Biomedical subjects

B M Lippert

Publications and source records attributed to B M Lippert.

At least 55 records · Page 3Linked to original sources

PubMed2000

Hazards of piercing and facial body art: a report of three patients and literature review.

Piercing has become a widespread fashion trend in Western industrialized nations within recent years. The invasive application of ornaments through cutaneous and mucosal surfaces enables the penetration of various pathogens into subcutaneous tissue. The authors describe the hazards of piercing and facial body art as they apply to 3 patients. Perichondrial auricular abscess, granulomatous perichondritis of the nasal ala, and embedding of a stud in the lower lip were the respective diagnoses. Literature was reviewed for the cultural origins and current practices of piercing, the legal background of piercing as a business, typical medical complications, and treatment recommendations. Numerous communications have been published on medical complications of piercing. The patients presented and the review of the literature illustrate that piercing is not a harmless fashion and that regulations of piercing as a business seem desirable to prevent further complications.

Adolescent↗

PubMed2000

mRNA differential display of human laryngeal carcinoma cells and corresponding benign keratinocytes: cloning versus PCR-amplification.

The mRNA expression profile of mucosal keratinocyte cell lines was compared to that of squamous cell carcinoma cell lines of the head and neck (UMSCC-10A and UTSCC-19A) by the differential display technique. Before the sequencing procedure, the differentially expressed fragments can be reamplified either by PCR amplification only or by PCR amplification combined with molecular cloning. In this study, these two methods are compared. Total RNA of both cell types was reverse transcribed into cDNA followed by amplification with PCR. After electrophoresis in a non-denaturing gel, differentially expressed fragments were isolated, reamplified, and sequenced. Reamplification was carried out following two different protocols: the first one included two additional rounds of PCR, the second one only one additional round of PCR followed by cloning. Differentially expressed fragments could be sequenced after reamplification with both methods. Different cloned recombinants of the same PCR pool showed sequence differences in one to three bases. On the other hand, amplification of the differentially expressed fragment by PCR alone was reproducible without any differences in sequence. But in the latter case, only one of the complementary strands could be sequenced. Differentially expressed mRNA fragments detected by differential display can be sequenced directly after reamplification in two additional rounds of PCR. This method is no adequate replacement for bacterial cloning, but it might be a suitable solution if cloning procedures cannot be performed.

Adult↗

PubMed2000

Laryngeal chondrosarcoma with regard to the ultrastructure.

Most common among the laryngeal sarcomas is the chondrosarcoma. The difficulties in differentiation between benign and malignant behavior of cartilaginous tumors are responsible for the danger of misinterpretation of chondrosarcoma as chondroma. A case of a laryngeal chondrosarcoma is presented examined by light and electron microscopy to determine if the ultrastructure of chondrosarcoma could be helpful in the correct diagnosis. The cells and their formation play a more important role than the extracellular matrix in the differentiation of tumor's behavior. As special criterias of malignancy by electron microscopy are the presence of dominant mitochondria, fat vacuoles, dilated rough endoplasmatic reticulum and the irregular shape of chondrocytes. The knowledge of the ultrastructure of chondrosarcomas may be helpful to distinguish between a benign chondroma and low-grade chondrosarcoma, especially when only small tumor biopsies are valuable.

Aged↗

PubMed1999

Transcriptional repression of the human galactocerebrosidase gene in squamous cell carcinomas of the larynx.

Alterations of gene expression in squamous cell carcinoma (SCC) cell lines derived from the larynx and keratinocytes derived from adjacent normal mucosa of the larynx have been studied using the mRNA differential display technique. Lane-to-lane comparison of reverse transcribed mRNA showed a strong repression of a 148 bp fragment in SCC cells. The fragment was reamplified and cloned. Sequencing revealed a 99.3% homology with a region in exon 17 of the human galactocerebrosidase (GALC) gene. Northern blot analysis confirmed the differential expression of this gene in both carcinoma cell lines and laryngeal SCC biopsies in contrast with corresponding normal mucosa. To provide further evidence for the differential expression rate, both types of cells were transiently transfected with a 152 bp (-176 to -24) high regulatory promoter element of the 5' flanking region of the GALC gene. Results of 3 independent transfection experiments indicated a 16-fold repression of the GALC gene expression in SCC cells compared with benign keratinocytes. However, neither mutation nor other alterations of the promoter sequence were detected. Expression of the GALC gene is thus greatly affected in SCCs of the larynx.

