype could be explained by overexpression of fatty acid synthase (FASN) in cancer cells. The diagnostic performance of FFA 18:1-to-ceramide (d18:1/16:0) ratio supports its use for diagnosis of malignant pleural effusions.

  9. Primary Intestinal Lymphangiectasia (Waldmann's Disease) Presenting with Chylous Effusions in a 15-Year-Old.

    PubMed

    Surampalli, Vijay; Ramaswamy, Srinath; Surendran, Deepanjali; Bammigatti, Chanaveerappa; Swaminathan, Rathinam Palamalai

    2017-08-01

    Primary Intestinal Lymphangiectasia (PIL) is a rare disease of unknown aetiology which presents in the paediatric age group with anasarca, diarrhoea, hypoproteinaemia, lymphoedema and chylous effusions. Tuberculosis, filariasis, chest trauma, malignancies and haematological disorders usually contribute to most cases of secondary lymphangiectasia and chylous effusions. We hereby describe a case of PIL presenting with chylous effusions which remained undiagnosed for eight years.

  10. Dissecting aneurysm of arch and descending thoracic aorta presenting as a left sided hemorrhagic pleural effusion

    PubMed Central

    Shamim, Shelley; Thakur, Sumitra Basu; Sengupta, Amitava; Bhattacharyya, Sujit Kumar; Sit, Niranjan

    2010-01-01

    The most common cause of massive hemorrhagic effusion is malignancy. Herein we present a case of dissecting aneurysm of descending thoracic aorta presenting initially with shortness of breath due to left sided massive pleural effusion. Effusion was hemorrhagic in nature with high hematocrit value. CT scan of thorax with CT angiogram was done and that revealed the diagnosis. PMID:21139725

  11. Acceleration induced water removal from ear canals.

    NASA Astrophysics Data System (ADS)

    Kang, Hosung; Averett, Katelee; Jung, Sunghwan

    2017-11-01

    Children and adults commonly experience having water trapped in the ear canals after swimming. To remove the water, individuals will shake their head sideways. Since a child's ear canal has a smaller diameter, it requires more acceleration of the head to remove the trapped water. In this study, we theoretically and experimentally investigated the acceleration required to break the surface meniscus of the water in artificial ear canals and hydrophobic-coated glass tubes. In experiments, ear canal models were 3D-printed from a CT-scanned human head. Also, glass tubes were coated with silane to match the hydrophobicity in ear canals. Then, using a linear stage, we measured the acceleration values required to forcefully eject the water from the artificial ear canals and glass tubes. A theoretical model was developed to predict the critical acceleration at a given tube diameter and water volume by using a modified Rayleigh-Taylor instability. Furthermore, this research can shed light on the potential of long-term brain injury and damage by shaking the head to push the water out of the ear canal. This research was supported by National Science Foundation Grant CBET-1604424.

  12. Facial Asymmetry: Brow and Ear Position.

    PubMed

    Perumal, Balaji; Meyer, Dale R

    2018-04-01

    The purpose of the current study was to analyze brow and ear position, and examine the relationship between these structures in patients presenting for blepharoplasty evaluation. A retrospective chart review was performed, which included all patients presenting to one oculoplastic physician for a blepharoplasty evaluation from November, 2012 to March, 2014. The prevalence of brow ptosis and brow and ear asymmetry was calculated; the proportional distribution was determined, and chi-square analysis and the z-test of proportions were used to calculate the significance. Institutional Review Board approval was obtained for this study. A total of 133 patients met the inclusion criteria. Some degree of brow ptosis was noted in 83% of patients. Brow asymmetry was found in 88% of patients, and ear asymmetry in 77%. Of those patients who had asymmetry, 61% had the right brow lower and 75% had the right ear lower; 73% of all patients had the brow and ear lower on the same side ( p  < 0.001). In this study, brow ptosis and asymmetry were quite common. In addition, the side of the lower brow correlated strongly with the side of the lower ear, and the right side structures were lower more often than the left. Patients presenting for blepharoplasty evaluation may have an element of generalized facial asymmetry which includes the brows and ears. These observations can be important for preoperative planning and patient counseling. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. Middle ear impedance measurements in large vestibular aqueduct syndrome.

    PubMed

    Bilgen, Cem; Kirkim, Günay; Kirazli, Tayfun

    2009-06-01

    To assess the effect of inner ear pressure on middle ear impedance in patients with large vestibular aqueduct syndrome (LVAS). Data from admittance tympanometry and multifrequency tympanometry on 8 LVAS patients and control subjects were studied. Static acoustic compliance (SAC) values for the ears with stable sensorineural hearing loss (SNHL) were within the limits of the mean values of control groups except for two ears. The resonance frequency (RF) values of the ears with stable SNHL were lower than the mean values of control groups except for three ears. SAC values for the two ears with fluctuating SNHL were lower and the RF values were higher than the mean values of control groups. Decreased SAC values and increased RF values found in the ears with fluctuating SNHL might be an indirect indicator of increased inner ear pressure, while low RF values in the ears with stable SNHL might reflect the decreased inner ear impedance.

  14. EARS: Electronic Access to Reference Service.

    PubMed Central

    Weise, F O; Borgendale, M

    1986-01-01

    Electronic Access to Reference Service (EARS) is a front end to the Health Sciences Library's electronic mail system, with links to the online public catalog. EARS, which became operational in September 1984, is accessed by users at remote sites with either a terminal or microcomputer. It is menu-driven, allowing users to request: a computerized literature search, reference information, a photocopy of a journal article, or a book. This paper traces the history of EARS and discusses its use, its impact on library staff and services, and factors that influence the diffusion of new technology. PMID:3779167

  15. EARS: Electronic Access to Reference Service.

    PubMed

    Weise, F O; Borgendale, M

    1986-10-01

    Electronic Access to Reference Service (EARS) is a front end to the Health Sciences Library's electronic mail system, with links to the online public catalog. EARS, which became operational in September 1984, is accessed by users at remote sites with either a terminal or microcomputer. It is menu-driven, allowing users to request: a computerized literature search, reference information, a photocopy of a journal article, or a book. This paper traces the history of EARS and discusses its use, its impact on library staff and services, and factors that influence the diffusion of new technology.

  16. [Fibrinolytics in the Treatment of Complicated Pleural Effusions].

    PubMed

    Coelho, Ana; Coelho, Margarida; Pereira, Joana; Lavrador, Vasco; Morais, Lurdes; Carvalho, Fátima

    2016-11-01

    The treatment of complicated pleural parapneumonic effusions with intrapleural instillation of fibrinolytics, has shown similar results as surgical treatment. The present study aimed to evaluate the results of the use of intrapleural instillation of fibrinolytics in the treatment of complicated pleural parapneumonic effusions, in patients followed in our hospital. A retrospective review of all the patients (aged between one month and 18 years) diagnosed with complicated parapneumonic effusions, which had chest drain insertion with intrapleural instillation of fibrinolytic, between January 2005 and December 2013, was undertaken. A total of 37 patients were identified. Mean duration of hospital stay was 17 ± 7.60 days. Chest drain was placed in the first 48 h of hospital admission in most of the patients (89.2%), with a mean of six days of drainage. Treatment failure was reported in 2.7% of cases and was related with effusion recurrence. This patient underwent video-assisted thoracoscopic surgery with the need to convert to open thoracotomy. A favorable outcome was achieved in 96.9 % of cases. In our review, therapeutic success rate was as expected, with a failure rate below those reported in literature. We present intrapleural instillation of fibrinolytics and video-assisted thoracoscopic surgery as part of the same protocol, in which fibrinolytic therapy is the first-line treatment. The therapeutic option presented shows a low failure rate and avoids a more aggressive surgical procedure. We consider this an effective treatment option, with low sequelae rate.

  17. Factors influencing residual pleural opacity in tuberculous pleural effusion.

    PubMed

    Kwon, Jee Sook; Cha, Seung-Ick; Jeon, Kyung-Nyeo; Kim, Young-Joo; Kim, Eun-Jin; Kim, Chang-Ho; Park, Jae-Yong; Jung, Tae-Hoon

    2008-08-01

    Tuberculous pleural effusion (TPE) leads to residual pleural opacity (RPO) in a significant proportion of cases. The aim of this study was to investigate which TPE patients would have RPO following the treatment. This study was performed prospectively for a total of 60 TPE patients, who underwent pleural fluid analysis on the initial visit and chest radiographs and computed tomography (CT) scans before and after the administration of antituberculous medication. At the end of antituberculous medication, the incidence of RPO was 68.3% (41/60) on CT with a range of 2-50 mm. Compared with the non-RPO group, the RPO group had a longer symptom duration and lower pleural fluid glucose level. On initial CT, loculation, extrapleural fat proliferation, increased attenuation of extrapleural fat, and pleura-adjacent atelectasis were more frequent, and parietal pleura was thicker in the RPO group compared with the non-RPO group. By multivariate analysis, extrapleural fat proliferation, loculated effusion, and symptom duration were found to be predictors of RPO in TPE. In conclusion, RPO in TPE may be predicted by the clinico-radiologic parameters related to the chronicity of the effusion, such as symptom duration and extrapleural fat proliferation and loculated effusion on CT.

  18. Tuberculosis of the Chest Wall with Massive Tuberculous Pleural Effusion.

    PubMed

    Monteiro, Mongressa V; Keny, Sanjivani J; Lawande, Durga J; Kakodkar, Uday C

    2016-01-01

    Primary tuberculosis of components of the chest wall is a rare entity. Involvement of skeletal muscle by tuberculosis without any primary focus is also rare. Here, we report a case of tuberculosis of chest wall without pulmonary or bone involvement, that invaded into the pleural space leading to a massive pleural effusion.

  19. Prognostic factors of hydrops fetalis with pleural effusion.

    PubMed

    Nakayama, Atsushi; Oshiro, Makoto; Yamada, Yasumasa; Hattori, Tetsuo; Wakano, Yasuhiro; Hayashi, Seiji; Kokubo, Minoru; Takemoto, Koji; Honda, Shigeru; Ieda, Kuniko; Yamamoto, Hikaru; Kouwaki, Masanori; Yokoi, Kyoko; Shinohara, Osamu; Kato, Takenori; Miyata, Masafumi; Tanaka, Taihei; Hayakawa, Masahiro

    2017-10-01

    Hydrops fetalis (HF) has a low survival rate, particularly in the case of preterm birth. In addition, the severity index of HF has not been fully investigated yet. The aim of this study was to clarify the prognostic factors of HF with pleural effusion. All live-born HF patients with pleural effusion, except for chromosomal abnormality or complex congenital heart disease, born from 2009 to 2013 in Aichi Prefecture in Japan were included. Prenatal, perinatal, and postnatal information was obtained from the medical records and was retrospectively analyzed. Forty-one HF patients with pleural effusion were included, and 28 patients (68%) survived. On multivariate logistic stepwise analysis, gestational birth week (OR, 0.71; 95% CI: 0.52-0.96, P = 0.027) and standard deviation (SD) score of the birthweight (OR, 1.74; 95% CI: 1.01-2.99, P = 0.045) were significant factors for postnatal death. All patients with both ≥32 gestational weeks and <3.0 birthweight SD score survived. Combined with the gestational weeks data, birthweight SD score may be useful to estimate the prognosis of HF with pleural effusion. © 2017 Japan Pediatric Society.

  20. Bedside talc pleurodesis for malignant pleural effusion: factors affecting success.

    PubMed

    Aydogmus, Umit; Ozdemir, Servet; Cansever, Levent; Sonmezoglu, Yasar; Kocaturk, Celalettin Ibrahim; Bedirhan, Mehmet Ali

    2009-03-01

    To determine the factors affecting the success of bedside talc slurry (TS) used for symptomatic treatment of patients with malignant pleural effusion (MPE). Data of 113 effusions in 103 MPE patients treated between 1999 and 2007 were retrospectively evaluated for the study. The study group involved 73 patients whose follow-up information was available out of 81 patients treated by TS. Causes of MPE were lung cancer in 22 patients (30.1%) and breast carcinoma in 21 patients (28.8%). The success rate of TS was significantly higher if the time period between radiological diagnosis of effusion and administration of TS was less than 30 days (P= .02), or spontaneous expansion was attained after chest tube drainage (CTD) (P= .01). Success rate was higher for patients with daily drainage of less than 200 ml before TS than patients with more than 200 ml of daily drainage (P= .01). Dose of talc, either 4 g or above (P= .34), primary cause of MPE (P= .53), time to termination of CTD (P= .57), amount of drainage when CTD was terminated (P= .23), and time period between CTD and administration of TS (P= .20) did not show a statistically significant effect on the success of TS. In the treatment of malignant pleural effusion, patients with daily drainage of less than 200 ml before TS developed less recurrence than patients with daily drainage of more than 200 ml. Longer time period between the diagnosis of MPE and onset of CTD increased recurrence.

  1. Fluctuation theorem for the effusion of an ideal gas.

    PubMed

    Cleuren, B; Van den Broeck, C; Kawai, R

    2006-08-01

    The probability distribution of the entropy production for the effusion of an ideal gas between two compartments is calculated explicitly. The fluctuation theorem is verified. The analytic results are in good agreement with numerical data from hard disk molecular dynamics simulations.

  2. Diagnostic yield of pleural biopsy in exudative pleural effusion.

    PubMed

    Devkota, K C; Chokhani, R; Gautam, S

    2014-09-01

    To know the diagnostic role of pleural biopsy in determining underlying etiological causes of exudative pleural effusion. A total of 47 patients, aged 16-104 years with mean age of 47.36 years, of either sex, with exudative pleural effusion underwent closed pleural biopsy with Abram's needle in standard way. Average 4-6 biopsy specimens were obtained from each patient, which were sent for histopathological examination. In this study, 47 cases of exudative pleural effusion were included, among them 26 (55.31%) cases were male and 21 (44.69%) were female with mean age 47.36 years. Cough was reported by 42 (89.36%) cases, expectoration 28 (59.57%), hemoptysis 3 (6.38%), breathlessness 27 (57.44%), wheezing 3 (6.38%), chest pain 38 (80.85%) and fever by 30 (63.82%) cases. Out of 47 cases, 28 (59.57%) cases had a positive yield, whereas in 19 (40.43%) cases the result was nonspecific inflammation. Out of 28 (59.57%) cases with positive yield 21 (44.68%) were found to have granulomatous inflammation and 10 (21.28%) cases were malignant. Among malignant pleural effusion, 4 cases were squamous cell carcinoma; 3 small cell carcinoma; 1 case adenocarcinoma and 1 case found to have mesothelioma. Tuberculosis and malignancy are the two most common causes of exudative pleural effusion in our set up. Pleural biopsy is a safe, simple and well validated diagnostic tool that helps us to differentiate between malignancy and tuberculosis.

  3. A Simple Method for Differentiating Complicated Parapneumonic Effusion/Empyema from Parapneumonic Effusion Using the Split Pleura Sign and the Amount of Pleural Effusion on Thoracic CT.

    PubMed

    Tsujimoto, Naoki; Saraya, Takeshi; Light, Richard W; Tsukahara, Yayoi; Koide, Takashi; Kurai, Daisuke; Ishii, Haruyuki; Kimura, Hirokazu; Goto, Hajime; Takizawa, Hajime

    2015-01-01

    Pleural separation, the "split pleura" sign, has been reported in patients with empyema. However, the diagnostic yield of the split pleura sign for complicated parapneumonic effusion (CPPE)/empyema and its utility for differentiating CPPE/empyema from parapneumonic effusion (PPE) remains unclear. This differentiation is important because CPPE/empyema patients need thoracic drainage. In this regard, the aim of this study was to develop a simple method to distinguish CPPE/empyema from PPE using computed tomography (CT) focusing on the split pleura sign, fluid attenuation values (HU: Hounsfield units), and amount of fluid collection measured on thoracic CT prior to diagnostic thoracentesis. A total of 83 consecutive patients who underwent chest CT and were diagnosed with CPPE (n=18)/empyema (n=18) or PPE (n=47) based on the diagnostic thoracentesis were retrospectively analyzed. On univariate analysis, the split pleura sign (odds ratio (OR), 12.1; p<0.001), total amount of pleural effusion (≥30 mm) (OR, 6.13; p<0.001), HU value≥10 (OR, 5.94; p=0.001), and the presence of septum (OR, 6.43; p=0.018), atelectasis (OR, 6.83; p=0.002), or air (OR, 9.90; p=0.002) in pleural fluid were significantly higher in the CPPE/empyema group than in the PPE group. On multivariate analysis, only the split pleura sign (hazard ratio (HR), 6.70; 95% confidence interval (CI), 1.91-23.5; p=0.003) and total amount of pleural effusion (≥30 mm) on thoracic CT (HR, 7.48; 95%CI, 1.76-31.8; p=0.006) were risk factors for empyema. Sensitivity, specificity, positive predictive value, and negative predictive value of the presence of both split pleura sign and total amount of pleural effusion (≥30 mm) on thoracic CT for CPPE/empyema were 79.4%, 80.9%, 75%, and 84.4%, respectively, with an area under the curve of 0.801 on receiver operating characteristic curve analysis. This study showed a high diagnostic yield of the split pleura sign and total amount of pleural fluid (≥30 mm) on thoracic

  4. A Simple Method for Differentiating Complicated Parapneumonic Effusion/Empyema from Parapneumonic Effusion Using the Split Pleura Sign and the Amount of Pleural Effusion on Thoracic CT

    PubMed Central

    Tsujimoto, Naoki; Saraya, Takeshi; Light, Richard W.; Tsukahara, Yayoi; Koide, Takashi; Kurai, Daisuke; Ishii, Haruyuki; Kimura, Hirokazu; Goto, Hajime; Takizawa, Hajime

    2015-01-01

    Background Pleural separation, the “split pleura” sign, has been reported in patients with empyema. However, the diagnostic yield of the split pleura sign for complicated parapneumonic effusion (CPPE)/empyema and its utility for differentiating CPPE/empyema from parapneumonic effusion (PPE) remains unclear. This differentiation is important because CPPE/empyema patients need thoracic drainage. In this regard, the aim of this study was to develop a simple method to distinguish CPPE/empyema from PPE using computed tomography (CT) focusing on the split pleura sign, fluid attenuation values (HU: Hounsfield units), and amount of fluid collection measured on thoracic CT prior to diagnostic thoracentesis. Methods A total of 83 consecutive patients who underwent chest CT and were diagnosed with CPPE (n=18)/empyema (n=18) or PPE (n=47) based on the diagnostic thoracentesis were retrospectively analyzed. Results On univariate analysis, the split pleura sign (odds ratio (OR), 12.1; p<0.001), total amount of pleural effusion (≥30 mm) (OR, 6.13; p<0.001), HU value≥10 (OR, 5.94; p=0.001), and the presence of septum (OR, 6.43; p=0.018), atelectasis (OR, 6.83; p=0.002), or air (OR, 9.90; p=0.002) in pleural fluid were significantly higher in the CPPE/empyema group than in the PPE group. On multivariate analysis, only the split pleura sign (hazard ratio (HR), 6.70; 95% confidence interval (CI), 1.91-23.5; p=0.003) and total amount of pleural effusion (≥30 mm) on thoracic CT (HR, 7.48; 95%CI, 1.76-31.8; p=0.006) were risk factors for empyema. Sensitivity, specificity, positive predictive value, and negative predictive value of the presence of both split pleura sign and total amount of pleural effusion (≥30 mm) on thoracic CT for CPPE/empyema were 79.4%, 80.9%, 75%, and 84.4%, respectively, with an area under the curve of 0.801 on receiver operating characteristic curve analysis. Conclusion This study showed a high diagnostic yield of the split pleura sign and total

  5. Neonatal Ear Molding: Timing and Technique.

    PubMed

    Anstadt, Erin Elizabeth; Johns, Dana Nicole; Kwok, Alvin Chi-Ming; Siddiqi, Faizi; Gociman, Barbu

    2016-03-01

    The incidence of auricular deformities is believed to be ∼11.5 per 10,000 births, excluding children with microtia. Although not life-threatening, auricular deformities can cause undue distress for patients and their families. Although surgical procedures have traditionally been used to reconstruct congenital auricular deformities, ear molding has been gaining acceptance as an efficacious, noninvasive alternative for the treatment of newborns with ear deformations. We present the successful correction of bilateral Stahl's ear deformity in a newborn through a straightforward, nonsurgical method implemented on the first day of life. The aim of this report is to make pediatric practitioners aware of an effective and simple molding technique appropriate for correction of congenital auricular anomalies. In addition, it stresses the importance of very early initiation of ear cartilage molding for achieving the desired outcome. Copyright © 2016 by the American Academy of Pediatrics.

  6. Animal models of middle ear cholesteatoma.

    PubMed

    Yamamoto-Fukuda, Tomomi; Takahashi, Haruo; Koji, Takehiko

    2011-01-01

    Middle ear acquired cholesteatoma is a pathological condition associated with otitis media, which may be associated with temporal bone resorption, otorrhea and hearing loss, and occasionally various other complications. Cholesteatoma is characterized by the enhanced proliferation of epithelial cells with aberrant morphologic characteristics. Unfortunately, our understanding of the mechanism underlying its pathogenesis is limited. To investigate its pathogenesis, different animal models have been used. This paper provides a brief overview of the current status of research in the field of pathogenesis of middle ear acquired cholesteatoma, four types of animal models previously reported on, up-to-date cholesteatoma research using these animal models, our current studies of the local hybrid ear model, and the future prospect of new animal models of middle ear cholesteatoma.

  7. Animal Models of Middle Ear Cholesteatoma

    PubMed Central

    Yamamoto-Fukuda, Tomomi; Takahashi, Haruo; Koji, Takehiko

    2011-01-01

    Middle ear acquired cholesteatoma is a pathological condition associated with otitis media, which may be associated with temporal bone resorption, otorrhea and hearing loss, and occasionally various other complications. Cholesteatoma is characterized by the enhanced proliferation of epithelial cells with aberrant morphologic characteristics. Unfortunately, our understanding of the mechanism underlying its pathogenesis is limited. To investigate its pathogenesis, different animal models have been used. This paper provides a brief overview of the current status of research in the field of pathogenesis of middle ear acquired cholesteatoma, four types of animal models previously reported on, up-to-date cholesteatoma research using these animal models, our current studies of the local hybrid ear model, and the future prospect of new animal models of middle ear cholesteatoma. PMID:21541229

  8. Milestones in the History of Ear Reconstruction.

    PubMed

    Berghaus, Alexander; Nicoló, Marion San

    2015-12-01

    The reconstruction of ear deformities has been challenging plastic surgeons since centuries. However, it is only in the 19th century that reports on partial and total ear reconstruction start increasing. In the quest for an aesthetically pleasing and natural-looking result, surgeons worked on the perfect framework and skin coverage. Different materials and flap techniques have evolved. Some were abandoned out of frustration, while others kept evolving over the years. In this article, we discuss the milestones in ear reconstruction-from ancient times to early attempts in Western civilization to the key chapters of ear reconstruction in the 20th century leading to the current techniques. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. EAR Program Research Results : Updated through 2013

    DOT National Transportation Integrated Search

    2013-12-31

    The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...

  10. EAR Program Research Results: Updated through 2014

    DOT National Transportation Integrated Search

    2014-12-31

    The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...

  11. Diode Laser Ear Piercing: A Novel Technique.

    PubMed

    Suseela, Bibilash Babu; Babu, Preethitha; Chittoria, Ravi Kumar; Mohapatra, Devi Prasad

    2016-01-01

    Earlobe piercing is a common office room procedure done by a plastic surgeon. Various methods of ear piercing have been described. In this article, we describe a novel method of laser ear piercing using the diode laser. An 18-year-old female patient underwent an ear piercing using a diode laser with a power of 2.0 W in continuous mode after topical local anaesthetic and pre-cooling. The diode laser was fast, safe, easy to use and highly effective way of ear piercing. The advantages we noticed while using the diode laser over conventional methods were more precision, minimal trauma with less chances of hypertrophy and keloids, no bleeding with coagulation effect of laser, less time taken compared to conventional method and less chance of infection due to thermal heat effect of laser.

  12. Torsion of partial cleft of ear lobule.

    PubMed

    Kumaraswamy, M; Waiker, Veena P

    2014-02-01

    Torsion is a well-known phenomenon involving organs with long mesentery. Torsion in the ear lobule is rare. Ear lobule is very well vascularized. In cases of partial cleft ear lobule, there is a small segment of lobule inferior to the cleft which is vascularized through the pedicles on either side of the cleft. A lady aged 89 years presented with discoloration of the ear lobule. She was diagnosed as having gangrene of the central part of lobule. The segment of the lobule had undergone more than 360° torsion. She underwent debridement of gangrenous part and lobuloplasty. In our case laxity of the stretched lobule caused the torsion of the segment followed by gangrene. This rare complication indicates the need for correction of the cleft lobule not only for esthetic purpose, but also for the prevention of torsion. Copyright © 2013 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  13. EAR Program Research Results: Updated through 2016

    DOT National Transportation Integrated Search

    2016-12-31

    The Exploratory Advanced Research (EAR) Program addresses the need for longer term, higher risk research with the potential for long-term improvements to transportation systemsimprovements in planning, building, renewing, and operating safe, conge...

  14. Middle ear abnormalities in Van Maldergem syndrome.

    PubMed

    Verheij, Emmy; Thomeer, Henricus G X M; Pameijer, Frank A; Topsakal, Vedat

    2017-01-01

    Van Maldergem syndrome (VMS) is a very rare syndrome that was first described in 1992. The main features of this syndrome comprise intellectual disability, blepharo-naso-facial malformation, and hand anomalies. Almost all nine described patients have been shown to be affected by conductive hearing impairment attributed to microtia, and atresia of the outer ear canal. Here, we present a VMS patient with congenital malformations of the middle ear as the main reason for severe conductive bilateral hearing impairment. To our knowledge, this is the first report to describe middle ear abnormalities in VMS. These malformations were seen on high resolution Computed Tomography scanning and during an exploratory tympanotomy. Due to the severity of the middle ear abnormalities and the risk for facial nerve damage, the patient was not offered an ossicular chain reconstruction but a bone conduction device after this exploratory tympanotomy. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Clinical implications of pleural effusion in patients with acute type B aortic dissection.

    PubMed

    Yamada, Yoshihiro; Tanno, Jun; Nakano, Shintaro; Kasai, Takatoshi; Senbonmatsu, Takaaki; Nishimura, Shigeyuki

    2016-11-01

    Pleural effusion may complicate acute Stanford type B aortic dissection (ABAD). To identify the relationships between the quantity and side of the pleural effusion, biomarkers and outcomes in patients with ABAD. We undertook a retrospective review of 105 patients with ABAD. Their demographics, the data on admission and during hospital stay, the volume of pleural effusion calculated from the area on computed tomography images and clinical outcomes were analysed. The median estimated peak volume (median 6.7 days after onset) was 129 ml (63-192, range 26-514 ml) on the left and 11 ml (6-43, range 2-300 ml) on the right. On univariate analysis, the volume of bilateral effusions was associated with anaemia, hypoalbuminaemia and inflammatory markers, whereas the volume of left-sided effusions was associated with older age, low diastolic blood pressure and maximum aortic diameter. Multivariate analysis revealed that hypoalbuminaemia was independently associated with bilateral effusion volume ( P<0.001), while maximum aortic diameter was associated with left-sided effusion volume ( P=0.019). A greater volume of bilateral plural effusion was associated with longer intensive care unit stay. Larger bilateral pleural effusions in patients with ABAD were associated with hypoalbuminaemia and potentially with anaemia and inflammation, and may increase the length of intensive care unit stay. Left-sided effusion volume appears to be influenced by the nature of the aortic dilatation. Multiple mechanisms may underpin the development of pleural effusion in ABAD, and are likely to influence clinical outcomes.

  16. Verrucous carcinoma of the middle ear.

    PubMed

    Woodson, G E; Jurco, S; Alford, B R; McGavran, M H

    1981-01-01

    A case of a highly destructive, cytologically nondysplastic squamous epithelial lesion of the middle ear is presented. The cranial nerve involvement and bone destruction are more extensive than has been seen in cholesteatoma. Cultures are negative for Pseudomonas, and the patient does not have the reported diathesis for malignant otitis externa. The gross and microscopic features are those of verrucous carcinoma. To our knowledge, the middle ear has not been previously reported as a site of involvement by verrucous carcinoma.

  17. Postoperative Pleural Effusions After Orthotopic Heart Transplant: Cause, Clinical Manifestations, and Course.

    PubMed

    Ulubay, Gaye; Küpeli, Elif; Er Dedekargınoğlu, Balam; Savaş Bozbaş, Şerife; Alekberov, Mahal; Salman Sever, Özlem; Sezgin, Atilla

    2016-11-01

    Postoperative pleural effusions are common in patients who undergo cardiac surgery and orthotopic heart transplant. Postoperative pleural effusions may also occur as postcardiac injury syndrome. Most of these effusions are nonspecific and develop as a harmless complication of the surgical procedure itself and generally have a benign course. Here, we investigated the cause and clinical and laboratory features of postoperative early and late pleural effusions in orthotopic heart transplant patients. We retrospectively reviewed the medical records of 50 patients who underwent orthotopic heart transplant between 2004 and 2015 at Baskent University. Patient demographics and clinical and laboratory data, including cause of heart failure, presence of pleural effusions at chest radiography in the first year after transplant, timing of onset, microbiologic and biochemical analyses of pleural effusions, and treatment strategies were noted. Mean age of patients was 39.22 ± 13.83 years (39 men, 11 women). Reason for heart failure was dilated cardiomyopathy in most patients (76%). Nineteen patients (38%) had postoperative pleural effusions, with 15 patients (78.9%) with pleural effusion during the first week after transplant. Of these, 4 patients had recurrent pleural effusion. A diagnostic thoracentesis was performed in 10 patients, with 4 showing transudative effusion and 6 showing exudative effusion secondary to infection (2 patients), postcardiac injury syndrome (1 patient), and hemothorax (3 patients). Aspergillus fumigatus was detected by quantitative culture from pleural effusion in 1 patient. Tube thoracoscopy drainage was performed in 10 patients (25%), and 2 patients received antibiotic therapy. Pleural effusions are frequent after cardiac transplant. Complications may occur in a small portion of patients, with most effusions being nonspecific and having a benign course with spontaneous resolution. Early diagnostic thoracentesis could improve postoperative outcomes

  18. [Constricted ear therapy with free auricular composite grafts].

