Acidity in the endolymphatic sac fluid of guinea pigs.

The pH value and the DC potential in the endolymphatic sac (ES) were measured using H(+)-selective double-barreled electrodes and the intra- and extradural approach, the pH value in the ES fluid (6.65 +/- 0.12, n = 7) was markedly lower than that in the cerebrospinal fluid (7.39 +/- 0.07, n = 7). Acidity in the ES fluid, under normal (nontreated) conditions may be closely associated with metabolism in the epithelium of the ES.

Cortical activation in profoundly deaf patients during cochlear implant stimulation demonstrated by H2(15)O PET.

Cochlear implants (CIs) are used to provide sensations of sound to profoundly deaf patients. The performance of the CI is assessed mainly by the subjective reports of patients. The aim of this study was to look for objective cortical responses to the stimulation of the CI. Two postlingually and two prelingually deaf patients were investigated by positron emission tomography (PET) using 15O-labeled water (H2(15)O) to determine the regional cerebral blood flow (rCBF). Instead of quantifying rCBF in absolute terms, it was estimated by referring the regional tissue concentration of H2(15)O to the mean whole brain concentration. CI stimulation encoded from white noise and sequential words led to an increased rCBF in the primary and secondary (Wernicke) auditory cortex. Relative elevations of up to 33% were observed bilaterally, although they were higher contralateral to the CI. These results were obtained not only in the postlingually deaf patients but also in two patients who had never been able to hear. Thus, it could be demonstrated that PET measurements of cerebral H2(15)O distribution yield objective responses of the central auditory system during electrical stimulation by CIs in profoundly deaf patients.

[Establishing three dimensional tumors in vitro and the reaction of the lymphokine-activated killer cells (LAK) to the three dimensional tumors]. / Etablierung dreidimensionaler Tumoren in vitro und Wirkung von lymphokin-aktivierten Killer (LAK)-Zellen auf die dreidimensionalen Tumoren.

In this study, we attempted to develop a technique, by which three-dimensional tumors were produced from two cultured head and neck tumor cell lines (Hep2, KB) and a colon adenocarcinoma cell line (HT29) using fibrinogen, thrombin, and double layered agar system. The three-dimensional tumor was large enough to perform the histologic study, which showed no significant histologic difference in comparison with the histologic findings of the xenografted tumor on nude mice. Furthermore, we applied this assay model to evaluate the antitumor effect of lymphokine activated killer (LAK) cells on the three-dimensional tumor produced by the technique. When tumor cells were cocultured with LAK cells, the damage of the three-dimensional structure due to the degeneration of tumor cells was observed. These findings suggest that the three-dimensional tumor may be useful to evaluate the antitumor effect of LAK cells in term of head and neck solid tumors.

[The effect of functional impairments and autonomic symptoms on the quality of life after the therapy of tumors in the ENT area]. / Einfluss von Funktionsbeeinträchtigungen und vegetativen Symptomen auf die Lebensqualität nach Tumortherapie im Kopf-Hals-Bereich.

Life quality in tumour patients has received growing scientific and public attention. While most studies focus on patients with tumours in the thorax or abdomen, less is known about determinants of life quality in patients with tumours in the head-neck region. In this report, we focus on the role of tumour localisation, clinical staging, functional impairments, and vegetative symptoms on the rating of life quality. In a structured interview, 222 tumour patients regularly followed-up by the Department of Otorhinolaryngology were asked about aspects of their illness, especially with regard to life quality. The results show that clinical stage of tumour had an U-shaped effect on life quality. Patients on stage 1 or on stage 3 had higher life quality ratings than patients on stage 2, which may indicate divergent coping styles of the patients. Patients with impairments of swallowing, tasting, whispering or breathing rated significant lower on life quality. Moreover, patients suffering from pain, with sleeping problems, with impairments of their bodily appearance or of their sex life rated significantly lower on life quality. Tumour localisation had no effect on ratings of life quality. In conclusion, it can be stated that life quality of tumour patients in otorhinolaryngology is influenced by clinical stage of the tumour, functional impairments and vegetative symptoms.

Effect of lymphokine-activated killer cells on head and neck tumours in nude mouse model.

The present study was designed to investigate the in vivo effect of local application of lymphokine-activated killer (LAK) cells on the growth of tumours implanted under the renal capsule in nude mice, and especially to test whether large granular lymphocytes (LGL), regarded as natural killer (NK) cells, are the main precursor of LAK cells in vivo. Our results showed that the local application of LAK cells inhibited the growth of tumours in the head and neck region. The growth of tumours implanted under the renal capsule was inhibited by local application of 1 x 10(7) recombinant interleukin-2 (rIL-2) activated non-adherent lymphocytes, but the inhibitory effect was almost the same as produced by 3 x 10(6) rIL-2-activated LGL application. The findings indicate that the rIL-2-activated LGL are the main effectors in inhibiting tumour growth. In addition, rIL-2-activated non-adherent lymphocytes as well as LGL significantly prolonged the number of days of 50% survival and mean survival time of nude mice, in which HLaC78 cells, from a laryngeal tumour cell line, were injected into the subrenal capsule space with effector cells at various effector: target (E:T) ratios. The results indicate that the application of LAK cells may be useful in the treatment of patients with head and neck tumours.

[Clinical aspects, diagnosis and therapy of space-occupying tumors of the orbit]. / Klinik, Diagnose und Therapie raumfordernder Prozesse der Orbita.

