Search PubMed⌕ Search

Biomedical subjects

H G Kempf

Publications and source records attributed to H G Kempf.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Malignant fibrous histiocytoma in the area of the head and neck].

Although malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma of adult life, it is fairly rare in the head and neck region (3-6%). Between 1983 and 1991 8 patients with MFH in the head and neck region have been observed and treated at the ENT-department of the University of Tübingen. 5 patients have been operated (laryngopharyngeal localization), 2 patients underwent irradiation (unresectable fast growing T4-tumors of the pharynx and thyroid) and one female patient refused further therapy after two resections elsewhere. Operated patients showed no evidence of disease 2-8 years after resection (all margins have been controlled histologically). Both irradiated patients died 4 respectively 2 months after full (70 Gy) and incomplete (17 Gy) radiotherapy without visible positive effects. Both patients developed pulmonary metastasis. Since MFH can grow in thin layers along musculaoponeurotic structures the exact size is not always demonstrable by ultrasound, CT or MR scans. Metastasis occur in up to 40%, preferentially in regionary lymph nodes, in lung, liver and skeletal system. These phenomenon requires a full pretherapeutic staging. Histologically MFH is sometimes hard to distinguish from other tumors as for example various sarcomas and pleomorphic carcinoma. Therefore, immunohistochemical (mesenchymal markers) and electron microscopical investigations are advised. Resection with exact histological controll of all margins is the therapy of choice. We experienced that laryngeal MFH (n = 3) can be resected without laryngectomy under certain circumstances. Although unsuccessfull in our two cases, according to the literature, radiotherapy should be administered in unresectable cases. Depending on localization and size of MFH long survival, in single cases healing, of this disease is possible by surgical treatment.

Adult↗
PubMed1992

[Adjuvant and drug therapy of chronic pain in the head and neck area].

Head and neck pain caused of benign or malignant disease reduces remarkable the patient's quality of life. In the following are presented adjuvant and medicamentous methods for pain control. Surgery, irradiation and chemotherapy aim to diminish the tumor extension and reduce algesic transmitting substances in the periphery. Nerve blocs, cryoanalgesia and transcutaneous electrical nerve stimulation lead to an interruption of the painful spinal reflex arc. Active, passive and relaxation exercises prevent from dolorific muscular tensions. Psychological treatment, so as relaxation techniques in connection with behavior therapy, helps to develop coping strategies. The mainstay of pain relief is effective use of analgetics which should be given orally if possible, on a regular schedule and on an individualized basis according with the WHO guidelines.

Analgesics, Opioid↗
PubMed1992

Regeneration of free grafted respiratory epithelium on severely altered lamina propria.

The lamina propria of nasal mucosa has been thought to play a key role in function and metabolism of respiratory epithelia by allowing exchange of various substances and migratory cells from blood vessels into the epithelium. Here we show that the lamina propria of mucosa transplanted to rat rectus abdominis muscle looses its typical structure and becomes vascularized connective tissue. In the subepithelial space of free grafted respiratory epithelia nasal glands, ducts and nerves degenerate and are no more detectable 3 weeks after transplantation. By contrast the epithelial cell layer regenerates, resulting in a healthy appearing mucosa. Histological and functional controls revealed that regenerated respiratory epithelium lies on a layer of vascularized connective tissue and displays normal cellular differentiation and ciliary function. The present experiments demonstrate that the lamina propria can be replaced by vascularized connective tissue without functional loss of the overlaying epithelium. Thus the results argue against a key role of lamina propria in mucosal function.

Abdominal Muscles↗
PubMed1991

[Diagnosis and therapy of aggressive fibromatosis (extra-abdominal desmoid) in the head and neck area].

Desmoid tumours (extraabdominal desmoids, aggressive fibromatosis) are rare connective tissue tumours, that grow infiltratively and destructively. The analysis of the course of disease in three patients suffering from desmoid tumours in the head and neck region (regio submandibularis, regio parotidea, parapharyngeal space) confirmed the data in literature that painless swelling and dysfunction are the first non-specific signs of the disease. Morphologically reactive fibromatosis and fibrosarcoma should be considered (amongst others) in differential diagnosis. CT and MR scans are useful in determining the extent of the tumours and help to distinguish the tumour from nerves, vessels and bone. Surgery is the therapy of choice in the head and neck region. Primary surgery was performed in our patients. Due to recurrences two of our patients have been operated on several times including major plastic reconstructive surgery. One patient died three and a half years after primary treatment due to sarcomatous degeneration. A large parapharyngeal recurrence was successfully reduced by percutaneous radiation therapy in our second patient. Follow-up of our third patient was NAD 15 months after resection of a large parapharyngeal/mediastinal process including blocking of two cervical vertebrae. Summing up, desmoid tumours are rare connective tissue tumours in the head and neck region with a destructive biological behaviour similar to malignant tumours and a high recurrence rate. Surgery is the treatment of choice. In recurrences or if the tumour is not properly resectable, radiation must be considered, whereas the chemotherapeutical approach is not yet well established.

