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Biomedical subjects

U Koch

Publications and source records attributed to U Koch.

At least 145 records · Page 8Linked to original sources
PubMed1983

[Significance of tube manometry in the assessment of tube function. A comparison of tube manometry results and continuous direct determination of pressure in the middle ear].

Tube manometry--also known as aspiration-deflation-test--is an often used, practicable clinical test for tube function. By comparing tube manometric results with continual measurements of the middle ear pressure, a close correlation between both test results could be demonstrated. Tube manometric tests thus permit an estimation of the tube function as well as of the probable development of the middle ear pressure. An exact classification in terms of physiologic and pathologic tube function, however, is not possible. It is clear that even a partial equalization of low-pressure values in tube manometry should be interpreted as physiologic.

Ear, Middle↗
PubMed1983

[Comparison of active foreign flow rhinomanometry (oscillation method) and active personal flow rhinomanometry in 17 patients before and after correction of the nasal septum].

The nasal resistance of 17 patients with nasal septum deviation was measured before and after septum correction using two active rhinomanometric methods; the one with external flow (oscillation method), the other with spontaneous flow. Both methods correlated closely (p less than 0.01). The oscillation method proved to be as reliable and sensitive as the spontaneous flow method and less strenuous for the patient. Conventional rhinomanometric methods have failed especially in children because of their great demands on the patient's compliance; thus the oscillation method serves to increase the clinical application of rhinomanometry.

Airway Resistance↗
PubMed1983

[Photodocumentation of intra-arterial infusions using fluorescein].

Intra-arterial chemotherapy was given to 12 patients with Head and Neck tumours with the aim of selective perfusion of the tumour area, usually located in the area of supply of the lingual and/or facial artery. A catheter was inserted retrograde into the external carotid artery. The skin or mucous membrane area thus selectively infused by the antineoplastic drug and fluorescein solution could be controlled and documented using an excitation- and barrier filter. Serial photographs were used to demonstrate the higher fluorescence in the perfused area during the intra-arterial infusion lasting 60 or 90 minutes. The use of a balloon catheter increased the selectivity of the fluorescent region. At the end of the infusion the fluorescence disappeared rapidly. From our findings we conclude that it is possible to produce a selective higher concentration of a substance in the tumour during the intra-arterial infusion.

Catheterization↗
PubMed1983

Should treatment of highly differentiated thyroid carcinoma be conservative?

On the basis of three selected cases (one with clinically occult follicular and two with metastatic papillary carcinoma) the necessity of a comprehensive therapeutic concept even in highly differentiated thyroid cancer is stressed. Thyroid tissue and regional metastases should be eliminated by surgery, followed by radioiodine therapy in any event. Radiation teletherapy should be reserved to patients with invasive tumor growth exceeding the organ capsule, with lymph node metastases, and with massive angioinvasive growth.

Adenocarcinoma↗
PubMed1983

[Malignant otitis externa].

Malignant otitis externa represents a special form of inflammatory alteration of the external ear. The inflammation can spread to surrounding bones (temporal bone, skull base - to the foramen magnum), as well as to neighbouring tissue, such as the parotid gland, the temporo-mandibular joint and soft tissue near the skull base. Most patients are elderly, latent or manifest diabetics. The causative organism was always proved to be Pseudomonas aeruginosa. The disease is called "malignant" because of its high mortality rate. Decreasing this mortality is possible - as demonstrated in 6 patients - via early diagnosis, sufficient surgery, as well as local and systemic antibiotics.

Adult↗
PubMed1982

[Intra-arterial chemotherapy as a part of a combination-therapy in carcinoma of the oropharynx].