    PubMed

    Liu, Tun; Zhang, Lian-sheng; Zhuang, Hong-xing; Zhang, Ke-yuan

    2004-03-01

    A simple and effective therapy for single side constricted ear. Transplanting normal side free composite auricular grafts to constricted ear (15 patients and 15 sides), then lengthening the helix, exposing the scapha, correcting deformity. The 15 patients composite grafts all survived. The helix has been lengthened, the scapha exposed, the normal ear reduced, the constricted ear augmented and two sides ear have become symmetry. This method is simple and results are satisfied.

  19. Non-invasive optical interferometry for the assessment of biofilm growth in the middle ear

    PubMed Central

    Nguyen, Cac T.; Tu, Haohua; Chaney, Eric J.; Stewart, Charles N.; Boppart, Stephen A.

    2010-01-01

    Otitis media (OM) is the most common illness in children in the United States. Three-fourths of children under the age of three have OM at least once. Children with chronic OM, including OM with effusion and recurrent OM, will often have conductive hearing loss and communication difficulties, and need surgical treatment. Recent clinical studies provide evidence that almost all chronic OM cases are accompanied by a bacterial biofilm behind the tympanic membrane (eardrum) and within the middle ear. Biofilms are typically very thin, and cannot be recognized using a regular otoscope. Here we demonstrate how optical low coherence interferometry (LCI) noninvasively depth-ranges into the middle ear to detect and quantify biofilm microstructure. A portable diagnostic system integrating LCI with a standard video otoscope was constructed and used to detect and quantify the presence of biofilms in a newly-developed pre-clinical animal model for this condition. Using a novel classification algorithm for acquired LCI data, the system identified the presence of a biofilm with 86% sensitivity and 90% specificity, compared to histological findings. This new information on the presence of a biofilm, its structure, and its response to antibiotic treatment, will not only provide better understanding of fundamental principles that govern biofilm formation, growth, and eradication, but may also provide much needed clinical data to direct and monitor protocols for the successful management of otitis media. PMID:21258533

  20. [Atypical inflammation of the middle ear].

    PubMed

    Garov, E V; Kryukov, A I; Zelenkova, V N; Sidorina, N G; Kaloshina, A S

    The objective of the present study was to characterize the patients presenting with atypical inflammation of the middle ear and consider the currently available methods for their examination. A total of 20 patients at the age from 16 to 66 years were admitted to the Department of Ear Microsurgery during the period from 2008 and 2016 for the treatment of atypical inflammation of the middle ear. Eleven of them (18 ears) were found to have tuberculous lesions (TL) of the middle ear while the remaining 9 patients (11 ears) suffered giant cell vasculitis (GCV). All the patients underwent the general clinical and otorhinolaryngological examination, computed tomography of the temporal bones and the thoracic cavity organs, cytological, bacteriological, pathomorphological, and molecular-genetic studies including PCR diagnostics, rheumatological tests, as well as counseling by a phthisiotherapist and rheumatologist. The primary localization of TL in the middle ear was documented in 6 patients including its association with lung lesions in 5 cases. The clinical picture of the disease in 5 patients was that of smoldering exudative pathology and in 6 ones was accompanied by suppurative perforative otitis media. According to the laboratory analyses, bacteriological diagnostics proved efficient in 9% of the patients, pathomorphological and cytological diagnostics in 18% and 27.3% of the cases respectively while the effectiveness of PCR diagnostics was estimated at 55%. The diagnosis in individual patients was established within the period from 1 month to 1.5 years after they first sought medical advice in connection with complaints of the ear disease. Tuberculosis of the middle ear began to develop as exudative middle otitis that acquired the form of bilateral pathology in 4 patients. Three patients had a concomitant pulmonary disease. In 4 patuents, the diagnois of middle ear tuberculosis was established based on the presence of the specific antibodies and in 5 ones based on the

  1. Middle Ear Pressures in Wind Instrument Musicians.

    PubMed

    Osborne, Max Sallis; Morris, Simon; Clark, Matthew P; Begg, Philip

    2018-05-22

    This study aimed to assess if playing wind instruments leads to a measurable increase in middle ear pressure during note generation and to provide evidence to clinicians to advise musicians undergoing middle ear surgery. An observational cohort study of 40 volunteers in 7 different wind instrument categories underwent tympanometry at rest and during note production. Community. Recreational musicians aged over 18 years recruited from the student body attending Birmingham University, UK. None. Tympanometry is used as a noninvasive measure of middle ear pressure. The pressure at which peak compliance occurred was taken as an indirect measure of middle ear pressure. The data produced at rest and during note production was statistically analysed with paired t testing and significance set at a p value less than 0.01. Overall a statistically significant increase in middle ear pressure change of 0.63 mm Hg (p = 0.0001) during note production was identified. Musicians playing the oboe and trumpet demonstrate the largest increase in middle ear pressure of 1.46 mm Hg (p = 0.0053) and 0.78 mm Hg (p = 0.0005) respectively. The data provided by this study gives evidence for the first time that playing wind instruments does increase middle ear pressure. Although the clinical significance of this is yet to be determined the authors would advise that musicians who undergo otological procedures should refrain from playing their instruments until full recovery has been achieved as advised by their clinician following direct microscopic review.

  2. Structure and function of the mammalian middle ear. I: Large middle ears in small desert mammals.

    PubMed

    Mason, Matthew J

    2016-02-01

    Many species of small desert mammals are known to have expanded auditory bullae. The ears of gerbils and heteromyids have been well described, but much less is known about the middle ear anatomy of other desert mammals. In this study, the middle ears of three gerbils (Meriones, Desmodillus and Gerbillurus), two jerboas (Jaculus) and two sengis (elephant-shrews: Macroscelides and Elephantulus) were examined and compared, using micro-computed tomography and light microscopy. Middle ear cavity expansion has occurred in members of all three groups, apparently in association with an essentially 'freely mobile' ossicular morphology and the development of bony tubes for the middle ear arteries. Cavity expansion can occur in different ways, resulting in different subcavity patterns even between different species of gerbils. Having enlarged middle ear cavities aids low-frequency audition, and several adaptive advantages of low-frequency hearing to small desert mammals have been proposed. However, while Macroscelides was found here to have middle ear cavities so large that together they exceed brain volume, the bullae of Elephantulus are considerably smaller. Why middle ear cavities are enlarged in some desert species but not others remains unclear, but it may relate to microhabitat. © 2015 Anatomical Society.

  3. Prenatal evaluation of the middle ear and diagnosis of middle ear hypoplasia using MRI.

    PubMed

    Katorza, Eldad; Nahama-Allouche, Catherine; Castaigne, Vanina; Gonzales, Marie; Galliani, Eva; Marlin, Sandrine; Jouannic, Jean-Marie; Rosenblatt, Jonathan; le Pointe, Hubert Ducou; Garel, Catherine

    2011-05-01

    Analysis of the middle ear with fetal MRI has not been previously reported. To show the contribution of fetal MRI to middle ear imaging. The tympanic cavity was evaluated in 108 fetal cerebral MRI examinations (facial and/or cerebral malformation excluded) and in two cases, one of Treacher Collins syndrome (case 1) and the other of oculo-auriculo-vertebral (OUV) spectrum (case 2) with middle ear hypoplasia identified by MRI at 27 and 36 weeks' gestation, respectively. In all 108 fetuses (mean gestational age 32.5 weeks), the tympanic cavity and T2 hypointensity related to the ossicles were well visualised on both sides. Case 1 had micro/retrognathia and bilateral external ear deformity and case 2 had retrognathism with a left low-set and deformed ear. MRI made it possible to recognize the marked hypoplasia of the tympanic cavity, which was bilateral in case 1 and unilateral in case 2. Both syndromes are characterized by craniofacial abnormalities including middle ear hypoplasia, which cannot be diagnosed with US. The middle ear cavity can be visualized with fetal MRI. We emphasize the use of this imaging modality in the diagnosis of middle ear hypoplasia.

  4. [Effect size on resonance of the outer ear canal by simulation of middle ear lesions using a temporal bone preparation].

    PubMed

    Scheinpflug, L; Vorwerk, U; Begall, K

    1995-01-01

    By means of a model of the external and the middle ear it is possible to simulate various, exactly defined pathological conditions of the middle ear and to describe their influence on ear canal resonance. Starting point of the investigations are fresh postmortem preparations of 8 human temporal bones with an intact ear drum and a retained skin of the ear canal. The compliance of the middle ear does not significantly differ from the clinical data of probands with healthy ears. After antrotomy it is possible to simulate pathological conditions of the middle ear one after the other at the same temporal bone. The influence of the changed middle ear conditions on ear drum compliance, ear canal volume and on the resonance curve of the external ear canal was investigated. For example, the middle ear was filled with water to create approximately the same conditions as in acute serous otitis media. In this middle ear condition a significant increase of the sound pressure amplification was found, on an average by 4 decibels compared to the unchanged temporal bone model. A small increase in resonance frequency was also measured. The advantages of this model are the approximately physiological conditions and the constant dimensions of the external and middle ear.

  5. Filarial pleural effusion without peripheral blood or pleural fluid eosinophilia.

    PubMed

    Shukla, Amitabh Das; Chaudhary, Abhinav; Verma, Arvind Kumar; Anantha, Shreenivasa

    2017-09-19

    Lymphatic filariasis is a tropical parasitic disease and is endemic in India. It is present in various forms but its manifestation as pleural effusion is rare. Here, we describe a case of 58-year-old male who presented with complaint of left side chest pain and breathlessness. He was investigated and diagnosed as a case of left side pleural effusion due to filariasis, with peripheral blood lymphocytosis but without peripheral blood or pleural fluid eosinophilia. Our case foregrounds that filariasis can present with peripheral blood lymphocytosis and without peripheral blood or pleural fluid eosinophilia. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Recommendations of diagnosis and treatment of pleural effusion. Update.

    PubMed

    Villena Garrido, Victoria; Cases Viedma, Enrique; Fernández Villar, Alberto; de Pablo Gafas, Alicia; Pérez Rodríguez, Esteban; Porcel Pérez, José Manuel; Rodríguez Panadero, Francisco; Ruiz Martínez, Carlos; Salvatierra Velázquez, Angel; Valdés Cuadrado, Luis

    2014-06-01

    Although during the last few years there have been several important changes in the diagnostic or therapeutic methods, pleural effusion is still one of the diseases that the respiratory specialist have to evaluate frequently. The aim of this paper is to update the knowledge about pleural effusions, rather than to review the causes of pleural diseases exhaustively. These recommendations have a longer extension for the subjects with a direct clinical usefulness, but a slight update of other pleural diseases has been also included. Among the main scientific advantages are included the thoracic ultrasonography, the intrapleural fibrinolytics, the pleurodesis agents, or the new pleural drainages techniques. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  7. Ultrasound in the Diagnosis & Management of Pleural Effusions

    PubMed Central

    Soni, Nilam J.; Franco, Ricardo; Velez, Maria I.; Schnobrich, Daniel; Dancel, Ria; Restrepo, Marcos I.; Mayo, Paul H.

    2015-01-01

    We review the literature on the use of point-of-care ultrasound to evaluate and manage pleural effusions. Point-of-care ultrasound is more sensitive than physical exam and chest radiography to detect and characterize pleural fluid, and avoids many negative aspects of computerized tomography (CT). Additionally, point-of-care ultrasound can be used to assess pleural fluid volume and character, revealing possible underlying pathologies and guiding management. Thoracentesis performed with ultrasound guidance has lower risk of pneumothorax and bleeding complications. Future research should focus on the clinical-effectiveness of point-of-care ultrasound in the routine management of pleural effusions and how new technologies may expand its clinical utility. PMID:26218493

  8. Management of Pleural Effusion, Empyema, and Lung Abscess

    PubMed Central

    Yu, Hyeon

    2011-01-01

    Pleural effusion is an accumulation of fluid in the pleural space that is classified as transudate or exudate according to its composition and underlying pathophysiology. Empyema is defined by purulent fluid collection in the pleural space, which is most commonly caused by pneumonia. A lung abscess, on the other hand, is a parenchymal necrosis with confined cavitation that results from a pulmonary infection. Pleural effusion, empyema, and lung abscess are commonly encountered clinical problems that increase mortality. These conditions have traditionally been managed by antibiotics or surgical placement of a large drainage tube. However, as the efficacy of minimally invasive interventional procedures has been well established, image-guided small percutaneous drainage tubes have been considered as the mainstay of treatment for patients with pleural fluid collections or a lung abscess. In this article, the technical aspects of image-guided interventions, indications, expected benefits, and complications are discussed and the published literature is reviewed. PMID:22379278

  9. Lyme Disease Presenting as a Spontaneous Knee Effusion.

    PubMed

    Matzkin, Elizabeth; Suslavich, Kaytelin; Curry, Emily J

    2015-11-01

    Musculoskeletal complaints, which are frequently associated with Lyme disease, often prompt patients to see a physician. In particular, transient episodes of spontaneous knee effusion are common early in the progression of Lyme disease, and, if left untreated, 60% of patients diagnosed with the disease develop Lyme arthritis. This disease is easily treated with antibiotics; therefore, inclusion of Lyme disease in the differential diagnosis as a potential cause of a spontaneous knee effusion can prevent the development of more severe symptoms associated with the disease. However, the time required to receive test results and the inconsistencies between serum and synovial tests can complicate diagnosis of the disease. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

  10. Isolation of Mycobacterium arupense from pleural effusion: culprit or not?

    PubMed

    Zhou, Xian; Ruan, Qiaoling; Jiang, Weimin; Wang, Xinyu; Jiang, Yuan; Yu, Shenglei; Xu, Yu; Li, Jing; Zhang, Yangyi; Zhang, Wenhong; Hu, Yuekai

    2018-05-15

    Mycobacterium arupense, first identified in 2006, is a slow-growing nontuberculous mycobacterium (NTM) and an emerging cause of tenosynovitis, potentially associated with immunosuppression. However, unlike the diagnostic value of its isolation from osteoarticular specimens, the significance of detecting M. arupense in respiratory specimens is not yet clear. To our knowledge, we, for the first time, described the identification of M. arupense from the pleural effusion of an immunocompetent patient, who presented with fever and chylothorax. The symptoms resolved with doxycycline treatment for 45 days and a low-fat, high-protein diet. Follow-up at 14 months showed no relapse. Because the patient fully recovered without combined anti-NTM treatment, we did not consider M. arupense the etiological cause in this case. This indicates that M. arupense detected in pleural effusion is not necessarily a causative agent and careful interpretation is needed in terms of its clinical relevance.

  11. Lava effusion rate definition and measurement: a review

    USGS Publications Warehouse

    Calvari, Sonia; Dehn, Jonathan; Harris, A.

    2007-01-01

    Measurement of effusion rate is a primary objective for studies that model lava flow and magma system dynamics, as well as for monitoring efforts during on-going eruptions. However, its exact definition remains a source of confusion, and problems occur when comparing volume flux values that are averaged over different time periods or spatial scales, or measured using different approaches. Thus our aims are to: (1) define effusion rate terminology; and (2) assess the various measurement methods and their results. We first distinguish between instantaneous effusion rate, and time-averaged discharge rate. Eruption rate is next defined as the total volume of lava emplaced since the beginning of the eruption divided by the time since the eruption began. The ultimate extension of this is mean output rate, this being the final volume of erupted lava divided by total eruption duration. Whether these values are total values, i.e. the flux feeding all flow units across the entire flow field, or local, i.e. the flux feeding a single active unit within a flow field across which many units are active, also needs to be specified. No approach is without its problems, and all can have large error (up to ∼50%). However, good agreement between diverse approaches shows that reliable estimates can be made if each approach is applied carefully and takes into account the caveats we detail here. There are three important factors to consider and state when measuring, giving or using an effusion rate. First, the time-period over which the value was averaged; second, whether the measurement applies to the entire active flow field, or a single lava flow within that field; and third, the measurement technique and its accompanying assumptions.

  12. Pleurovenous shunt for treating refractory benign pleural effusion.

    PubMed

    Bayram, Ahmet Sami; Köprücüoğlu, Mustafa; Aygün, Mert; Gebitekin, Cengiz

    2008-05-01

    We report the case of a 63-year-old female with hepatic cirrhosis due to chronic hepatitis C, successfully treated for refractory nonmalignant hepatic hydrothorax by using a long-term pleurovenous shunt (PVS). After failure of conventional treatment by mechanical pleurodesis, a PVS was inserted to drain the pleural fluid into the right subclavian vein. After 8 months of follow-up, the effusion is well controlled, and the shunt remains patent.

  13. Characterization of primary pulmonary adenosquamous carcinoma-associated pleural effusion.

    PubMed

    Stewart, Jennifer; Holloway, Andrew; Rasotto, Roberta; Bowlt, Kelly

    2016-03-01

    A 10-year-old, female spayed Shih Tzu was presented due to weight loss, increased respiratory effort and lethargy, determined to be secondary to a congenital para-esophageal diaphragmatic defect with partial herniation of the stomach and spleen. Four days following reduction surgery of the displaced abdominal organs thoracic effusion developed. Thoracic fluid evaluation revealed a cell-rich, protein-poor modified transudate with neutrophils, reactive mesothelial cells, and atypical epitheloid cells which occasionally appeared to be keratinizing, consistent with neoplastic exfoliation. Thoracic effusion recurred 2 days later, with similar characteristics as the initial sample. Computed tomography (CT) indicated consolidation and displacement of the right middle and accessory lung lobes. Exploratory thoracic surgery demonstrated a thickened, hyperemic right middle lung lobe, and thickened pericardial diaphragmatic ligament. Histologic evaluation of these tissues identified a primary pulmonary adenosquamous carcinoma with intravascular and pleural invasion. Based on these cytologic, histologic, and clinical findings, we conclude that primary pulmonary carcinomas may involve superficial thoracic structures and exfoliate into a thoracic effusion. © 2016 American Society for Veterinary Clinical Pathology.

  14. Black pleural effusion due to pancreatic pseudocyst: A case report.

    PubMed

    Guo, Feng; Wu, Junli; Peng, Yunpeng; Tu, Min; Xiao, Bin; Dai, Cuncai; Jiang, Kuirong; Gao, Wentao; Li, Qiang; Wei, Jishu; Chen, Jianmin; Xi, Chunhua; Lu, Zipeng; Miao, Yi

    2017-12-01

    Black pleural effusion (BPE) is an extremely uncommon type of pleural fluid, which can be due to infection, primary or metastatic malignancy, and hemorrhage. As reported in previous studies, BPE is also observed in some patients with pancreatic pseudocyst. We herein reported a case of a 14-year-old female patient who was admitted to our center with a history of cough for 1 and a half months and right chest pain for 1 month. Before this, she was consecutively hospitalized in 3 different hospitals due to the same symptoms. However, the previous treatments were ineffective due to the lack of a definitive diagnosis. Laboratory examination of the pleural effusion showed BPE with a high amylase concentration. Chest x-ray and computed tomography (CT) showed massive pleural effusion, more prominent in the right chest. CT and MRCP of the abdomen showed a cystic lesion located in the tail of the pancreas, which entered the chest cavity via an esophageal hiatal hernia. DIAGNOSES:: pancreatic pseudocyst. After confirming that the tumor was a pancreatic pseudocyst by intraoperative biopsy, internal drainage to the jejunum was performed. The postoperative recovery was rapid and without complications, and the final discharge diagnosis was idiopathic pancreatic pseudocyst (without history of pancreatitis or pancreatic injuries) with BPE of the right chest. This case demonstrates that massive BPE could present as a rare complication of pancreatic pseudocyst, and surgery is a potential treatment for such patients. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  15. Lung cancer, pulmonary emphysema and pleural effusion: An autopsy study.

    PubMed

    Marel, Miloslav; Koubkova, Leona; Kovarikova, Zuzana; Grandcourtova, Alzbeta; Petrik, Frantisek; Hroudova, Hana; Capkova, Linda; Kodet, Roman; Fila, Libor

    2015-12-01

    To determine the exact incidence of lung cancer, pulmonary emphysema and pleural effusion we decided to carry out an autopsy study. In this autopsy study carried out over two years, we compared the results of autopsy findings with the clinical data in accompanying records of the deceased. Among the 708 deceased subjects, there were 398 males and 310 females with a median age of 71 years. At autopsy, 55 cases of lung carcinoma (BCA) were found, of which 24 have not been identified during life (44%). Among the deceased with BCA, emphysema was also observed at autopsy in 40% of the cases. Pulmonary emphysema was described macroscopically in 28% of the full set of 708 deceased, whereas the accompanying records of the deceased described this condition in only 12% of the cases. Microscopic changes compatible with emphysema were identified in 54% of the examined lungs. Pleural effusions were described in the accompanying records of 13% of the deceased, while the autopsies showed this condition in 33% of the deceased. BCA was accompanied by effusion in 25% of the cases. The obtained results show that the studied conditions are present in more cases than are reported by clinicians. The study confirms the commonly accepted association between lung cancer and emphysema.

  16. Medical thoracoscopy: a useful diagnostic tool for undiagnosed pleural effusion.

    PubMed

    Agarwal, Abhishek; Prasad, Rajendra; Garg, Rajiv; Verma, S K; Singh, Abhijeet; Husain, N

    2014-01-01

    We aimed to assess the role of medical thoracoscopy in patients with undiagnosed pleural effusion. Patiens presenting with pleural effusion underwent three pleural aspirations. Patients in whom pleural fluid analysis was inconclusive underwent closed pleural biopsy for diagnostic confirmation. Patients in whom closed pleural biopsy was incolcusive underwent medical thoracoscopy using a rigid thoracoscope with a viewing angle of zero degrees was done under local anaesthesia and sedation with the patient lying in lateral decubitus position with the affected side up. Biopsy specimens from parietal pleura were obtained under direct vision and were sent for histopathological examination. Of the 128 patients with pleural effusion who were studied, pleural fluid examination established the diagnosis in 81 (malignancy 33, tuberculosis 33, pyogenic 14 and fungal 1); 47 patients underwent closed pleural biopsy and a diagnosis was made in 28 patients (malignancy 24, tuberculosis 4). The remaining 19 patients underwent medical thoracoscopy and pleural biopsy and the aetiological diagnosis could be confirmed in 13 of the 19 patients (69%) (adenocarcinoma 10, poorly differentiated carcinoma 2 and mesothelioma 1). Medical thoracoscopy is a useful tool for the diagnosis of pleural diseases. The procedure is safe with minimal complications.

  17. Pericardiocentesis in massive pericardial effusions due to hypothyroidism

    NASA Astrophysics Data System (ADS)

    Nainggolan, F. H.; Dalimunthe, N. N.; Harahap, S.; Isnanta, R.; Realsyah, T.; Safri, Z.; Hasan, R.

    2018-03-01

    Pericardial effusion is the accumulation of abnormal fluid in the pericardial cavity. The symptoms are not specific and associated with the underlying disease. It was reported that a 53-year-old male patient entered the Emergency Room with a shortness of breath, and getting worse during activity and position. There was weight loss and smoking history. The history of diabetic, hypertension and malignancy were denied. On physical examination showed the enlarged right and left heart border and weakened heartbeat sheer off is found and edema pretibial and normal the other. The laboratory results;blood routine, renal and liver function within normal; lipid profile: hypercholesterolemia; viral marker is non-reactive.Rontgen thorax suggests cardiomegaly, but there was no infiltrate or nodules. Electrocardiogram (ECG) showed a low voltage. Echocardiography examination showed massive pericardial effusion. Pericardiosynthetis performed produces 750 cc of clear yellow liquid and showed transudate. Other laboratory tests such as ANA test, anti ds-DNA, cyfra were a normal impression. Thyroid function: hypothyroid, Mantoux test is negative. Finally, the patient is a massive pericardial effusion caused by hypothyroidism. The pericardiocentesis took, and the hypothyroid drug of euthirax is administered. The patient was well done and continued for recontrol.

  18. Prevalence of vomiting in dogs with pericardial effusion.

    PubMed

    Fahey, Rachel; Rozanski, Elizabeth; Paul, April; Rush, John E

    2017-03-01

    Pericardial effusion (PE) is common in dogs. Clinical signs may be vague until cardiac tamponade and associated cardiovascular decompensation develops. Vomiting has previously been identified in some dogs, but the actual prevalence of vomiting in dogs with PE is unknown. The purpose of this study is to report the prevalence of vomiting associated with PE, and to determine if vomiting is associated with the underlying cause of effusion, presenting plasma lactate concentration, or volume of PE removed. The medical records of 49 dogs diagnosed with PE were restrospectively reviewed. Data collected from the medical record included signalment, the presence or absence of vomiting, presenting plasma lactate concentration, and the etiology of the PE. Twenty-five of 49 dogs (51%) identified with PE had recently vomited. Vomiting was more common in dogs with presenting plasma lactate concentration > 5.0 mmol/L (P = 0.02) but was unrelated to the specific etiology of the PE. The volume of PE obtained via pericardiocentesis did not differ (P = 0.79) between dogs with (8.7 ± 3.4 mL/kg) and without historical vomiting (9.1 ± 4.3 mL/kg). Vomiting is common in dogs with PE, and in particular, dogs with evidence of hypoperfusion. Pericardial effusion should be included as a differential diagnosis in dogs with a history of vomiting that present with weakness or collapse. © Veterinary Emergency and Critical Care Society 2017.

  19. Maintaining ear aesthetics in helical rim reconstruction.

    PubMed

    Taylor, James M; Rajan, Ruchika; Dickson, John K; Mahajan, Ajay L

    2014-03-01

    Wedge resections of the helical rim may result in a significant deformity of the ear with the ear not only smaller but cupped and prominent too. Our technique involves resection of the wedge in the scaphal area without extending into the concha followed by advancement of the helical rim into the defect. This technique is most suitable for peripheral defects of the helical rim, in the middle third. Our modified surgical technique was applied to reconstruction of the pinna after resection of the tumor in 12 patients. Free cartilaginous helical rim, length of helical rim to be resected, and projection of the ear from the mastoid was measured. This was then compared with measurements after the operation, and the patient satisfaction assessed with a visual analog scale. The free cartilaginous rim was 91.67 ± 5.61 mm. Of this, 21.92 ± 3.78 mm was resected, which amounted to 23.84% ± 3.35% of the rim. Although this resulted in a mean increase in ear projection of 6.42 ± 1.68 mm, the aesthetic outcome was good (visual analog scale, 9.08 ± 0.9). This technique reduces cupping and does not make the ear as prominent as it may do after a conventional wedge resection and results in high patient satisfaction.

  20. Evolution and development of the vertebrate ear

    NASA Technical Reports Server (NTRS)

    Fritzsch, B.; Beisel, K. W.

    2001-01-01

    This review outlines major aspects of development and evolution of the ear, specifically addressing issues of cell fate commitment and the emerging molecular governance of these decisions. Available data support the notion of homology of subsets of mechanosensors across phyla (proprioreceptive mechanosensory neurons in insects, hair cells in vertebrates). It is argued that this conservation is primarily related to the specific transducing environment needed to achieve mechanosensation. Achieving this requires highly conserved transcription factors that regulate the expression of the relevant structural genes for mechanosensory transduction. While conserved at the level of some cell fate assignment genes (atonal and its mammalian homologue), the ear has also radically reorganized its development by implementing genes used for cell fate assignment in other parts of the developing nervous systems (e.g., neurogenin 1) and by evolving novel sets of genes specifically associated with the novel formation of sensory neurons that contact hair cells (neurotrophins and their receptors). Numerous genes have been identified that regulate morphogenesis, but there is only one common feature that emerges at the moment: the ear appears to have co-opted genes from a large variety of other parts of the developing body (forebrain, limbs, kidneys) and establishes, in combination with existing transcription factors, an environment in which those genes govern novel, ear-related morphogenetic aspects. The ear thus represents a unique mix of highly conserved developmental elements combined with co-opted and newly evolved developmental elements.

  1. Ear molding in newborn infants with auricular deformities.

    PubMed

    Byrd, H Steve; Langevin, Claude-Jean; Ghidoni, Lorraine A

    2010-10-01

    A review of a single physician's experience in managing over 831 infant ear deformities (488 patients) is presented. The authors' methods of molding have advanced from the use of various tapes, glues, and stents, to a comprehensive yet simple system that shapes the antihelix, the triangular fossa, the helical rim, and the overly prominent conchal-mastoid angle (EarWell Infant Ear Correction System). The types of deformities managed, and their relative occurrence, are as follows: (1) prominent/cup ear, 373 ears (45 percent); (2) lidding/lop ear, 224 ears (27 percent); (3) mixed ear deformities, 83 ears (10 percent) (all had associated conchal crus); (4) Stahl's ear, 66 ears (8 percent); (5) helical rim abnormalities, 58 ears (7 percent); (6) conchal crus, 25 ears (3 percent); and (7) cryptotia, two ears (0.2 percent). Bilateral deformities were present in 340 patients (70 percent), with unilateral deformities in 148 patients (30 percent). Fifty-eight infant ears (34 patients) were treated using the final version of the EarWell Infant Ear Correction System with a success rate exceeding 90 percent (good to excellent results). The system was found to be most successful when begun in the first week of the infant's life. When molding was initiated after 3 weeks from birth, only approximately half of the infants had a good response. Congenital ear deformities are common and only approximately 30 percent self-correct. These deformities can be corrected by initiating appropriate molding in the first week of life. Neonatal molding reduces the need for surgical correction with results that often exceed what can be achieved with the surgical alternative.

