[The measures of the invalid insurance in the field of ORL (author's transl)].
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Biomedical subjects
Publications and source records attributed to J Sopko.
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The early clinical and histological diagnosis of acquired bullous dermatoses (pemphigus, bullous pemphigoid and the cicatricical pemphigoid of mucous membranes) may prove to be difficult when the disease is confined to the upper air and food passages. Histological differentiation between these diseases can also be difficult. In a number of cases it could be shown that the first signs of the disease were frequently mistaken for inflammatory conditions and that routine histological examination rarely confirmed the diagnosis. Only after immunohistological and immunoserological examination could the diagnosis be confirmed. In pemphigus, the treatment can be individually adapted to the titre of antibodies. The typical otorhinolaryngological findings in each of the three diseases are described.
Liver disease is a common complication in renal transplant recipients. Several types of liver disease can occur. The most common are acute and chronic hepatitis. The variety of acute hepatitis include hepatitis A, hepatitis B, cytomegalovirus hepatitis, herpes simplex hepatitis and azathioprine hepatitis. The incidence of azathioprine hepatitis may not be as high as initially suggested. Chronic hepatitis is a serious problem because the disease seems to be progressive despite prednisone therapy. The causes of this chronic hepatitis are not fully known, although hepatitis B, cytomegalovirus and herpes simplex virus have been implicated. Discontinuation of azathioprine therapy has no appreciable effect on the course of chronic hepatitis.
Organs which contain collagen can have connective tissue new growth in systemic scleroderma. The occurrence of scleroderma of the larynx and organs of speech is rare. The disease develops in the mucous membrane in three stages: oedema; infiltration and induration; and atrophy. The oedema stage is generally the shortest. Three patients with systemic scleroderma with involvement of larynx and organs of speech have been seen. In one is described (graphically, sonographically and with stroboscopy) the progress of the disease from an initial severe hoarseness to later resolution of the oedema. In another patient involvement of the soft palate produced rhinolalia. In spite of the limitation of tongue movement in 2 patients there was no disorder of articulation.
The quality of esophageal voice and speech after laryngectomy depends on several factors. Negative influences are produced by irradiation, resection of the hyoid bone and radical neck dissection. The factors important in esophageal speech were analyzed, with consideration given to the functional morphology of the pseudoglottis and the reconstructed hypopharynx. Phoniatric, laryngologic and radiologic aspects are considered.
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Between 1968 and 1974 10 patients (4 men, 5 women, and 1 10-year-old girl) with spastic dysphonia were observed at the Phoniatric Department of the ENT clinic in Lucerne. According to the clinical documentation, the probable etiologic factors, the clinic appearance as well as the therapeutic measures and their results are discussed.