Pancreolauryl and NBT-PABA tests were performed in urine of 54 patients with exocrine pancreatic insufficiency and, additionally, in serum of 29 of these patients. All patients underwent a secretin-pancreozymin test and a 72-hr fecal fat analysis. Pancreatic steatorrhea occurred (with only three exceptions) when the pancreolauryl test revealed a T/C ratio [recovery of the fluorescein of the test (T) and the control (C) day] of less than 10, or when serum fluorescein concentrations were below 0.5 microgram/ml. The NBT-PABA test also showed a negative correlation between urinary PABA excretion or serum PABA concentration and fecal fat excretion, but there was no diagnostically useful cutoff limit indicating decompensation of exocrine pancreatic insufficiency. These findings indicate that the pancreolauryl test may facilitate clinical evaluation of patients with chronic pancreatitis by simultaneously assessing exocrine pancreatic insufficiency as a cause and predicting pancreatic steatorrhea as a sequel of maldigestion. In clinical practice, the pancreolauryl test can be used as a parameter for deciding whether to initiate pancreatic enzyme substitution if direct pancreatic function tests and fecal fat analysis are not available.
A total of 28 patients with a hemifacial spasm were examined using transcranial magnetic stimulation. The potentials were evoked cortically and cisternally; latencies and amplitudes of each potential were measured in the levator labii muscle and in the orbicularis oculi muscle. After cortical stimulation, differences in latencies were found between the healthy and the diseased side of the levator labii muscle. Prolonged latencies were measured more frequently on the diseased side (cortical stimulation). The method of magnetic stimulation is an important addition to electrophysiological diagnostic procedures in facial hyperkinesias. Cortical stimulation combined with measurements of the blink reflex and neuromyography may allow separate parts of the route of the whole facial nerve and supranuclear structures to be examined.
Nowadays an infusion therapy composed of cortisone, low-molecular dextran, and pentoxifylline is the most common treatment of Bell's palsy. During recent years it has become well known that low-molecular dextran has several severe side effects (e.g. acute renal failure). - At the ENT Department of the University of Göttingen 33 patients with Bell's palsy were treated with an infusion therapy which replaced low-molecular dextran by hydroxyethyl starch. Before and after therapy patients underwent a special diagnostic procedure for the facial nerve function consisting of --determination of the degree of paralysis and secondary defects (14) --a complete electrophysiological examination. The patients were followed up for at least 6 months. It was found that 97% of the patients had a complete functional recovery.
It is well known that the incidence of malignant lymphomas (non-Hodgkin type) is increased in patients with Sjögren's syndrome. The occurrence of malignant diseases was retrospectively studied in 62 patients. In the course of the disease two patients developed a non-Hodgkin lymphoma, one patient developed a transitional-cell carcinoma located in the nasopharynx and three patients developed a squamous-cell carcinoma located in the salivary glands. The large quantity of epithelial carcinomas seems to be remarkable, especially compared with the number of non-Hodgkin lymphomas. It might be possible that early surgical treatment of persistent or progressive swelling of the salivary glands helps to prevent the occurrence of malignant lymphoma in patients with known myoepithelial sialadenitis.
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