In the presence of obvious, diffuse tissue proliferation in the retrobulbar space coupled with pain, increased erythrocyte sedimentation rate and a good response to corticosteroid administration, it is safe to assume, in consultation with an ophthalmologist and without doing a biopsy, that the lesion is a pseudotumour. For all other proliferative processes in the orbit and around the medial and inferior rectus muscles histological verification is indicated. The surgical approach is dictated by the site of the tumour in relation to the optic bulb and nerve. Computer tomography does not provide any indication as to the nature of a retrobulbar lesion. A specific neoplasm with destruction of the bone requires immediate diagnostic verification by biopsy via an orbitotomy.

Xenografting of nasopharyngeal carcinoma into athymic mice.

Four nasopharyngeal carcinomas (NPC) with positive Epstein-Barr virus serology were successfully grafted into athymic mice. Tumor growth could be maintained up to the 22nd passage. Strong similarity between original NPC biopsies and xenografts is demonstrated in terms of light microscopy and immunohistochemistry. Growth kinetics show an increase of tumor volume doubling time and a decrease of the labeling index after several passages. Xenografting of NPC into nude mice is evaluated as a useful in vivo tumor model for experimental NPC investigation.

Stimulation of peripheral blood lymphocytes with autologous tumor and serum-derived fractions from patients with laryngeal carcinomas.

We investigated the in vitro stimulation of peripheral blood lymphocytes with tumor extracts and serum-derived fractions from five patients with laryngeal carcinomas. Lymphocyte cultures were propagated by Interleukin-2 or phytohemagglutinin. Sera of the same patients were fractionated and the amount of circulating immune complexes present was measured by a Raji cell assay. A positive lymphocyte reaction was found in only two of the five cases after stimulation with autologous tumor extract. This response was determined by an increased 3H-thymidine incorporation. The reactive lymphocytes could be restimulated by autologous serum-derived fractions, which contained high or very low levels of circulating immune complexes. A characterization of different lymphocyte subsets revealed an elimination of natural killer cells and a relative enrichment of T-helper cells during in vitro stimulation and cultivation.

The expression of Ia-antigen on nasopharyngeal carcinomas xenografted into nude mice.

The expression of Ia-antigen on four different Epstein-Barr virus associated nasopharyngeal carcinomas xenografted into athymic mice could be detected by the monoclonal antibody OKIa. Xenografts of four additional head and neck tumors other than nasopharyngeal carcinoma and one xenograft of a metastatic melanoma cell line were negative for the Ia-antigen. Control antibodies OKT3, OKT4, OKT9, OKM1 and Leu7 were negative with all nasopharyngeal carcinomas and the non-nasopharyngeal carcinoma xenografts. Complement receptors as the presumed receptors for the Epstein-Barr virus could not be detected on xenografted nasopharyngeal carcinoma cells but were found on freshly prepared peripheral blood lymphocytes as well as on the Epstein-Barr virus transformed lymphoblastoid cell line QIMR-WIL. The possible role of the Ia-antigen on nasopharyngeal carcinoma cells in respect to the Epstein-Barr virus association of this malignancy is discussed.

[Therapy of acute hearing loss]. / Zur Therapie des akuten Hörverlustes.

In the treatment of sudden deafness there is no significant difference between Rheomacrodex i.v., Procain i.v., Dusodril i.v., Ronicol i.v., Complamin i.v. or anaesthesia of Ganglion stellatum. We show that good outcomes are attributed to spontaneous recovery. The so called "good effect of early therapy" in sudden deafness is the result of selection of spontaneous recovery. The prognosis of sudden deafness with according vestibular symptoms is less favourable. A definite clarifying of spontaneous recovery needs a prospective randomised double blind study.

[Effect of tumor size on lymph node metastasis and type of treatment on the prognosis of hypopharyngeal cancer]. / Der Einfluss von Tumorgrösse, Lymphknotenbefall und Behandlungsart auf die Prognose des Hypopharynxkarzinoms.

A retrospective follow-up examination of 117 cases results in: (1) The crude survival rates for 3 resp. 5 years are 19% resp. 15%. If those patients whose cause of death has not been the tumour, are taken into consideration, the crude survival increases to 44.5 resp. 31%. The unfavourable prognosis depends on the enlarged stage of the carcinomas in the moment of diagnosis. (2) The survival chance decreases with increasing tumor size. Much more however it will be affected by the neck node metastases. In our patients the survival rate for pN 1-3 is less by half of pN 0. Therefore not only the TNM-system (UICC) but also the staging (AJC) should be used for the classification of hypopharyngeal carcinomas. (3) The main cause of death are lymph node relapses. The high frequency of contralateral node relapses requires bilateral neck dissection in most of the cases. (4) Combined radio-surgery gives the best results in cases of hypopharyngeal carcinoma, no matter if radiation will be applied pre- or postoperatively. (5) Radiation alone may be useful only in tumours of stage IV. In our opinion, mutilating surgical intervention will not improve the survival chance in these cases.

Functional and morphological findings of endolymphatic sac.

After obliteration of endolymphatic sac and duct, no significant alteration in d.c. potential, K+ activity or protein content during the development of endolymphatic hydrops could be observed. The K+ activity of endolymphatic sac was only one-ninth of that in the cochlear part of the endolymph. After injection of Thorotrast into the endolymphatic sac, aggregated particles were found in the cochlear endolymph 2 days later. Ethacrynic acid (60 mg/kg) caused a decrease in K+ activity in the cochlear endolymph, but an increase in the endolymphatic sac. Intercellular edema was observed both in stria vascularis and in endolymphatic sac by light and electronmicroscopy after ethacrynic acid administration. These results suggest the existence of an active transport mechanism in the endolymphatic sac epithelium.