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Biomedical subjects

E Kastenbauer

Publications and source records attributed to E Kastenbauer.

At least 73 records · Page 4Linked to original sources
PubMed1993

[New aspects on the pathogenesis of cholesteatoma: the possible role of immune cell-induced keratinocyte hyperproliferation].

Cholesteatoma of the middle ear consists of keratinising squamous epithelium in the middle ear cavity. Many points of the pathogenesis of cholesteatoma seem to be related to immune cell infiltrates in stroma and to epithelial cell migration and proliferation. In our study we found that the vast majority of cells infiltrating the stroma consisted of T-cells and macrophages, showing an immunologically activated state. Furthermore, the cholesteatoma epithelium showed an enhanced simultaneous expression of keratine-16 and Ki-67 positive cells. This expression was accompanied by the over-expression of transforming growth factor (TGF)-alpha, and its receptor, epidermal growth factor receptor (EGF-R) and interleukin-1, suggesting that the proliferation of keratinocytes could be stimulated in an autocrine manner. Finally, we conclude that the presence of immunologically activated immune cells in the stroma may be responsible for keratinocyte dysregulation in cholesteatoma epithelium.

Cell Division↗
PubMed1993

[Photodynamic therapy with derivatives from hemotoporphyrines for recurrent laryngeal papillomatosis of the children. Early results].

The big problem, unsolved till now, of the juvenile laryngeal Papillomatosis, is the high rate of recurrences compelling the affected to periodical surgery in order to remove the papillomatous masses that obstruct the airway. In this paper the AA. report 3 cases with infantile laryngeal papillomatosis treated with photodynamic therapy employing haematoporphyrinic derivatives inside cylindrical applicators introduced in the larynx through direct laryngoscopy. One month after the radiation the papillomata were completely gone and the mucous membrane looked normal and without any scar. In none of the cases could be seen synechiae. Two years follow-up with one recurrence detected after 15 months of a laser sitting.

Adult↗
PubMed1993

Endoscopically-controlled electrohydraulic intracorporeal shock wave lithotripsy (EISL) of salivary stones.

Twenty-nine patients with salivary stones were treated with the endoscopically-controlled electrohydraulic shock wave lithotripsy (EISL). This new minimally invasive treatment of sialolithiasis is performed under local anesthesia on an outpatient basis with little inconvenience to the patient. For endoscopy, a flexible fibroscope with an additional probe to generate shock waves is placed into the submandibular duct and advanced until the stone is identified. For shock wave-induced stone disintegration, the probe electrode must be placed 1 mm in front of the concrement. The shock waves are generated by a sparkover at the tip of the probe. By means of the endoscopically-controlled shock wave lithotripsy it was possible to achieve complete stone fragmentation in 20 out of 29 patients without serious side effects. In three patients, only partial stone fragmentation could be achieved due to the stone quality. Endoscopically-controlled electrohydraulic intracorporeal shock wave lithotripsy represents a novel minimally invasive therapy for endoscopically accessible salivary gland stones. The advantage in comparison to the endoscopically-controlled laser lithotripsy will be discussed.

Endoscopes↗
PubMed1992

Interstitial hypertension in head and neck tumors in patients: correlation with tumor size.

Elevated interstitial fluid pressure (IFP) is associated with poor blood supply and inadequate delivery of drugs to solid tumors. IFP was measured in squamous cell carcinomas of the head and neck region in humans using the wick-in-needle technique. In all lesions (n = 19), the IFP was elevated (4-33 mm Hg). Furthermore, the IFP increased with tumor size. The highest IFP was 33 mm Hg in a 24-ml tumor. In one tumor, the IFP was found to be negative (-2.6 mm Hg), which is comparable to that in human skin or subcutaneous tissue. The histopathology of this tumor was benign. If this pressure difference between malignant and benign lesions can be confirmed in a large number of tumors, then the IFP could be used to aid tumor detection during needle biopsy. The value of IFP as a predictor of response to radiotherapy, photodynamic therapy, hyperthermia, and chemotherapy should be assessed prospectively.

