[SinuTroc--a new irrigation system for the maxillary sinus with indwelling catheter].
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Adult↗
Biomedical subjects
O Kaschke
Publications and source records attributed to O Kaschke.
[Effect of the phytogenic secretolytic drug Gelomyrtol forte on mucociliary clearance of the maxillary sinus].
BACKGROUND: To date, there has not been sufficient experimental evidence to demonstrate the pharmacological effect of secretolytic and mucolytic drugs. METHODS: Scintigraphic studies to detect the mucociliary clearance in the maxillary sinus before and after application of the secretolytic drug Gelomyrtol forte were performed on four healthy persons and one patient after sinus surgery. The most important parameter was the mucociliary transport velocity of the "region of interest-maxillary sinus" and the increase of radioactivity accumulated in a tampon placed in the middle meatus of the nose. Measurements were done with a gamma-camera, 99 m Technetium-sulphurcolloid was used as the radiopharmacentical. A dose of 1 MBq in 0.2 ml NaCl-solution was injected into the maxillary sinus. RESULTS: The results show a clear increase of mucociliary transport velocity in the maxillary sinus after intake of secretolytics in connection with an increase of radioactivity in the tampon. DISCUSSION: The results can be explained by the secretolytic and secretomotoric effects of the investigated drug. CONCLUSION: The study reveals that ethereal oils have secretolytic effects and also have a pharmacological effect on the mucociliary apparatus.
Adult↗
[Epithelialization of porous biomaterials with isolated respiratory epithelial cells in vivo].
Extensive tracheal defects after prolonged assisted ventilation, trauma or large resections in tumor surgery are a challenge in plastic and reconstructive surgery. Defects which cannot be satisfactorily repaired reguine near of an alloplastic tracheal replacement. Previous experimental and clinical experiences in the development of an alloplastic tracheal prosthesis have demonstrated that the main cause for failure is the lack of an epithelial lining of luminal surfaces and inadequate biophysical properties of the prosthesis. With the use of a cell-seeding technique tested in vitro on biomaterials epithelialization of tracheal prostheses can be tested in vivo. In animal experiments isolated respiratory cells were seeded into implanted tubular prostheses of porous polyurethane or expanded polytetrafluorethylene. Light and scanning microscopic investigations then showed the tendency of epithelialization to occur on the luminal surfaces. Vigorous squamous epithelium cell layers that were single and (predominantly) multiple layers were found. Differentiated cilated or mucous cells were not detected in any case. The present results have shown that epithelialization of incorporated porous implants is possible. The realization of usable tracheal replacement for clinical practice must still be tested in further experiments.
Animals↗
A new concept for reconstruction of atresias of larynx and trachea: lining of wound surfaces with autologous isolated respiratory epithelial cells.
A new method, first applied two years ago in our clinic, has proved to be reliable for achieving a rapid reepithelialisation of epithelial defects after scar removal inside the trachea. The defect is seeded with isolated respiratory epithelial cells harvested the day before from the ethmoid. Isolation of epithelial cells was achieved by keeping the mucosa in 0.25% trypsin buffer solution under room temperature for about 16 h. Afterwards, the epithelial layer was separated from the submucosa using small forceps and knife. Cells were then isolated by pipetting. For seeding the wound the surface was covered with silastic sheeting and the cell suspension then injected into the cleft between both of them. Cell distribution occurred by capillary attraction. The tracheal lumen was maintained by inserting a silastic stent for about three weeks. So far, 10 patients between 6 and 45 years have been treated in this way. In 4 patients the tracheal wall additionally had to be stabilized using rip cartilage. Only in one case above the tracheostoma, considerable scar formation occurred again requiring a second operation some months later. In 8 patients decannulation was meanwhile possible.
Adolescent↗
[Menière's disease. An analysis of clinical findings].
During a period of about 25 years 500 patients with Ménière's disease underwent treatment for their disease in the ENT clinic of the Charité Hospital in Berlin. In a long-term follow-up study of the course of the disease, 170 patients (80 female, 90 male) with a minimum duration of illness of 5 years could be registered. The detailed analysis based on differentiation of vertigo attacks, audiological and vestibular findings offered 3 different phases of the natural course of Méniére's disease: 1. Early phase: Vertigo attacks and fluctuating hearing loss mainly in the low-tone frequencies; 2. Chronic phase: Decrease of frequency and duration of attacks; 3. Late chronic phase: Hearing loss of nearly 50-60 dB and loss of vestibular excitability (caloric response, side difference ca. 50%). In consideration of neurological symptoms in the late chronic phase symptoms of Ménière's disease are changing into symptoms of vertebrobasilar insufficiency. The natural course of Ménière's disease and resulting therapeutical and diagnostical aspects require long-term therapeutic planning. An appropriate schedule is suggested.
Adult↗
Experimental in vitro and in vivo studies of epithelium formation on biomaterials seeded with isolated respiratory cells.
Extensive tracheal defects after intensive care medicine, trauma, or large resections in tumor surgery remain a major challenge in plastic and reconstructive surgery. Defects that cannot be satisfactorily treated by complicated and costly reconstructive techniques reveal a need for an alloplastic tracheal replacement. Recent experimental and clinical studies in the development of alloplastic tracheal prostheses proved that the lack of an epithelial lining on the luminal surfaces and inadequate biophysical properties and shapes of the prostheses were the main causes for failure of these prostheses. In this study a cell-seeding technique has been used. Adhesion, spreading, and differentiation of seeded mucosa cells on biomaterials in vitro were observed by scanning electron microscopy (SEM). Chemical properties and surface structure of the material influenced the differentiation process. Epithelium formation of incorporated tracheal prostheses was tested in animal experiments. Isolated respiratory cells were seeded into implanted tubular prostheses of porous polyurethane or expanded polytetrafluorethylene. Light microscopy and SEM showed the tendency of epithelium formation on the surface of the lumen. Vigorous cell layers, predominantly as multiple cell layers of squamous epithelium, were observed. Ciliated or mucus cells were not detected. It can be stated that the epithelium formation on incorporated porous implants is possible. Further studies of the stability and the differentiation process of the epithelium on such implants is needed before an introduction of tracheal replacements into the clinical practice can be considered.
Biocompatible Materials↗