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Biomedical subjects

K Albegger

Publications and source records attributed to K Albegger.

At least 37 records · Page 2Linked to original sources
PubMed1991

Regulatory peptides and general neuroendocrine markers in human nasal mucosa, soft palate and larynx.

Various peptide immunoreactivities in the respiratory system have been reported, indicating complex physiological mechanisms. There is only little information on the upper respiratory system of man. The present study was carried out to demonstrate regulatory peptides in the nasal mucosa, larynx (vocal cords and ventricular folds) and soft palate of man using highly efficient immunocytochemical methods. In addition, some peptide immunoreactivities were measured by use of radioimmunoassay (RIA). Using indirect immunofluorescence and immunogold-silver staining (IGSS) with silver acetate autometallography, a series of peptides could be detected, including vasoactive intestinal polypeptide (VIP), peptide histidine methionine (PHM), galanin, calcitonin gene-related peptide (CGRP), substance P, neuropeptide tyrosine (NPY), C-flanking peptide of NPY (CPON) and somatostatin. In addition, antibodies to protein gene-product (PGP) 9.5, neuron-specific enolase (NSE), S-100, PHE-5 and neurofilament proteins gave positive reactions in tissue sections. Using RIA, CGRP, substance P, and neurokinin A were measured. Our results demonstrate a complex network of regulatory peptide-containing nerve fibers and the possible existence of endocrine cells regulating various functions of the upper respiratory system, which need to be further investigated.

Biomarkers↗
PubMed1991

[Idiopathic facial paralysis and magnetic resonance tomography (MRT)].

We investigated 15 patients with unilateral facial paralysis using gadolinium(Gd)-DTPA (diethylenetriamine pentaacetic acid) enhanced (magnetic resonance imaging (MRI). Eleven were idiopathic and 1 each was due to basal skill trauma, Lyme's disease, Foville's syndrome and herpes zoster oticus. Ten of 11 Bell's palsies showed a significant enhancement of the facial nerve on the paralysed side. In all cases enhancement was shown in the labyrinthine segment, in 9 in the meatal segment, in 8 in the mastoid segment and in 7 in the tympanic segment also. Follow-up Gd-enhanced MRI investigation was performed 3-11 months later in 8 patients. In 1 case with incomplete return of function after 3 months MRI enhancement was decreased. We could not find any correlation between the intensity of the Gd enhancement and the course, severity or outcome of Bell's palsy, or stapedius reflex audiometry. The mechanisms and aetiology of the Gd enhancement in Bell's palsy seem to be non-specific phenomena which are also found in post-traumatic facial lesions, for instance. Nevertheless, the ability to image the facial nerve in Bell's palsy provides a new means of examination in this disorder. In our opinion Gd-enhanced MRI is recommended in cases of recurrent or "atypical" Bell's palsy and in cases with total loss of electrical excitability, to exclude tumours. It is further suggested that MRI may provide valuable information concerning areas which may require surgical exploration or decompression.

Adolescent↗
PubMed1991

[Diagnosis of allergic rhinitis. I. Anamnesis--ENT medical examination--skin tests--intranasal provocation].

One of the most important factors in the diagnosis of allergic diseases of the nose is the history, which requires a detailed knowledge of the allergic disease, and of the personal and occupational environment of the patient. Skin tests usually confirm the allergens suggested by the history. If this is not the case, a further history must be taken with respect to the agents identified by the positive skin tests. Other additional investigations must be performed such as RAST, the human basophil degranulation test, the histamine liberation test and the intranasal provocation test (IPT) with anterior rhinomanometry. The guidelines of the working group on bronchial and nasal provocation tests of the German Society for Research into Allergy and Immunity for the performance of the IPT should be respected because they are reproducible and standardised.

Desensitization, Immunologic↗
PubMed1990

[The symptomatic therapy of allergic rhinitis].

For the symptomatic treatment of allergic rhinitis the following groups of drugs are available: decongestants (sympathicomimetics), stabilizers of the mast cell membrane (DNCG, nedocromil), corticosteroids (aerosols), antihistamines, ketotifen, anticholinergics. The world wide use (and abuse) of decongestants (sympathicomimetics) is limited by the so-called rhinopathia medicamentosa, when the necessary treatment exceeds 3 or 4 weeks. The antiallergic preparations like sodiumcromoglycat and nedocromil prevent sneezing, rhinorrhea and eye irritations. Their reported effect is "stabilisation" of the mast cell membrane. They have practical no side effects, but the patients compliance is limited by the short, prophylactic effect, necessitating frequent topical applications up to 6 times daily. As the overall symptom scores are only reduced between 30% to 50%, they are not suited for severe cases of allergic rhinitis. Nedocromil should have a significantly better efficiency than DNCG. The development of efficient topical glucocorticosteroid aerosols was a great progress in the treatment of allergic rhinitis. With daily doses of 100 micrograms to 800 micrograms they are very effective against hypersecretion, sneezing, itching and also blocking of the nose. Because of the so-called "first pass" effect after resorption through the nasal mucosa they have minimal general side effects, especially on the balance of the endocrine system. Their rate local side effects on the nasal respiratory mucosa include local irritations, crusting, dryness and seldom nose bleeding.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1990

[Pruritus--a side effect of hydroxyethyl starch? First report].