Aged↗
PubMed1992

Immunotype findings in macrophages in aural cholesteatomas.

Since a heavy cellular infiltrate is seen in the stroma of most aural cholesteatomas, we attempted to characterize this cell population in more detail using monocyte/macrophage-specific monoclonal antibodies. KiM1 + (specific for CD11c antigen, the 150 kDa alpha-chain of a leukocyte integrin), and KiM6+ phagocytes were present in two- or fourfold higher numbers in the stroma of the six excised cholesteatomas than in the control tissues. Since the stroma of the cholesteatoma is devoid of microvessels, the typical perivascular localization of dermal macrophages was not seen in the cholesteatomas studied. The density of the macrophages in the normal ear skin was much higher in the upper dermis than in the lower dermis. In the cholesteatomatous specimens, the phagocytes were evenly scattered within the connective tissue and the cellular infiltrate. In contrast to diseased skin, no Mac 387+ macrophages were detected in the cholesteatomas. A great number of phagocytic cells closely resembling dermal macrophages was found in the stroma of the cholesteatomas and probably contributes to an active autoimmune process.

Antibodies, Monoclonal↗
PubMed1992

[Immunohistochemical identification of cholesteatoma-associated macrophage populations].

Extensive bone resorption occurring in aural cholesteatoma is responsible for the severe complications of this disease. In the area of active bone destruction, typical multinucleated osteoclasts are rarely seen, but a heavy cellular infiltrate is found. In the present study we tried to characterize the immunophenotype and the functional state of the cells infiltrating the stroma and the epithelial layer of aural cholesteatoma, using a panel of monoclonal antibodies directed against cell type specific antigens. The results were compared with normal retroauricular skin. The vast majority of cells infiltrating the stroma was bone marrow derived and consisted of T-cells and macrophages. By means of the activation markers HLA-DR and Interleukin-2 receptor an immunologically activated state of the majority of infiltrating cells in cholesteatomas was shown. The great number of activated macrophages in cholesteatomas seems to be very important in the cholesteatomatous immunological process. Because of their various immunological functions (antigen presentation to T-lymphocytes, participation in ingestion and killing of different invading microorganisms and synthesizing a great number of substances involved in host defence and inflammation) these cells play a central role in human immunological system. Langerhans cells, however, did not appear to be involved in the immune process of cholesteatoma. The characteristics of the infiltrating cell population with the great number of phagocytic cells suggest an active immune process resulting in autoaggressive bone resorption.

Antibodies, Monoclonal↗
PubMed1992

[Treatment of laryngeal papillomatosis with photodynamic laser therapy].

Laryngeal papillomas represent a disease of the head and neck that can be treated only symptomatically by surgical means. Twelve Patients (six adults and six children) with recurrent laryngeal papillomas were admitted to a pilot study for photodynamic laser treatment (Fig. 2). Forty-eight hours after intravenous application of hematoporphyrin derivative, PDT was performed by means of a specially developed laser light applicator (Fig. 1) under general anaesthesia. The laser light was generated by an argon-pumped dye laser system operating at a wavelength of 630 nm. On endoscopic evaluation the papilloma showed a whitish livid colour 24 hours after PDT. During the following 3-5 days the papilloma tissue was sloughed and the true and false vocal cords were covered by fibrin. Some 3-4 weeks after PDT the endolaryngeal mucosa had reepithelized in all patients with no signs of residual disease (Fig. 3). Despite the initial multifocal nature of the papilloma, even beyond the anterior commissure, no synechia developed.

Adult↗
PubMed1992

[Assessing the quality of the speaking voice after therapy of T1 and T2 vocal cord cancers].

All studies which analysed voice quality after T1 and T2 glottic cancer employed sustained vowels for evaluation. Sustained vowels can often be produced more clearly than expected in a severe degree of hoarseness in running speech. In this investigation voice quality was analysed by measuring the signal-to-noise-ratio (SNRc) in running speech. For evaluation these data were correlated to the scores from an auditive evaluation and from a clinical examination of the larynx considering functional parameters. 39 patients were examined after different therapies (primary radiation, chordectomy, frontolateral partial resection). The grading of the three different methods for characterisation of the voice quality correlated well. Therefore the SNRc is presumed to be a valuable additional method to the psychoacoustic voice evaluation. Comparison of voice quality after different therapies provided no significant difference between radiotherapy and chordectomy. The functional results after frontolateral partial resection were significantly less satisfying as expected.

