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Biomedical subjects

R Jakse

Publications and source records attributed to R Jakse.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Pneumothorax after mediastinal emphysema. The site and mechanism of pleural rupture].

By rupture of the mediastinal pleura a mediastinal emphysema may lead to a pneumothorax. An experiment imitating this process is able to point out two spots where the pleura is most likely to tear: An area as large as a thumb tip above the root of the left lung; there mediastinal pleura covers a space the width of which changes most in respirating. The border of a fatty fold based on the pericardium and covered by mediastinal pleura; it is there that maxima of tension occur by emphysematic inflation. In general, air from the mediastinum far more often enters the left pleural cavity than the right one.

Aged↗
PubMed1986

[Chemotherapy of recurrent squamous cell carcinomas in the ENT area with cisplatin/adriamycin (DDP/ADM) and methotrexate/5-fluorouracil (MTX/5-Flu): a retrospective comparison of 2 protocols].

The efficacy of two chemotherapy regimens for recurrent and inoperable squamous cell carcinoma of the head and neck is reported. All patients had failed prior surgery and/or radiotherapy. 23 patients (group A) were treated with Cisplatin 120 mg/m2 and Adriamycin 60 mg/m2. 21/23 were evaluable for tumour response. The overall response rate (RR) was 28.5% (6/21, 2 CR and 4 PR). Methotrexate 250 mg/m2 with Leucovorin-Rescue 5 X 10 mg/m2 and 5-Fluorouracil 600 mg/m2 were administered to 28 patients. In 26 evaluable patients a RR of 38.4% (10/26, 5 CR and 5 PR) was achieved. The responders in groups A and B had a median survival of 98 and 85.5 weeks respectively and the non-responders 27 weeks in both groups. Nausea, vomiting and alopecia were common and severe in the DDP/ADM group. The major toxic effect of MTX/5-FU was neutropenia with two associated deaths from septicemia, although subjective side-effects were almost completely absent. MTX/5-FU can be recommended for the palliative treatment of recurrent squamous head and neck cancer because of an acceptable response rate, good subjective tolerance and the possibility of outpatient treatment.

Adult↗
PubMed1985

Problems in the differential diagnosis of Kartagener's syndrome and ATP-ase deficiency.

Two cases of Kartagener's syndrome with a partial loss of the dynein arms and the central spokes within the cilia are presented. In light microscopic examination the predominant cell types were mast cells within the stroma and the epithelium and plasma cells and lymphocytes in the stroma. The reaction for the magnesium-activated ATP-ase located in the apical cytoplasm of ciliated cells was negative in one case and slightly positive in the same case on year later; in our second case, the ATP-ase reaction was variable, slightly to moderately positive, in the same biopsy. Besides the dynein arm defect this is a second defect of another ATP-ase, located in the apical region of the ciliated and mucus producing epithelial cells. Based on histological examination of nasal mucosal biopsies a differential diagnosis has been established for Kartagener's syndrome, the more common cystic fibrosis and the relative frequent allergic rhinitis.

Adenosine Triphosphatases↗
PubMed1985

[Initial results of hyperthermia in palliative therapy of cancers in the ENT area].

Preliminary results of an interdisciplinary study, conducted to investigate the efficacy of combined local hyperthermia and radiation/chemotherapy on carcinoma of head and neck, are reported. Upto now, eleven patients with recurrent squamous cell carcinoma of head and neck were treated, all of them had loco-regional recurrence, and 2 distant metastases in addition. 7 patients were pretreated by surgery and radiotherapy, 4 by radiotherapy only, and 6 by chemotherapy. Microwave-induced low-dose local hyperthermia was combined with radiotherapy (telecobalt 1100-2400 rad) 6 cases (group A) and with chemotherapy (bleomycin and cis-platin/bleomycin) in 5 patients (group B). Intratumoural temperatures between 43 and 45 degrees C were achieved for at least 30 minutes. The loco-regional efficacy of hyperthermia was assessed. 10/11 patients with 13 tumours could be evaluated, Group A: 3 CR, 4 PR, Group B: 1 PR, 4 MR and 1 NC.

Adult↗
PubMed1985

[Therapy of recurrent squamous cell cancers in the ENT area with the sequential methotrexate (MTX)/5-fluorouracil (5-Fu) protocol].

MTX 250 mg./m2 was administered via i.v. push, followed 1 hour later by a 5-Fu 600 mg./m2 i.v. push. 24 hours after methotrexate, oral leucovorin-rescue started with 15 mg. Every 6 hours for a total of 5 doses. The courses were repeated at weekly intervals, if the toxicity permitted such repetition. 28 patients could be evaluated for response. The overall response rate was 39.2%, with 17.8% (5/28) complete response. The mean duration of complete and partial remissions was 30,8 and 24 weeks, respectively. Subjectively, the patients tolerated the treatment very well. Objective toxicity was moderate, and the major side effect was a generally mild myelosuppression. Thus, in our experience, this regimen can be recommended in the palliative treatment of rSCCHN.

