[Implants in middle ear surgery].
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Biocompatible Materials↗
Biomedical subjects
G Geyer
Publications and source records attributed to G Geyer.
[Treatment of prolactinoma with a new dopamine agonist].
Eleven patients (6 men, 5 women, mean age 42 [25-65] years) with prolactinomas were treated for 4-16 months with a new dopamine agonist (CV 205-502), at a daily dose of between 0.075 and 0.45 mg. All patients had previously undergone surgery and/or been treated with bromocriptine or lisuride, but had not tolerated this therapy well, and/or had not shown sufficient suppression of serum prolactin levels. Baseline prolactin levels were between 149 and 4120 ng/ml. During treatment, levels fell significantly in all patients, to between 2.0 and 683 ng/ml, and to within the reference range in five patients. In seven patients, the adenoma size decreased by 10 to greater than 50%. Adverse reactions were less frequent and less marked than with the prior therapy. The new dopamine agonist is an alternative treatment for prolactinomas where other therapies have been unsuccessful.
Adult↗
Tetracosactrin vs. methylprednisolone in the prevention of emesis in patients receiving FEC regimen for breast cancer.
0.5 mg tetracosactrin is considered to be equivalent to 40 mg methylprednisolone with regard to the induced cortisol secretion. 97 female breast cancer patients who received their first two FEC courses (epirubicin 50-75 mg/m2, 5-fluorouracil 500 mg/m2, cyclophosphamide 500 mg/m2) entered this randomised crossover study (76 had previously received an adjuvant treatment); tetracosactrin was administered intramuscularly and methylprednisolone intravenously immediately before chemotherapy administration. The tolerability was evaluated using a diary card during 5 days and patients were asked for their preference at the end of the two cycles. There was no difference either for vomiting (dry heaves were included) or nausea between the two treatments (the analysis was performed on day 1, the worse day of days 2 and 3 and the worse day of days 4 and 5). At day 1, 49% of the patients experienced no or mild nausea after tetracosactrin and 62% after methylprednisolone (not significant) (first period analysis); a complete control of vomiting (including dry heaves) was observed in 49% of the patients after tetracosactrin and 53% after methylprednisolone (not significant). No difference was observed between patients with or without previous chemotherapy. However, slightly more patients preferred tetracosactrin (P = 0.048).
Antineoplastic Combined Chemotherapy Protocols↗
Medroxyprogesterone acetate lowers plasma corticotropin and cortisol but does not suppress anterior pituitary responsiveness to human corticotropin releasing factor.
The endocrine action of medroxyprogesterone acetate (MPA) has been claimed to be of a glucocorticoid-like nature. Upon clinical observation, MPA has been shown to improve life quality and overall well-being in patients with advanced breast cancer, renal carcinoma, prostatic carcinoma, and uterine adenocarcinoma. The authors have evaluated MPA endocrine action by the administration of human corticotropin releasing factor (hCRF) in a 90-minute assay in 15 patients with advanced breast cancer or renal cell carcinoma both, before the initiation of oral high-dose MPA treatment (1000 mg MPA) as well as after at least 10 days of therapy. The curves for corticotropin, beta-endorphin, and cortisol responses to hCRF of tumor patients who were tested before the initiation of MPA treatment were parallel to the curves of a healthy control group of probands tested under equal conditions, although at significantly higher respective hormone levels. In patients with malignant disorders assayed after MPA administration, both basal and peak hormone levels were found to be comparable with values obtained in healthy controls. In conclusion, MPA appeared to act at a suprapituitary level since pituitary responsiveness to hCRF was preserved under MPA treatment. Moreover, it appeared that MPA brought the hormonal stress state found in patients with malignant tumors back to normal.
Administration, Oral↗
Studies on the ascorbic acid metabolism of callitrichid monkeys by 14C isotope excretion technique.