Base Sequence↗

PubMed1999

Management of Zenker's diverticulum and postlaryngectomy pseudodiverticulum with the CO2 laser.

Dysphagia is a common symptom and can be caused by anterior pharyngeal (pseudodiverticulum after laryngectomy) and posterior pharyngeal (Zenker's) diverticula. The only treatment is surgical. The experience with an endoscopic treatment, especially with the CO(2) laser, is limited. Between 1984 and 1996, 81 patients with dysphagia were treated endoscopically with the CO(2) laser at the Department of Otorhinolaryngology-Head and Neck Surgery, University of Kiel. In 70 patients the swallowing disorder was caused by a hypopharyngeal diverticulum, and in 11 patients it was caused by a pseudodiverticulum after laryngectomy. In the Zenker's group, more than 90% of the patients were treated successfully. Eight of 11 patients with pseudodiverticula were without symptoms, and in the remaining 3 patients dysphagia was improved after laser therapy. The excision technique was superior to the incision procedures. The rate of postoperative complications was generally low. The microendoscopic approach with the CO(2) laser is a recommendable method for the treatment of Zenker's diverticulum and pseudodiverticulum in the postlaryngectomy patient. The surgical technique with the CO(2) laser at low power settings is a less invasive, quick, relatively safe, and effective procedure requiring only short hospitalization.

Aged↗

PubMed1999

[Studies on significance of sentinel lymphadenectomy in pharyngeal and laryngeal carcinoma].

BACKGROUND: Management of the suspected N0-neck (sonography and CT) in squamous cell carcinoma (SCC) of the head and neck is discussed controversially. The question arises whether the sentinel node (SN) concept as it is performed in different areas of clinical oncology is applicable to ear, nose, and throat medicine. METHODS: Nine male patients with SCC were studied (4 oropharynx, 2 hypopharynx, and 3 larynx) in whom different lymph node status was diagnosed clinically (5 x N0, 2 x N1, 2 x N2c). After intraoperative scintillation probe detection, the histological examination of the SN with neck dissection (ND) specimen followed. RESULTS: In 7 of 9 cases SN detection was successful. In 4 of 5 cases of clinical N0 status, SN, and ND specimens were free of tumor histologically, while in one patient radiolabel-identified SN showed tumor cells in histological examination. In 2 patients with clinical N1 neck, SN, and ND were histologically tumor-free in one patient and contained one single tumor metastasis located in the SN in the other patient. In 2 patients with clinically and histologically proven N2c neck, lymph nodes located in regions II and III showed metastasis including capsular rupture. In both cases no lymph node radioactivity was detectable during the operation. CONCLUSIONS: The results suggest that sentinel lymphonodectomy may be suited for ear, nose, and throat medicine. Before it is applied to clinical practice, further problems must be resolved. These include the short distance between the primary injection side and lymph nodes and the influence of intranodal tumor metastasis on the uptake of the radiolabeled tracer.

Aged↗

PubMed1999

The influence of laser surgery on the assessment of "molecular margins" in carcinomas and mucous membranes of the upper aerodigestive tract.

