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Biomedical subjects

W Stoll

Publications and source records attributed to W Stoll.

At least 55 records · Page 3Linked to original sources
PubMed1999

Effects of alcohol on body-sway patterns in human subjects.

The vestibulospinal aspects of vestibular function are commonly neglected in the evaluation of alcohol-induced intoxication. Thus, in the present study the effect of an acute intoxication with a low or moderate quantity of alcohol was examined with respect to the equilibrium in 30 healthy subjects. The blood alcohol concentration (BAC) was measured 30 min after the ingestion of the last alcohol, ranging between 0.22 and 1.59 per thousand. Stability of stance was quantified by static platform posturography in Romberg-test conditions with eyes open and eyes closed. Among other parameters, the average body sway path (SP) and area of body sway (SA) were assessed. Posturography revealed a significant increase in body sway. There was a positive correlation between SA (or SP) and BAC both with eyes open and eyes closed. Multiple group comparisons revealed that the large-alcohol-dose group (BAC > or = 1.0 per thousand) could be clearly differentiated from test cases with BAC lower than 0.8 per thousand. Sway area was the most sensitive parameter for detecting increased body sway after alcohol ingestion. The area increase, present not only with eyes closed but with eyes open, revealed an inadequate compensation of the ethanol-induced ataxia by visual stabilization. The Romberg's quotient, which denotes eyes closed relative to eyes open, remained constant. The increase in sway path with eyes closed showed an omnidirectional sway. A comparison of the sway pattern of subjects after acute ethanol ingestion with the data of patients with permanent cerebellar lesions suggested that the acute effect of alcohol resembles that of a lesion of the spinocerebellum. This finding contrasts with earlier studies, which postulated an acute effect of ethanol resembling that in patients with an atrophy of the anterior lobe of the cerebellum due to chronic alcohol abuse. In seven cases of the lower dose group (BAC < or = 0.8 per thousand), a reduction in body sway after alcohol ingestion was observed. This finding may be consistent with a dose-related biphasic action of alcohol, which - besides its well-known depressant effects with high doses - also shows stimulatory action with small doses.

Adult↗
PubMed1999

[Nasal T-cell lymphoma as a differential diagnosis of the midline granuloma syndrome].

BACKGROUND: The lethal midline granuloma is a heterogeneous disorder and the pathogenesis is likely to be complex. Advances in immunocytochemical phenotyping and molecular genetics suggest that in several cases the origin have been proven to be malignant lymphomas, especially of T-cell lineage. PATIENT: The present clinical and pathological cases of a 35-year-old woman shows how difficult it is to establish the precise diagnosis of lethal midline granuloma (LMG). The patient presented with recurrent infections of the paranasal sinuses. Later she developed infiltrates and ulcerous lesions of the nose, paranasal sinuses, and the base of the skull clinically consistent with a LMG. Immunohistologic studies using monoclonal antibodies led to the positive diagnosis of peripheral lymphoma of T-cells. RESULTS: Several surgical interventions and explorations revealed a diffuse infiltration and partly necrotic lesions of the tissue. After identification of a T-cell lymphoma by histological examination, the patient received megavoltage irradiation of 45 Gy. Additional chemotherapy with alkylating agents was given. Two years after treatment the patient achieved and remained in remission. CONCLUSION: The midline granuloma syndrome is a mutilating process produced by a number of diseases that progressively destroy the nose, paranasal sinuses and other regions of the midface. Infectious, neoplastic and idiopathic forms have been described. The specific diagnosis must be ascertained, as the treatment is different depending of the etiology of the disease. Sinonasal lymphomas constitute a important distinct clinicopathologic entity which may present as lethal midline granuloma. They seems to be strongly associated with Epstein-Barr virus. Aggressive therapy with radiotherapy and chemotherapy can stop the progress of the midfacial destruction. The correct treatment is still discussed controversially.

Adult↗
PubMed1999

[Special characteristics of expert assessment of olfactory and taste disorders].

