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Biomedical subjects

E Stennert

Publications and source records attributed to E Stennert.

At least 109 records · Page 6Linked to original sources
PubMed1988

[Results of a phase II study with the new cytostatic drug carboplatin in combination with 5-fluorouracil in the primary treatment of advanced squamous cell cancers of the head and neck].

Chemotherapeutic regimens containing Cisplatin are the most effective in the treatment of squamous cell carcinoma of the head and neck. Because of the high rate of dose-limiting side effects of Cisplatin, Carboplatin, a second generation Cisplatin analog, was tested in a phase II trial with 5-FU on 55 previously untreated patients with advanced carcinoma of the head and neck. The results of the completed study are: 33% CR, 54% PR, 10% NR and 4% PD. Toxic side effects were tolerable myelotoxicity as with Cisplatin/5FU, mild nausea, vomiting and nephrotoxicity. No ototoxicity was seen. Most patients showed better performance status after chemotherapy with increased body weight. These results indicate that Carboplatin/5-FU is more effective and has milder side effects than Cisplatin/5-FU.

Adult↗
PubMed1988

[Oncogenes in squamous epithelial cancers in the area of the head and neck].

Proto-oncogenes are a part of the genetic code of each human cell. Physiologically they code special enzymes, membrane receptors and growth factors which are necessary for cell growth and function. Alterations in these genes like amplification, rearrangements, mutations or chromosomal translocation appeared to be implicated in the induction of neoplasms. So these genes were called "oncogenes". Recent work has shown that increased expression of the c-myc oncogene in squamous cell carcinoma (SCC) of the head and neck is related to advanced SCC stages (TNM). We examined more than fourty human SCC of the head and neck with Southern blot analysis for c-myc amplification and rearrangement. Our preliminary results indicate that c-myc amplification is correlated with advanced tumour stages and highly aggressive tumour behaviour. Patients with c-myc amplification (15%) all show regional lymph node metastasis. No rearrangement has been seen. Further studies must confirm our results and examine whether c-myc amplification is correlated with the biological characteristics of SCC of the head and neck.

Carcinoma, Squamous Cell↗
PubMed1987

The ultrastructure of normal and denervated human facial muscle.

The ultrastructure of normal human facial muscles from 25 nonparalytic and 17 paralytic patients revealed normal features in nondenervated human facial muscles, identical to the fine structure of other normal human and mammalian cross-striated muscle fibers. However, in denervated facial muscle, a broad spectrum of ultrastructural lesions had affected sarcomeres, abnormal inclusions, and organelles. A large variety of inclusion bodies, some of which have not been described, were also found. The spectrum of ultrastructural changes showed no dependence on the length of the denervation period. There were no inclusion bodies in all the normal facial muscle biopsies. To our knowledge, this study represents the first systematic electron microscopic investigation of normal and denervated human facial muscles.

Adolescent↗
PubMed1986

[Cisplatin ototoxicity. A clinical study].

The ototoxicity of cis-DDP (cisplatin) has been known for some time. It affects the outer and inner hair cells of the cochlea which are damaged. So far, the data laid down in the literature concerning extent and frequency of hearing defects differ widely. In the present study we analysed the ototoxic effect of cis-DDP in 124 patients with different types of carcinoma. We investigated a possible dependence of ototoxicity of the patient's age, the platinum dose, the manner of administration, and of the previously existing audiometric anomaly. In 48% of the patients studied we found a therapy-induced, dose-dependent hearing defect mainly at a high frequency range (4-8 kilohertz). Its degree is influenced by the mode of cisplatin application. The most serious hearing defects were caused by a dose of 100 mg per square metre body surface. The results of our investigations are discussed and compared with those of other clinical studies.

Adult↗
PubMed1984

[Cytostatic therapy of advanced squamous cell carcinoma of the head and neck. A randomized study comparing cis-dichlorodiammineplatinum(II) and bleomycin with methotrexate and vindesine].

79 patients were randomized and treated either with cis-DDP 33 mg/kg i.v. day 1 and BLM 15 mg/m2 i.v. continuously day 2-6 (arm A) or less aggressively with MTX 30 mg/m2 i.v. day 1 + 6 and VDS 3 mg/m2 day 2 + 7 (arm B). Patients with inadequate response were further treated with the alternative regimen ("cross over"). Regarding response rates therapy A was superior to B (p = 0.01) respectively p = 0.05 for the cross over patients. Not pretreated in comparison to pretreated patients demonstrated not significantly better results. Pretreated patients had statistically superior response rates with arm A than with arm B (p = 0.05). All other prognostic factors were without any influence on treatment results. CR induced by chemotherapy (2 X) in not pretreated patients could be increased by additional surgery and X-ray therapy (CR = 26X). Survival times demonstrated no difference between both regimes. Chemotherapy was of less influence on median survival times after 39 months than in comparison to post-chemotherapeutically performed surgery +/- radiotherapy in 44 not pretreated patients. Chemotherapy: CR + PR to MR + NC + PD 16 respectively 13 months with 38 respectively 48% survivors (p = 0.25). Surgery +/- radiotherapy: CR + PR median not reached yet, MR + NC + PD 13 months with 60 respectively 18% survivors (p = 0.001).

Adult↗
PubMed1984

Morphology of denervated human facial muscles.