BACKGROUND AND OBJECTIVE: A correlation has been shown between the occurrence of the p53 protein in margins of excised carcinomas and a higher incidence of recurrences. The presented study deals with thermic alterations in resection margins after laser surgery and their impact on p53 protein and LDH detection. STUDY DESIGN/MATERIAL AND METHODS: Healthy mucosa of the oropharynx and carcinoma samples were excised with scalpel, CO2 laser and Nd:YAG laser. Alterations of lactate dehydrogenase (LDH) and the p53 status of the samples were determined by immunohistochemistry and molecular biologic methods. RESULTS: Total activity of LDH was not altered by the different modes of excision. The expression of p53 could be detected in all mucosa specimen by ELISA. In laser-surgically excised tissue regularly a small zone adjacent to the cutting edge could be demonstrated where p53 could not be detected by immunohistochemistry. CONCLUSION: Immunohistochemical and molecular assessment of laser surgical margins is possible despite thermic artefacts. Laser surgery therefore does not minimize the prognostic value of resection margins of carcinomas of the upper aerodigestive tract.

Biomarkers, Tumor↗

PubMed1998

Long-term results after laser turbinectomy.

BACKGROUND AND OBJECTIVE: Different types of lasers have been used for reduction of hypertrophic inferior turbinates in recent years with good results. Reports about the long-term benefits of the laser treatment are rare. STUDY DESIGN/MATERIALS AND METHODS: At the Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, from April 1987 to March 1997, 658 patients with nasal obstruction caused by hypertrophic inferior turbinates were treated with the CO2 or Nd:YAG laser. Of these patients, 118 were able to be followed for a period of 5 years. RESULTS: After 5 years, 54 of 70 patients (77.1%) treated with the CO2 laser were satisfied. The success rate after Nd:YAG laser surgery was 64.6% (31/48 patients). Severe intra- or postoperative complications were not observed. CONCLUSION: The results suggest that the CO2 and Nd:YAG laser surgical techniques are suitable for the treatment of hypertrophic inferior turbinates. The main advantages are the decreased bleeding risk and the fact that the operation can be conducted as an outpatient procedure.

Follow-Up Studies↗

PubMed1998

[Clinical and molecular biology studies of laryngeal papillomatosis].

BACKGROUND: Recurrent laryngeal papillomatosis is a benign neoplastic disease which is probably caused by but at least associated with the Human Papilloma Virus. It can be of significant importance for the affected patients because of its recurrent clinical course. A wide variety of therapeutic measures have been described including the surgical removal either with conventional instruments or laser. Malignancies developing from papillomas have been reported. PATIENTS: The clinical courses of all 95 patients who have been treated for laryngeal papillomatosis since 1960 were analysed retrospectively. The two most common forms of treatment, surgical removal either conventionally or with the use of the laser, were compared. "Hot-start" polymerase chain reaction and Southern blot hybridization were used to detect HPV-DNA. The case reports of all patients developing cancer of the larynx are included. RESULTS: Laryngeal papillomatosis is a disease of all ages, more often first diagnosed before age 10 or after age 30. Puberty had no effect on the clinical course. However, the rate of complications such as tracheostomy and glottic webs was significantly reduced after laser surgery. HPV-DNA was found in 10 of 11 samples. Squamous cell carcinoma subsequently developed in four cases, three of which occurred almost simultaneously and were therefore not included. CONCLUSION: The term juvenile laryngeal papillomatosis should be replaced by recurrent respiratory papillomatosis. The occurrence of squamous cell carcinomas in patients previously treated for papillomas underlines the need for repeated histological studies. The surgical treatment remains the mainstay in the management of laryngeal papillomatosis. The laser surgical technique is superior to conventional removal. Using the most sensitive and specific methods presently available, HPV-DNA can be detected in a large percentage of laryngeal papillomas.

Adolescent↗

PubMed1998

[Re-amplification of differentially expressed mRNA fragments of head-neck cancers without cloning].