BACKGROUND: The number of medical expert opinions dealing with smell and taste disorders has continuously increased in recent years. However, an overview of the specific problems and results of those expert opinions has not been published until now. INDIVIDUALS AND METHODS: Olfaction was assessed by multiple subjective tests in 145 individuals with chemosensory dysfunction caused by trauma or occupational and environmental exposures. Additionally, a gustatory test, nasal endoscopy, anterior rhinomanometry, and radiography of the paranasal sinuses were performed. Malignering was diagnosed on a trial of multiple symptoms. Retronasal olfaction was tested using the Güttich gustatory olfaction test. RESULTS: Most of the medical expert opinions have been ordered by professional associations (42%) and insurance companies (28%). Compensation for olfactory dysfunction was claimed after trauma (64%), occupational exposure (23%) rhinosurgical procedures (8%), and laryngectomy (5%). Anosmia or hyposmia was claimed by 66% and 24% of all individuals, respectively. According to the results of the chemosensory tests, 41% of patients suffered from anosmia and 40% had hyposmia. Malignering was registered in 14%. CONCLUSIONS: The study shows that the "characteristic case" is a male in the late fourties, complaining of anosmia initially noticed after an occipital or frontobasal head trauma. The assessment of olfactory deficits related to toxic or chemical occupational exposure is difficult when a latency between the occupational exposure and the onset of chemosensory dysfunction is present. Moreover, interactions between the occupational exposure and nicotine or alcohol abuse must be taken into consideration. Claims for medical liability arose in 3% of the study group after septoplasty and sinus surgery.

Adolescent↗
PubMed1999

[Effect of cytokines and fibroblasts on eosinophilic granulocyte survival in polyposis nasi].

BACKGROUND: Eosinophilic infiltration is the most prominent histologic feature of nasal polyps. The effects of eosinophil-associated cytokines and fibroblast derived factors on survival of isolated eosinophils from blood of patients with nasal polyps were investigated. METHODS AND PATIENTS: Peripheral blood eosinophils of 9 patients with nasal polyps were incubated in 1. culture medium alone and in a medium containing, 2. IL-5 (10 pg/ml); 3. IL-3, IL-5, GM-CSF (10 pg/ml); 4. supernatants of fibroblasts cultured from polyps of the same 9 patients; and 5. supernatants of fibroblasts enriched with IL-5, -3, and GM-CSF. Viability of eosinophils was assessed by their ability to take up WST-1. RESULTS: The survival index (T50) of eosinophils cultured in different culture medium is listed as follows: 1. medium alone: 0.8 +/- 0.14 days (MV +/- SEM), 2. medium containing IL-5; 1.2 +/- 0.19 days, 3. medium containing IL-3, IL-5, and GM-CSF: 3.1 +/- 0.13 days, 4. fibroblast supernatants: 1.6 +/- 0.29 days, and in 5. fibroblast supernatants enriched with IL-3, IL-5 and GM-CSF: 2.2 +/- 0.21 days. CONCLUSION: IL-5, prolongs eosinophil survival in vitro, IL-3, IL-5 and GM-CSF revealed synergistic effects; survival of eosinophils was significantly prolonged in comparison to stimulation with IL-5 alone. Supernatants of fibroblasts also prolonged eosinophil survival. This effect is probably due to GM-CSF, which was found in high concentrations in fibroblast supernatants.

Cell Count↗
PubMed1999

Effect of prednisolone on cytokine synthesis in nasal polyps.

