bluuebunny/crossref_metadata_2025 huggingface dataset:
Human Sleep EEG under the Influence of Pulsed Radio Frequency Electromagnetic Fields
Authors: Wagner Peter , Röschke Joachim , Mann Klaus , Fell Jürgen , Hiller Wolfgang , Frank Clarissa , Grözinger Michael
Published: April 2003

Former exploratory investigations of sleep alterations due to global system for mobile communications (GSM) signals have shown a hypnotic and REM-suppressive effect under field exposure. This effect was observed in a first study using a power flux density of 0.5 W/m2, and the same trend occurred in a second study with a power flux density of 0.2 W/m2. For the present study, we applied a submaximal power flux density of 50 W/m2. To investigate putative effects of radio frequency electromagnetic fields (EMFs) of cellular GSM phones on human sleep EEG pattern, all-night polysomnographies of 20 healthy male subjects both with and without exposure to a circularly polarized EMF (900 MHz, pulsed with a frequency of 217 Hz, pulse duration 577 μs) were recorded. The results showed no significant effect of the field application either on conventional sleep parameters or on sleep EEG power spectra.
Cystic Fibrosis and Lens Opacity
Authors: Famà F. , Castagna I. , Palamara F. , Roszkowska A.M. , Ferreri G.
Published: April 2003

Cystic fibrosis (CF) is a fairly common lethal genetic disease in whites, inherited via an autosomal recessive pattern. Several clinically evident anomalies of the eye such as xerophthalmia, papilledema, retinal alterations and optic neuropathy have been described. In the present study we investigated lens changes in 40 patients affected by CF, to relate the results to the stage of digestive insufficency. Each patient underwent an accurate ocular examination including visual acuity, slit-lamp examination, and measurement of lens transparency with the Opacity Lens Meter 701. The results were compared with those of an age- and sex-matched control group. The comparison between the lens opacity values obtained in the CF patients and those measured in the control group showed a statistically significant difference; moreover, lens transparency was more decreased in patients with severe digestive insufficiency.
Retinal Pigment Epithelial Changes Associated with Systemic Corticosteroid Treatment: Report of Cases and Review of the Literature
Authors: Spraul Christoph W. , Lang Gabriele E. , Lang Gerhard K.
Published: April 2003

Purpose: The aim of our study was to describe two different manifestations of retinal pigment epithelial changes associated with systemic corticosteroid treatment. Methods: We report 4 patients who developed maculopathy during treatment with systemic corticosteroids. Additionally, the literature was reviewed for similar cases. Results: Two patients showed diffuse retinal pigment epitheliopathy. Two patients developed central serous chorioretinopathy with localized changes in the retinal pigment epithelium. A review of the literature revealed 51 patients with similar changes during treatment with corticosteroids. Conclusion: These 4 patients provide further evidence that systemic treatment with corticosteroids may cause central serous chorioretinopathy or diffuse retinal pigment epitheliopathy. Ophthalmologic examination is recommended on a regular basis for patients treated with systemic corticosteroids.
Leber’s Hereditary Optic Neuropathy Mitochondrial DNA Mutations at Nucleotides 11778 and 3460 in Multiple Sclerosis
Authors: Mojon DanielS. , Herbert Joseph , Sadiq SaudA. , Miller JamesR. , Madonna Michelle , Hirano Michio
Published: April 2003

Objectives: Leber’s hereditary optic neuropathy (LHON) can be difficult to distinguish from optic neuritis seen in multiple sclerosis (MS). About half of the LHON patients harbor a mutation at nucleotide (nt) 11778 in the mitochondrial (mt) DNA. In addition, mutations at nt-3460 and nt-14484 have been associated with LHON. An association of LHON and MS has been suspected for decades, and, recently, the LHON nt-11778 and nt-3460 mtDNA mutations have been found in several patients with MS or MS-like disease. We attempted to determine which MS patients should be evaluated further for LHON mutations. Methods: We screened 103 clinically definite MS patients (age range from 18 to 72 years, 27 men and 76 women) for the LHON nt-11778 and nt-3460 mtDNA mutations. Results: Neither mutation was identified in the patients. Conclusions: Our findings confirm previous reports which found that both LHON mutations are rare in unselected MS patients. The reports to date suggest that MS patients with peripapillary teleangiectasia typical of LHON, with relatives harboring LHON or with early severe bilateral optic neuropathy, particularly if female, should be further evaluated for LHON mutations.
Idiopathic Multiple Serous Detachments of the Retinal Pigment Epithelium Followed by Bilateral Central Serous Chorioretinopathy: A Case Report
Authors: Bandello Francesco , Incorvaia Carlo , Parmeggiani Francesco , Sebastiani Adolfo
Published: April 2003

An uncommon case of a 25-year-old woman affected by bilateral idiopathic multiple serous detachments of the macular retinal pigment epithelium is described. During the fluorescein angiography follow-up, in either macular area one of these detachments resulted in a typical central serous chorioretinopathy active leakage point. These findings detail that idiopathic serous detachments of the retinal pigment epithelium may represent predisposing changes for the development of macular neurosensory retinal detachment.
Carotid Artery Reconstruction following Resection during Radical Neck Dissection
Authors: Soulier C. , Dulguerov P. , Maurice J. , Allal A.S. , Faidutti B. , Lehmann W.
Published: April 2003

From 1972 to 1991, 7 patients with advanced cancer of the head and neck and nodal metastasis with capsular rupture underwent radical neck dissection and sacrifice of the carotid artery. Vascular reconstruction was performed with either an autologous venous (8 cases) or arterial (1 case) graft. In all patients, the postoperative course was uneventful without neurologic complications. One patient is alive 4 years after the procedure. Six patients expired after a mean survival of 20 months. The indications for vascular reconstruction are discussed.
Use of Fluorescein for Detecting Cerebrospinal Fluid Rhinorrhoea: A Safe Technique for Intrathecal Injection
Authors: Bateman N. , Mason J. , Jones N.S.
Published: April 2003

