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Biomedical subjects

B M Lippert

Publications and source records attributed to B M Lippert.

108 records · Page 6Linked to original sources
PubMed1994

[Adenoid cystic carcinoma of the trachea. Case report and review of the literature on malignant tracheal tumors].

Primary tumours of the trachea are rare. In most cases one finds squamous cell carcinoma or adenoid cystic carcinoma. At the Department of Otolaryngology, Head and Neck Surgery at the Christian-Albrechts-Universität of Kiel only 19 malignant tumours of the trachea were diagnosed between 1949 and 1992 among a total of 6000 malignancies. In most cases the patients suffered from invasive thyroid carcinoma. Only five patients had a primary malignancy of the trachea (2 squamous cell carcinomas, 1 adenoid cystic carcinoma, 1 undifferentiated carcinoma, 1 solid, otherwise not classifiable carcinoma). Of these patients we report on the case of a 57-year old female patient who was diagnosed with an adenoid cystic carcinoma of the trachea and is free of disease eight years after open resection. Since initial symptoms are nonspecific emphasis is on the diagnostic process. The latest publications on therapeutic measures are reported.

Carcinoma, Adenoid Cystic↗
PubMed1994

Laser tissue effects with regard to otorhinolaryngology.

The multitude of medical laser systems with different wavelengths and technical appliances implicates the necessity of fundamental knowledge about the effects of laserbeams on living tissue. This is necessary to allow sufficient and therefore successful results for the patient. In this paper tissue effects of the mostly used lasers in otorhinolaryngology, CO2 laser and Nd:YAG laser will be presented. Influence on blood and lymphatic vessels, wound healing, and several CO2 laser parameters will be discussed.

Animals↗
PubMed1993

[Anthracycline derivatives as photosensitizing agents in photodynamic laser therapy: an in vitro study with squamous epithelial cancer cells of the mouth cavity].

Photodynamic laser therapy performed with hematoporphyrin derivatives has become increasingly important in the treatment of well-defined tumors in superficial sites. Limitations of this procedure result from the side effects of hematoporphyrin derivatives. In searching for possible alternatives to the usual photosensitizing agents, we studied the cytostatic drugs adriamycin and epirubicin. In order to evaluate the photodynamic effects of these agents we conducted in vitro studies on isolated cells from a squamous cell carcinoma of the oral cavity. The light source employed was an argon laser with wavelengths at 488/514 nm. Comparison of the cytostatic effect achieved by these anthracycline derivatives with and without laser light treatment showed a pronounced photodynamic effect. These results may herald new photodynamic therapeutic modalities.

Antibiotics, Antineoplastic↗
PubMed1993

[Giant mucocele of the paranasal sinuses with extension to the contralateral posterior cranial fossa and reversible retrocochlear deafness].

Report on a huge mucocele of the right maxillary sinus extending into the ethmoid and sphenoid sinuses, and protruding into the contralateral left posterior cranial fossa. The patient, a 45-year old male, had no history of paranasal sinus energy, nasal or paranasal symptoms. He went to his physician because of a slowly developing deafness in his left ear and because of episodes of loss of consciousness when blowing his nose. A reversible episode of vertigo and reversible paresis of the left abducent nerve 17 years previously, were later assumed to have been the first symptoms of endocranial extension of the mucocele. The diagnosis of a mucocele was made by MRI. MRI in T2 weighted spin-echo sequences is the best imaging technique for diagnosing a mucocele. The mucocele was treated primarily with endonasal surgery of the paranasal sinuses, using telescopes and an operating microscope. After opening the right maxillary sinus via the middle meatus liquid contents of the mucocele poured into the nasal cavity. The sack of the mucocele was removed partially. Three months later the patient was reoperated with a combined transfacial and endonasal approach, because of progression from partial hearing loss to total deafness. Postoperatively hearing improved nearly completely and compression of the pons and the posterior fossa had disappeared on MRI. It is concluded that in mucoceles no longer the extirpation of the sack, but endonasal marsupialization, using the operating microscope and telescopes, is the therapy of choice.

Audiometry, Evoked Response↗
PubMed1992

[Treatment of hemangioma with the neodymium:yttrium-aluminum-garnet laser (Nd:YAG laser)].

