Amoxicillin concentrations in nasal secretions of patients with acute uncomplicated sinusitis and in paranasal sinus mucosa of patients with chronic sinusitis.

In this prospective randomized clinical study a total of 59 patients of both sexes (above 18 years of age) were enrolled. Thirty patients with acute sinusitis were randomly allocated to two treatment groups, one group receiving 1000 mg amoxicillin every 12 h for 10 days and the other group receiving 500 mg amoxicillin every 8 h for 10 days. The median concentration of amoxicillin in nasal secretions was 2.34 micrograms/ml in the 12-h administration group and 1.95 micrograms/ml in the 8-h administration group. Median bioavailability of antibiotic at 8-24 h did not show any statistical differences between the two treatment schemes [probability (Z) = 0.2]. Twenty-nine patients with chronic sinusitis were then randomly allocated to three groups, with patients receiving 1000 mg amoxicillin at 12, 8 or 6 h before nasal and/or sinus surgery was carried out. The mean amoxicillin concentrations in mucosal tissues removed intraoperatively ranged from 0.69 to 0.99 microgram/g samples. Statistical evaluation by analysis of variance did not show any statistically significant differences among the three treatment groups [probability (F) = 0.1705]. In all cases of acute and chronic sinusitis, amoxicillin concentrations exceeded minimum inhibitory concentration values for pathogens common in sinusitis. Our results indicate that 1000 mg amoxicillin administered twice daily produces tissue concentrations high enough to be clinically effective in patients with either acute or chronic sinusitis.

Local benefit of prostaglandin E2 in radiochemotherapy-induced oral mucositis.

In 15 patients suffering from maxillofacial cancer with radiochemotherapy-induced oral mucositis the local application of prostaglandin E2 (PGE2) tablets, 0.5 mg four times a day at a 4-h interval was performed. Plasma determination of the bicyclo-prostaglandin E2 metabolite showed no significant amount of the locally applied substance in the circulation. It is claimed that for this particular indication, PGE2 is a potent locally acting compound without affecting circulating levels.

Local prostaglandin E2 in patients with oral malignancies undergoing chemo- and radiotherapy.

Patients undergoing chemo- and/or radiotherapy for malignancies were often found to develop annoying inflammation of the oral mucosa. As prostaglandins are known to be cytoprotective. Prostaglandin E2 was given to 10 patients who received combined radio- and chemotherapy for oral neoplasms. Patients receiving PGE2 reported substantially less intense pain then those in the control group. Our statistically significant results indicate that topical treatment of side effects produced by combined radio- and chemotherapy of oral neoplasms with PGE2 holds promise and is clearly superior to conventional treatment modalities.

[Collection, preparation and storage of human plasma for radioimmunologic determination of thromboxane B2]. / Abnahme, Präparation und Aufbewahrung menschlichen Plasmas zur radioimmunologischen Bestimmung von Thromboxan B2.

There are at present several methods available for the quantitative determination of thromboxane B2. However, they give results differing in precision and biological information. If it were possible to exclude sampling and storage artefacts, radioimmunological plasma thromboxane B2 measurement would be the method of choice for routine clinical determinations. The optimum conditions for processing the plasma for such purposes were assessed in 10 healthy volunteers (6m, 4f, 24-37a). They include a 30-minute resting period before blood sampling, constant needle diameter, blood withdrawal without venous occlusion, proper anticoagulation and cyclooxygenase inhibition. Storage at -70 degrees C for less than 2 weeks and the avoidance of repeated freezing and thawing are further prerequisites. In contrast to widely-held opinion, the plasma levels of thromboxane B2 obtained using these precautions are of practical value, roughly comparable to those employing the platelet proteins beta-thromboglobulin and platelet factor 4. However, practically speaking determinations are limited to a small number of carefully handled samples. Hence, the method cannot be unreservedly applied to daily routine clinical use.

Indium 111-A-bleomycin--a new tracer for imaging orofacial neoplasms.

Forty-six patients with maxillofacial squamous cell cancer of variable keratinization underwent radioisotope diagnosis using Indium 111-A-bleomycin. This new technique was applied to expand the battery of diagnostic tools available for detecting maxillofacial neoplasms. Its high specificity (100%) and sensitivity (96%) make it well suited for detection of both local and distant recurrences as well as tumor regrowth. Preliminary whole body retention measurements also indicate that this technique looks promising for potential therapeutic use.

The role of interstitial irradiation (brachytherapy) with iridium-192 in the treatment of head and neck cancers.

The value of interstitial radiotherapy (brachytherapy) in the treatment of malignant tumors of the head and neck is reported, with special regard to different methods of iridium-192 implantation. The advantages and disadvantages of these techniques are discussed. Results obtained in treating patients with oral cancers are presented.

Increased plasma-6-oxo-PGF1-alpha but normal PGI2 half-life in patients with maxillo-facial tumors.

In 56 patients with histologically verified maxillo-facial cancer the plasma 6-oxo-PGF1-alpha was determined prior surgery using a specific RIA and the double antibody technique. Furthermore, the half-life of synthetic PGI2 has been assessed via the disappearance curve of biological activity on platelet aggregation inhibition. Part of the patients has been monitored by the same test different time intervals after radical surgery. Normal values of 6-oxo-PGF1-alpha amount below 1 pg/ml. - normal half-life of PGI2 in plasma in-vitro about 10 minutes. Prior surgery a significantly increased 6-oxo-PGF1-alpha can be seen, whereas the PGI2 half-life is unaffected. In patients without local or general recurrence normal 6-oxo-PGF1-alpha levels are monitored. No change occurred in the half-life of PGI2. These findings underline the additive value of 6-oxo-PGF1-alpha as a tumor marker. The data do not support the view presented earlier, that a change in plasmatic PGI2 half-life might favour the onset and the extent of recurrence at least in patients suffering on maxillo-facial cancer.

Electron beam therapy in treatment of parotid neoplasm.

In a retrospective analysis, 42 patients with malignant primary tumor of the parotid gland were evaluated considering survival, local recurrence and tolerance of treatment. All patients referred to radiotherapy were treated by electron beam (10-15 MeV) and followed for more than 5 years. Postoperative radiotherapy after radical operation, with no macroscopic disease, was performed in 18 patients, 7 of whom were treated by radical re-operation and radiation of a recurrent parotid neoplasm. In these groups, the local recurrence rate was 4/18 (22%) and 2/7 (29%), the 5-year survival rate was 9/18 (50%) and 5/7 (71%). In 17 patients, radiotherapy started with gross tumor left behind. This group showed a local recurrence rate of 10/17 (59%) and a 5-year survival of 7/17 (41%). Treatment was well tolerated with no major sequelae. Local tumor control and its impact on survival is discussed.

[Initial results of digital video image analysis procedures in the evaluation of endoscopic ENT findings]. / Erste Ergebnisse digitaler Videobildanalyseverfahren zur Auswertung von endoskopischen HNO-Befunden.

Recent developments in data processing allow transformation of video frames into digital information. This makes it possible to perform computerised analysis of endoscopic ENT-videos. Two simple pilot systems ("Genlock Computer with Superimposer" and "Videodigitizer") are shown to discuss the advantages and drawbacks of these methods.