The use of intrathecal injections of fluorescein has a role in the diagnosis and management of cerebrospinal fluid leaks using endoscopic techniques. The Polymedic ‘pencil point’ needle has a lower incidence of headache after dural puncture than standard bevelled needles. We describe a safe method of introducing fluorescein into the thecal space.
Effect of Endotoxin on Cultured Human Middle Ear Epithelium
Authors: Nell M.J. , Op’t Hof B.M. , Koerten H.K. , Grote J.J.
Published: April 2003

The effect of endotoxin was investigated on air-exposed cultured human middle ear epithelium. Concentrations of 0, 1 and 100 ng/ml endotoxin were used. Complete differentiation of the cells was not reached at 12 days. After 21 days, endotoxin had induced an increased proliferation of the epithelial layer. Furthermore, an increase in the number of secretory cells and in the amount and length of microvilli was observed at this time. There were no significant morphological differences between the high and the low endotoxin concentrations, which supports our hypothesis that endotoxin induces an all-or-nothing reaction. These findings are in agreement with our previous results on serially submerged cultured rat middle ear epithelium. From these results we conclude that endotoxin is an important factor in the disturbance of the morphology of the middle ear epithelium, which may lead to chronic otitis media with effusion. In addition, our tissue culture method proved to be a good model for further studies on human middle ear mucosa.
Anomalous Vessels in the Middle Ear Associated with Congenital Anomalies of the Internal Carotid Artery
Authors: Himi Tetsuo , Akiba Hidenari , Yama Naoya , Sakata Motomichi , Kataura Akikatsu
Published: April 2003

A case with unilateral hypoplasia of the internal carotid artery was reported. The rerouting of anomalous vessels in the middle ear, visualized by otoscopy, was demonstrated with CT and MRI. Associations with internal carotid hypoplasia, the intercarotid collaterals, both anomalous middle ear arteries and the enlarged internal maxillary artery were confirmed with MRI. MR images were helpful to diagnose not only the anomalous vessels but also the multiple anastomoses.
Malignant Oncocytoma of a Minor Salivary Gland: An Unusual Presentation at the Base of the Tongue
Authors: Gavilanes Javier , Pérez Campos Ana , Brandáriz José Antonio , Domingo Carlos , García Alfredo , Zajchowski Joseph , Alvarez Vicent Juan José
Published: April 2003

In contrast to malignant oncocytomas of the parotid gland, malignant oncocytomas arising from minor extraparotid glandular tissue are rare. The latter may display a locally aggressive behaviour as well as a variable tendency to develop secondary cervical lymph nodes. We report a new case of malignant oncocytoma in a 43-year-old man presenting with greatly enlarged cervical lymph nodes accompanied by a poorly defined swelling at the base of the tongue microscopically identified as a malignant oncocytoma. The diagnosis was strongly supported by the ultrastructural features of the cells almost completely filled with mitochondria. The cervical mass was excised, and the patient has suffered no recurrence for nearly 2 years after surgical treatment.
Speech Understanding with the CIS and the n-of-m Strategy in the MED-EL COMBI 40+ System
Authors: Ziese M. , Stützel A. , von Specht H. , Begall K. , Freigang B. , Sroka S. , Nopp P.
Published: April 2003

Speech tests have been performed on 6 subjects for comparing the standard 12-channel continuous interleaved sampling (CIS) strategy (CIS12), the 7-channel CIS strategy (CIS7) and the 7-of-12 strategy in the MED-EL COMBI 40+ system. An ABAB experimental design was used whereby each strategy was reversed and replicated. Speech tests were performed in quiet (vowels, consonants, monosyllables, sentences) and noise (sentences). Results showed that for vowels, CIS12 is significantly superior to CIS7, for consonants and sentences CIS12, CIS7 and 7-of-12 performed equally well, and that for monosyllables 7-of-12 is significantly superior to both CIS12 and CIS7. In addition, 7-of-12 is superior to CIS7 by almost the same amount as CIS12, but in this case the difference is not significant. Further, all strategies have been found to be equally robust in noise with respect to sentence understanding. The differences between CIS12 and 7-of-12 on the one hand and CIS7 on the other hand may be attributed to decreased spectral resolution of the latter. The fact that – in contrast to what has been reported for the SPEAK strategy – 7-of-12 is equally robust in noise as the CIS strategies is explained by the use of higher stimulation rates, wider frequency bands and a higher percentage of channels stimulated in each cycle.
Geschichte der Otosklerose
Authors: Schrader Martin
Published: April 2003

In der zweiten Hälfte des 19. Jahrhunderts hatten mehrere Otologen eine Stapesfixation als Ursache einer Schwerhörigkeit beschrieben; die älteste Quelle stammt von Antonio Maria Valsalva im 18. Jahrhundert. Aber es war Adam Politzer, Wien, der 1893 als erster die Otosklerose als eigenständiges Krankheitsbild erkannte und in seiner Entität beschrieb. Hingegen lehnte er die chirurgische Behandlung, wie sie 1876 von Kessel vorgeschlagen wurde, strikt ab, so dass es letztendlich bis 1956 dauerte, bis die heute übliche Operationstechnik der Stapesplastik publiziert wurde. Die Geschichte der Pathologie und Therapie der Otosklerose zeigt beispielhaft die Entwicklung der modernen Otologie.
Geschwülste der Augenhöhlen im Material der Laryngologischen Klinik in Krakau
Authors: Składzień Jacek , Modrzejewski Maciej , Olszewski Eugeniusz , Reroń Elżbieta , Tomik Jerzy , Strek Pawel
Published: April 2003