Adult↗
PubMed1985

[Diagnosis and therapy of laryngeal sarcoidosis].

The larynx may be involved in patients with systemic sarcoidosis or may be the first or only manifestation of the disease. The symptoms depend on the degree of involvement of the larynx, and include a sensation of lump in the throat, dysphagia, hoarseness, cough, stridor and dyspnea. The supraglottis is the most frequently affected area. There are pale pink, edematous, diffuse hypertrophy of the supraglottic structures or granular areas of the glottic and subglottic region. The diagnosis is made by the characteristic appearance of the larynx, histologic and laboratory findings and exclusion of other granulomatous diseases. Laryngeal sarcoidosis may cause life-threatening upper airway obstruction. Systemic corticosteroid therapy is the treatment of choice in most cases, but surgical excision or local steroid injections are useful in selected cases.

Adult↗
PubMed1985

[Emphysema as a leading symptom].

Air may enter the tissue via injuries of the respiratory and alimentary tracts. The mechanisms governing the entrance of air are traumas, and surgical or anaesthesiological measures; spontaneous entry is also possible. Infections with aerogenic bacteria are very rare. Numerous possible aetiologies for the accumulation of air in the head and neck have been reported. Case reports are given to discuss the pathomechanism and therapy of emphysema as a result of injuries of cranium and larynx, dental treatment, whiplash injury, adenotonsillectomy and spontaneously in asthma. The otolaryngologist should have thorough knowledge of differential diagnosis and prophylactic measures, since therapy depends upon the aetiology.

Accidents, Traffic↗
PubMed1984

[Biology of tumor behavior and curative primary therapy of ORL neoplasms].

The biology of squamous cell carcinoma of head and neck (SCCHN) e.g. precursors, cellular kinetics, type of growth, formation of metastases, prognosis, is shortly described. Therapeutic guidelines regarding SCCHN in general and methods and results of treatment in laryngeal and tonsillar carcinoma in particular are reported. Surgery and radiation appear equally effective in stage I-tumors, in stage II, however, surgery yields better results than radiotherapy. Both modalities are combined in advanced stages aiming at an increase of the cure rates.

Carcinoma in Situ↗
PubMed1984

[Drug therapy in advanced squamous cell carcinoma of the ORL region].

This paper reviews the role of chemotherapy in advanced squamous cell carcinoma of the head and neck region (SSCHN). Two different areas of administration are discussed separately: (1) Palliative therapy in recurrent disease, and (2) chemotherapy as additional measure in first line treatment of advanced SSCHN aiming at an increase of the disease-free survival and the cure rate. Overall response rates of 80% and complete clinical remissions in about 40% of the cases can be achieved in locally untreated tumors. On the other hand, recurrent SSCHN respond not as well to chemotherapy; nevertheless, a good temporary palliative effect is reached in more than half of the patients. As example for the numerous combination programs studied in the last few years, we report some data of the two protocols evaluated at our clinic, cis-diamminedichloroplatinum/adriamycin and methotrexate/5-fluorouracil, respectively.

Antineoplastic Agents↗
PubMed1983

[Aspergillus mycoses of the paranasal sinuses. Detection and analysis of roentgen opaque structures in fungal concretions].

Out of 59 patients with aspergillosis of the paranasal sinuses 25 showed almost metal-dense X-ray-shadows in Highmore's sinus, resembling foreign bodies at first. It can be demonstrated, that these areas are equivalent to local enrichment of calcium phosphate mainly in the center of the fungal masses in the sinuses. Technique and methods of investigation and analysis are described. X-ray findings like these should be looked upon as a sign reading: "aspergillosis of the paranasal sinuses ahead."

Adult↗
PubMed1982

[Wegener's granulomatosis causing diabetes insipidus].

Very few cases of Wegener's granulomatosis which were associated with diabetes insipidus have hitherto been described. Our patient was a young man with severe (also histological) changes in the nose and paranasal sinuses. Typical pulmonal involvement developed. The hypothalamus seemed not to be affected; hyperprolactinemia, as described by other authors, did not exist. A computerized tomography was normal with regard to the hypothalamus. Typically the disease responded well to cyclophosphamide. An affection of the anterior lobe of the hypophysis was not demonstrable; likewise the kidneys were unaffected.

Adolescent↗
PubMed1982

[Diagnosis and pathogenetic aspects of the Kartagener syndrome based on nasal mucosa biopsies].