Adult↗
PubMed1991

[Closure of septum perforation using an individual obturator].

Alternatively to operative procedures we present the production of an individually formed septal obturator to close an iatrogenic septal perforation. After taking the impression from the perforation the obturator was casted out of silicone via a plaster mould. This possibility can help in those cases where septal perforation cannot be closed by operative procedures.

Adult↗
PubMed1991

[Laryngeal tuberculosis today. A case report].

We report the clinical, CT and histopathological findings of an 84-year-old female with laryngeal tuberculosis. Despite extensive clinical investigations no other manifestation of tuberculosis was found. Antituberculous therapy healed the disease. The clinical relevance and the differential diagnosis of laryngeal tuberculosis are discussed.

Aged↗
PubMed1990

[Hearing ability after cholesteatoma surgery].

Five years after cholesteatoma surgery (primary operation in 1981 and 1982) we examined 112 patients to determine the hearing and clinical results in follow-up. In 12 (10.7%) patients Cholesteatoma recurred. During the period of follow-up 28 (25%) ears underwent second surgery. Comparing the open (50.9%) with the closed (49.1%) technique a better air bone gap was gained for the closed technique procedures. This was confirmed when the different types of tympanoplasty were compared between the two groups. In 69.5% of the closed procedures the air bone gap was less than 20 dB, whereas the value for the open technique was 51.1%. In 30 patients a second-look operation was recommended, which was performed in 15 persons; 8 recurrent cholesteatoma were detected. Reducing the application of the closed procedures from a rate of 78.1% in the years 1971/1972 to 49.1% in 1981/1982, we saw a distinct reduction of cholesteatoma recurrence from 25% in 1971/1972 to 10.7% in the present study. The data show that the advice for a second-look operation should be seriously considered. Furthermore, the study indicates that due to modern tympanoplastic techniques also in longterm follow-up good hearing results can be obtained.

Adolescent↗
PubMed1990

[Clinical picture and immunology of Wegener's granulomatosis].

In the last 21 years, 22 histologically proven cases of Wegener's granulomatosis (WG) were observed and treated. In 19 patients WG appeared primarily in the ENT-area. Ten patients had middle ear involvement. Whereas, in 9 cases the inner ear was affected too. Before introduction of immunosuppressive therapy the patients (n = 8) died averagely after 5.6 months after onset of the first symptoms. Under therapy with cyclophosphamide and prednisone total remission of WG can be reached for long times (n = 14, 3.2 years of follow up). In 14 cases serologically anti-cytoplasmatic antibodies against neutrophil granulocytes were determined in high activity stage of WG. In combination with the clinical and histological findings the determination of these antibodies gives the possibility to solve difficulties in differential diagnosis of WG.

Female↗
PubMed1990

[Non-Hodgkin's lymphoma of the parotid gland].

Since 1969 we have seen 17 patients with non-Hodgkin's lymphoma of the parotid gland. Retrospective analysis of these patients reveals that the primary diagnosis was established in 14 patients by parotid surgery. In 10 (58.8%) cases there was a single focus of NHL in the parotid gland proven by extensive medical and radiological examinations. Histology showed that 14 (82.3%) of the tumors were low grade and 3 (17.7%) were high grade (Kiel classification). In 5 specimens myoepithelial sialadenitis was found in the parotid gland tissue. Six patients died within 1.5 years on average, 4 of them without evidence of disease. Four of the 7 patients alive have been followed for an average of 3.1 years without evidence of disease. Primary radiation of the parotid region in stage IE in cases of parotid gland NHL seems to be an effective therapy. NHL presenting in myoepithelial sialadenitis seems to be rare, but offers the opportunity of observing an organ specific malignant process.

Aged↗
PubMed1989

[Intratemporal facial neurinoma].

Two patients with intratemporally localised facial nerve schwannomas developed conductive hearing loss beside persisting facial nerve palsy. Tympanotomy revealed a tumour of the facial nerve that was totally removed. In one case reconstruction was performed with great auricular nerve interposition. The long-term follow-up (12 years) showed a good functional result. Facial nerve schwannomas present problems in detection, and reconstruction methods are not safe with regard to long-term prognosis.

