[Otorhinolaryngology--1: Earache is often only a symptom].
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Diagnosis, Differential↗
Biomedical subjects
M Reiss
Publications and source records attributed to M Reiss.
[Otorhinolaryngology--2: "Finger tip sense" is needed].
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Diagnosis, Differential↗
[Taste disorders].
Gustatory problems have deleterious consequences to systemic health, nutritional status and quality of life. Chemosensory dysfunction is most often secondary to one of only a few causes: viral infection, toxic chemical exposure, head trauma, as well as medication-related and idiopathic conditions. Many gustatory disorders are secondary to a wide variety of diseases. History taking may provide clues to these and other problems. Therapy should not begin until a standardized test has been given that established impairment of the sense of taste. Treatment of underlying diseases may restore chemosensory function. Reference is made to the need for adequate psychic guidance of patients with chemosensorial problems. If restoration of their sense of taste is unlikely, patient should be cautioned to take steps to ensure safety in regard to such dangers and spoiled foods.
Diagnosis, Differential↗
[Nasal odors].
This review discusses the etiology and pathogenesis of fetor e naso and the associated disease. This paper reviews also the diagnostic management and therapy of nasal fetor. Fetor e naso is a very important and dangerous sign, which should always be clarified.
Diagnosis, Differential↗
[Importance of computer tomography in preoperative diagnostics of polyposis nasi].
Computed tomography (CT) is a very important diagnostic tool prior to endoscopic nasal or paranasal sinus surgery. However, it is frequently notice during endonsal surgery of the paranasal sinuses, that the intraoperative results do not completely agree with the radiological ones. The objective of the present study was to compare clinical and operative findings with those of CT investigations. We collected 200 cases treated during the past 2 years and studied their CT reports. Paranasal sinuses were separated into six regions, and the pathological changes due to sinusitis found by CT were classified into four groups. Altogether, we found a highly significant relationship between CT and intraoperative findings (r = 0.44; P < 0.0001), but differences were found in several regions. The highest correlation was found in the anterior ethmoid bone area (r = 0.98), posterior ethmoid bone area (r = 0.53), maxillary sinus (r = 0.36) and sphenoid sinus (r = 0.35). There was only a low agreement in the case of frontal sinus and recessus frontalis. Possible factors such as time between CT and operation or inflammation are discussed. While CT is the image modality of choice in evaluating patients with chronic paranasal sinusitis, agreement to intraoperative findings is not perfect. This should be taken into consideration when planning functional endoscopic sinus surgery.
Chronic Disease↗
Bcl-2 antisense oligodeoxynucleotide therapy of Epstein-Barr virus-associated lymphoproliferative disease in severe combined immunodeficient mice.
Bcl-2 is upregulated by Epstein-Barr virus (EBV) in immortalized lymphoblastoid (LCL) B cells and is expressed in the majority of EBV-associated posttransplant lymphoproliferative disorders (PTLDs). Given the antiapoptotic function and chemoprotective effects of Bcl-2, it represents a rational target for modulation using antisense oligodeoxynucleotides in Bcl-2-expressing, EBV-associated lymphoproliferative disorders. Using a fully phosphorothioated oligodeoxynucleotide targeted to the first six codons of Bcl-2, we examined the effects of Bcl-2 antisense both in vitro in LCLs and in vivo in the human/severe combined immunodeficient chimeric model of EBV-associated lymphoproliferative disorders. In vitro treatment of LCLs with Bcl-2 antisense in the presence of cationic lipid was associated with decreased expression of Bcl-2 protein, inhibition of proliferation, and stimulation of apoptotic cell death; these effects were sequence-dependent. Furthermore, treatment of LCL-bearing severe combined immunodeficient mice with Bcl-2 antisense but not control oligodeoxynucleotides completely prevented or significantly delayed the development of fatal EBV-positive lymphoproliferative disease in vivo. These studies demonstrate that Bcl-2 antisense oligodeoxynucleotides mediate sequence-dependent antitumor effects in EBV-associated B-cell lymphoproliferations both in vitro and in vivo. These findings suggest that Bcl-2 antisense therapy may represent a novel antitumor treatment strategy for EBV-associated PTLDs and other Bel-2-expressing, EBV-positive malignancies.
Animals↗
[The value of conventional roentgen imaging and computerized tomography in diagnosis of frontobasal fractures].
