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Die Wirksamkeit einer intralasionalen Sklerosierungsbehandlung des Lymphangioms und der Ranula mit OK-432 (Picibanil) wurde in mehreren klinischen Studien nachgewiesen. Das Ziel der Studie war die Uberprufung der Wirksamkeit einer Sklerosierung mit Picibanil bei gutartigen zystischen Halsraumforderungen. Im Zeitraum zwischen Marz 2002 und Dezember 2003 behandelten wir 6 Patienten mit zystischen Halsraumforderungen intralasional mit Picibanil in einer Dosierung von 0,01 mg/ml. Wir verwendeten Picibanil bisher bei 6 Patienten mit gutem Erfolg. In 2 Fallen kam es klinisch und sonographisch zu einer kompletten Ruckbildung der Zyste. In 4 Fallen bildete sich die Raumforderung so weit zuruck, dass nur noch sonographisch ein nachweisbarer Restbefund verblieb, der in 2 Fallen komplett sklerosiert war. Sollte sich nach 4–6 Wochen kein eindeutiges Ansprechen der Zyste auf die Injektionsbehandlung zeigen, ist eine zeitnahe Exstirpation zur Gewinnung einer aussagefahigen Histologie indiziert. Es zeigten sich keine wesentlichen Komplikationen nach Picibanil-Sklerosierung. Die Anwendung von OK-432 (Picibanil) stellt nach unseren bisherigen Ergebnissen eine risikoarme Methode zur Sklerosierung von gutartigen zystischen Halsraumforderungen dar, die in vielen Fallen die operative Exstirpation ersetzen kann. Grundsatzlich muss jedoch vor jeder Picibanil-Behandlung das Risiko fur eine maligne Erkrankung weitestgehend ausgeschlossen werden.

Background: The treatment of recurrent laryngeal papillomatosis still presents an important therapeutic problem. This primarily benign disease of the larynx is caused by an infection with the human papilloma virus (HPV) and forms epithelial neoplastic papillomas. Therapy in larynx obstructing papillomatosis usually requires laser ablation. Cidofovir acts virustatically as an nucleosidanalogon. Currently pilot studies investigate the effectiveness of intralesional Cidofovir injection. Patients and Methods: The present study covers the period from October 2001 to March 2003. Seven patients, age of five to 70 years, were treated with intralesional injections of Cidofovir after microlaryngoscopic ablation of laryngeal papillomas. In all patients papillomatosis was confirmed histologically and a clinical-phoniatric examination and a photo documentation pre- and postoperatively was carried out. We treated patients to a maximum of six sessions. Results and Conclusions: After three to six sessions of laser ablation of the papillomas and intralesional injections with Cidofovir a distinct papilloma reduction could be observed in all patients and in two cases a complete remission was achieved. The follow-up period of seven to 15 months revealed no recurrent laryngeal papillomatosis. The majority of patients showed a defined voice improvement. There were no local or systemic side-effects caused by the virustatic drug. Intralesional injection of Cidofovir appears to develop into a promising adjuvant therapy option in recurrent laryngeal papillomatosis. First results of the study seem to achieve a considerable reduction of the previously high rate of recurrence of laryngeal papillomatosis.

Background Cystic fibrosis (CF) is an inherited multisystemic disorder that results in generalized dysfunction of exocrine glands. In patients with cystic fibrosis dyscrinia with affection of exocrine glands function is a main problem of the upper and lower respiratory tract. In addition to chronic obstructive pulmonary disease, chronic sinusitis, nasal polyposis and hypertrophy of inferior turbinates with nasal airway obstruction are typical signs. To understand pathophysiological mechanisms in CF and to correlate morphological findings with clinical symptoms, investigations of nasal mucosa are important. Methods Tissue samples of inferior turbinates were taken during nasal surgery from 7 children, ranging from 3 to 11 years of age between September 1998 and May 2000. Histological sections were cut followed by a light- and electron microscopical examination (EM 902 A Zeiss). Additionally, specimens of duodenal mucosa were investigated. Results In comparison with sections of normal nasal mucosa the lamina propria mucosae shows different morphological changes. Under a thick layer of respiratory epithelium with a high portion of goblet cells and particulary vacuoles there is an edematous subepithelial area. The capillary layer is reduced and the seromucous glands show an atypical morphological structure with widely mucous cells and cystic dilatation. On an ultrastructural level the glandular cells show atypical and inhomogeneous glandular droplets in the supranuclear cell portion. A viscous secretion was detectable at the glandular lumen. The nucleus contains dispersed chromatin as a sign of increased activity and the structures of Golgi apparatus were obviously detectable. Conclusions In respective literature studies on the different morphological changes on light- and electron microscopical level in CF-associated rhinopathies are rare. This histological study demonstrated various morphological changes of nasal mucosa and shows a correlation between the glandular dysfunction and the typical symptoms in CF. Additionally a comparison with ultrastructural findings of CF-enteropathies is proposed. These findings could help to look at new aspects in the pathophysiology for patients with CF.

Simple models for the optimization of multiple field convergent beam therapy as used in stereotactic irradiations are presented. They allow to predict start parameters for individual treatment planning and for the preparation of class solutions. The models with different grades of approximation are compared with calculations of a treatment planning system.

The intralesional injection of OK-432 has been proposed as an effective treatment of lymphangiomas and ranulas. The aim of this study was to review our experience with sclerotherapy of benign cervical cysts as an alternative method to surgical extirpation.We performed a case note review of six patients who received OK-432 injections in a concentration of 0.01 mg/ml between March 2002 and December 2003.Disappearance of the lesions was achieved after one to three injections in all patients. We found a complete remission in two of six patients and a marked reduction in four of six patients. There were no significant complications observed.OK-432 is an effective alternative in the treatment of benign cervical cysts, but it is very important to exclude malignancy-associated diseases before instillation of OK-432. Long-term results will be awaited.

