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Biomedical subjects

E Esser

Publications and source records attributed to E Esser.

At least 19 recordsLinked to original sources
PubMed2006

[Arthrocentesis--a highly efficient therapy for acute TMJ arthropathy].

PURPOSE: This clinical study deals with the efficiency of arthrocentesis in acute arthropathy of the temporomandibular joint (TMJ). PATIENTS AND METHODS: In total 142 patients (41.5 years average) were included in the examination. Inclusion criteria were a restriction of mouth opening <40 mm and/or TMJ pain >3 on a visual analog scale (VAS). The first examination took place the day before surgery; follow-up was performed 1 day and 4 weeks after arthrocentesis. Study parameters were active mouth opening, TMJ pain on preauricular or intra-auricular palpation, myalgia of the temporalis or masseter muscle, and a deviation clicking or crepitation during mouth opening. Arthrocentesis was performed in all patients under general anesthesia by a double puncture, continuous rinsing technique in an inferolateral approach as recommended by Murakami. The upper temporomandibular joint space was rinsed with 250 ml of a physiological sterile saline solution and a pressure of 200 mmHg. RESULTS: Arthrocentesis resulted in a highly significant increase of mouth opening and a highly significant reduction of TMJ pain on palpation (p<0.001). CONCLUSION: It can be postulated that TMJ arthrocentesis represents a highly efficient therapy of acute TMJ arthropathy. Whether the results have to be judged as a palliative short-time therapy or if even long-term results can be achieved has to be proved by long-term follow-up studies.

Acute Disease↗
PubMed2001

[The value of qualitative regression grading as a prognostic factor for survival after preoperative radiochemotherapy in patients with advanced head and neck cancer].

BACKGROUND: Multimodal therapeutic strategies gain importance in locally advanced squamous cell carcinoma of the head and neck. Quantitative regression grading can be traced as an independent prognostic parameter in the histological examination in many neoadjuvantly treated cancers. Various regression systems have been suggested. We propose an easy to apply and economical score that seems to have a significant prognostic value in squamous cell carcinoma of the head and neck. PATIENTS AND METHODS: 43 patients with Stage IV squamous cell carcinoma of the head and neck have been treated neoadjuvantly with two cycles chemotherapy (ifosfamide 1.5 g/m2 day 1-5 with mesna [300 mg/m2], cisplatin 60 mg/m2 day 5, second cycle day 22). Hyperfractionated accelerated radiotherapy (30 Gy) was given from day 29 on. We divided the resected tumors histologically as follows: Grade I--no tumor cells to be identified, Grade II--necrosis, Grade III--partial destruction of the carcinoma, Grade IV--vital carcinoma. RESULTS: After 1 year the overall survival amounted to 79%, after 2 years 56%. A significant correlation could be established between qualitative tumor regression and survival. The 1-year survival depended on the regression of the primary as follows: 94% in Grade I, 80% in Grade II, 60% in Grade III and 56% in Grade IV. For the 2-year survival: 76%, 40%, 40%, 11% (p < 0.01). The results were similar regarding the neck dissections. CONCLUSIONS: After radiochemotherapy the histological regression is a significant prognostic factor of survival. A simple system with four subgroups is suggested which seems to be of a high prognostic value. We discuss to intensify the treatment for patients with good regression after neoadjuvant therapy for a further reduction of recurrence.

Adult↗
PubMed2000

Prognostic value of hemoglobin concentrations in patients with advanced head and neck cancer treated with combined radio-chemotherapy and surgery.

PURPOSE: Hemoglobin levels are currently the focus of interest as prognostic factors in patients with head and neck cancer. Most published clinical trials have confirmed hemoglobin to possess a significant influence on survival in patients treated with radiotherapy. In our study we have investigated the prognostic value of hemoglobin in a combined modality schedule. PATIENTS AND METHODS: Forty-three patients with advanced head and neck tumors were treated with combined radio-chemotherapy. The therapy comprised 2 courses of induction chemotherapy with ifosfamide (1,500 mg/m2, day 1 to 5) and cisplatin (60 mg/m2, day 5) followed by hyperfractionated accelerated radiotherapy with a total dose of only 30 Gy. Surgery involved tumor resection and neck dissection. RESULTS: The 1-year overall survival rate and the 2-year survival rate were 79% and 56%, respectively. The 1- and 2-year recurrence-free survival rates were 68% and 49%, respectively. Prognostic factors with an impact on survival were seen in tumor size (T3 vs T4, p = 0.0088), response to radio-chemotherapy at the primary site (no vital tumor rest vs vital tumor rest, p = 0.045), response to lymph node radio-chemotherapy (no vital tumor cells vs vital tumor cells, p = 0.013) and level of hemoglobin after radio-chemotherapy (Hb > or = 11.5 g/dl vs < 11.5 g/dl, p = 0.0084). CONCLUSION: In our study hemoglobin level after radio-chemotherapy was identified for the first time to be also a significant prognostic factor (univariate analysis) in head and neck cancer patients who underwent combined radio-chemotherapy. Besides chemotherapy plus low-dose irradiation achieved similar results in comparison with radical resection and high-dose radiotherapy at least for the first 2 years after therapy. Relapsing disease could be treated with 1 additional course of radiotherapy which is supposed to be well tolerated.