BACKGROUND: mRNA expression of healthy and malignant cells can be compared to each other by employing the "differential display" (DD) technique. Most studies describe sequence analysis of differentially expressed fragments after reamplification by a second round of PCR and subsequent molecular cloning to gain a sufficient amount of DNA for sequencing. The aim of this study was to show whether a sufficient amount of differentially expressed mRNA of squamous cell carcinoma cells of the head and neck region can be generated by PCR alone without cloning steps. MATERIAL AND METHODS: mRNA isolated from cultivated keratinocytes and squamous cell carcinoma cells was reverse transcribed into cDNA which was amplified with PCR. Differentially expressed fragments detected after gel electrophoresis were isolated from the gel and reamplified in a second PCR. The resulting cDNA amounts of the second PCR were suitable for cloning but not for direct sequencing. A third round of PCR with the undiluted final product of the second PCR as template regularly failed. Dilutions of the second PCR products between 1:10 and 1:10(10) were prepared. The third round of PCR was carried out with these various template concentrations. RESULTS: A sufficient amount of differentially expressed fragments for sequencing procedures resulted when dilutions of the second PCR products ranging from 1:10(2) to 1:10(7) were used as templates in the third round of PCR. CONCLUSION: Modifications of PCR parameters provide high DNA copy numbers of differentially expressed mRNA fragments from squamous cell carcinoma cells of the upper aerodigestive tract in amounts that are needed for sequence analysis. This may make it possible to avoid labor-intensive cloning procedures requiring high safety standards.

Base Sequence↗

PubMed1998

[Clinical and molecular biology studies of respiratory papillomatosis].

BACKGROUND: Recurrent laryngeal papillomatosis is a benign neoplastic disease which is probably caused by but at least associated with the human papillomavirus. It can be of significant importance for the affected patients because of its recurrent clinical course. A great variety of therapeutic measures has been described including the surgical removal either with conventional instruments or using the laser. Development of malignancies from papillomas have been reported. PATIENTS: The clinical courses of all 95 patients who have been treated for laryngeal papillomatosis since 1960 were analysed retrospectively. The two most common forms of treatment, surgical removal either conventionally or with the use of the laser, were compared. "Hot start" polymerase chain reaction and Southern blot hybridization were used to detect HPV DNA. The case reports of all patients developing cancer of the larynx are included. RESULTS: Laryngeal papillomatosis is a disease of all ages, more often first diagnosed in the first and fourth decade. Puberty had no effect on the clinical course. The different forms of treatment did not affect the rate of recurrence. However, the rate of complications such as tracheostomy and glottic webs was significantly reduced after laser surgery. Since the introduction of this new form of therapy no more tracheostomies had to be performed on these patients. HPV DNA was found in four of five samples (HPV 6:3, HPV 11:1). Squamous cell carcinoma subsequently developed in four cases, three of which occurred almost simultaneously and were therefore not included. CONCLUSION: The term juvenile laryngeal papillomatosis should be replaced by recurrent respiratory papillomatosis. One could then distinguish according to the age of onset, i.e., in children below the age of 16 years and in adolescents and adults older than 15 years. The occurrence of squamous cell carcinomas in patients previously treated for papillomas underlines the need for repeated histological studies. The surgical treatment remains the mainstay in the management of laryngeal papillomatosis. The laser surgical technique is superior to conventional removal. Using the at present most sensitive and specific methods HPV DNA can be detected in a large percentage of laryngeal papillomas.

Adolescent↗

PubMed1998

[Primary mucous membrane melanoma of the base of the tongue].

BACKGROUND: Primary mucosal melanoma of the tongue is an absolute rarity. A review of the literature revealed only 28 cases. PATIENT: The following report deals with an 87-year-old male patient who developed a primary melanoma of the left base of his tongue. The melanoma was excised with the CO2 laser. The patient refused surgical removal of the lymph nodes as well as radiation therapy. RESULTS: The laser resection of the melanoma led to a local control of the tumor at its primary site until the patient died from a stroke 30 months after the initial diagnosis. CONCLUSION: Limited melanoma of the mucosa of the tongue can be excised with the CO2 laser, if the resection can be performed with margins of healthy tissue as large as those in conventional surgery. Surgical therapy with primary palliative intention seems also to be adequate as relief of local symptoms can be achieved even for a longer period of time.

Aged↗

PubMed1998

Prevalence of human papillomavirus in squamous cell carcinoma of the head and neck determined by polymerase chain reaction and Southern blot hybridization: proposal for optimized diagnostic requirements.