It is generally assumed that a disturbance of microcirculation is the common pathogenic pathway of various cochleovestibular disorders. Several studies have demonstrated that hydroxyethyl starch (HES) has better rheological effects than dextran 40, and fewer side-effects. Therefore, we changed from dextran 40 to hydroxyethyl starch in 1987 for the treatment of several otoneurological disorders. However, some patients complained of general pruritus after 1 or 2 weeks of therapy with HES. Therefore, a retrospective study was performed using a questionnaire of 491 patients treated for various cochleovestibular disorders. We received answers from 94 (20%): 25 of 59 (42.4%) patients treated with HES complained of pruritus compared with only 4 of 35 (11.4%) patients treated with dextran 40. The difference was significant (P less than 0.01). Critical points are the retrospective study design and the small number of patients, so that no conclusions can be drawn about the incidence of pruritus after therapy with HES. However, we would like to focus attention on this side-effect, which has been neglected in the literature but is extremely uncomfortable and socially embarrassing for some patients.

Dextrans↗
PubMed1990

[Current aspects of hyposensitization].

Hyposensitation (HS) or immunotherapy has long been used to block the allergic response to inhaled allergens. Double-blind studies with a placebo arm have established the effectiveness of HS, especially in allergic rhinitis. The aim of HS is to achieve a better tolerance after exposure to inhaled allergens by subcutaneous injections of the relevant allergen extract in repeated doses of increasing concentrations. Although the clinical efficacy is obvious, the pathogenesis of HS is not yet fully understood. The HS must be used strictly in accordance with the guidelines of the European Academy of Allergology and Clinical Immunology (EAACI) with respect to therapeutic effect, side-effects, and cost for doctor and patient. The indications, relative and absolute contraindications, guidelines for the HS and the therapeutic monitoring of the patients during HS are outlined. In addition to the correct therapeutic regimen, a critical criterion is the quality and standardization of the allergen extracts. The recommendations of the International Union of Immunological Societies (IUIS) should be respected. Semi-depot extracts are preferred nowadays. The side-effects consist of local reactions, general reactions with urticaria, asthma, and even anaphylactic shock. The immediate therapy, precautions and drugs necessary to treat this life-threatening event are described.

Allergens↗
PubMed1990

[Current pathophysiologic aspects of allergic rhinitis. I].

Allergic rhinitis is a classic example of a type I immunological reaction. After allergic provocation tests a biphasic reaction is seen in the respiratory tract that is more pronounced in the lower than in the upper respiratory tract due to the physiological changes during the nasal cycle. The early phase of the immediate reaction starts some minutes after allergen provocation. After 5-10 h the nasal symptoms (discharge, blockage, sneezing and itching of the nose) reappear, a phenomenon which is called the "late-phase response" (LPR). The LPR is of great clinical importance in the pathophysiology of perennial allergic rhinitis and phenomena such as nasal priming and nasal hyper-reactivity. The most important effector cell of the early phase of the immediate reaction is the mast cell, whereas basophils, eosinophils and neutrophil granulocytes seem to be more important for the LPR. There is also evidence for morphological and functional heterogeneity of mast cells in man. The role of the chemotactically immigrated eosinophils in allergic reactions has not been clear until now: the eosinophil-derived mediators may enhance or inhibit the allergic reaction. Also the eosinophils show different morphological and functional states (so-called hypo- and hyperdense eosinophils). The symptoms of allergic rhinitis (sneezing, discharge, blockage, itching of the nose) are caused by different mediators, of which the most important is histamine. Other mediators or modulators of the allergic reactions are leucotrienes, prostaglandins, PAF, serotonin, and the kallikrein-kinine and complement systems. In recent years many regulatory peptides have been detected in the human nasal mucosa.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergens↗
PubMed1988

[Current aspects of nasal hyperreactivity].

The term hyper-reactivity defines an inadequate reaction of the nose to normal airborne stimuli that are harmless to most of the population. In such cases the nose always shows exactly the same symptoms, irrespective of whether the rhinitis is allergic (IgE- or cell-mediated) or nonspecific (vasomotor). These symptoms include sneezing, nasal obstruction, hypersecretion, and itching of the nose. The vascular supply of the nose consists of capacitance vessels (veins, venules, sinusoids), resistance vessels (arteries, arterioles), and exchange vessels (capillaries of fenestrated types). Drug and mediator effects may be directed to different nasal vessel systems. The autonomic innervation of the nose is complex. Some neuropeptides have been demonstrated, in addition to the classical neurotransmitters of the sympathetic and parasympathetic system. Neuropeptide Y (NPY) is found in adrenergic fibers, vasoactive intestinal peptide (VIP) in cholinergic neurones; substance P (SP), calcitonin-gene-related peptide (CGRP) and neurokinine (NKA) are found in sensory nerves. The possible significance of the different neurotransmitters and mediators in nasal hyperreactivity is discussed.