Adult↗
PubMed2000

[Implantology].

Endosseous osseointegrated implants have become an integral part of the treatment scheme for the prosthetic reconstruction and rehabilitation of masticatory function following scientific studies of the reactions between implant and soft and hard tissues. Furthermore, implants offer good chances for prosthetic rehabilitation in the insufficient bone site, if the extremely atrophic jaw is to be reconstructed by grafting procedures with avascular and vascular grafts, by guided bone regeneration, by distraction osteogenesis, by bone substitutes and in the future by osteoinductive proteins in order to prepare the conditions for implant insertion. Those reconstruction procedures combined with implants become often necessary, if complicated hard and soft tissue defects of the skull have to be reconstructed to create the prerequisites for the stabilisation of epitheses or to insert implant-supported devices.

Bone Regeneration↗
PubMed1999

[Comparative studies of Brånemark implants in the irradiated and not irradiated mandible].

A comparative study was carried out of 276 Brånemark fixtures in the irradiated and nonirradiated anterior mandible with a mean follow-up period of 58.2 months. Postoperative radiotherapy with 60 Gy and 100% isodose for the anterior mandible using a 6-MV linear accelerator, conventional fractioning, and a split-course technique was administered in the irradiated patient group. HBO therapy was not applied. A statistical difference in the 5-year success rate between the irradiated and nonirradiated group was not found. Nevertheless, a significantly higher rate of perioperative soft tissue complications at implant insertion was seen in the irradiated group. The statistical analysis showed no significance for sex, interval between radiation and implant insertion (with a minimum of 10 months), or type of periimplant soft tissue (regional vs. flap). The prognosis for implants in the irradiated mandible was, however, statistically improved (n = 0.0035) when the healing period was longer than 4 months. Mobile periimplant soft tissue proved to be the main problem regardless of radiation load. Late complications have not been observed so far. The available results and clinical studies support a positive assessment of the regenerative potential of the irradiated mandible with regard to osteointegration of endosseous implants. A preceding radiotherapy up to 60 Gy should therefore not be considered as a contraindication for an implant/prosthetic rehabilitation.

Adult↗
PubMed1999

Comparison of characteristics of the nodX genes from various Rhizobium leguminosarum strains.

We have analyzed the nucleotide sequences of the nodX genes from two strains of Rhizobium leguminosarum bv. viciae able to nodulate Afghan peas (strains A1 and Himalaya) and from two strains of R. leguminosarum bv. trifolii (ANU843 and CSF). The nodX genes of strains A1 and ANU843 were shown to be functional for the induction of nodules on Afghan peas. To analyze the cause of phenotypic differences of strain A1 and strain TOM we have studied the composition of the lipochitin-oligosaccharides (LCOs) produced by strain A1 after induction by the flavonoid naringenin or various pea root exudates. The structural analysis of the LCOs by mass spectrometry revealed that strain A1 synthesizes a family of at least 23 different LCOs. The use of exudates instead of naringenin resulted only in quantitative differences in the ratios of various LCOs produced.

Amino Acid Sequence↗
PubMed1998

Osseointegration of dental implants in patients with and without radiotherapy.

Between 1987 and 1997, 275 dental implants were inserted in the mandibles of 63 patients with squamous cell carcinoma of the lower oropharyngeal level following a radical surgical procedure. Thirty-five of these patients had been preirradiated with a complete dose of 60 Gy. In a retrospective analysis we have reviewed the data of these patients for age, sex, localization of the implants, irradiation, interval of implantation and interval of the abutment operation. Thus far, the median follow-up time is 65 months. The 5-year success rate for all implants was 97.9%. We found that radiotherapy, age, sex, localization of implantation or the interval between the end of the tumor therapy and the time of implantation did not have any significant influence on osseointegration or loss of osseointegration. Only the time interval between implantation and the abutment operation was recorded to be of any great significance (p = 0.0001). No augmentation in the osteoradionecrosis rate could be recorded after dental implantation (1.6%), which leads us to conclude that radiotherapy (60 Gy) in patients with head and neck cancers should not be regarded as a contraindication for dental implantation.

Adult↗
PubMed1994

[Long-term results of mandibular reconstruction with avascular spongiosa transfer and titanium mesh].

Severe and mild complications could only be detected in damaged transplant bed (radical operation and radiation exposure, traumatic lesions) in osteoplastic reconstruction of the mandible with avascular cancellous bone transfer using a titanium carrier. Altogether, we rate this method as more favorable compared to an avascular block transplant because of advantages in handling the system in the surgical technique, contouring of the problem zones in the chin and mandibular angle region, more simple transplant extraction and greater resistance to infections. Owing to the high osteogenic potency of the cancellous bone, a relatively slight tendency to secondary absorption was found. We hence still value avascular cancellous bone transfer as a method which can be recommended for reconstruction of small and medium-size mandibular defects (up to about 6 cm) in good to moderate transplant bed. At present, we restrict vascularized transfer of the cortico-cancellous block transplant to larger mandibular defects and transplant beds which are not ideal for substitution after radical operation and radiation exposure.

