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Experimental data on Fick diffusion coefficients of ternary and higher mixtures depend on the reference frame; those which are in common use are associated with the average velocity either with respect to volume, mass or mole number. In this study, the dependence of diffusion coefficients on the reference frame is thoroughly analyzed for three ternary mixtures of different types. The first one, tetralin-isobutylbenzene-dodecane, can almost be considered as ideal, the second one, cyclohexane-toluene-methanol, exhibits liquid-liquid phase separation and the third one, water-ethanol-triethylene glycol, contains three associating species and is also strongly non-ideal. Experimental diffusion coefficient data sampled in the volume reference frame are transformed to the molar and mass reference frames. The required partial molar volumes are derived from present density measurements. Four additional mixtures are considered along a single or two composition paths. A highlight of this study is the existence of a strong similarity of the main diffusion coefficients in the volume and mass reference frames for all considered mixtures. When the excess volume is small, the coefficients in the molar reference frame are also similar. However, for the mixture with a large excess volume (containing water), the diffusion coefficients in the molar reference frame differ significantly, even indicating negative main diffusion coefficients. It is shown that negative main diffusion coefficients appear due to relatively large experimental uncertainties of cross diffusion coefficients, which are propagated and amplified by frame transformation.
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Thermodynamic properties of aqueous solutions containing alkali and halide ions are determined by molecular simulation. The following ions are studied: Li(+), Na(+), K(+), Rb(+), Cs(+), F(-), Cl(-), Br(-), and I(-). The employed ion force fields consist of one Lennard-Jones (LJ) site and one concentric point charge with a magnitude of ±1 e. The SPC/E model is used for water. The LJ size parameter of the ion models is taken from Deublein et al. [J. Chem. Phys. 136, 084501 (2012)], while the LJ energy parameter is determined in the present study based on experimental self-diffusion coefficient data of the alkali cations and the halide anions in aqueous solutions as well as the position of the first maximum of the radial distribution function of water around the ions. On the basis of these force field parameters, the electric conductivity, the hydration dynamics of water molecules around the ions, and the enthalpy of hydration is predicted. Considering a wide range of salinity, this study is conducted at temperatures of 293.15 and 298.15 K and a pressure of 1 bar.
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A strategy is proposed for empirical fundamental equation of state correlations for pure fluids on the basis of hybrid data sets, composed of experimental and molecular simulation data. Argon and hydrogen chloride are used as examples.
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In spite of considerable research on the nature of aqueous alcohol mixtures that are characterized by microscopic inhomogeneity or incomplete mixing at the molecular level, transport properties have received little attention. We report the results of a study on diffusion in the ternary mixture of water with two alcohols, that is, water + methanol + ethanol, which is investigated on microscopic and macroscopic scales by means of molecular simulation and Taylor dispersion experiments. A novel protocol is developed for the comparison of mutual diffusion coefficients sampled by two fundamentally different approaches, which allows for their critical analysis. Because of complex intermolecular interactions, given by the presence of hydrogen bonding, the analysis of transport processes in this mixture is challenging for not only on the microscopic scale for simulation techniques but also on the macroscopic scale due to unfavorable optical properties. Binary limits of the Fick diffusion matrix are used for validation of the experimental ternary mixture results together with the verification of the validity of the phenomenological Onsager reciprocal relations. The Maxwell-Stefan diffusion coefficients and the thermodynamic factor are sampled by molecular simulation consistently on the basis of given force field models. The protocol for the comparison of the results from both approaches is also challenging because Fick diffusion coefficients of ternary mixtures depend on the frame of reference. Accordingly, the measured coefficients are transformed from the volume-averaged to the molar-averaged frame of reference, and it is demonstrated that both approaches provide not only similar qualitative behavior along two concentration paths but also strong quantitative agreement. This coordinated work using different approaches to study diffusion in multicomponent mixtures is expected to be a significant step forward for the accurate assessment of cross-diffusion.
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OBJECTIVE: To determine the most effective method of short-term middle ear aeration in patients unable to tolerate hyperbaric oxygen (HBO) therapy. STUDY DESIGN: Prospective study comparing two methods of short-term tympanostomy in each patient. METHODS: Seventeen adult patients were referred for management of barotitis and inability to tolerate hyperbaric oxygen therapy (HBO). Each patient underwent CO2 laser tympanostomy on the right ear and tympanostomy with T-tube placement in the left ear. The tube was removed on completion of HBO. Patients were asked to rate pain and their satisfaction with each method of tympanostomy using a visual analog scale. Otorrhea, persistent perforation, recurrent barotitis, hearing loss, and otalgia occurring during the study period were documented. RESULTS: Laser tympanostomy was associated with a significantly lower incidence of otorrhea but was attended by recurrent barotitis in four of 16 patients. Laser tympanostomy was perceived as being less painful and was rated higher in overall satisfaction. CONCLUSIONS: Laser tympanostomy is an effective method for management of barotitis in patients unable to tolerate HBO. Otorrhea is significantly reduced, although a risk of recurrent barotitis exists if the laser perforation closes prior to completion of HBO. Both methods of short-term tympanostomy reduce complications when compared with a retrospective cohort.