Humans↗
PubMed1988

[Excluding a recurrence of cholesteatoma using high resolution computerized tomography. Can one dispense with the second-look operation?].

In a prospective study 20 patients were examined by high-resolution computed tomography of the temporal bone (HR-CT) before an early or late second-look operation. One year earlier 8 of the patients had undergone a posterior tympanotomy ("intact canal wall" technique) for a cholesteatoma and if necessary a one-stage ossicular reconstruction. In 4 other patients a two-stage ossicular reconstruction was carried out. In the remaining 8 patients a one stage operation had been carried out several years before. After a cholesteatoma operation three typical X-ray findings can be observed in HR-CT: 1. Normal findings (no granulation tissue in the middle ear space, antrum or mastoid) 2. Granulation tissue without destruction 3. Cholesteatoma recurrence (homogeneous soft tissue mass with bony destruction) Based on previous experience we forego an early second-look 1 year later and suggest the following plan: 1. Providing the post-operative follow up proves normal, a HR-CT examination is carried out 2 years, after a cholesteatoma operation. 1.1 If the HR-CT, the clinical and audiological examinations are normal a HR-CT investigation is necessary a further 2 years later. 1.2 In the case of granulation tissue a further HR-CT must be carried out 1 year later. Should the granulations become progressively worse a second-look is mandatory. 1.3 Homogeneous soft tissue mass and destruction are signs of cholesteatoma recurrence. Immediate operation is necessary. 2. If audiological or clinical findings suggest a recurrent cholesteatoma within the first 2 years after the operation, HR-CT should be carried out at once.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Inflammatory diseases of the nose and nasal sinuses in children].

Inflammatory diseases in childhood are quite different from those occurring in adults. The reasons are the special physiological, anatomical and immunological factors at the different stages of development. The different diagnostic possibilities (nasal swabs for virological and bacteriological examinations, X-ray, sonography, CT, endoscopy of the nose and paranasal sinuses) are discussed and the principles of the conservative and surgical therapy were demonstrated.

Acupuncture Therapy↗
PubMed1985

[Local therapy of rhinopathies with topically active glucocorticosteroid aerosols. Review].

The topical application of recently developed steroid aerosols is of great advantage in the treatment of rhinopathies. The modern steroid aerosols are inactivated after the first passage in the liver, following resorption by the respiratory or gastrointestinal mucosa. The desired therapeutic effect is therefore, restricted to the mucous membrane, and the well-known undesirable general side effects of the steroid hormone are avoided. The main indications for nasal application of steroid aerosols are allergic and non-allergic vasomotor rhinopathies and polyposis nasi. The basic requirement for a good therapeutic effect is tue proper application; therefore, satisfactory nasal ventilation and precise instruction and handling of the applicator are mandatory. The basic biochemical mechanisms of the glucocorticosteroid effects in relation to rhinopathies are given in a survey.

Administration, Topical↗
PubMed1985

[Animal bite injuries in the head and neck area and their care].

Animal bites in the head and neck vary in severity. Surgical treatment depends on the size, extent and site of the wound. Straightforward injuries need only to be cleaned and disinfected or may require simple surgery. Extensive, complex bites must be treated by the techniques of plastic-reconstructive surgery. Good cosmetic results can only be achieved in this way. Lacerations should be treated immediately. Bites with loss of tissue can be treated immediately by flaps, skin or composite grafts or revascularised flaps. Usually however, the wound is covered by gauze impregnated with ointment or artificial skin. Two to three weeks after granulation the lesion is reconstructed. An anti-tetanus injection must be given for every animal bite. Simple bites do not require antibiotics, but extensive wounds do. The indication for rabies vaccination is described and questions concerning the treatment of injuries caused by rabid or suspected-rabid animals are clearly explained.

Adult↗
PubMed1984

[Iatrogenic and environmentally-induced hearing disorders in advanced age].

In a short survey the physiologic basis of hearing mechanisms, main etiological factors and histopathological findings in hearing disorders are reviewed. The main cause of iatrogenic sensoneural hearing disorders are aminoglycosides. Some hints are given to prevent these ototoxic side effects. The so-called "sociacusis" is a special part of environmental hearing disorders, due to non-occupational noise trauma. Presbyacusis is therefore the end result of various exogenous and also endogenous factors impairing the hearing ability during the individual course of life.

Aged↗