  2. Precise individualized armature for ear reconstruction

    NASA Astrophysics Data System (ADS)

    Evenhouse, Raymond J.; Chen, Xiaoming

    1991-04-01

    The cosmetic result of an ear restored surgically or via prosthetics is dependent on the surgeon''s ability to carve a precise cartilage armature at the time of surgery or the prosthetist''s ability to sculpt in wax an exact duplicate of the patient''s " missing" ear. Introducing CAD/CAM technology into the process benefits the esthetic outcome of these procedures. By utilizing serial section information derived from CAT MRI or moulage techniques a mirrorimage of the patient''s " donor" ear is generated. The resulting earform data is then used for the design of a cartilage armature produced by multi-axis milling or to produce by stereolithography a model which serves as the basis for a prosthesis.

  3. Building an endoscopic ear surgery program.

    PubMed

    Golub, Justin S

    2016-10-01

    This article discusses background, operative details, and outcomes of endoscopic ear surgery. This information will be helpful for those establishing a new program. Endoscopic ear surgery is growing in popularity. The ideal benefit is in totally transcanal access that would otherwise require a larger incision. The endoscope carries a number of advantages over the microscope, as well as some disadvantages. Several key maneuvers can minimize disadvantages. There is a paucity of studies directly comparing outcomes between endoscopic and microscopic approaches for the same procedure. The endoscope is gaining acceptance as a tool for treating otologic diseases. For interested surgeons, this article can help bridge the transition from microscopic to totally transcanal endoscopic ear surgery for appropriate disease.

  4. Expansion method in secondary total ear reconstruction for undesirable reconstructed ear.

    PubMed

    Liu, Tun; Hu, Jintian; Zhou, Xu; Zhang, Qingguo

    2014-09-01

    Ear reconstruction by autologous costal cartilage grafting is the most widely applied technique with fewer complications. However, undesirable ear reconstruction brings more problems to plastic surgeons. Some authors resort to free flap or osseointegration technique with prosthetic ear. In this article, we introduce a secondary total ear reconstruction with expanded skin flap method. From July 2010 to April 2012, 7 cases of undesirable ear reconstruction were repaired by tissue expansion method. Procedures including removal of previous cartilage framework, soft tissue expander insertion, and second stage of cartilage framework insertion were performed to each case regarding their local conditions. The follow-up time ranged from 6 months to 2.5 years. All of the cases recovered well with good 3-dimensional forms, symmetrical auriculocephalic angle, and stable fixation. All these evidence showed that this novel expansion method is safe, stable, and less traumatic for secondary total ear reconstruction. With sufficient expanded skin flap and refabricated cartilage framework, lifelike appearance of reconstructed ear could be acquired without causing additional injury.

  5. Active middle ear implant after lateral petrosectomy and radiotherapy for ear cancer.

    PubMed

    Cristalli, Giovanni; Sprinzl, Georg M; Wolf-Magele, Astrid; Marchesi, Paolo; Mercante, Giuseppe; Spriano, Giuseppe

    2014-04-01

    Tumor of the temporal bone is a rare disease with a very poor prognosis. Surgery and postoperative radiotherapy are usually the recommended treatments for squamous cell carcinoma (SCC) of the external and middle ear, which may cause conductive hearing loss. The purpose of this study was to evaluate the audiologic results and compliance of active middle ear implant (AMEI) and establish the feasibility of the procedure in a patient treated for middle ear cancer. A 73-year-old patient treated with lateral petrosectomy, neck dissection, reconstruction/obliteration by pedicled pectoralis major myocutaneous flap, and postoperative full dose radiotherapy for external and middle ear SCC was selected for AMEI. Preoperative audiometric and speech audiometry tests were performed on both ears before and after the activation. Pure tone free field audiometry. Binaural free field speech audiogram. Aided pure tone free field audiometry AMEI results show an increase in air conduction. Speech audiogram showed better discrimination scores in AMEI-aided situations. No complications were observed. AMEI after surgery followed by radiotherapy for middle ear cancer is feasible. Acoustic results in obliterated ear are satisfactory.

  6. Gustatory otalgia and wet ear syndrome: a possible cross-innervation after ear surgery.

    PubMed

    Saito, H

    1999-04-01

    The chorda tympani and Arnold's nerves have close approximation to each other and their cross-innervation is possible after ear surgery. A retrospective study was performed with a temporal bone pathology case and two clinical cases as representatives of such a possibility. Patients had severe otalgia and wet ear during gustatory stimulation. A temporal bone pathology case was studied under a light microscope. Earache and/or wet ear were provoked during gustatory stimulation. Wet ear was tested with iodine-starch reaction after the subject tasted lemon juice. The temporal bone specimen has clusters of regenerated fibers in the tympanic cavity in the area of the chorda tympani and Arnold's nerves, suggesting a possibility of mixing. There are regenerated fibers in the iter chordae anterius, showing successful bridging of the chorda tympani nerves across a long gap. Detachment of the skin over the operated mastoid bowl obscured signs in one clinical case. Another clinical case of gustatory wet ear showed objective evidence of cross-innervation with iodine-starch reaction. The detachment procedure and iodine-starch reaction were the proofs that the signs were related to regenerated fibers. This is the first report of gustatory otalgia and wet ear after ear surgery.

  7. Protocol of the PLeural Effusion And Symptom Evaluation (PLEASE) study on the pathophysiology of breathlessness in patients with symptomatic pleural effusions.

    PubMed

    Thomas, Rajesh; Azzopardi, Maree; Muruganandan, Sanjeevan; Read, Catherine; Murray, Kevin; Eastwood, Peter; Jenkins, Sue; Singh, Bhajan; Lee, Y C Gary

    2016-08-03

    Pleural effusion is a common clinical problem that can complicate many medical conditions. Breathlessness is the most common symptom of pleural effusion of any cause and the most common reason for pleural drainage. However, improvement in breathlessness following drainage of an effusion is variable; some patients experience either no benefit or a worsening of their breathlessness. The physiological mechanisms underlying breathlessness in patients with a pleural effusion are unclear and likely to be multifactorial with patient-related and effusion-related factors contributing. A comprehensive study of the physiological and symptom responses to drainage of pleural effusions may provide a clearer understanding of these mechanisms, and may identify predictors of benefit from drainage. The ability to identify those patients whose breathlessness will (or will not) improve after pleural fluid drainage can help avoid unnecessary pleural drainage procedures, their associated morbidities and costs. The PLeural Effusion And Symptom Evaluation (PLEASE) study is a prospective study to comprehensively evaluate factors contributing to pleural effusion-related breathlessness. The PLEASE study is a single-centre prospective study of 150 patients with symptomatic pleural effusions that require therapeutic drainage. The study aims to identify key factors that underlie breathlessness in patients with pleural effusions and develop predictors of improvement in breathlessness following effusion drainage. Participants will undergo evaluation pre-effusion and post-effusion drainage to assess their level of breathlessness at rest and during exercise, respiratory and other physiological responses as well as respiratory muscle mechanics. Pre-drainage and post-drainage parameters will be collected and compared to identify the key factors and mechanisms that correlate with improvement in breathlessness. Approved by the Sir Charles Gairdner Group Human Research Ethics Committee (HREC number 2014

  8. Dysmorphism of the middle ear: case report

    PubMed Central

    Solero, P; Ferrara, M; Musto, R; Pira, A; Di Lisi, D

    2005-01-01

    Summary Although there are numerous publications in the literature describing the wide range of diagnosis, classifications and treatment of malformations of the hearing apparatus, even more variations can be found in clinical practice. Indeed, each individual case is unique as far as concerns pathogenesis, clinical course and treatment. The case reported herein describes a 12-year-old boy affected by cranio-facial dysmorphism and monolateral conductive hearing loss in the right ear: followed from radiological diagnosis – carried out to study a malformation of the ear pinna – to surgical treatment. PMID:16602328

  9. Correcting prominent ears with the island technique.

    PubMed

    DeMoura, L F

    1977-01-01

    A surgical procedure is described which corrects the ansiform ear by repositioning and reconstructing the anthelix and the anterior crus with the formation of the triangular fossa. This corrects the scaphoconchal angle and improves the cephaloauricular angle, overcoming the problem of prominent ears. Correction in early childhood is recommended in order to avoid personality problems that may result from the deformity, particularly in boys. The technique employed yields important advantages: (1) prolonged use of the helmet-type of surgical dressing is unnecessary; (2) scars are less conspicuous; (3) the outcome is attractive and normal; (4) bleeding and inflammatory complications are avoided; and (5) recurrence of the malformation is unlikely.

  10. Are two ears not better than one?

    PubMed

    McArdle, Rachel A; Killion, Mead; Mennite, Monica A; Chisolm, Theresa H

    2012-03-01

    The decision to fit one or two hearing aids in individuals with binaural hearing loss has been debated for years. Although some 78% of U.S. hearing aid fittings are binaural (Kochkin , 2010), Walden and Walden (2005) presented data showing that 82% (23 of 28 patients) of their sample obtained significantly better speech recognition in noise scores when wearing one hearing aid as opposed to two. To conduct two new experiments to fuel the monaural/binaural debate. The first experiment was a replication of Walden and Walden (2005), whereas the second experiment examined the use of binaural cues to improve speech recognition in noise. A repeated measures experimental design. Twenty veterans (aged 59-85 yr), with mild to moderately severe binaurally symmetrical hearing loss who wore binaural hearing aids were recruited from the Audiology Department at the Bay Pines VA Healthcare System. Experiment 1 followed the procedures of the Walden and Walden study, where signal-to-noise ratio (SNR) loss was measured using the Quick Speech-in-Noise (QuickSIN) test on participants who were aided with their current hearing aids. Signal and noise were presented in the sound booth at 0° azimuth under five test conditions: (1) right ear aided, (2) left ear aided, (3) both ears aided, (4) right ear aided, left ear plugged, and (5) unaided. The opposite ear in (1) and (2) was left open. In Experiment 2, binaural Knowles Electronics Manikin for Acoustic Research (KEMAR) manikin recordings made in Lou Malnati's pizza restaurant during a busy period provided a typical real-world noise, while prerecorded target sentences were presented through a small loudspeaker located in front of the KEMAR manikin. Subjects listened to the resulting binaural recordings through insert earphones under the following four conditions: (1) binaural, (2) diotic, (3) monaural left, and (4) monaural right. Results of repeated measures ANOVAs demonstrated that the best speech recognition in noise performance was

  11. Minimal Pleural Effusion in Small Cell Lung Cancer: Proportion, Mechanisms, and Prognostic Effect.

    PubMed

    Ryu, Jeong-Seon; Lim, Jun Hyeok; Lee, Jeong Min; Kim, Woo Chul; Lee, Kyung-Hee; Memon, Azra; Lee, Seul-Ki; Yi, Bo-Rim; Kim, Hyun-Jung; Hwang, Seung-Sik

    2016-02-01

    To determine the frequency and investigate possible mechanisms and prognostic relevance of minimal (<10-mm thickness) pleural effusion in patients with small cell lung cancer (SCLC). The single-center retrospective study was approved by the institutional review board of the hospital, and informed consent was waived by the patients. A cohort of 360 consecutive patients diagnosed with SCLC by using histologic analysis was enrolled in this study. Based on the status of pleural effusion on chest computed tomographic (CT) scans at diagnosis, patients were classified into three groups: no pleural effusion, minimal pleural effusion, and malignant pleural effusion. Eighteen variables related to patient, environment, stage, and treatment were included in the final model as potential confounders. Minimal pleural effusion was present in 74 patients (20.6%) and malignant pleural effusion in 83 patients (23.0%). Median survival was significantly different in patients with no, minimal, or malignant pleural effusion (median survival, 11.2, 5.93, and 4.83 months, respectively; P < .001, log-rank test). In the fully adjusted final model, patients with minimal pleural effusion had a significantly increased risk of death compared with those with no pleural effusion (adjusted hazard ratio, 1.454 [95% confidence interval: 1.012, 2.090]; P = .001). The prognostic effect was significant in patients with stage I-III disease (adjusted hazard ratio, 2.751 [95% confidence interval: 1.586, 4.773]; P < .001), but it disappeared in stage IV disease. An indirect mechanism representing mediastinal lymphadenopathy was responsible for the accumulation in all but one patient with minimal pleural effusion. Minimal pleural effusion is a common clinical finding in staging SCLC. Its presence is associated with worse survival in patients and should be considered when CT scans are interpreted. © RSNA, 2015.

  12. Automated extraction of pleural effusion in three-dimensional thoracic CT images

    NASA Astrophysics Data System (ADS)

    Kido, Shoji; Tsunomori, Akinori

    2009-02-01

    It is important for diagnosis of pulmonary diseases to measure volume of accumulating pleural effusion in threedimensional thoracic CT images quantitatively. However, automated extraction of pulmonary effusion correctly is difficult. Conventional extraction algorithm using a gray-level based threshold can not extract pleural effusion from thoracic wall or mediastinum correctly, because density of pleural effusion in CT images is similar to those of thoracic wall or mediastinum. So, we have developed an automated extraction method of pulmonary effusion by use of extracting lung area with pleural effusion. Our method used a template of lung obtained from a normal lung for segmentation of lungs with pleural effusions. Registration process consisted of two steps. First step was a global matching processing between normal and abnormal lungs of organs such as bronchi, bones (ribs, sternum and vertebrae) and upper surfaces of livers which were extracted using a region-growing algorithm. Second step was a local matching processing between normal and abnormal lungs which were deformed by the parameter obtained from the global matching processing. Finally, we segmented a lung with pleural effusion by use of the template which was deformed by two parameters obtained from the global matching processing and the local matching processing. We compared our method with a conventional extraction method using a gray-level based threshold and two published methods. The extraction rates of pleural effusions obtained from our method were much higher than those obtained from other methods. Automated extraction method of pulmonary effusion by use of extracting lung area with pleural effusion is promising for diagnosis of pulmonary diseases by providing quantitative volume of accumulating pleural effusion.

  13. A different type of 'glue ear': report of an unusual case of prominent ears.

    PubMed

    Purcell, Elizabeth M; O'Neill, Ann C; Regan, Padraic J

    2003-09-01

    Prominent ears is a condition that can cause extreme psychological distress in young people. This cosmetic deformity can be corrected by otoplasty, an outpatient surgical procedure that is associated with a high rate of patient satisfaction. We report the unusual case of a teenage boy who had repeatedly applied cyanoacrylate adhesive ("superglue") to his postauricular skin in an attempt to pin back his prominent ears. This case of "glue ear" was ultimately resolved by successful otoplasty, although the residual effects of the glue resulted in delayed healing of the surgical wound.

  14. [Determination of isoniazide concentration in pleural effusion and its pleural permeability in patients with tuberculous pleurisy].

    PubMed

    Liu, Yuan; Zhang, Qing; Zhang, Junfeng; Huang, Guohua; Zhu, Shunfang; Liu, Sijia; Li, Guofeng

    2012-05-01

    To establish a high-performance liquid chromatography (HPLC)-based method for determining isoniazide concentration in pleural effusion and plasma of patients with tuberculous pleurisy, and evaluate the permeability of isoniazide from blood into pleural effusion. We collected pleural effusion from 15 patients with tuberculous pleurisy 2 h after administration 300 mg isoniazide in the morning of day 1. Pleural effusion and plasma were obtained 2 h after isoniazide administration on day 3. Isoniazide concentration was measured using HPLC, and the penetration rate of isoniazide in pleural effusion was calculated. Isoniazide concentration in the pleural effusion averaged 1.156∓1.190 µg/ml in the 15 patients at 2 h after isoniazide administration on day 1. On day 3, isoniazide concentration was 1.920∓1.294 µg/ml in the pleural effusion and 2.445∓1.463 µg/ml in the plasma, and the mean penetration rate of isoniazide from blood into the pleural effusion was 86.0%. As isoniazide has a high penetration rate into the pleural effusion in most patients, continuous oral administration of isoniazid has been sufficient to achieve an effective treatment concentration, and intrapleural injection of isoniazide may seem unnecessary for non-drug-resistant tuberculosis pleurisy.

  15. Different expression of FoxM1 in human benign and malignant pleural effusion.

    PubMed

    Tang, Zhonghao; Li, Hongqing; Zhu, Huili; Bai, Chunxue

    2015-01-01

    The aims of this study were as follows: to analyze the forkhead box M1 (FoxM1) expression in benign and malignant pleural effusion by reverse transcription-polymerase chain reaction assay (RT-PCR); to explore the role of FoxM1 in formation and progress in malignant pleural effusion, and whether there is significant difference in expression level of FoxM1 between benign and malignant pleural effusion; to seek a gene marker diagnostically useful to identify benign and malignant pleural effusion in diagnosis and treatment of pleural effusion; and to collect expression level data of FoxM1 in 23 malignant pleural effusion samples (17 adenocarcinoma samples, four squamous carcinoma samples and two small cell lung carcinoma samples) and 15 benign pleural effusion samples (11 inflammatory pleural effusions, two transudates, two tuberculous pleural effusions) by RT-PCR. Among all 38 samples, average FoxM1 expression level of benign pleural effusions is (235.09 ± 59.99), while malignant pleural effusions (828.77 ± 109.76). Among 23 malignant samples, average FoxM1 expression level is (529.27 ± 75.85) in samples without cytological diagnostic evidence, while (1,218.12 ± 167.21) in samples with cytological diagnostic evidence. Differences of FoxM1 expression level between benign pleural effusions and malignant ones have statistical significance. There is an area of 0.881 under the receiver-operating characteristic curve, which verifies the accuracy of using FoxM1 expression level as diagnostic index to identify benign and malignant pleural effusions. According to our study, diagnostic sensitivity and specificity for FoxM1 expression level at 418.1 were 82.6 and 86.7 %, respectively, while 47.8 and 100 %, respectively, at 768.7. FoxM1 expression level in malignant pleural effusions is significantly higher than in benign ones. This study provides a new approach in clinical diagnosis, with FoxM1 as a specific molecule marker to identify benign and malignant pleural

  16. Effects of tumor necrosis factor alpha antagonist, platelet activating factor antagonist, and nitric oxide synthase inhibitor on experimental otitis media with effusion.

    PubMed

    Kim, Dong-Hyun; Park, Yong-Soo; Jeon, Eun-Ju; Yeo, Sang-Won; Chang, Ki-Hong; Lee, Seung Kyun

    2006-08-01

    We studied the inflammatory responses in otitis media with effusion induced by lipopolysaccharide (LPS) in rats, and compared the preventive effects of tumor necrosis factor (TNF) soluble receptor type I (sTNFRI, a TNF-alpha antagonist), platelet activating factor antagonist, and the nitric oxide synthase inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME). We used 2 control groups of Sprague Dawley rats (untreated and saline-treated) and 4 experimental groups, which all received an intratympanic injection of LPS, followed in 3 groups by experimental treatment of the same ear. The LPS group had no additional treatment. The L-NAME group received intraperitoneal injection of L-NAME and was reinjected after 12 hours. The A-85783 group was first given an intraperitoneal injection of A-85783. The sTNFRI group was first given an intratympanic injection of sTNFRI. Twenty-four hours after the initial intratympanic injection of LPS, temporal bones from each group were examined histopathologically and the vascular permeability of the middle ear mucosa was measured by Evans blue vital dye staining. The L-NAME, A-85783, and sTNFRI groups showed significantly reduced capillary permeability, subepithelial edema, and infiltration of inflammatory cells in comparison with the LPS group. There were no differences in capillary permeability, subepithelial edema, or infiltration of inflammatory cells between the A-85783 and sTNFRI groups. The L-NAME group showed no difference in vascular permeability or subepithelial edema in comparison with the A-85783 and sTNFRI groups, but showed more infiltration of inflammatory cells. We conclude that sTNFRI, A-85783, and L-NAME can be proposed as alternative future treatments for otitis media with effusion. However, L-NAME may be the least effective of these agents.

  17. [An ear thermometer based on infrared thermopiles sensor].

    PubMed

    Xie, Haiyuan; Qian, Mingli

    2013-09-01

    According to the development of body temperature measurement mode, an ear thermometer with infrared thermopiles sensor is designed for body thermometry Compared with oral thermometer, the accuracy of ear thermometer is acceptable.

  18. Pediatric Obesity and Ear, Nose, and Throat Disorders

    MedlinePlus

    ... Marketplace Find an ENT Doctor Near You Pediatric Obesity and Ear, Nose, and Throat Disorders Pediatric Obesity ... self-esteem, and isolation from their peers. Pediatric obesity and otolaryngic problems Otolaryngologists, or ear, nose, and ...

  19. Pediatric Obesity and Ear, Nose, and Throat Disorders

    MedlinePlus

    ... Although there is no proven medical link between middle ear infections and pediatric obesity there may be a behavioral association between the two conditions. Some studies have found that when a child is rubbing or massaging the infected ear the ...

  20. Transmission matrix analysis of the chinchilla middle ear

    PubMed Central

    Songer, Jocelyn E.; Rosowski, John J.

    2008-01-01

    Despite the common use of the chinchilla as an animal model in auditory research, a complete characterization of the chinchilla middle ear using transmission matrix analysis has not been performed. In this paper we describe measurements of middle-ear input admittance and stapes velocity in ears with the middle-ear cavity opened under three conditions: intact tympano-ossicular system and cochlea, after the cochlea has been drained, and after the stapes has been fixed. These measurements, made with stimulus frequencies of 100–8000 Hz, are used to define the transmission matrix parameters of the middle ear and to calculate the cochlear input impedance as well as the middle-ear output impedance. This transmission characterization of the chinchilla middle ear will be useful for modeling auditory sensitivity in the normal and pathological chinchilla ear. PMID:17672642

  1. Ear tube surgery - what to ask your doctor

    MedlinePlus

    What to ask your doctor about ear tube surgery; Tympanostomy - what to ask your doctor; Myringotomy - what to ask your doctor ... need ear tubes? Can we try other treatments? What are the risks of the surgery? Is it ...

  2. Getting Teens to Read with Their Ears

    ERIC Educational Resources Information Center

    Fues, Marianne Cole

    2009-01-01

    Audiobooks have been around for years in various formats, like cassette tapes and CDs. This article describes a new type of audiobook on the market which is generating an interest in "reading." The device, called Playaway, is the size of a MP3 player and comes with a lanyard and ear buds. Buttons on the back of the player control the…

  3. Congenital tuberculosis localised to the ear.

    PubMed Central

    Naranbhai, R C; Mathiassen, W; Malan, A F

    1989-01-01

    We report two infants who had localised congenital tuberculous otitis. In both cases the infants presented with an ear discharge and both mothers had been diagnosed as having miliary tuberculosis. Infection is thought to have occurred in utero or during birth. Images Figure PMID:2786383

  4. A systematic review on external ear melanoma.

    PubMed

    Toia, Francesca; Garbo, Giuseppe; Tripoli, Massimiliano; Rinaldi, Gaetana; Moschella, Francesco; Cordova, Adriana

    2015-07-01

    External ear melanoma accounts for only 1% of all cutaneous melanomas, and data on its optimal management and prognosis are limited. We aim to review the literature on external ear melanoma to guide surgeons in the treatment of this uncommon and peculiar pathology. A systematic review of English language studies on ear melanoma published from 1993 to 2013 was performed using the PubMed electronic database. Data on epidemiology, oncological treatment (tumor resection and regional lymph nodes management), and reconstruction were extrapolated from selected papers. The total number of patients was 858 (30 studies). The helix was the most common location (57%); superficial spreading melanoma was the most common histopathological subtype (41%). The mean Breslow thickness was 2.01 mm, with 88% of stage I-II patients. Sentinel lymph node biopsy was performed in 45% of patients, with 8% of positive nodes. Available data on its prognosis are fragmentary and contrasting, but the Breslow thickness appears to be the main prognostic factor. There is a tendency towards reduced resection margins and preservation of the underlying perichondrium and cartilage. Local flaps are the most popular reconstructive option. To the best of our knowledge, this systematic review presents the largest data series on external ear melanoma. There is no general agreement on its surgical management, but a favorable prognosis seems to justify the tendency towards conservative treatments. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Surgical correction of the cauliflower ear.

    PubMed

    Vogelin, E; Grobbelaar, A O; Chana, J S; Gault, D T

    1998-07-01

    The cauliflower ear presents a challenge to the surgeon. Patients complain of discomfort and appearance. Three patients were treated surgically via a posterior approach to remove the hardened segment and re-sculpture a leaf of cartilage left in place. An acceptable cosmetic result was achieved and all patients are currently pain free.

  6. A review of microvascular ear replantation.

    PubMed

    Jung, Sung Won; Lee, Junsang; Oh, Suk Joon; Koh, Sung Hoon; Chung, Chul Hoon; Lee, Jong Wook

    2013-03-01

    Microvascular ear replantation is a significant challenge because of the small size of the vessels and the fact that traumatic amputations are frequently avulsed. The zone of trauma is therefore extended and the primary repair of the injured vessel is rendered unlikely. The purpose of this study is to review the literature of ear replantation. A review of the relevant literature that has been published since 1980 revealed 47 cases reported in 37 publications. We present 5 cases from our own experience and analyze a total 52 cases of microvascular ear replantation. The patient's age, sex, degree of amputation, cause of injury, ischemic time, method of arterial and venous anastomosis, complications, any additional outflow used, postoperative medications, the requirement for transfusions, and the number of hospital admission days are described. Successful microvascular ear replantations require anastomosis of the vessels if possible. Rather than a vein graft, primary repair of the vessels, or at least pedicled repair of the artery, should be considered to ensure flap survival. In addition, vein repair should be considered if possible to ensure the secure drainage of blood from the replant. With secure circulation, the replant can survive, resulting in a very satisfactory outcome. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. Keep Your Ear-Lids Open.

    ERIC Educational Resources Information Center

    Ferrington, Gary

    1994-01-01

    This article suggests that the development of listening skills should extend to the "soundscape" of nonspeech acoustical information. It presents a model for effective aural processing, identifies categories of information obtained from nonverbal sound, and explores "ear-tuning" or listening exercises that use sound to glean…

  8. [The effect of OSAHS on middle ear and inner ear vestibule function advances].

    PubMed

    Li, K L; Li, J R

    2016-05-20

    Obstructive sleep apnea hypopnea syndrome(OSAHS) as a common frequentlyoccurring disease, it can cause repeated episodes of hypoxaemia and hypercapnia during sleep. With long period of hypoxaemia, obvious pathological changes and dysfunction emerged in heart,brain and lung then all kinds of clinical symptoms appear. Because of the middle ear and inner ear themselves anatomical characteristics and blood supply of regulating mechanism, they often has been damaged before the other important organ damage. As scholars have indepth study of the auditory system complications in patients with OSAHS, various influence of OSAHS on the middle ear,inner ear also gradually be known.This paper will review the effect of OSAHS on middle ear, inner ear and vestibule function, hope to have some application value for clinical work. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

  9. Eosinophilic pleural effusion: incidence, etiology and prognostic significance.

    PubMed

    Ferreiro, Lucía; San José, Esther; González-Barcala, Francisco Javier; Alvarez-Dobaño, José Manuel; Golpe, Antonio; Gude, Francisco; Anchorena, Christian; Pereyra, Marco F; Zamarrón, Carlos; Valdés, Luis

    2011-10-01

    Eosinophilic pleural effusion (EPE) has been associated with less risk for malignancy with a potential causal relationship with the presence of air and/or blood in the pleural space. However, these theories have fallen by the wayside in the light of recent publications. To determine the incidence and etiology of EPE and to observe whether the eosinophils in the pleural liquid (PL) increase in successive thoracocenteses. We analyzed 730 PL samples from 605 patients hospitalized between January 2004 and December 2010. We identified 55 samples with EPE from 50 patients (8.3%). The most frequent etiologies of EPE were: unknown (36%) and neoplasm (30%). There were no significant differences in the incidence of neoplasms between the non-eosinophilic pleural effusions (non-EPE) (25.9%) and the EPE (30%) (p=0.533). One hundred patients (16.5%) underwent a second thoracocentesis. Out of the 9 who had EPE in the first, 6 maintained EPE in the second. Out of the 91 with non-EPE in the first thoracocentesis, 8 (8.8%) had EPE in the repeat thoracocentesis. The percentage of eosinophils did not increase in the successive thoracocenteses (p=0.427). In the EPE, a significant correlation was found between the number of hematites and eosinophils in the PL (r=0.563; p=0.000). An EPE cannot be considered an indicator of benignancy, therefore it should be studied as any other pleural effusion. The number of eosinophils does not seem to increase with the of repetition of thoracocentesis and, lastly, the presence of blood in the PL could explain the existence of EPE. Copyright © 2011 SEPAR. Published by Elsevier Espana. All rights reserved.

  10. 40 CFR 211.206-1 - Real ear method.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Real ear method. 211.206-1 Section 211... PRODUCT NOISE LABELING Hearing Protective Devices § 211.206-1 Real ear method. (a) The value of sound... “Method for the Measurement of Real-Ear Protection of Hearing Protectors and Physical Attenuation of...

  11. The middle ear mass: a rare but important diagnosis.

    PubMed

    Pankhania, Miran; Rourke, Thomas; Draper, Mark R

    2011-12-02

    The authors report a rare case of primary intracranial meningioma presenting as a middle ear mass with conductive hearing loss. The authors aim to highlight the importance of diagnosing a middle ear mass, which although rare, may have a substantial impact on ongoing patient management. A discussion of other middle ear pathologies is made in order to demonstrate the subtle differences in presentation.

