[A contribution to the differential diagnosis of odnotogeneous cysts]. / Differentialdiagnostischer Beitrag zur Problematik der odnotogenen Zysten

Problems concernint the diagnosis and differential diagnosis of odontogenic cystic lesions of the jaw are discussed with reference to a series of patients and some specially selected cases. The use of isotope examination is often of particular significance in coming to a decision. The position and value of scintigraphy has been demonstrated by referring to the literature and to our own investigations. The often difficult differentiation from certain types of odontogenic tumours is also discussed.

[Sudden deafness and cytomegaly virus infection (author's transl)]. / Hörsturz bei Zytomegalievirusinfektion

A 49-year old patient complained of sudden deafness in his right ear. With the exception of a rising titre level of the complement-fixing antibodies there were no positive findings for the cytomegaly virus. However, the eight-fold rise in the titre level after a latent period made it appear likely that the sudden deafness was caused by a cytomegaly virus infection. This assumption was also supported by the lack of vestibular symptoms, which, according to literature, is quite frequent in virus diseases of the inner ear. The usual therapy led to an improvement in the patient's hearing, which was also accompanied by a drop in the titre level of the antibodies. No prognosis can be made, since similar observations have not yet been recorded.

[Sudden deafness and virus infection (author's transl)]. / Hörsturz und Virusinfektion

A survey of the literature concerning sudden deafness caused by virus infection is followed by a discussion of 46 patients with the history of acute loss of hearing, who were subjected to virological-serological examination. In 9 patients the titre movement of the complement fixation reaction was regarded to imply a viral cause of the acute loss of hearing. This was corroborated in 5 cases by the history of recent viral infection. Pathogenetically, the significance of the viral endolymphatic labyrinthitis was underlined. The success of traditional therapy did not differ from the results in cases of sudden deafness due to factors other than viral disease. In the absence of specific therapy the importance of prophylactic measures is stressed.

[Virological investigations in peripheral idiopathic facial pareses (author's transl)]. / Virologische Untersuchungen bei peripheren, idiopathischen Fazialisparesen

Virological investigations were carried out on the serum of 62 patients suffering from peripheral facial pareses. The aetiology was definitely attributable to a virus infection in 12 of these cases. Neuropathological changes induced by these neurotropic viruses, predisposing anatomical features and pathogenesis are discussed. Since only symptomatic treatment is possible, the importance of active immunization, where available, is stressed in the prevention of virus diseases; a decrease in morbidity could lead to a reduction in neurological complications.

[Oto-rhino-laryngological complications in patients receiving intermittent haemodialysis and in renal transplant recipients (author's transl)]. / Oto-rhino-laryngologische Komplikationen chronisch dialysierter und nierentransplantierter Patienten

Patients with chronic uraemia and renal transplant recipients were examined for oto-rhino-laryngological diseases over the course of a five-year period. During dialysis treatment, 58 out of 77 chronic uraemic patients developed complications, mainly affecting the nose and the ear, on a degenerative or toxic uraemic basis. In the period under review, renal transplantations were carried out in 63 patients, in whom infectious processes had occurred mainly in the upper respiratory and digestive tracts; postoperative immuno-suppressive therapy is responsible for the morbidity in these cases. Particular reference is made to the necessity of eradicating any possible sources of infection already during the period of dialysis treatment and to the importance of cooperation between physicians and oto-rhino-laryngologists.

Psychiatric home care in Austria.

As in many parts of the world, mental health care in Austria is growing more progressive and multidisciplinary in scope, moving from an "alternative" to an established treatment. One region in Austria has established a counseling center that provides comprehensive in-home patient services to complement inpatient care and to keep individuals stabilized in society.

[Pathomorphologic studies of the endocrine cells in the gastrointestinal mucosa. Physiology, cytochemistry and ultrastructure (author's transl]. / Funtionelle Pathomorphologie des gastrointestinalen endokrinen Zellsystems. Physiologie, Cytochemie, und Ultrastruktur