Aged↗
PubMed1992

[Interleukin-1-containing cells in cholesteatoma of the middle ear].

Cholesteatoma of the middle ear and the adjacent temporal bone consists of hyperproliferative keratinizing squamous epithelium in the middle ear cavity, and is capable of destroying the bone. Interleukin-1 (IL-1), an autocrine growth factor for epithelial keratinocytes, is characterized by its capacity to initiate bone absorption. Using immunohistochemical methods, the distribution of two different species of interleukin, IL-1 alpha and IL-1 beta, in cholesteatoma tissue (Fig. 2), the skin of the external ear canal, and the retroauricular region was investigated (Fig. 1). Comparable amounts of both IL-1-species were found in all squamous epithelia examined, but interleukin in cholesteatoma epithelium was increased in comparison with normal epidermis. All cellular layers stained uniformly and equally strongly for IL-1 alpha and IL-1 beta, whereas the dead cells of the keratin layer were negative for both. Some intensely stained cells were found scattered in the connective tissue underlying the basal layer of the cholesteatoma (Fig 4). Using double staining techniques these cells were shown to be mainly macrophages (Fig 6). Our results suggest that IL-1 could be liberated from disintegrating keratinocytes and cells of the monocyte-/macrophage lineage, and stimulate the proliferation of the cholesteatoma epithelium in an autocrine manner, thus contributing to the increased bone destruction seen in cholesteatoma.

Cholesteatoma↗
PubMed1992

Possible role of interleukin 1 alpha and interleukin 1 beta in the pathogenesis of cholesteatoma of the middle ear.

Cholesteatoma of the middle ear is characterized by the presence of hyperproliferative keratinizing squamous epithelium in the middle ear cavity and destruction of adjacent bone. Interleukin 1 (IL-1) is an autocrine growth factor for normal keratinocytes and is capable of inducing bone degradation. The distribution of two molecular species of IL-1, IL-1 alpha and IL-1 beta, was investigated immunohistochemically in the hyperproliferative epithelium of cholesteatoma, in normal epidermis of the auditory canal and of the retroauricular region, and in nonkeratinizing tonsillar epithelium. In all squamous epithelia examined, IL-1 alpha and IL-1 beta were present in comparable amounts. The IL-1 content of cholesteatoma epithelium was clearly increased in relation to normal skin keratinocytes. All cellular layers of cholesteatoma epithelium stained strongly and uniformly for Il-1 alpha and IL-1 beta, whereas the keratin layer was negative for IL-1. No particularly strong reaction with basal cells was detected. In the connective tissue under the squamous epithelium of cholesteatoma, intensely positive cells were scattered between negative stromal cells. Our results suggest that IL-1 could be liberated from disintegrating keratinocytes and cells of the monocyte-macrophage lineage, stimulate the proliferation of the cholesteatoma epithelium in an autocrine manner, and contribute to the enhancement of bone destruction in the presence of cholesteatoma.

Cholesteatoma↗
PubMed1991

[Time resolved laser fluorescence microscopy of hematoporphyrin derivative in vivo].

Laser-assisted fluorescence microscopy proved a powerful method for quantitative in vivo measurement of HpD fluorescence. Therefore the aim of the present work was to study the distribution of HpD in tumor vs. adjacent tumor-free tissue of 10 animals over a period of 8 days. We measured additionally the differences in HpD uptake in different tumor subcompartments. In tumor tissue HpD fluorescence showed maximum values 5-9 hours after i.v. application of the drug. The relation tumor-free tissue at that time was about 3-8. The third day of examination showed nearly identical values for both tissues. Between day 5 and day 8 we found an increase of HpD contents in tumor vs. normal tissue in 50% of the examined animals. Comparative measurements in the tumor centre and the tumor edge showed a preferential uptake of HpD in the tumor edge area. Probably the higher retention of HpD in this area is due to the oedema zone surrounding the tumor and to extravasation of HpD.