Laser therapy and in particular Nd:YAG laser therapy has become of increasing importance amongst the various methods of treating haemangiomas. Nd:YAG laser radiation penetrates deep into the tissue. To avoid undesirable results of treatment, certain treatment guidelines must be observed: to protect the tissue from serious heat damage, the Nd:YAG laser radiation should be applied exclusively with simultaneous tissue cooling. Depending on the location of the haemangioma, this is carried out with ice cubes (if possible, not containing air bubbles) or with an ice-cold Ringer solution. The depth of penetration of the laser radiation can be increased by tissue compression with a piece of ice or with a special glass disc. In very voluminous haemangiomas, the laser light is additionally applied via a bare fibre directly on to the vascular tissue. The laser power densities we use are between 500 and 3,000 watts/cm2. The power chosen depends on the tissue effect of the laser radiation. Blanching of the vascular tissue without carbonisation is aimed at. With consistent observance of the treatment guidelines specified, haemangiomas should be treated as early as possible with the Nd:YAG laser. The treatment principle of "wait and see" is often advocated, but we consider to be obsolete, since cosmetically and functionally unsatisfactory residual scars may remain even after complete haemangioma regression. Moreover, the progressive haemangiomas which often lead to complications cannot be distinguished from regressive haemangiomas. Last but not least, the child and the parents should be spared the (in some cases appreciable) psychological strain of a haemangioma.

Adolescent↗
PubMed1992

[Mucoepidermoid cancer of the larynx. Case report and review of the literature].

Mucoepidermoid carcinoma (MEC) is classified among the salivary gland tumours and is most commonly found in the parotid gland. It rarely occurs in the larynx. There have been only 87 cases of laryngeal MEC reported in the literature. We report on an MEC of the vocal cord in a 75-year-old man, with a thickened right vocal cord without any loss of movement. The initial diagnosis was squamous cell carcinoma. One year after radiotherapy a tumour recurrence developed. Because the patient refused to laryngectomise, a tumour resection with the CO2 laser was performed twice. To date, the patient has been free from disease for more than five years. The true incidence of this type of neoplasm could be higher than is believed because of its frequent misdiagnosis as squamous cell carcinoma.

Aged↗
PubMed1992

Laryngeal paraganglioma and pregnancy.

Paraganglioma is an uncommon tumor of the larynx. We present a 30-year-old woman with a paraganglioma which took a heretofore not described clinical course. The first clinical sign was persistent hoarseness, when she was 26 weeks pregnant. A histological examination of a piece of the reddish, racemose tumor removed during microlaryngoscopy revealed only some slight nonspecific inflammatory changes. The patient remained free of symptoms following this operative procedure until 3 years later when she presented with a recurrence of hoarseness and a laryngeal tumor and was 25 weeks pregnant. Histology showed a laryngeal paraganglioma in the same supraglottic localization as before. Histological studies failed to confirm the obvious suspicion that the episodic growth of the paraganglioma may have been induced by estrogen or gestagen. To date, 6 years after the removal of the tumor, there has been no recurrence.

Adult↗
PubMed1991

[Subglottic metastasis of multiple myeloma. Case report and review of the literature of laryngeal plasmacytoma].

A total of 111 cases of laryngeal plasmacytoma have now been reported. The disease may present either as a primary extramedullary plasmacytoma (n = 90) or as a metastasis of a multiple myeloma (n = 21). The distinction between these two types is very important in therapy and prognosis. We report a subglottic plasmacytoma in a 48-year-old woman. Investigations showed bone marrow infiltration, osteolysis and light chain expression in serum, indicating generalized disease. Therefore polychemotherapy was given, during which complete macroscopic and microscopic regression of the laryngeal plasmacytoma was observed. However, 14 months later, the patient died of renal failure due to systemic progression of the multiple myeloma.

Airway Obstruction↗
PubMedDate not supplied

Leiomyosarcoma of the nasal cavity. Case report and literature review.

Leiomyosarcoma (LMS) accounts for approximately 7% of all soft tissue sarcomas and occurs most frequently in the gastrointestinal tract and uterus. LMS of the nasal cavity and paranasal sinuses are rare and only about 40 cases of LMS of the nose and paranasal sinuses have been reported in the literature. A further case of LMS of the right turbinate is presented, treated twice by surgery. To date, the patient has been free of disease for more than 48 months. The symptoms, pathology, treatment and prognosis, and origin of this tumor are discussed. Initially, LMS should be treated by extensive surgical excision, but long-term follow-up is essential due to the high rate of local recurrence. Radiotherapy and chemotherapy are insufficient therapeutic approaches. Frequency of recurrence and prognosis depend on the tumor site. The prognosis of LMS of the nasal cavity is better than LMS of the paranasal sinuses.

Adult↗
PubMedDate not supplied

CYFRA 8/18 in head and neck cancer.

