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Biomedical subjects

U Koch

Publications and source records attributed to U Koch.

At least 163 records · Page 9Linked to original sources
PubMed1981

[The importance of nasal provocation and rhinomanometry (author's transl)].

The diagnostic investigation of allergic rhinitis requires nasal provocation. Subjective signs of such an allergy are secretion, irritation (itching and sneezing), and swelling of the nasal mucosa. Mainly the latter can be determined objectively, by measuring the change in nasal airway resistance using rhinomanometry. We shall discuss the current method which is especially suitable for determining nasal allergies in children. The results of 69 allergic and 22 healthy subjects investigated with the oscillation method will be presented.

Adult↗
PubMed1981

[The influence of transtympanal gas insufflation on the tympanogram. Studies in cases of retracted or adhesive tympanic membranes and in middle ear models (author's transl)].

Transtympanal insufflation of the inert gas SF6 in cases of atelectasis mostly makes the atrophic tympanic membrane shift lateral, thus reaching a better functional position. The pathological tympanogram may become almost normal after insufflation. Model studies show that this is not only caused by equalisation of possible negative pressures but also by the enlargement of the middle ear volume and the improved position of the tympanic membrane.

Absorption↗
PubMed1980

[The influence of tympanoplasty and middle ear aeration on tubal function in chronic middle ear disease (author's transl)].

Eustachian tube dysfunction could be demonstrated in 2/3 of our patients with chronic middle ear diseases (inclusive of central perforations, tympanic membrane retractions, adhesive otitis and cholesteatoma). In 68 patients with grommet tubes placed at surgery, Eustachian tube function was followed over a period of three years by using a pressure-equalization test. Four months after surgery, only a few of the patients with impaired tube function showed any improvement of function. Prolonged ventilation through the grommet was not found to have any significant effect on tubal function. In patients with impaired Eustachian tube function--especially when the tube cannot be opened by forced pressurizations--the development of negative middle ear pressures must be expected if existing tympanic membrane perforations are closed. This is considered to be one of the important causes for the high rate of failure following tympanoplasties. Reducing this rate can possibly be achieved by the use of grommet tubes at time of surgery, thus securing ventilation of the middle ear. In addition, radical mastoidectomy should be considered in comparable patients with cholesteatomas.

Eustachian Tube↗
PubMed1980

[The adhesive process. Part II: Research on pathogenesis (author's transl)].

In adhesive middle ears the rate of recidives after operation is very high - irrespective of the tube function (part I). This may be caused by changed middle ear pressure and other pressure determinating factors like the tube function, the elasticity of the tympanic membrane, the volume of the middle ear space and gas diffusion. Registration of the tube function by pressure equalisation test as well as the direct, continous measurement of the middle ear pressure shows, that in 30-40% of the patients examined, a physiological tube function with normal pressure was found before and after tympanoplasty. In model studies we could demonstrate, that even in normal middle ear pressure tympanograms may be achieved, which are typical for adhesive processes, with a peak in the negative pressure area. The volumes of the middle ear spaces after tympanoplastics are larger (4,3 ml on an average) then preoperatively, but smaller than normal. Continuous registration of the middle ear pressure shows that in adhesive middle ears that development of negative pressure is diminished - compared with a collective of patients with normal elasticity of the tympanic membrane. This difference can only be explained by decreased elasticity of the membrane, found with adhesive processes and after tympanoplatics. Recidives after tympanoplastics in atelectatic ears may be caused by the development of negative pressure due to tube dysfunction. In cases of normal tube function (30-40% of the patients) and normal pressure, the rate of recidives is mostly caused by decreased elasticity of the tympanic membrane together with the smaller volume of the middle ear spaces.

Acoustic Impedance Tests↗
PubMed1980

[The adhesive process. Part I: clinical results (author's transl)].

In 71 patients with adhesive processes the development and rate of recidives after tymplasty is studied by clinical and tympanometric observation. The typical tympanogram in adhesive processes is flattened with a peak in the negative pressure area. Initially after tympanoplasty permanent aeration was secured by grommets. When these came out and the tympanic membrane was closed, most of the cases showed almost normal tympanograms. Within 3 months in most cases the preoperative tympanogram re-developed, regardless what the tube function was like. The typical peak in the negative area must not necessarily be caused by negative pressure in the middle ear - as we could demonstrate in model studies. These results correspond closely to the clinical findings. The enlargement of the middle ear cavity by tympanoplastics can only be obtained by permanent aeration. When the tympanic membrane is closed - regardless of the tube function - often new retractions occur, which can easily lead to recidives of the adhesive process. Hearing tests showed close correlations to the tympanometric findings. Hearing is improved as long as the grommet secure permenent aeration; when the tympanic membrane is closed, it may become worse during a very short period. Correlations between hearing and the mobility of the tympanic membrane and ossicles in adhesive processes could be shown in the tympanoaudiogram.

Ear Diseases↗
PubMed1980

[Measurement of nasal resistance using the oscillation method (author's transl)].

The nasal resistance of 15 healthy subjects aged 12 to 45 years was measured using the spontaneous flow method (Rhinomanometer A 440) and a new variation of the external flow method, namely the oscillation method (Siregnost FD-5). The results of both types of methods were so similar, that the methods can be interchanged for one another. In comparison to the spontaneous flow method, the oscillatory external flow method has the advantage of being simpler to carry out. In addition, there is little stress to the patient that it is especially suitable for children.

