[1H and 31P MR spectroscopy of tumors of the head and neck].
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Acid-Base Equilibrium↗
Biomedical subjects
S Holtmann
Publications and source records attributed to S Holtmann.
Cervico-ocular eye movements in relation to different neck torsion velocities.
Rotation of the trunk with a fixed head causes isolated stimulation of cervical afferent input. Eleven patients with marked cervico-ocular reactions (COR) were selected. A neck torsion test (NTT) was performed with the help of a special apparatus. The resulting cervically induced eye movements consisted of two components. In addition to a cervical nystagmus, with its slow, compensatory phase, a deviation of the mean eye position (shift) in an anticompensatory direction, opposite to trunk rotation was observed. The COR in relation to different neck torsion velocities distinctly showed a tuning curve with maximum reactions between 4 degrees/s and 9 degrees/s. Above these values, a strong decrease in COR resulted. The optimal working range vastly differs from that of the vestibulo-ocular reflex (VOR).
Adult↗
[Quantifying the stimulus parameters in the neck torsion test].
Cervically induced eye movements can be observed when the trunk is rotated and the head fixed. In most test situations, rotating chair motion and head fixation are carried out manually. As a result, specific and non-specific sources of error are involved in these procedures that hamper the reproducibility of test conditions. A system is described that provides quantifiable and reproducible, electronically controlled movements of the rotating chair. Ramp and rectangular stimulus profiles are achieved by infrared optical gate devices on the chair axis. Various processor-controlled sequences of angular displacement and duration can be programmed and monitoring of chair movement is available to the operator during testing, which is otherwise performed in complete darkness. Individual casts of the upper jaw connected with a telescope wall clamp facilitate optimal head fixation. Since great caution is required when using an electronically controlled chair for such tests, and the possibility of damage to the vertebral column is increased by head fixation, several devices have been incorporated into the equipment to fulfil safety requirements such as release mechanism in the head fixation system, besides other safety devices. This system enables cervically induced eye movements which can be related to amplitude, acceleration and velocity of trunk rotation. The results are important for direction and extent of eye shifts, nystagmus and circular-vection.
Fixation, Ocular↗
[Preserving the accessory nerve in neck dissection].
A total of 104 patients who had undergone neck dissection were examined with respect to disturbance of shoulder function on the operated side. The accessory nerve had been severed in half the patients and preserved in the other half. A dynamo-meter was used to measure the force a patient standing upright could exert in pulling upward with his arm outstretched. The relative loss of strength after neck dissection was determined by relating the difference between the two sides to the strength of the healthy shoulder. On average, the loss of strength in the operated shoulder was significantly less after preservation of the accessory nerve than after its severance. An additional influence due to tumour stage or postoperative irradiation was not found. The functional loss determined by the difference quotient correlated well with the patients' subjective account of their functional impairment. Preservation of the eleventh cranial nerve is discussed with respect to the question of increased risk of lymph node recurrence.
Accessory Nerve↗
[Causes and treatment of seasickness].
Seasickness is usually induced by conflicting sensory cues. However, very little is known about the neural pathways and processes which play a role in the development of nausea. Since the symptoms, for example, pallor, sweating and vomiting are all of parasympathetic origin, the common antiemetic drugs are anticholinergically efficient. More recently, additional drugs and modified forms of application have been introduced to reduce the soporific side effects. It is pointed out that onboard behaviour and even choice of vessel can be of more importance than use of antivertiginous drugs. Besides attention to the individual adaptation to the atypical seagoing environment, simple behaviour patterns such as fixation on the horizon, avoiding of head movements and reduction of conflicting sensory cues can be very effective in reducing symptoms.
Antiemetics↗
[Work disability in peripheral vestibular disorders].
The circumstances prevalent in each particular line of work must be taken into consideration when examining for occupational disability. Peripheral vestibular disorders can be a source of danger to the patient himself and to those in his working environment, e.g. in traffic or on building sites. Some criteria for judgement on incapacity as related to the most important peripheral disorders are proposed. A further problem involves those cases with complaints of vertigo but whose responses to clinical testing appear normal. Such patients require a clear decision as to whether they are to be classified as occupationally disabled.
Disability Evaluation↗
[Dangers in the use of gas-sterilized materials].
After gas sterilisation of synthetic materials, some traces of the gases employed (ethylene oxide; formaldehyde) can remain in the sterilised material, and, in the case of moist materials, in drops of water. These gases are carcinogenic and, in case of contact to tissue, can lead to fibrinous inflammation and consequently to stenotising scars. Two cases of laryngotracheitis are described, in which insufficiently aired tracheal tubes were used. On contact with material containing chloride ions, e.g. PVC or body fluids, ethylene oxid can be converted to highly toxic ethylene chlorohydrine. For this reason, it is prohibited to sterilise synthetics containing chlorine ions with ethylene oxide.