Fragestellung: In der vorliegenden Arbeit werden Ergebnisse der chirurgischen Behandlung von Augenhöhlengeschwülsten unter Erhaltung der Sehkraft dargestellt. Die entscheidende Frage lautete, wann und bei welchen Lokalisationen der Geschwülste es möglich ist, die Sehkraft des Kranken zu erhalten. Material: In den Jahren 1981–1991 wurden in der Laryngologischen Klinik in Krakau 101 Kranke im Alter von 2 Monaten bis 81 Jahren behandelt. In der analysierten Gruppe befanden sich 56 Männer und 45 Frauen. In 86 Fällen wurden gutartige, in 15 Fällen bösartige Geschwülste behandelt. Bei 63 Kranken wurde eine laterale Orbitotomie nach der Krönleinschen Methode durchgeführt, bei 10 Kranken wurde die Augenhöhlenoperation über den Uffenorde-Zugang gemacht, und im Falle von 28 Kranken konnte man über einen Schnitt unter dem unteren Augenhöhlenrand in die Augenhöhle gelangen. Innerhalb von 5 Jahren nach dem Eingriff wurden die Patienten einer HNO-ärztlichen und ophthalmologischen Kontrolluntersuchung unterzogen. Alle 6 Monate wurde ein Sonogramm und 1 Jahr nach der Operation eine Computertomographie durchgeführt. Ergebnisse: Ein Rezidiv wurde bei 7 von den wegen eines bösartigen Tumors operierten Kranken festgestellt. In 39 Fällen war es notwendig, einen Teil der externen Augenmuskeln zu entfernen, nur bei 7 Kranken aus der Gruppe kam es jedoch zu einer anhaltenden Diplopie. Ein Kranker erblindete nach dem Eingriff. Schlussfolgerungen: Bei der lateralen und supralateralen Lokalisation der Geschwulst ergeben sich trotz gleichzeitiger onkologischer Radikalität des Eingriffs die besten Chancen, die Sehkraft zu erhalten.
Antibiotics Are Not Effective for Otitis media with Effusion: Reanalysis of Meta-Analyses
Authors: Cantekin Erdem I. , McGuire Timothy W.
Published: April 2003

Objective: To determine the effectiveness of antibiotic therapy for otitis media with effusion (OME) and to examine the validity of meta-analysis for combining the results of published randomized controlled trials (RCTs) to reach generalized efficacy conclusions. Data Sources: English-language publications in refereed journals and proceedings published between 1980 and 1997, inclusive, producing 16 usable RCTs involving 2,067 children. Study Selection: RCTs evaluating the efficacy of antimicrobials for the treatment of OME with or without placebo controls. Data Synthesis: We used the technique of Der Simonian and Laird to determine heterogeneity and estimated the mean rate difference (RD). We also used weighted regression analysis to evaluate efficacy trends in light of changing quality of the included randomized trials, and sensitivity analysis to investigate the effects of quality differences among the clinical trials on estimated RDs. Results: The placebo-controlled trials had RDs significantly lower than non-placebo-controlled trials (RD of 0.04 vs. RD of 0.32; p < 0.001). When conventional techniques of meta-analysis were used for data synthesis, the presence of significant heterogeneity (p < 0.0001) precludes reaching any efficacy conclusions. Using weighted regression analysis to account for the effects of study quality on efficacy, we found that antimicrobial efficacy for OME is insignificant, less than 2% for an ideal clinical trial (p = 0.660). Conclusions: We conclude that meta-analysis as applied conventionally is inadequate to detect selection bias and is not useful for estimating true RDs when the results of the RCTs vary systematically with study quality. Our meta-analysis fails to support the continued use of antibiotics in the treatment of OME.
Technik und Resultate der Hammergriffstapedektomie
Authors: Oestreicher E. , Häusler R.
Published: April 2003

Fragestellung: Retrospektive Evaluation der Hammergriffstapedektomie in bezug auf Indikation, Operationstechnik, postoperativen Verlauf und Hörresultate. Patienten und Methoden: Zwischen 1992 und 1998 wurden an der Klinik für HNO, Hals- und Kopf-Chirurgie des Inselspitals in Bern vom Senior-Autor 44 Hammergriffstapedektomien an 40 Patienten durchgeführt. Bei 31 Patienten (71%) handelte es sich um einen Revisionseingriff, welcher wegen zusätzlicher Ankylose von Incus und/oder Hammerkopf (n = 8), Nekrose des langen Incusfortsatzes (n = 6), Luxation der Incus (n = 3) oder nach vorangegangener Fenestration (n = 4) durchgeführt wurde. In 6 Fällen wurde der Eingriff nach verschiedenen anderen Ohroperationen durchgeführt, z.B. nach vorangegangener Incusinterposition bei fixiertem Stapes. Eine primäre Hammergriffstapedektomie wurde bei 13 Patienten (29%) wegen kongenital oder entzündlich fixiertem Amboss und/oder Hammerkopf zusätzlich zur Steigbügelfixierung durchgeführt. In 4 Fällen handelt es sich um eine Revision bzw. eine Zweitrevision einer Hammergriffstapedektomie. Die Hammergriffstapedektomie wurde transkanalär unter Lokalanästhesie durchgeführt unter Benützung des Skeeter-Mikrodrills und des Argon-Lasers. Eingesetzt wurden überlange Draht-Teflonpiston-Prothesen, die unter Verwendung von Zement am Hammergriff fixiert wurden. Ergebnisse: 39 Patienten konnten nachkontrolliert werden. 36 Patienten (92%) hatten postoperativ ein verbessertes Gehör mit einem positiven Stimmgabeltest nach Rinne. Der mittlere residuelle Air-bone gap bei 0,5, 1, 2 und 3 kHz betrug in 40% der Fälle ≤10 dB und in 85% der Fälle ≤20 dB. Ein Patient entwickelte einige Wochen nach der Hammergriffstapedektomie einen hochgradigen Innenohrhörverlust mit vorübergehenden Schwindelanfällen, wahrscheinlich aufgrund eines aus dem ovalen Fenster gesprungenen Pistons.  Schlussfolgerungen: Verglichen mit den Resultaten nach der üblichen primären Incusstapedektomie sind die Resultate nach der Hammergriffstapedektomie weniger gut, aber die Technik hat sich als relativ sicher erwiesen und erlaubt in den meisten Fällen einen Hörgewinn. Moderne technische Mittel, wie überlange Draht-Teflonpiston-Prothesen, die Benützung des Skeeter-Mikrodrills und des Argon-Lasers mit fiberoptischem Mikrohandstück sowie der Einsatz von Zement erwiesen sich als besonders nützlich bei diesen chirurgisch heiklen Eingriffen.
Neurektomie des Nervus singularis nach Gacek
Authors: Häusler Rudolf , Marchal Francis
Published: April 2003

