[Space-occupying tumor of the temporal region with facial nerve palsy, vestibular dysfunction and hearing loss]. / Raumforderung der Regio temporalis bei Fazialisparese, vestibulärem Ausfall und Hörminderung.

A 73-year-old female patient complained of right-sided facial pain, progressive loss of hearing, giddiness when changing position, a pre-auricular swelling and lack of facial expression. Clinically there was a right-sided indolent and immovable swelling approximately 7 cm in size and an incomplete ipsilateral acute peripheral facial paralysis. Magnetic resonance tomography revealed a space-occupying lesion approximately 75 mm in diameter right temporal and multilocular metastases in the pelvis, spinal column, clavicle and skull. Histology showed this to be a well to moderately differentiated adenocarcinoma with centers of positive immune response to GCDFP-24 (gross cystic disease fluid protein). The subsequent computed tomography of the thorax and mammography located the approximately 25 mm in size primary tumor in the left breast. After surgery and radiation therapy the TNM classification was a tubular adenocarcinoma of the left breast grade 2, T2N0M1 (OSS multiple osseous, BRA brain) stage IV.

[Tongue coating, mouth odor, gustatory sense disorder - earlier and new treatment options by means of tongue scraper]. / Zungenbelag, Mundgeruch und Schmeckstörung - bisherige Behandlungsmethoden und neue Therapieoption durch mechanische Zungenreiniger.

The tongue is said to be the mirror of physical health. The tongue dorsum is most delicate regarding the sense of touch. Pathologic coating of the tongue accounts for paresthesia during chewing, swallowing, speaking, tasting, and also may result in mouth odor. Tongue coating can result from increased formation or decreased natural abrasion, and from xerostomia or dyschylia. In clinical otorhinolaryngology pathologic tongue coating often is idiopathic or present after surgery of the oral cavity or pharynx. Critical analysis of published studies reveals that effectivity and justification to administer xenobiotics or vitamins in that condition is doubtful. Recently, it has been shown that tongue fur was able to be reduced by an easy-to-handle mechanical tongue cleaner or tongue scraper. Due to its simple use, tongue scrapers could be a welcome supplement for the treatment of tongue fur, mouth odor, and in particular cases, to enhance gustatory sense. Preliminary results of an ongoing prospective trial showed that tongue scrapers can effectively be applied after surgery of the oral cavity or pharynx. After tonsillectomy, tongue fur seemed to be reduced and gustatory sense to be enhanced when tongue scrapers were applied during postoperative care. After confirming these promising results in further investigations, an inexpensive and simple option for the treatment of a large amount of patients in clinical otorhinolaryngology would exist.

Tensile bond strength of composite to air-abraded enamel.

PURPOSE: The purpose of this study was to test the tensile bond strength of composite resin to enamel surfaces treated with kinetic cavity preparation (KCP) and acid etching, respectively. MATERIALS AND METHODS: Plane labial surfaces of 280 human maxillary central incisors were treated with either KCP by varying treatment conditions or phosphoric acid gel. Composite samples were bonded to the pretreated surfaces with a bonding resin. After 24 hours specimens were loaded in tension in an Instron testing machine until bond failure. A two-way analysis of variance was used to determine significant differences. The failure sites were qualitatively evaluated by SEM. RESULTS: The determined tensile bond strengths and observed failure modes demonstrated that acid-etched enamel has a significantly higher bond strength to composite resin than KCP-treated enamel surfaces. CONCLUSION: KCP-prepared enamel has to be acid etched before bonding to composite resin.

Is there a beneficial effect of the calcium channel blocker diltiazem on cyclosporine A nephrotoxicity in rats?

To investigate whether or not there is a beneficial effect of diltiazem (D) on cyclosporine A (CsA) nephrotoxicity, renal function, CsA blood levels, and effects of CsA on biotransformation in the liver and on lipid peroxidation were characterized in rats. A single administration of D (60 mg/kg b.wt.) reduced urinary volume (UV), GFR and excretion of Na+ and K+, whereas a single dose of CsA (60 mg/kg b.wt.) alone had no respective effects. P-aminohippurate excretion was almost equal in all groups. Lower doses of D (and CsA) were without effects. After repeated CsA treatment a retardation in body weight gain was seen, with little effect of a co-administration with D hereon. In all tests, thymus mass was reduced by CsA, the weight of spleen, liver, adrenal glands, and kidney were not generally affected by any of the treatments. Furthermore, after repeated administration of CsA and/or D, urinary volume, GFR and Na+ excretion were reduced by CsA, too. Electrolyte concentrations in plasma showed no evident changes by any of the treatments for Na+ and Ca2+. After long time treatment, CsA and CsA + D quite similarly led to higher K+ but lower Mg2+ concentrations in plasma. Only with 7 days highest dosage treatment PAH excretion was reduced significantly by CsA and CsA + D treatment. Surprisingly, CsA levels measured in blood and in kidney tissue, showed lower values after co-administration with D compared to CsA treatment alone. This could be caused by higher activities of monooxygenase functions revealed after pretreatment with D alone. Reduced glutathione (GSH) contents in kidney were elevated in CsA and CsA + D treated groups. In general no significant differences were to be observed concerning lipid peroxidation and stimulated H2O2 formation. Altogether evident protective effects of diltiazem on CsA nephrotoxicity in rats could not be proven.

[Which patients in psychosomatic rehabilitation can be reached by psychotherapy?]. / Welche Patienten in der psychosomatischen Rehabilitation sind psychotherapeutisch erreichbar?

This report presents a cross-sectional study of the patients in a psychosomatic clinic (n = 112). Possible predictors concerning psychotherapeutic cooperation of patients are presented and discussed. Negative predictors found were: The presence of two or more strictly somatic rehabilitation treatments in the past; a therapist rating of "not capable of being motivated for psychotherapy"; a pension application, or a degree of disability of 50 ("severely disabled person" status). A positive predictor for psychotherapy is a patient's previous experience with psychosomatic therapies. Some consequences are discussed concerning indication as well as client information, preparation of clients prior to clinical treatment, and cooperation with other institutions providing psychosocial services.

[Effects of dentin bonding agents on the proximal margins of ceramic inlays]. / Einfluss von Dentinhaftmitteln auf den approximalen Randschluss keramischer Inlays.

Ceramic inlays have shown good marginal seal as long as the margins of the cavities are located in enamel. The purpose of this study was to investigate the marginal seal of ceramic inlays with the cervical margins situated in dentin and to determine the effectiveness of dentin bonding agents. Sintered ceramic inlays were adhesively luted either without dentin bonding agents or with the use of Gluma or Miragebond. After thermocycling and incubation in a colored dye the penetration depth of the dye was measured on sequential sections. The used dentin bonding agents did not improve marginal seal. The glass ionomer cement base was able to prevent further penetration in most of the cases when deep leakage occurred. Unless a tight marginal seal in dentin can be achieved, the indication for adhesively luted inlays must be limited to cavities with margins located in enamel.