Recently it has been found that the two monkey species Callithrix jacchus and Saguinus fuscicollis, both belonging to the same New World monkey family Callitrichidae and held in the same colony under identical conditions, had extremely different serum ascorbate levels. To examine the ascorbic acid metabolism the 14C-excretion of orally given 1-14C-ascorbic acid was studied under conditions of marginal and abundant vitamin C supply and under intentional stress. There were large differences in the mode of 14C excretion between low and high ascorbate supply. The differences were smaller between stress/no stress conditions intraindividually than between the two species, but they were in the same manner. In comparable trials S. fuscicollis reacted such that a higher status of stress can be supposed in this species.
Animals↗
[Differential diagnosis of otorhinolaryngologic pain syndromes].
As a guiding symptom, acute pain usually leads to the correct diagnosis. In most cases, chronic pain has lost its warning effect. It is often a diagnostic problem to localize the starting point of the pain. Thus, seeking the advice of a number of specialists has proved to be valuable. In more than half of the "pain patients", complaints of pain in the head and neck area are prevalent. The article deals with several pain syndromes which are of importance for the ENT physician. Pain in the ear can be caused by inflammation, tumor, or injury in the area of 5th, 7th, 9th, and 10th cranial nerves, and of the course of the cervical nerves 1-3. In facial pain, symptomatic reasons such as tumors along the involved nerves, Sjögren's, or styloid syndrome, have to be taken into consideration.
Cranial Nerve Injuries↗
[Therapy of metastatic carcinoid with the somatostatin analog octreotide and with recombinant interferon alfa 2b].
A 69 year-old male with carcinoid syndrome and undetectable primary tumour, but disseminated liver metastases, was treated with somatostatin analogue octreotide (Sandostatin) and later additionally with recombinant interferon alpha 2 b (r IFN alpha 2 b, Intron A). The carcinoid symptoms (flushing, diarrhoea) were stopped within hours by octreotide. Simultaneously, the urinary 5-hydroxyindolacetic acid (5-HIAA) excretion and serum serotonin levels decreased by more than 50%. In spite of continued treatment with r IFN alpha 2 b a reduction in dosage of octreotide resulted in a rapid recurrence of carcinoid symptoms, suggesting that IFN alpha 2 b had no effect on the carcinoid symptoms in this patient. Since, furthermore, no regression of the tumour mass was observed, treatment with IFN was stopped after 8 months. During 15 months of treatment to date the patient has been kept free of symptoms by octreotide.
Aged↗
The influence of age on human pancreatic growth hormone releasing hormone stimulated growth hormone secretion.
63 non-obese healthy subjects aged 18 to 95 years were investigated for age-dependence of GHRH-stimulated GH-secretion. In addition, priming of GH-secretion with three oral doses of propranolol (3 x 80 mg, the last dose 2 hours prior to the second GHRH-bolus) was carried out in 15 subjects below 40 years and 13 subjects older than 70 years. We found that mean maximal incremental GH-levels were inversely correlated with chronological age (r = -0.44, P = 0.001) of the probands. Propranolol premedication caused a significant rise of both basal and peak GHRH-induced relative increases in all subjects tested, whereas GHRH-induced relative increases of GH remained unchanged. In a well selected group of non-obese healthy subjects stimulated GH-secretion is found to undergo an aging process that is supposed to be of pituitary and suprapituitary origin. Priming GH-secretion with a beta-Blocker is possible both in young and very old healthy subjects and is likely to affect the basal GH secretory tone and not GHRH-stimulated GH-secretion.
Adult↗
[Bacteriological, clinical, and pharmacokinetic studies of perioperative antibiotic prophylaxis in head and neck surgery].