With combined immunofluorescent, cytochemical and electron microscopic investigations the enterochromaffin cell system has been differentiated into 5 distinct endocrine cell types in the human stomach and into 8 cell types in the intestine. These endocrine cells are probably of neuroectodermal origin and belong to the APUD (amine precursor uptake and decarboxylation)-system. Maximal gastrointestinal hormone concentrations as determined by tissue extracts correlate fairly well to the location of each endocrine cell type in various segments of the gastrointestinal tract. In certain gastroenteropathies the pathophysiological disturbances can be explained by pathomorphological alterations of the disseminated endocrine cells. 1. The gastrin-producing G-cell is the predominating endocrine cell in the gastric antrum. Besides immunocytochemistry the G-cell can be demonstrated with argyrophilic reaction (Grimelius, 1968), masked metachromasia and leadhematoxylin. The ultrastructural features are variable, depending on functional activity. The secretory granules are usually only slightly osmiophilic, measuring 200 till 250 nm in diameter. By some working groups a positive immunofluorescence with gastrin-antisera has been demonstrated in A1- or D-cells of the pancreatic islets. However, numerous negative results have been reported, too. Considering physiological conditions, a gastrin-secretion of the human pancreatic islets has not been secured without doubt. 2. The EC-cell produces serotonin and in the intestine motilin, too. Besides the formaldehyde-induced fluorescence, these cells can be demonstrated with diazonium and argentaffin reactions, less specific with argyrophilic methods. Ultrastructurally the EC-granules are easily differeniated from the other endocrine cells by their pronounced osmiophilia and pleomorphism. In experimental conditions the EC-cells demonstrate species- and site-specific alterations. With reserpine no ultrastructural changes were demonstrable in EC-cells of the rat. However, marked ultrastructural alterations with an increase of the hormone-producing organelle system were noticed after administration of parachlorophenylalanine (PCPA) which interferes with serotonine synthesis; 5. The gastric D-cells are characterized by large secretory granules similar to pancreatic D-cells. They secrete the HCl-inhibitory peptide somatostatin. 4. The D1-cell is a cell type with unknown function. The cytoplasm contains small granules with variable electron density. According to most authors, they represent a distinct cell type and not just a variant of the G-cells. It may be very difficult, however, to separate certain forms of D1-cells from functionally altered G-cells. 5. The A-cell can be found in the gastric mucosa of certain animal species, where it has been demonstrated by immunocytochemistry with antisera to gut-glucagon. This cell type does not occur in the human gastric mucosa. 6...

[Sudden deafness and cytomegalievirusinfection of adults (author's transl)]. / Der Hörsturz, eine mögliche zentrale Manifestation der Zytomegalievirus-Infektion Erwachsener.

By means of virologuc--serologic examination methods it was possible to find in four patients with sudden deafness a cytomegaloinfection, whereby the complement-fixation reaction was determined with the CMV antigen. With the usual therapeutical measures all cases with an, in part high-degree, labyrinthine deafness improved or normalized simultaneously with the serologically ascertained subsiding of the virus infection. The paper discusses the pathogenesis of viruscaused sudden deafness and tries to explain the benign nature of central complications in cytomegaloinfections.

[Oto-rhino-laryngological diseases in patients with advanced kidney failure after kidney transplantation]. / Hals-Nasen-Ohren-Krankheiten bei weit fortgeschrittener Niereninsuffizienz und nach Nierentransplantation.

Within a period of 7 years a total of 113 patients could be oto-rhino-laryngologically examined. The cases comprise chronic uremic patients under conservative therapy, patients with chronic intermittent haemodialysis treatment, and patients after successful renal transplantation. In 52% of all patients examined an impairment of hearing can be diagnosed and specified as inner ear deafness. As common etiological factors for inner ear deafness can be excluded, an accumulation of so-called uremic toxins is regarded to be the most probable cause of uremic deafness. This is confirmed by the fact that uremic deafness is not affected by haemodialysis treatment, but can be influenced favorably by a normal transplant function. Besides infiltrations of chronic inflammation and metaplasia of epithelium, nasal biopsies on uremic patients yielded histological findings invariably showing wide, thin-walled vessels in the subepithelium and the stroma. This phenomenon is possibly another pathogenic factor for epistaxis in chronic uremic patients. The depression of immunological resistance in uremia and the medication of immunosuppressive drugs after renal transplantation may explain the fact that serious otorhino-laryngological injections could frequently be observed in our patients. Careful observation may be helpful for early diagnosis and treatment of possible bacterial and mycotic infections in a very early stage.

[Morphologic alterations of the gastric mucosa following vagotomy (author's transl)]. / Morphologische Veränderungen der Magenschleimhaut nach Vagotomie.

A progression in the development of gastritis is not observed following selective proximal vagotomy. Morphometrically, a moderate compensatory foveolar hyperplasia can be noticed in addition to a reduction of parietal cells. Paralleles can be found concerning the ultrastructural alterations of parietal cells following vagotomy or after anticholinergic treatment. They consist in an increase of lamellar osmiophilic bodies, reduction of tubulovesicles, a narrow canalicular lumen and sparse mitochondria. A few years after vagotomy, the parietal cells appear rather unstimulated. After vagotomy, numerous antral G-cells can be demonstrated, with ultrastructural features of increased secretory activity in correlation to raised plasma gastrin levels. This moderate G-cells hyperplasia may, however, already exist preoperatively with the duodenal ulcer. 5 years after vagotomy, there is no pronounced alteration concerning the number of granular or agranular vesicles inside the terminal axons. Experimentally, a degeneration of sympathetic nerves has been described a few days after vagotomy.