Bone Transplantation↗
PubMed1992

[Medical high-risk patient in the dental practice].

Cardiovaskular and pulmonary diseases, terminal renal failure, hepatitis B and C as well as the acquired immune deficiency syndrome, hemorrhagic diatheses, diabetes mellitus and hyperthyreosis are the major systemic diseases related to the practice of dentistry and require a modified treatment plan. Dental treatment during pregnancy may involve a risk for the woman and the fetus. The article outlines the most important aspects of interdisciplinary care for medial high-risk patients in the dental practice, refers to further readings and emphasizes the necessity of active continued education in the field of general medicine and specific emergency care.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[The experiences of 10 years of an interdisciplinary dysgnathia consultation].

We regard the down-fracture technique in maxillary osteotomy of the Le Fort-I plane, the possibility of simultaneous bimaxillary procedure as well as adaptation osteotomy in the maxillary region, semirigid osteosynthesis technique with miniplates and miniscrews and consistent interdisciplinary cooperation in planning and therapy as the most important advances during the last ten years. A joint dysgnathia clinic has proved to be of great benefit. Sagittal and vertical recurrences are avoided in particular using the bimaxillary procedure and a timely and consistent orthodontic follow-up treatment. The quality of the definitive result crucially depends on the consistency and quality of the immediate postoperative orthodontic follow-up treatment.

Bone Plates↗
PubMed1991

Phorbol ester cardiotoxicity: are .O2-radicals involved?

The effect of superoxide dismutase (SOD) on cardiotoxic effects induced by phorbol 12-myristate 13-acetate (PMA) was investigated in isolated perfused rat hearts. The negative inotropic effect, vasoconstriction, and mild bradycardia were uneffected by SOD in the perfusion medium. Perfusion of Langendorff hearts with PMA and oxidized cytochrome c +/- SOD gave no evidence for a formation of .O2 radicals in response to PMA. Cytochrome c reduction detected in the perfusate of PMA-treated Langendorff hearts is not inhibited by SOD and has thus to be attributed to .O2-independent myocardial reducing systems.

Animals↗
PubMed1991

Defective activation of the alternative pathway of complement in patients with homozygous C2 deficiency: studies in two unrelated families.

Selective homozygous deficiency of the second component of complement, C2, with increased susceptibility to infection was detected in five children of two unrelated families. Because the haemolytic activity of the alternative complement pathway (AP) was in the low normal range, we evaluated the AP activation pattern. Serum levels of factor B measured immunochemically and the haemolytic function of factor B were low normal. Levels of C3d were not increased. Activation products of factor B were undetectable indicating the absence of in vivo activation of AP. Activation of C3 in vitro by activators of the AP (zymosan A and lipopolysaccharide) was profoundly deficient in homozygous C2 deficiency while heterozygous carriers exhibited intermediate values. There was no correlation between serum levels of factor B and in vitro C3 activation. We conclude that defective AP activation may contribute to increased susceptibility to bacterial infections in some patients with homozygous C2 deficiency.

Child↗
PubMed1991

[Studies following Wassmund osteotomy in the modified down-fracture technic].

The down-fracture technique enables three-dimensional displacement of the maxilla in the Le Fort-I plane as well as its simultaneous multisegmentation. Using a semirigid technique of fixation with miniplates, a stable result can be obtained in orthodontic follow-up treatment without tendency to vertical and sagittal recurrence. The transverse deviations detected are interpreted primarily as functional adaptations. In cranial displacement of the maxilla by more than 10 mm, there is a risk of esthetic problems involving the region of the upper lip, the soft tissues of the nose and the cheek. The rate of subjective postoperative disorders is small. In the event of damage to the descending palatine artery, areas of necrosis may occur in the region of the anterior lateral teeth. The disorders of sensitivity of the gum and the gingiva typical for such operations do not result in subjective discomfort. The rate of iatrogenic damage to teeth is 5.6% in the patients followed up. Because of high acceptance of therapy and the low incidence of complications on the one hand as well as the various possibilities of therapy on the other hand, the down-fracture technique is regarded as the most important method of operation in orthodontic surgery at present.

Cleft Lip↗
PubMed1991

Leukocytic .O2- and cardiac dysfunctions in isolated perfused rat hearts.

Superoxide radicals are supposed to contribute to myocardial reperfusion injury. Their origin, however, is still a matter of debate. Polymorphonuclear leukocytes (PMNL) have been discussed as a major postischaemic .O2- source [Lucchesi and Mullane (1986) Ann Rev Pharmacol Toxicol 26: 201-224]. We studied the role of .O2- derived from human polymorphonuclear leukocytes in reperfused and normoxic perfused isolated rat hearts. During reperfusion PMNL exerted deleterious effects on different parameters (e.g. contractility, coronary flow) of isolated rat hearts. Under normoxic perfusion conditions stimulation of PMNL with N-formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP) caused bradycardia and a transient vasoconstriction. Superoxide dismutase (SOD) administration did not influence any of the PMNL effects mentioned, suggesting that leukocytic .O2- was not involved in PMNL-induced cardiac dysfunctions.

Animals↗