  12. 40 CFR 211.206-1 - Real ear method.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Real ear method. 211.206-1 Section 211... PRODUCT NOISE LABELING Hearing Protective Devices § 211.206-1 Real ear method. (a) The value of sound... “Method for the Measurement of Real-Ear Protection of Hearing Protectors and Physical Attenuation of...

  13. 40 CFR 211.206-1 - Real ear method.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Real ear method. 211.206-1 Section 211... PRODUCT NOISE LABELING Hearing Protective Devices § 211.206-1 Real ear method. (a) The value of sound... “Method for the Measurement of Real-Ear Protection of Hearing Protectors and Physical Attenuation of...

  14. 40 CFR 211.206-1 - Real ear method.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Real ear method. 211.206-1 Section 211... PRODUCT NOISE LABELING Hearing Protective Devices § 211.206-1 Real ear method. (a) The value of sound... “Method for the Measurement of Real-Ear Protection of Hearing Protectors and Physical Attenuation of...

  15. 40 CFR 211.206-1 - Real ear method.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Real ear method. 211.206-1 Section 211... PRODUCT NOISE LABELING Hearing Protective Devices § 211.206-1 Real ear method. (a) The value of sound... “Method for the Measurement of Real-Ear Protection of Hearing Protectors and Physical Attenuation of...

  16. 15 CFR 734.2 - Important EAR terms and principles.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... technology and software not subject to the EAR are described in §§ 734.7 through 734.11 and supplement no. 1... of items subject to the EAR out of the United States, or release of technology or software subject to... source code and object code software subject to the EAR. (2) Export of technology or software. (See...

  17. 15 CFR 734.2 - Important EAR terms and principles.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... technology and software not subject to the EAR are described in §§ 734.7 through 734.11 and supplement no. 1... of items subject to the EAR out of the United States, or release of technology or software subject to... source code and object code software subject to the EAR. (2) Export of technology or software. (See...

  18. 15 CFR 734.2 - Important EAR terms and principles.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... technology and software not subject to the EAR are described in §§ 734.7 through 734.11 and supplement no. 1... of items subject to the EAR out of the United States, or release of technology or software subject to... source code and object code software subject to the EAR. (2) Export of technology or software. (See...

  19. 15 CFR 734.2 - Important EAR terms and principles.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... technology and software not subject to the EAR are described in §§ 734.7 through 734.11 and supplement no. 1... of items subject to the EAR out of the United States, or release of technology or software subject to... source code and object code software subject to the EAR. (2) Export of technology or software. (See...

  20. 15 CFR 734.2 - Important EAR terms and principles.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... technology and software not subject to the EAR are described in §§ 734.7 through 734.11 and supplement no. 1... of items subject to the EAR out of the United States, or release of technology or software subject to... source code and object code software subject to the EAR. (2) Export of technology or software. (See...

  1. Role of skeletal muscle in ear development.

    PubMed

    Rot, Irena; Baguma-Nibasheka, Mark; Costain, Willard J; Hong, Paul; Tafra, Robert; Mardesic-Brakus, Snjezana; Mrduljas-Djujic, Natasa; Saraga-Babic, Mirna; Kablar, Boris

    2017-10-01

    The current paper is a continuation of our work described in Rot and Kablar, 2010. Here, we show lists of 10 up- and 87 down-regulated genes obtained by a cDNA microarray analysis that compared developing Myf5-/-:Myod-/- (and Mrf4-/-) petrous part of the temporal bone, containing middle and inner ear, to the control, at embryonic day 18.5. Myf5-/-:Myod-/- fetuses entirely lack skeletal myoblasts and muscles. They are unable to move their head, which interferes with the perception of angular acceleration. Previously, we showed that the inner ear areas most affected in Myf5-/-:Myod-/- fetuses were the vestibular cristae ampullaris, sensitive to angular acceleration. Our finding that the type I hair cells were absent in the mutants' cristae was further used here to identify a profile of genes specific to the lacking cell type. Microarrays followed by a detailed consultation of web-accessible mouse databases allowed us to identify 6 candidate genes with a possible role in the development of the inner ear sensory organs: Actc1, Pgam2, Ldb3, Eno3, Hspb7 and Smpx. Additionally, we searched for human homologues of the candidate genes since a number of syndromes in humans have associated inner ear abnormalities. Mutations in one of our candidate genes, Smpx, have been reported as the cause of X-linked deafness in humans. Our current study suggests an epigenetic role that mechanical, and potentially other, stimuli originating from muscle, play in organogenesis, and offers an approach to finding novel genes responsible for altered inner ear phenotypes.

  2. [European Portuguese EARS test battery adaptation].

    PubMed

    Alves, Marisa; Ramos, Daniela; Oliveira, Graça; Alves, Helena; Anderson, Ilona; Magalhães, Isabel; Martins, Jorge H; Simões, Margarida; Ferreira, Raquel; Fonseca, Rita; Andrade, Susana; Silva, Luís; Ribeiro, Carlos; Ferreira, Pedro Lopes

    2014-01-01

    The use of adequate assessment tools in health care is crucial for the management of care. The lack of specific tools in Portugal for assessing the performance of children who use cochlear implants motivated the translation and adaptation of the EARS (Evaluation of Auditory Responses to Speech) test battery into European Portuguese. This test battery is today one of the most commonly used by (re)habilitation teams of deaf children who use cochlear implants worldwide. The goal to be achieved with the validation of EARS was to provide (re)habilitation teams an instrument that enables: (i) monitoring the progress of individual (re)habilitation, (ii) managing a (re)habilitation program according to objective results, comparable between different (re)habilitation teams, (iii) obtaining data that can be compared with the results of international teams, and (iv) improving engagement and motivation of the family and other professionals from local teams. For the test battery translation and adaptation process, the adopted procedures were the following: (i) translation of the English version into European Portuguese by a professional translator, (ii) revision of the translation performed by an expert panel, including doctors, speech-language pathologists and audiologists, (iii) adaptation of the test stimuli by the team's speechlanguage pathologist, and (iv) further review by the expert panel. For each of the tests that belong to the EARS battery, the introduced adaptations and adjustments are presented, combining the characteristics and objectives of the original tests with the linguistic and cultural specificities of the Portuguese population. The difficulties that have been encountered during the translation and adaptation process and the adopted solutions are discussed. Comparisons are made with other versions of the EARS battery. We defend that the translation and the adaptation process followed for the EARS test battery into European Portuguese was correctly conducted

  3. Clinical role of vitamin D in prognosis of otitis media with effusion.

    PubMed

    Akcan, Fatih Alper; Dündar, Yusuf; Akcan, Hümeyra Bayram; Uluat, Ahmet; Cebeci, Derya; Sungur, Mehmet Ali; Ünlü, İlhan

    2018-02-01

    To investigate the clinical role of Vitamin D in prognosis of Otitis media with effusion. This prospective-controlled study was conducted at otolaryngology department in Duzce University, Turkey. The study group comprised children who were diagnosed with Otitis media with effusion between September 2016 and February 2017. Control group was conducted with children underwent circumcision or inguinal hernia repair operations that confirmed with ENT examination they do not have any sign of otitis media. After 3 months of follow-up without any treatment, unresolved cases who were accepted as chronic otitis media with effusion were operated under general anesthesia for ventilation tube application. Study and control groups were assessed depending on the serum 25(OH)Vitamin D levels at the end of 3 months; < 15 ng/mL was accepted as vitamin D deficiency. The results were compared with the control group in terms of vitamin D levels. Also, subgroup analysis was performed addressing to the complete recovery otitis media with effusion and chronic otitis media with effusion. One-hundred-seventy-four children with otitis media with effusion and 80 control patients were included to the study. One-hundred-eight (62%) out of 174 patients with otitis media with effusion was completely recovered after a 3-months follow up. Of those 66 out of 174 children, they had persistent diseases, underwent ventilation tube insertion after a 3-months follow-up. The mean 25(OH)Vitamin D level was 18.98 ± 10.60 in otitis media with effusion group and 28.07 ± 14.10 in control group and the difference was statistically significant between the study and control group (p < 0.001). Vitamin D deficiency was observed in 33 out of 66 patients (50.0%) in chronic otitis media with effusion group whilst 35 out of 108 patients (32.4%) in complete recovery otitis media with effusion group (p = 0.021). The rate of 25(OH)Vitamin D deficiency was 25% in control group which was statistically different

  4. Vaporization Studies of Olivine via Knudsen Effusion Mass Spectrometry

    NASA Technical Reports Server (NTRS)

    Costa, G. C. C.; Jacobson, N. S.

    2014-01-01

    Olivine is the major mineral in the Earth's upper mantle occurring predominantly in igneous rocks and has been identified in meteorites, asteroids, the Moon and Mars. Among many other important applications in planetary and materials sciences, the thermodynamic properties of vapor species from olivine are crucial as input parameters in computational modelling of the atmospheres of hot, rocky exoplanets (lava planets). There are several weight loss studies of olivine vaporization in the literature and one Knudsen Effusion Mass Spectrometry (KEMS) study. In this study, we examine a forsterite-rich olivine (93% forsterite and 7% fayalite, Fo93Fa7) with KEMS to further understand its vaporization and thermodynamic properties.

  5. Cardiac juvenile xanthogranuloma in an infant presenting with pericardial effusion.

    PubMed

    Kobayashi, Daisuke; Delius, Ralph E; Debelenko, Larisa V; Aggarwal, Sanjeev

    2013-01-01

    Juvenile xanthogranuloma is a rare histiocytic disorder of childhood mainly affecting skin and rarely deep soft tissues and viscera. We report a 2-month-old infant who presented with respiratory distress secondary to a large pericardial effusion associated with an epicardial mass. Excisional biopsy was performed and the mass was diagnosed as juvenile xanthogranuloma. The child is well without evidence of disease 8 months following the excision. The corresponding literature on juvenile xanthogranuloma with cardiac manifestations is reviewed. © 2012 Wiley Periodicals, Inc.

  6. Pericardial fat mimicking pericardial effusion on two-dimensional echocardiography.

    PubMed

    Kanna, Balavenkatesh; Osorio, Federico; Dharmarajan, Lekshmi

    2006-05-01

    A 78-year-old overweight woman with diabetes mellitus, bronchial asthma, and Sheehan's syndrome on chronic steroid therapy presented with mild short-lived hematemesis, significant hypotension disproportionate to the degree of bleeding and radiographic evidence of cardiomegaly. Endoscopy showed duodenal ulcer. During evaluation of the unexplained brief hypotension and cardiomegaly, 2D-echocardiogram demonstrated anterior and posterior echo-free spaces consistent with large pericardial effusion (PE). However, subsequent elective surgical pericardiotomy unexpectedly revealed large amounts of pericardial fat. Pericardial fat was also noted on magnetic resonance imaging of the chest. Our case illustrates a potential pitfall of 2D-echocardiography in the diagnosis of PE.

  7. Contemporary management of pericardial effusion: practical aspects for clinical practice.

    PubMed

    Imazio, Massimo; Gaido, Luca; Battaglia, Alberto; Gaita, Fiorenzo

    2017-03-01

    A pericardial effusion (PE) is a relatively common finding in clinical practice. It may be either isolated or associated with pericarditis with or without an underlying disease. The aetiology is varied and may be either infectious (especially tuberculosis as the most common cause in developing countries) or non-infectious (cancer, systemic inflammatory diseases). The management is essentially guided by the hemodynamic effect (presence or absence of cardiac tamponade), the presence of concomitant pericarditis or underlying disease, and its size and duration. The present paper reviews the current knowledge on the aetiology, classification, diagnosis, management, therapy, and prognosis of PE in clinical practice.

  8. Naturopathic treatment for ear pain in children.

    PubMed

    Sarrell, E Michael; Cohen, Herman Avner; Kahan, Ernesto

    2003-05-01

    Otitis media is 1 of the most frequent diseases of early infancy and childhood and 1 of the most common reasons for children to visit a physician. In the past 2 decades, there has been a substantial increase in the diagnosis of otitis media worldwide. In the United States, 93% of all children have had at least 1 episode of acute otitis media (AOM) by 7 years of age. Otalgia is the hallmark of AOM. Most affected children either complain of earache or manifest behavior that the parents interpret as indicating ear pain. Treatment of the ear pain early in the course of AOM decreases both parental anxiety and the child's discomfort and accelerates the healing process. The objective of this study was to determine the efficacy and tolerability of naturopathic versus traditional treatment for the management of otalgia commonly associated with AOM in children. The study was designed as a double-blind trial in an outpatient community clinic. A total of 171 children who were aged 5 to 18 years and had otalgia and clinical findings associated with middle-ear infection were studied. The children were randomly assigned to receive treatment with Naturopathic Herbal Extract Ear Drops (NHED) or anesthetic ear drops, with or without amoxicillin. On enrollment, the children were assigned by computer-numbered randomization to receive NHED (contents: allium sativum, verbascum thapsus, calendula flores, hypericum perfoliatum, lavender, and vitamin E in olive oil) 5 drops 3 times daily, alone (group A) or together with a topical anesthetic (amethocaine and phenazone in glycerin) 5 drops 3 times daily (group B), or oral amoxicillin 80 mg/kg/d (maximum 500 mg/dose) divided into 3 doses with either NHED 5 drops 3 times daily (group C) or topical anesthetic 5 drops 3 times daily (group D). A double-blind design was used, and all ear drops were placed in identical bottles. Treatment was initiated by the nurse in all cases. A single physician (M.S.) evaluated and treated all of the patients

  9. Chinchilla middle ear transmission matrix model and middle-ear flexibilitya)

    PubMed Central

    Ravicz, Michael E.; Rosowski, John J.

    2017-01-01

    The function of the middle ear (ME) in transforming ME acoustic inputs and outputs (sound pressures and volume velocities) can be described with an acoustic two-port transmission matrix. This description is independent of the load on the ME (cochlea or ear canal) and holds in either direction: forward (from ear canal to cochlea) or reverse (from cochlea to ear canal). A transmission matrix describing ME function in chinchilla, an animal commonly used in auditory research, is presented, computed from measurements of forward ME function: input admittance YTM, ME pressure gain GMEP, ME velocity transfer function HV, and cochlear input admittance YC, in the same set of ears [Ravicz and Rosowski (2012b). J. Acoust. Soc. Am. 132, 2437–2454; (2013a). J. Acoust. Soc. Am. 133, 2208–2223; (2013b). J. Acoust. Soc. Am. 134, 2852–2865]. Unlike previous estimates, these computations require no assumptions about the state of the inner ear, effectiveness of ME manipulations, or measurements of sound transmission in the reverse direction. These element values are generally consistent with physical constraints and the anatomical ME “transformer ratio.” Differences from a previous estimate in chinchilla [Songer and Rosowski (2007). J. Acoust. Soc. Am. 122, 932–942] may be due to a difference in ME flexibility between the two subject groups. PMID:28599566

  10. Chinchilla middle ear transmission matrix model and middle-ear flexibility.

    PubMed

    Ravicz, Michael E; Rosowski, John J

    2017-05-01

    The function of the middle ear (ME) in transforming ME acoustic inputs and outputs (sound pressures and volume velocities) can be described with an acoustic two-port transmission matrix. This description is independent of the load on the ME (cochlea or ear canal) and holds in either direction: forward (from ear canal to cochlea) or reverse (from cochlea to ear canal). A transmission matrix describing ME function in chinchilla, an animal commonly used in auditory research, is presented, computed from measurements of forward ME function: input admittance Y TM , ME pressure gain G MEP , ME velocity transfer function H V , and cochlear input admittance Y C , in the same set of ears [Ravicz and Rosowski (2012b). J. Acoust. Soc. Am. 132, 2437-2454; (2013a). J. Acoust. Soc. Am. 133, 2208-2223; (2013b). J. Acoust. Soc. Am. 134, 2852-2865]. Unlike previous estimates, these computations require no assumptions about the state of the inner ear, effectiveness of ME manipulations, or measurements of sound transmission in the reverse direction. These element values are generally consistent with physical constraints and the anatomical ME "transformer ratio." Differences from a previous estimate in chinchilla [Songer and Rosowski (2007). J. Acoust. Soc. Am. 122, 932-942] may be due to a difference in ME flexibility between the two subject groups.

  11. Anthropometric growth study of the ear in a Chinese population.

    PubMed

    Zhao, Shichun; Li, Dianguo; Liu, Zhenzhong; Wang, Yibiao; Liu, Lei; Jiang, Duyin; Pan, Bo

    2018-04-01

    A large number of anthropometric studies of the auricle have been reported in different nations, but little data were available in the Chinese population. The aim of this study was to analyze growth changes in the ear by measuring the width and length of ears in a Chinese population. A total of 480 participants were enrolled and classified into 1-, 3-, 5-, 7-, 9-, 12-, 14-, and 18-year groups (half were boys and half were girls in each group). Ear length, ear width, body weight, and body length were measured and recorded; ear index was calculated according to ear length and ear width. The growth of auricle and differences between genders were analyzed. Growth of ear in relation to body height and weight and the degree of emphasis on the length and width of the auricle were also analyzed. Ear length and width increased with age. Ear length achieved its mature size in both 14-year-old males and females. Ear width reached its mature size in males at 7 years and in females at 5 years. Different trends of ear index were shown between males and females. People in this population paid more attention to the length than the width of the auricle. The data indicated that ear development followed increase in age. There were gender and ethnic difference in the development of ear. These results may have potential implications for the diagnosis of congenital malformations, syndromes, and planning of ear reconstruction surgery. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Knowledge, Attitude and Practice of Ear Care in Coastal Karnataka.

    PubMed

    Dosemane, Deviprasad; Ganapathi, Keerthan; Kanthila, Jayashree

    2015-12-01

    Ear as an organ is necessary for the perception of sound and body balance. Ear infection, diabetes mellitus, hypertension and excessive use of mobile phone for listening to music at high volume all can reduce hearing. No earlier study was available in the costal Karnataka population, regarding the practice of ear care. The study objective was to ascertain the level of knowledge of the community regarding ear care, to find out whether some of the common conditions affecting hearing are known and to find out the common practices involved in maintaining ear hygiene. This cross-sectional study was conducted on 500 subjects in two tertiary care hospitals by convenient sampling, using self-administered questionnaire. Knowledge, Attitude and Practice across the age groups, religion & education background were studied. Across different education groups, 66.7%-90% did not know that 'cold' can cause ear infection and 46.7%-75.0% did not know that diabetes and hypertension can reduce hearing. When there is ear pain or discharge, people put ear drops available at home in 48.3%-75.0% across 3 age groups; 58.5%-61.5% across 3 religions and 44.8%-67.9% across 5 education groups. No statistically significant difference was found in the practice of pouring oil into ears across religions. A total of 58.6%-100% daily clean inside the ear and 70-100% use cotton buds. General perception of the people is that ear is necessary only for hearing. Majority did not know that nasal infection can affect the ear and that DM and hypertension can cause hearing loss. When there is ear pain and discharge, most of the adults put drops that are available at home. Pouring oil into the ears and cleaning inside the ear canals is routinely practiced in costal Karnataka.

  13. Interventions for the prevention of postoperative ear discharge after insertion of ventilation tubes (grommets) in children.

    PubMed

    Syed, Mohammed Iqbal; Suller, Sharon; Browning, George G; Akeroyd, Michael A

    2013-04-30

    Grommets are frequently inserted in children's ears for acute otitis media and otitis media with effusion. A common complication is postoperative ear discharge (otorrhoea). A wide range of treatments are used to prevent the discharge, but there is no consensus on whether or not intervention is necessary nor which is the most effective intervention. To assess the effectiveness of prophylactic interventions, both topical and systemic, in reducing the incidence of otorrhoea following the surgical insertion of grommets in children. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the search was 3 July 2012. We included randomised controlled trials (RCTs) that compared the efficacy of prophylactic interventions against placebo/control and/or with other prophylactic interventions for postoperative otorrhoea in children. Two review authors independently assessed study eligibility and risk of bias, and extracted data. The outcome data were dichotomous for all the included trials. We calculated individual and pooled risk ratios (RR) using the Mantel-Haenszel fixed-effect method. We also calculated the numbers needed to treat to benefit (NNTB). We found 15 eligible RCTs (2476 children, aged from four months to 17 years). We graded seven RCTs as being at a low risk of bias (n = 926 children) and for an eighth RCT we also graded two of the arms as being at a low risk of bias. We graded the other seven trials as being at a high risk of bias.For a single application at surgery, there was evidence from two low risk of bias trials that at two weeks postoperatively the risk of otorrhoea was reduced by multiple saline washouts (from 30% to 16%; RR 0.52, 95% confidence interval (CI) 0.27 to 1.00; NNTB 7; one RCT; 140 children

  14. Should homeopathy be considered as part of a treatment strategy for otitis media with effusion in children?

    PubMed

    Fixsen, Alison

    2013-04-01

    Otitis media with effusion (OME) or 'glue ear' is the most common cause of pediatric hearing loss, and a drain on global healthcare resources. It is associated with frequent episodes of acute otitis media (AOM) and upper respiratory tract infections (URTIs) and linked with environmental and social factors, including diet, smoking households, overcrowding and day care use. Current conventional treatment for OME is unsatisfactory, the area constitutes an 'effectiveness gap'. Homeopathy is a relatively common and popular choice of complementary and alternative medicine (CAM) treatment for childhood conditions, including otitis media. Antibiotic resistance is now a major global problem, homeopathy may have a role to play in combating its further development. Systematic review of the literature for clinical studies of homeopathy for AOM and upper respiratory tract disorders. Discussion in the context of current treatment options and public health issues including antibiotic resistance. Several randomized trials and outcome studies of homeopathy for AOM and upper respiratory tract disorders have been published. The results are encouraging, but the volume of research is small and insufficient to draw definitive conclusions. A strategy based on multi-centre or multiple, linked clinical trials of homeopathy for OME, using a pragmatic framework and evaluating long-term effects in different settings, in conjunction with other healthcare and social services should be considered. Reduction of antibiotic use is an important outcome. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  15. Correction of Lying Ears by Augmentation of the Conchoscaphal Angle.

    PubMed

    Kim, Sung-Eun; Yeo, Chi-Ho; Kim, Taegon; Kim, Yong-Ha; Lee, Jun Ho; Chung, Kyu-Jin

    2017-01-01

    Lying ears are defined as ears that protrude less from the head, and in frontal view, are characterized by lateral positioning of antihelical contour relative to the helical rim. These aesthetically displeasing ears require correction in accord with the goals of otoplasty stated by McDowell. The authors present a case of lying ears treated by correcting the conchomastoid angle using Z-plasty, resection of posterior auricular muscle, and correction of the conchoscaphal angle by releasing cartilage using 2 full-thickness incisions and grafting of a conchal cartilage spacer. By combining these techniques, the authors efficiently corrected lying ears and produced aesthetically pleasing results.

  16. Management of auricular hematoma and the cauliflower ear.

    PubMed

    Greywoode, Jewel D; Pribitkin, Edmund A; Krein, Howard

    2010-12-01

    Acute auricular hematoma is common after blunt trauma to the side of the head. A network of vessels provides a rich blood supply to the ear, and the ear cartilage receives its nutrients from the overlying perichondrium. Prompt management of hematoma includes drainage and prevention of reaccumulation. If left untreated, an auricular hematoma can result in complications such as perichondritis, infection, and necrosis. Cauliflower ear may result from long-standing loss of blood supply to the ear cartilage and formation of neocartilage from disrupted perichondrium. Management of cauliflower ear involves excision of deformed cartilage and reshaping of the auricle. © Thieme Medical Publishers.

  17. Diagnostic Ability of FDG-PET/CT in the Detection of Malignant Pleural Effusion.

    PubMed

    Nakajima, Reiko; Abe, Koichiro; Sakai, Shuji

    2015-07-01

    We investigated the role of F-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) for the differential diagnosis of malignant and benign pleural effusion. We studied 36 consecutive patients with histologically proven cancer (excluding malignant mesothelioma) who underwent FDG-PET/CT for suspected malignant pleural effusion. Fourteen patients had cytologically proven malignant pleural effusion and the other 22 patients had either negative cytology or clinical follow-up, which confirmed the benign etiology. We examined the maximum standardized uptake values (SUV max) of pleural effusion and the target-to-normal tissue ratio (TNR), calculated as the ratio of the pleural effusion SUV max to the SUV mean of the normal tissues (liver, spleen, 12th thoracic vertebrae [Th12], thoracic aorta, and spinalis muscle). We also examined the size and density (in Hounsfield units) of the pleural effusion and pleural abnormalities on CT images. TNR (Th12) and increased pleural FDG uptake compared to background blood pool were significantly more frequent in cases with malignant pleural effusion (P < 0.05 for both). The cutoff TNR (Th12) value of >0.95 was the most accurate; the sensitivity, specificity, and accuracy for this value were 93%, 68%, and 75%, respectively. FDG-PET/CT can be a useful method for the differential diagnosis of malignant and benign pleural effusion.

  18. Diagnostic Ability of FDG-PET/CT in the Detection of Malignant Pleural Effusion

    PubMed Central

    Nakajima, Reiko; Abe, Koichiro; Sakai, Shuji

    2015-01-01

    Abstract We investigated the role of F-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) for the differential diagnosis of malignant and benign pleural effusion. We studied 36 consecutive patients with histologically proven cancer (excluding malignant mesothelioma) who underwent FDG-PET/CT for suspected malignant pleural effusion. Fourteen patients had cytologically proven malignant pleural effusion and the other 22 patients had either negative cytology or clinical follow-up, which confirmed the benign etiology. We examined the maximum standardized uptake values (SUVmax) of pleural effusion and the target-to-normal tissue ratio (TNR), calculated as the ratio of the pleural effusion SUVmax to the SUVmean of the normal tissues (liver, spleen, 12th thoracic vertebrae [Th12], thoracic aorta, and spinalis muscle). We also examined the size and density (in Hounsfield units) of the pleural effusion and pleural abnormalities on CT images. TNR (Th12) and increased pleural FDG uptake compared to background blood pool were significantly more frequent in cases with malignant pleural effusion (P < 0.05 for both). The cutoff TNR (Th12) value of >0.95 was the most accurate; the sensitivity, specificity, and accuracy for this value were 93%, 68%, and 75%, respectively. FDG-PET/CT can be a useful method for the differential diagnosis of malignant and benign pleural effusion. PMID:26200610

  19. Markers to differentiate between Kaposi's sarcoma and tuberculous pleural effusions in HIV-positive patients.

    PubMed

    Coleman, M; Finney, L J; Komrower, D; Chitani, A; Bates, J; Chipungu, G A; Corbett, E; Allain, T J

    2015-02-01

    Kaposi's sarcoma (KS) and tuberculosis (TB) commonly cause pleural effusions in high human immunodeficiency virus (HIV) burden resource-limited countries. Differentiating between them is challenging, as pleural biopsy and TB culture are rarely available. To identify markers to differentiate between TB effusions and KS effusions in HIV-positive patients, and to compare liquid culture and Xpert MTB/RIF in pleural fluid. Fifty HIV-positive patients with pleural effusions recruited in Malawi underwent pleural ultrasound and aspiration. Fluid visual inspection, cell count, bacterial culture, glucose/protein, solid and liquid TB culture and Xpert were performed. The mean age of the patients was 32 years; 30/50 (60%) were male and 29 (58%) had cutaneous/oral KS. Thirteen (26%) pleural fluid samples were liquid culture-positive for TB, while 9/13 (69%) were Xpert-positive. Three (10.3%) KS patients had culture-positive TB effusions; 17 (58.6%) had KS effusions. The relative risk of TB in KS patients increased with limited KS, loculated fluid and low glucose. Eleven (52.3%) non-KS patients had culture-positive TB effusions associated with male sex, straw-coloured fluid and fibrin stranding on ultrasound. KS patients were most likely to have KS effusion, but TB should be considered. Most non-KS patients had TB, supporting the use of World Health Organization guidelines. Xpert identified two thirds of liquid culture-positive results.

  20. Pleural effusion following blunt splenic injury in the pediatric trauma population.

    PubMed

    Kulaylat, Afif N; Engbrecht, Brett W; Pinzon-Guzman, Carolina; Albaugh, Vance L; Rzucidlo, Susan E; Schubart, Jane R; Cilley, Robert E

    2014-09-01

    Pleural effusion is a potential complication following blunt splenic injury. The incidence, risk factors, and clinical management are not well described in children. Ten-year retrospective review (January 2000-December 2010) of an institutional pediatric trauma registry identified 318 children with blunt splenic injury. Of 274 evaluable nonoperatively managed pediatric blunt splenic injures, 12 patients (4.4%) developed left-sided pleural effusions. Seven (58%) of 12 patients required left-sided tube thoracostomy for worsening pleural effusion and respiratory insufficiency. Median time from injury to diagnosis of pleural effusion was 1.5days. Median time from diagnosis to tube thoracostomy was 2days. Median length of stay was 4days for those without and 7.5days for those with pleural effusions (p<0.001) and 6 and 8days for those pleural effusions managed medically or with tube thoracostomy (p=0.006), respectively. In multivariate analysis, high-grade splenic injury (IV-V) (OR 16.5, p=0.001) was associated with higher odds of developing a pleural effusion compared to low-grade splenic injury (I-III). Pleural effusion following pediatric blunt splenic injury has an incidence of 4.4% and is associated with high-grade splenic injuries and longer lengths of stay. While some symptomatic patients may be successfully managed medically, many require tube thoracostomy for progressive respiratory symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Delayed diaphragmatic herniation masquerading as a complicated parapneumonic effusion.