Nasal mucosa biopsies were taken from a child with Kartagener's syndrome. The biopsies were prepared for light and electron microscopic examination. Unfixed cryocut sections were stained with the magnesium-activated ATPase reaction. There was a partial loss of the dynein arms within the cilia. Many compound cilia were present and, sometimes, defects of the mitochondria of the lining epithelial cells as well as the glandular cells were observed. Histochemically the ATPase reaction was at first completely negative and sometime later it was greatly reduced within the lining and the glandular epithelial cells, especially in the apical border. Biopsies from children with cystic fibrosis and allergic rhinitis served as controls.

Biopsy↗
PubMed1982

[Palliative chemotherapy of recurring squamous cell carcinomas of the ENT field with the combination cis-diamminodichloroplatinum (II)/adriamycin].

23 patients with recurrent squamous cell carcinoma of head and neck (SCCHN) were treated with a combination of cisplatin 120 mg/m2 and adriamycin 60 mg/m2, both administered by I.V. infusion over 4 hours and 15 minutes, respectively, at day 1. The courses were repeated at 3-weeks interval. Hydration and diuresis forced via mannitol were much lower than usual with such high doses of cisplatin. All patients were intensively pretreated by surgery and/or radiotherapy, further local treatment being impossible; all had loco-regional recurrence, 2 distant metastases additionally. 21/23 patients could be evaluated, 6/21 objective responses (2 CR, 4 PR, RR = 28,5%) were seen, in 7/21 patients a minor response was obtained. Objective toxicity, especially nephrotoxicity, was mild, the major effect being short-lasting severe nausea and vomiting. The results obtained with this regimen are comparable to data obtained by other chemotherapy programmes. However, in our opinion at the moment the subjective toxicity seems too severe to recommend this regime for palliative treatment of recurrent SCCHN. Possibly the cisplatin-induced vomiting can be avoided or at least diminished by high doses of metoclopramid.

Adult↗
PubMed1982

[Features of aspergillosis in ENT. Histopathology of fungal infections of the paranasal sinuses caused by Aspergillus fumigatus (author's transl)].

Fungal diseases of nasal and paranasal sinuses caused by Aspergillus fumigatus are not rare. Second to diagnosis in defined culture medium only, histological diagnosis can easily be achieved in Haematoxilin-Eosin-, and PAS-stained samples of fungal masses in the sinuses. Specific histological features of Aspergillus fumigatus are described, especially the onion-skin like structure of the fungus balls, and their development discussed. Out of seventy cases only one showed invasion of the mucosa of the sinus, the others all showing extramucous position of the fungus.

Aspergillosis↗
PubMed1982

[Features of aspergillosis in ENT. Clinical features of aspergillosis in ENT (author's transl)].

Etiology, pathogenesis and clinical features of fungal diseases in ENT caused by Aspergillus are discussed. In this paper special stress is put upon the diagnosis and therapy of the Aspergillosis of the paranasal sinuses and the ear. Out of a group of 65 patients with Aspergillosis of the nose and paranasal sinuses 25 were examined in detail. Two of them suffered from a malignancy, while the remainder of the group had been in general good health. It was remarkable, that many patients got into touch with domestic animals, garden mould and soil of ornamental plants. In X-ray 12 calcareous concrements were detected. In one case only histological signs of an invasion of Aspergillus could be demonstrated. Fungus infections of cavity of radical mastoidectomy and external ear were often seen and easily diagnosed because of their clinical appearance. In the last years we have neither observed Aspergillosis of the middle and inner ear, nor of the larynx.

Adult↗
PubMed1981

[For prevention of complications, especially postoperative bleeding, in tonsillectomy and adenoidectomy (author's transl)].

Hemorrhages after tonsillectomy and adenoidectomy are the most frequent lethal complications except of the mortality due to incidents of anaesthesia. A precise clinical, personal and family history regarding bleeding disorders must be taken. We preoperatively perform laboratory tests on each patient (Platelet count, PTT, Quick, Thrombintest, Fibrinogen, Bleeding Time) to detect possible bleeding disorders. Furthermore, we ask for previous medications, such as analgetics, sedatives and antiarthritics. A careful surgical technique for removal of tonsils and adenoids and meticulous hemostasis reduce the danger of postoperative bleeding. An exact control after the operation helps prevent serious complications.

Adenoidectomy↗
PubMed1981

[Scalene node biopsy (author's transl)].

On the basis of our own experience the importance and usefulness of the scalene-node-biopsy for the diagnosis of intrathoracic diseases will be reported. If there is no positive histological result in the obtained lymph nodes during surgery, one can continue with the mediastinoscopy (Carlens) without aggravating Daniels biopsy. The scalene-node biopsy is a short surgical procedure, that can easily be done in local anaesthesia. A positive lymph node makes mediastinoscopy or a following thoracotomy unnecessary. Especially in sarcoidosis, systemic diseases (malignant lymphomas) and silicosis biopsy yields good results.

Adult↗