The point of this study was to analyze the possible benefits of perioperative antibiotic prophylaxis in patients from whom oral cavity or throat tumors are removed. The criteria used to judge the efficacy of each treatment included the clinical course of the treatment, the bacterial colonization of the surgical area as well as the growth of bacteria during the postoperative phase. 50 patients were chosen and grouped according to their surgical treatment: laryngectomy (n = 20), partial laryngectomy (n = 22) or tongue, floor of the mouth, soft palate, gum or base of the tongue partial resection (n = 8). Within each surgical group, patients were randomly chosen for antibiotic prophylaxis; others constituted the untreated control group. The antibiotic prophylaxis consisted of 5 g Mezlocillin administered at the time of narcosis for 20 min followed by 0.5 g Metronidazol for 10 min. These medications were given in 8-hour intervals for three days following surgery. Investigation of the first 20 patients (prophylaxis group n = 7, control group n = 13) revealed that the combination of Mezlocillin and Metronidazol positively influenced post-operative recovery (no complications) while the patients without prophylactic antibiotic treatment suffered general or local complication leading to, in 10 cases, the necessity of postoperative therapy. On the basis of these results, the random grouping of the patients was ended and all 30 remaining patients were given the antibiotic prophylaxis. Regardless of antibiotic treatment, the great majority of microbes isolated from throat swabs and tracheal secretions were gram-negative, aerobic bacteria. A prerequisite for efficacious prophylaxis is that the antibiotics be applied before the operation, so that a sufficient concentration is present at the time of pharyngotomy. On the basis of pharmacokinetic investigations, administration of the antibiotic 30 min preoperatively fulfills this requirement. Further, our recommendation, based on our measurement of the spectrum of bacteria present and their growth is that the antibiotics be applied over a period of three days postoperatively. This recommendation is also based on the fact that some patients (those having undergone partial laryngectomy or tongue, floor of the mouth, base of the tongue partial resections) have suffered loss of the swallowing reflex so that there exists a continuous contamination of the surgical area with pathogens or facultative pathogens coming from the nasal or oral cavities.
Adult↗
[Perioperative prophylaxis with cefmenoxime and metronidazole in patients with head and neck tumors].
Twenty-one patients with carcinoma of the larynx, hypopharynx and the tongue underwent surgery under perioperative prophylaxis with cefmenoxime and metronidazole. Healing was uneventful and the clinical and the chemical parameters remained normally. The level of the antibiotics was effective against most of the bacteria cultured from tracheal aspirate and the posterior wall of the oral cavity. Effective perioperative antibiotic prophylaxis is necessary in head and neck surgery: the use of simple antibiotics in short courses should be assessed.
Cefmenoxime↗
[Multicenter study with 3 different doses of ketanserin in essential arterial hypertension].
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Adult↗
[Echographic diagnosis in orbital mucoceles].
Sonography in 68 patients with orbital mucoceles revealed the following, pathognomonical A-scan criteria: Regular structure, low to extremely low reflectivity, sharply outlined borders, bony defects, missing or minimal compressibility and typical location in the supero-nasal anterior orbit. The echographical findings of "mucoceles" secondary to paranasal tumours are specially emphasised. Echography proves to be a very useful method in the detection and differentiation of orbital complications in paranasal diseases.
Diagnosis, Differential↗
Horseradish peroxidase as a label of injured cells.
The present study is concerned with artifacts likely to occur in a horseradish peroxidase exclusion test. Incubation of murine peritoneal macrophages and lymphocytes with the peroxidase showed a close relationship between the number of living cells and the percentage of cells excluding the tracer. The penetration of the cytoplasm by horseradish peroxidase is attributed to an increase in the permeability of the cell membrane during the incubation (ranging from 10 to 120 min). It was not increased by the presence of tracer throughout the incubation period. However, concomitant fixation of the cell in the presence of horseradish peroxidase caused an increase in the influx of the tracer. The horseradish peroxidase exclusing test applied to the guinea-pig organ of Corti has proved to be valid provided that: (a) mechanical lesions prior to the tracer incubation are avoided; (b) incubation is terminated by removal of the extracellular tracer; (c) fixation is carried out as soon as possible; (d) a low concentration of horseradish peroxidase is used; and (e) specimens are incubated in diaminobenzidine-H2O2 medium for the shortest possible period. Although fixation-induced cytoplasmic infiltration by horseradish peroxidase was not detected in cochlear specimens, the findings call attention to possible sources of error and define the level of significance of the test. Horseradish peroxidase does not appear to be a cytotoxic agent under the conditions used.
Animals↗
Rat endo- and mesothelium lack Fc receptors.