Fragestellung: Evaluation der Wirksamkeit der Neurektomie des Nervus singularis nach Gacek bei Patienten, die an chronisch persistierendem paroxysmalem Lagerungsschwindel leiden. Patienten und Methodik: Zwischen 1980 und 1998 wurde bei 14 Patienten, die an chronisch persistierendem paroxysmalem Lagerungsschwindel (Symptomdauer 1–15 Jahre, mittlere Dauer 5 Jahre) litten, eine selektive Singularisneurektomie unter Lokalanästhesie durch transkanalären Zugang durchgeführt. Zusätzlich wurden die Variationen des anatomischen Verlaufs des N. singularis und seine Beziehung zum runden Fenster anhand von Bohrungen in Felsenbeinpräparaten studiert. Ergebnisse: 13 (93%) von den 14 operierten Patienten waren nach dem Eingriff von ihrem Lagerungsschwindel befreit. Während des Eingriffs konnte der N. singularis allerdings nur bei 3 Patienten eindeutig identifiziert und durchtrennt werden. Bei 9 weiteren Patienten provozierte die Bohrung unter dem runden Fenster plötzlich ein Schwindelgefühl mit einem vertikalen, nach unten schlagenden Nystagmus, was ebenfalls als Zeichen einer Durchtrennung des N. singularis gedeutet wurde. Bei 1 Patientin kam es zu einer zusätzlichen Innenohreröffnung mit postoperativem Hörverlust. Dieser Hörverlust war die einzige Komplikation bei den 14 operierten Patienten. Bei 1 Patienten konnte der N. singularis nicht identifiziert werden, und der Eingriff wurde abgebrochen. Dieser Patient wurde später durch eine Okklusion des hinteren Bogengangs vom Lagerungsschwindel befreit. Schlussfolgerung: Die Ergebnisse unserer Studien bestätigen die Resultate von Gacek und anderen Autoren, wonach die selektive Neurektomie des N. singularis ein wirksamer und wenig invasiver Eingriff ist, um chronisch persistierenden und rezidivierenden Lagerungsschwindel definitiv zu heilen.
Der Einfluss der Stapesfussplattenfläche auf den Druck in der Perilymphe und die Auslenkung der Basilarmembran
Authors: Arnold W. , Böhnke F. , Scherer E.
Published: April 2003

Bei Steigbügeloperationen hängt die Qualität der Resultate einerseits von Geschick und Erfahrung des Operateurs, andererseits aber auch von der Art der verwendeten Prothese ab. Eine statistische Auswertung der qualitativen Ergebnisse von Stapedektomien und Stapedotomien ergab, dass der postoperative Knochenleitungsgewinn bei der Stapedektomie im Frequenzbereich von 1–2 kHz um etwa 8 dB höher ist. Methode: Um eine optimale Prothese zu entwickeln, wird eine numerische Simulation der Mechanik der Koppelstelle zwischen der Stapesfussplatte und der Perilymphe der Cochlea in drei Dimensionen vorgenommen, die zu einer speziellen Geometrie der Grenzfläche zwischen der Prothese und der angekoppelten Perilymphe führt. Resultate: Die Resultate zeigen, dass eine Vergrösserung der Stapesfussplattenfläche eine Erhöhung des Drucks in der Perilymphe bewirkt. Da dies auch eine Zunahme der maximalen Auslenkung der Basilarmembran zur Folge hat, wäre eine weitere Verbesserung der Knochenleitung nach Stapedektomie bei Otosklerose mit bereits vorliegender Innenohrdepression mit einer entsprechend verbesserten Prothesenform zu erwarten.
Results of Pediatric Cochlear Implantation Compared with Results Obtained with Hearing Aids
Authors: Kiefer Jan , Pfennigdorff Thomas , Spelsberg Anja , Gall Volker , Diller Gottfried , von Ilberg Christoph
Published: April 2003

Objectives: The performance of cochlear implanted children was evaluated in comparison with results of children wearing hearing aids. Patients and Methods: 88 cochlear implanted children were included in this study. Onset of deafness was prelingual (except 1 perilingual), mean age at implantation was 5.4 years (range 1–17.2), preoperative pure tone average (PTA) ranged from 130 to 83 dB HL in the better ear with a mean value of 110.5 dB HL. The hearing aid group consisted of 34 children with prelingual onset of hearing loss. PTA ranged from 122 to 46 dB HL, mean age at test was 5.3 years (range 1.3–15.4). The ‘Frankfurt Functional Hearing Test’ was used for evaluation. Based on the results of the hearing aid group, predicted performance with hearing aids was calculated individually for all cochlear implanted children and compared to the actual results with cochlear implants. Results and Conclusions: Results of cochlear implanted children improved steadily after implantation, progressing from a compound score of 22% prior to implantation to 72.2% after 4–9 years. Actual performance with cochlear implants was significantly better than predicted values with hearing aids. Children implanted prior to age 6 showed a greater benefit and faster improvements after implantation than children implanted later. The performance of children implanted beween age 2 and 4 was equivalent to the mean performance of children with hearing loss of 70–85 dB wearing hearing aids.
Zentral-auditive Verarbeitungsstörungen bei Lese- und Rechtschreibschwäche – Ergebnisse einer retrospektiven Erhebung
Authors: Matulat Peter , Riebandt Michael , Lamprecht-Dinnesen Antoinette
Published: April 2003

