Biomedical subjects

H Maier

Publications and source records attributed to H Maier.

At least 19 recordsLinked to original sources

PubMed2007

[Epidemiology, diagnosis, and treatment of giant pleomorphic adenomas of the parotid gland].

Pleomorphic adenomas of the parotid gland can be slowly growing over the course of many years and may reach an enormous and disfiguring size associated with significant morbidity of the patients. To our knowledge, over the last 80 years 20 cases of giant pleomorphic adenomas (weight 1.2-26.5 kg) have been reported. These tumors occurred predominantly in women (90%). The mean period from initial clinical manifestation until definitive surgical treatment was 20.7 years. The mean age of the patients at the time of surgery was 58.9 years. Malignant transformation occurred in 15.8% of cases. It is likely that the reasons for delayed treatment are the patient's fear of surgery on the one hand, and insufficient medical advise on the other. We report on a 77 year old female who had a 40-year history of a growing parotid tumor that weighed 3.9 kg after resection. The implications of this case for diagnosis and treatment of giant pleomorphic adenomas, and a review of the world literature on these unusual parotid tumors, are presented.

Adenoma, Pleomorphic↗

PubMed2007

[Genotoxic effects of insecticides in current use on mucosal epithelial cells from human tonsil tissue].

BACKGROUND: Vector control is of critical medical importance in disease prevention, as reflected in sections 17 and 18 of the German Protection Against Infection Act. In the past, a large number of biocides were found to be hazardous to human health and were banned from the market, subsequently being replaced by new active ingredients and galenic forms. Many of these new insecticides are available in spray or nebuliser form. Whether these preparations have genotoxic effects on mucosal epithelial cells of the upper aerodigestive tract has thus far not been investigated. MATERIALS AND METHODS: We used the comet assay, as a well-established genotoxicity test, to investigate whether malathion, diazinon, pyridostigmine bromide, piperonyl butoxide, silafluofen, and fipronil had genotoxic effects on tonsil specimens taken from 85 patients. RESULTS: All substances tested proved to have a strong genotoxic effect on mucosal epithelial cells taken from human tonsil tissue. We found clear differences between substance groups. CONCLUSIONS: Sufficient doses of a wide range of insecticides are indispensable in many areas of human life, especially for the prevention of diseases. Depending on the method of application, however, ingestion or inhalation of these substances can damage mucosal epithelial cells of the upper aerodigestive tract. Further epidemiological studies should be undertaken to investigate whether this involves potential health hazards in at-risk populations.

Adolescent↗

PubMed2006

Hands-free speech after surgical voice rehabilitation with a Provox voice prosthesis: experience with the Provox FreeHands HME tracheostoma valve system.

Excellent results have been reported with the use of voice prostheses for the rehabilitation of laryngectomees. Patients, however, consider it a disadvantage that the tracheostoma must be closed manually for speech production. This limits their ability to simultaneously communicate by gesture or to work with both hands. An automatic tracheostoma valve helps patients overcome this problem. We describe a prospective clinical trial evaluating our experience with the Provox FreeHands HME Automatic Tracheostoma Valve system. Twenty-four laryngectomees were randomly selected from the patients who had undergone laryngectomy at the ENT Department. Immediately, after 4 weeks and 6 months later having been fitted with a Provox FreeHands HME, the patients were asked to complete a questionnaire in order to assess their satisfaction, voice quality, wearing comfort, fixation, potential problems, and the effectiveness of the HME cassette. In addition, we investigated relevant voice quality parameters including dynamics range, frequency range of the speaking voice, and maximum phonation time. Seven patients discontinued the study due to problems of securing the valve to the skin (four patients) or recurrent cancer (three patients). Ten of the remaining 17 patients wore the valve daily for an average of 8.4 h. A total of 88% of the patients considered it a great advantage to be able to speak without having to use their hands. With the Provox FreeHands HME, maximum phonation time was 8.7 (+/-6.2) s and the dynamic range was 21.9 (+/-5.8) decibels. The results show that the Provox FreeHands HME Automatic Tracheostoma Valve system not only allows hands-free speech but is also associated with excellent compliance and good voice rehabilitation.

