Biomedical subjects
Publications and source records attributed to R Laskawi.
In the present study patients suffering from facial nerve palsy caused by a herpes zoster oticus were treated with aciclovir. After therapy all patients could be controlled via clinical grading system and electromyographic observations. Aciclovir therapy did not yield any results superior to those obtained with other forms of therapy presented in the literature.
In case of myoepithelial sialadenitis cytological diagnosis by fine-needle aspiration biopsy is not a reliable measure, because the typical islets of myoepithelial cells can be demonstrated by cytology in only 6% of cases. Since lymphocytic infiltrations dominate the histological aspect a cytological specimen that contains these cell elements, may be taken as an indication for the presence of myoepithelial sialadenitis if a sicca syndrome exists at the same time. If a non-Hodgkin lymphoma has to be suspected after cytology, this must be followed by a histological verification (despite the fact that this suspicion was unfounded in all the cases mentioned here), because it is well known that in myoepithelial sialadenitis there is a danger of transformation into a malignant lymphoma. By detailed anamnestic data, especially by mentioning an existing sicca syndrome, the clinician can help the cytologist in assessing his findings properly.
It is well known that the incidence of malignant lymphomas (non-Hodgkin type) is increased in patients with Sjögren's syndrome. The occurrence of malignant diseases was retrospectively studied in 62 patients. In the course of the disease two patients developed a non-Hodgkin lymphoma, one patient developed a transitional-cell carcinoma located in the nasopharynx and three patients developed a squamous-cell carcinoma located in the salivary glands. The large quantity of epithelial carcinomas seems to be remarkable, especially compared with the number of non-Hodgkin lymphomas. It might be possible that early surgical treatment of persistent or progressive swelling of the salivary glands helps to prevent the occurrence of malignant lymphoma in patients with known myoepithelial sialadenitis.
We found that thirteen per cent of all head and neck malignomas are malignant lymphomas. In 75% of these cases the Non-Hodgkin type could be found. The major salivary glands were involved by the lymphoma in 55% out of 104 patients. Paraglandular lymph nodes of the parotid gland were affected as well as intraglandular lymph nodes and the lymphoid tissue within the gland proper. The submandibular gland normally shows an involvement only with its paraglandular lymph nodes. Two thirds of the Non-Hodgkin lymphomas located in the salivary glands were low-grade. In case of clinical suspicion of a malignant lymphoma, fine needle biopsy is required for cytological diagnosis. However, surgery is mandatory for histological diagnosis, not as a therapeutic measure.
Explore the source record for details and available documents.
Tumour biopsies of 93 patients with head and neck malignancy were analysed by cytophotometry. Ploidy and the proportion of cells in S-phase were measured. Tumours were classified as proliferative if the S-phase fraction was greater than 8%; the rest were classified as being less proliferative. Proliferative tumours produce local and distant metastases earlier and more frequently, so that the proportion of cells in S-phase is of prognostic importance. The response to chemotherapy of irradiation was no different in either group.
Treatment of chronic recurrent parotitis was attempted in 12 patients by occlusion of Stensen's duct with a mixture of fibrin glue and gentamycin. This therapy failed to induce long-term improvement. It is recommended to undertake surgical intervention as soon as possible in all cases of progressive chronic recurrent parotitis.
We report a case of transient disappearance of contralateral blepharospasm following Edgerton-Wolfort's operation and attempt to explain it in neurophysiological terms.
Pretherapeutic staging is essential for the management of head and neck cancer. The diagnostic value of liver, brain and bone scanning was estimated by a retrospective study of 281 patients. Bone and liver scans are useful for detecting distant metastases from head and neck cancer. Brain scanning should be replaced by computed tomography, if there is clinical suspicion of intracerebral metastases. Nowadays ultrasound examination of the liver is more useful than liver scans. Thus, bone scanning remains the only radioisotope method used in the routine pretherapeutic staging of head and neck cancer. Chest X-ray, abdominal ultrasound examination and bone scans are adequate methods for the detection of metastases. The management of malignant lymphoma needs a special and more detailed diagnostic approach.
In a prospectively randomized trial, conduced jointly by the University ENT Department, Göttingen, and the ENT Department of Zentralkrankenhaus St.-Juergen-Strasse, Bremen, the therapeutic efficiencies of naftidrofuryl and pentoxifyllin, both in combination with a basic medication (cortison, dextran), were compared in 151 patients with sudden deafness. Evaluation of the results revealed a decisive influence of cardiovascular risk factors (particularly vascular diseases) on the outcome of therapy. There was no difference between naftidrofuryl and pentoxifyllin with respect to therapeutic success. Since further improvement was evident 6 months later, long-term treatment is recommended for either substance. The therapeutic success rate of our own treatment schedule is not higher than that of other therapeutic schedules given in the literature.