To investigate steroid effects on eosinophils and their associated cytokines in nasal polyps, we sampled nasal polyp tissue from 20 subjects during routine surgery. Freshley removed polyps were cut into small pieces and incubated in culture medium for 24 h in different concentrations of prednisolone (10(-2)-10(-6) mol/L). Cell viability was assessed by means of trypan dye exclusion of the supernatants. The number of eosinophils was quantified by means of cytocentrifuge smears stained by May-Giemsa-Grunwald stain. The cytokine protein content of interleukin-5 (IL-5), IL-3, and granulocyte-macrophage colony-stimulating factor (GM-CSF) was measured by ELISA technique in supernatants and in homogenates of nasal polyp tissue. Our results revealed a significant reduction in the number of eosinophils and total number of vital cells at concentrations of 10(-3) and 10(-2) mol/L. GM-CSF and IL-5 protein levels were significantly reduced in supernatants and in homogenates after treatment with prednisolone, whereas IL-3 synthesis was not diminished. Corticosteroid effects known to inhibit synthesis of eosinophil-associated cytokines could be measured in terms of a significant decrease in IL-5 and GM-CSF protein level as well as in a decrease in the number of vital cells.

Cell Survival↗
PubMed1999

[Congenital laryngotracheo-esophageal cleft: diagnosis and surgical treatment by anterior, translaryngeal approach].

BACKGROUND: Laryngotracheoesophageal cleft is a rare but potentially life-threatening anomaly. Less than 200 cases have been published to date. Both the diagnostic and therapeutic recommendations are discussed controversially in the international literature. PATIENT: We report on the diagnostic and surgical management of a type III cleft larynx in a one month old male presenting with aspiration, pneumonia, and aphonia. Hypoplasia of the cricoarytenoid muscles was associated to the cleft. Rigid endoscopy was found to be the best tool for the diagnostic exploration of the cleft, whereas flexible endoscopy failed to detect the defect. The cleft was broadly exposed using a modified anterior translaryngeal approach that included a tracheostomy. After debriding the mucosal margins, the defect was closed in two layers, and a t-shaped Montgomery tube was implanted. Two further revisions using the mentioned translaryngeal approach and one endoscopic procedure were necessary to achieve complete and permanent closure of the cleft. RESULTS: Twenty months after birth the boy is able to swallow thick and liquid food without any problems. Stable scar tissue has grown within the former cleft region. The vocal cords are somewhat thickened but mobile in a reduced range. Both the trachea and the esophagus show quite normal diameters. CONCLUSION: Considering the fact that the arytenoid cartilages touch or overlap each other a congenital defect within the posterior midline of the larynx can only be diagnosed by rigid endoscopy that spreads the cleft apart. In addition to our positive experiences with traumatic fistulas and stenosis of the juvenile trachea we recommend now the anterior vertical laryngeal incision for the operative management of the congenital type III cleft larynx. This direct open approach provides excellent exposure of all components of the defect without the risk of recurrent laryngeal nerve injury. Subglottic stenosis or impaired stability of the larynx described by other authors did not occur in this case. However, the postoperative period is relatively short and careful follow-up for a period of several years is therefore required.

Aphonia↗
PubMed1998

[Aneurysmal hemorrhage as a complication of paracentesis].

Aneurysms of the temporal part of the carotid artery are unusually rare. The literature contains only a few previous reports dealing with hemorrhage from such malformations. In the present case massive bleeding occurred from a right-sided intrapetrous aneurym after myringotomy, which was performed as treatment for bilateral secretory otitis media. Due to the absence of any specific symptoms and the masking effect of middle ear glue preoperative identification of the aneurysm was not possible. Subsequent angiography showed the large fusiform extension of the intrapetrous aneurysm as well as multiple intracranial aneurysms. Leakage from the aneurism was closed definitively with muscle, fascia lata and a gelatin-resorcin-formalin-glue (Cardial). In order to apply the tissue patch the hypotympanic site of the aneurism was exposed using a posterior otosurgical approach. Due to extensive intracranial collateralization to the vertebral arteries bleeding persisted even after ligation of both carotid arteries. Temporary cardiac asystole was then induced to allow safe closure of the aneurysm. Following surgery the patient sustained loss of hearing in her ear and a partial peripheral facial palsy.

Aneurysm, Ruptured↗
PubMed1998

The effect of antiallergic intranasal formulations on ciliary beat frequency of human nasal epithelium in vitro.