The treatment of recurrent laryngeal papillomatosis still presents an important therapeutic problem. This primarily benign disease of the larynx is caused by an infection with the human papilloma virus (HPV) and forms epithelial neoplastic papillomas. Therapy in larynx obstructing papillomatosis usually requires laser ablation. Cidofovir acts virustatically as an nucleosidanalogon. Currently pilot studies investigate the effectiveness of intralesional Cidofovir injection.The present study covers the period from October 2001 to March 2003. Seven patients, age of five to 70 years, were treated with intralesional injections of Cidofovir after microlaryngoscopic ablation of laryngeal papillomas. In all patients papillomatosis was confirmed histologically and a clinical-phoniatric examination and a photo documentation pre- and postoperatively was carried out. We treated patients to a maximum of six sessions.After three to six sessions of laser ablation of the papillomas and intralesional injections with Cidofovir a distinct papilloma reduction could be observed in all patients and in two cases a complete remission was achieved. The follow-up period of seven to 15 months revealed no recurrent laryngeal papillomatosis. The majority of patients showed a defined voice improvement. There were no local or systemic side-effects caused by the virustatic drug. Intralesional injection of Cidofovir appears to develop into a promising adjuvant therapy option in recurrent laryngeal papillomatosis. First results of the study seem to achieve a considerable reduction of the previously high rate of recurrence of laryngeal papillomatosis.

Peritonsillar abscess (PTA) is a common but potentially serious complication of acute exudative tonsillitis. Several treatment guidelines have been described including needle aspiration, incision and drainage or abscess tonsillectomy. From January 1996 to September 2000 145 patients (53 female and 92 male, age range 3-95 years) were treated for PTA at the Department of Otorhinolaryngology, Head and Neck Surgery of the MLU Halle-Wittenberg, Germany. The highest incidence of PTA was observed in the second and third decades of life. Immediate abscess tonsillectomy was performed in 105 cases. This procedure, considered as safe and easy, has a lot of advantages. Compared with other treatments, it removes the abscess with amelioration of the trismus and dysphagia. Needle aspiration as the initial and only treatment was performed in 13 patients. In 20 patients without clinical improvement after aspiration, abscess tonsillectomy was undertaken. We conclude that immediately performed abscess tonsillectomy is an effective and safe treatment for peritonsillar abscess.

Cystic fibrosis (CF) is an inherited multisystemic disorder that results in generalized dysfunction of exocrine glands. In patients with cystic fibrosis dyscrinia with affection of exocrine glands function is a main problem of the upper and lower respiratory tract. In addition to chronic obstructive pulmonary disease, chronic sinusitis, nasal polyposis and hypertrophy of inferior turbinates with nasal airway obstruction are typical signs. To understand pathophysiological mechanisms in CF and to correlate morphological findings with clinical symptoms, investigations of nasal mucosa are important.Tissue samples of inferior turbinates were taken during nasal surgery from 7 children, ranging from 3 to 11 years of age between September 1998 and May 2000. Histological sections were cut followed by a light- and electron microscopical examination (EM 902 A Zeiss). Additionally, specimens of duodenal mucosa were investigated.In comparison with sections of normal nasal mucosa the lamina propria mucosae shows different morphological changes. Under a thick layer of respiratory epithelium with a high portion of goblet cells and particulary vacuoles there is an edematous subepithelial area. The capillary layer is reduced and the seromucous glands show an atypical morphological structure with widely mucous cells and cystic dilatation. On an ultrastructural level the glandular cells show atypical and inhomogeneous glandular droplets in the supranuclear cell portion. A viscous secretion was detectable at the glandular lumen. The nucleus contains dispersed chromatin as a sign of increased activity and the structures of Golgi apparatus were obviously detectable.In respective literature studies on the different morphological changes on light- and electron microscopical level in CF-associated rhinopathies are rare. This histological study demonstrated various morphological changes of nasal mucosa and shows a correlation between the glandular dysfunction and the typical symptoms in CF. Additionally a comparison with ultrastructural findings of CF-enteropathies is proposed. These findings could help to look at new aspects in the pathophysiology for patients with CF.

Die 31P NMR-Spektroskopie erlaubt ein nichtinvasives Monitoring des Phosphatstoffwechsels nach Hyperthermie. Ziel unserer Studie war es aufzuzeigen, welche phosphorresonanzspektroskopischen Parameter verbunden sind mit der tumorziden Hyperthermie des Plattenepithelkarzinoms des Kopf-Hals-Bereichs.

A comparison of the excretion of amino acids by normal and wounded rats on a high protein and protein-free diet was made. The nontaurine amino acid nitrogen excretion was found to be the same the control and wounded animals, although the rats on the high protein diet excreted considerably more amino acid nitrogen than did those on the protein-free diet. The wounded animals on the high protein diet had the same total nitrogen output but excreted significantly larger amounts of taurine than did the nonwounded controls. The wounded animals given the protein-free diet excreted the same amount of taurine but produced more total nitrogen than did the control rats. On the basis of the total nitrogen-taurine excretion ratios, data indicate that cystine is conserved by the wounded as compared to the normal animals.

We report on 888 patients with perioral dermatitis treated in our department from 1969-1975. The patients are evaluated according to age, sex and duration of treatment with fluorinated corticosteroids. The enormous increase of morbidity and the importance of highly effective topical corticosteroids are emphasized.

The application of three methods to the determination of the terminal free carboxyl groups in pepsin has been described. It was determined that pepsin has two terminal free carboxyl groups, both of which are alanine.