Electromyography of the larynx has been increasingly used during recent years in the diagnosis and differential diagnosis of laryngeal motility disorders. The method is routinely employed at the university ENT department in Göttingen. The qualitative experience gained with regard to the diagnostic and prognostic value of electromyography in the region of the larynx is described and compared with the results and experience reported so far in the literature.
Lymphocytic meningopolyradiculitis (Bannwarths' syndrome) is a tick-borne Borrelia infection of man. About 60 per cent of such patients exhibit a peripheral facial paresis whose characteristics are clinically not distinguishable from Bell's paresis. Of major importance for the diagnosis, besides the radicular pain that nearly always prevails, are particularly further motoric deficits, a previous erythema migrans and remembered thick bites. A tentative diagnosis can be verified by liquor examination which reveals a characteristic pattern of protein distribution and lymphocytic pleocytosis. Penicillin in high doses is the therapy of choice.
We report on our clinical experience with the so-called temporary injection of the vocal cords by means of gelatin paste (Gelfoam) application, performed on 24 patients. In a fairly high percentage of patients we noted a long-lasting positive result in respect of vocal performance, despite persisting vocal cord paresis. It is believed that in such cases the relatively slow absorption of the gelatin paste creates favourable conditions for spontaneous phonatory compensation.
The ototoxicity of cis-DDP (cisplatin) has been known for some time. It affects the outer and inner hair cells of the cochlea which are damaged. So far, the data laid down in the literature concerning extent and frequency of hearing defects differ widely. In the present study we analysed the ototoxic effect of cis-DDP in 124 patients with different types of carcinoma. We investigated a possible dependence of ototoxicity of the patient's age, the platinum dose, the manner of administration, and of the previously existing audiometric anomaly. In 48% of the patients studied we found a therapy-induced, dose-dependent hearing defect mainly at a high frequency range (4-8 kilohertz). Its degree is influenced by the mode of cisplatin application. The most serious hearing defects were caused by a dose of 100 mg per square metre body surface. The results of our investigations are discussed and compared with those of other clinical studies.
Following a general description of pathophysiological changes of an injured peripheral nerve, a survey is presented in which those electrodiagnostic tests that are of practical relevance today in cases of facial and recurrent nerve pareses, are defined and the methods used are described (electromyography, neuromyography, blink reflex, reflex myography of the larynx). Typical electrodiagnostic findings are explained and demonstrated, using examples from our own case material. The relative merits and diagnostic efficiency of separate and combined findings are discussed.
Nicergolin is used in the treatment of tinnitus, cerebral insufficiency, and sensorineural hearing loss. An increase of cerebral blood flow was observed after i.v. injection of Nicergolin (0.1 mg/kg). The effect of this drug on the inner ear was studied by measuring the DC potential and K+ activity in the endolymph. A rapid fall of the DC potential and hypocapnea were observed after the injection of Nicergolin (0.2 mg/kg). An increase of expiratory PCO2 (10-20 mm Hg) was also observed. Arteficial respiration with pure oxygen prevented the fall of the DC potential. The present investigation demonstrates that this drug primarily acts on the respiratory center with secondary PCO2 increase in the blood which then causes the dilatation of cerebral vessels. The fall of the DC potential after the injection of Nicergolin appears to be caused by hypoxia and not by direct effect on the inner ear.
The effect of the coil position along the interaural line on motor evoked potentials of lower-lip muscles to cortical transcranial magnetic stimulation was investigated in 17 healthy subjects. Using a figure-8-shaped coil, we observed ipsi- and contralateral middle-latency motor evoked potentials in all subjects, when the coil was centered within an area between 4 and 13 cm lateral to the vertex. Maximal responses (mean amplitude 1.4 +/- 0.8 mV contralateral, 0.7 +/- 0.5 mV ipsilateral) with shortest mean onset latencies (11.3 +/- 1.6 ms contralateral, 12.1 +/- 2.8 ms ipsilateral) were obtained at a stimulus position of 10 cm lateral to the vertex. Cortical maps of mean amplitude and mean response duration showed inverse U-shaped configuration. Furthermore, we observed an additional polyphasic and mostly bilateral response in 16 of the 17 subjects.
The cortical representation of the abductor pollicis brevis muscle (APB) was investigated by transcranial magnetic stimulation (TMS) along the interaural line on the head surface in 17 healthy subjects. Comparing amplitudes of motor evoked potentials (MEPs) with those obtained by cortical TMS of lower-lip muscles, we found a considerable overlap between the areas from which reproducible MEPs of APB and lower-lip muscles could be elicited. However, there was a statistically significant separation of the two areas, the APB area being placed more medially. With regard to short examination procedures it can be concluded that a separation between distal arm and facial muscles is possible not only by two-dimensional cortical mapping procedures, but also by one-dimensional cortical TMS.