The present study is concerned with the interaction of rat endo- and mesothelium with homologous erythrocytes under various conditions of pretreatment and incubation. Its findings show rat endo- and mesothelial cells a) nonadhesive to native or pretreated erythrocytes irrespective of the presence of gamma-globulin in the medium, b) devoid of primary or cryptic receptors sensitive to the Fc segment of the IgG molecule, and c) provided with binding sites at the oxidized glycocalyx which together with receptor groups of modified erythrocytes share the same class of IgG.
Agglutination↗
Hypotonic unmasking of erythrocyte receptor sites.
The study reports on plasmalemmal perturbation of erythrocytes under osmotic stress. In comparison with isotonic human erythrocytes a 10 minutes incubation in 150 mosm sodium cacodylate pH 7.4 at 20 degrees C results in an increase of the anti AH P binding rate by a factor of two. 0.1 M N-acetyl galactosamine inhibits the binding of anti-AH P of both isotonic and hypotonic red cells. Contrary to isotonic mouse erythrocytes the agglutination with peritoneal murine leukocytes of hypotonic red cells is greatly enhanced provided the erythrocytes have been incubated in autologous serum. The findings are considered evidence of the unmasking of binding sites due to nonspecific rearrangement of membrane constituents.
Acetylgalactosamine↗
Alteration of the enucleating erythroblast glycocalyx.
Plasmalemmal differentiation of the enucleating normoblast of rabbit and rat was studied by means of cytochemical methods and freeze-etching. Staining with colloidal iron revealed about identical amounts of iron particles bound to various areas of the normoblast membrane. Cationized ferritin and ruthenium red, likewise, failed in the demonstration of significant changes of the enucleating normoblast glycocalyx. Despite these findings the topo-optical staining with toluidine blue showed the plasmalemmal envelope of the protruding normoblast nucleus moderately birefringent, clearly discriminated from the intense anisotropic staining of the future reticulocyte membrane. The ferritin-labeled snail lectin anti AHP localized a great number of binding sites at the plasmalemmal envelope of the nucleus under extrusion. That is in sharp contrast with rather low lectin binding to the future reticulocyte membrane which amounts to about 30 to 50% of the nuclear envelope label. The findings provide evidence of unmasking of bindings sites of the normoblast membrane. Apparently, the effect is due to conformational changes of the cell membrane, rather than it could be attributed to degradation of glycoproteins. Moreover, enucleation kinetics may also be related to supramolecular changes of membrane structure albeit missing evidence for the rearrangement of membrane particles.
Animals↗
CPC-PTA section staining of acid glycans.
A cetylpyridinium chloride-phosphotungstic acid procedure suggested by Kelényi and Kiss (1976) for the staining of mast cell granules in ultrathin sections was slightly modified with regard to pretreatment, pH of incubation, and rinsing of sections. The method also proved suitable for the demonstration of various mucosubstances and of cartilage proteoglycan aggrebates.
Animals↗
Decay of murine intestinal epithelial cells under extrusion.
Electron microscopic findings of this study revealed 2 types of extrusion of brush border cells from the summits of intestinal villi: a) By expansion of initial vacuolation the degenerating cell enlarges and elevates itself above the level of the extrusion zone. Cells about to lift become sphered and are shed into the lumen for degradation to continue. b) Another group of cells vacuolating to a similar extend already may start apical decay in situ. In this case mechanical elevation, apparently, is inefficient or retarded such as to offer a cell the opportunity to decompose at its proper place in the mucosal lining. Contrary to type A extrusion, i.e. the desquamation of the entire degenerating cell, type B produces cellular debris to be shed into the lumen. Either type of exfoliation may be associated with the formation of gaps the closure of which proceeds slowly. The light microscopic test of cell viability by means of horseradish peroxidase demonstrated many brush border cells leaky such as to become loaded with the tracer irrespective of its vascular or enteric approach to the extrusion zone. Damage of the cell membrane due to a brief pretreatment with digitonin resulted in a dramatic rise of horseradish peroxidase positive cells. With respect to these findings, one cannot escape the conclusion that both types of extrusion confer intermittent leakage on the summits of intestinal villi which at least could account for part of the diffusion of macromolecules in either direction.
Animals↗