    PubMed

    Tsang, J; Ryan, F

    1999-01-01

    Injury to the diaphragm following blunt or penetrating thoracoabdominal trauma is not uncommon. Recognition of this important complication of trauma continues to be a challenge because of the lack of specific clinical and plain radiographic features, the frequent presence of other serious injuries and the potential for delayed presentation. Delayed diaphragmatic herniation often presents with catastrophic bowel obstruction or strangulation. Early recognition of diaphragmatic injury is required to avoid this potentially lethal complication. The case of a 35-year-old man with a history of a knife wound to the left flank 15 years previously, who presented with unexplained acute hypoxemic respiratory failure and a unilateral exudative pleural effusion that was refractory to tube thoracostomy drainage, is reported. After admission to hospital, he developed gross dilation of his colon; emergency laparotomy revealed an incarcerated colonic herniation into the left hemithorax. Interesting clinical features of this patient's case included the patient's hobby of weightlifting, a persistently deviated mediastinum despite drainage of the pleural effusion and deceptive pleural fluid biochemical indices.

  2. Preliminary impact assessment of effusive eruptions at Etna volcano

    NASA Astrophysics Data System (ADS)

    Cappello, Annalisa; Michaud-Dubuy, Audrey; Branca, Stefano; De Beni, Emanuela; Del Negro, Ciro

    2016-04-01

    Lava flows are a recurring and widespread form of volcanic activity that threaten people and property around the world. The growing demographic congestion around volcanic structures increases the potential risks and costs that lava flows represent, and leads to a pressing need for faster and more accurate assessment of lava flow impact. To fully evaluate potential effects and losses that an effusive eruption may cause to society, property and environment, it is necessary to consider the hazard, the distribution of the exposed elements at stake and the associated vulnerability. Lava flow hazard assessment is at an advanced state, whereas comprehensive vulnerability assessment is lacking. Cataloguing and analyzing volcanic impacts provide insight on likely societal and physical vulnerabilities during future eruptions. Here we quantify the lava flow impact of two past main effusive eruptions of Etna volcano: the 1669, which is the biggest and destructive flank eruption to have occurred on Etna in historical time, and the 1981, lasting only 6 days, but characterized by an intense eruptive dynamics. Different elements at stake are considered, including population, hospitals, critical facilities, buildings of historic value, industrial infrastructures, gas and electricity networks, railways, roads, footways and finally land use. All these elements were combined with the 1669 and 1981 lava flow fields to quantify the social damage and economic loss.

  3. Minimally invasive surgical treatment of malignant pleural effusions.

    PubMed

    Ciuche, Adrian; Nistor, Claudiu; Pantile, Daniel; Prof Horvat, Teodor

    2011-10-01

    Usually the pleural cavity contains a small amount of liquid (approximately 10 ml). Pleural effusions appear when the liquid production rate overpasses the absorption rate with a greater amount of liquid inside the pleural cavity. Between January 1998 to December 2008 we conducted a study in order to establish the adequate surgical treatment for MPEs. Effective control of a recurrent malignant pleural effusion can greatly improve the quality of life of the cancer patient. The present review collects and examines the clinical results of minimally invasive techniques designed to treat this problem. Patients with MPEs were studied according to several criteria. In our study we observed the superiority of intraoperative talc poudrage, probably due to a more uniform distribution of talc particles over the pleural surface. Minimal pleurotomy with thoracic drainage and instillation of a talc suspension is also a safe and effective technique and should be employed when there are contraindications for the thoracoscopic minimally invasive procedure. On the basis of comparisons involving effectiveness, morbidity, and convenience, we recommend the thoracoscopic insufflations of talc as a fine powder with pleural drainage as the procedure of choice.

  4. Estimation of outer-middle ear transmission using DPOAEs and fractional-order modeling of human middle ear

    NASA Astrophysics Data System (ADS)

    Naghibolhosseini, Maryam

    Our ability to hear depends primarily on sound waves traveling through the outer and middle ear toward the inner ear. Hence, the characteristics of the outer and middle ear affect sound transmission to/from the inner ear. The role of the middle and outer ear in sound transmission is particularly important for otoacoustic emissions (OAEs), which are sound signals generated in a healthy cochlea, and recorded by a sensitive microphone placed in the ear canal. OAEs are used to evaluate the health and function of the cochlea; however, they are also affected by outer and middle ear characteristics. To better assess cochlear health using OAEs, it is critical to quantify the impact of the outer and middle ear on sound transmission. The reported research introduces a noninvasive approach to estimate outer-middle ear transmission using distortion product otoacoustic emissions (DPOAEs). In addition, the role of the outer and middle ear on sound transmission was investigated by developing a physical/mathematical model, which employed fractional-order lumped elements to include the viscoelastic characteristics of biological tissues. Impedance estimations from wideband refectance measurements were used for parameter fitting of the model. The model was validated comparing its estimates of the outer-middle ear sound transmission with those given by DPOAEs. The outer-middle ear transmission by the model was defined as the sum of forward and reverse outer-middle ear transmissions. To estimate the reverse transmission by the model, the probe-microphone impedance was calculated through estimating the Thevenin-equivalent circuit of the probe-microphone. The Thevenin-equivalent circuit was calculated using measurements in a number of test cavities. Such modeling enhances our understanding of the roles of different parts of the outer and middle ear and how they work together to determine their function. In addition, the model would be potentially helpful in diagnosing pathologies of

  5. Relationship between chronic otitis media with effusion and overweight or obesity in children.

    PubMed

    Kaya, S; Selimoğlu, E; Cureoğlu, S; Selimoğlu, M A

    2017-10-01

    Otitis media with effusion and obesity are both common in childhood and might share some immunological alterations. This study aimed to investigate the relationship between chronic otitis media with effusion and childhood overweight or obesity, including the potential effects of adenoid or tonsillar hypertrophy on that relationship. This study included 60 children with chronic otitis media with effusion and 86 healthy children aged from 2 to 10 years. Measures of height and weight were used to calculate the body mass index, weight for height and weight z score. The prevalence of overweight or obesity was higher in children with chronic otitis media with effusion, according to the weight for height percentiles (p = 0.012). However, neither the presence of adenoid or tonsillar hypertrophy nor the degree of adenoid hypertrophy was associated with overweight or obesity. Overweight and obesity might be risk factors for developing chronic otitis media with effusion, or vice versa.

  6. Structures that Contribute to Middle-Ear Admittance in Chinchilla

    PubMed Central

    Rosowski, John J.; Ravicz, Michael E.; Songer, Jocelyn E.

    2009-01-01

    We describe measurements of middle-ear input admittance in chinchillas (Chinchilla lanigera) before and after various manipulations that define the contributions of different middle-ear components to function. The chinchilla’s middle-ear air spaces have a large effect on the low-frequency compliance of the middle ear, and removing the influences of these spaces reveals a highly admittant tympanic membrane and ossicular chain. Measurements of the admittance of the air spaces reveal that the high-degree of segmentation of these spaces has only a small effect on the admittance. Draining the cochlea further increases the middle-ear admittance at low frequencies and removes a low-frequency (less than 300 Hz) level dependence in the admittance. Spontaneous or sound-driven contractions of the middle-ear muscles in deeply anesthetized animals were associated with significant changes in middle-ear admittance. PMID:16944166

  7. The use of light's criteria in hospitalized children with a pleural effusion of unknown etiology.

    PubMed

    McGraw, Matthew D; Robison, Kyle; Kupfer, Oren; Brinton, John T; Stillwell, Paul C

    2018-05-27

    Pleural effusions are common in pediatrics. When the etiology of a pleural effusion remains unknown, adult literature recommends the use of Light's criteria to differentiate a transudate from an exudate. Pediatricians may rely on adult literature for the diagnostic management of pleural effusions as Light's criteria has not been validated in children. The purpose of this study was to review the use of Light's criteria in hospitalized children with a pleural effusion of unknown etiology. Retrospective review was performed on children hospitalized with a pleural effusion requiring chest tube placement or thoracentesis between January 1, 2016 to January 1, 2017 at Children's Hospital Colorado. Charts were reviewed for primary team, use of Light's criteria, pleural effusion diagnosis, and 30-day recurrence of repeat intervention or fluid analysis. Sixty-eight patients were hospitalized with a pleural effusion of unknown etiology requiring intervention. Only 16 pleural effusions (24%) were classified using Light's criteria. In those patients for whom Light's criteria was used, a diagnosis or change in management occurred in 10 of 16 patients (63%). Pleural effusions were most common on the cardiology service (26/68). Use of Light's criteria was most frequent on the oncology service (7/8). Thirty-day need for repeat intervention was lower in those with Light's criteria (13%) compared to those without (27%). Light's criteria were utilized infrequently in hospitalized children with a pleural effusion of unknown etiology at a single institution. There was considerable practice variation among provider teams. When utilized, Light's criteria assisted in making a diagnosis or changing management in many patients, and may lead to a reduction in 30-day recurrence requiring repeat intervention. © 2018 Wiley Periodicals, Inc.

  8. Management of prominent ears: personal approach.

    PubMed

    Pérez-Macias, José Manuel

    2008-03-01

    Various methods for correcting prominent ears have been reported. Although anterior cartilage antihelix abrasion combined with posterior retention sutures is a conventional procedure, it does not include anterior conchal cartilage abrasion and thus allows easier reduction of the condromastoid angle. A simple and effective technique is described that involves using a rasp to score the whole anterior surface of the auricular cartilage, including the concha, in combination with Mustarde-type conchal-antihelical and conchal-mastoid retention sutures. This method was applied to 342 patients (675 ears) over 23 years, who were followed up for periods varying from 18 to 24 months. Good results were obtained for all patients with minimal complications.

  9. A rare case of petrified ear.

    PubMed

    Buikema, Kathryn E; Adams, Erin G

    2012-01-01

    Calcification or ossification of the auricle, also referred to as petrified ear, is a rare diagnosis in dermatology. In medical literature, it has most often been attributed to trauma, hypothermia and frostbite, or hypercalcemia secondary to a metabolic or endocrine disorder, such as Addison's disease. Here, we report the clinical and radiologic findings of a 79-year-old African American male whose unilateral petrified auricle was an incidental finding. He had a preceding history of hyperparathyroidism and subsequent hypercalcemia treated with a subtotal parathyroidectomy three years prior to presentation. In addition to laboratory analysis, a history and physical examination was performed which revealed no other signs of hypercalcemia. Radiologic studies demonstrated partial ossification of the external auricular cartilage on the left side. The patient was diagnosed with the rare occurrence of a petrified ear. In light of this case, we provide a discussion concerning the possible etiologies of this diagnosis including appropriate patient evaluation and possible treatment recommendations.

  10. A Rare Case of Petrified Ear

    PubMed Central

    Buikema, Kathryn E.; Adams, Erin G.

    2012-01-01

    Calcification or ossification of the auricle, also referred to as petrified ear, is a rare diagnosis in dermatology. In medical literature, it has most often been attributed to trauma, hypothermia and frostbite, or hypercalcemia secondary to a metabolic or endocrine disorder, such as Addison's disease. Here, we report the clinical and radiologic findings of a 79-year-old African American male whose unilateral petrified auricle was an incidental finding. He had a preceding history of hyperparathyroidism and subsequent hypercalcemia treated with a subtotal parathyroidectomy three years prior to presentation. In addition to laboratory analysis, a history and physical examination was performed which revealed no other signs of hypercalcemia. Radiologic studies demonstrated partial ossification of the external auricular cartilage on the left side. The patient was diagnosed with the rare occurrence of a petrified ear. In light of this case, we provide a discussion concerning the possible etiologies of this diagnosis including appropriate patient evaluation and possible treatment recommendations. PMID:23259082

  11. Ewing Sarcoma of the External Ear Canal

    PubMed Central

    Kecelioglu Binnetoglu, Kiymet; Gerin, Fatma; Sari, Murat

    2016-01-01

    Background. Ewing sarcoma (ES) is a high-grade malignant tumor that has skeletal and extraskeletal forms and consists of small round cells. In the head and neck region, reported localization of extraskeletal ES includes the larynx, thyroid gland, submandibular gland, nasal fossa, pharynx, skin, and parotid gland, but not the external ear canal. Methods. We present the unique case of a 2-year-old boy with extraskeletal ES arising from the external ear canal, mimicking auricular hematoma. Results. Surgery was performed and a VAC/IE (vincristine, adriamycin, cyclophosphamide alternating with ifosfamide, and etoposide) regimen was used for adjuvant chemotherapy for 12 months. Conclusion. The clinician should consider extraskeletal ES when diagnosing tumors localized in the head and neck region because it may be manifested by a nonspecific clinical picture mimicking common otorhinolaryngologic disorders. PMID:27313930

  12. [Preoperative CT Scan in middle ear cholesteatoma].

    PubMed

    Sethom, Anissa; Akkari, Khemaies; Dridi, Inès; Tmimi, S; Mardassi, Ali; Benzarti, Sonia; Miled, Imed; Chebbi, Mohamed Kamel

    2011-03-01

    To compare preoperative CT scan finding and per-operative lesions in patients operated for middle ear cholesteatoma, A retrospective study including 60 patients with cholesteatoma otitis diagnosed and treated within a period of 5 years, from 2001 to 2005, at ENT department of Military Hospital of Tunis. All patients had computed tomography of the middle and inner ear. High resolution CT scan imaging was performed using millimetric incidences (3 to 5 millimetres). All patients had surgical removal of their cholesteatoma using down wall technic. We evaluated sensitivity, specificity and predictive value of CT-scan comparing otitic damages and CT finding, in order to examine the real contribution of computed tomography in cholesteatoma otitis. CT scan analysis of middle ear bone structures shows satisfaction (with 83% of sensibility). The rate of sensibility decrease (63%) for the tympanic raff. Predictive value of CT scan for the diagnosis of cholesteatoma was low. However, we have noticed an excellent sensibility in the analysis of ossicular damages (90%). Comparative frontal incidence seems to be less sensible for the detection of facial nerve lesions (42%). But when evident on CT scan findings, lesions of facial nerve were usually observed preoperatively (spécificity 78%). Predictive value of computed tomography for the diagnosis of perilymphatic fistulae (FL) was low. In fact, CT scan imaging have showed FL only for four patients among eight. Best results can be obtained if using inframillimetric incidences with performed high resolution computed tomography. Preoperative computed tomography is necessary for the diagnosis and the evaluation of chronic middle ear cholesteatoma in order to show extending lesion and to detect complications. This CT analysis and surgical correlation have showed that sensibility, specificity and predictive value of CT-scan depend on the anatomic structure implicated in cholesteatoma damages.

  13. Structural Metadata Research in the Ears Program

    DTIC Science & Technology

    2005-01-01

    detecting structural information in the word stream (the so-called “structural MDE” portion of the EARS program); other MDE efforts on speaker ... diarization are overviewed in [13]. The rest of this paper is organized as follows. We describe the structural MDE tasks, performance measurement, and corpora...tems have only recently been introduced, with NIST reporting re- sults with the Wilcoxon signed rank test for speaker -level average score differences

  14. Theory of forward and reverse middle-ear transmission applied to otoacoustic emissions in infant and adult ears

    PubMed Central

    Keefe, Douglas H.; Abdala, Carolina

    2008-01-01

    The purpose of this study is to understand why otoacoustic emission (OAE) levels are higher in normal-hearing human infants relative to adults. In a previous study, distortion product (DP) OAE input/output (I/O) functions were shown to differ at f2=6 kHz in adults compared to infants through 6 months of age. These DPOAE I/O functions were used to noninvasively assess immaturities in forward/reverse transmission through the ear canal and middle ear [Abdala, C., and Keefe, D. H., (2006). J. Acoust Soc. Am. 120, 3832–3842]. In the present study, ear-canal reflectance and DPOAEs measured in the same ears were analyzed using a scattering-matrix model of forward and reverse transmission in the ear canal, middle ear, and cochlea. Reflectance measurements were sensitive to frequency-dependent effects of ear-canal and middle-ear transmission that differed across OAE type and subject age. Results indicated that DPOAE levels were larger in infants mainly because the reverse middle-ear transmittance level varied with ear-canal area, which differed by more than a factor of 7 between term infants and adults. The forward middle-ear transmittance level was −16 dB less in infants, so that the conductive efficiency was poorer in infants than adults. PMID:17348521

  15. Ear recognition from one sample per person.

    PubMed

    Chen, Long; Mu, Zhichun; Zhang, Baoqing; Zhang, Yi

    2015-01-01

    Biometrics has the advantages of efficiency and convenience in identity authentication. As one of the most promising biometric-based methods, ear recognition has received broad attention and research. Previous studies have achieved remarkable performance with multiple samples per person (MSPP) in the gallery. However, most conventional methods are insufficient when there is only one sample per person (OSPP) available in the gallery. To solve the OSPP problem by maximizing the use of a single sample, this paper proposes a hybrid multi-keypoint descriptor sparse representation-based classification (MKD-SRC) ear recognition approach based on 2D and 3D information. Because most 3D sensors capture 3D data accessorizing the corresponding 2D data, it is sensible to use both types of information. First, the ear region is extracted from the profile. Second, keypoints are detected and described for both the 2D texture image and 3D range image. Then, the hybrid MKD-SRC algorithm is used to complete the recognition with only OSPP in the gallery. Experimental results on a benchmark dataset have demonstrated the feasibility and effectiveness of the proposed method in resolving the OSPP problem. A Rank-one recognition rate of 96.4% is achieved for a gallery of 415 subjects, and the time involved in the computation is satisfactory compared to conventional methods.

  16. Why Do Elephants Flap Their Ears?

    NASA Astrophysics Data System (ADS)

    Koffi, Moise; Jiji, Latif; Andreopoulos, Yiannis

    2009-11-01

    It is estimated that a 4200 kg elephant generates as much as 5.12 kW of heat. How the elephant dissipates its metabolic heat and regulates its body temperature has been investigated during the past seven decades. Findings and conclusions differ sharply. The high rate of metabolic heat coupled with low surface area to volume ratio and the absence of sweat glands eliminate surface convection as the primary mechanism for heat removal. Noting that the elephant ears have high surface area to volume ratio and an extensive vascular network, ear flapping is thought to be the principal thermoregulatory mechanism. A computational and experimental program is carried out to examine flow and heat transfer characteristics. The ear is modeled as a uniformly heated oscillating rectangular plate. Our computational work involves a three-dimensional time dependent CFD code with heat transfer capabilities to obtain predictions of the flow field and surface temperature distributions. This information was used to design an experimental setup with a uniformly heated plate of size 0.2m x 0.3m oscillating at 1.6 cycles per second. Results show that surface temperature increases and reaches a steady periodic oscillation after a period of transient oscillation. The role of the vortices shed off the plate in heat transfer enhancement will be discussed.

  17. Pathology of ear hematomas in swine.

    PubMed

    Drolet, Richard; Hélie, Pierre; D'Allaire, Sylvie

    2016-05-01

    The objectives of our study were to describe the pathology of ear hematomas in swine and to add to the comprehension of the pathogenesis of this condition. The pathogenesis of aural hematomas has been studied mainly in dogs; however, disagreements exist about the precise anatomic location of the hemorrhage. Sixteen pigs with ear hematoma at various stages of development were included in this study. The pigs were submitted for routine autopsy for various and unrelated reasons over a period of several years. Based on gross examination, the 16 cases of aural hematomas were subjectively classified as acute (n = 6), subacute (n = 3), and chronic (n = 7). The age of the animals at the time of autopsy ranged from 2 weeks to adulthood, with all acute cases being <7 weeks of age. Morphologic examination of all acute cases revealed that the hematoma developed predominantly in a subperichondral location on both sides of the cartilaginous plate simultaneously. Within these same cases, there were also some areas in which blood-filled clefts had formed within the cartilage itself. Besides fibroplasia, neoformation of cartilage was found to represent a significant part of the repair process. All chronic cases were characterized on cross-section of the ear by the presence of at least 2 distinct, wavy, focally folded, and roughly parallel plates of cartilage separated from each other by fibrous tissue. © 2016 The Author(s).

  18. An investigation of ear necrosis in pigs.

    PubMed

    Park, Jeonghwa; Friendship, Robert M; Poljak, Zvonimir; DeLay, Josepha; Slavic, Durda; Dewey, Catherine E

    2013-05-01

    Porcine ear necrosis was investigated in 23 conveniently chosen farms, consisting of 14 case farms and 9 control farms. Biopsies of lesions and oral swabs from pigs on 11 case farms were examined by histology and bacterial culture. All farms were visited for observations and a survey on management, housing, and the presence of other clinical signs or behavioral vices. Histological examination revealed that the lesions began on the surface and progressed to deeper layers, and that vascular damage did not appear to be the initiating cause. Spirochetes were only rarely observed in histological examination and were not cultured from biopsies and oral swabs. Staphylococcus aureus and Staphylococcus hyicus were cultured from 91% and 66% of samples, respectively. Ear biting and a humid environment were associated with ear necrosis. On some farms large numbers of pigs were affected and lesions were sometimes extensive. The condition appears to be an infectious disease beginning on the surface of the skin; contributing environmental and management factors are likely.

  19. An investigation of ear necrosis in pigs

    PubMed Central

    Park, Jeonghwa; Friendship, Robert M.; Poljak, Zvonimir; DeLay, Josepha; Slavic, Durda; Dewey, Catherine E.

    2013-01-01

    Porcine ear necrosis was investigated in 23 conveniently chosen farms, consisting of 14 case farms and 9 control farms. Biopsies of lesions and oral swabs from pigs on 11 case farms were examined by histology and bacterial culture. All farms were visited for observations and a survey on management, housing, and the presence of other clinical signs or behavioral vices. Histological examination revealed that the lesions began on the surface and progressed to deeper layers, and that vascular damage did not appear to be the initiating cause. Spirochetes were only rarely observed in histological examination and were not cultured from biopsies and oral swabs. Staphylococcus aureus and Staphylococcus hyicus were cultured from 91% and 66% of samples, respectively. Ear biting and a humid environment were associated with ear necrosis. On some farms large numbers of pigs were affected and lesions were sometimes extensive. The condition appears to be an infectious disease beginning on the surface of the skin; contributing environmental and management factors are likely. PMID:24155434

  20. Pressure equilibration in the penguin middle ear.

    PubMed

    Sadé, Jacob; Handrich, Yves; Bernheim, Joelle; Cohen, David

    2008-01-01

    King penguins have a venous structure in the form of a corpus cavernosum (CC) in their middle ear (ME) submucosa. The CC may be viewed as a special organelle that can change ME volume for pressure equilibration during deep-sea diving it is a pressure regulating organelle (PRO). A similar CC and muscles also surround the external ear (EE) and may constrict it, isolating the tympanic membrane from the outside. A CC was previously found also in the ME of marine diving mammals and can be expected to exist in other deep diving animals, such as marine turtles. Marine animals require equalization of middle ear (ME) pressure when diving hundreds or thousands of meters to catch prey. We investigated what mechanism enables king penguins to protect their ME when they dive to great depths. Biopsies and serial sections of the ME and the EE of the deep diving king penguin (Aptenodytes patagonicus) were examined microscopically. It was demonstrated that the penguin ME has an extensive network of small and large submucosal venous sinuses. This venous formation, a corpus cavernosum, can expand and potentially 'flood' the ME almost completely on diving, thus elevating ME pressure and reducing the ME space. The EE has a similar protective mechanism.

  1. Predicting skin deficits through surface area measurements in ear reconstruction and adult ear surface area norms.

    PubMed

    Yazar, Memet; Sevim, Kamuran Zeynep; Irmak, Fatih; Yazar, Sevgi Kurt; Yeşilada, Ayşin Karasoy; Karşidağğ, Semra Hacikerim; Tatlidede, Hamit Soner

    2013-07-01

    Ear reconstruction is one of the most challenging procedures in plastic surgery practice. Many studies and techniques have been described in the literature for carving a well-pronounced framework. However, just as important as the cartilage framework is the ample amount of delicate skin coverage of the framework. In this report, we introduce an innovative method of measuring the skin surface area of the auricle from a three-dimensional template created from the healthy ear.The study group consisted of 60 adult Turkish individuals who were randomly selected (30 men and 30 women). The participant ages ranged from 18 to 45 years (mean, 31.5 years), and they had no history of trauma or congenital anomalies. The template is created by dividing the ear into aesthetic subunits and using ImageJ software to estimate the necessary amount of total skin surface area required.Reconstruction of the auricle is a complicated process that requires experience and patience to provide the auricular details. We believe this estimate will shorten the learning curve for residents and surgeons interested in ear reconstruction and will help surgeons obtain adequate skin to drape over the well-sculpted cartilage frameworks by providing a reference list of total ear skin surface area measurements for Turkish men and women.

  2. Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review.

    PubMed

    Ngo, Chinh C; Massa, Helen M; Thornton, Ruth B; Cripps, Allan W

    2016-01-01

    Otitis media (OM) is amongst the most common childhood diseases and is associated with multiple microbial pathogens within the middle ear. Global and temporal monitoring of predominant bacterial pathogens is important to inform new treatment strategies, vaccine development and to monitor the impact of vaccine implementation to improve progress toward global OM prevention. A systematic review of published reports of microbiology of acute otitis media (AOM) and otitis media with effusion (OME) from January, 1970 to August 2014, was performed using PubMed databases. This review confirmed that Streptococcus pneumoniae and Haemophilus influenzae, remain the predominant bacterial pathogens, with S. pneumoniae the predominant bacterium in the majority reports from AOM patients. In contrast, H. influenzae was the predominant bacterium for patients experiencing chronic OME, recurrent AOM and AOM with treatment failure. This result was consistent, even where improved detection sensitivity from the use of polymerase chain reaction (PCR) rather than bacterial culture was conducted. On average, PCR analyses increased the frequency of detection of S. pneumoniae and H. influenzae 3.2 fold compared to culture, whilst Moraxella catarrhalis was 4.5 times more frequently identified by PCR. Molecular methods can also improve monitoring of regional changes in the serotypes and identification frequency of S. pneumoniae and H. influenzae over time or after vaccine implementation, such as after introduction of the 7-valent pneumococcal conjugate vaccine. Globally, S. pneumoniae and H. influenzae remain the predominant otopathogens associated with OM as identified through bacterial culture; however, molecular methods continue to improve the frequency and accuracy of detection of individual serotypes. Ongoing monitoring with appropriate detection methods for OM pathogens can support development of improved vaccines to provide protection from the complex combination of otopathogens within

  3. Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review

    PubMed Central

    Ngo, Chinh C.; Massa, Helen M.; Thornton, Ruth B.; Cripps, Allan W.

    2016-01-01

    Background Otitis media (OM) is amongst the most common childhood diseases and is associated with multiple microbial pathogens within the middle ear. Global and temporal monitoring of predominant bacterial pathogens is important to inform new treatment strategies, vaccine development and to monitor the impact of vaccine implementation to improve progress toward global OM prevention. Methods A systematic review of published reports of microbiology of acute otitis media (AOM) and otitis media with effusion (OME) from January, 1970 to August 2014, was performed using PubMed databases. Results This review confirmed that Streptococcus pneumoniae and Haemophilus influenzae, remain the predominant bacterial pathogens, with S. pneumoniae the predominant bacterium in the majority reports from AOM patients. In contrast, H. influenzae was the predominant bacterium for patients experiencing chronic OME, recurrent AOM and AOM with treatment failure. This result was consistent, even where improved detection sensitivity from the use of polymerase chain reaction (PCR) rather than bacterial culture was conducted. On average, PCR analyses increased the frequency of detection of S. pneumoniae and H. influenzae 3.2 fold compared to culture, whilst Moraxella catarrhalis was 4.5 times more frequently identified by PCR. Molecular methods can also improve monitoring of regional changes in the serotypes and identification frequency of S. pneumoniae and H. influenzae over time or after vaccine implementation, such as after introduction of the 7-valent pneumococcal conjugate vaccine. Conclusions Globally, S. pneumoniae and H. influenzae remain the predominant otopathogens associated with OM as identified through bacterial culture; however, molecular methods continue to improve the frequency and accuracy of detection of individual serotypes. Ongoing monitoring with appropriate detection methods for OM pathogens can support development of improved vaccines to provide protection from the

  4. Glue Ear, Hearing Loss and IQ: An Association Moderated by the Child’s Home Environment

    PubMed Central

    Hall, Amanda J.; Maw, Richard; Midgley, Elizabeth; Golding, Jean; Steer, Colin

    2014-01-01

    Background Glue ear or otitis media with effusion (OME) is common in children and may be associated with hearing loss (HL). For most children it has no long lasting effects on cognitive development but it is unclear whether there are subgroups at higher risk of sequelae. Objectives To examine the association between a score comprising the number of times a child had OME and HL (OME/HL score) in the first four/five years of life and IQ at age 4 and 8. To examine whether any association between OME/HL and IQ is moderated by socioeconomic, child or family factors. Methods Prospective, longitudinal cohort study: the Avon Longitudinal Study of Parents and Children (ALSPAC). 1155 children tested using tympanometry on up to nine occasions and hearing for speech (word recognition) on up to three occasions between age 8 months and 5 years. An OME/HL score was created and associations with IQ at ages 4 and 8 were examined. Potential moderators included a measure of the child’s cognitive stimulation at home (HOME score). Results For the whole sample at age 4 the group with the highest 10% OME/HL scores had performance IQ 5 points lower [95% CI −9, −1] and verbal IQ 6 points lower [95% CI −10, −3] than the unaffected group. By age 8 the evidence for group differences was weak. There were significant interactions between OME/HL and the HOME score: those with high OME/HL scores and low 18 month HOME scores had lower IQ at age 4 and 8 than those with high OME/HL scores and high HOME scores. Adjusted mean differences ranged from 5 to 8 IQ points at age 4 and 8. Conclusions The cognitive development of children from homes with lower levels of cognitive stimulation is susceptible to the effects of glue ear and hearing loss. PMID:24498289

  5. The preliminary exploration of 64-slice volume computed tomography in the accurate measurement of pleural effusion.

    PubMed

    Guo, Zhi-Jun; Lin, Qiang; Liu, Hai-Tao; Lu, Jun-Ying; Zeng, Yan-Hong; Meng, Fan-Jie; Cao, Bin; Zi, Xue-Rong; Han, Shu-Ming; Zhang, Yu-Huan

    2013-09-01

    Using computed tomography (CT) to rapidly and accurately quantify pleural effusion volume benefits medical and scientific research. However, the precise volume of pleural effusions still involves many challenges and currently does not have a recognized accurate measuring. To explore the feasibility of using 64-slice CT volume-rendering technology to accurately measure pleural fluid volume and to then analyze the correlation between the volume of the free pleural effusion and the different diameters of the pleural effusion. The 64-slice CT volume-rendering technique was used to measure and analyze three parts. First, the fluid volume of a self-made thoracic model was measured and compared with the actual injected volume. Second, the pleural effusion volume was measured before and after pleural fluid drainage in 25 patients, and the volume reduction was compared with the actual volume of the liquid extract. Finally, the free pleural effusion volume was measured in 26 patients to analyze the correlation between it and the diameter of the effusion, which was then used to calculate the regression equation. After using the 64-slice CT volume-rendering technique to measure the fluid volume of the self-made thoracic model, the results were compared with the actual injection volume. No significant differences were found, P = 0.836. For the 25 patients with drained pleural effusions, the comparison of the reduction volume with the actual volume of the liquid extract revealed no significant differences, P = 0.989. The following linear regression equation was used to compare the pleural effusion volume (V) (measured by the CT volume-rendering technique) with the pleural effusion greatest depth (d): V = 158.16 × d - 116.01 (r = 0.91, P = 0.000). The following linear regression was used to compare the volume with the product of the pleural effusion diameters (l × h × d): V = 0.56 × (l × h × d) + 39.44 (r = 0.92, P = 0.000). The 64-slice CT volume-rendering technique can

  6. Computational Modeling of Blast Wave Transmission Through Human Ear.

    PubMed

    Leckness, Kegan; Nakmali, Don; Gan, Rong Z

    2018-03-01

    Hearing loss has become the most common disability among veterans. Understanding how blast waves propagate through the human ear is a necessary step in the development of effective hearing protection devices (HPDs). This article presents the first 3D finite element (FE) model of the human ear to simulate blast wave transmission through the ear. The 3D FE model of the human ear consisting of the ear canal, tympanic membrane, ossicular chain, and middle ear cavity was imported into ANSYS Workbench for coupled fluid-structure interaction analysis in the time domain. Blast pressure waveforms recorded external to the ear in human cadaver temporal bone tests were applied at the entrance of the ear canal in the model. The pressure waveforms near the tympanic membrane (TM) in the canal (P1) and behind the TM in the middle ear cavity (P2) were calculated. The model-predicted results were then compared with measured P1 and P2 waveforms recorded in human cadaver ears during blast tests. Results show that the model-derived P1 waveforms were in an agreement with the experimentally recorded waveforms with statistic Kurtosis analysis. The FE model will be used for the evaluation of HPDs in future studies.