Spezifische phonologische und temporale auditive Verarbeitungsstörungen werden als Hauptursachen für eine Lese-Rechtschreib-Schwäche angesehen. Vor diesem Hintergrund werden die klinischen Daten zur zentral-auditiven Verarbeitung bei 53 Kindern mit Lese-Rechtschreib-Schwäche dargestellt. Mit einer Häufigkeit von 84,9% zeigt sich in dieser Gruppe ein sehr hoher Prozentsatz auffälliger Befunde in mindestens einer der audiologischen oder logopädischen Untersuchungen. Entgegen der Erwartung konnten jedoch in der Untersuchungsgruppe nur geringe Häufigkeiten pathologischer Befunde in der auditiven Synthese (8,3%) sowie im Gap-Detection-Test (11,4%) nachgewiesen werden.
Die Lokalisation von Mehrfachtumoren in den Luft- und oberen Speisewegen als Hinweis auf eine diagonale Rauchstrasse
Authors: Lamprecht J. , Löser St.
Published: April 2003

Neben der individuellen Disposition ist der Einfluss exogener Noxen für die Entstehung von Karzinomen der Luft- und oberen Speisewege weitgehend unbestritten. Eine nachhaltig intensive Einwirkung derartiger Karzinogene birgt das Risiko der lokalen Tumorentwicklung. In bezug auf die Folgen des Zigarettenrauchens hat sich bereits der Begriff «Rauchstrasse» etabliert. Voruntersuchungen zur betroffenen Seite (Links-Rechts-Verteilung) bei Einfachtumoren hatten eine diagonale Rauchstrasse nahegelegt. Unsere Untersuchung der Seitenverteilung von 126 Tumoren bei 63 Patienten zeigt nun, dass innerhalb eines Individuums synchron oder metachron auftretende Doppel-Karzinome → bei alleinigem Befall der Mundhöhle teils links und rechts, teils auf der gleichen Seite lokalisiert sind, → Tumoren der Mundhöhle überwiegend mit Rachen- oder Kehlkopftumoren der Gegenseite kombiniert sind (25:12) und → Doppel-Tumoren jenseits des Isthmus faucium (in Rachen und Kehlkopf) jeweils auf der gleichen Seite liegen (21:0). Als Konsequenz für die Betreuung unserer Tumorpatienten ergibt sich nach wie vor die Forderung nach einer Zweittumorsuche sowohl im prätherapeutischen Staging als auch während der Tumornachsorge. Bei der Panendoskopie dürfte es Sinn machen, den hier beschriebenen typischen Lokalisationen besonderes Augenmerk zu widmen.
Zur chirurgischen Therapie der Amiodaron (Cordarex)-induzierten Hyperthyreose und thyreotoxischen Krise
Authors: Biermann E. , Morgenstern C.
Published: April 2003

Das Antiarrhythmikum Amiodaron (Cordarex) ist eine der häufigen Ursachen schwerer, jodinduzierter Hyperthyreosen. Aufgrund der mehrmonatigen Halbwertszeit des Medikamentes und der vollen Jodspeicher sind thyreostatische Therapien wenig effektiv, so dass eine notfallmässige Ablation des Schilddrüsengewebes erforderlich werden kann. Die kardiale Vorschädigung mit Amiodaron behandelter Patienten erhöht das Operationsrisiko deutlich, so dass eine frühzeitige Thyreoidektomie angestrebt werden sollte. Die niedrigen Komplikationsraten elektiv ausgeführter Schilddrüsenresektionen lassen uns eine prophylaktische Operation fordern, sowie das TSH basal unter Amiodarontherapie supprimiert und T3 erhöht sind.
Idiopathic Sudden Sensorineural Hearing Loss
Authors: Tran Ba Huy Patrice
Published: April 2003

Idiopathic sudden sensorineural hearing loss (ISSHL) is a syndrome covering several heterogenous entities resulting from different pathogenetic mechanisms. No argument allows to consider ISSHL a therapeutic emergency. Consequently, poor outcome cannot be attributed to therapeutic delay. The various therapeutic strategies currently recommended are highly empirical and should be questioned in terms of cost-effectiveness. The methodological requirements of clinical trials come up against hardly surmountable obstacles, namely the difficulty in gathering sufficient numbers of various subgroups within a reasonable period of time and limitations to assess the physiopathological process underlying ISSHL. At this time, the audiogram is the unique tool which may help clinicians to identify these entities and provide a classification based on the types of hearing loss. New investigation tests are required for improving our approach to ISSHL.
Sudden Deafness and Viral Infections
Authors: Pitkäranta Anne , Vasama Juha-Pekka , Julkunen Ilkka
Published: April 2003

Sudden deafness is a dramatic and relatively common otological problem. The etiology in most cases remains unresolved although virus involvement has strong support. Sudden deafness has been associated with mumps, rubella, the respiratory and herpes groups of viruses as well as other more rare ones like hantavirus and Lassa virus. Perhaps the bestknown example of virus-induced sudden deafness is acute unilateral hearing loss associated with mumps virus infection. Mumps virus has also been isolated from the inner ear suggesting a direct virus-induced cytolytic mechanism for deafness. Herpesviruses are neurotropic and they have a tendency to become chronic. Therefore they have been strong candidates for viruses being responsible for acute hearing loss. Although serological associations have been found in certain studies, convincing evidence for the involvement of herpes and varicella-zoster viruses as agents causing direct cochlear damage and hearing loss in humans is missing. A number of case reports have associated sudden deafness to rubella, adeno- and hantavirus infections. Multiple studies showing no association of viruses with sudden deafness may reflect seasonal, geographical or epidemiological differences in this disease. This may also bring up the possibility of other etiological factors such as general inflammatory or autoimmune mechanisms for the disease. Histopathological changes in the affected ears are characterized by abnormal cellular architecture in the inner ear with loss of apical and spiral ganglion cells and destruction of the organ of Corti. Similar histopathological changes have been found in experimental animal models infected with mumps, rubella or herpesviruses. Histopathological observations could favor the theory of viral etiology in idiopathic sudden deafness but do not rule out the possibility of immunological disturbances, which would lead to similar histopathological changes.
Funktionelle und morphologische Zweiteilung der Eustachi-Röhre
Authors: Mulder J.J.S. , Peters T.A. , Tonnaer E.L.G.M. , Kuijpers W.
Published: April 2003