The nasal mucociliary clearance is an important defense mechanism of the upper respiratory tract. It is known to be influenced by many pharmacologic substances. We investigated the effects of three topical intranasal antiallergic formulations containing disodium cromoglycate (DNCG), dimethindene maleate (DMM), and azelastine-HCL (AZL) on nasal ciliary beat frequency (CBF) in vitro. Nasal ciliated cells were harvested from 16 healthy volunteers. Cells were diluted 1:10 in culture medium and incubated with a placebo formulation (PLAC), containing 0.022% benzalkonium chloride, which was part of all formulations, a registered 2% formulation of DNCG, a 0.1% formulation of DMM, and a registered 0.1% formulation of AZL. After an incubation period of 20 min, CBF was registered by a photoelectric measurement device. Under control conditions (CONTROL), CBF was 11.4 +/- 1.3 Hz. PLAC reduced CBF to 9.7 +/- 2.3 Hz (NS). DNCG reduced CBF to 9.7 +/- 2 Hz (NS). DMM reduced CBF to 7.2 +/- 1.7 Hz (P < or = 0.05 vs CONTROL, NS vs PLAC), and AZL reduced CBF to 0.9 +/- 1.8 Hz (P < or = 0.001 vs CONTROL, P < or = 0.001 vs DNCG, P < or = 0.001 vs PLAC). In conclusion, a possible influence of antiallergic intranasal formulations on nasal ciliary function has to be considered in clinical application.

Anti-Allergic Agents↗
PubMed1998

Olfactory function after functional endoscopic sinus surgery for chronic sinusitis.

One hundred and fifteen patients suffering from chronic sinusitis were observed to analyse the prevalence of olfactory dysfunction and the influence of FESS. Pre-operative questionnaires were supplemented by examination of olfactory thresholds and discrimination. Pre-operatively, 58% of the collective were aware or complained of any olfactory deficit. However, the olfactory tests demonstrated that of the collective 52% were hyposmic and 31% anosmic. Eight per cent of the hyposmic patients presented with an isolated reduction of their ability to discriminate odours. Post-operative improvements were found in 70%. Normosmia was post-operatively achieved in 25% of the hyposmic patients, but only in 5% of the anosmic patients. Olfaction changed to the worse in 8% after FESS. Therefore, the prevalence of olfactory dysfunction in chronic sinusitis is pre-operatively higher, and the rate of improvement is lower than generally assumed. The extent of sinus disease as measured by the degree of intranasal polyposis correlates with olfactory dysfunction. Resections of the middle turbinate may have a negative effect on olfaction, due to damage to the olfactory fila or alteration of the normal aerodynamic pattern within the olfactory cleft. However, this hypothesis is based on a few observations and needs to be verified by further investigations.

Adolescent↗
PubMed1998

Auditory reaction times in patients with chronic tinnitus with normal hearing.

HYPOTHESIS: This study aimed to compare reaction times (RTs) to auditory stimuli of two groups of normal-hearing subjects differing only in terms of tinnitus sensation. BACKGROUND: The RTs to auditory stimuli as a psychophysical measurement for threshold and suprathreshold hearing are said to provide a behavioral clue to some aspects of neural processing in the auditory system. METHODS: To explore how patients with tinnitus perceive the intensity of threshold and suprathreshold sound stimuli, RTs were obtained from normal-hearing subjects with tinnitus (experimental group, N=15) and from normal-hearing subjects without tinnitus (control group, N=15) by means of exposure to two different sets of frequencies: the tinnitus frequencies and the nontinnitus frequency of 1,000 Hz. RESULTS: There were significant differences in RTs in the experimental group and in the control group not only for the tinnitus frequencies, but also for the nontinnitus frequency of 1,000 Hz. The experimental group had shorter RTs than did the control group at sensation levels (SLs) near the threshold, with no significant differences between groups at sound stimuli in the suprathreshold intensity range. CONCLUSIONS: It is assumed that the above-mentioned reduction in RTs shows a dysfunction of cochlear mechanisms contributing to tinnitus. Conversely, tinnitus also can be considered as an additional auditory input leading to shorter RTs at SLs near the threshold. The current study suggests that the reaction time procedure to auditory stimuli offers complementary information on tinnitus sensation and might be a valuable method in demonstrating general differences and tendencies that have been neglected so far. Analysis for the mechanisms of tinnitus sensation allows for the possibility of facilitating the process of tinnitus habituation and, ultimately, the relief from it.

