Biomedical subjects
K G Rose
Publications and source records attributed to K G Rose.
[Drug and non-drug tumor pain therapy in ENT medicine].
The basic of analgesic therapy in patients with advanced cancer of the head and neck is the regular application of analgesics and adjuvant analgesics. Radiotherapy is the treatment of choice in patients suffering from severe pain by bone metastases. Analgesic-resistant pain of dura in patients with tumour infiltration of the skull base is an indication for intraventricularly application of opioids by neurosurgeon.
[The expanded transconjunctival approach with lateral canthotomy to the orbital margin, floor and infraorbital nerve].
The range of indications for and the surgical technique of the extended transconjunctival approach to the inferior and lateral orbital margin, the floor of the orbit, the upper part of the facial wall of the maxillary sinus and the medial part of the zygomatic bone are described. We present 64 patients with mid-face fractures: 9 with fractures of the orbital margin, 48 with isolated blow-out fractures, and 7 with zygomaticomaxillary fractures. All have been operated on in the last 5 years. The transconjunctival approach extended by a lateral canthotomy is better than infraorbital or subciliary access. Exposure and cosmesis are excellent. None of the complications that follow other methods were seen after our surgical treatment.
Chemotherapy of advanced and relapsed squamous cell cancer of the head and neck with split-dose cisplatinum (DDP), 5-fluorouracil (Fura) and leucovorin (CF).
58 patients with locally advanced or relapsed squamous cell head and neck cancer were treated on 5 consecutive days with DDP 20 mg/m2/d IV-push, followed by CF 100 mg/m2/d IV-bolus and Fura 400 mg/m2/d IV-push 60 minutes later. Treatment was recycled on day 22(-29), according to toxicity. CF was added to the widely used DDP/Fura combination, because recent studies showed enhancement of Fura-activity by CF. 45/58 patients had no prior therapy and 13/58 pts were relapsed after chemotherapy and/or radiation therapy. All patients were evaluable for toxicity and response. After 3 courses of induction chemotherapy 23/45 pts in the previously untreated group had a complete response (CR); 20/45 a partial response (PR), 2/45 were restaged as no change (CR + PR: 95%). Induction chemotherapy was followed by radical surgery and postoperative radiation therapy. In the pretreated group 4/13 pts had a complete response; 6/13 a partial response; no change in 3/13 pts. Median duration of remission (MDR) has not been reached in the primarily untreated group, whereas in pretreated patients the MDR was 3.8 months (range 2.3 - 11.7 months). Hematologic and gastrointestinal toxicity was substantial but manageable and therapy was performed on an outpatient basis. The combination of DDP, CF and Fura has high activity in untreated and pretreated head and neck cancer patients. The obtained results are comparable to the widely used DDP/Fura continuous infusion regimen.
[Magnetic resonance tomography in acoustic neurinomas].
The possibilities of MR and CT were compared in respect of neurinomas of the acoustic nerve (n. acusticus). The comparison showed that MR detection of tumours in the posterior of the cranial cavity is the more sensitive method, especially in respect of neurinomas of the acoustic nerve, although CT enables the use of the small-level technique with or without the addition of a contrast substance, as well as the application of pneumocisternography. The sensitivity of MR can be increased further by adding a contrast medium. Whereas in diagnosis of extrameatal neurinomas of the n. acusticus, CT and MR are of equal value, MR shows substantial advantages over CT in the diagnosis of intrameatal tumours (without enlargement of the inner ear canal). The same holds true for very small tumours of up to 1 mm diameter, the visualisation of which is greatly facilitated by the multidimensional possibilities of MR and by the administration of a contrast medium.
[Pre-irradiation and surgery of patients with squamous cell carcinoma of the oral cavity and oropharynx: the results of a 1973-1984 study].
In collaboration with the Radiotherapeutic Hospital, 87 patients with squamous cell carcinomas of the oral cavity and the oropharynx were treated by combined pre-irradiation and surgical intervention at the University ORL Hospital of Cologne. The study was supposed to improve the five-year survival of patients suffering from advanced carcinomas of the head and neck area. The male and female patient's ratio was 4.5 to 1. Half of the patients had squamous cell carcinomas of the oropharynx, 21 patients had tumors of the floor of the mouth, and another 21 had tumors of the anterior two thirds of the tongue. The tumor and lymph node status was classified according to the UICC regulations (1979). In the pre-irradiation, 40 to 50 Gy were applied to the primary tumor and the regional lymph nodes. Surgery was executed generally four weeks after pre-irradiation. The tumor remission following to pre-irradiation was very good. 27% of the patients showed little or moderate post-operative disturbances in wound healing. An osteoradionecrosis was found in 4.6%. Almost 25% of the patients developed local recurrences. The cumulated five-year survival of all patients is 32%. In dependence on TNM stages, the three-year survival rates are as follows: stage I and II 80%, stage III 44%, and stage IV 40%.
[Radical surgery following preliminary irradiation of oropharyngeal cancer].
Explore the source record for details and available documents.
[Magnetic resonance tomography in tumors of the facial bones and neck area].