[Experiences gained in the treatment of oto- and rhinogenic meningitides, 1965-1975 (author's transl)]. / Erfahrungen bei der Behandlung oto- und rhinogener Meningitiden: 1965-1975

The studies permit the conclusion that morbidity and mortality due to purulent oto- or rhinogenic meningitides have not essentially changed over the past eleven years despite antibiotics that are more effective and can be given in higher doses than so far. Resistent strains of bacteria, allergies and insufficient antibiotic therapy are probable causes for that fact. Under certain circumstances a sufficient and specific antibiotic therapy may delay surgical intervention or make it even unnecessary. Advanced age and additional diseases seem neither to influence operability nor to increase morbidity.

[Late results of frontal bone reconstructions using Paladon]. / Spätergebnisse von Paladon-Stirnbein-Plastiken.

Report about 12 cases of defect of the frontal bone: state after radical operation of the frontal sinus (Riedel's operation) or after removal of bone splinters after injury. 6--12 months later a paladon-inlay (acrylate prosthesis) can be implanted to fill the defect and to restore the profile. Description of the production, forming, sterilization and operative implantation of the prosthesis. The patients have been observed up to 18 years. In one case the implanted material was removed after 10 years because of recurrent local suppurations. All the other patients showed an uncomplicated course until today; the cosmetic and functional result was permanently good.

[Surgical elimination of endonasal triggerpoints of a trigeminal neuralgia caused by cauterization (author's transl)]. / Chirurgische Ausschaltung korrosionsbedingter endonasaler Triggerpoints einer Trigeminusneuralgie

A severe injury by fluid Ammonia of the nasal mucosa resulted with a strong irritation of the 1. and 2. branch of the trigeminus nerve with sudden and heavy attacks of pain. The region below the head of the right inferior nasal concha was detected as a trigger zone for smoke, smell, dust and cold air. Local anaesthesia stopped the attacks. The surgical excision and electrocoagulation of that aerea and the lateropexis of the inferior concha avoided the returning of the troubles for over a half year. The recommencement of the attacks could be stopped by local application of carbolic acid solution (10%). A similar treatment could not be found in the literature.

[The determination of the sum potential amplitude for the prognostication of facial paresis of viral etiology]. / Die Bestimmung der Summenpotentialamplitude zur Prognoseerstellung bei viral bedingter Fazialisparese

In 29 patients with facial pareses of viral etiology the sum potential amplitude of the M. orbicularis oris was determined in a comparison of the two sides for prognostication purposes. If the sum potential amplitude is reduced by less than 70 per cent a return of good functions can be expected within 6-8 weeks. If the reduction of the sum potential amplitude lies between 70 and 95 per cent, a reliable prognosis is not possible, whereas with values below 95 per cent the paresis does not improve at all or hardly improves within 6-8 weeks. An evaluation of the returned function, about 1 year after the beginning of the paresis, i.e. at a time when the regeneration is basically completed, shows that all cases with an originally poor function (judged 6-8 weeks after onset of paresis) had changed into cases with a moderate function, and all cases with an originally moderate function had turned into cases with a good function. In another study concerning patients with idiopathic facial paresis the same method yielded results comparable to those of the above-mentioned study, so that the conclusion can be drawn that in the prognostication of the peripheral facial paresis by means of determining the sum potential amplitude-regardless of whether the facial paresis is of viral or idiopathic etiology-the same yardsticks have to be applied.

[Diarrhea and islet cell tumor. Clinical and morphological report on 2 observations]. / Diarrhoen und Inselzelltumor. Klinischer und morphologischer Bericht über 2 Beobachtungen

The combination of diarrhea with an islet cell tumor (Verner-Morrison Syndrome) is a clinical picture presenting many diagnostic problems. It is probable that larger numbers of cases will be encountered with more widespread knowledge of this disease. The clinical features and the pathologic-anatomical findings of two characteristic cases are reported and discussed.

[Skeletal scintigraphy in otolaryngology (author's transl)]. / Die Skelettszintigraphie im HNO-Bereich.

Close relation of non osseus facial skull portions to the skeleton cause rapidly the bone to become co-involved in presence of various diseases. Early diagnosis is of decisive importance for therapeutic measures. For localisation scintigraphy has proved particularly reliable in aids to early determination. This can be shown clearly in inflammatory diseases and tumour infiltrations with various tumour affections. Technical requirements and the use of skeletal scinitgraphy are demonstrated on hand of 6 cases.

[Primary choroidal alveolar soft part sarcoma. Ophthalmopathology and histogenesis]. / Primäres alveolares Weichteilsarkom der Aderhaut. Ophthalmopathologie und Histogenese.

This is the first report on a primary choroidal alveolar soft part sarcoma in a 37-year-old male, who died 1 1/2 years following enucleation secondary to multiple metastases. Histology and differential diagnosis of this tumour are discussed. Histogenetically, because of the localization in the choroid, as far as the origin of these tumour cells is concerned, they supposedly stem from cell systems of the neuroectoderm. Since from these cell systems the malignant melanoma of the choroid arises too, a close relationship of these tumours is concluded.