  7. Inner ear problems of Thai priest at Priest Hospital.

    PubMed

    Karnchanakas, Taweporn; Tantanavat, Are; Sinsakontavat, Jamjan

    2008-01-01

    The inner ear problems of Thai priest at Priest Hospital had never been reported previously, so Department of Ear Nose Throat try to correlate the metebotic disorder with inner ear problems. 1) To study the fasting blood sugar (FBS), total cholesterol (T. Chol), low density lipoprotein (LDL), and triglyceride (TG), the factors expected to involve in inner ear problems of priests at Priest Hospital. 2) To compare the FBS, T. Chol, HDL, LDL, and TG of priests with inner ear problems at Priest Hospital. 3) To find the percentage of abnormal from FBS, T. Chol, LDL, and TG. The study using 83 sampling of priests with inner ear problems and 107 priests as a controlled group. The research instruments used to collect data was the questionnaire which composed of general information, physical, ear-nose-throat and neurological examination, pure tone audiometry, brainstem evoke response audiometry (BERA) and the blood tests:FBS, T. Chol, TG, and LDL. The inner ear problems were composed of: 1) Dizziness 2) Hearing Loss 3) Tinnitus Aurium. The descriptive statistics were used to analyze the data from questionnaires and utilized frequency, percentage, standard deviation (S.D.) and t-test to achieve desired results. Priest at middle age and elderly with inner ear problems had greater FBS and TG than expected values of the control group. The middle age and elderly priests who had greater FBS and TG than expected values were sick with inner ear problems that causing dizziness, hearing loss and tinnitus aurium.

  8. Sheep as a large animal ear model: Middle-ear ossicular velocities and intracochlear sound pressure.

    PubMed

    Péus, Dominik; Dobrev, Ivo; Prochazka, Lukas; Thoele, Konrad; Dalbert, Adrian; Boss, Andreas; Newcomb, Nicolas; Probst, Rudolf; Röösli, Christof; Sim, Jae Hoon; Huber, Alexander; Pfiffner, Flurin

    2017-08-01

    Animals are frequently used for the development and testing of new hearing devices. Dimensions of the middle ear and cochlea differ significantly between humans and commonly used animals, such as rodents or cats. The sheep cochlea is anatomically more like the human cochlea in size and number of turns. This study investigated the middle-ear ossicular velocities and intracochlear sound pressure (ICSP) in sheep temporal bones, with the aim of characterizing the sheep as an experimental model for implantable hearing devices. Measurements were made on fresh sheep temporal bones. Velocity responses of the middle ear ossicles at the umbo, long process of the incus and stapes footplate were measured in the frequency range of 0.25-8 kHz using a laser Doppler vibrometer system. Results were normalized by the corresponding sound pressure level in the external ear canal (P EC ). Sequentially, ICSPs at the scala vestibuli and tympani were then recorded with custom MEMS-based hydrophones, while presenting identical acoustic stimuli. The sheep middle ear transmitted most effectively around 4.8 kHz, with a maximum stapes velocity of 0.2 mm/s/Pa. At the same frequency, the ICSP measurements in the scala vestibuli and tympani showed the maximum gain relative to the P EC (24 dB and 5 dB, respectively). The greatest pressure difference across the cochlear partition occurred between 4 and 6 kHz. A comparison between the results of this study and human reference data showed middle-ear resonance and best cochlear sensitivity at higher frequencies in sheep. In summary, sheep can be an appropriate large animal model for research and development of implantable hearing devices. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Evaluation of intraperitoneal vincristine in malignant peritoneal effusion.

    PubMed

    Bairy, K L; Sanath, S; Jagetia, G C; Somayaji, S N; Vidyasagar, M S; Baliga, M S

    2003-07-01

    The efficacy and safety of intraperitoneal administration of vincristine sulphate was determined in mice bearing Ehrlich ascitic carcinoma. The tumor bearing animals were administered with 0.5 mg/kg body weight (b.wt) of freshly prepared vincristine sulphate intraperitoneally on day 6 after tumor transplantation followed by drug administration once daily 5 days a week consecutively. The observations regarding the survival, alteration in the volume of peritoneal fluid, increase in life span and pathological changes in the liver, kidney, gastrointestinal tract and bone tissues were made. The vincristine sulphate treatment reduced the malignant cell population significantly and there were no significant changes in the histological picture of liver, kidney, bone, except the intestine, where atropy of villi demonstrating nests and cords of uniform small round cells were observed. Our experimental data suggests that intraperitoneal administration of vincristine is beneficial in malignant peritoneal effusion.

  10. Management of malignant pleural effusion: challenges and solutions

    PubMed Central

    Penz, Erika; Watt, Kristina N; Hergott, Christopher A; Rahman, Najib M; Psallidas, Ioannis

    2017-01-01

    Malignant pleural effusion (MPE) is a sign of advanced cancer and is associated with significant symptom burden and mortality. To date, management has been palliative in nature with a focus on draining the pleural space, with therapies aimed at preventing recurrence or providing intermittent drainage through indwelling catheters. Given that patients with MPEs are heterogeneous with respect to their cancer type and response to systemic therapy, functional status, and pleural milieu, response to MPE therapy is also heterogeneous and difficult to predict. Furthermore, the impact of therapies on important patient outcomes has only recently been evaluated consistently in clinical trials and cohort studies. In this review, we examine patient outcomes that have been studied to date, address the question of which are most important for managing patients, and review the literature related to the expected value for money (cost-effectiveness) of indwelling pleural catheters relative to traditionally recommended approaches. PMID:28694705

  11. Chronic eosinophilic pneumonia presenting with ipsilateral pleural effusion: a case report.

    PubMed

    Sriratanaviriyakul, Narin; La, Hanh H; Albertson, Timothy E

    2016-08-12

    Chronic eosinophilic pneumonia is a rare idiopathic interstitial lung disease. The nearly pathognomonic radiographic finding is the peripheral distribution of alveolar opacities. Pleural effusions are rarely seen. We report a case of chronic eosinophilic pneumonia with transudative eosinophilic pleural effusion. A 57-year-old Hispanic woman, a nonsmoker with a history of controlled asthma, presented to the hospital with unresolving pneumonia despite three rounds of antibiotics over a 2-month period. She was later diagnosed with chronic eosinophilic pneumonia based on the presence of peripheral blood eosinophilia, the peripheral distribution of alveolar infiltrates on chest radiograph, and a lung parenchymal biopsy with infiltrates of eosinophils. Upon presentation, our patient had a right-sided moderate-sized pleural effusion. The pleural fluid profile was consistent with a transudative effusion with eosinophil predominance. Our patient responded promptly to oral corticosteroid treatment in a few days. The pulmonary infiltrates and pleural effusion subsided on a 1-month follow-up chest radiograph after starting corticosteroid treatment. We report the first case of chronic eosinophilic pneumonia presenting with pneumonia with ipsilateral transudative eosinophilic pleural effusion. Like other cases of chronic eosinophilic pneumonia, early recognition and diagnosis is essential and prompt treatment with corticosteroids is the mainstay of therapy. Pleural effusion resolved without the further need for therapeutic thoracentesis.

  12. [A case having chyliform pleural effusion caused by former tuberculous pleurisy].

    PubMed

    Nishio, Kazumi; Harada, Kana; Nakano, Yasushi; Aida, Shinji; Okabayashi, Ken

    2011-02-01

    A 49-year-old male who had been treated for pulmonary tuberculosis and tuberculous pleurisy in 2007 was referred to our hospital with the complaint of dyspnea on exertion in Nov. 2009. Chest X-ray showed increased pleural effusion compared with that remaining after the previous treatment of pleurisy in 2008. A chest CT revealed that fluid collection was surrounded by thickened pleura. Thoracocentesis was performed, and yellow milky liquid was obtained. The pleural effusion contained few cells. The triglyceride concentration was 83 mg/dl, and the cholesterol level was very high at 628 mg/dl. Based on these findings we diagnosed this case as chyliform pleural effusion. Both smear of acid-fast bacilli and PCR-TB test of the pleural effusion were positive, but culture was negative for mycobacterium, suggesting that this chyliform pleural effusion was produced by the former episode of tuberculous pleurisy, not by the recent reactivation of tuberculous pleurisy. The ADA concentration in the pleural effusion was high at 91.7 IU/l. No increase in the amount of pleural effusion was observed after thoracocentesis without any anti-tuberculosis therapy.

  13. Identifying Malignant Pleural Effusion by A Cancer Ratio (Serum LDH: Pleural Fluid ADA Ratio).

    PubMed

    Verma, Akash; Abisheganaden, John; Light, R W

    2016-02-01

    We studied the diagnostic potential of serum lactate dehydrogenase (LDH) in malignant pleural effusion. Retrospective analysis of patients hospitalized with exudative pleural effusion in 2013. Serum LDH and serum LDH: pleural fluid ADA ratio was significantly higher in cancer patients presenting with exudative pleural effusion. In multivariate logistic regression analysis, pleural fluid ADA was negatively correlated 0.62 (0.45-0.85, p = 0.003) with malignancy, whereas serum LDH 1.02 (1.0-1.03, p = 0.004) and serum LDH: pleural fluid ADA ratio 0.94 (0.99-1.0, p = 0.04) was correlated positively with malignant pleural effusion. For serum LDH: pleural fluid ADA ratio, a cut-off level of >20 showed sensitivity, specificity of 0.98 (95 % CI 0.92-0.99) and 0.94 (95 % CI 0.83-0.98), respectively. The positive likelihood ratio was 32.6 (95 % CI 10.7-99.6), while the negative likelihood ratio at this cut-off was 0.03 (95 % CI 0.01-0.15). Higher serum LDH and serum LDH: pleural fluid ADA ratio in patients presenting with exudative pleural effusion can distinguish between malignant and non-malignant effusion on the first day of hospitalization. The cut-off level for serum LDH: pleural fluid ADA ratio of >20 is highly predictive of malignancy in patients with exudative pleural effusion (whether lymphocytic or neutrophilic) with high sensitivity and specificity.

  14. Initial 12-h operative fluid volume is an independent risk factor for pleural effusion after hepatectomy.

    PubMed

    Cheng, Xiang; Wu, Jia-Wei; Sun, Ping; Song, Zi-Fang; Zheng, Qi-Chang

    2016-12-01

    Pleural effusion after hepatectomy is associated with significant morbidity and prolonged hospital stays. Several studies have addressed the risk factors for postoperative pleural effusion. However, there are no researches concerning the role of the initial 12-h operative fluid volume. The aim of this study was to evaluate whether the initial 12-h operative fluid volume during liver resection is an independent risk factor for pleural effusion after hepatectomy. In this study, we retrospectively analyzed clinical data of 470 patients consecutively undergoing elective hepatectomy between January 2011 and December 2012. We prospectively collected and retrospectively analyzed baseline and clinical data, including preoperative, intraoperative, and postoperative variables. Univariate and multivariate analyses were carried out to identify whether the initial 12-h operative fluid volume was an independent risk factor for pleural effusion after hepatectomy. The multivariate analysis identified 2 independent risk factors for pleural effusion: operative time [odds ratio (OR)=10.2] and initial 12-h operative fluid volume (OR=1.0003). Threshold effect analyses revealed that the initial 12 h operative fluid volume was positively correlated with the incidence of pleural effusion when the initial 12-h operative fluid volume exceeded 4636 mL. We conclude that the initial 12-h operative fluid volume during liver resection and operative time are independent risk factors for pleural effusion after hepatectomy. Perioperative intravenous fluids should be restricted properly.

  15. Diagnostic value and safety of medical thoracoscopy in tuberculous pleural effusion.

    PubMed

    Wang, Zhen; Xu, Li-Li; Wu, Yan-Bing; Wang, Xiao-Juan; Yang, Yuan; Zhang, Jun; Tong, Zhao-Hui; Shi, Huan-Zhong

    2015-09-01

    Differentiating tuberculous pleural effusion from other lymphocytic pleural effusions is often challenging. This retrospective study aimed to assess the efficacy and safety of medical thoracoscopy in patients with suspected tuberculous pleural effusion. Between July 2005 and June 2014, patients with pleural effusions of unknown etiologies underwent medical thoracoscopy in our institute after less invasive means of diagnosis had failed. Demographic, radiographic, procedural, and histological data of patients with tuberculous pleural effusion were analyzed. During this 9-year study, 333 of 833 patients with pleural effusion were confirmed to have tuberculous pleurisy. Under thoracoscopy, we observed pleural nodules in 69.4%, pleural adhesion in 66.7%, hyperemia in 60.7%, plaque-like lesions in 6.0%, ulceration in 1.5% of patients with tuberculous pleurisy. Pleural biopsy revealed the presence of Mycobacterium tuberculosis in the pleural tissue or/and demonstration of caseating granulomas in 330 (99.1%) patients. No serious adverse events were recorded, and the most common minor complication was transient chest pain (43.2%) from the indwelling chest tube. Our data showed that medical thoracoscopy is a simple procedure with high diagnostic yield and excellent safety for the diagnosis of tuberculous pleural effusion. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. [Clinical analysis of thoracoscopy of 30 coalworker's pneumoconiosiswith pleural effusion cases].

    PubMed

    Liang, Yandong; Jiang, Ruiling; Yu, Chunxiao; Huang, Cheng

    2015-07-01

    To investigate the diagnostic value of thoracoscopy on idiopathic coalworker's pneumoconiosis with pleural effusion in general medicine. Routine (general medicine) thoracoscopyof patients suffering from iIdiopathiccoalworker's pneumoconiosis with pleural effusion, pathological examination of lesions obtained (direct vision). Pathological examination revealed grayish-white miliary nodules with multiple protruding nodules, irregular focal pleura thickening, pulmonary congestion, edema, fibrous adhesion. Thorascopy produced a diagnostic rate of 93.3%. Confirmed cases includes 13 cases of tuberculous pleurisy, 11 cases of malignant pleural effusion, 4 cases of cardiac insufficiency with pleural effusion and 2 cases of idiopathic pleural effusion, with no serious complications. Thoracoscopy of idiopathic coalworker's pneumoconiosis with pleural effusion is a safe, accurate diagnostic methodin general medicine, and could benefit the establishment of a treatment method quickly, visual observation of the lesions of patients suffering from coalworker's pneumoconiosis with pleural effusion using thoracoscopy, and at the same time offer preliminary investigationof the correlation between the intensity and compactibilityof coal macule distribution and clinical stages of coalworker's Pneumoconiosis.

  17. The Effects of Knee Joint Effusion on Quadriceps Electromyography During Jogging

    PubMed Central

    Torry, Michael R.; Decker, Michael J.; Millett, Peter J.; Steadman, J. Richard; Sterett, William I.

    2005-01-01

    To investigate and describe the influence of intra-articular effusion on knee joint kinematics and electromyographic (EMG) profiles during jogging. Thirteen individuals underwent a 20 cc 0.9% saline insufflation of the knee joint capsule and completed 8 jogging trials. Stance phase, sagittal plane knee joint kinematics and thigh muscular EMG profiles were compared pre- and post-insufflation utilizing a paired t-test ( = 0.05). Mild knee effusion caused a reduction in vastus medialis (p = 0.005) and lateralis (p = 0.006) EMG activity. The rectus femoris, biceps femoris and medial hamstring muscles did not exhibit changes due to this protocol. There were no changes in the sagittal plane knee joint kinematic pattern. Twenty cc effusion can cause quadriceps inhibition in the vastus medialis and the vastus lateralis in otherwise healthy individuals during jogging. This study provides baseline data for the effects of mild knee joint effusion on thigh musculature during jogging. Key Points 20 cc of knee effusion can cause vastus medialis and lateralis inhibition as noted by decreases in EMG amplitude. This effusion does not appear to alter sagittal plane knee joint kinematics during jogging. This finding if different from previous work investigating knee joint kinematic changes during a less dynamic activity (gait) with 20 cc of effusion. PMID:24431955

  18. Characteristics of pleural effusions in systemic lupus erythematosus: differential diagnosis of lupus pleuritis.

    PubMed

    Choi, B Y; Yoon, M J; Shin, K; Lee, Y J; Song, Y W

    2015-03-01

    We investigated the clinical characteristics of pleural effusion in systemic lupus erythematosus (SLE). A prospective analysis of 17 SLE patients with pleural effusion (seven lupus pleuritis, eight transudative effusions and two parapneumonic effusions) was performed. Thirty non-SLE patients with pleural effusion were recruited as controls. A pleural fluid ANA titer ≥1:160 was found in 8/17 (47.1%) SLE patients and none of the 30 non-SLE patients (p = 0.0001). Pleural fluid to serum C3 ratios were significantly lower in SLE than in non-SLE (median (minimum-maximum) 0.29 (0.03-0.43) versus 0.52 (0.26-0.73), p = 0.0002). Among SLE patients, pleural fluid ANA titers ≥1:160 were more frequently found in patients with lupus pleuritis than in those with pleural effusion from causes other than lupus itself (85.7% versus 20.0%, p = 0.0152). Serum CRP levels were significantly increased in patients with lupus pleuritis compared with SLE patients with transudative pleural effusion (2.30 (0.30-5.66) versus 0.7 (0.12-1.47) mg/dl, p = 0.0062). In conclusion, pleural fluid ANA titer and serum CRP levels are significantly increased in lupus pleuritis. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  19. Surgical Treatments for Infantile Purulent Meningitis Complicated by Subdural Effusion.

    PubMed

    Wang, Xianshu; Zhang, Xiaoru; Cao, Hongbin; Jing, Shiyuan; Yang, Zhiguo; Cheng, Zhenghai; Liu, Ye; Li, Xin; Gao, Feifei; Ji, Yuanqi

    2015-10-20

    Infantile purulent meningitis (PM) is a commonly severe intracranial infectious disease in infants under age 1 year. In recent years, several diagnostic and treatment methods were reported, but in these cases the neurological complications and sequel were often observed, among which subdural effusion (SE) is the most common complication in PM. Timely diagnosis and early intervention are vital for better outcomes. In this study, the surgical treatments for infantile PM complicated by SE were investigated. Patients who had PM complicated by SE in the Children's Hospital of Hebei Province from June 2000 to June 2012 were retrospectively analyzed and 170 patients were enrolled in the study. Surgical treatment for each patient was adopted according to producing effusion time, leucocyte count, protein content, intracranial pressure, and bacteria culture, coupled with cranial ultrasound examination, CT, and MRI scans. Nearly, 15 patients were cured using serial taps, with a 50% cure rate. Seventeen out of 30 (56.6%) patients receiving subcutaneous reservoir drainage had better outcome. Nearly 80% of patients (55/69) who underwent minimally invasive trepanation and drainage were positive. Surgical procedure of minimally invasive trepanation and drainage combined with drug douche was effective in 63% of patients (19/30). In addition, 6 patients were cured with subdural-peritoneal shunt. Only 1 patient died, after the recurrence of meningitis, and the remaining 4 patients were cured by craniotomy. For infantile PM complicated with SE, treatment needs be chosen according to the specific situation. Surgical procedure of minimally invasive trepanation and drainage is a very effective treatment in curing PM complicated by SE. The treatment was highly effective with the use of drug douche. Subdural-peritoneal shunt and craniotomy were as effective as in refractory cases.

  20. Surgical Treatments for Infantile Purulent Meningitis Complicated by Subdural Effusion

    PubMed Central

    Wang, Xianshu; Zhang, Xiaoru; Cao, Hongbin; Jing, Shiyuan; Yang, Zhiguo; Cheng, Zhenghai; Liu, Ye; Li, Xin; Gao, Feifei; Ji, Yuanqi

    2015-01-01

    Background Infantile purulent meningitis (PM) is a commonly severe intracranial infectious disease in infants under age 1 year. In recent years, several diagnostic and treatment methods were reported, but in these cases the neurological complications and sequel were often observed, among which subdural effusion (SE) is the most common complication in PM. Timely diagnosis and early intervention are vital for better outcomes. In this study, the surgical treatments for infantile PM complicated by SE were investigated. Material/Methods Patients who had PM complicated by SE in the Children’s Hospital of Hebei Province from June 2000 to June 2012 were retrospectively analyzed and 170 patients were enrolled in the study. Surgical treatment for each patient was adopted according to producing effusion time, leucocyte count, protein content, intracranial pressure, and bacteria culture, coupled with cranial ultrasound examination, CT, and MRI scans. Results Nearly, 15 patients were cured using serial taps, with a 50% cure rate. Seventeen out of 30 (56.6%) patients receiving subcutaneous reservoir drainage had better outcome. Nearly 80% of patients (55/69) who underwent minimally invasive trepanation and drainage were positive. Surgical procedure of minimally invasive trepanation and drainage combined with drug douche was effective in 63% of patients (19/30). In addition, 6 patients were cured with subdural-peritoneal shunt. Only 1 patient died, after the recurrence of meningitis, and the remaining 4 patients were cured by craniotomy. Conclusions For infantile PM complicated with SE, treatment needs be chosen according to the specific situation. Surgical procedure of minimally invasive trepanation and drainage is a very effective treatment in curing PM complicated by SE. The treatment was highly effective with the use of drug douche. Subdural-peritoneal shunt and craniotomy were as effective as in refractory cases. PMID:26482715

  1. Quantification of pericardial effusions by echocardiography and computed tomography.

    PubMed

    Leibowitz, David; Perlman, Gidon; Planer, David; Gilon, Dan; Berman, Philip; Bogot, Naama

    2011-01-15

    Echocardiography is a well-accepted tool for the diagnosis and quantification of pericardial effusion (PEff). Given the increasing use of computed tomographic (CT) scanning, more PEffs are being initially diagnosed by computed tomography. No study has compared quantification of PEff by computed tomography and echocardiography. The objective of this study was to assess the accuracy of quantification of PEff by 2-dimensional echocardiography and computed tomography compared to the amount of pericardial fluid drained at pericardiocentesis. We retrospectively reviewed an institutional database to identify patients who underwent chest computed tomography and echocardiography before percutaneous pericardiocentesis with documentation of the amount of fluid withdrawn. Digital 2-dimensional echocardiographic and CT images were retrieved and quantification of PEff volume was performed by applying the formula for the volume of a prolate ellipse, π × 4/3 × maximal long-axis dimension/2 × maximal transverse dimension/2 × maximal anteroposterior dimension/2, to the pericardial sac and to the heart. Nineteen patients meeting study qualifications were entered into the study. The amount of PEff drained was 200 to 1,700 ml (mean 674 ± 340). Echocardiographically calculated pericardial effusion volume correlated relatively well with PEff volume (r = 0.73, p <0.001, mean difference -41 ± 225 ml). There was only moderate correlation between CT volume quantification and actual volume drained (r = 0.4, p = 0.004, mean difference 158 ± 379 ml). In conclusion, echocardiography appears a more accurate imaging technique than computed tomography in quantitative assessment of nonloculated PEffs and should continue to be the primary imaging in these patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Managing malignant pleural effusion with an indwelling pleural catheter: factors associated with spontaneous pleurodesis.

    PubMed

    Wong, W M; Tam, T Cc; Wong, M Ky; Lui, M Ms; Ip, M Sm; Lam, D Cl

    2016-08-01

    Malignant pleural effusion can be recurrent despite active anti-cancer treatment. Significant malignant pleural effusion leads to debilitating dyspnoea and worsening quality of life in patients with advanced cancer. An indwelling pleural catheter offers a novel means to manage recurrent malignant pleural effusion and may remove the need for repeated thoracocentesis. Spontaneous pleurodesis is another unique advantage of indwelling pleural catheter placement but the factors associated with its occurrence are not clearly established. The aims of this study were to explore the safety of an indwelling pleural catheter in the management of symptomatic recurrent malignant pleural effusion, and to identify the factors associated with spontaneous pleurodesis. This case series with internal comparisons was conducted in the Division of Respiratory Medicine, Department of Medicine, Queen Mary Hospital, Hong Kong. All patients who underwent insertion of an indwelling pleural catheter from the initiation of such service from January 2010 to December 2014 were included for data analysis. Patients were monitored until December 2014, with the last catheter inserted in July 2014. Between 2010 and 2014, a total of 23 indwelling pleural catheters were inserted in 22 consecutive patients with malignant pleural effusion, including 15 (65.2%) cases with malignant pleural effusion as a result of metastatic lung cancer. Ten (43.5%) cases achieved minimal output according to defined criteria, in five of whom the pleural catheter was removed without subsequent re-accumulation of effusion (ie spontaneous pleurodesis). Factors associated with minimal output were the absence of trapped lung (P=0.036), shorter time from first appearance of malignant pleural effusion to catheter insertion (P=0.017), and longer time from catheter insertion till patient's death or end of study (P=0.007). An indwelling pleural catheter provides a safe means to manage symptomatic malignant pleural effusion

  3. Predicting Malignant and Paramalignant Pleural Effusions by Combining Clinical, Radiological and Pleural Fluid Analytical Parameters.

    PubMed

    Herrera Lara, Susana; Fernández-Fabrellas, Estrella; Juan Samper, Gustavo; Marco Buades, Josefa; Andreu Lapiedra, Rafael; Pinilla Moreno, Amparo; Morales Suárez-Varela, María

    2017-10-01

    The usefulness of clinical, radiological and pleural fluid analytical parameters for diagnosing malignant and paramalignant pleural effusion is not clearly stated. Hence this study aimed to identify possible predictor variables of diagnosing malignancy in pleural effusion of unknown aetiology. Clinical, radiological and pleural fluid analytical parameters were obtained from consecutive patients who had suffered pleural effusion of unknown aetiology. They were classified into three groups according to their final diagnosis: malignant, paramalignant and benign pleural effusion. The CHAID (Chi-square automatic interaction detector) methodology was used to estimate the implication of the clinical, radiological and analytical variables in daily practice through decision trees. Of 71 patients, malignant (n = 31), paramalignant (n = 15) and benign (n = 25), smoking habit, dyspnoea, weight loss, radiological characteristics (mass, node, adenopathies and pleural thickening) and pleural fluid analytical parameters (pH and glucose) distinguished malignant and paramalignant pleural effusions (all with a p < 0.05). Decision tree 1 classified 77.8% of malignant and paramalignant pleural effusions in step 2. Decision tree 2 classified 83.3% of malignant pleural effusions in step 2, 73.3% of paramalignant pleural effusions and 91.7% of benign ones. The data herein suggest that the identified predictor values applied to tree diagrams, which required no extraordinary measures, have a higher rate of correct identification of malignant, paramalignant and benign effusions when compared to techniques available today and proved most useful for usual clinical practice. Future studies are still needed to further improve the classification of patients.

  4. Chinchilla middle-ear admittance and sound power: High-frequency estimates and effects of inner-ear modifications

    PubMed Central

    Ravicz, Michael E.; Rosowski, John J.

