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Biomedical subjects

P Herrmann

Publications and source records attributed to P Herrmann.

At least 19 recordsLinked to original sources
PubMed1991

[Fever, headache and paralysis of the left leg].

A 17 year old man was hospitalized because of fever, headache and a paresis of his left leg. Radiologic findings demonstrated a subdural interhemispheric empyema on the right side as a complication of ipsilateral pansinusitis. Streptococcus milleri was cultured as the only pathogen from maxillary sinus suppuration. Pathogenesis and therapy of subdural empyema are discussed. Cure was achieved with ceftriaxone, flucloxacilline and ornidazole during one week followed by ceftriaxone as monotherapy during further five weeks. The importance of streptococcus milleri as causing agent of purulent lesions in internal organs is stressed.

Adolescent↗
PubMed1990

Acute mastoiditis: clinical, microbiological, and therapeutic aspects.

The charts of 73 children (31 girls, 42 boys) aged 4 months to 14 years (mean 4.5 years) with acute mastoiditis managed during a 16-year period were reviewed. Of the patients 36% were less than 24 months old. Retro-auricular swelling was described in 63 of the 73 children, tenderness in 59, erythema in 58, and protrusion of the auricle in 45. A pathological tympanic membrane was noted in 33% of the patients and fever in only 29%. Apart from local inflammation, the most frequent complaints and symptoms were otalgia (n = 42), recent upper respiratory tract infections (n = 22), and fever alone (n = 22). A subperiosteal abscess was found in 36 patients, and CNS involvement in 5. Nearly half of the patients (48%) were on antibiotic therapy at admission. The isolation rates in bacterial cultures from subperiosteal aspirated (81%) and from mastoid mucosa (68%) were considerably higher than from blood cultures (14%) and were not influenced by previously administered antibiotics. Pneumococci (9/32) and Staphylococcus epidermidis (6/32) were the agents most often isolated. The incidence of the bacteria isolated from patients pre-treated with antibiotics differed from the incidence in patients not previously treated. In 24 patients (33%) the lesion healed with antibiotic therapy without mastoid surgery. Myringotomy and the insertion of a ventilation tube is indicated initially, if acute otitis media with effusion is found. In the absence of a subperiosteal abscess and of CNS involvement, a 48-hour trial of intravenous antibiotic therapy, directed also against staphylococci, is justified before mastoid surgery is considered.

Abscess↗
PubMed1988

Delayed type hypersensitivity (DTH) in anti-IgM-treated B cell-depleted mice: analysis of induction and effector phase.

The induction and the effector phase of murine delayed type hypersensitivity (DTH) were evaluated in mice treated from birth with anti-IgM antibodies; these mice had no mature B cells and could not produce an antibody response. To study the effector phase, long-term cultured cloned helper T cells were injected subcutaneously together with the specific antigen into the hind footpad of normal and B cell-deficient mice. Antigen-specific DTH responses assessed by the local swelling reaction 24 h after transfer measured against a particulate antigen (sheep red blood cells, SRBC) as well as a soluble antigen (ovalbumin, OVA) were unaffected by the absence of B cells. To study the induction phase of DTH, 3-day immune in vivo primed lymphocytes from normal or B cell-depleted mice were adoptively transferred by subcutaneous injection into the hind footpad of naive syngeneic recipients. B cell depletion did not affect the induction of cells capable of responding to SRBC; in contrast, the response to soluble antigen (OVA) was significantly reduced, suggesting that B cells or their products participated in the induction of a DTH response to a soluble antigen.

Animals↗
PubMed1988

Mast cell degranulation as a major event in the effector phase of delayed-type hypersensitivity induced by cloned helper T cells.

A kinetic study (0-72 h) was performed on the cellular composition of the exudate in delayed-type hypersensitivity (DTH) induced by the injection of cloned helper T cells into the footpad of C57BL/6J mice. In this model the reaction was maximal at 24 h, as assessed by local swelling. After an initial phase of inflammatory cell infiltration, we observed pronounced degranulation of mast cells, occurring at 15-19 h. Administration of antihistamines shortly before this time significantly inhibited the increase in footpad thickness at 24 h, suggesting mast cell mediators as a major cause of swelling in DTH. Furthermore, a new arrival of inflammatory cells, particularly eosinophils, was clearly correlated with mast cell degranulation. The latter, which might function to suppress local reactions, persisted as the only intact cell type after 48 h. Supplementary examination of peripheral blood smears showed successive peaks of neutrophils (at 3 h), monocytes (at 15 h) and finally eosinophils (after 20 h). These results suggest a local and systemic cascade in DTH which depends on mast cell degranulation for its full expression.

Animals↗
PubMed1988

[Normal values in rhinomanometry].

Despite various methods of investigation, there are few reports as to the normal values of nasal airway resistance. A total of 56 adult subjects free of any nasal disease underwent nasal airway resistance measurement using active anterior rhinomanometry according to the guidelines of the international committee on standardization of rhinomanometry. Inspiratory and expiratory resistance was measured before and after application of a topical decongestant spray. This test was reproducible in that 46 of the subjects underwent a second study with resistance values quite close to that of the initial measurement. The upper range of the total inspiratory nasal airway resistance was 0.45 Pa s/cm3 before and 0.3 Pa s/cm3 after decongestant administration. There was no statistically significant difference between the inspiratory and expiratory resistance measurements. No correlation could be made between nasal airway resistance, age, sex, height or weight.

Adult↗
PubMed1988

[Clinical comparison of 2 modern rhinomanometers].