Ethylene Oxide↗
[Dysontogenetic median maxillary cysts].
Nasopalatine duct cysts, median palatine cysts and nasoalveolar cysts belong to the developmental cysts of the upper jaw. They are situated at the midline in the fusion areas of embryonic facial processes and for this reason are known as "fissural cysts". They are, therefore, not of odontogenic origin and, on account of their relationship to the mouth, the nose and the nasal cavities, are of practical relevance to the otolaryngologist. The various clinical symptoms and the histological findings are described, and a review of the literature is presented.
Bone Cysts↗
[Frequent errors in neuro-otologic diagnosis].
A number of characteristic sources of error during the testing of vestibular function, originating from anamnesis, equipment and examination, are described. It is stressed that false-positive findings are often due to the influence of alcohol and that false-negative findings may be the result of tiredness or sedative drugs. With regard to the caloric test, it is recommended that water provides a better stimulus than air, and that the warm caloric stimulus is more valid than the cold caloric stimulus. Attention should be paid to the ENG-recorders, particularly to an adequate writing breadth, and to time constants. Different parameters in use for quantitative analysis of the intensity of vestibular reactions are discussed. If the findings are vague, repeated examination will often help to clarify matters. The regular use of Frenzel glasses is of great importance, since otherwise examination of the vestibular organs must be considered incomplete.
Alcohol Drinking↗
[Standardization of electronically evaluated Romberg tests].
A procedure is presented here permitting calibration of examinations recording postural changes. With the help of physical calibration a "posturographic unit" (PU) can be defined. "Biological" calibration is not only facilitated for shifting of the centre of gravity of the body, resulting in swaying, but also practically for all other parameters describing postural stability. The advantages of this method are demonstrated. It is pointed out that it is now possible to compare the results of various authors using different measuring devices.
Adult↗
[A simple measuring device for nystagmus amplitude. A contribution to rapid, exact and inexpensive evaluation of electronystagmograms].
Different parameters in use for quantitative analysis of ENG recordings are being discussed. Special importance can be attributed to the slow-phase velocity of the nystagmus and above all to the total amplitude. However, measurement of the total amplitude via digital computers is very expensive. Hence we present a device to measure amplitudes by means of a potentiometer. This is easy to handle, works accurately and is inexpensive.
Electronystagmography↗
[Modification of vestibular tests by alcohol].
Besides the positional alcohol nystagmus, PAN I and PAN II, alcohol in conventional doses causes marked side differences in experimental vestibular and oculomotor tests together with qualitative and quantitative alterations of the experimental nystagmus. These toxic, false positive results cannot be distinguished from post-traumatic central and peripheral pathological findings. When writing an expertise, we must therefore prevent a social insurance pension based on alcohol effects, by analysing the concentration of alcohol in the blood.
Adult↗
31P-spectroscopy of head and neck tumors--surface coil technique.
Comparative phosphorus-31 magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) of 15 patients with superficial masses such as sarcoma, carcinoma, lymphoma, adenoma, and tuberculosis revealed significant increased concentrations of phosphomonoester, phosphodiester, and inorganic phosphorus in the lesion, whereas the concentration of the phosphocreatine was lower in comparison to muscle tissue. In nearly all masses, pH showed a slight alkaline shift. Existence of necrotic regions detected by MRI was marked by an increase of inorganic phosphorous in the spectra. Tumor growth was characterized by raised concentrations of phosphomonoester. Follow-up studies in a case of lymphoma showed a six-fold decrease of the tumor, while the spectra indicated a gradual transition of tumor values to muscle values. A follow-up study during irradiation of a squamous cell carcinoma revealed a considerable decrease of inorganic phosphate and a subsequent increase of phosphodiester.
Adult↗
The anti-motion sickness mechanism of ginger. A comparative study with placebo and dimenhydrinate.
A controlled, double-blind study was carried out to determine whether nystagmus response to optokinetic or vestibular stimuli might be altered by some agent contained in powdered ginger root (Zingiber officinale). For comparative purposes, the test subjects were examined after medication with ginger root, placebo and with dimenhydrinate. Eye movements were recorded using standard ENG equipment and evaluation was performed by automatic nystagmus analysis. It could be demonstrated that the effect of ginger root did not differ from that found at baseline, or with placebo, i.e. it had no influence on the experimentally induced nystagmus. Dimenhydrinate, on the other hand, was found to cause a reduction in the nystagmus response to caloric, rotatory and optokinetic stimuli. From the present study it can be concluded that neither the vestibular nor the oculomotor system, both of which are of decisive importance in the occurrence of motion sickness, are influenced by ginger. A CNS mechanism, which is characteristic of the conventional anti-motion sickness drugs, can thus be excluded as regards ginger root. It is more likely that any reduction of motion-sickness symptoms derives from the influence of the ginger root agents on the gastric system.
Adult↗