Since 1973 75 patients with carcinoma of the oropharynx were treated with regional cytostatic chemotherapy as an initial step of a combined therapy which consists of an follow-up operation and/or radiation. Methotrexate was used in intraarterial short infusions with Leucovorin rescue. The tumor response to i.a. chemotherapy was definite in 80% of the cases, without any negative side effects in the patients who are usually in a reduced general condition. After i.a. chemotherapy to reach a partial remission of the tumor and to create better conditions for the following therapy, we always tried to perform an operation and radiation. With this combination-therapy we reached, in the 1 year NED results as well as in the 3 year survival rate, with 60% resp. 54% better results than in patients who were only radiated after i.a. chemotherapy (43% 1 year NED results resp. 43% 3 year survival rate). A chemotherapy of oropharynx carcinoma is only justified, if other therapy forms follow up, if possible, composed of an operation and radiation. Because of the high rate of response of tumors seen in our patients, the low rate of side effects and the noticeable remission of the tumor-caused complaints it seems to us that the i.a. infusion therapy with methotrexate is a suitable form of chemotherapy for carcinoma of the oropharynx.

Antineoplastic Agents↗
PubMed1982

[X-ray-findings in intra-arterial chemotherapy of tumours of the head and neck (author's transl)].

On the basis of x-ray-findings in 70 patients with tumours of the head and neck, who had intraarterial chemotherapy the authors demonstrate the varying approaches to an indirect catheterisation of the external carotid artery. Paying due attention to possible complications arising from i.a. catheterisation, they stress the need for x-ray checks of the correct position of the catheter before commencement of intraarterial chemotherapy.

Angiography↗
PubMed1981

[Intraarterial chemotherapy in carcinomas of the oral cavity, oro- and hypopharynx (author's transl)].

Intraarterial chemotherapy using Methotrexate (MTX) was applied on 128 patients with carcinoma of the head and neck. If possible, the operation was performed followed by radiation, including cervical lymph nodes after initial chemotherapy. The aim of i.a. chemotherapy is to realise a partial remission of the tumor mass so that better conditions are available for the following operation respectively radiation. The 1 year NED results and the 3 year survival rate show an improvement in comparison with published results, including the regional lymph nodes metastases. This is especially the case when chemotherapy is followed by the operation and radiation. The tumor mass and in many cases the regional lymph nodes were reduced and subjective complaints were lessened. -- The additional i.a. chemotherapy with MTX seems to us justified, especially because of the low complication rate, although it is no substitute for radiation and surgery.

Humans↗
PubMed1981

[Morphological and cell kinetic investigations on squamous cell carcinomas of the oropharynx under intraarterial therapy of methotrexat and irradiation (author's transl)].

To examine the effect of methotrexate therapy and irradiation morphological and cell kinetic studies were performed on squamous cell carcinomas of the oropharynx at the begin, the middle and the end of therapy. In the incubated biopsies the morphological pattern especially the proliferative activity of the carcinomas under therapy and after estimation of the mitotic index changed not significantly. However, the cell kinetic analysis by in vitro autoradiography with tritiated thymidine showed a continuous decrease of the labeling indices of tumor cells. These cell kinetic results were in good agreement with the clinical findings and supported a good response of squamous cell carcinomas on intraarterial methotrexate therapy as well as on irradiation.

Carcinoma, Squamous Cell↗
PubMed1981

[Closure of recurrent perforations of the tympanic membrane by means of cialit-conserved fascia and human fibrin tissue adhesive (author's transl)].

In 20 patients with recurrent perforations of the tympanic membrane after tympanoplasties the membrane defect was closed by using cialit-conserved temporal fascia and human fibrin tissue adhesive. The defects differed in size from 2 mm up to a subtotal defect. In 19 cases there was increasing vascularisation from the perforation margins towards the transplant centre after 4 weeks. After 8 weeks the connection between the transplant and the surrounding tissue was so tight that tympanometry could be performed using pressures up to 300 mmWS without any damage. Only in 1 case there was an infection. We had to remove the transplant. In comparison with the method of using only human fibrin tissue adhesive to close recurrent perforations, this method has the advantage that even bigger perforations of the tympanic membrane can be closed. The number of recurrencies of perforation also is lessened.

