Arch Otolaryngol
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A patient with recurrent squamous carcinoma of the neck showed hypercalcemia with the immunoreactive parathyroid hormone (PTH) level within the upper limits of normal range, this being inappropriate for the degree of hypercalcemia. An immunoreactive peak of PTH was found in the tumor tissue extract, which appeared on column chromatography to be in the region of elution of pure bovine PTH. The tumor tissue showed positive immunoperoxidase reaction for PTH compared with negative reaction when the patient had normocalcemia. These findings are strong evidence that the tumor produced a PTHlike substance.
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This study was undertaken to determine what optimal levels of suction pressure were necessary to provide good drainage volume and obliteration of any dead space and also to determine the prevalence of clotting and complications secondary to various levels of suction pressure. The patients were grouped by their degree of nutritional depletion, prior radiation exposure, the types of surgical procedures undergone, and the results of tests using four levels of suction pressure. ⋯ All wall suction pressure levels were certainly comparable with the portable unit. However, the portable unit provided continuous suction pressure when the patients were ambulatory and was not associated with any statistically significant increase in wound complications or equipment failure.
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We developed a canine animal model of subglottic stenosis following prolonged intubation with modified non-cuffed endotracheal tubes. None of the puppies intubated for seven days had an irreversible stenosing subglottic lesion, whereas all animals intubated for 14 days or more had at least a 40% to 50% reduction of the subglottic lumen secondary to maturing fibrotic stenosis. The model described is more congruent with the known and suspected pathogenesis in those infants and children who require prolonged endotracheal intubation and subsequently acquire subglottic stenosis, and can be used in evaluating the efficacy of medical therapy or surgical therapy, or both, in the prevention or management of this disease.
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An updated method of replanting a severed auricle is reported. Management consists of early, meticulous replantation with minimal debridement; cooling of the auricle; low-dose heparin sodium; dextran 40; antibiotic coverage; and multiple stab incisions to relieve venous congestion. The regimen is based on experience with nine successfully replanted auricles.