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Oxigenoterapia Hiperbárica/efeitos adversos , Ventilação da Orelha Média , Adulto , Idoso , Idoso de 80 Anos ou mais , Dor de Orelha/etiologia , Dor de Orelha/prevenção & controle , Humanos , Terapia a Laser , Pessoa de Meia-Idade , Ventilação da Orelha Média/efeitos adversos , Satisfação do Paciente , Estudos Prospectivos , Inquéritos e QuestionáriosRESUMO
Basic fibroblast growth factor (bFGF) has been shown to enhance speed of wound repair at a number of anatomic sites. This study presents an evaluation of bFGF in a model of acute tympanic membrane (TM) perforation in order to assess rate of healing as well as structural and functional outcome. Perforations were created in the tympanic membranes of rats, then allowed to heal in the presence of topically applied bFGF with the opposite ear serving as a control. The growth factor was applied in repeated doses beginning 2 days after creation of the TM defect. The treated ears healed faster by an average of 4.0 days. The healed tympanic membranes were assessed using tympanometry and light microscopy. Structurally and functionally, the healed tympanic membranes were similar to the controls. The observed results indicate that bFGF promotes accelerated healing and restoration of normal architecture in acute TM defects.
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Fator 2 de Crescimento de Fibroblastos/uso terapêutico , Membrana Timpânica/efeitos dos fármacos , Membrana Timpânica/lesões , Testes de Impedância Acústica , Animais , Colágeno , Tecido Conjuntivo/patologia , Epitélio/patologia , Fator 2 de Crescimento de Fibroblastos/administração & dosagem , Fibroblastos/patologia , Glicerol , Hiperplasia , Mucosa/patologia , Pressão , Ratos , Fatores de Tempo , Membrana Timpânica/patologia , Membrana Timpânica/fisiopatologia , Cicatrização/efeitos dos fármacosRESUMO
OBJECTIVES/HYPOTHESIS: Fistulae of the otic capsule occur in approximately 10% of cholesteatoma cases. Preoperative imaging of this complication is valuable in limiting intraoperative morbidity. Three-dimensional virtual endoscopic imaging provides a new method for analysis of conventional computed tomography (CT) imaging data. The purpose of the study was to examine the feasibility and efficacy of this technique in detecting labyrinthine fistulae caused by cholesteatoma. STUDY DESIGN: Retrospective case study. METHODS: Fifteen patients with surgically confirmed lateral semicircular canal fistula and preoperative CT scan were included. Scans meeting inclusion criteria were imported into a software program for production of virtual endoscopic images. Dehiscent and normal lateral semicircular canals were navigated while varying threshold values for surrounding bone. Changes in threshold values produce the effect of thickening or thinning the bone enveloping the semicircular canal. Threshold parameters that produced easy circumnavigation ("open") and intact inner surface of the lateral canal ("closed") were recorded. RESULTS: The fistula group demonstrated a significantly lower "closed" threshold level and, consequently, a greater range of navigation between "open" and "closed" thresholds. Intrasubject absolute differences in threshold values between normal and abnormal ears appeared to be the most accurate method for detecting a fistula. The suggested imaging parameters displayed an overall sensitivity for fistula detection of 67% with a specificity of 93%. CONCLUSIONS: The three-dimensional virtual endoscopic algorithm shows promise as a method for confirmation of otic capsule dehiscences. Sensitivity for detection is suboptimal but can be improved by alterations in image acquisition parameters.