Adult↗
PubMed1989

Ear involvement in Wegener's granulomatosis.

In 16 of 19 patients with biopsy-proved Wegener's granulomatosis the early manifestations were limited to the ear and nose. The audiological data of 13 patients revealed middle ear involvement in 16 of 26 ears. Twenty-one of 26 ears presented with a low to moderate sensorineural hearing loss. One ear remained deaf after a sudden hearing loss in the early stage of the disease. Serologically, 4 of 6 tested patients with sensorineural hearing loss demonstrated antibodies against sarcolemma. One patient showed antinuclear antibodies. It is remarkable that these antibodies can often be detected in classic inner ear disorders. The course of inner ear function, serum findings and the success of immunosuppressive therapy in Wegener's granulomatosis are comparable with immunologically mediated vasculitis in the inner ear.

Adult↗
PubMed1989

[Lermoyez syndrome. Clinical aspects and follow-up].

The clinical data and follow-up of five patients with Lermoyez syndrome are reported. Three of them presented with marked lesions of the cervical spine. Serological antibodies against nuclei and sarcolemma as well as against heart muscle and gastric cells were found. Tests of the sera against guinea pig cochlear tissue showed antinuclear antibodies in one patient and against basilar membrane structures in another. Three sera were negative despite positive heterologous finding. Therapy included infusions active on the inner ear, decompression of the saccus endolymphaticus in two cases and physiotherapy for the cervical spine. These achieved marked improvement or long term relief. The available literature supports the conclusions based on pathophysiological considerations of our results. We cannot postulate an independent immunopathogenesis for Lermoyez Syndrome, but we think that the immunological findings conform with the clinical and experimental data found in the literature.

Autoantibodies↗
PubMed1989

[Extra-temporal localized facial neuromas].

Nine facial nerve schwannomas were observed in more than 1,350 operations on the parotid gland. Eight patients had a pre-operative diagnosis of pleomorphic adenoma without facial palsy. One patient who underwent extensive surgery without preservation of the facial nerve for a tumour present for more than 10 years had a pre-operative facial palsy. Facial nerve function recovered totally or partially in six peripheral schwannomas. In two cases with main trunk schwannoma no reinnervation was observed despite end-to-end anastomosis or interposition of the great auricular nerve. Histology showed eight typical schwannomas and one neurofibroma. Neurofibromas are extremely rare in the parotid gland. Clinical and operative experience with parotid gland schwannomas shows that recovery of facial nerve defects is mostly incomplete. Reconstructive methods should be used, but the long-term prognosis is uncertain.

Adult↗
PubMed1988

[When should removed adenoids be studied histologically?].

Two children with nasopharyngeal rhabdomyosarcoma are used to discuss the relevance of the histopathological investigation of adenoid tissue. Histopathological investigation should only be omitted if there is complete agreement between symptoms, intra-operative findings and macroscopic findings. Histopathology is advised for very large adenoids, alteration of consistency and in older children or young adolescents.

Adenoidectomy↗
PubMed1987

[Incidence of kidney diseases in inner ear disorders].

A retrospective study is reported based on a questionnaire sent to family doctors and otolaryngologists. Of 213 patients with various inner ear disorders, 19 were found to have renal disease. A further 19 patients were found who had abnormal laboratory and urinary tests. There was no increased frequency of renal disease compared with the normal population nor were there any differences in immunological findings. Experimental findings of renal and inner ear disorders are discussed. The serological data of the patients investigated are compared with etiological considerations of sensorineural hearing loss. This was no correlation of the clinical data with anatomical, physiological or experimental findings in the kidneys and cochlea.

Autoantibodies↗
PubMed1987

[Immunologic findings and therapeutic results in chronic progressive inner ear hearing loss].

In a retrospective study of 147 patients with progressive sensorineural hearing loss we analysed the therapeutic results in relationship to the serum tissue antibody. Serum antibodies against heterologous tissue were detected in about 50% of the patients studied. These antibodies were mainly against sarcolemma, endothelium and smooth muscle. One group of patients was treated with corticosteroids. In this group, one third of the antibody-positive patients and 10% of the antibody-negative patients had hearing improvement. The second group of patients was treated with rheological substances (Dextrane 40 with Procaine or Naftidrofuryl). In this group, there was hearing improvement in 17% of the antibody-positive and 20% of the antibody-negative patients. The results of our study suggest that routine immunological tests may not be sufficient to predict the usefulness of corticosteroid treatment. It may be necessary to develope new immunological techniques which are more specific to the inner ear.

Adolescent↗