Adult↗

PubMed2006

Histopathological prognostic factors in medulloblastoma: high expression of survivin is related to unfavourable outcome.

Standard postoperative treatment of medulloblastoma consists of craniospinal irradiation and chemotherapy. Currently, only clinical factors are used for therapy stratification. To optimise treatment and patient outcome, biological prognostic markers are needed. In the present study we tested the prognostic influence of four histopathological parameters considered in recent publications as prognostic factors in medulloblastoma. We analysed a series of 82 Austrian medulloblastoma patients who were treated according to the consecutive HIT protocols for medulloblastoma conducted by the German Society of Paediatric Haematology and Oncology. Histological subtype and immunohistochemical expression of erbB-2, TRKC, and survivin were determined on paraffin embedded tumour tissue and correlated with patient outcome. Statistical analysis showed a significant correlation of high expression levels of survivin with decreased survival. None of the other investigated histopathological factors correlated significantly with patient outcome. Our data indicate that high survivin expression is related to unfavourable clinical outcome in medulloblastoma patients.

Adolescent↗

PubMed2006

[Leiomyosarcoma of the larynx].

Leiomyosarcoma is usually found in the female genital tract, retroperitoneum, the wall of the gastrointestinal tract and subcutaneous tissues. An appearance of this malignant tumor in the larynx is extremely rare and may be difficult to diagnose. Because of its rarity, little information exists on management and prognosis. We report on a 64-year old male with a supraglottic leiomyosarcoma who was treated with supraglottic laryngectomy and postoperative radiotherapy. After 19 months the patient was well and free of disease. The most commonly used diagnostic and therapeutic procedures are analysed in a review of the 46 published cases of laryngeal leiomyosarcoma.

Combined Modality Therapy↗

PubMed2006

[Can preoperative fine-needle aspiration of parotid tumors pose problems for a definitive histological diagnosis?].

INTRODUCTION: Fine-needle aspiration cytology (FNAC) is a minimally invasive procedure that offers high specifity and acceptable sensitivity in the preoperative diagnosis of parotid tumors. FNAC provides information that can be particularly valuable in surgical planning and patient education. In some cases, it may even help prevent unnecessary surgery. After an FNA procedure, on rare occasions, morphological changes in the tumor may be observed and can make a definitive histological examination difficult or even impossible. METHODS: Histopathological changes in parotid tumors after preoperative FNAC are described on the basis of a case report and a survey of the literature. RESULTS: In rare cases, puncture-induced histopathological changes, such as hyalinization of the subepithelial stroma, necrosis and squamous metaplasia, so extensive that a definitive histological diagnosis is difficult, are observed. In the present case report, fine-needle aspiration of a 3 x 2 cm tumor, which had been classified as malignant on the basis of cytological findings, resulted in complete necrosis and made a definitive histological diagnosis impossible. Similar cases have been described by other authors in recent years. DISCUSSION: In rare cases, histological changes in the tumor tissue can occur after an FNA procedure, making a definitive histological examination difficult or even impossible. When a preoperative FNAC is performed, the pathologist in charge should be advised accordingly. In addition, patients should be informed about this infrequent risk before undergoing the procedure.

Aged↗

PubMed2006

[The use of the BrainLAB Kolibri navigation system in endoscopic paranasal sinus surgery under local anaesthesia. An analysis of 35 cases].

BACKGROUND: As a result of technological advances, 3D-navigation systems are playing an increasingly important role in paranasal sinus and anterior skull base surgery. PATIENTS AND METHODS: The BrainLAB Kolibri navigation system (BrainLAB, Heimstetten, Germany) was used in the surgical management of chronic sinusitis and nasal polyposis in 35 patients. Surgery was performed under local anaesthesia. In order to compare this technique with traditional methods, 35 additional patients underwent conventional surgery. A clinical plausibility test using specific anatomical landmarks was performed to evaluate intraoperative navigation accuracy. In addition, a standardised questionnaire was used to document setup and registration times. Standardised rating scales helped assess whether the system can make surgery safer. RESULTS: It took approximately 5.8 min to set up the navigation system. The time required for system and patient positioning, including the attachment of the headband, was 4.2 min on average. Patient registration with the z-touch system was completed after an average of 4.2 min. It took an average of approximately 8.1 min to register a patient using the soft-touch system. The use of the navigation system increased the total time for preparation and surgery by approximately 50% in comparison to the conventional technique. An average accuracy of 1.5-2.3 mm in all three planes was measured. Participating surgeons felt that the system made surgery considerably safer. CONCLUSIONS: The BrainLAB Kolibri navigation system offers good accuracy, a short setup time and an easy registration technique. The combination of these qualities and intuitive operation make this system a suitable option for routine use in paranasal sinus surgery. As a result of its compactness, the BrainLAB Kolibri navigation system can be moved easily between different operating rooms and can also be used in small facilities (e.g. container operating theatres in field hospitals).