BACKGROUND: Cytokeratins (Ck) 8, 18 and 19 that are normally expressed in head and neck tissue in only small amounts, become overexpressed in head and neck squamous cell cancerous tissue. It was questioned whether Ck 8 and 18, which occur together, were also detectable and of value as a tumor markers for this cancer entity. MATERIALS AND METHODS: One hundred forty-nine sera from patients with squamous cell carcinoma of the head and neck (SCCHN) were investigated with a novel ELISA kit for the detection of fragments of Ck 8 and 18. Twenty-five sera from healthy volunteers and 39 patients with benign diseases of the head and neck region served as controls. RESULTS: It was found that CYFRA 8/18 had a sensitivity of 7%. CYFRA 8/18 values did not show a correlation with clinical parameters. CONCLUSIONS: Because of a low sensitivity CYFRA 8/18 seems not to be of value as a tumor marker for SCCHN.

Biomarkers, Tumor↗
PubMedDate not supplied

A new prognostic indicator for head and neck cancer--p53 serum antibodies?

BACKGROUND: p53 antibodies are a new serological parameter of unknown potential in patients with malignancies. Their occurrence has been described in various types of cancer patients and several studies in head and neck cancer patients and other cancer patient groups have indicated its prognostic value. MATERIAL AND METHODS: We investigated the incidence of p53 serum antibodies in 271 head and neck cancer patients with an ELISA and investigated a possible correlation with clinical parameters like tumor staging and grading. RESULTS: Sixty-seven head and neck cancer patients (24.7%) were seropositive for p53 antibodies. No correlation between p53 antibody status, tumor staging and grading was found. CONCLUSIONS: These results indicate that the occurrence of p53 antibodies does not correlate with the most relevant prognostic factors, rate of regional metastasis and primary tumor size, in patients with head and neck cancer.

Autoantibodies↗
PubMedDate not supplied

The influence of differing dissection techniques on p53 as a possible indicator for local recurrences in carcinomas of the upper aerodigestive tract.

BACKGROUND: A correlation between the occurrence of p53 protein in margins after tumor resection has been proposed as indicator for recurrence. This study should clarify whether differences occur in p53 protein detection after laser surgery as opposed to surgery with the scalpel. MATERIAL AND METHODS: Healthy mucosa of the oropharynx (n = 28) and squamous cell carcinoma of the head and neck (SCCHN) (n = 19) were excised with scalpel, CO2 and Nd:YAG laser and then examined for the presence of p53 protein with immunohistochemistry and ELISA. RESULTS: The occurrence of p53 protein in SCCHN was dependent on the applied resection technique. In lasersurgically excised tissue only a small zone adjacent to the cutting edge was found to be negative for p53. This zone of necrosis was smaller in margins after CO2 than after Nd:YAG laser resection. CONCLUSIONS: Lasersurgical excision does only inhibit the detection of p53 in the zone of necrosis.

Adult↗
PubMedDate not supplied

Lymphogenic metastatic spread of auricular VX2 carcinoma in New Zealand white rabbits.

INTRODUCTION: The auricular VX2 carcinoma of the New Zealand white rabbit serves as an animal model for human squamous cell carcinomas of the head and neck region (HNSCC), since both tumors tend to metastasize lymphatically, leading to early lymph node and subsequent distant metastasis. The aim of this study was to examine the pattern of lymphogenic metastatic spread in untreated auricular VX2 carcinomas, since the resulting knowledge potentially could help in the development of new treatment strategies for human HNSCC. MATERIALS AND METHODS: VX2 carcinomas were implanted into both ears of 22 New Zealand white rabbits. The animals were sacrificed at days 7, 14, 21, 28 or 32 after tumor implantation, followed by a detailed histopathological examination of their head and neck lymph nodes. RESULTS: On day 7 after tumor implantation 25% of the animals had metastases in the parotid lymph node, which is the first draining lymph node of the tumor region. This number rose to 87.5% by day 28. At this time 12.5% of all animals also had an additional metastasis in the second echelon node. CONCLUSION: A reproducible metastatic spread into the first draining lymph node could be demonstrated for the auricular VX2 carcinoma of the New Zealand white rabbit. The VX2 carcinoma therefore appears to be a highly suitable animal model for studying the sentinel node concept in the context of human HNSCC.