    2012-01-01

    The middle-ear input admittance relates sound power into the middle ear (ME) and sound pressure at the tympanic membrane (TM). ME input admittance was measured in the chinchilla ear canal as part of a larger study of sound power transmission through the ME into the inner ear. The middle ear was open, and the inner ear was intact or modified with small sensors inserted into the vestibule near the cochlear base. A simple model of the chinchilla ear canal, based on ear canal sound pressure measurements at two points along the canal and an assumption of plane-wave propagation, enables reliable estimates of YTM, the ME input admittance at the TM, from the admittance measured relatively far from the TM. YTM appears valid at frequencies as high as 17 kHz, a much higher frequency than previously reported. The real part of YTM decreases with frequency above 2 kHz. Effects of the inner-ear sensors (necessary for inner ear power computation) were small and generally limited to frequencies below 3 kHz. Computed power reflectance was ∼0.1 below 3.5 kHz, lower than with an intact ME below 2.5 kHz, and nearly 1 above 16 kHz. PMID:23039439

  5. [Ear, nose and throat disease profile in children with Down syndrome].

    PubMed

    Paul D, María A; Bravo V, Alejandra; Beltrán M, Constanza; Cerda L, Jaime; Angulo M, Daniela; Lizama C, Macarena

    2015-01-01

    The children with Down syndrome (DS) are at increased risk of ear-nose-throat (ENT) disorders. International recommendations suggest early hearing screening and periodic specialist evaluation. Our goal was to characterize ENT disorders in children with DS, and propose recommendations for the Chilean population. Cross-sectional, descriptive study, of children with DS, between 6 months and 15 years of age. The data was obtained by a health interview to the parents and review of medical records. We analyzed 134 patients with an average age of 44.5 months. The 78.8% had ENT disorders, the most frequent ENT disorders was allergic rhinitis and otitis media with effusion. Hearing screening was abnormal in a quarter of the patients, 50% of children over 3 years of age had obstructive sleep apnea diagnosed by polysomnogram. Older children had a statistically higher frequency of ENT disorders. This series shows a high rate of ENT disorders in children with DS, which supports recommendations for hearing screening, high suspicion of obstructive sleep apnea and routine referral to an ENT specialist for prevention and aggressive therapy in order to reduce hearing loss and improve development of the child with DS. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Diagnostic value of radiological imaging pre- and post-drainage of pleural effusions.

    PubMed

    Corcoran, John P; Acton, Louise; Ahmed, Asia; Hallifax, Robert J; Psallidas, Ioannis; Wrightson, John M; Rahman, Najib M; Gleeson, Fergus V

    2016-02-01

    Patients with an unexplained pleural effusion often require urgent investigation. Clinical practice varies due to uncertainty as to whether an effusion should be drained completely before diagnostic imaging. We performed a retrospective study of patients undergoing medical thoracoscopy for an unexplained effusion. In 110 patients with paired (pre- and post-drainage) chest X-rays and 32 patients with paired computed tomography scans, post-drainage imaging did not provide additional information that would have influenced the clinical decision-making process. © 2015 Asian Pacific Society of Respirology.

  7. Goose-skin Pleura: A Thoracoscopic Finding in a Case of Recurrent Undiagnosed Pleural Effusion.

    PubMed

    Al-Halfawy, Ahmed; Light, Richard W

    2010-10-01

    We present the case of a female patient who presented with undiagnosed pleural effusion. Thoracoscopy was performed and at the beginning of the procedure, the parietal pleura was rather uniformly congested but with a smooth surface. As time passed, the parietal pleura became roughened by bumpy areas of mucosal elevations, which looked soft and watery. This became evident during the biopsy procedure, as the pleura was markedly edematous. The biopsy specimens were nonspecific and the cause of the effusion remained unclear. This phenomenon, which we termed "goose-skin" pleura, showed that the origin of the pleural effusion formed was the parietal pleura, for unknown causes.

  8. Massive pericardial effusion and rhabdomyolysis secondary to untreated severe hypothyroidism: the first report.

    PubMed

    Zare-Khormizi, M R; Rahmanian, M; Pourrajab, F; Akbarnia, S

    2014-10-01

    Hypothyroidism is an endocrine disease with various clinical manifestations. It is a rare cause for rhabdomyolysis and massive pericardial effusion. We describe a case of severe hypothyroidism secondary to autoimmune hashimoto thyroiditis with massive pericardial effusion and rhabdomyolysis. Improvement of mentioned complications after hypothyroidism treatment and rule out of other possible causes are supportive clues that hypothyroidism is the main cause of patient's rare presentation. With the best of our knowledge, it is the first report of rhabdomyolysis and massive pericardial effusion coincidence in a patient of adult population with primary uncontrolled hypothyroidism for years.

  9. Thoracentesis-reverting cardiac tamponade physiology in a patient with myxedema coma and large pleural effusion.

    PubMed

    Werlang, Monia E; Pimentel, Mario R; Diaz-Gomez, Jose L

    2017-07-01

    A large pleural effusion causing cardiac tamponade physiology and severe hemodynamic compromise is an uncommon event. We report a case of a 53-year-old woman with severe hypothyroidism presenting with myxedema coma and refractory shock. Her hemodynamic status failed to respond to fluid resuscitation and vasopressors. A transthoracic echocardiogram and chest radiograph demonstrated a pericardial fluid accumulation associated with a large left-sided pleural effusion. Thoracostomy tube insertion resulted in prompt improvement of the patient's hemodynamic status. Our finding demonstrates that a large pleural effusion may play an important role in cardiac tamponade physiology.

  10. Very large pericardial effusion attributable to minoxidil: resolution without drainage of fluid.

    PubMed

    Shirwany, Arsalan; D'Cruz, Ivan A; Munir, Ahmad

    2002-08-01

    A 52-year-old man with a history of chronic hypertension presented with worsening dyspnea and leg edema. He had been on minoxidil for 10 years. The cardiac silhouette was markedly enlarged. Echocardiography and computed tomography showed a large pericardial effusion. His cardiac status was stable and he was in no cardiorespiratory distress. No attempt was made to drain the fluid. Minoxidil was discontinued, and a month later, the effusion had virtually disappeared. Cessation of minoxidil administration and conservative management may suffice, even though the pericardial effusion is large.

  11. Recurrent massive pleural effusion due to pleural, pericardial, and epicardial fibrosis in histoplasmosis.

    PubMed

    Kilburn, C D; McKinsey, D S

    1991-12-01

    Acute histoplasmosis is generally a benign, self-limited pulmonary infection. Although Histoplasma capsulatum pneumonitis is common, pleural effusions associated with histoplasmosis are quite rare, and massive pleural effusions have not been reported. There have been several reports of pericardial fibrosis secondary to histoplasmosis, but epicardial fibrosis has not been described. We report a biopsy-proven case of histoplasmosis initially associated with recurrent massive pleural effusions and excessive pleural fibrosis causing a trapped lung. The patient later developed constrictive pericarditis. Despite pericardiectomy, severe cor pulmonale occurred, and the patient died. Necropsy demonstrated fibrosis of the epicardium.

  12. The role of liquid-based cytology and ancillary techniques in pleural and pericardic effusions: an institutional experience.

    PubMed

    Rossi, Esther Diana; Bizzarro, Tommaso; Schmitt, Fernando; Longatto-Filho, Adhemar

    2015-04-01

    Fine-needle aspiration cytology (FNAC) of serous membrane effusions may fulfil a challenging role in the diagnostic analysis of both primary and metastatic disease. From this perspective, liquid-based cytology (LBC) represents a feasible and reliable method for empowering the performance of ancillary techniques (ie, immunocytochemistry and molecular testing) with high diagnostic accuracy. In total, 3171 LBC pleural and pericardic effusions were appraised between January 2000 and December 2013. They were classified as negative for malignancy (NM), suspicious for malignancy (SM), or positive for malignancy (PM). The cytologic diagnoses included 2721 NM effusions (2505 pleural and 216 pericardic), 104 SM effusions (93 pleural and 11 pericardic), and 346 PM effusions (321 pleural and 25 pericardic). The malignant pleural series included 76 unknown malignancies (36 SM and 40 PM effusions), 174 metastatic lesions (85 SM and 89 PM effusions), 14 lymphomas (3 SM and 11 PM effusions), 16 mesotheliomas (5 SM and 11 SM effusions), and 3 myelomas (all SM effusions). The malignant pericardic category included 20 unknown malignancies (5 SM and 15 PM effusions), 15 metastatic lesions (1 SM and 14 PM effusions), and 1 lymphoma (1 PM effusion). There were 411 conclusive immunocytochemical analyses and 47 molecular analyses, and the authors documented 88% sensitivity, 100% specificity, 98% diagnostic accuracy, 98% negative predictive value, and 100% positive predictive value for FNAC. FNAC represents a primary diagnostic tool for effusions and a reliable approach with which to determine the correct follow-up. Furthermore, LBC is useful for ancillary techniques, such as immunocytochemistry and molecular analysis, with feasible diagnostic and predictive utility. © 2015 American Cancer Society.

  13. Optoacoustic induced vibrations within the inner ear.

    PubMed

    Zhang, K Y; Wenzel, G I; Balster, S; Lim, H H; Lubatschowski, H; Lenarz, T; Ertmer, W; Reuter, G

    2009-12-07

    An acoustic transient can be generated inside an absorbing tissue as a result of laser-tissue interaction after pulsed laser irradiation. Herein we report a novel application of this physical process, the optoacoustic wave generation in the inner ear and subsequently the induction of basilar membrane vibrations. These laser induced vibrations show a direct correlation to the laser energy and an indirect correlation to the distance from the irradiation focus. Through these characteristics they may be used, in a new generation of cochlear implants, to improve the frequency specific cochlear activation and consequently improve speech perception in hearing impaired patients with residual hearing.

  14. The velocity field of growing ear cartilage.

    PubMed Central

    Cox, R W; Peacock, M A

    1978-01-01

    The velocity vector field of the growing rabbit ear cartilage has been investigated between 12 and 299 days. Empirical curves have been computed for path lines and for velocities between 12 and 87 days. The tissue movement has been found to behave as an irrotational flow of material. Stream lines and velocity equipotential lines have been calculated and provide akinematic description of the changes during growth. The importance of a knowledge of the velocity vector in physical descriptions of growth and morphological differentiation at the tissue and cellular levels is emphasized. PMID:689993

  15. Vitamin D receptor deficiency impairs inner ear development in zebrafish

    SciTech Connect

    Kwon, Hye-Joo; Biology Department, Princess Nourah University, Riyadh 11671

    The biological actions of vitamin D are largely mediated through binding to the vitamin D receptor (VDR), a member of the nuclear hormone receptor family, which regulates gene expression in a wide variety of tissues and cells. Mutations in VDR gene have been implicated in ear disorders (hearing loss and balance disorder) but the mechanisms are not well established. In this study, to investigate the role of VDR in inner ear development, morpholino-mediated gene knockdown approaches were used in zebrafish model system. Two paralogs for VDR, vdra and vdrb, have been identified in zebrafish. Knockdown of vdra had no effectmore » on ear development, whereas knockdown of vdrb displayed morphological ear defects including smaller otic vesicles with malformed semicircular canals and abnormal otoliths. Loss-of-vdrb resulted in down-regulation of pre-otic markers, pax8 and pax2a, indicating impairment of otic induction. Furthermore, zebrafish embryos lacking vdrb produced fewer sensory hair cells in the ears and showed disruption of balance and motor coordination. These data reveal that VDR signaling plays an important role in ear development. - Highlights: • VDR signaling is involved in ear development. • Knockdown of vdrb causes inner ear malformations during embryogenesis. • Knockdown of vdrb affects otic placode induction. • Knockdown of vdrb reduces the number of sensory hair cells in the inner ear. • Knockdown of vdrb disrupts balance and motor coordination.« less

  16. Piercing the upper ear: a simple infection, a difficult reconstruction.

    PubMed

    Cicchetti, S; Skillman, J; Gault, D T

    2002-04-01

    Piercing the upper ear to retain jewellery is now commonplace. When infection ensues, devastating chondritis leads to collapse of the ear. To our knowledge, the surgical reconstruction of post-piercing deformities has not been documented in the literature. We present five such cases referred for autogenous-tissue ear reconstruction. In four of these, the destroyed segments of ear cartilage were replaced with a carved costal-cartilage framework. One patient declined surgery. The importance of preventing infection is stressed. Copyright 2002 The British Association of Plastic Surgeons.

  17. Fly-ear inspired acoustic sensors for gunshot localization

    NASA Astrophysics Data System (ADS)

    Liu, Haijun; Currano, Luke; Gee, Danny; Yang, Benjamin; Yu, Miao

    2009-05-01

    The supersensitive ears of the parasitoid fly Ormia ochracea have inspired researchers to develop bio-inspired directional microphone for sound localization. Although the fly ear is optimized for localizing the narrow-band calling song of crickets at 5 kHz, experiments and simulation have shown that it can amplify directional cues for a wide frequency range. In this article, a theoretical investigation is presented to study the use of fly-ear inspired directional microphones for gunshot localization. Using an equivalent 2-DOF model of the fly ear, the time responses of the fly ear structure to a typical shock wave are obtained and the associated time delay is estimated by using cross-correlation. Both near-field and far-field scenarios are considered. The simulation shows that the fly ear can greatly amplify the time delay by ~20 times, which indicates that with an interaural distance of only 1.2 mm the fly ear is able to generate a time delay comparable to that obtained by a conventional microphone pair with a separation as large as 24 mm. Since the parameters of the fly ear structure can also be tuned for muzzle blast and other impulse stimulus, fly-ear inspired acoustic sensors offers great potential for developing portable gunshot localization systems.

  18. Correction of Stahl ear deformity using a suture technique.

    PubMed

    Khan, Muhammad Adil Abbas; Jose, Rajive M; Ali, Syed Nadir; Yap, Lok Huei

    2010-09-01

    Correction of partial ear deformities can be a challenging task for the plastic surgeon. There are no standard techniques for correcting many of these deformities, and several different techniques are described in literature. Stahl ear is one such anomaly, characterized by an accessory third crus in the ear cartilage, giving rise to an irregular helical rim. The conventional techniques of correcting this deformity include either excision of the cartilage, repositioning of the cartilage, or scoring techniques. We recently encountered a case of Stahl ear deformity and undertook correction using internal sutures with very good results. The technical details of the surgery are described along with a review of literature on correcting similar anomalies.

  19. Incorporating anthropometry into design of ear-related products.

    PubMed

    Liu, Bor-Shong

    2008-01-01

    To achieve mass customization and collaborative product design, human factors and ergonomics should play a key development role. The purpose of this study was to provide product designers with the anthropometic dimensions of outer ears for different demographic data, including gender and age. The second purpose was to compare the dimensions of various ear-related products (i.e., earphone, bluetooth earphone and ear-cup earphone) with the anthropometic database and recommend appropriate solutions for design. Two hundred subjects aged 20-59 was selected for this study and divided into four age stratifications. Further, three different dimensions of the outer ear (i.e., the earhole length, the ear connection length and the length of the pinna) were measured by superimposed grid photographic technique. The analysis of variance (ANOVA) was used to investigate the effects of gender, and age on ear dimensions. The results showed that all ear dimensions had significant gender effects. A comparison between the anthropometric dimensions and those of current products revealed that most current ear-related products need to be redesigned using anthropometric data. The shapes of earhole and pinna are not circular. Consequently, ear products need to be elongated so that users may feel more comfortably and not have the product slip off easily.

  20. Magnetically driven middle ear ossicles for optical measurement of vibrations in an ear with opened eardrum

    NASA Astrophysics Data System (ADS)

    Peacock, John; Von Unge, Magnus; Dirckx, Joris

    2012-06-01

    Vibrations of the middle ear ossicles are easily measured by means of laser vibrometry. However, exposing the ossicles requires the removal of the eardrum, with the result that the ossicles can no longer be stimulated acoustically. To overcome this we devised a new set up in which the ossicles can be driven magnetically. After measuring the response of the eardrum to an acoustic signal, we then remove the eardrum and attach a small magnet to the exposed manubrium (the part of the first auditory ossicle, the malleus, which is normally attached to the eardrum). An electromagnetic excitation coil is then used to drive the magnet, and the output to the coil adjusted until the vibration of the manubrium, as measured by the vibrometer, matches that measured in response to the acoustic signal. Such a set-up has uses in research on middle ear mechanics, such as the measurement of non-linearities in their response, as well as applications in the diagnosis of middle ear conditions such as the fixation of the ossicles by otosclerosis, or in chronic otitis media. We describe our set up in which the vibrometer unit is attached to a surgical microscope, offering accurate positioning of the laser beam. We discuss the viability of our method and its future potential by presenting some measurements on artificially fixated ears.

  1. Pleural Effusion Developing in Two Patients on Continuous Ambulatory Peritoneal Dialysis.

    PubMed

    Asim, Muhammad

    2016-11-01

    Two patients with end-stage-renal-disease on continuous ambulatory peritoneal dialysis (CAPD) presented with pleural effusions. The aspirated fluid was categorised as transudate, based on alkaline pH, low protein and lactic dehydrogenase level. A striking feature of the pleural fluid was, its very high glucose content that resulted from translocation of dextrose containing peritoneal dialysate into the pleural space via a pleuroperitoneal connection. One patient was transferred to hemodialysis, which led to complete resolution of pleural effusion. The other patient was switched to automated peritoneal dialysis, using small dwell volumes with consequent reduction in size of the pleural effusion. Pleuroperitoneal leak should always be considered in the differential diagnosis of pleural effusion in CAPD patients. Although isotopic peritoneography can demonstrate reflux of the tracer in the pleural space, measurement of pleural fluid glucose is a simpler and reliable way of diagnosing pleuroperitoneal communication.

  2. Thermal Effusivity Determination of Metallic Films of Nanometric Thickness by the Electrical Micropulse Method

    NASA Astrophysics Data System (ADS)

    Lugo, J. M.; Oliva, A. I.

    2017-02-01

    The thermal effusivity of gold, aluminum, and copper thin films of nanometric thickness (20 nm to 200 nm) was investigated in terms of the films' thickness. The metallic thin films were deposited onto glass substrates by thermal evaporation, and the thermal effusivity was estimated by using experimental parameters such as the specific heat, thermal conductivity, and thermal diffusivity values obtained at room conditions. The specific heat, thermal conductivity, and thermal diffusivity values of the metallic thin films are determined with a methodology based on the behavior of the thermal profiles of the films when electrical pulses of few microseconds are applied at room conditions. For all the investigated materials, the thermal effusivity decreases with decreased thickness. The thermal effusivity values estimated by the presented methodology are consistent with other reported values obtained under vacuum conditions and more elaborated methodologies.

  3. Efficacy of ultrasound-guided thoracentesis catheter drainage for pleural effusion

    PubMed Central

    Cao, Weitian; Wang, Yi; Zhou, Ningming; Xu, Bing

    2016-01-01

    The factors influencing the efficacy of ultrasound-guided thoracentesis catheter drainage were investigated in the present study. A retrospective analysis of clinical data from 435 patients who presented with a pleural effusion was performed. Patients were divided into a control group and an intervention group. Thirty-seven patients in the control group were given standard care using pleural puncture to draw the excess fluid. The 398 patients in the intervention group were treated using ultrasound-guided thoracentesis catheter drainage. The rate of successful drainage of a pleural effusion was significantly higher (P<0.05), while the rate of complication was lower, in the ultrasound-guided thoracentesis cases compared to standard care treatment. In conclusion, ultrasound-guided thoracentesis catheter drainage is an efficient, safe and minimally invasive procedure to alleviate pleural effusion. The efficacy of the procedure is related to the separation of pleural effusion, drainage tube type and tube diameter. PMID:28105155

  4. IgG4-related Pleuritis with Elevated Adenosine Deaminase in Pleural Effusion: A Case Report.

    PubMed

    Nagayasu, Atsushi; Kubo, Satoshi; Nakano, Kazuhisa; Nakayamada, Shingo; Iwata, Shigeru; Miyagawa, Ippei; Fukuyo, Shunsuke; Saito, Kazuyoshi; Tanaka, Yoshiya

    2018-03-09

    An 81-year-old man was admitted with bilateral pleural effusion. A clinical examination showed lymphocytic pleura effusion and elevated serum IgG4 levels, so that IgG4-related disease was suggested, whereas tuberculous pleurisy was suspected because of high adenosine deaminase (ADA) levels in the pleural effusion. A surgical pleural biopsy revealed that there were large numbers of IgG4-positive cells and IgG4/IgG positive cell ratio exceeded 40% in several sites. Accordingly, we diagnosed IgG4-related pleuritis and treated with the patient with glucocorticoid therapy. The ADA levels in pleural effusion can increase in IgG4-related pleuritis, and it is therefore important to perform a pleural biopsy.

  5. Vortex Structure Effects on Impingement, Effusion, and Cross Flow Cooling of a Double Wall Configuration

    NASA Astrophysics Data System (ADS)

    Ligrani, P. M.

    2018-03-01

    A variety of different types of vortices and vortex structures have important influences on thermal protection, heat transfer augmentation, and cooling performance of impingement cooling, effusion cooling, and cross flow cooling. Of particular interest are horseshoe vortices, which form around the upstream portions of effusion coolant concentrations just after they exit individual holes, hairpin vortices, which develop nearby and adjacent to effusion coolant trajectories, and Kelvin-Helmholtz vortices which form within the shear layers that form around each impingement cooling jet. The influences of these different vortex structures are described as they affect and alter the thermal performance of effusion cooling, impingement cooling, and cross flow cooling, as applied to a double wall configuration.

  6. Fluctuation theorem for entropy production during effusion of a relativistic ideal gas.

    PubMed

    Cleuren, B; Willaert, K; Engel, A; Van den Broeck, C

    2008-02-01

    The probability distribution of the entropy production for the effusion of a relativistic ideal gas is calculated explicitly. This result is then extended to include particle and antiparticle pair production and annihilation. In both cases, the fluctuation theorem is verified.

  7. Wearable ear EEG for brain interfacing

    NASA Astrophysics Data System (ADS)

    Schroeder, Eric D.; Walker, Nicholas; Danko, Amanda S.

    2017-02-01

    Brain-computer interfaces (BCIs) measuring electrical activity via electroencephalogram (EEG) have evolved beyond clinical applications to become wireless consumer products. Typically marketed for meditation and neu- rotherapy, these devices are limited in scope and currently too obtrusive to be a ubiquitous wearable. Stemming from recent advancements made in hearing aid technology, wearables have been shrinking to the point that the necessary sensors, circuitry, and batteries can be fit into a small in-ear wearable device. In this work, an ear-EEG device is created with a novel system for artifact removal and signal interpretation. The small, compact, cost-effective, and discreet device is demonstrated against existing consumer electronics in this space for its signal quality, comfort, and usability. A custom mobile application is developed to process raw EEG from each device and display interpreted data to the user. Artifact removal and signal classification is accomplished via a combination of support matrix machines (SMMs) and soft thresholding of relevant statistical properties.

  8. Enhanced visualization of inner ear structures

    NASA Astrophysics Data System (ADS)

    Niemczyk, Kazimierz; Kucharski, Tomasz; Kujawinska, Malgorzata; Bruzgielewicz, Antoni

    2004-07-01

    Recently surgery requires extensive support from imaging technologies in order to increase effectiveness and safety of operations. One of important tasks is to enhance visualisation of quasi-phase (transparent) 3d structures. Those structures are characterized by very low contrast. It makes differentiation of tissues in field of view very difficult. For that reason the surgeon may be extremly uncertain during operation. This problem is connected with supporting operations of inner ear during which physician has to perform cuts at specific places of quasi-transparent velums. Conventionally during such operations medical doctor views the operating field through stereoscopic microscope. In the paper we propose a 3D visualisation system based on Helmet Mounted Display. Two CCD cameras placed at the output of microscope perform acquisition of stereo pairs of images. The images are processed in real-time with the goal of enhancement of quasi-phased structures. The main task is to create algorithm that is not sensitive to changes in intensity distribution. The disadvantages of existing algorithms is their lack of adaptation to occuring reflexes and shadows in field of view. The processed images from both left and right channels are overlaid on the actual images exported and displayed at LCD's of Helmet Mounted Display. A physician observes by HMD (Helmet Mounted Display) a stereoscopic operating scene with indication of the places of special interest. The authors present the hardware ,procedures applied and initial results of inner ear structure visualisation. Several problems connected with processing of stereo-pair images are discussed.

  9. Pleural effusion in patients with acute lung injury: a CT scan study.

    PubMed

    Chiumello, Davide; Marino, Antonella; Cressoni, Massimo; Mietto, Cristina; Berto, Virna; Gallazzi, Elisabetta; Chiurazzi, Chiara; Lazzerini, Marco; Cadringher, Paolo; Quintel, Michael; Gattinoni, Luciano

    2013-04-01

    Pleural effusion is a frequent finding in patients with acute respiratory distress syndrome. To assess the effects of pleural effusion in patients with acute lung injury on lung volume, respiratory mechanics, gas exchange, lung recruitability, and response to positive end-expiratory pressure. A total of 129 acute lung injury or acute respiratory distress syndrome patients, 68 analyzed retrospectively and 61 prospectively, studied at two University Hospitals. Whole-lung CT was performed during two breath-holding pressures (5 and 45 cm H2O). Two levels of positive end-expiratory pressure (5 and 15 cm H2O) were randomly applied. Pleural effusion volume was determined on each CT scan section; respiratory system mechanics, gas exchange, and hemodynamics were measured at 5 and 15 cm H2O positive end-expiratory pressure. In 60 patients, elastances of lung and chest wall were computed, and lung and chest wall displacements were estimated. Patients were divided into higher and lower pleural effusion groups according to the median value (287 mL). Patients with higher pleural effusion were older (62±16 yr vs. 54±17 yr, p<0.01) with a lower minute ventilation (8.8±2.2 L/min vs. 10.1±2.9 L/min, p<0.01) and respiratory rate (16±5 bpm vs. 19±6 bpm, p<0.01) than those with lower pleural effusion. Both at 5 and 15 cm H2O of positive end-expiratory pressure PaO2/FIO2, respiratory system elastance, lung weight, normally aerated tissue, collapsed tissue, and lung and chest wall elastances were similar between the two groups. The thoracic cage expansion (405±172 mL vs. 80±87 mL, p<0.0001, for higher pleural effusion group vs. lower pleural effusion group) was greater than the estimated lung compression (178±124 mL vs. 23±29 mL, p<0.0001 for higher pleural effusion group vs. lower pleural effusion group, respectively). Pleural effusion in acute lung injury or acute respiratory distress syndrome patients is of modest entity and leads to a greater chest wall expansion than lung

  10. Probing the Xenopus laevis inner ear transcriptome for biological function

    PubMed Central

    2012-01-01

    Background The senses of hearing and balance depend upon mechanoreception, a process that originates in the inner ear and shares features across species. Amphibians have been widely used for physiological studies of mechanotransduction by sensory hair cells. In contrast, much less is known of the genetic basis of auditory and vestibular function in this class of animals. Among amphibians, the genus Xenopus is a well-characterized genetic and developmental model that offers unique opportunities for inner ear research because of the amphibian capacity for tissue and organ regeneration. For these reasons, we implemented a functional genomics approach as a means to undertake a large-scale analysis of the Xenopus laevis inner ear transcriptome through microarray analysis. Results Microarray analysis uncovered genes within the X. laevis inner ear transcriptome associated with inner ear function and impairment in other organisms, thereby supporting the inclusion of Xenopus in cross-species genetic studies of the inner ear. The use of gene categories (inner ear tissue; deafness; ion channels; ion transporters; transcription factors) facilitated the assignment of functional significance to probe set identifiers. We enhanced the biological relevance of our microarray data by using a variety of curation approaches to increase the annotation of the Affymetrix GeneChip® Xenopus laevis Genome array. In addition, annotation analysis revealed the prevalence of inner ear transcripts represented by probe set identifiers that lack functional characterization. Conclusions We identified an abundance of targets for genetic analysis of auditory and vestibular function. The orthologues to human genes with known inner ear function and the highly expressed transcripts that lack annotation are particularly interesting candidates for future analyses. We used informatics approaches to impart biologically relevant information to the Xenopus inner ear transcriptome, thereby addressing the

  11. Cauliflower Ear and Skin Infections among Wrestlers in Tehran.

    PubMed

    Kordi, Ramin; Mansournia, Mohammad Ali; Nourian, Roh Allah; Wallace, W Angus

    2007-01-01

    The purpose of the study was to describe the magnitude of the selected sports medicine problems (i.e. cauliflower ear and skin infections) among wrestlers in Tehran. A number of 411 wrestlers were randomly selected from wrestling clubs in Tehran employing cluster sample setting method. The participants were interviewed using a specially designed and validated questionnaire. Nearly half of the participants (44%) had "cauliflower ears". Only 23% of these participants had received any kind of treatment for their acute ear haematomas that are known to result in "cauliflower ears". The prevalence of reported hearing loss among participants with cauliflower ears (11.5%, 95%CI: 6.9 to 16.2) was significantly more than this prevalence among those participants without cauliflower ears (1.8%, 95%CI: 0.1 to 3.5) (p < 0.05). More than half of the participants (52%) had skin infection diagnosed by a physician during the previous year. This study has identified evidence of an increase in hearing loss as a possible side effect of either cauliflower ear or ear injury in wrestling in Iran. There has been an outbreak of ringworm and there is a significant potential for an outbreak of impetigo among wrestlers in Tehran. Key pointsSkin infections are prevalent among wrestlers in Tehran.Commonly wrestlers in Tehran continue to carry out wrestling training while affected by skin infections.Cauliflower ear "is common among wrestlers in Tehran.More research is needed to investigate hearing loss as a possible side effect of either cauliflower ear or ear injury in wrestling in Iran.