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Colesteatoma da Orelha Média/diagnóstico , Fístula/diagnóstico , Imageamento Tridimensional , Doenças do Labirinto/diagnóstico , Otoscópios , Canais Semicirculares , Interface Usuário-Computador , Adolescente , Adulto , Idoso , Colesteatoma da Orelha Média/cirurgia , Feminino , Fístula/cirurgia , Humanos , Doenças do Labirinto/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Canais Semicirculares/cirurgia , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To determine the prevalence of herpes simplex virus (HSV) in malignant laryngeal lesions. STUDY DESIGN: Retrospective review. MATERIALS AND METHODS: Paraffin-embedded, histologically confirmed specimens containing benign laryngeal lesions, squamous cell carcinoma of the larynx, and squamous cell carcinoma of the oral cavity were identified from archived surgical specimens. Biopsies of normal-appearing oral cavity tissue were also obtained from fresh-frozen cadavers. These tissues were analyzed for the presence of HSV DNA using polymerase chain reaction techniques. Patient charts were reviewed for patient demographics, risk factors, stage, clinical course, treatment, and outcome. RESULTS: HSV was detected in nine laryngeal squamous cell carcinomas (75%) and in none of the benign laryngeal lesions (P = .0001). HSV was also found in three oral cavity squamous cell carcinomas (25%) and in none of the controls (P = .049). CONCLUSION: HSV is more prevalent in squamous cell carcinoma of the larynx and oral cavity than in their respective control groups, suggesting a role for carcinogenesis. HSV is more prevalent in squamous cell carcinoma of the larynx than of the oral cavity. Further studies to determine the role of HSV as a cocarcinogen and its interrelationship with other environmental factors in laryngeal cancer are warranted.
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Carcinoma de Células Escamosas/virologia , Neoplasias Laríngeas/virologia , Simplexvirus/isolamento & purificação , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , DNA Viral/análise , Feminino , Humanos , Neoplasias Laríngeas/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos RetrospectivosRESUMO
Tumor involvement or sacrifice of the vagus nerve at the level of the jugular foramen is a cause of significant morbidity in skull base surgery. Management of the resulting dysphagia and dysphonia has been significantly improved by the development of vocal cord medialization. However, rehabilitation of palatal paralysis with the resulting velopharyngeal incompetence has not been widely addressed. In an effort to alleviate the symptoms of hypernasality and nasal reflux, unilateral adhesion of the palate to the posterior wall of the nasopharynx is proposed. This report summarizes the operative approach and results in eight patients. Results have been favourable with no significant postoperative complications observed to date.
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Palato/cirurgia , Paralisia/complicações , Nervo Vago , Insuficiência Velofaríngea/etiologia , Adulto , Idoso , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Palato/inervação , Insuficiência Velofaríngea/cirurgiaRESUMO
OBJECTIVE: To review presenting symptoms and illustrate management options for this uncommon lesion. DESIGN: Case series and literature review. SETTING: Tertiary referral center. PATIENTS: Three cases of osteoma of the internal auditory canal are presented. Additional cases from the literature, diagnosed by radiographic appearance or gross description, are included for comparison. MAIN OUTCOME MEASURE: Response of clinical symptoms. RESULTS: Presenting symptoms are highly variable. Available reports do not adequately define the natural history of the lesion. CONCLUSION: The lack of a consistent presentation despite a similar radiographic appearance suggests that the osteoma is often an incidental finding.
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Neoplasias da Orelha/diagnóstico , Doenças do Labirinto/diagnóstico , Osteoma/diagnóstico , Adulto , Audiometria , Neoplasias da Orelha/diagnóstico por imagem , Feminino , Humanos , Doenças do Labirinto/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Osteoma/diagnóstico por imagem , RadiografiaRESUMO
OBJECTIVE: To document the incidence of complications occurring secondary to placement of tympanostomy tubes in patients undergoing hyperbaric oxygen therapy. DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: Forty-five patients referred to the Department of Otolaryngology for inability to tolerate hyperbaric oxygen therapy between January 1, 1990, and December 31, 1995. INTERVENTIONS: All patients underwent bilateral myringotomy and tube placement. OUTCOME MEASURES: Charts were reviewed for complications of tube placement, including otorrhea, otalgia, hearing loss, persistent perforations, and tinnitus. RESULTS: Seventeen (38%) of 45 patients experienced complications, with most having more than 1. Most complications occurred after conclusion of hyperbaric oxygen therapy. Otorrhea was most common, occurring in 13 patients (29%). Persistent tympanic membrane perforations occurred in 7 patients (16%). CONCLUSIONS: The rate of complications is higher than reported for placement of tympanostomy tubes in other patient populations. Coexisting illness, such as diabetes mellitus, may contribute to the development of complications in patients undergoing hyperbaric oxygen therapy. Alternative methods of tympanostomy, with emphasis on shorter duration of intubation, should be considered in this patient population.