Two rhinomanometers (the NR 6 manufactured by Mercury, Scotland and the Rhino-Comp manufactured by Cintec, Sweden) were tested and compared in five subjects. Both instruments are suitable for clinical use and produced equal measurements of nasal airway resistance. The Rhino-Comp device is easier to handle. Technical improvements would be desirable in both machines.

Airway Resistance↗
PubMed1987

The pathogenesis of maxillary sinus pneumoceles.

Pneumocele is a pathologically expanding, air-containing paranasal sinus most common in the frontal sinus. To our knowledge, only six cases of pneumoceles of the maxillary sinus have been reported so far; to these we add a seventh. The pathogenesis of pneumoceles has not been fully understood. It has been postulated that a one-way valve between the nasal cavity and the affected sinus leads to increased antral pressure and sinus expansion after nose blowing. By monitoring antral pressure through a transoral puncture, we demonstrated a one-way valve between the nose and the maxillary antrum. To our knowledge, this is the first verification of the trap-valve hypothesis.

Adolescent↗
PubMed1987

Spontaneous cerebrospinal fluid otorrhea.

Spontaneous cerebrospinal fluid (CSF) otorrhea is rare. We present four new cases and an analysis of the literature. Two distinct subtypes occur. Seventy-two percent of cases are the childhood type with congenital defects of the otic capsule. Meningitis, usually pneumococcal and frequently recurrent, occurs in 92% of these cases. CSF otorrhea follows myringotomy for a presumed serous effusion. The child usually has unilateral and sometimes bilateral absence of cochlear and vestibular function and commonly exhibits a Mondini deformity. CSF usually enters the inner ear through a dural defect in the lateral aspect of the internal auditory canal and exists through the oval window. Treatment should consist of stapedectomy and packing of the vestibule with muscle or subtotal petrosectomy. Twenty-eight percent of cases of spontaneous CSF otorrhea are the adult type characterized by bony dehiscenses, most commonly of the tegmen tympani or tegmen mastoideum and less commonly of the posterior fossa plate. The meningeal defects are either meningoencephaloceles or simply holes in the dura. Therapy should consist of a mastoidectomy in conjunction with a transtemporal supralabyrinthine (middle fossa) approach if a meningoencephalocele of the tegmen is found.

Adolescent↗
PubMed1983

[Melanotic ectodermal tumor of infancy (melanotic progonoma)--an unusual soft tissue tumor].

In rare cases an utmost uncommonly pigmented lesion is found in young infants which is mostly located in the anterior maxilla. The histogenesis of this unusual soft tissue tumor has provoked a long-lasting debate, which is reflected in many synonyms. There is no anatomical precursor and the possibility of a phylogenetic ancestral form is discussed. Therefore, the term melanotic progonoma was proposed. Because of the derivation from neural crest cells the designation melanotic neuroectodermal tumor of infancy was introduced. This name is now generally accepted. In this study, two typical cases of this rare tumor are described. The tumors are composed of large epithelial-like melanin-producing cells and small nonpigmented cells, so-called lymphocyte- like cells resembling neuroblasts. The diagnostic relevant histological pattern is characterized by intensely pigmented cells arranged either in strands or clusters often forming the lining of small cleft-like or tubular spaces, or by alveolar structures surrounded by a fibrovascular stromal component. At ultrastructural level, the pigment corresponds to the cutaneous type of neural crest type of melanin. The histogenesis of these lesions and the classification of pigmented benign and malignant neuroectodermal tumors of the soft tissues are discussed especially taking into consideration the concept of the soft tissue variant of melanomas. The melanotic neuroectodermal tumor of infancy is a benign growth Only in very few cases a fatal outcome is reported in the literature. The melanotic neuroectodermal tumor of infancy must be distinguished from other types of benign and malignant neuroectodermal tumors. From histological point of view and with regard to its biological behaviour this lesion is a particular entity of pigmented neuroectodermal tumors of the soft tissues, and for subclassification the term melanotic progonoma should be maintained, too.

Female↗
PubMed1980

Comparison of late results in patients with corrected intestinal malrotation with and without fixation of the mesentery.

Between 1940 and 1975, 86 patients with malrotation of the intestine leading to intestinal obstruction or volvulus were treated at the University Children's Hospital of Zürich. All case histories and radiograms have been examined and a questionnaire has been sent to all surviving patients. Forty-four of them were reexamined personally 3 to 37 yr later. The study was undertaken to find out whether at the time of correction of intestinal malrotation simultaneous additional fixation of the mesentery had any value. Six of the 86 patients were successfully treated nonoperatively and 3 died before surgery of other severe malformations. Of the remaining 77 children who underwent surgery, additional fixation was done in 28 of the earlier cases, but not done in 49 of the later cases. The percentage of early survivors was 85.7% in the group with intestinal fixation and 83.7% in the group without fixation. The number of reoperations was slightly lower in the group without fixation (10.4%) when compared to the group with fixation (16.6%). 25% of the children with intestinal fixation and 21% of the children without fixation had occasionally slight abdominal symptoms at a later time. These results demonstrate that intestinal fixation neither increased the number of early survivors nor reduced the number of reoperations, nor the percentage of children with abdominal complaints. It was therefore concluded that additional fixation after correction of intestinal malrotations was of no benefit and unnecessary.

Adolescent↗
PubMed1978

[A rare case of hyperodontia].

A rare case of hyperdontia is described to demonstrate that under favourable conditions supernumerary, normally formed teeth must not be extracted, but can be fully included in the planning of orthodontic treatment.

Adolescent↗