  12. Empyema and effusion: outcome of image-guided small-bore catheter drainage.

    PubMed

    Keeling, A N; Leong, S; Logan, P M; Lee, M J

    2008-01-01

    Empyema and complicated pleural effusion represent common medical problems. Current treatment options are multiple. The purpose of this study was to access the outcome of image-guided, small-bore catheter drainage of empyema and effusion. We evaluated 93 small-bore catheters in 82 patients with pleural effusion (n = 30) or empyema (n = 52), over a 2-year period. Image guidance was with ultrasound (US; n = 56) and CT (n = 37). All patients were followed clinically, with catheter dwell times, catheter outcome, pleural fluid outcome, reinsertion rates, and need for urokinase or surgery recorded. Ninety-three small-bore chest drains (mean=10.2 Fr; range, 8.2-12.2 Fr) were inserted, with an average dwell time of 7.81 days for empyemas and 7.14 days for effusions (p > 0.05). Elective removal rates (73% empyema vs 86% effusions) and dislodgement rates (12% empyema vs 13% effusions) were similar for both groups. Eight percent of catheters became blocked and 17% necessitated reinsertion in empyemas, with no catheters blocked or requiring reinsertion in effusions (p < 0.05). Thirty-two patients (51%) required urokinase in the empyema group, versus 2 patients (6%) in the effusion group (p < 0.05). All treatment failures, requiring surgery, occurred in the empyema group (19%; n = 12; p < 0.05). In conclusion, noninfected pleural collections are adequately treated with small-bore catheters, however, empyemas have a failure rate of 19%. The threshold for using urokinase and larger-bore catheters should be low in empyema.

  13. EBV-associated but HHV8-unrelated double-hit effusion-based lymphoma.

    PubMed

    Chen, Bo-Jung; Chen, David Yen-Ting; Kuo, Chun-Chi; Chuang, Shih-Sung

    2017-03-01

    Effusion-based lymphoma is a rare and unique type of large B-cell lymphoma presenting in effusion without a mass lesion. It shares many clinicopathological features with primary effusion lymphoma (PEL), but is distinct from PEL by the absence of HHV8 association. Double hit lymphoma (DHL) is an aggressive B-cell lymphoma, defined by concurrent rearrangement of MYC and BCL2 or BCL6. DHL often presents as lymphadenopathy or an extranodal mass, but rarely occurs in effusion. Here we report a 61-year-old male with alcoholic cirrhosis presenting as massive ascites and left pleural effusion. He has no HIV, HBV or HCV infection and no mass lesion by CT scans. Cytology of both pleural effusion and ascites show large lymphoma cells with plasmablastic morphology characterized by pleomorphic and eccentric nuclei, prominent nucleoli and frequent mitoses. Immunohistochemical study with cell block shows that the lymphoma cells express plasma cell-related markers (CD138, MUM-1 and EMA), but not CD3, CD30, CD45, B-cell markers (CD19, CD20, CD79a, and PAX5), HHV8, ALK or cytokeratin. EBER is positive in most lymphoma cells. Fluorescence in situ hybridization reveals rearrangement at the IGH, BCL2, and MYC loci, but not at BCL6. It is diagnosed as an EBV-associated but HHV8-unrelated double hit effusion-based lymphoma with plasmablastic features. The patient passed away soon after diagnosis without chemotherapy. This is the first reported case of double-hit effusion-based lymphoma with MYC and BCL2 rearrangement. This case illustrates the importance of integrating clinical, cytological, immunophenotypical, and molecular findings to reach a correct diagnosis. Diagn. Cytopathol. 2017;45:257-261. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. [CHARACTERISTICS OF LARGE PERICARDIAL EFFUSION IN A WELL-DEFINED GEOGRAPHICAL REGION].

    PubMed

    Serhan, Moanis; Abdallah, Ruhi; Atar, Shaul

    2017-05-01

    Pericardial effusion can occur as a result of primary pericardial disease or secondary to systemic disease. Analysis of the features of pericardial effusion in correlation with clinical and demographic findings can help clinicians to determine the correct diagnosis and to choose the appropriate treatment and reduce patient mortality and morbidity. Retrospective analysis of the characteristics of pericardial effusion and the prevalence of the different etiologies and their correlation with demographics, clinical characteristics and medical history in 86 patients admitted to Galilee Medical Center from 2001 to 2010 who underwent pericardiocentesis or pericardial window. The most common etiology was idiopathic - 36% of cases, followed by cancer - 31.4%, coronary artery disease - 16.3%, renal failure - 4.6%, trauma - 4.6%, autoimmune disease - 4.6%, cirrhosis of liver - 1.2% of cases and hypothyroidism with 1.2% of cases. Laboratory tests rarely contributed to the diagnostic process; the most common symptom was dyspnea (76.6%). Most of the effusions were exudates (70.9%), and use of anti-coagulants increased the tendency to develop a bloody effusion (p=0.031). Idiopathic etiology, coronary heart disease or renal failure were more frequent in Arabs (58%, 57% and 75%, respectively) than in Jews (42%, 43% and 25%, respectively). In contrast, Jews had more malignant effusion (67% Jews and 33% Arabs). The average age of patients of all etiologies, except for trauma, was > 60 years (only 7% of patients were under the age of 17 years); the idiopathic etiology was mainly exudative (50%), compared with a transudative effusion in which coronary heart disease was most common (46%). The spectrum of etiologies of large symptomatic pericardial effusion in a community hospital in the Western Galilee region in the contemporary era is continuously evolving. Currently, the most frequent etiology is idiopathic, followed by malignancy. Routine laboratory testing rarely affects the pre

  15. Usefulness of a pleuroperitoneal shunt for treatment of refractory pleural effusion in a patient receiving maintenance hemodialysis.

    PubMed

    Habuka, Masato; Ito, Toru; Yoshizawa, Yuta; Matsuo, Koji; Murakami, Shuichi; Kondo, Daisuke; Kanazawa, Hiroshi; Narita, Ichiei

    2018-03-23

    Refractory pleural effusion can be a life-threatening complication in patients receiving maintenance hemodialysis. We report successful treatment of refractory pleural effusion using a Denver® pleuroperitoneal shunt in one such patient. A 54-year-old Japanese man, who had previously undergone left nephrectomy, was admitted urgently to our department because of a high C-reactive protein (CRP) level, right pleural effusion, and right renal abscess. Because antibiotics proved ineffective and his general state was deteriorating, he underwent emergency insertion of a thoracic drainage tube and nephrectomy, and hemodialysis was started. Although his general state improved slowly thereafter, the pleural effusion, which was unilateral and transudative, remained refractory and therefore he needed to be on oxygenation. To control the massive pleural effusion, a pleuroperitoneal shunt was inserted. Thereafter, his respiratory condition became stable without oxygenation and he was discharged. His general condition has since been well. Although pleural effusion is a common complication of maintenance hemodialysis, few reports have documented the use of pleuroperitoneal shunt to control refractory pleural effusion. Pleuroperitoneal shunt has been advocated as an effective and low-morbidity treatment for refractory pleural effusion, and its use for some patients with recurrent pleural effusion has also been reported, without any severe complications. In the present case, pleuroperitoneal shunt improved the patient's quality of life sufficiently to allow him to be discharged home without oxygenation. Pleuroperitoneal shunt should be considered a useful treatment option for hemodialysis patients with refractory pleural effusion.

  16. Hip Joint Effusion-Synovitis Is Associated With Hip Pain and Sports/Recreation Function in Female Professional Ballet Dancers.

    PubMed

    Mayes, Susan; Ferris, April-Rose; Smith, Peter; Cook, Jill

    2018-03-23

    To compare hip joint effusion-synovitis prevalence in professional ballet dancers with nondancing athletes and to evaluate the relationship between effusion-synovitis and clinical measures and cartilage defects. Case-control study. Elite ballet and sport. Forty-nine professional ballet dancers and 49 age-matched and sex-matched athletes. Group (dancers/athletes), sex, age, years of training, Copenhagen Hip and Groin Outcome Scores (HAGOSs), hip rotation range of motion (ROM), generalized joint hypermobility (GJH), and hip cartilage defect scores. Hip joint effusion-synovitis (absent, grade 1 = 2-4 mm, grade 2 = >4 mm) scored with 3-Tesla magnetic resonance imaging. Hip joint effusion-synovitis was found in 22 (45%) dancers and 13 (26.5%) athletes (P = 0.06). Grade 2 effusion-synovitis was only found in dancers (n = 8, r = 0.31, P = 0.009). The prevalence of effusion-synovitis was similar in men (n = 11, 26%) and women (n = 24, 43%, P = 0.09). Female dancers with effusion-synovitis had lower HAGOS pain (r = 0.63, P = 0.001) and sports/recreation scores (r = 0.66, P = 0.001) compared with those without effusion-synovitis. The HAGOS scores were not related to effusion-synovitis in male dancers or female and male athletes (P > 0.01 for all). Effusion-synovitis was not related to hip ROM, GJH, or cartilage defect scores (P > 0.05 for all). Hip joint effusion-synovitis was related to higher levels of pain and lower sports/recreation function in female ballet dancers. Effusion-synovitis was not related to hip rotation ROM, GJH or cartilage defects. Larger sized joint effusion-synovitis was exclusively found in dancers.

  17. Ultrasound estimation of volume of postoperative pleural effusion in cardiac surgery patients.

    PubMed

    Usta, Engin; Mustafi, Migdat; Ziemer, Gerhard

    2010-02-01

    The aim of this study was to establish a practical simplified formula to facilitate the management of a frequently occurring postoperative complication, pleural effusion. Chest ultrasonography with better sensitivity and reliability in the diagnosis of pleural effusions than chest X-ray can be repeated serially at the bedside without any radiation risk. One hundred and fifty patients after cardiac surgery with basal pleural opacity on chest X-ray have been included in our prospective observational study during a two-year period. Effusion was confirmed on postoperative day (POD) 5.9+/-3.2 per chest ultrasound sonography. Inclusion criteria for subsequent thoracentesis based on clinical grounds alone and were not protocol-driven. Major inclusion criteria were: dyspnea and peripheral oxygen saturation (SpO(2)) levels < or = 92% and the maximal distance between mid-height of the diaphragm and visceral pleura (D > or = 30 mm). One hundred and thirty-five patients (90%) were drained with a 14-G needle if according to the simplified formula: V (ml)=[16 x D (mm)] the volume of the pleural effusion was around 500 ml. The success rate of obtaining fluid was 100% without any complications. There is a high accuracy between the estimated and drained pleural effusion. Simple quantification of pleural effusion enables time and cost-effective decision-making for thoracentesis in postoperative patients.

  18. Enhanced immune response of MAIT cells in tuberculous pleural effusions depends on cytokine signaling.

    PubMed

    Jiang, Jing; Chen, Xinchun; An, Hongjuan; Yang, Bingfen; Zhang, Fuping; Cheng, Xiaoxing

    2016-09-02

    The functions of MAIT cells at the site of Mycobacterium tuberculosis infection in humans are still largely unknown. In this study, the phenotypes and immune response of MAIT cells from tuberculous pleural effusions and peripheral blood were investigated. MAIT cells in tuberculous pleural effusions had greatly enhanced IFN-γ, IL-17F and granzyme B response compared with those in peripheral blood. The level of IFN-γ response in MAIT cells from tuberculous pleural effusions was inversely correlated with the extent of tuberculosis infection (p = 0.0006). To determine whether cytokines drive the immune responses of MAIT cells at the site of tuberculosis infection, the role of IL-1β, IL-2, IL-7, IL-12, IL-15 and IL-18 was investigated. Blockade of IL-2, IL-12 or IL-18 led to significantly reduced production of IFN-γ and/or granzyme B in MAIT cells from tuberculous pleural effusions. Majority of IL-2-producing cells (94.50%) in tuberculous pleural effusions had phenotype of CD3(+)CD4(+), and most IL-12p40-producing cells (91.39%) were CD14(+) cells. MAIT cells had significantly elevated expression of γc receptor which correlated with enhanced immune responses of MAIT cells. It is concluded that MAIT cells from tuberculous pleural effusions exhibited highly elevated immune response to Mtb antigens, which are controlled by cytokines produced by innate/adaptive immune cells.

  19. Enhanced immune response of MAIT cells in tuberculous pleural effusions depends on cytokine signaling

    PubMed Central

    Jiang, Jing; Chen, Xinchun; An, Hongjuan; Yang, Bingfen; Zhang, Fuping; Cheng, Xiaoxing

    2016-01-01

    The functions of MAIT cells at the site of Mycobacterium tuberculosis infection in humans are still largely unknown. In this study, the phenotypes and immune response of MAIT cells from tuberculous pleural effusions and peripheral blood were investigated. MAIT cells in tuberculous pleural effusions had greatly enhanced IFN-γ, IL-17F and granzyme B response compared with those in peripheral blood. The level of IFN-γ response in MAIT cells from tuberculous pleural effusions was inversely correlated with the extent of tuberculosis infection (p = 0.0006). To determine whether cytokines drive the immune responses of MAIT cells at the site of tuberculosis infection, the role of IL-1β, IL-2, IL-7, IL-12, IL-15 and IL-18 was investigated. Blockade of IL-2, IL-12 or IL-18 led to significantly reduced production of IFN-γ and/or granzyme B in MAIT cells from tuberculous pleural effusions. Majority of IL-2-producing cells (94.50%) in tuberculous pleural effusions had phenotype of CD3+CD4+, and most IL-12p40-producing cells (91.39%) were CD14+ cells. MAIT cells had significantly elevated expression of γc receptor which correlated with enhanced immune responses of MAIT cells. It is concluded that MAIT cells from tuberculous pleural effusions exhibited highly elevated immune response to Mtb antigens, which are controlled by cytokines produced by innate/adaptive immune cells. PMID:27586092

  20. Malignancy-related pericardial effusion. 127 cases from the Roswell Park Cancer Institute.

    PubMed

    Wilkes, J D; Fidias, P; Vaickus, L; Perez, R P

    1995-10-15

    Malignancy-related pericardial effusions may represent a terminal event in patients with therapeutically unresponsive disease. However, select patients with malignancies sensitive to available therapies may achieve significant improvement in palliation and long term survival with prompt recognition and appropriate intervention. From 1968 to 1994, 150 invasive procedures were performed for the treatment or diagnosis of pericardial effusion in 127 patients with underlying malignancies. These cases were reviewed retrospectively to best identify the clinical features, appropriate diagnostic workup, and optimal therapy for this complication of malignancy. Dyspnea (81%) and an abnormal pulsus paradoxus (32%) were the most common symptoms. Echocardiography had a 96% diagnostic accuracy. Cytology and pericardial biopsy had sensitivities of 90% and 56%, respectively. Fifty-five percent of all effusions were malignant comprising 71% of adenocarcinomas of the lung, breast, esophagus, and unknown primary site. In 57 patients, a malignant effusion could not be determined, and no definitive etiology could be established for 74% of these effusions. Radiation-induced, infectious, and hemorrhagic pericarditis each were identified in fewer than 5% of cases. Subxyphoid pericardiotomy proved to be a safe and effective intervention that successfully relieved pericardial effusions in 99% of cases with recurrence and reoperation rates of 9% and 7%, respectively. Survival most closely was related to the extent of disease and its inherent chemo-/radiosensitivity, with 72% of the patients who survived longer than 1 year having breast cancer, leukemia, or lymphoma.

  1. Diagnostic value of eosinophils in pleural effusion: a prospective study of 26 cases.

    PubMed

    Matthai, Smita Mary; Kini, Usha

    2003-02-01

    Eosinophilic pleural effusions (EPFs), defined as the presence of 10% or more eosinophils in the pleural fluid, are relatively rare. Their diagnostic and prognostic significance, however, remains controversial, as most of the studies are based almost entirely on retrospective case studies. This prospective study examines 26 eosinophilic pleural effusions from among 444 consecutive pleural effusions investigated at this tertiary health care center from October 1999 to April 2002. This study was attempted to unravel the diagnostic and prognostic significance of these eosinophilic effusions and assess their clinical implications, if any. Koss and Light's criteria were applied in the analysis, which comprised macroscopic, biochemical, cytological, and microbiological examinations. Of the 26 EPFs studied, five were associated with tuberculosis and three with metastatic disease. Nineteen patients had significant associated lymphocytosis. Twenty-four patients have been followed up and are in good health to date and have had no recurrence of effusion. Thus, EPF could be associated with inflammatory, benign, and malignant conditions. Hence, a closer search for a definite etiological agent is warranted in the setting of such an effusion, especially in populations endemic for tuberculosis, as in a developing country like India and in populations with a high prevalence of malignancy. Copyright 2003 Wiley-Liss, Inc.

  2. Forecasting Effusive Dynamics and Decompression Rates by Magmastatic Model at Open-vent Volcanoes.

    PubMed

    Ripepe, Maurizio; Pistolesi, Marco; Coppola, Diego; Delle Donne, Dario; Genco, Riccardo; Lacanna, Giorgio; Laiolo, Marco; Marchetti, Emanuele; Ulivieri, Giacomo; Valade, Sébastien

    2017-06-20

    Effusive eruptions at open-conduit volcanoes are interpreted as reactions to a disequilibrium induced by the increase in magma supply. By comparing four of the most recent effusive eruptions at Stromboli volcano (Italy), we show how the volumes of lava discharged during each eruption are linearly correlated to the topographic positions of the effusive vents. This correlation cannot be explained by an excess of pressure within a deep magma chamber and raises questions about the actual contributions of deep magma dynamics. We derive a general model based on the discharge of a shallow reservoir and the magmastatic crustal load above the vent, to explain the linear link. In addition, we show how the drastic transition from effusive to violent explosions can be related to different decompression rates. We suggest that a gravity-driven model can shed light on similar cases of lateral effusive eruptions in other volcanic systems and can provide evidence of the roles of slow decompression rates in triggering violent paroxysmal explosive eruptions, which occasionally punctuate the effusive phases at basaltic volcanoes.

  3. Inner ear contribution to bone conduction hearing in the human.

    PubMed

    Stenfelt, Stefan

    2015-11-01

    Bone conduction (BC) hearing relies on sound vibration transmission in the skull bone. Several clinical findings indicate that in the human, the skull vibration of the inner ear dominates the response for BC sound. Two phenomena transform the vibrations of the skull surrounding the inner ear to an excitation of the basilar membrane, (1) inertia of the inner ear fluid and (2) compression and expansion of the inner ear space. The relative importance of these two contributors were investigated using an impedance lumped element model. By dividing the motion of the inner ear boundary in common and differential motion it was found that the common motion dominated at frequencies below 7 kHz but above this frequency differential motion was greatest. When these motions were used to excite the model it was found that for the normal ear, the fluid inertia response was up to 20 dB greater than the compression response. This changed in the pathological ear where, for example, otosclerosis of the stapes depressed the fluid inertia response and improved the compression response so that inner ear compression dominated BC hearing at frequencies above 400 Hz. The model was also able to predict experimental and clinical findings of BC sensitivity in the literature, for example the so called Carhart notch in otosclerosis, increased BC sensitivity in superior semicircular canal dehiscence, and altered BC sensitivity following a vestibular fenestration and RW atresia. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. 21 CFR 344.12 - Ear drying aid active ingredient.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 5 2012-04-01 2012-04-01 false Ear drying aid active ingredient. 344.12 Section...) DRUGS FOR HUMAN USE TOPICAL OTIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Active Ingredients § 344.12 Ear drying aid active ingredient. The active ingredient of the product consists of isopropyl...

  5. 21 CFR 344.12 - Ear drying aid active ingredient.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Ear drying aid active ingredient. 344.12 Section...) DRUGS FOR HUMAN USE TOPICAL OTIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Active Ingredients § 344.12 Ear drying aid active ingredient. The active ingredient of the product consists of isopropyl...

  6. 21 CFR 344.12 - Ear drying aid active ingredient.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 5 2013-04-01 2013-04-01 false Ear drying aid active ingredient. 344.12 Section...) DRUGS FOR HUMAN USE TOPICAL OTIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Active Ingredients § 344.12 Ear drying aid active ingredient. The active ingredient of the product consists of isopropyl...

  7. 21 CFR 344.12 - Ear drying aid active ingredient.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Ear drying aid active ingredient. 344.12 Section...) DRUGS FOR HUMAN USE TOPICAL OTIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Active Ingredients § 344.12 Ear drying aid active ingredient. The active ingredient of the product consists of isopropyl...

  8. 21 CFR 344.12 - Ear drying aid active ingredient.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 5 2014-04-01 2014-04-01 false Ear drying aid active ingredient. 344.12 Section...) DRUGS FOR HUMAN USE TOPICAL OTIC DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Active Ingredients § 344.12 Ear drying aid active ingredient. The active ingredient of the product consists of isopropyl...

  9. The maize rachis affects Aspergillus flavus movement during ear development

    USDA-ARS?s Scientific Manuscript database

    Aspergillus flavus expressing green fluorescent protein (GFP) was used to follow infection in ears of maize hybrids resistant and susceptible to the fungus. Developing ears were needle-inoculated with GFP-transformed A. flavus 20 days after silk emergence, and GFP fluorescence in the pith was evalu...

  10. Single-stage autologous ear reconstruction for microtia.

    PubMed

    Kasrai, Leila; Snyder-Warwick, Alison K; Fisher, David M

    2014-03-01

    The authors have been using the Nagata technique since 2002. In this review of 100 consecutive ear reconstructions, the authors present technique modifications that have evolved over this period that have contributed to improved auricular contour and that now allow for auricular reconstruction in a single stage. This study is a retrospective review of a prospectively acquired database. The series is restricted to primary reconstructions performed for congenital microtia. Photographs of 10 consecutive patients are presented to demonstrate the results of the technique. Surgical complication rates are discussed. One hundred ear reconstructions were performed in 96 patients. There were 75 primary cases of congenital microtia. Twenty-four ears underwent a two-stage reconstruction, and 51 ears were reconstructed with a Nagata stage I procedure or a single-stage reconstruction. There was a gradual shift in technique, with a trend to perform fewer Nagata stage II outsetting procedures and more single-stage reconstructions. In patients who underwent an ear reconstruction in two stages, the surgical complication rate was 22 percent. In the last 40 consecutive ear reconstructions since abandoning the two-stage approach, the surgical complication rate is now 15 percent. A modification of Nagata's technique of autologous ear reconstruction for microtia is described. Modifications of the three-dimensional framework address the contour of the inferior crus and control tragal projection and position. Inclusion of a projection block and recruitment of retroauricular skin allow for symmetric projection of the ear in a single stage. Therapeutic, IV.

  11. Surgical correction of the expanded earlobe after ear gauging.

    PubMed

    Henderson, James; Malata, Charles M

    2010-10-01

    Expansion of the earlobe by ear gauging or plugging is an increasingly fashionable practice. As patients get older, some seek to have their ears restored to normal. This report presents a simple local flap technique that has been successful in achieving uneventful healing with acceptable cosmetic results.

  12. [Adaptability of sweet corn ears to a frozen process].

    PubMed

    Ramírez Matheus, Alejandra O; Martínez, Norelkys Maribel; de Bertorelli, Ligia O; De Venanzi, Frank

    2004-12-01

    The effects of frozen condition on the quality of three sweet corn ears (2038, 2010, 2004) and the pattern (Bonanza), were evaluated. Biometrics characteristics like ear size, ear diameter, row and kernel deep were measured as well as chemical and physical measurement in fresh and frozen states. The corn ears were frozen at -95 degrees C by 7 minutes. The yield and stability of the frozen ears were evaluated at 45 and 90 days of frozen storage (-18 degrees C). The average commercial yield as frozen corn ear for all the hybrids was 54.2%. The industry has a similar value range of 48% to 54%. The ear size average was 21.57 cm, row number was 15, ear diameter 45.54 mm and the kernel corn deep was 8.57 mm. All these measurements were found not different from commercial values found for the industry. All corn samples evaluated showed good stability despites the frozen processing and storage. Hybrid 2038 ranked higher in quality.

  13. Long-eared owls nesting in Badlands National Park

    Treesearch

    Deborah D. Paulson; Carolyn Hull Sieg

    1985-01-01

    Long-eared Owls nest at high densities locally over the Great Plains where suitable habitat is limited (Bent 1938), yet , according to Whitney et al. (1978), this species is rare to uncommon in South Dakota. Especially west of the Missouri River, few nesting records have been reported. This paper reports the occurrence of Long-eared Owls in the Badlands National Park...

  14. Preventing Cauliflower Ear with a Modified Tie-Through Technique.

    ERIC Educational Resources Information Center

    Dimeff, Robert J.; Hough, David O.

    1989-01-01

    Describes a quick, simple tie-through suture technique (in which a collodion packing is secured to the auricle with two buttons) for preventing cauliflower ear following external ear trauma in wrestlers and boxers. The technique ensures constant compression; multiple treatments for fluid reaccumulation are rarely necessary. (SM)

  15. Redefinition of the helical rim in cauliflower-ear surgery.

    PubMed

    Schonauer, F; La Rusca, I; Pereira, J A; Molea, G

    2002-01-01

    Cauliflower ear is a serious deformity of the auricle induced by single or repeated injury to the external ear. Few papers deal with surgical techniques for correcting this deformity. We describe the use of ipsilateral excess cartilage to restore the helical rim. Copyright 2002 The British Association of Plastic Surgeons.

  16. Replantation of an avulsed ear, using a single arterial anastamosis.

    PubMed

    O'Toole, G; Bhatti, K; Masood, S

    2008-01-01

    Avulsion of the ear is relatively uncommon and replantation a technical challenge. A case in which an avulsed ear was successfully replanted using a single arterial anastamosis is described. The surgical difficulties encountered, the pharmaceutical approach to postoperative care and the problems which resulted from the lack of venous drainage are discussed.

  17. Gain affected by the interior shape of the ear canal.

    PubMed

    Yu, Jen-Fang; Chen, Yen-Sheng; Cheng, Wei-De

    2011-06-01

    This study investigated the correlation of gain distribution and the interior shape of the human external ear canal. Cross-sectional study of gain measurement at the first bend and second bend. Chang Gung Memorial Hospital and Chang Gung University. There were 15 ears in patients aged between 20 and 30 years (8 men/7 women) with normal hearing and middle ears. Stimulus frequencies of 500, 1000, 2000, 3000, and 4000 Hz were based on the standard clinical hearing test. Measurements closer to the tympanic membrane and the positions at the first and second bends were confirmed by using otoscope. Real ear measurement to analyze the canal resonance in human external ears was adopted. This study found that gain at stimulus frequencies of 4000 Hz was affected by the interior shape of the ear canal (P < .005), particularly at the first and second bends, whereas gain was only affected by the length of the ear canal for stimulus frequencies of 2000 Hz (P < .005). This study found that gain was affected not only by the length of the external auditory canal (EAC) but also by the interior shape of the EAC significantly. The findings of this study may have potential clinical applications in canalplasty and congenital aural atresia surgery and may be used to guide surgeries that attempt to reshape the ear canal to achieve more desirable hearing outcomes.

  18. Identifying position, visibility, dimensions, and angulation of the ear.

    PubMed

    Mohamed, Kasim; Christian, Jayanth; Jeyapalan, Karthigeyan; Natarajan, Shanmuganathan; Banu, Fathima; Veeravalli, Padmanabhan T

    2014-01-01

    We selected 254 subjects between the ages of 18 and 30 yr to assess the ear position, angulations of the ear in relation to the nose, visibility from the frontal view, and dimensions of the ear by using various anthropometric points of the face. Subjects were divided into four groups based on facial form. A reference plane indicator, facial topographical measurements, metal ruler, and digital photography were used. While considering the position of the ear, in all facial forms except square tapering, the most samples showed a tendency for the subaurale being in line with subnasale. Regression analysis showed a tendency to gnathion distance is the most dependent variable with length of the ear kept as a constant predictor, while both interalar distance and exocanthion to endocanthion distance correlate highly significantly to the width of the ear. In all subjects, the visibility of the ear when viewed from the front was an average of 1.5 mm. Regardless of facial form, ear angulation was generally less than nose angulation.

  19. Can you hear me now? Understanding vertebrate middle ear development

    PubMed Central

    Chapman, Susan Caroline

    2010-01-01

    The middle ear is a composite organ formed from all three germ layers and the neural crest. It provides the link between the outside world and the inner ear, where sound is transduced and routed to the brain for processing. Extensive classical and modern studies have described the complex morphology and origin of the middle ear. Non-mammalian vertebrates have a single ossicle, the columella. Mammals have three functionally equivalent ossicles, designated the malleus, incus and stapes. In this review, I focus on the role of genes known to function in the middle ear. Genetic studies are beginning to unravel the induction and patterning of the multiple middle ear elements including the tympanum, skeletal elements, the air-filled cavity, and the insertion point into the inner ear oval window. Future studies that elucidate the integrated spatio-temporal signaling mechanisms required to pattern the middle ear organ system are needed. The longer-term translational benefits of understanding normal and abnormal ear development will have a direct impact on human health outcomes. PMID:21196256

  20. Klippel-Feil syndrome and associated ear anomalies.

    PubMed

    Yildirim, Nadir; Arslanoğlu, Atilla; Mahiroğullari, Mahir; Sahan, Murat; Ozkan, Hüseyin

    2008-01-01

    Klippel-Feil syndrome (KFS) is a congenital segmentation anomaly of the cervical vertebrae that manifests as short neck, low hair line, and limited neck mobility. Various systemic malformations may also accompany the syndrome including wide variety of otopathologies affecting all 3 compartments of the ear (external, middle, and inner ear) as well as internal acoustic canal and vestibular aqueduct. We aimed to investigate these involvements and their clinical correlates in a group of patients with KFS. We present 20 KFS cases, of which 12 (% 60) displayed most of the reported ear abnormalities such as microtia, external ear canal stenosis, chronic ear inflammations and their sequels, anomalies of the tympanic cavity and ossicles, inner ear dysplasies, deformed internal acoustic canal, and wide vestibular aqueduct, which are demonstrated using the methods of otoscopy, audiologic testing, and temporal bone computed tomography. This series represents one of the highest reported rate of ear involvement in KFS. We found no correlation between the identified ear pathologies and the skeletal and extraskeletal malformations. The genetic nature of the syndrome was supported by the existence of affected family members in 4 (20%) of the cases.