Adult↗
PubMed1997

[Increased amplitude of distortion product emissions in the human caused by contralateral low intensity acoustic stimulation].

Distortion product otoacoustic emissions (DPOAEs) are probably based on the motile properties of the cochlear outer hair cells (OHCs), which are richly innervated by medial olivo-cochlear efferent nerves (MOCs). DPOAEs provide a stimulating model for functional exploration of the efferent system. The influences of contralateral acoustic stimulation were studied on the amplitude of ipsilateral DPOAEs at the frequency 2f1-f2. Fifteen ears of adults with normal hearing (7 women, 8 men, mean age; 23.1 +/- 4.2 years) were examined. Sound stimulation consisted of exposure to 6 successive series of contralateral pure tones at frequencies between 0.5 and 4.0 kHz and low intensities of 30 dB HL. DP grams were registered with f2 ranging from 708 to 6165 Hz. Contralateral pure tones in the frequency range above 750 Hz and with intensities of 30 dB HL increased the ipsilaterally registered DPOAE amplitudes. The results showed that this increase was frequency specific, at least for frequencies at 1 and 2 kHz. The frequency specificity was especially marked when ipsilateral f2 was near 1 kHz. Contralateral frequencies of 3 and 4 kHz induced a significant, increasing effect, including ipsilateral frequencies around f2 = 3 kHz (or 4 kHz) and also lower frequencies around f2 = 1 kHz. Our results support the concept that the observed increase in DPOAE amplitudes is mediated by the medial olivo-cochlear efferent system. The rule of OHCs as a cochlear amplifier in the presence of contralateral low-intensity sound stimulation is discussed.

Acoustic Stimulation↗
PubMed1997

[Value of smooth pursuit evaluation within the scope of clinical computerized nystagmography].

Testing gaze movements is very important for the detection of central vestibular diseases. The intent of this study was to clarify the pathological importance of partially disturbed and completely disturbed smooth pursuit movements. One hundred patients were analyzed and curves of smooth pursuit movements were classified into three groups of different deformations: i.e, regular, partially disturbed and completely disturbed movements. The correlation index of each curve was then calculated. In 16 patients qualitative analysis showed a completely disturbed result in the smooth pursuit test. Nine of the patients (56.3%) showed morphological signs of a central disease. Twenty-nine patients yielded a partially disturbed test result and in 2 of them (6.9%) a central pathological illness was uncovered. Patients with completely disturbed smooth pursuits showed the highest average binocular correlation index (1.44). Others with partially disturbed results gave an index of 1.24, while persons with regular smooth pursuits yielded a value of 1.17. Because of the scattering seen, it was not definitely possible to attach a correlation index to central disease. On the other hand, an index higher than 1.3 should arouse suspicion for a central illness. Only completely disturbed smooth pursuit movements frequently appear in connection with central diseases. As a rule, a partially disturbed result does not indicate diseases of the central nervous system.

Adult↗
PubMed1997

[Maculo-ocular reflex and visual perception during vertical acceleration].