Animals↗
PubMedDate not supplied

High rate of p53 overexpression in head and neck carcinomas detected with a refined ELISA.

p53 mutations are amongst the most prevalent alterations in human cancer. Overexpression of p53 is usually caused by mutation and is observed in a high percentage of squamous cell carcinomas of the head and neck (SCCHN). Fifty two fresh samples of SCCHN were examined for p53 overexpression and 23 tumor-free tonsils served as controls. Using the monoclonal antibody Pab 1801 a refined ELISA technique was employed. In contrast to established ELISA procedures tumor tissue was pulverized at -80 degrees C prior to the actual ELISA (ELISA I). Comparative p53 detection was carried out by immunohistochemistry (IHC) and a commercially available ELISA kit (ELISA II). The modified ELISA I revealed p53 overexpression in 48 tumor samples (92%). p53 detection was obtained in 26 cases (50%) with ELISA II and with IHC 39 stained positive for p53 (75%). All of the controls were negative for p53 with ELISA and IHC. The p53 staining in IHC showed a significant correlation with the grading of the tumor. The ELISA results of the p53 overexpression did not show any correlation with tumor size or stage and rate of metastasis or other clinical parameters. This ELISA represents a more sensitive detection method of p53 than any other technique so far. It improves on former ELISA and IHC results on p53 overexpression in squamous cell carcinoma of the head and neck and underlines the involvement and the importance of the p53 tumor suppressor protein in carcinogenesis of head and neck cancer.

Adult↗
PubMedDate not supplied

Cut-off value determination of CYFRA 21-1 for squamous cell carcinomas of the head and neck (SCCHN).

BACKGROUND: CYFRA 21-1 was found to be a sensitive and specific tumor marker especially for squamous cell carcinomas of the lung. There is no reliable tumor marker for squamous cell carcinomas of the head and neck (SCCHN) available. METHODS: The amount of Cytokeratin (Ck) 19 in healthy tissue and tissues of benign and malignant tumors from pharynx, larynx and lung was compared utilizing a dot-blot assay. CYFRA 21-1 serum levels were determined prior to therapy in 132 healthy controls, in a reference group consisting of 158 patients with benign diseases of the head and neck and in 238 patients with a histologically proven SCCHN. RESULTS: Compared to lung tissue Ck 19 levels were similar only in specimen of SCCHN. Ck 19 content in normal and benign tissue from pharynx and larynx was lower than in normal lung tissue. CYFRA 21-1 serum levels were significantly higher in patients with SCCHN compared to the control or reference group. The cut-off value for CYFRA 21-1 determined at a 95%-specificity of the reference group was found to be 2.2 ng/ml. CONCLUSIONS: The Ck 19 level in healthy tissue of the upper aerodigestive tract was lower than in normal lung tissue. Corresponding to this finding the CYFRA 21-1 serum level in the reference group with benign diseases of the head and neck was lower than that of patients with benign lung diseases. The cut-off level of CYFRA 21-1 for patients with SCCHN was determined to be 2.2 ng/ml.

Antigens, Neoplasm↗
PubMedDate not supplied

Head and neck cancer and p53-immunogenicity.

BACKGROUND: p53-mutations are of major importance in the development of human malignancies and occur frequently in head and neck cancer. The detection of serum p53-antibodies has been performed for a number of different cancers. For head and neck cancer though, the occurrence of serum p53-antibodies has not been determined so far. MATERIALS AND METHODS: A set of 82 sera from patients with squamous cell carcinomas of the head and neck were screened for circulating antibodies against p53 with ELISA. RESULTS: Of 82 patients 22% (n = 18) demonstrated p53-antibodies in their sera; the specificity for malignancy was 100%. CONCLUSIONS: As far as we know, this is the first study to reveal p53-antibodies in the sera of patients with SCCHN. The high incidence of positivity for p53-antibodies in this subset of cancer patients may give additional help in the diagnosis of this often disfiguring disease.

Adult↗
PubMedDate not supplied

The soluble interleukin-2 receptor--a marker for squamous cell carcinoma of the upper aerodigestive tract.

Various studies indicate that the soluble interleukin-2 receptor (sIL-2R) is of value as marker in chronic and malignant disorders. No data are available on sIL-2R levels in head and neck cancer. The serum of 86 patients with squamous cell carcinoma of the head and neck (SCCHN) prior to any therapy and of 25 healthy controls was taken. Six month later the serum of 49 patients was taken again. sIL-2R levels were determined with ELISA. Patients with SCCHN prior to therapy had significantly elevated sIL-2R serum levels (895 U/ml) compared to controls (437 U/ml). After an eight month follow up 78.4% of the SCCHN patients with tumor recurrence had increased and 80% of the carcinoma patients without recurrence had decreased sIL-2R levels compared to prior to therapy. sIL-2R seems to be an unspecific marker for SCCHN and may be of prognostic value.

Biomarkers, Tumor↗