Vom histologischen Aufbau der Eustachi-Röhre können deren Grundfunktionen (Schutz, Reinigung und Belüftung) abgeleitet werden. Neuere systematische histologische und Mikroschnittuntersuchungen sowie embryologische Untersuchungen zur Entwicklung der Tuba auditiva führten zu Ergebnissen, die unsere Einsicht in die Funktion der Eustachi-Röhre vertieft haben. Diese Befunde sind: 1. Squamöses, nicht sekretorisches Epithel kommt nur im dorsalen Teil der Tube vor. 2. Die Öffnungsmuskeln der Tube setzen ausschliesslich am dorsalen Abschnitt an. 3. Zur Zeit der Geburt ist lediglich das mukoziliare Epithel ausgereift. Das dorsale, squamöse hingegen erst kurz vor der Belüftung des Mittelohres (10 Tage postpartal). Diese Befunde führten zum Konzept der räumlich-funktionellen Zweiteilung des Tubenepithels: Der dorsale Teil spielt eine Rolle bei der Belüftung des Mittelohres, der ventrale dient der Clearance.
Dynamic Posturography (Equitest): Outcome after Vestibular Neurotomy or Acoustic Neuroma Removal
Authors: Gilain C. , Gersdorff M. , Decat M. , Deggouj N.
Published: April 2003

Objectives: This study has two aims. First, we analyze the results of dynamic computerized posturography (Equitest) achieved by patients who have undergone acoustic neuroma removal or vestibular neurotomy. The examination is performed during the preoperative assessment and at several postoperative consultations. Secondly, after analyzing the results, we evaluate the interest of this type of examination for such patients during preoperative assessment and postoperative follow-up. Patients: 25 patients underwent acoustic neuroma removal and 8 vestibular neurotomy from June 1996 until September 1997. All patients included in the study underwent dynamic posturography follow-up. The schema proposed was an examination before surgery and then 10 days and 1 and 3 months after the operation. Not all patients underwent all examinations (it is a retrospective study). Method: Retrospective case review. Results: 50% of the patients (n = 8) who underwent vestibular neurotomy achieved a normal score at the sensory organisation test (SOT) of the Equitest within the first 6 postoperative weeks. 60% of the patients (n = 25) undergoing acoustic neuroma removal developed a central vestibular compensation 3 months after surgery. Two patients developed an inadequate balance strategy with excessive visual dependence detected by the SOT. Conclusions: According to our experience, the SOT is a useful examination during the follow-up period of patients who have undergone neurootologic surgery. It provides information about the progress of postoperative central vestibular compensation. The dynamic posturography also detects inadequate balance strategies, therefore, allowing a personalized vestibular reeducation adapted to each patient.
Hypoglossal-Facial Nerve Anastomosis: Patients’ Self-Assessment of Facial Function
Authors: Rödel R. , Laskawi R.
Published: April 2003

Objectives: In a retrospective study, we tried to evaluate the recovery of facial function as well as the resulting discomfort and the role of priming tongue movements in voluntary facial movement after hypoglossal-facial nerve anastomosis (HFA) predominantly from the point of view of concerned patients. Patients and Methods: Our analysis was based upon a questionnaire, which was returned by 27 patients who had undergone HFA. Twenty-four of the 27 patients (89%) could be re-examined at our department where postoperative facial function was evaluated by the investigators using the nerve grading system as described by House and Brackmann. Results: The mean time interval between HFA and first voluntary movements as estimated by the patients was 5.5 months (range: 3–18). The patients’ main complaints consisted of mimic deficit (41%), dysphagia (26%), eye symptoms (22%), oral incontinence (19%), synkinesis (15%) and speech problems (11%). Twenty-one patients (78%) reported to perform facial training regularly. Priming tongue movements could be evaluated as necessary for voluntary facial function in 25 patients (92.5%). As a result of re-examination, a statistically significant correlation (p < 0.05) between the grade of facial nerve function and the time interval from onset of the facial palsy to HFA was evident. Conclusions: Despite the fact that HFA seems to be a good option for mimic rehabilitation in cases in which a direct nerve repair is not possible, there are some special functional and aesthetic deficits after reinnervation which can be minimized by surgical modifications or other additional therapeutic options.
Change of Vestibular Function after Cochlear Implantation
Authors: Szirmai Ágnes , Ribári Otto , Répássy Gábor
Published: April 2003

The vestibular system of patients with total deafness was examined before and after cochlear implantation. The authors have used a computer-based electronystagmography system with air caloric stimulation for 3 years. It is very useful for the examination of the operated ear. The results of 60 vestibular examinations of 64 patients are reported. Immediately after the surgery 10 patients had vertigo lasting 2–4 days. In 20 patients, the vestibular function of the operated ear was the same as preoperatively. In 14 patients, the vestibular function became worse after the cochlear implantation, in 16 patients the postoperative vestibular responsiveness became better. The preoperative labyrinthine anesthesia changed, and a normal or almost normal caloric reaction was registered in the operated ear. In 4 patients, the ear receiving the cochlear implant had a hyperreactive labyrinthine function.
Upper Airway Resistance Syndrome
Authors: Guilleminault Christian , Chowdhuri Susmita
Published: April 2003