Fascia↗
PubMed1981

[Treatment in cases of retractions of the tympanic membrane, adhesive processes and middle ear effusions with the inert gas sulfur hexa fluoride (SF6) (author's transl)].

The inert gas SF6(Sulfur Hexa Fluoride) is resorbed very slowly by the middle ear mucosa. After insufflation of SF6 into the middle ear in cases of retraction of the tympanic membrane, respectively atelectasis, and in beginning adhesive processes after tympanoplasties, pathologic negative pressure, and the retraction of the tympanic membrane can be equalized for at least 6 weeks. A precondition for this treatment is an intact tympanic membrane besides the tube dysfunction. So a temporary tube dysfunction with all its negative effects to the middle ear can be bridged. In some cases this method is successful over a long period. In the other cases the gas insufflation with SF6 can be repeated. Also in the treatment of serous middle ear effusions in adults and in cases of tinnitus caused by middle ear diseases SF6 can be helpful.

Ear Diseases↗
PubMed1981

[The tasks of a rehabilitation psychology in teaching, services, and research (author's transl)].

The first Chair of rehabilitation psychology established in the Federal Republic of Germany was started at the Institute of Psychology of Freiburg University in the 1979/1980 winter semester. On the basis of the conviction that interdisciplinarity constitutes a fundamental requirement for work and research in the rehabilitation field, the author discusses the tasks of rehabilitation psychology, and its relationship with medical and vocational rehabilitation. The working conditions faced by psychologists in the rehabilitation facilities as well as the preparation they hitherto used to receive during their studies for work in the rehabilitation field, are criticised. The curriculum developed in Freiburg for "rehabilitation psychology", as one of the fields of applied psychology included the studies for a university degree in psychology, is explained. Further, the new department's service delivery functions and intended research are presented.

Germany, West↗
PubMed1981

[Late laryngeal and tracheal complications after prolonged naso-tracheal intubation (author's transl)].

The causes, incidence and means of preventing sequelae (late complications) after long-term intubation are discussed and the literature is reviewed. 6 of 353 surviving patients with neurosurgical disorders required treatment following prolonged intubation. The incidence of subglottic and tracheal stenoses was 1,14 per cent and of other laryngeal damages was 1,13 per cent. The primary disorder and unfavourable conditions attending its treatment appear to be responsible for the complications.

Adolescent↗
PubMed1981

[First experiences with a new method of intra-arterial chemotherapy in tumours of the head and neck (author's transl)].

The article reports on the use of a new catheter in intraarterial infusion therapy of head and neck tumours. A balloon catheter is inserted into the external carotid artery so that the catheter tip is positioned at the juncture of the artery which provides the blood supply in the tumourous area. Through temporary blockage of the balloon, selective perfusion of the tumour artery with cytostatic drugs is possible. In 10 patients with squamous cell carcinoma of the oral cavity this catheter was used, and the possibilities of this method of selective perfusion explored in contrast to the conventional procedure practised so far.

Angiography↗
PubMed1981

[Postoperative epitympanic retraction in cases of cholesteatomas (author's transl)].

Patients with epitympanic cholesteatomas, where the intact canal technique was performed, were observed over 5 resp. 6 years following surgery. While in 27 out of 55 patients a new epitympanic retraction of the tympanic membrane was found, only in 4 cases in these pockets a cholesteatoma developed. This, including the residual cholesteatoma, represents the most important postoperative complication. In tube pressure equalization test we found in 43% of the patients tested an almost normal tube function; in the other patients the tube function is impaired to a varying extent. According to our test results postoperative retraction pockets develop independent of tube function. Even in normal tube function, inserted grommets or perforations of the tympanic membrane - where a sufficient aeration of the middle ear is secured - retraction pockets of varying dimensions may develop. Factors which support the formation of postoperative epitympanic retraction pockets and the part of the tube function are discussed.

Acoustic Impedance Tests↗