Biomedical subjects
Publications and source records attributed to P Gundlach.
We report a case of bulimia nervosa with bilateral swelling of the parotid and submandibular glands. It was the only symptom of the behavioral disorder. Sjögren's disease was excluded histologically. In our case, the parotomegaly as a symptom of sialadenosis was found at the same time as the eating disorder. MRI or ultrasound are important diagnostic tools to confirm the diagnosis.
The diagnosis of obstructive salivary duct disorders to date has been based on imaging by roentgenography and ultrasound, which do not always yield a precise diagnosis. Sialendoscopy is a new procedure for identifying the cause of obstructive symptoms with direct inspection of the efferent salivary duct system by means of a microendoscope. This new technique does not impose a strain on the patient and is performed under local anaesthesia on an outpatient basis.
Progressive miniaturization of flexible fibreoptic systems has made it possible for the first time to perform atraumatic endoscopy of the Eustachian tube and tympanic cavity with the ear drum intact. With the aid of special actively steerable microcatheters, flexible fibrescopes having outer diameters of 350 to 650 microns are inserted into the opening of the naso-pharyngeal tube and advanced into the tympanic cavity under direct visual control. This new technique is indicated for any disturbance of sound conduction and in those sensorineural hearing disorders in which direct inspection of the middle ear cavity can provide information on the pathogenesis of the disturbance. In the future it may thus replace purely diagnostic tympanoscopy. In combination with fibre-delivery laser systems, this new method forms the basis of "microendoscopically controlled laser surgery" of pathological changes within this anatomical region.
Tumours originating from the laryngeal skeleton are a rarity. They occur in most cases in adults aged between 40 and 60 years and are seen four times more often in males than in females. A case study of a congenital chondroma of the larynx is presented that resulted in a connatal stridor. It is emphasised that chondromas of the larynx should be considered in differential diagnosis of congenital anomalies of the larynx. Early excision of the complete tumour with minimal destruction of the adjacent laryngeal tissues is recommended as the treatment of choice.
Reconstruction of defects after tumor ablation has been accomplished by a variety of different techniques. The platysma musculocutaneous flap for reconstruction is outlined and the surgical technique described. It provides 8 x 10 cm of flap coverage. The donor site is closed primarily without cosmetic defect. Forty of 48 patients on whom this flap was used healed without complication.
An in vitro study was performed to examine the application of a laser beam for the fragmentation of salivary stones. In accordance with the absorption and reflection spectra of sections of salivary stones, optimal fragmentation was achieved using a pulsed excimer laser with a pulse width of 60 ns and a wave-length of 308 or 351 nm. Further studies on particle size were conducted and a new "sialoendoscope" technique was developed. Twelve patients suffering from a sialolithiasis of the submandibular gland were treated. Under continuous endoscopic monitoring a laser-induced shock wave lithotripsy was performed. In 11 cases complete fragmentation and removal of the salivary stones was achieved. This approach to laser lithotripsy of salivary stones with endoscopic monitoring represents a novel method that permits treatment on an outpatient basis under local anaesthesia, with little inconvenience to the patient.
Caloric testing was performed during parabolic flight at the NASA Reduced Gravity Facility in Houston, Texas. Six test subjects were stimulated with continuous unilateral air insufflation (25 degrees R), in a manner similar to the experiments performed in the extended weightlessness of orbital flight during the SL1 and D1 Spacelab missions. Nystagmus response was recorded by electro-oculography and eye video image. It was the purpose of the experiments to re-examine the apparent discrepancy between the disappearance of caloric nystagmus during short episodes of weightlessness and the finding that caloric responses can be elicited during periods of extended weightlessness. The present results agree with those of earlier experiments in that a prompt reduction of caloric nystagmus occurs on transition from hypergravity (1.8 G) to weightlessness. The time constant of nystagmus decay was estimated to be approximately 2-3s, a value which cannot be explained by cupular mechanics. A central gating mechanism involving the labyrinthine canal and otolithic afferents is proposed for the observed modulation of caloric nystagmus.
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Spinal hemangioblastoma in early infancy is an extreme rarity. In the case presented here such a hamartomatous tumor is combined with dysraphic malformation of the CNS in a male infant aged seven months. The morphological, epidemiological and clinical aspects are discussed with special reference to the possibility of congenital occurrence.
A case of incomplete von Hippel-Lindau's disease is described. Our patient is characterized by multilocular and recurring typical hemangioblastomas in the cerebellum and the spinal cord. Moreover there are hints at familiar pre-disposition. Based on the recent literature the morphological and clinical characteristics are discussed with special consideration of modern radiological (myelography, arteriography, computertomography) and laboratory (hemoglobin levels follow-ups) investigations.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.