[Puncture of the maxillary sinus with the Sinojet]. / Kieferhöhlenpunktion mit Sinoject.

A method is presented by which "blind" puncture of the maxillary sinuses can be performed and which is based on the use of the Sinoject puncture set. This technique has been applied so far in 36 patients. It enables puncture of the maxillary sinus with minimum trauma and hardly any pain. The fact that the puncture needle is pushed via a spring coil to a depth of only 1 cm greatly reduces the risk of injuring neighbouring structures such as the posterior wall of the maxillary sinus. Contrary to the classical procedure a small drainage tube is introduced into the maxillary sinus simultaneously with the puncture. Due to the low tendency to bleeding when this procedure is applied, the method is particularly suitable for use with patients with disturbed coagulation, as well as for AIDS patients.

[Real-time analysis of orofacial movements using electromagnetic articulography]. / Echtzeitanalyse von orofacialen Bewegungen mit Hilfe der elektromagnetischen Artikulographie.

A real-time version of electromagnetic articulography is presented, which permits the recording of five positions of the articulators in the oro-facial system. Movements can be shown online on PC screen. Owing to its biological safety and ease of handling, the system is especially suitable for clinical applications.

Increased alpha-adrenergic responsiveness in idiopathic Raynaud's disease.

In our study of 28 patients with idiopathic Raynaud's disease, the patients had significantly greater digital blood flow responses to intraarterial phenylephrine and clonidine than did normal control subjects. There were no group differences in finger blood flow responses to body heating, reflex cooling, digital ischemia, or to intraarterial tyramine or isoproterenol. There were also no group differences in blood pressure or heart rate during any procedure. These results suggest that patients with idiopathic Raynaud's disease have increased peripheral vascular alpha-adrenergic receptor sensitivity and/or density compared with normal persons.

Nonneural beta-adrenergic vasodilating mechanism in temperature biofeedback.

Although finger temperature feedback has been used to produce digital vasodilation in normal persons and those with Raynaud's disease, the mechanism and site of this effect have not been studied. In the present investigation, feedback-induced vasodilation was attenuated by brachial artery infusions of propranolol in infused, but not contralateral, hands and was not affected by digital nerve blockade. Quantitative measurements of finger blood flow demonstrated that this vasodilation occurred in arteriovenous shunts in normal persons and in the finger capillary bed in those with Raynaud's disease. Raynaud's disease patients who received finger temperature feedback reported 80 fewer percent symptoms 1 and 2 years after treatment and retained the ability to increase finger temperature and capillary blood flow at these times. These effects were not shown by patients given autogenic training, a relaxation procedure.

Electromagnetic articulography: use of alternating magnetic fields for tracking movements of multiple points inside and outside the vocal tract.

The purpose of this paper is to present a new electromagnetic device which uses alternating magnetic fields for tracking movements of multiple points inside and outside the vocal tract. It is biologically safe, noninvasive, it does not interfere with speech movements, allows for multiple recording in the same subject, and for easy collection of large amounts of data. It is especially suitable for evaluation of patients with speech motor impairments.

Lower extremity swelling: computerized tomography following negative venography.

In 21 patients who had lower extremity swelling and negative venography, radiographic evaluation was extended to include computerized tomography (CT) of the lower extremity, which we have termed venography-CT, or VCT. All patients were referred with the diagnosis of deep vein thrombosis (DVT) and no patient had a history of trauma. CT was effective in demonstrating two occult mechanisms of lower extremity swelling: knee joint effusion (three patients) and intramuscular hemorrhage (five patients). Selective utilization of CT in the evaluation of lower extremity swelling is effective in directing the clinical management of these patients.

Behavioral treatment of Raynaud's phenomenon in scleroderma.

Twenty-four patients with Raynaud's phenomenon and scleroderma were randomly assigned to receive finger temperature biofeedback, frontalis EMG biofeedback, or autogenic training. Only those receiving temperature feedback showed significant increases in finger temperature during training and during a posttraining test of voluntary control, effects not attributable to general relaxation. However, no group demonstrated significant clinical improvement, assessed by symptom reports and by ambulatory monitoring of finger temperature. The need for careful classification of patients with Raynaud's disease and Raynaud's phenomenon in scleroderma is emphasized.