Adult↗

PubMed2006

[Malignant external otitis].

Malignant external otitis or skull base osteomyelitis and osteoradionecrosis of the skull base and the skull are potentially life-threatening conditions. The standard methods of treatment involve the use of antibiotics, local treatment and, where necessary, surgical excision of necrotic tissue. These approaches do not provide a complete cure in many cases. Severe functional deficits and even death can occur in advanced stages. We conducted a long-term retrospective follow-up study and report on a multimodal approach that we have been using with great success since 1987. The four cornerstones of this treatment are surgical debridement, combinations of antibiotics, specific immunoglobulins, and adjunctive hyperbaric oxygen therapy. This multimodal treatment approach has proved to be highly effective in improving the survival and quality of life of the patients concerned. These excellent outcomes justify the high costs that this therapy admittedly involves.

Anti-Bacterial Agents↗

PubMed2005

Linking disease-associated genes to regulatory networks via promoter organization.

Pathway- or disease-associated genes may participate in more than one transcriptional co-regulation network. Such gene groups can be readily obtained by literature analysis or by high-throughput techniques such as microarrays or protein-interaction mapping. We developed a strategy that defines regulatory networks by in silico promoter analysis, finding potentially co-regulated subgroups without a priori knowledge. Pairs of transcription factor binding sites conserved in orthologous genes (vertically) as well as in promoter sequences of co-regulated genes (horizontally) were used as seeds for the development of promoter models representing potential co-regulation. This approach was applied to a Maturity Onset Diabetes of the Young (MODY)-associated gene list, which yielded two models connecting functionally interacting genes within MODY-related insulin/glucose signaling pathways. Additional genes functionally connected to our initial gene list were identified by database searches with these promoter models. Thus, data-driven in silico promoter analysis allowed integrating molecular mechanisms with biological functions of the cell.

Binding Sites↗

PubMed2005

[Hydrodissection for tonsillectomy. Results of a pilot study--intraoperative blood loss, postoperative pain symptoms and risk of secondary hemorrhage].

BACKGROUND: : Tonsillectomy is one of the most common procedures in head and neck surgery. Various techniques have been developed to reduce the risk of postoperative bleeding and postoperative pain. Water-jet technology has been designed for a gentle dissection of parenchymal organs. We report the results of a first pilot study using the water-jet technique for tonsillectomy.METHODS.: Water-jet-cutting tonsillectomy was compared with conventional blunt dissection tonsillectomy. 60 Patients were stratified in two groups within a preliminary prospective randomised study. Postoperative pain scores, frequency of postoperative bleeding and intraoperative blood loss were documented.RESULTS.: There was no difference in the average duration of the surgical procedure. The intraoperative bloodloss was markedly decreased in water-jet-cutting tonsillectomy. Postoperative bleeding and postoperative pain were decreased in the water-jet-cutting group.CONCLUSION.: The results of this pilot study demonstrate that water-cutting tonsillectomy is associated with less intraoperative bleeding, reduced frequency of postoperative bleeding events and with less postoperative pain.

Adolescent↗

PubMed2005

[Cavernous hemangioma of the parotid gland in adults].