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Oxigenoterapia Hiperbárica , Ventilação da Orelha Média/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Barotrauma/prevenção & controle , Otorreia de Líquido Cefalorraquidiano/etiologia , Orelha Média/lesões , Feminino , Transtornos da Audição/etiologia , Humanos , Oxigenoterapia Hiperbárica/efeitos adversos , Oxigenoterapia Hiperbárica/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Zumbido/etiologia , Perfuração da Membrana Timpânica/etiologiaRESUMO
OBJECTIVE: To determine which preoperative conditions or surgical techniques may influence the success of tympanoplasty in the pediatric population. DATA SOURCES: A MEDLINE search of the English-language literature from 1966 to May 1997 was conducted using the search terms pediatric or child and tympanoplasty or myringoplasty. STUDY SELECTION: Articles that provided age-specific data on tympanoplasty or myringoplasty were included. Of the original 651 studies retrieved, 30 were accepted for inclusion. The principal reason for exclusion was inability to separate adult and pediatric results in series that combined both patient populations. DATA EXTRACTION: Success was defined as an intact tympanic membrane for the purpose of this review. Data were tabulated by consensus of 2 reviewers. DATA SYNTHESIS: The effect of surgical technique, prior adenoidectomy, presence of active infection, size of perforation, status of the contralateral ear, age, and eustachian tube function on healing of the tympanic membrane after surgery was assessed. Only those studies providing data on a given parameter of interest could be included when comparing each variable. Weighted means were compared and subjected to sensitivity analysis. Simple linear regression analysis was used to assess the effect of age on outcome. CONCLUSIONS: Greater success in healing of the tympanic membrane following tympanoplasty in children is seen with advancing age. None of the other parameters studied was shown to be a significant predictor of success. Guidelines for reporting results of tympanoplasty are presented.
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Timpanoplastia , Criança , Humanos , Modelos Lineares , Resultado do TratamentoRESUMO
A case report of a female patient with Wegener's granulomatosis is presented. After an initial involvement of the upper respiratory tract in the form of a sinusitis, there followed a severe necrotizing bilateral scleritis necessitating the enucleation of the left eye ball. Renal involvement developed as late as 24 months after the onset of the disease and led to renal failure within three months. Throughout the duration of her disease, the patient had joint symptoms in the form of episodes of migratory nondeforming polyarthritis. The administration of corticosteroids alone in daily doses up to 60 mg prednisone failed to control the progression of the disease, while immunosuppressive therapy with cyclophosphamide combined with methylprednisolone pulse therapy and haemodialysis resulted in a marked improvement of renal function and in the subsidence of the ocular and articular symptoms.
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Injúria Renal Aguda/complicações , Artrite/complicações , Granulomatose com Poliangiite/complicações , Imunossupressores/uso terapêutico , Esclera , Injúria Renal Aguda/tratamento farmacológico , Injúria Renal Aguda/patologia , Adulto , Artrite/tratamento farmacológico , Feminino , Granulomatose com Poliangiite/tratamento farmacológico , Granulomatose com Poliangiite/patologia , Humanos , Inflamação/complicações , Inflamação/tratamento farmacológico , Inflamação/patologia , Necrose , Esclera/patologiaRESUMO
Animal models of type I and type II diabetes mellitus have been studied intensively in an effort to define the pathophysiology of the diabetic condition. An often-observed clinical manifestation of diabetes is poor wound repair. Thus diabetic animals have emerged as useful models for the study of impaired wound healing. The healing of acute tympanic membrane (TM) perforations in diabetic animals has not been reported. This investigation compares time to closure of a standardized TM perforation in rats with streptozotocin-induced diabetes, Zucker diabetic fatty rats, and normal control rats. The Zucker diabetic fatty rats demonstrate a significantly prolonged time to closure compared with the other two groups. This animal model may be useful for future study of TM wound repair.
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Diabetes Mellitus Experimental/fisiopatologia , Membrana Timpânica/lesões , Cicatrização/fisiologia , Animais , Diabetes Mellitus Experimental/patologia , Diabetes Mellitus Tipo 1/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Masculino , Ratos , Ratos Sprague-Dawley , Ratos Zucker , Membrana Timpânica/anatomia & histologia , Membrana Timpânica/fisiopatologiaRESUMO
The true incidence of herpetic infections of the larynx is unknown. This entity may be underreported because of the difficulty in establishing the diagnosis. This report describes an immune-competent patient in whom extubation failed because of mass lesions of the posterior glottis. A biopsy specimen of the lesions revealed herpes simplex virus. We review the clinical presentation and histopathologic findings in this patient.
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Herpes Simples/diagnóstico , Laringite/diagnóstico , Biópsia , Diagnóstico Diferencial , Herpes Simples/patologia , Humanos , Intubação Intratraqueal , Laringite/patologia , Laringe/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
The elderly patient can present with a variety of skin lesions of the head and neck. This article is designed to acquaint the otolaryngologist-head and neck surgeon with normal skin morphology and with the changes that occur with aging and sun exposure. Common benign and malignant skin lesions of the aging patient are discussed.
