[Intubation aid by a rigid endoscope]. / Intubationshilfe durch starre Endoskope.

A method has been developed making it possible to look around intubation obstacles with the aid of rigid angular-lens systems. A glottis that is not or is only partly visible in direct laryngoscopy can be visualized endoscopically. The normal intubation technique is retained. A rigid endoscope is additionally introduced into the oropharynx, the glottis located endoscopically, and the endoscope secured to the laryngoscope in the position. The free hand can then be used to advance the tube through the glottis into the trachea under endoscopic control. This endoscopic method is intended to augment the physician's instrumental repertoire.

[Lymphocyte subpopulations and HLA-DR determinations in diseases of the inner ear and Bell's palsy]. / Lymphozytensubpopulationen- und HLA-DR-Bestimmungen bei Erkrankungen des Innenohres und Bellschen Paresen.

Thymus lymphocytes-subpopulations (T-helper T4 and T-suppressorcells T8) were determined in inner ear diseases (e.g. sudden hearing loss, neuronitis vestibularis, Morbus Menière, Bell's Palsy) by specific monoclonal antibodies. T-cell subset ratio (T4/T8) was elevated (less than 3) in about 50% of all patients. DR-typifying was performed because of the well-known control of the immunoregulation through the class II HLA-DR antigens. There was a relative risk of 5.2 in peripheral vestibular lesion (neuronitis vestibularis). The relative risk of autoimmune diseases is found at this level.

[Significance of human salivary and mucosa mucins in the area of the upper respiratory and digestive tract]. / Zur Bedeutung menschlicher Speichel- und Schleimhautmuzine im Bereich der oberen Luft- und Speisewege.

The importance of the mucins in saliva and mucus for the mucous membranes of the aero-digestive tract is underlined. The biochemistry of the mucins is briefly talked over, with the biological significance of the neuraminic acid being especially evoked. Decisive functions of the mucins for the mucous membranes of the upper respiratory and alimentary tracts, such as the protective, lubrication and transport functions, as well as their contribution to the formation of surface tension are discussed. Some of the few known pathobiochemical relationships are described. Pathobiochemistry of the mucins may also contribute to a better understanding of unsettled oncological problems of the aero-digestive tract. Mucin changes due to noxae--as e.g. by alcohol--may lead to a reduction of the mucous and salivary protective functions. After restricted mucin protective function, noxae--such as tobacco smoke--may then exercise their cancerogenic effects on the then unprotected epithelium.

[A protective hearing aid (author's transl)]. / Gerät zur Spracherkennung bei gleichzeitigem Lärmschutz.

A device consisting of a hearing protector headset and a modified hearing aid is used as a protective hearing aid for normal hearing subjects. Understanding of sufficiently redundant speech is remarkably improved, especially for noise level of about 20 dB above speech level. Tests have been made with the "Freiburger Zahlentest" and amplified "party noise" up to noise levels of 105 dBSPL. As an example: the above mentioned device enables the wearer to understand speech of 85 dB with 105 dB loud speech similar background noise while still the ears are charged with no more than 90 dB at all. Application for hyperacusis and recruitment patients is discussed.

[Audiological results in hearing loss in old age]. / Audiologische Ergebnisse der Altersschwerhörigkeit.

A significant loss of performance of the ear was found to be a function of age in all audiological tests. Clear cases of presbycusis were only determined in persons above 70 years of age. According to finds, a severely handicapping loss in the ability to understand speech only occurred in the 90-year-old group suffering from primary presbycusis. A disturbing impairment of hearing in younger persons is most likely due to a secondary presbycusis. Contrary to previous opinions suprathreshold tests indicate a high percentage of sensoneural hearing losses are due to cochlear lesions. The dichotic discrimination test showed the highest correlation to age. This especially seems to be caused by age-inherent changes in central pathways. Altogether, although it has been this study were considerably handicapped, they were, however, thoroughly able to understand speech under favorable conditions.

[Speech audiometry in advanced age - differentiating between the elements of primary and secondary presbyacusis (author's transl)]. / Sprachaudiometri im Alter. Versuch einer Trennung von primärer und sekundärer Presbyakusis.

Tone threshold, speech intelligibility by the Freiburg test with loss of hearing for speech, discrimination loss and total word intelligibility, dichotic discrimination and binaural summation ability were all measured in 167 test subjects aged between 65 and 91 years. The statistical processing of the numerous parameters shows that all parameters manifest a worsening of hearing with age, the individual values revealing a considerable scatter. Tone loss proved to be largely cochlear in nature. All the speech audiometric parameters correlated highly significantly (binaural summation significantly) with age, in the sense that increasing was accompanied by a worsening of the hearing ability. The complex correlations among all the hearing parameters lead us to believe that ageing affects the organ of hearing as a whole, and not merely specific parts of the auditory pathway. A possibility for differentiating between the elements of primary and secondary presbyacusis, and for measurement of the biological age of the sense organ, ear, is discussed.

