[Laryngectomy - a treatment on the way out? Voice restoration, quo vadis?]. / Laryngektomie, ein auslaufendes Therapieverfahren? - Stimmrehabilitation, quo vadis?1 -

BACKGROUND: The number of laryngectomized patients in stationary rehabilitation decreases, while the number of laryngectomized - carrying a voice-prosthesis - increases. PATIENTS: From 1980 to 1999 more than 7000 laryngectomized participated in stationary rehabilitation. RESULTS: The number of laryngectomized dropped from an average of more than 400 per year between 1980 and 1989 to less than 300 between 1990 and 1999 to merely 130 in 1999. Until 1992 oesophageal speech dominated over voice-prosthesis with less than 1 %. Since 1994 the number of voice-prosthesis is increasing at about 10 % a year to 60 % in 1998 and 1999. Patients with voice-prosthesis were insufficiently cared for medically and left on their own in matters concerning their voice function. CONCLUSIONS: The decreasing number of laryngectomized is in part caused by economic reasons, and in part by increasingly organ-saving therapeutical procedures. Logopedic therapy for patients with voice-prosthesis results in an earlier and wider range of voice function.

[The voice prosthesis. An underutilized procedure in rehabilitation?]. / Die Stimmprothese. Ein zu wenig genutztes Verfahren der Rehabilitation?

In the last 10 years nearly 4450 patients who had undergone laryngectomy have attended speech therapy as part of a resident rehabilitation programme. Most of them mastered the technique of esophageal speech. The most surprising finding was that only 1.5% achieved speech by way of a tracheo-esophageal fistula or voice prosthesis, whereas this was true of 15% of such patients seen in the first 3 months of 1993.

[Malformation syndrome with sensorineural deafness and disturbed development of speech]. / Missbildungssyndrom mit Schallempfindungsschwerhörigkeit und Sprachentwicklungsstörung.

Report on a boy in whom, apart from high-grade sensorineural deafness and disturbed development of speech with possible mental impairment, multiple malformations were found, mainly in the area of the foregut: multiple composite compound odontoma, hypoplasia of the jaws, submucous cleft palate, membrana bucco-pharyngea persistens, dystopia of the palatine tonsils and rectum stenosis.

[Ultrastructure of female rat FSH gonadotrophs following two LH-RH stimulations (author's transl)]. / Ultrastruktur der FSH-Zelle der weiblichen Ratte nach zweimaliger LH-RH-Stimulation.

In FSH-cells of female rats increased granule extrusion and increased granule synthesis was observed using electron-microscopy 60 min and 60--120 min, respectively, after a single 250 microgram LH-RH injection. Granule content was distinct higher 120 min after LH-RH when compared with NaCl treated animals. These "excessively" synthesized granules were subsequently removed by increased cytolysosomal degradation. When a second LH-RH injection of the same dose was given 120 min. after the first, a distinct augmentation of granule extrusion, -synthesis and -degradation was observed indeed in the same time-sequence as observed after the first LH-RH stimulation. As reported previously for LH, also FSH is secreted from FSH gonadotrophs by in toto granule extrusion. Subsequently the granule content was immediately restored by intracellular regulatory processes.

Ultrastructure of rat pituitary LH gonadotrophs in relation to serum and pituitary LH levels following repeated LH-RH stimulation.

The effects of single and repeated LH-RH injections at 120 min intervals on female rat LH gonadotrophs and on pituitary and serum LH levels were investigated using electronmicroscopy and radioimmunoassay. A temporary stimulation of granule release, of protein and new granule synthesis and of the accumulation of lysosomal structures was found in LH cells after the first LH-RH injection. The temporary stimulations were massively enhanced after the second injection. These consecutive yet in their time-sequence overlapping processes account for the initial depletion of secretory granule content (3--15 min after LH-RH injection), for the subsequent regranulation and accumulation of granules above control levels (60--120 min after injection) and also for the reduction in the number of granules to control levels (150 min after LH-RH injection and thereafter). Increased polymorphic lysosomal structures are believed to be responsible for this reduction of excess granules. The amount of assayable pituitary and serum LH generally corresponds with the morphological changes observed in LH-gonadotrophs, thus further substantiating the above observations. A schema which summarizes the observed morphological and hormonal changes in their time-sequence in response to LH-RH stimulation depicts the short-term regulation of secretory processes in female gonadotrophs.

[The surface-coat of Rathke's pouch and the neural tube in embryonic mice]. / Der "Surface-Coat" embryonaler Hohlräume (Rathke-Tasche und Neuralrohr) der Maus

Mouse embryos, gestation days 10 and 11, were fixed by the method of LUFT (ruthenium red). At the ultrastructural level, luminal epithelial cell membranes of Rathke's pouch and the neural tube were coated with a continuous, electron-dense layer of 100-700 A thickness. The biological property of this surface coat is discussed.