The classical x-ray diagnosis and the computer tomography (CT) examination depends mainly on clinical examination. The purpose of our study was to compare the value of conventional x-ray diagnosis and CT in detecting rhinobasal fractures. We examined 133 patients retrospectively who had a fracture. Altogether we considered with the classical x-ray diagnosis 111 and with the CT 250 regions of the frontobasis. In all, one third of fractures in the regions could not be detected preoperatively by CT and not the half by classical x-ray-diagnosis. CT allows a direct detection of brain hernias and far better imaging of osseous lesions, also of fine structures, such as a better appraisal of paranasal sinus pathology. Classical radiology is, however, still indispensable for imaging certain fracture types and localization of a pneumocranium. Except in case of special demands, conventional x-ray diagnosis is important for the routine diagnostics of the facial skull as a primary method supplying an answer to the most important questions at a lower cost and in a shorter time. Altogether, CT allows an improvement of postoperative results, influencing indication, timing of operation, such as surgical approach.
Adult↗
[Some viewpoints on ear cleaning].
The present paper discuss the cleaning of the external auditory canal. It is purpose of this article to show that the insertion of foreign bodies in form of cotton buds, into the ear, is absolutely unnecessary and may be a dangerous practice. We conclude that cotton-tipped swab use may be associated with cerumen accumulation.
Cerumen↗
[Differential diagnosis of unilateral hearing loss].
There are two main kinds of hearing disorders: sensorineural and conductive. Sensorineural hearing loss is a common disorder that results from damage to the inner ear in over 95% of all cases; therefore, retrocochlear hearing disorders are rare and cannot be differentiated from sensory losses by clinical symptoms alone. Unilateral hearing loss entails many problems in hearing during the entire life of the affected patients. Conductive deafness has a readily determined etiology in most cases. In contrast, unilateral sensorineural hearing loss requires more refined and extensive investigation. The etiology of an asymmetric sensorineural hearing loss can often be difficult to determine. Because a wide variety of pathologic processes may be responsible for the hearing loss, numerous diagnostic tests are usually used during initial evaluation, including pure-tone audiometry, acoustic reflex testing, imaging, serologic testing, and auditory brainstem response testing. The most frequent causes of unilateral sensorineural hearing loss were sudden deafness, Menière's disease and cerebellopontine angle tumors. Early diagnosis of acoustic neuroma or other lesions of the internal auditory meatus or cerebello-pontine angle requires special attention. The patient with an acoustic neuroma may present to the otologist with a variety of clinical features. Classically these include a retrocochlear pattern of sensorineural hearing loss, reduced vestibular response on caloric testing and a pathological auditory brainstem response. Magnetic resonance imaging offers greater specificity than computed tomography. Therapy of unilateral sensorineural hearing loss includes efforts to treat known causes either medically or surgically.
Diagnosis, Differential↗
[Pulsating tinnitus].
Tinnitus is a frequent symptom but a tinnitus that is rhythmic and synchronous with the patient's heartbeat is rare. The symptom "pulsating noise in the ear" may be due to various cause but most frequently, by glomus tumors, intracranial hypertension and atherosclerosis of the carotid arteries. Pulsatile tinnitus can often present a serious diagnostic problem. The diagnostic evaluation includes physical examination, audiologic assessment and imaging techniques (ultrasonic examination of cervical vessels, high-resolution computed tomography of the temporal bones, nuclear magnetic resonance, angiography of the carotid arteries and magnetic resonance angiography). Evaluation should be individualized but must include a thorough ENT work up. The evaluation of the patient includes otomicroscopy, palpation and auscultation of ears and cervical region and the head positioning test. The cause of pulsatile tinnitus may be even identified on otoscopic examination. Further investigations by other specialities (neurology, internal medicine, ophthalmology) may become necessary. Life-threatening causes such as arteriovenous shunts or carotid artery stenosis must be ruled out. Nevertheless, in several cases it will not be possible to determine the etiology of tinnitus. Finally, therapeutic options which occasionally can include surgical techniques or interventional radiology are discussed.
Diagnosis, Differential↗
[Motor assymetry].