The term ‘upper airway resistance syndrome’ denotes an entity characterized by the presence of daytime fatigue or sleepiness in the presence of a normal respiratory disturbance index and oxygen saturation. Despite some similarities, certain specific clinical and diagnostic features distinguish it from the obstructive sleep apnea syndrome. The essence of diagnosis lies in the documentation of increasing esophageal pressures during sleep with associated transient EEG arousals. Furthermore, the evidence suggests an abnormal blood pressure response to the changes in esophageal pressures and arousals. The exact pathophysiology is currently unclear. Continuous positive airway pressure is an effective mode of therapy, although the low compliance rate limits its use. The role of radiofrequency ablation of the palatal tissues, other surgical procedures, and oral appliances in the treatment of upper airway resistance syndrome need to be investigated more rigorously.
Antitussive Action of Antihistamines Is Independent of Sedative and Ventilation Activity in the Guinea Pig
Authors: McLeod Robbie L. , Mingo Garfield , O’Reilly Sandra , Ruck LoriAnn , Bolser Donald C. , Hey John A.
Published: April 2003

We studied the oral actions of antihistamines from six chemical classes, namely: the ethanolamines (ENA, diphenhydramine and clemastine); ethylenediamines (EDA, pyrilamine and tripelennamine); piperidines (PPD, terfenadine and astemizole); piperazines (PPZ, hydroxyzine and cetirizine); phenothiazines (PTZ, promethazine), and the alkylamines (ALA, chlorpheniramine and bromopheniramine) on cough reflexes, pentobarbital-induced sedation and minute ventilation in the conscious guinea pig. Antihistamines of the ENA class had minimal effects on capsaicin-induced cough although both diphenhydramine (30 and 100 mg/kg p.o.) and clemastine (30 and 100 mg/kg p.o.) increased sedation time (ST). The PPZ class demonstrated both antitussive and sedating activity. The minimum effective oral antitussive dose (MED) of cetirizine and hydroxyzine was 30 and 10 mg/kg, respectively. The EDA did not exhibit antitussive activity. Tripelennamine (10, 30 and 100 mg/kg p.o.) but not pyrilamine enhanced ST. The MED for the PTZ, promethazine, was 10 mg/kg, and at 100 mg/kg promethazine increased ST. The ALA group displayed antitussive activity but only chlorpheniramine (10 mg/kg p.o.) had any effects on ST. The MED for chlorpheniramine and bromopheniramine was 3 and 10 mg/kg p.o., respectively. The PPD antihistamines, namely terfenadine and astemizole, inhibited cough (MED 30 and 10 mg/kg p.o.) without sedative effects. Of the antihistamines tested only promethazine (100 mg/kg p.o.) depressed ventilation responses; however, this dose of promethazine was associated with adverse behavioral effects. The present findings indicate that the antitussive actions of antihistamines are not directly related to histamine H1-receptor blockade because several antihistamines did not antagonize capsaicin-induced cough. In addition, the antitussive actions of antihistamines are independent of their sedative or ventilation effects.
Schild Regression Analysis of Antidepressant and Bicuculline Antagonist Effects at the GABAA Receptor
Authors: Malatynska Ewa , Crites Glenda , Yochum Andrew , Kopp Ryan , Giroux Monique L. , Dilsaver Steven C.
Published: April 2003

We showed previously that antidepressants inhibit GABA-stimulated 36Cl– uptake in rat cerebral cortex. In this study Schild analysis was used to determine if antidepressants are competitive antagonists or allosteric modulators at GABAA receptors. GABA concentration-response curves for 36Cl– uptake in rat cerebral cortex were generated in the absence or presence of different concentrations of the following antidepressants: amitriptyline, amoxapine, mianserin, and also the GABAA receptor antagonist, bicuculline. The pA2 values for amitriptyline, amoxapine, mianserin, and bicuculline were 4.2 ± 0.2, 5.5 ± 0.3, 4.4 ± 0.1 and 6.2 ± 0.6, respectively. The respective Schild slope values were 0.7 ± 0.1, 0.6 ± 0.03, 0.7 ± 0.2 and 1.0 ± 0.3. All slope values for antidepressants differed from unity. The maximum effect produced by GABA to stimulate chloride influx was decreased by both antidepressants and bicuculline. It is concluded that neither the antidepressants studied nor bicuculline are pure competitive GABA antagonists at the GABAA receptor-chloride-ionophore complex in the rat cerebral cortex.
Correlation of EGTA and Calcium- Blocking Agents on the Response of the Bladder to in vitro Ischemia
Authors: Levin Robert M. , Leggett Robbert , Whitbeck Catherine , Horan Patrick
Published: April 2003

The effects of repetitive field stimulation (model of hyperrelexia) on the responses of isolated strips of rabbit urinary bladder to FS and carbachol were evaluated under a variety of incubation conditions. Compared to control conditions, 2 h of repetitive FS in normal, oxygenated Tyrode’s solution followed by incubation for 1 h with no stimulation resulted in a 50% decrease in contractile response to FS and a 30% decrease in the response to carbachol. Incubation in the absence of O2 and glucose was used as an in vitro model for ischemia. Repetitive stimulation during in vitro ischemia resulted in a significantly greater decrease in the contractile responses to FS and carbachol than did in vitro ischemia without repetitive stimulation. The magnitude of contractile dysfunctions in response to both stimuli were significantly reduced in the presence of EGTA (calcium chelator), diltiazem (calcium channel blocker) or pincidil (potassium channel opener). Incubation with thapsigargin (SR calcium uptake inhibitor) + ryanodine (SR calcium storage inhibitor) had no effect. The results of these studies indicate that inhibition of Ca2+ entry reduces the contractile dysfunctions induced by repetitive stimulation in the presence of in vitro ischemia. Inhibition of Ca2+i storage and release had no significant effect on the magnitude of contractile dysfunctions induced by repetitive stimulation an in vitro ischemia.
Role of Oxidative Stress and Glutathione in Busulfan Toxicity in Cultured Murine Hepatocytes
Authors: DeLeve Laurie D. , Wang Xiangdong
Published: April 2003