17 biopsies of denervated facial muscles, the zygomatic, the orbicularis oris and the levator labii muscles, showed atrophic myofibers in most cases. There was loss of fiber typability when applying the NADH, the MAG and the alkaline ATPase reactions. The acid ATPase preparations allowed differentiation of myofibers into type I and type II without subtypes. Contrary to normal facial muscles that are richly endowed with motor endplates, no neuromuscular junctions were observed in denervated muscle fibers except one example which might have been obtained by false sampling from the marginal area of denervation or might be the result of partial reinnervation due to sprouting axons from the neighborhood. There was no correlation between the degree of muscle fiber atrophy and the duration of the paralysis. However, fibrosis corresponded to length of denervation. The presence of highly atrophic muscle fibers even 36 years after denervation indicates that the final aim of facial nerve surgery, namely the reinnervation of denervated facial musculature may still be achievable. However, endomysial and perimysial fibrosis may have a considerable impact on the final outcome of such facial nerve surgery. Unsatisfactory correlation between morphological and clinical as well as electromyographical findings in denervated facial muscles requires individual morphological study of each biopsy to assess the probable outcome of reconstructive facial nerve surgery. It therefore appears reasonable even in long-standing facial paralysis, to biopsy denervated facial muscles before or during surgical reanastomosation of the facial nerve. This study provides hints that morphological examination of denervated facial muscles may supplement clinical, electrophysiological, and possibly biochemical diagnostic findings.

Adolescent↗
PubMed1984

[Indications for cytostatic therapy of recurrent cancer].

28 patients with recurrent squamous cell carcinoma of the Head and Neck underwent consecutive chemotherapy. Two different regimens were used: cis-platinum plus bleomycin and methotrexate plus vindesine. The former seemed to produce a better response to the latter, but neither differed in its influence on survival. Those patients in whom further radiation therapy or surgery was possible had the longest survival times. Two out of 28 patients who had surgery are still alive 36 months later. The indications for consecutive chemotherapy for recurrent squamous cell carcinoma ought to take into account the age and general condition of the patient, the extent of the recurrence and the possibility of further therapeutic measures.

Adult↗
PubMed1984

[Results of primary chemotherapy in 44 patients with advanced squamous cell carcinoma in the area of the head and neck].

44 patients with advanced squamous cell carcinoma of the head and neck were randomized and treated preoperatively either with arm "A": cis-DDP (3 mg/kg iv day 1) and BLM (15-20 mg iv continuously day 2-6) or arm "B": MTX (30 mg/m2 iv day 1 + 6) and VDS (3 mg/m2 iv day 2 + 7). Treatment with arm "A" was superior producing 73% complete and partial remissions (CR + PR) compared to 40% for arm "B" (p = 0,05). The number of patients with CR could be increased from 2 to 26 by surgery and/or radiotherapy. The median survival for patients with chemotherapeutically induced CR and PR was 16 months but this did not differ significantly from the median survival (13 months) of non responders (p = 0.25). For patients with CR and PR achieved by surgery and/or x-ray therapy the median survival point has not yet been reached, and this is significant compared to the non responders (p = 0.001). Five of 26 patients with CR died after 39 months of observation and 6 are living with recurrence. In addition to clinical trials, chemotherapy is indicated for patients with inoperable tumours. The value of chemotherapy can only be answered by randomized trials comparing chemotherapy combined with standard procedures against surgery and radiotherapy alone.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

[The autoparalytic syndrome--a leading symptom of postparetic facial function].

Contradictory clinical and electromyographical findings following operations on the facial nerve have given rise to an analysis of the functional anatomy of the mimic musculature. This has led to the isolation of two sphincter systems in one half of the face to which all muscles on that side belong and which are innervated independently. Because of post-operative fiber aberrations, the innervational autonomy of both systems is lost, thus leading to mass movements. Since each system contains a number of antagonists, a mutual blocking that is the result of the heteromorphous neurotization occurs, producing the symptoms of a residual paresis, although these "weak" muscles are well reinnervated. These anatomical-functional relationships also offer an explanation for the fact that a clinically visible functional rehabilitation of the frontalis muscle rarely occurs following a neuroplasty in the truncal region of the facial nerve. The term "autoparalytic syndrome" thus offers itself as a description of this pathomechanism.

Electromyography↗
PubMed1982

Enzyme histochemical and histographic data on normal human facial muscles.

Four human facial muscles, platysma, m. levator labii, zygomaticus major and orbicularis oris, obtained during head and neck surgery, revealed no qualitative differences from normal human limb muscles, but differences with regard to fiber type distribution and fiber size. Mean fiber diameters of each muscle studied were largely 50% of those encountered in normal human limb muscles. Histographic analysis revealed that type II fibers were more frequent than type I fibers but that type IIB fibers were extremely scarce in number. The myofiber diameter spectrum was also larger in facial than in limb muscles, as myofibers produced variability coefficients around 325. The frequent presence of intramuscular nerve twigs and motor endplates may provide the opportunity of studying pre- and postsynaptic pathology in future studies of denervated facial muscles.

Adolescent↗
PubMed1982

[Emergency surgical treatment of injuries to the lateral region of the face].

If not treated correctly, injuries to the lateral part of the face can result in permanent mimetic disturbances. Since the final results of such treatment are often determined by the initial measures taken, close adherence to several basic principles for emergency surgical treatment of injuries to the parotid gland and facial nerve is imperative. To ensure optimal conditions for a successful follow-up nerve plasty, a special method of marking the nerve ends with silver clips and silicone tubes is recommended.

Emergencies↗