Adolescent↗
PubMed1979

Problems in interaction between patients undergoing long-term hemodialysis and their partners.

186 patients undergoing hemodialysis and their partners were examined with a personality inventory (Giessen test) and a questionnaire which was specially developed for this purpose. The instrument was used to measure the social interaction between patient and partner. The Giessen test was applied in four versions: self-description, description by the partner, referring to the present, referring to the past. One of the main interests of the analyses was in finding dependencies of the variables upon the types of hemodialysis setting (unit, private unit, and at home). Various correlations were found.

Dominance-Subordination↗
PubMed1979

[Direct continuous measurement of middle ear pressure: method and clinical results (author's transl)].

Method (part 1): A method for the direct measurement of the middle ear pressure for clinical use is introduced. This method allows continuous pressure registration in the normal and pathological middle ear. The determination of the parameters influencing middle ear pressure like volume of the middle ear cavity, gas resorption, tube function is possible. The influence of body movement, changes of temperature etc. on the middle ear pressure can be registrated. The precondition for this method is a tube in the tympanic membrane. Clinical results (part 2): In 42 patients pressure development in physiological tube function and dysfunction, in patulous Eustachian tubes and tube obstructions can be registrated. The volume of the middle ear cavities and the increasing negative pressure because of gas resorption can be analysed with this method. In obstructed tubes different development of negative pressure may indicate differences in the elasticity of tympanic membranes. This method gives valuable criterion on middle ear pressure changes considering parameters like gas diffusion, tube function, cavity volume and membrane elasticity in normal and pathological middle ears.

Catheterization↗
PubMed1979

[Changes of tube ventilation after nasal septal reconstruction and turbinotomy (author's transl)].

The influence of endonasal operations on tube dysfunction was examined. Because of rhinomanometric proved reduced ventilation a nasal septal reconstruction, in some patients combined with turbinotomy, was performed. Before the operation and then up to two years after the operation tube function was registrated using tube manometry. Compared with the praeoperative results 12 patients out of 37 showed an improvement in tube function. After the operation 7 out of 28 patients were able to provide active equalization of a negative pressure in the middle ear and thus required the ability for physiological middle ear ventilation. In some cases the optimal tube manometric results were achieved not before the end of the observation period of two years. This investigation leads to the conclusion that in cases of reduced ventilation a nasal septum reconstruction should precede a tympanoplasty in order to improve tube function. An improvement of tube function only by permanent ventilation over a period of 2 years can not be obtained, as could be proved by statistic analysis.

Deglutition↗
PubMed1979

[Problems of autologic incus interposition in cholesteatoma operations (author's transl)].

Our clinical study proves whether or not the warning is justified not to reimplantate autologic ossicula in cholesteatoma operations in order to avoid recidives. After interposition of the autologic incus in 18 patients we found cholesteatome recidives--originating from the incus--in two cases. According to histological studies, even the most careful preparation cannot avoid that some cells of the epithelium remain on the ossicula, from which a cholesteatoma recidive may develop. Clinical studies show rather low rates of recidives compared with the histological findings. Possibly remaining squamous epithelium cells in autologic ossicles need not always cause recidives. Clinical and histological studies lead to the demand that because of the possibility of cholesteatoma recidives autologic ossicula should not be reimplated in cholesteatoma operations.

Cholesteatoma↗
PubMed1979

[Hereditary combination of branchial fistulas and middle ear malformations (author's transl)].

Four cases with hereditary combinations of branchial fistulas and middle ear malformations in three generations of one family are reported. We found preauricular fistulas and lateral cervical fistulas combined with different types of middle ear dysplasias. In one case a preauricular fistula running through the middle ear and ending in the dura could be exstirpated. Such rare varieties must be considered, when preauricular fistulas are found together with congenital middle ear deafness.

Abnormalities, Multiple↗
PubMed1978

[On a case of a repidly proceeding lethal intoxication due to n-propylajmalium bitartrate (author's transl].

A case of N-Propylajmalinum bitartrate intoxication (Neo-Gilurytmal) is reported in which the death occurred within 20 minutes after the consumption of the drug. The quantitative estimation of the drug after isolation using Extrelut--columns was carried out in stomach spectrometrically, in the blood, bile, liver, kidney, and brain by gaschromatography after trifluoroacetylation. A high Prajmalium-bitartrate concentration was found in the blood (3,85 mg/l), negative results in bile and brain, low levels in liver (0,29 mg/kg wet weight) and kidney (0,06 mg/kg wet weight). Prajmalium-bitartrate was ingested together with beer, and a blood alcohol concentration of 0.061% was determined. Furthermore, a quantity corresponding to six tablets of Neo-Gilurytmal was still found in the stomach. The rapid fatal progress of the intoxication is explained as a strong effect of the drug on the heart due to the alcohol accelerated resorption of the substance.

Adult↗
PubMed1978

[The pathogenesis of the secondary adhesive processes. A clinical and experimental study (author's transl)].

According to the clinical experience the rate of relapses in operated adhesive processes is very high. We found tympanic pressure to be normal in one third of the cases, therefore the impaired tubal function cannot be the only reason for relapses. With a special method we could demonstrate that there is a great difference in the development of tympanic pressure in cases of operated adhesive processes compared with cases with normal elasticity of the tympanic membrane. So changes of the elasticity may be an important factor influencing the rate of relapses. We could support this conception using models for tympanometric experiments.

Ear Diseases↗