Parotid hemangiomas are rare in adults. Whereas both capillary and cavernous hemangiomas are seen in children, only cavernous hemangiomas have thus far been reported in adults. Clinically, cavernous hemangiomas usually present as slowly growing, soft or firm, movable, painless parotid masses. Severe pain and swelling can occur, however, depending on the size of the hemangioma or in particular in the presence of acute hemorrhage or thrombosis. CT and MRI are the diagnostic tools of choice. Prior to surgery, magnetic resonance angiography or intra-arterial digital subtraction angiography should be performed to investigate the vascular supply of the tumor. Surgical excision is the treatment of choice for small lesions. Large cavernous hemangiomas usually require superficial or total parotidectomy. Especially in the case of extended lesions, the facial nerve may be difficult to identify and should be monitored intraoperatively.

Adult↗

PubMed2005

[Ductal carcinoma of the parotid gland with the clinical picture of obstructive sialadenitis].

Salivary duct carcinoma is a highly malignant tumor. Pain, facial nerve palsy, perineural and lymphatic invasion are common findings, as well as an extensive cervical lymph node involvement and distant metastasis. However, occasionally, as in the case presented, the clinical features of this tumor may resemble obstructive sialadenitis and thus cause a delay in appropriate treatment. Although salivary duct carcinoma exhibits an unpredictable clinical course and a poor overall prognosis, total parotidectomy with neck dissection and adjunctive radiation therapy appear to be appropriate for local and regional control of this aggressive neoplasm.

Adult↗

PubMed2005

Late occurrence of bilateral tuberculous-like epididymo-orchitis after intravesical bacille Calmette-Guérin therapy for superficial bladder carcinoma.

We report a case of bilateral tuberculous-like epididymo-orchitis occurring 3 years after intravesical bacille Calmette-Guérin instillation therapy in an 83-year-old patient with proven superficial bladder carcinoma. The patient had no previous history of tuberculosis. Because of persistent inflammation and painful swelling of the epididymides and testes, the patient underwent bilateral orchiectomy. This case demonstrates the late adverse effects that can occur after intravesical BCG therapy, which in our patient ended in surgical removal of both gonads.

Adenocarcinoma↗

PubMed2005

[The importance of PET in searching the primary tumor site in CUP patients -- a case report].

A 58 years old male patient presented with a left cervical metastasis of a poorly differentiated squamous cell carcinoma, which was diagnosed by fine needle aspiration cytology. Clinical examination, MRT scans and panendoscopy did not detect the primary tumour site. The positron emission tomography localized an uptake of FDG in the left sided base of the tongue. The patient underwent an ipsilateral modified radical neck dissection and a lateral pharyngotomy. In the left tongue base an induration was palpable which was resected with security distance. The histopathological examination showed a poorly differentiated squamous cell carcinoma with a largest extension of 5 mm x 10 mm.

Carcinoma, Squamous Cell↗

PubMed2005

Ultraviolet protective performance of photoprotective lipsticks: change of spectral transmittance because of ultraviolet exposure.

BACKGROUND: Photoinstability of sunscreens because of ultraviolet (UV) exposure is a well-known and common phenomenon. Recently, it was also shown that sunscreens with complex filter combinations are photoinactivated by UV exposures, which can easily be acquired by solar exposure over several hours. OBJECTIVES: To assess the change of the spectral transmission after UV exposure (UV-challenged protective performance) of 27 commercially available photoprotective lipsticks. METHODS: Quartz slides were covered with a lipstick layer (area density 1.0+/-0.1 mg/cm2) and irradiated with increasing doses of solar-simulated radiation. The spectral transmission (T) was measured spectrophotometrically before and after 5, 12.5, 25, and 50 standard erythema doses (SED) of exposure. We calculated the change in transmission (photoinstability) as the difference between the spectral transmission before and after a defined UV exposure, DeltaT, and the arithmetic mean, for both the UVA (DeltaTA) and UVB (DeltaTB) ranges. A product was labelled as photounstable if the mean photoinstability in the UVA, DeltaTA, or UVB range, DeltaTB, was higher than 5% for an UV exposure of 12.5 SED. RESULTS: Eleven products showed a significant photoinstability in the UVA range (DeltaTA between 6% and 27%), only one product in the UVB range (DeltaTB = 13%), and one product in both the UVA (DeltaTA = 31%) and UVB (DeltaTB = 9%) range. In one product photoinstability became significant in the UVA range at higher UV exposures. CONCLUSIONS: Out of 27 lipsticks only 13 products showed a photostable performance (DeltaTA < 5% and DeltaTB < 5% for 12.5 SED). We propose therefore that only products, which fulfil these UV photostability criteria should be marketed.

