Biomedical subjects
Publications and source records attributed to R Fikentscher.
Based on the experience of the Olfactogustometry Laboratories in Halle and in Poznan, a proposal of clinical terminology and systematization of smell and taste disorders has been presented. Individual interpretation of the data from anamnesis in relation to the findings of the olfactogustometric investigations were stressed as indispensable.
Out of oxyfedrine++ side effects known up to the present (mild agitation, stupor, heat sensation, pains in the epigastrium++, skin allergy) 24 cases of ageusia appearing usually after 4 weeks of treatment with oxyfedrine++ were presented. Disturbances of taste are found to be unpleasant for patients, and result in remarkable exacerbation of their general feeling. The complaints subside completely after finishing treatment, and the time of taste disorder withdrawal is prolonged according to the time of oxyfedrine++ treatment.
Taste thresholds were investigated by means of chemical and electric stimulation in order to prove the induction of taste disturbances by chrome dust. There were examined 46 persons with exposition by potassium bichromate, chromic acid and zinc chromate, 19 of them working under conditions of a lower chrome exposition level but 27 of them working under conditions of a higher chrome exposition level. We could find a increasing threshold in taste qualities "sweet", "poor", "salty" and "bitter" corresponding to an increase of chrome exposition on the one hand and likewise of electric stimuli on the other hand. The quantity of chrome exposition must be regarded more important than its quality and its duration. Finally we want to recommend the appliance of always as electrogustometry as chemogustometry for occupational taste investigations because both the methods seem to differ somewhat.
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Olfactometric fitness examinations in relation to the place of work are required since the olfactory organ has support and protective functions. Smelling disorders result at work from trauma, hypersensitivity, acute and chronic intoxications, but most frequently from chemical and physical substances taken up by inhalation. They are different due to their expression (slight hyposmia till to anosmia, parosmia), latency, localization (respiratory, epithelial, nerval, central), and a combination with other disorders. In order to examine rhinologically the patient, the nasal mucosa has to be assessed. Its lesion does not necessarily correlate to the smell disorder. 475 patients were exposed to a total of 10 different substances or classes of substances. It was demonstrated that disorders of the whole nasal physiology can be caused by toxic and nontoxic substances, e.g. calcium carbide when taking effect for a longer period, even below their legally required "maximum absorption concentration". The treatment is started after ending the exposition. The expert's opinion is based on the clinical findings, a standardized investigation of smelling, the patient's history incl. the history of occupation, and an analysis of the place-of-work conditions. The degree of bodily defect is related to the single types of disorder. In case of a complete anosmia it is 20%. It is assumed that a growing number of occupation-related smell disorders become known and, hence, have to be assessed.
The smell and taste disorders are defined in terms due to two principles - the type and site of lesion. The quantitative dysosmias (anosmia, hyposmia, hyperosmia) correspond to the quantitative dysgeusias (ageusia, hypogeusia, hypergeusia) and the qualitative dysosmias (parosmia, pseudo-osmia, phantosmia, agnosmia) correspond to the qualitative dysgeusias (parageusia, pseudogeusia, phantogeusia, agnogeusia). Due to the site of lesion we can differentiate between respiratory, epithelial, combined, neural, and central dysosmias as well as epithelial, neural, and central dysgeusias. Typical examples are demonstrated, denying other classifications and terms as not precisely enough or negligible ones.
At the examination of 55 children from a regular care group suffering from asthma bronchiale by an ENT-specialist, in two third of them pathological findings demanding treatment were found. Since the majority of the findings remained clinically silent, the need of co-operation of ENT-specialist and pediatrician is obvious. According to our results, one single examination as it is usually done routinely at the onset of the disease is not sufficient.
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In 20 patients with a heavy overweight in the course of a fasting cure at 5 different moments gustation tests were carried out: in satiated state, in the acute fasting state and during the building-up phase. It could be proved that the thresholds in the acute fasting state are significantly lower than in the satiated state. Also in the building-up phase this tendency is pointed at. An efferent influence on the receptors evoked by hunger is discussed as cause. A direct relation between the change of the gustation sensitivity and individual metabolic parameters did, however, not develop under the experimental conditions given.
The paper proposes the definition and technical terms with greater precision for the description of qualitative smelling disturbances. Thereafter, parosmias are relevant only for the ENT specialist. Their further classification seems to be unnecessary or even false. These parosmias are always described to be troublesome for the patient since he feels the abnormality of the olfactory sensation. Thus, a clear distinction against phantosmias (olfactory hallucinations) and pseudoosmias (olfactory illusions) is given. The cause of parosmias is frequently speculative. Most frequently there occur traumas and influenza. Their treatment is equally the same as in postinfluenza hyposmias. Additionally, the dripping of 4% novocaine or 10% cocaine on the olfactory mucosa is performed. The parosmia is defined to be an independent entity of disorder, not only accompanying hyposmia. The parosmia may occur separately, too, and it does not necessarily recede together with hyposmia and anosmia.
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A flexible silicone-rubber suturamide retention tube, the procedure of intubation and special instruments for the repair of persistent congenital nasolacrimal duct obstructions are described. The results of the treatment of 8 infants are discussed. With the exception of one functional failure, the very good results are due to the histological compatibility and flexibility of the silicone-rubber suturamide tube and its careful introduction. This technique is not indicated if there are osseous anomalies of the nasolacrimal canal and a functionless ectatic tear sac. Then, and in the case of restenosis, an external dacryocystorhinostomy after Toti ought to be performed.
345 patients with Bell's palsy showed that the curing results get worse with increasing age. The analysis of a 3-dimensional contingency table shows that neither a worse recovery nor a worse starting point can explain this fact. Each of these influences points to only a weak but not significant tendency. Only both together exhibit such a clear relation.
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The treatment-surgery and irradiation- of 722 patients with cancer of the larynx in the years 1940-1969 are being statistically evaluated. The classification was done accordingly to localisation, stage (TNM-system) and the kind of therapy. The evaluation of the results only considers the 5-years-healing. Surgical therapy and primary irradiation were confronted. The irradiation ranks equally to surgery only at stages I and II of the carcinoma of the vocal cords. Tumors at other localisation or at a different stage (III and IV) can only be successfully treated by surgery.
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