32 patients with lesions of the facial skeleton, the neck and the parapharyngeal space were examined with NMR (Nuclear Magnetic Response). The results are compared with CT scanning. NMR offers high soft tissue contrast. Multiplanar imaging easily distinguishes tumours and lymph nodes from the cervical vessels and muscles. In contrast CT, is more useful for the imaging of destruction of the facial skeleton and the skull base.
[Livedo racemosa].
Livedo racemosa is a very rare disease with an idiopathic and symptomatic form. The diagnosis is very difficult to make because many primary diseases are responsible. Skin reactions show no typical form and range from urticarial nodules and purpuriform papillae to ulceration. The symptomatic form of livedo racemosa causes circumscribed, asymmetric lesions restricted to one half of the body, while the idiopathic form is characterised by arborization figures and livid tendril-like discolorations. There are many suggestions given in the literature for the therapy of the primary disease and of the skin, including long term therapy with high dosed rubifacient drugs or steroids. However, livedo racemosa often shows a slow progression despite treatment.
[Stapes anomaly, Gorlin-Goltz and hand-foot-uterus syndrome as partial aspects of a generalized ectodermal-mesodermal abnormality syndrome with variable expression].
A case of a Gorlin-Goltz-syndrome with anomalies of the stapes and incus of one ear is described for the first time. In the reported case, the hand-foot-uterus-syndrome could be recognised simultaneously. In the literature, about 250 cases of the syndrome are known, first published by Gorlin and Goltz in 1960. Malformations of the middle ear, however, have not yet been described in the Gorlin-Goltz-syndrome. As in the reported case both of the syndromes, the Gorlin-Goltz-syndrome and the hand-foot-uterus-syndrome, could be diagnosed, it must be discussed whether there are two independent syndromes or only one syndrome of polyvalent malformations characterised by variable expressivity.
[Fibrolipomas of the hypopharynx and esophagus. Contribution to their clinical aspects and therapy].
Five patients with benign fibrolipomas of the hypopharynx or the oesophagus are presented. The diagnosis, clinical features, differential diagnosis and therapy of these rare tumours are discussed with special reference to an uncommon case.
[Sleep apnea syndrome in children: indications for tonsillectomy].
Laryngo-tracheo-bronchoscopy on a 2 year old boy with the sleep apnea syndrome showed no anatomic abnormalities and no signs of upper airway obstruction. After tonsillectomy the infant revealed an improvement in sleep pattern, and 1 1/2 years later, the syndrome has been relieved completely. In our opinion, the sleep apnea syndrome is an indication for tonsillectomy.
[Antibiotic therapy in patients with renal insufficiency].
For the otolaryngologist (ENT specialist), too, antibiotics are among the most frequently prescribed drugs. This article gives the essential fundamentals for the antibiotic treatment of patients with restricted kidney functions, as well as advice for antibiotic therapy in clinics and in medical practice.
[The use of antibiotics and chemotherapeutic agents during pregnancy].
Physicians engaged in all general and specialist fields of medicine may at times be confronted with the necessity of prescribing an antibiotic or chemotherapy for pregnant patients. This article gives ample advice on the therapy with antibiotics and chemotherapeutic agents during pregnancy.
[Tuberculosis of the cervical lymph nodes: report of 193 cases].
193 patients suffering from tuberculosis of the cervical lymph nodes are analysed. All cases were examined with respect to sex, age, nationality and typical findings of blood parameters. The diagnostic and therapeutic proceedings are elucidated. Histological diagnosis should be done, but micro-biology is only significant in a few cases. Tuberculosis of lymph nodes of neck should be considered in obscure swellings of the neck.
[Significance and problems of pseudomonas infection in ENT medicine].
Pseudomonas aeruginosa is frequently cultured in chronic otitis media, in external otitis, and from infected radical mastoid cavities. Necrotizing external otitis is a typical infection caused by Pseudomonas aeruginosa. Perichondritis of the external ear is sometimes due to a Pseudomonas aeruginosa infection. Some cases of chronic sinusitis and wound infections in patients with tracheostomy are caused by this organism. Antiseptic agents or astringents should be used for local treatment of Pseudomonas infected ears. If these fail local treatment with azlocillin for several days is a good alternative. Systemic antibiotic therapy is also available for Pseudomonas aeruginosa infections.
[Secondary effects of antibiotics].
Explore the source record for details and available documents.
[Diagnosis and therapy of syphilitic changes of the skin and mucous membrane in the head and neck].
Since the mid seventies the German Federal Board of Statistics has recorded a decrease in the incidence of the classical venereal diseases gonorrhoea and syphilis. This decrease is based only on a decline in the morbidity of gonorrhoea. Statistics on syphilis show an increase, from about 6000 to 8900 new cases each year, that is an increase of 48% between 1974 and 1978. Some cities such as Cologne, with a total of 401 new cases each year, show an increase, while numbers in rural regions remain unchanged or show a slight decline. Between 1978 and 1980 at the ENT and Dermatologic OPC of Cologne University many ulcers of uncertain aetiology in the head and neck region have been diagnosed as primary or secondary syphilis or as unusual presentations of this disease. In our Department a primary lesion of the head and neck was the presenting symptom in about 6% of all newly diagnosed cases. The differential diagnosis of early syphilitis lesions in the head and neck, the present position of serological diagnosis, and the current treatment of syphilis are illustrated by selected typical lesions.