Granulomatous tonsillitis. A rare extraintestinal manifestation of Crohn's disease.

Oral lesions, varying in nature and location, appear to be one of the common extraintestinal manifestation of Crohn's disease. In particular, oral involvement preceding intestinal disease may lead to the diagnosis of Crohn's disease. The present case report of a 17-year-old male patient describes a very rare nonintestinal manifestation of Crohn's disease with severe granulomatous involvement of the tonsils. A sore throat caused by hyperplastic tonsils with granulomatous inflammation as an oral manifestation of Crohn's disease was the leading symptom in this case.

[Injuries of the central base of the skull]. / Verletzungen der zentralen Schädelbasis

In different types of lesions, especially in frontobasal and laterobasal ones, the central base of the skull is injured, too (in about 20% of severe frontabasal lesions). Surgical treatment is necessary. Examination of intra- and infrabasal structures and localized intracranial operations may be performed by transthemoidal-transphenoidal or transpyramidal approaches. Main problems are the treatment of dura lesions, the control of hemorrhages, the examination of the optic nerve, and the compensation of disturbances of central regulation. The above experiences we gathered from patients in the ORL Clinic of Jena University.

[Rhinomanometric findings during brine aerosol inhalations (author's transl)]. / Rhinomanometrische Befunde bei Soleinhalationen

Brine aerosol inhalations cause reactions of the nasal mucous membrane and the submucousal vascular bed as is shown by rhinomanometric examinations of healthy persons and patients suffering from various kinds of rhinitis. Changes in the resistance as a whole differ from those in partial resistances. The reactions are depending on the form of inhalation, the spectrum and concentration of the aerosol, climatic parameters and the pathophysiologic condition of the nasal mucosa.

[Enzyme diagnosis of human parotid glands and its problems]. / Enzymdiagnostik im menschlichen Parotisspeichel und ihre Probleme

The gland-specific enzymes amylase, lysozyme and kallikrein the activities and their dependence on the speed of salivation were studied in normal persons. In these investigations the specification or standard ranges for differentiated secretion states is useful. In contrast to amylase activity, the activities of lysozyme and kallikrein weaken appreciably with increasing speed of salivation. The activity secreted, as measured in time units, increases. In the case of a diseased parotis, a comparison of enzyme activities with the standard values will show a significant reduction of lysozyme and amylase activity in the chronic processes. Acute inflammation affects the amylase activity slightly, but raises the lysozyme activity significantly. Parotid mixed tumours probably do not lead to any changes in the enzyme activities. The splitting up of amylase into isoenzymes by polyacrylamide gel electrophoresis and its possible importance for the diagnosis of pathological processes are discussed. First results of the splitting up of the parotid lysozyme are reported.

[The effect of various aerosols on nasal ventilation (rhinomanometric investigations (author's transl)]. / Die Wirkung verschiedener Aerosole auf die Nasenventilation (Rhinorheomanometrische Untersuchungen)

Rhinomanometry is useful for estimating the reactions of nasal mucosa to saline aerosol inhalations. The resistance of the whole nose provides insufficient evidence. Reactions on one side of the nose clearly show that--it is possible to differentiate qualitatively and quantitatively between the first and the second stage after inhalation. The reaction on one side of the nose may be opposite in character to the other side. The same person may respond in a contrary manner on different days both qualitatively and quantitatively. Patients with rhinitis and allergy react particularly briskly. The problems of nasal dynamics are indicated.