Biomedical subjects
H Maier
Publications and source records attributed to H Maier.
[Mouth dryness and burning sensation of the oral mucosa: causes and possibilities for treatment].
Both sets of complaints, mouth dryness and a burning sensation of the oral mucosa, can have a variety of causes. Local and regional as well as systemic causes can be responsible for burning mouth syndrome. Diseases of the oral mucosa can have genetic, inflammatory, or neoplastic origins. Autoimmune diseases and allergies as well as different afflictions relating to internal medicine can be accompanied by a burning sensation in the oral mucosa. Neurological and psychiatric illnesses must be clarified during interdisciplinary diagnostics in order to identify idiopathic forms. The causes of mouth dryness are similarly complex. In addition to inadequate fluid intake, particularly in elderly patients, drug side effects or systemic diseases are frequently also responsible. Treatment is directed at the underlying disease; in ambiguous cases, symptomatic therapy can provide relief for medical complaints.
Production rates of testosterone and of dihydrotestosterone in female pattern hair loss.
Production rates of testosterone (T) and of dihydrotestosterone (DHT) were determined in young women (n=8, age, 23 to 40 years) with female-pattern hair loss using the stable isotope dilution technique and mass spectrometry. 1 alpha,2 alpha-d-testosterone and 2,3,4-13C-dihydro-testosterone were infused for 10 hours at a dose of 2 microg/h each and blood samples were obtained at 20-minute intervals during the last 4 hours of the observation period. In the presence of normal metabolic clearance rates (MCRs), production rates of T were increased (9.4+/-5.0 microg/h; normal, 4.3+/-1.9 microg/h, P<.05). MCRs of DHT (8.0+/-3.4 L/h; normal, 25.9+/-12.3 L/h, P<.002) were subnormal in all women and the production rates of DHT were within or below the normal range (mean, 1.6+/-0.6 microg/h; normal, 2.9+/-1.1 microg/h, P<.02). Unlike men with male-pattern baldness, women with female-pattern baldness are characterized by increased production rates of T, but not of DHT. These results are compatible with the idea that 5 alpha-reductase inhibition is of no therapeutical value in female-pattern baldness.
Assessment of thickness of photoprotective lipsticks and frequency of reapplication: results from a laboratory test and a field experiment.
BACKGROUND: The thickness of the sunscreen layer that is actually applied by consumers under usual conditions has been determined for photoprotective lotions and creams; however, this question is still unanswered for photoprotective lipsticks. OBJECTIVES: To assess lipstick thickness (area density) and frequency of application per day for two commercially available photoprotective lipsticks with different consistency. METHODS: The study consisted of a laboratory test and a field experiment. In the laboratory test the applied lipstick thickness was determined as area density in mg cm(-2) for a group of 28 panellists under standardized conditions. In a separate group of 18 subjects we assessed the area density and the frequency of application per day for two photoprotective lipsticks during a 6-day skiing course. RESULTS: In the laboratory test the median and 95% confidence interval of the area density was 0.98 mg cm(-2) (0.66-1.65) and 0.86 mg cm(-2) (0.63-1.40) for products A and B, respectively. The respective values of the field experiment were 1.58 mg cm(-2) (0.79-2.23) (product A) and 1.76 mg cm(-2) (1.16-3.50) (product B). Only 11% of all applications of lipstick A and 6% of all applications of lipstick B reached the reference area density of 2.0 mg cm(-2). The difference between the median of the area density for lipstick A (firm consistency) and lipstick B (soft consistency) was not statistically significant. No statistically significant influence on the area density was found for age, sex, photobiological skin type or regular lipstick use. The median daily frequency of application was 2.2 times for lipstick A and 3.0 times for lipstick B. CONCLUSION: Our investigation shows that photoprotective lipsticks are applied in a much thinner layer than recommended by international standards (2 mg cm(-2)). This results in a significant reduction of the photoprotective capacity. Furthermore, the frequency of application is too low for adequate protection. Therefore, we propose that the sun protection factor (SPF) should be assessed for an area density that reflects the actual usage patterns. As long as the test protocol is not adapted to the reduced area density, photoprotective lipsticks with high and ultrahigh SPF should be recommended, especially for individuals with increased risk for the development of lip malignancies.
The oak processionary caterpillar as the cause of an epidemic airborne disease: survey and analysis.
