Impedance pneumography is based on the relationship between respired volume (delta V) and changes of transthoracic impedance (delta/Z/) during breathing. The impedance signal, the relationship between delta V and delta/Z/ and the success rate during long-term recording was studied in 11 healthy adult males, aged 21-46, by a portable tape recorder (Oxford Medilog 4-24). The signals from the tape recorder (delta/Z/), and from a spirometer (delta V) were recorded simultaneously on a mingograph during normal breathing, apnoea, deep sighs, and coughs. The relationship between delta V and delta/Z/ was also analysed on an X-Y recorder. Delta/Z/ was delayed in relation to delta V and during one respiratory cycle the relationship was not linear. The time constant of delta/Z/ was 6 s. A significant correlation was found between peak values of delta V and delta/Z/ for 0 less than delta V less than 2.5 litres. Long-term recording of delta/Z/ during one night's sleep resulted in a success rate of 63-100%, mean 90%. Invalidation of the impedance signal was caused by overloading (81%) and interference (19%). It is concluded that the Medilog respiratory recorder enables determination of respiratory frequency, periods of apnoea and a semiquantitative estimate of volume, but artifacts may invalidate the signal.
The results of unilateral immediate tonsillectomy, as the routine treatment of peritonsillar abscess, were studied in 47 patients with no previous history of serious tonsillitis. The follow-up was carried out between three and four years after operation. The incidence of tonsillitis in the contralateral tonsil remained unchanged and peritonsillar abscess did not occur in that tonsil. Symptoms of pharyngitis, periodic or chronic, were present in three patients only. This was found to be significantly lower than that found in the literature in a similar group of patients in whom bilateral immediate tonsillectomy had been performed. The results are discussed and the authors recommend unilateral immediate tonsillectomy in cases of peritonsillar abscess in all patients with no previous history of serious tonsillitis, as this apparently prevents the troublesome side-effects of chronic pharyngitis.
The aim of this investigation was to monitor fluctuations in middle ear pressure, to study tympanometric signs of Eustachian tube functioning and to assess the validity of the tympanometric readings. In 20 patients with a low initial middle ear pressure (-150 daPa or lower) and 5 normals, impedance tympanometry was performed every 3 min through 7 h. Median pressure for the patients was -150 daPa (range 100 to -400 daPa) and for the normals 0 daPa (range 50 to -50 daPa). A remarkable pressure increase was seen after changing the body position to the supine. The patients were arranged into three groups according to the lowest middle ear pressure registered. Median pressures for the groups were running at a rather constant level. However, the individual pressure fluctuations in many patients were so great that a single tympanometric reading has to be considered unreliable when selecting patients for insertion of ventilation tubes. Thirteen patients never equalized their negative middle ear pressure, indicating that their Eustachian tube did not open during the test period. In spite of this the pressure did not decrease to lower values, indicating that maintaining a relative constant middle ear pressure is independent of opening of the Eustachian tube.
From an abscess of the submandibular gland, Salmonella typhimurium biotype 10 was isolated in pure culture. The patient had no history of gastroenteritis, and Salmonella could not be isolated from faeces.
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