Human papillomaviruses (HPV) are discussed as cofactors in the carcinogenesis of squamous cell carcinoma of the head and neck (SCCHN). The prevalence of HPV infection in SCCHN is the subject of controversy since reported HPV prevalences range from less than 10% to almost 100%, depending mainly on the detection method employed. This study presents a realistic approximation to the real prevalence of HPV in SSCHN by applying polymerase chain reaction (PCR) and Southern blot hybridization (SBH), which are the most sensitive and specific HPV detection methods. Diagnostic procedures were optimized by applying a "hot-start" PCR protocol followed by a confirmatory SBH of the PCR products to reactions using both type-specific and consensus primers and probes. DNA of 75 tumour samples and 22 normal mucosa samples of the same patients were investigated. In 14 cases genomic SBH using complete HPV genomes as probes was performed additionally. HPV DNA was detected in 17/75 (22.7%) SCCHN specimens. HPV 16 was identified in four cases, HPV 45 in three cases, and HPV 6 and 18 in one case each. Hot-start PCR and SBH are the most reliable HPV detection methods, as they minimize both false-positive and false-negative results. With these methods, a HPV prevalence of 23% was achieved, which can be assumed to be representative for comparable study populations. The significant number of positives detected only by consensus primer PCR, along with the identification of HPV 45, indicate that further HPV types may play an important role in the genesis of SCCHN.

Adult↗

PubMed1998

Ultrasound-guided interstitial Nd: YAG laser treatment of voluminous hemangiomas and vascular malformations in 92 patients.

In many cases voluminous vascular anomalies of the head and neck region are still treated with conventional surgery, although neodymium:yttrium-aluminum-garnet (Nd:YAG) laser therapy offers a valuable treatment alternative. Ninety-two patients with voluminous hemangiomas and vascular malformations were treated with interstitial Nd:YAG laser therapy (power density, 1300 to 3300 W/cm2), partly complemented by a noncontact-mode Nd:YAG laser light application (energy density, 1000 to 2500 J/cm2). The vascular tumors had a diameter of more than 3 cm in at least two dimensions. Treatment was carried out under ultrasound and manual control. Nearly 60% of the patients (n = 55) showed a complete clinical regression. Thirty-three patients (35.8%) had a partial regression and were satisfied with the treatment outcome. Four patients were treated unsuccessfully with the laser, and three of them subsequently underwent conventional surgery. Only nine of the 92 patients (9.8%) showed cosmetic or functional impairments. The results of this first consecutive series study with a retrospective clinical evaluation of the interstitial Nd:YAG laser therapy of voluminous hemangiomas and vascular malformations in a large patient group demonstrate a high effectiveness of this novel therapy modality.

Adolescent↗

PubMed1998

Differentially expressed genes in head and neck cancer.

Carcinogenesis is considered a multistep process. To further elucidate involved genetic changes, the differential display method was applied to compare gene expression of head and neck carcinoma cells and normal keratinocytes from the upper aerodigestive tract. Total RNA was extracted from cultured squamous carcinoma cells and keratinocytes. mRNA was reverse transcribed into cDNA, amplified by PCR, and separated on a gel. Currently three DNA transcripts were identified with a length of 191 to 336 base pairs (bp) that were either expressed only by the keratinocytes or by the malignant cells. Differentially expressed DNA fragments of the carcinoma cells and the keratinocytes were cloned and sequenced. A gene bank database search identified one fragment expressed by the carcinoma cells as an unknown gene, another one found in the keratinocytes as probably a part of the human cell attachment domain, and the third one with homology to the mRNA of the human epidermal growth factor receptor (EGFR). Northern blot analysis confirmed the differential expression in the malignant cells or the keratinocytes. Differential display seems to confirm the well-known overexpression and up-regulation of the EGFR, the differential expression of the cell attachment domain may play a role as a cofactor in carcinogenesis of head and neck cancer, and the third unknown fragment is still under investigation to elucidate the role in carcinogenesis.