Animals↗
PubMed1991

[Microcirculatory effects of photodynamic therapy with hematoporphyrin derivative].

Hematoporphyrin derivative photosensitizes selectively malignant tumors following intravenous administration and shows typical fluorescence patterns in the range between 630 nm and 690 nm. Irradiation with laser light (630 nm) causes selective tumor necrosis due to a phototoxic effect. The site of action of this "photodynamic treatment (PDT)" remains obscure. In this study it could be demonstrated that directly after PDT a selective haemorrhage and thrombosis of blood vessels occurs in the tumor tissue. Furthermore, the arterioles of the surrounding normal tissue constrict completely. Venules of normal tissue showed slow thrombosis. Basically, the result of photodynamic treatment was a complete breakdown of tumor tissue microcirculation accompanied by partial damage to the surrounding normal tissue perfusion. This evaluation of the impact of PDT on tumor microcirculation led to the conclusion that a primary site of action of photodynamic therapy may contribute to the selective destruction of tumor microcirculation.

Animals↗
PubMed1991

Class II antigenicity of human cartilage: relevance to the use of homologous cartilage graft for reconstructive surgery.

The presence and distribution of class II transplantation antigens was studied on fresh and Merthiolate-preserved human nasal, tracheal, auricular, and rib cartilage using monoclonal antibodies in an indirect immunoperoxidase method. Substantial class II antigen expression was found on cells of the superficial area of the perichondrium of the nasal, auricle, and tracheal cartilages. In contrast, cartilage tissue lacked cells with detectable class II antigens. Our results indicate that the host response to fresh cartilage graft is induced by class II antigens presented in the perichondrium. A complete disappearance of this class II antigenicity of perichondrium can be achieved by means of an adequate Merthiolate preservation.

Cartilage↗
PubMed1991

[Benign lymphoepithelial parotid cysts in patients infected with the human immunodeficiency virus].

This report describes four patients who presented with masses in the tail of the parotid gland and who were seropositive for antibody to the human immunodeficiency virus. Two had unilateral gland enlargement and the other two had bilateral disease. A characteristic cyst appearance and a benign lymphoepithelial infiltrate with cystic degeneration was found on the radiographic and the histological examinations, respectively. They were located peri- and intraparotid. Benign lymphoepithelial parotid cysts appear to be an early manifestation of pre-AIDS or AIDS-related complex. Surgical excision is recommended for therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1990

The effect of gamma-interferon on HLA class II antigen expression on isolated human nasal chondrocytes.

HLA class II antigens play an important role in the immunological response. In this study, we report on HLA class II antigen expression in vitro by human nasal cartilage cells as detected with an immunoperoxidase staining and immunofluorescence flow cytometric analysis using monoclonal antibodies. Their expression was induced during a 7-day incubation period with gamma-interferon. These findings suggest that a possible mode of action of the preservation methods of cartilage allografts for inducing a prolonged acceptance time is based on the prevention of HLA class II antigen expression by the cartilage cells.

Antibodies, Monoclonal↗
PubMed1990

Photodynamic therapy in head and neck surgery.

The results of a clinical study of photodynamic therapy (PDT) on early stage cancer in head and neck surgery are presented in this report. 30 patients with T1 malignancies of the face and oropharynx have been treated primarily with PDT. After the longest follow up of 14 months two patients revealed recurrence of the disease or residual tumor, two patients have been retreated because of residual dysplastic cells in the control biopsy, and all other patients stay histologically proven free of disease. Hence, PDT appears to be a promising cancer treatment for different histological tumors that penetrate the host tissue definitely less than a laser beam of 630 nm, which is the appropriate wavelength for PDT. Deeper-penetrating malignomas may be accessable for PDT using insertable filters when applying interstitial laser light.

Basal Cell Carcinoma↗