BACKGROUND: We investigated the effect of vertical acceleration upon the otolithic-ocular reflex of 22 healthy people. The study was performed to obtain standard values for subsequent investigations at patients. METHODS: People sitting on a chair were accelerated in the vertical axis with an amplitude of 4 cm and the frequencies of 0.5 Hz, 1 Hz, 1.5 Hz, 2 Hz, 2.5 Hz and 2.7 Hz. The movements of the ocular globe were initially recorded during vertical acceleration with the eyes closed. Then visual acuity was tested during linear acceleration with the eyes open. As parameters of evaluation we used coherence and alteration of the visual acuity. RESULTS: When the frequency was increased while the eyes were closed, coherence increased and the number of people with vertical eye movements increased. Amplitude was observed to increase and a phase shift occurred. A significant value of coherence (> 0.8) was observed at a frequency above 2.5 Hz. During the test of visual acuity, coherence also increased but did not reach quantity we observed initially. A significant loss of visual acuity occurred at a frequency above 2.5 Hz. A phase shift was also observed. The reason for the loss of visual acuity was the increment of amplitude and the phase shift, which had a negative influence on fixation. CONCLUSIONS: In summary, reactions with closed eyes are best tested at frequencies of 2.5 and 2.7 Hz. We recommended frequencies of 1.5 and 2 Hz for testing visual acuity.

Acceleration↗
PubMed1997

[What is the role of contact lenses within the scope of electronystagmography?].

BACKGROUND: During electronystagmography it is necessary to correct detective vision for calibration, smooth pursuit, and saccadic eye movements. Therefore more and more people use contact lenses instead of normal glasses. Given the lack of detailed information about this phenomenon, in the current literature we decided to investigate the influence of soft contact lenses on electronystagmography. The aim of this study was to find out differences in the results of electronystagmography between using glasses or contact lenses. METHODS: Our investigation involved 20 vestibular healthy human subjects with myopia. In the first part of the examination they used their contact lenses and in the second part they were wearing normal glasses. After measuring the calibration potential we wanted to see if contact lenses would increase the rate of artifacts in the electronystagmogram. Then we attempted to determine whether contact lenses would an influence on the registration of the optokinetic nystagmus. Induced saccadic eye movements were recorded and analysed. RESULTS: Contact lenses had a negative influence neither on the calibration potential nor on the rate of artifacts. The latency of the saccadic eye movements also showed no differences between both parts of this investigation. Only the velocity of the saccades and the gain value during the optokinetic test were reduced when glasses were used. CONCLUSIONS: Contact lenses may stimulate the secretory function of the lacrimal gland and thus decrease friction forces. It is also possible that the reduced image size produced or the reduction-effect of minus by glasses in near sighted persons negatively influences eyeball velocity. In summary, our study demonstrates that contact lenses do not have a negative influence on electronystagmography. Therefore electronystagmographic studies of patients with contact lenses are permissible for purposes of documenting a medical opinion.

Adult↗
PubMed1997

[Petrous bone tumors: primary non-Hodgkin lymphoma of the inner ear canal and cerebellopontile angle].

BACKGROUND: We report about a primary Non-Hodgkin Lymphoma (NHL) of the internal auditory canal. The only previously known manifestations of a NHL in the temporal bone have been infiltrations or hemorrhagic complications due to a late manifestation or advanced systemic disease. Involvement of both temporal bones is typical. CLINICAL CASE: The 60-year-old female patient complained of an acute one-sided deafness, accompanied by a high-pitched tinnitus, rotating vertigo, and paralysis of the left half of the face. RESULTS: We found a deafness in the left ear, spontaneous nystaxis, which was interpreted as a deficiency in excitement of the vestibular organ, and a complete peripheral facial paralysis. Diagnostic imaging studies revealed a large, intrameatal solid mass in the temporal bone, measuring 1.2 x 0.8 cm. Histologic examination after translabyrinthine tumor removal demonstrated a centroblastic Non-Hodgkin Lymphoma. The following extensive interdisciplinary staging examination showed no other tumor manifestations; the CSF analysis was negative. CONCLUSIONS: The uniqueness of this case lies in the detection of a primary nongeneralized centroblastic lymphoma of the internal auditory canal. In contrast to infiltrations of systemic NHL in the same location, in which the advanced disease is responsible for the bad prognosis, this isolated lymphoma of the internal auditory canal seems analogous to extranodal MALT Lymphomas with a better prognosis. The primary extranodal NHL of the temporal bone, not reported in previous studies, is discussed with regard to clinical symptoms, differential diagnoses, and therapeutic strategies.

Combined Modality Therapy↗