Base Sequence↗

PubMed1998

Metalloproteinases and their inhibitors in squamous cell carcinoma of the hypopharynx: indicators of individual tumor aggressiveness.

BACKGROUND: Matrix metalloproteinases (MMP) are proteolytic enzymes capable of degrading connective tissue components. MMP activity is modulated by tissue inhibitors of metalloproteinases (TIMP). Imbalanced secretion of certain MMP or disturbances in the differential control of MMP by TIMP have been implicated in the invasive potential of malignant tumors. METHODS: Thirty-nine surgically obtained specimens of the hypopharynx were immunohistochemically stained with antibodies against MMP-1, MMP-2, MMP-3, MMP-9 and their inhibitors, TIMP-1 and TIMP-2. Thirty-one samples derived from primary tumors (PT-group) and 8 samples from recurrent tumors (RT-group). RESULTS: In the PT-group, MMP-1 was expressed in almost all tumors. Expression of TIMP-1 was rarer than of TIMP-2. Relapse occurred in 8/31 cases expressing MMP-1 or MMP-9 (4 cases each). Staining for TIMP-1 was negative in these patients, while TIMP-2 was expressed in most cases. In the RT-group, MMP-1 and MMP-9 stained positive in an almost equal number of cases. Only TIMP-1 was not expressed in any tumor. Patients who died of tumor were uniformly negative for TIMP-1. CONCLUSIONS: The findings suggest that the presence of MMP-9 and concomitant lack of TIMP-1 serve as prognostic indicators of tumor aggressiveness and increased risk of relapse.

Adult↗

PubMed1997

Microendoscopic treatment of the hypopharyngeal diverticulum with the CO2 laser.

BACKGROUND AND OBJECTIVE: The hypopharyngeal (Zenker's) diverticulum is a herniation of mucosa and submucosa on the posterior wall of the pharynx. The only treatment is surgical. STUDY DESIGN/MATERIAL AND METHODS: Between 1976 and 1993, 109 patients with a hypopharyngeal diverticulum were operated on at the Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, either transcutaneously combined with a cricopharyngeal myotomy (n = 76), or microendoscopically (n = 37) using the CO2 laser. Results and complications of both techniques were evaluated and compared. RESULTS: With both surgical procedures, > 90% of the patients were treated successfully. The rate of postoperative complications was generally low. In comparison to the microendoscopic procedure, serious complications were found to be more frequent in patients treated with the conventional transcutaneous diverticulectomy. CONCLUSION: The laser surgical tissue bridge dissection is a less invasive, quick, relatively safe, and effective procedure requiring only short hospitalisation. Therefore, the laser surgical tissue bridge dissection can be considered as the method of choice for the treatment of the hypopharyngeal diverticulum.

Adult↗

PubMed1997

DNA ploidy and protein synthesis in squamous cell carcinoma cell lines of the head and neck.

Aneuploidy as abnormal nuclear DNA content, is considered almost positive evidence of malignancy. In this study three diploid and three aneuploid squamous cell carcinoma (SCC) cell lines were examined for DNA content by flow cytometry. The DNA indices of the SCC cell lines were found to range from 1.0 to 2.1. The mitotic activity of the diploid cell lines was 1.6 times higher and the cells were smaller than aneuploid cells. To find a molecular basis for these differences, the pattern of the de-novo synthesized proteins was analyzed by means of [35S]methionine incorporation, electrophoresis, and autoradiography. In all aneuploid SCC cell lines tested in this experiment, the increase of nuclear DNA content is associated with the synthesis of a novel protein with a molecular mass of approximate 55 kDa as well as with altered synthesis rates of two preexisting proteins (50 kDa and 100 kDa). For determination of the amino acid uptake in diploid and aneuploid cells, the accumulation of [35S]methionine was measured as a function of time by liquid scintillation counting. No significant difference was found in the uptake rate between diploid and aneuploid cells with the same protein content. However, discrepancies were revealed when equal numbers of cells with different DNA index were used, suggesting, that protein turnover is different in diploid and aneuploid SCC cells.

Aneuploidy↗