Although the study of handedness and its association with hemispheric specialisation represents the prevailing focus of motor dominance research, recent inquiry into footedness and other motoric asymmetries has stimulated several interesting propositions. The present review show the variability of assessing motoric asymmetries. Asymmetry in hand use takes two forms: differential hand preference and differential dexterity between the hands. Motoric asymmetries are strongest and most manifest for handedness (hand preference, performance and dexterity), descending through footedness and other less known asymmetries (tonguedness, chewing preference). Handedness is the most easily observed expression of cerebral lateralization. The alpha and omega of relating handedness to other neuropsychological variables or indices of lateral specialization lies in the classification of handedness. A vast range of testing techniques have been used to assess handedness. Writing hand and self-report are two of the most popular techniques. Other preference measures include observation of how people use tools and questionnaires. Performance tests assess speed and accuracy in tasks stressing manipulative dexterity. Although questionnaires are generally thought to be reliable and valid instruments, there is a disagreement as to the nature, the number and weighting of the items to be included. The least stable results will be obtained if a categorization into "right-handers" and "non-right-handers" is made on the basis of exclusive "right" answers. Slightly more stable is a classification that is based on "right-handers", "mixed preference handers" and "left-hander" based on extreme choices in either direction and intermediate choices. We present shortly a possible inventory assessing motoric asymmetries.
Foot↗
The dominant ear.
Presented are some aspects of the dominant ear or earedness which are also important for other lateralities. Earedness refers not only to a sensory but also to a motor phenomenon.
Auditory Perception↗
Smad protein expression and activation in transforming growth factor-beta refractory human squamous cell carcinoma cells.
In contrast to nonneoplastic keratinocytes, human squamous carcinoma cell lines are able to proliferate in the presence of transforming growth factor-beta (TGF-beta) in vitro. This has raised the question whether, how frequently, by which mechanism, and at which stage of development squamous carcinomas escape from TGF-beta control in vivo. We have developed a method to rapidly identify the most common molecular alterations in the TGF-beta signaling pathway by combining measurements of the levels and the activation state of Smad signaling intermediates with DNA-based diagnostic assays. In this report, we demonstrate the validity of this approach using a panel of seven squamous cell carcinoma (SCC) lines known to be refractory to TGF-beta-mediated cell cycle arrest. Each of the SCCs expressed the pathway-restricted Smad proteins, Smad2 and-3. Furthermore, treatment with TGF-beta induced phosphorylation of Smad2 in each of the SCCs with the exception of the two cell lines that carry inactivating mutations of the TGF-beta type II receptor. Three of the remaining SCC lines failed to express the common mediator Smad4, two on the basis of loss of transcription and one by a posttranscriptional mechanism. Thus, a mechanism for TGF-beta resistance was identified in five of the seven tumor cell lines. Interestingly, in the two remaining lines, no abnormalities of signaling intermediates were found, and TGF-beta was able to activate TGF-beta-responsive promoters. This suggests that the ability of these two cell lines to grow in the presence of TGF-beta is due to factors extraneous to the TGF-beta pathway itself. Application of our protein-based strategy to interrogate the TGF-beta signaling pathway should allow us to determine whether or not and, if so, how and at which stage human squamous cell carcinomas become TGF-beta resistant in vivo.
Carcinoma, Squamous Cell↗
[Idiopathic peripheral facial paralysis. Therapeutic possibilities].
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Bell Palsy↗
[Bad breath. Etiology, diagnosis and therapeutic problems].
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Halitosis↗
[The problem of anosmia].
Olfactory problems have deleterious consequences to systemic health, nutritional status and quality of life. Olfactory disorders are not as rare as generally assumed. Chemosensory dysfunction is most often secondary to one of only a few causes: nasal/sinus disease, viral infection, toxic chemical exposure, head trauma, as well as medication-related and idiopathic conditions. Many olfactory disorders are secondary to a wide variety of diseases, e.g. Alzheimer's disease. The patient's history may provide clues to these and other problems (e.g. toxin exposure, congenital dysosmia). Therapy should not begin until a standardized test has been established the impairment of the sense of smell. Treatment of the underlying diseases may restore chemosensory function. The only truly reversible cause is inflammation, which is confirmed when smell returns after administration of corticosteroids. Reference is made to the need for adequate psychologic guidance of patients with chemosensorial problems. If restoration of their sense of smell is unlikely, patients should be educated to ensure safety in regard to such dangers as gas leaks, smoke, and spoiled foods.
Diagnosis, Differential↗
[Headaches in otorhinolaryngology].
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Headache↗