Humans↗

PubMed2004

Short term efficacy and safety in glaucoma patients changed to the latanoprost 0.005%/timolol maleate 0.5% fixed combination from monotherapies and adjunctive therapies.

AIMS: To evaluate efficacy and safety in patients with ocular hypertension or open angle glaucoma changed to latanoprost/timolol fixed combination (LTFC). METHODS: A prospective, multicentre, historical control in which qualified patients had their previous therapy substituted by LTFC and were followed for at least 2 months. RESULTS: In 1676 patients LTFC was continued in 93% throughout the observation period. In all patients LTFC reduced the intraocular pressure (IOP) from 20.6 (SD 3.8) to 17.7 (3.0) mm Hg (p<0.001) compared to previous monotherapies including latanoprost, timolol, alpha agonists or carbonic anhydrase inhibitors (CAI). LTFC provided more efficacy after changing from adjunctive therapies including: a beta blocker added to either CAI, alpha agonist, or pilocarpine, or CAI added to an alpha agonist, or latanoprost added to either CAI, alpha agonist, or beta blocker (unfixed combination), and travoprost added to timolol (p<0.007). LTFC was as effective as latanoprost used with dorzolamide/timolol fixed combination (-0.9 mm Hg, p = 0.1792). The most common reason to discontinue therapy was lack of efficacy (n = 70, 4%) and adverse event (n = 17, 1%). CONCLUSION: In a clinical setting, patients who have their monotherapy or adjunctive therapy substituted with LTFC may experience reduced IOP, good tolerability, and continuation of therapy for the first 2-3 months of treatment.

Aged↗

PubMed2003

[Quality of life for patients after laryngectomy and surgical voice rehabilitation. Experience with the Provox prosthesis].

BACKGROUND: Our study included 52 patients who received follow-up care after laryngectomy; a Provox I prosthesis was used for voice rehabilitation. METHODS: The EORTC Quality of Life Questionnaire was used to assess the postoperative quality of life of these patients with voice prostheses. RESULTS: Of the patients, 36.1% complained of a lack of energy, and 22% experienced sadness suggesting a reactive depression. Of the 55.6% of patients who expressed satisfaction with managing their disease, more than two-thirds were afraid of a potential deterioration of their health. More than 90% of the patients received extensive support from family and friends. As many as 52.8% expressed themselves satisfied with their current life, which is perhaps attributable to the successful rehabilitation of their voice. Eating problems, i.e., varying degrees of dysphagia as a result of treatment, were experienced by 47.3% of the patients. CONCLUSIONS: After the laryngectomy, 11% continue to smoke and 46% regularly consume alcohol. For this reason, rehabilitation measures should place more emphasis on patient education and on programs designed to help patients stop smoking and drinking alcohol.

Adult↗

PubMed2003

[The treatment of necrotizing otitis externa with a combination of surgery, antibiotics, specific immunoglobulins and hyperbaric oxygen therapy. Results of the Ulm Treatment Concept].

BACKGROUND: Even today, necrotizing otitis externa is still a life-threatening condition. The standard treatment concepts based on antibiotic therapy, topical treatment and--if necessary--surgical debridement of necrotic tissue, remain ineffective in many cases. In advanced stages, necrotizing otitis externa can therefore be expected to result in severe functional impairment or even a fatal outcome. PATIENTS AND METHODS: We describe our experience with a multimodal treatment concept that we have been using with great success at the Federal Armed Forces Hospital in Ulm since 1987. This treatment is based on four pillars: 1. Surgical debridement, 2. Use of a combination of antibiotics, and 3. Administration of specific immunoglobulins, accompanied by, 4. Hyperbaric oxygen therapy RESULTS: Over a period of more than 5 years 16 of the 22 patients treated on the basis of this multimodal concept remained free of recurrences. In addition, significant reductions in analgesic use and in the insulin doses needed by diabetic patients were possible. CONCLUSIONS: The treatment concept under scrutiny has proved particularly successful. The various modes involved and the results of this combined therapy are discussed.

Acinetobacter Infections↗