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Envelhecimento da Pele/fisiologia , Dermatopatias/patologia , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Neoplasias Cutâneas/patologia , Luz Solar/efeitos adversosRESUMO
This article has reviewed the genetic disorder, neurofibromatosis 2. The history, nomenclature, genetic etiology, epidemiology, diagnostic criteria, pathogenesis, and presentation of neurofibromatosis 2 have been given. A related but distinctly different disorder, neurofibromatosis 1, has also been described. The diagnostic evaluation of neurofibromatosis 2 has been discussed with an emphasis on the importance of early diagnosis. An analysis of the surgical treatment of bilateral acoustic neuromas as well as nonsurgical therapeutic alternatives has been presented. The results and complications in the operative management of 86 acoustic tumors in 49 patients with neurofibromatosis 2 have been described in detail. The poor immediate hearing results and the even poorer long-term hearing results have been examined in light of the invasive histopathology of these tumors. It has been emphasized that patients with neurofibromatosis 2 and asymptomatic family members require comprehensive, multidisciplined, long-term management.
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Neurofibromatose 2 , Audiometria de Tons Puros , Eletronistagmografia , Seguimentos , Aconselhamento Genético , Humanos , Imageamento por Ressonância Magnética , Neurofibromatose 1/diagnóstico , Neurofibromatose 1/terapia , Neurofibromatose 2/diagnóstico , Neurofibromatose 2/terapia , Linhagem , Complicações Pós-Operatórias , Radiocirurgia , Procedimentos Cirúrgicos Operatórios/métodosRESUMO
The unusual occurrence of an otic capsule fracture with preservation of hearing is presented. In addition, the patient suffered facial paralysis beginning 6 days after the injury that rapidly recovered. Fifteen-month follow-up reveals stable hearing thresholds. The course of a fracture through the inner ear could be an important factor in determining the potential for hearing preservation.
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Traumatismos do Nervo Facial/complicações , Paralisia Facial/complicações , Audição , Fraturas Cranianas/complicações , Osso Temporal/lesões , Criança , Traumatismos do Nervo Facial/diagnóstico , Humanos , Masculino , Radiografia , Fraturas Cranianas/diagnóstico por imagem , Fraturas Cranianas/fisiopatologia , Osso Temporal/diagnóstico por imagem , Fatores de TempoRESUMO
A number of cranial nerve disorders are known to result from viral infection or reactivation, including Bell's palsy, Ramsay Hunt syndrome and herpetic laryngitis. The consequences of these diseases are well established although the patient population at risk is not. Prevalence studies in the general population are an initial step toward defining individuals at risk. The aim of this study was to determine the prevalence of herpesvirus DNA in cranial nerve ganglia in a random population sample. Qualitative molecular biologic analysis using polymerase chain reaction assay of the trigeminal, geniculate, vestibular, spiral and vagal ganglia was used in 18 randomly selected fresh cadaver heads. Herpes simplex virus (HSV) DNA was detected in 42% of all ganglia surveyed. Varicella zoster virus (VZV) DNA was detected in 44% of all ganglia. The difference in the prevalence rate between viruses was not significant (p = 0.63). At least 1 of the 2 viruses was found in 65% of all ganglia. Both HSV and VZV can commonly be recovered from cranial nerve ganglia. In order to confirm a viral etiology for various cranial nerve disorders, demonstration of a significant difference in prevalence of the viruses in specimens from afflicted individuals will be necessary.
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Doenças dos Nervos Cranianos/virologia , Gânglios Sensitivos/virologia , Infecções por Herpesviridae/epidemiologia , Herpesvirus Humano 3/isolamento & purificação , Simplexvirus/isolamento & purificação , Adolescente , Adulto , Idoso , Técnicas de Cultura de Células , Criança , DNA Viral , Eletroforese em Gel de Ágar/métodos , Humanos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , PrevalênciaRESUMO
Partial resection of the labyrinth is becoming accepted as a means of improving access to the internal auditory canal and central skull base neoplasms. In this investigation, an infralabyrinthine approach was performed on 20 temporal bones. The dissection was extended by transection of the endolymphatic duct, then excision of the posterior semicircular canal. The maximal lateral exposure of the internal auditory canal (IAC) was measured after each manoeuvre. Resection of the posterior semicircular canal increased lateral exposure in 7/20 specimens to an average 61% of the length of the IAC. Posterior canal resection improved superior exposure and increased the circumference of exposure in all specimens.