This study examines busulfan metabolism. Busulfan given in vivo or in vitro decreased hepatocyte glutathione (GSH) by 60 and 50%, respectively. In vitro, busulfan toxicity was prevented by glutathione S-transferase inhibitors or by antioxidants and led to increased production of oxidized GSH and thiobarbituric acid reactive substances. ‘Rescue’ from toxicity by GSH precursors was prevented by N,N-bis(2-chloroethyl)-N-nitrosourea (BCNU). Depletion of GSH exacerbated toxicity. In GSH-depleted hepatocytes, busulfan decreased GSH by 95% and BCNU did not prevent rescue by GSH precursors. Conclusions: (1) In hepatocytes with normal GSH: busulfan toxicity requires GSH conjugation, does not cause profound GSH depletion and is mediated by oxidative stress. We postulate that a GSH conjugate promotes oxidative stress. (2) In GSH-depleted hepatocytes: busulfan profoundly depletes GSH; toxicity is mediated by oxidative stress and is prevented by restoring GSH levels; cell death may be due to unopposed endogenous oxidative stress.
Glutathione S-Transferase Polymorphisms and Their Biological Consequences
Authors: Hayes John D. , Strange Richard C.
Published: April 2003

Two supergene families encode proteins with glutathione S-transferase (GST) activity: the family of soluble enzymes comprises at least 16 genes; the separate family of microsomal enzymes comprises at least 6 genes. These two GST families are believed to exert a critical role in cellular protection against oxidative stress and toxic foreign chemicals. They detoxify a variety of electrophilic compounds, including oxidized lipid, DNA and catechol products generated by reactive oxygen species-induced damage to intracellular molecules. An increasing number of GST genes are being recognized as polymorphic. Certain alleles, particularly those that confer impaired catalytic activity (e.g. GSTM1*0, GSTT1*0), may be associated with increased sensitivity to toxic compounds. GST polymorphisms may be disease modifying; for example, in subgroups of patients with basal cell carcinoma or bronchial hyper-responsiveness, certain GST appear to exert a statistically significant and biologically relevant impact on disease susceptibility.
An Electropalatographic and Acoustic Study of Temporal Coarticulation for Catalan Dark/l/ and German Clear/l/
Authors: Recasens D. , Pallarès M.D. , Fontdevila J.
Published: April 2003

Electropalatographic and F2 frequency data in /VlV/ sequences reveal more prominent C-to-V effects for Catalan dark /l/ than for German clear /l/, more so in the /i/ context than in the /a/ context, which is in agreement with the existence of high lingual requirements on the formation of two constriction places for dark /l/. German clear /l/ exerts a similar amount of F2 displacement on both vowels which may be indicative of the tongue dorsum being directed towards a target position; this is also suggested by dorsopalatal contact and formant frequency data showing less vowel-dependent variability than clear /l/ in other languages though more so than Catalan dark /l/. Salient anticipatory requirements for the implementation of /l/ in the two languages block V1-dependent carryover effects to a large extent which results in more prominent vocalic anticipation than vocalic carryover. This directionality trend in vocalic coarticulation is more obvious for Catalan dark /l/ than for German clear /l/ (in agreement with the former consonantal variety requiring more anticipation than the latter) and opposes German /l/ to clear /l/ in other languages (i.e., the less constrained /l/ variety of Spanish may favor vocalic carryover over vocalic anticipation in VCV sequences).
Categorical Perception as a Function of Stimulus Quality
Authors: van Hessen A.J. , Schouten M.E.H.
Published: April 2003

A number of experiments were carried out in order to test the hypothesis that categorical perception of speech stimuli is a function of synthetis quality – specifically, that the greater complexity of more natural speech stimuli makes it difficult for listeners to focus on particular stimulis parameters as psychoacoustic cues. The results show that there is an increase in categorical perception as synthesis quality improves from a simple synthesis by rule, via LPC synthesis, to a much more complex type called sinewave generation.
Articulatory Vowel Lengthening and Coordination at Phrasal Junctures
Authors: Byrd Dani
Published: April 2003

Recent work has demonstrated that progressively stronger prosodic boundaries result in increasing amounts of lengthening for consonant gestures, both preceding and following the boundary. The present experiment extends these earlier findings by considering kinematic data collected with a magnetometer to determine (1) if vocalic gestures demonstrate lengthening patterns comparable to those of consonantal gestures due to adjacent prosodic boundaries, and (2) if the relative timing of consonant and vowel gestures is affected by adjacent boundaries. A magnetometer system was used to track articulator movements of 3 speakers producing sentences in which a /...C1V1(#)C2V2.../ sequence was embedded with varying medial boundaries. All subjects demonstrated lengthening of the vocalic articulation before stronger boundaries. Additionally, effects on the relative timing of words spanning a boundary and the relative timing of segments in boundary-adjacent syllables were observed.
The Question of ‘Stress’ in West Greenlandic1
Authors: Jacobsen Birgitte
Published: April 2003

The main purpose is to investigate whether stress is a relevant category in Greenlandic word prosody. I focus on tonal and durational parameters. The data material consists of word lists read aloud seven times by two subjects. The main findings are: (1) The prosodic characteristics of words can be explained in either tonal or durational terms. (2) The four different syllable types (of different ‘weight’) are distinguished in durational terms; further, there appears to be only a tripartite system of short, long and overlong. (3) There are intra-syllabic as well as inter-syllabic rhythmical adjustments. It is concluded that Greenlandic prosody does not include an autonomous stress category, either tonal or durational parameters alone will do. And although Greenlandic has distinctive quantity, there is room for considerable durational variation of segments.