[Hearing defects after purulent meningitis (author's transl)]. / Hörstörungen nach Meningitis purulenta.

80 children in the age of 4 to 20 years who got over a purulent meningitis in infancy or childhood were examined by means of several audiological methods. Two children (2,5 percent) were found to be deaf. In 4 cases (5 percent) deafness was detected only unilateral not preferring the right or left ear. Hearing impairment after the eights cranial nerve damage was found in four children. 4 children suffered from severe to profound hearing defects on one side or bilateral. No correlation could be found between incidence and severity of the hearing defects to the total dose of the antibiotics that were penicillin, ampicillin and gentamycin. Before the background of the literature reported on this subject and the presented results hearing impairment after purulent meningitis seems to be more likely a sequela of inflammation than a toxic side-effect of the antibiotics.

The mechanical properties of exposed human common carotid arteries in vivo.

In exposed common carotid arteries of 15 patients (36-74 years) undergoing neck surgery, the intra-arterial pressure (P) was recorded by means of a catheter-tip manometer and, at the same site, the external diameter (D) by means of a contact-free photoelectric device. On the average, the pulsatile diameter changes were 5.6% of the end-diastolic diameter at pulse pressures of about 50 mm Hg. Due to viscoelasticity, the P-D diagrams exhibited hysteresis loops. Using the criterion of loop elimination, an iterative procedure was applied which permitted, by the use of an appropriate computer program, the separation of the purely elastic and the purely viscous components of the P-D relationships. In all cases, the purely elastic P-D curves markedly deviated from linearity. The tangential elastic modulus (Et) and the pulse wave velocity (c) calculated from these curves were normalized by dividing these quantities by the respective end-diastolic values and plotted against the normalized external diameters. During each pulse cycle, Et increased, with increasing diameter, by a factor between 1.2 and 3.5, while c increased by a factor between 1.1 and 1.9 with reference to the respective end-diastolic values.

[T-lymphocyte subpopulation and HLA-DR antigens in hearing loss of vestibular neuropathy, Ménière's diseases and Bell's palsy]. / T-Lymphozytensubpopulationen und HLA-DR-Antigene beim Hörsturz, der Neuropathia vestibularis, dem Morbus Ménière und der Bellschen Parese.

In patients with various otoneurological diseases like hearing loss, neuronitis vestibularis, Ménière's disease and Bell's palsy, analyses concerning the immunoregulation and immunogenetics were done. For analysing the immunoregulation the T-helper (CD4) T-suppressor (CD8) ratio was determined. In contrast to patients with hearing loss caused by otobasal fractures and a healty control group, this ratio was elevated in 50% of the patients suffering from hearing loss. The elevation of the CD4/CD8 ratio was mainly caused by a reduction of CD8 positive cytotoxic-suppressor T-lymphocytes. The CD4/CD8 ratio may be of prognostic value, since an elevated ratio was found more often in patients with relapse of hearing loss, fluctuations, persistence of tinnitus or vestibular symptoms. An elevated ratio could also be detected in 48% of the patients with neuronitis vestibularis, in 50% of the patients with Ménière's disease and in 39% of the patients with Bell's palsy. A normal value was found in paralysis of the facial nerve of known origin like a state after trauma or after herpes zoster oticus paralysis. Immunogenetics was tested by HLA-DR typing. In patients with hearing loss HLA-DR4 antigen was distinctly increased, the relative risk was 2.8. The presence of the HLA-DR4 antigen proved to be an unfavourable sign, since in 44% of the patients presenting these antigens we found no improvement of the hearing. In patients with neuronitis vestibularis we found a relative risk of 3.12 and in patients with Ménière's disease a relative risk of 3.64, both for HLA-DR4.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of carbohydrate composition and sialidase activity in oral secretions of patients with tumors in the upper aerodigestive tract.

Total saliva and secretions from parotid and submandibular glands of patients with carcinomas in the oral cavity, oropharynx or larynx and a control group of healthy individuals were analyzed for concentrations of glycosidically bound sugars and free N-acetylneuraminic acid as well as for sialidase activity. When compared to the data obtained for normal donors, the relative amounts of the individual monosaccharides fucose, galactose, mannose, N-acetylgalactosamine, and N-acetylglucosamine as components of glycoconjugates showed variable differences to the group of tumor patients depending on the type of secretion and the location of the tumor. The percentage of glycosidically linked N-acetylneuraminic acid, however, was always higher for the healthy donors. A significant difference was found in the amount of free sialic acid, with the exception of submandibular gland secretion from a patient with an oropharyngeal carcinoma, and sialidase activity which were increased for tumor patients, independent of the type of secretion and the location of the tumor. From these results it is concluded that free sialic acid and sialidase activity may be considered as markers for carcinomas in the upper aerodigestive tract.