BACKGROUND: Thaumetopoea processionea L. (order Lepidoptera), the oak processionary moth, is found in oak forests in most European countries. Its third to sixth larval instars are armed with poisonous hairs (setae) containing an urticating toxin (thaumetopoein) potentially harmful to humans. Because T. processionea infests trees at the edges of forests or standing alone people frequently come into contact with its setae. In the woodland bordering on the western suburbs of Vienna conditions favouring its increase have led to frequent outbreaks of lepidopterism. OBJECTIVES: To determine the incidence of lepidopterism in a suburban environment with three separate caterpillar-infested oak trees and to ascertain the frequency of the various symptoms of lepidopterism and the manner of contact with setae. METHODS: We conducted a telephone survey of all the households/institutions located within 500 m of the infested trees. To gain more information on patients' symptoms and on situations likely to lead to increased contact with setae we asked those who reported cutaneous reactions to complete a questionnaire. As part of the environmental study we described the outbreak site, examined patients and, with tape-strip samples taken from the surface of the soil, looked for setae persisting in the environment. RESULTS: Of 1025 people surveyed 57 (5.6%) reported one or more symptoms of lepidopterism: 55 (96%) reported pruritus, 54 (95%) dermatitis, eight (14%) conjunctivitis, eight (14%) pharyngitis and two (4%) respiratory distress. The questionnaire was returned by 37 (69%) of the individuals with dermatitis. Of those, 16% had reacted with weal formation, 49% with papular rash and 22% with toxic irritant dermatitis. In 13% of respondents it was not possible to define the reaction. The risk factor analysis showed that airborne contamination was the most important cause: 97% of people had frequently passed an infested tree, 57% lived near a tree (in a neighbouring garden) and 32% had a tree in their own garden. Direct contact with larvae was of minor importance (38%). In four of the tape-strip samples intact setae were identified 1 year after the infestation. CONCLUSIONS: Lepidopterism caused by T. processionea is a public health problem of increasing significance. In years with outbreaks of the pest it can reach epidemic proportions in communities located near infested trees. Contact with airborne setae was mainly responsible for the occurrence of the disease.
Expression of retinoblastoma gene product in respiratory epithelium and sinonasal neoplasms: relationship with p16 and cyclin D1 expression.
Transition from G1 to S phase of the cell cycle is mediated by interactions between the Retinoblastoma gene product (pRb), p16, and cyclin D1. To determine the expression of these proteins in the sinonasal mucosa immunohistochemistry was carried out on archived tissue sections from 46 patients (37 men, 9 women, age range 17 to 82 years, median 55 years). Nuclear immunostaining for these proteins was assessed and the expression rates (percentages of immunoreactive nuclei) in normal respiratory epithelium, inverted sinonasal papillomas, cylindrical (oncocytic) sinonasal papillomas, and squamous cell carcinomas were compared. Normal respiratory epithelium showed significantly higher pRb expression in surface cells compared to basal cells (p < 0.05). In contrast, abundant pRb expression in surface and basal cells was detected in columnar differentiation in sinonasal papillomas and adjacent mucosa. Cuboidal and squamous metaplasia in inverted papillomas showed significantly reduced pRb expression in surface cells compared to columnar epithelium in inverted papillomas (p < 0.05, respectively). Expression of p16 was detected in all epithelial cell layers of normal respiratory epithelium, sinonasal papillomas, and adjacent mucosa. Cuboidal and squamous metaplasia in inverted papillomas showed increased p16 expression in surface cells compared to columnar epithelium in inverted papillomas (p < 0.05 between squamous metaplasia and columnar epithelium). Sinonasal squamous cell carcinomas showed the coexpression of pRb and p16. Expression rates of cyclin D1 higher than 10% were detected only in invasive carcinomas but not in carcinoma in situ, sinonasal papillomas or respiratory epithelium. Conclusively, pRb expression accompanies terminal differentiation in columnar surface cells. Expression of pRb in proliferating basal cells is present in sinonasal papillomas and adjacent mucosa but not in normal respiratory epithelium. Cuboidal and squamous metaplasia in inverted papillomas involves downregulation of pRb expression along with increased p16 expression in surface cells. Sinonasal squamous cell carcinomas coexpress pRb and p16. Overexpression of cyclin D1 in sinonasal lesions is confined to invasive squamous cell carcinomas.
[New aspects of the mechanics of the auditory tube].
The aim of the present article is to describe the mechanical components of the auditory tube and the role of these components in auditory tube function. Particular attention will be given to those aspects which have not been sufficiently dealt with in the past, such as the role of the isthmus region, the function of the lateral mucosal folds, the significance of the of the surfactant proteins and the pathophysiology of the patulous auditory tube. Special attention is given to the tensor veli palatini muscle and its physiology. Because of its isometric contraction, the function of this muscle depends on so-called hypomochlia changing the direction of its force. In the context of this article, the three hypomochlia involved are the pterygoid hamulus, Ostmann's fatty tissue and the medial pterygoid muscle. The so-called "Eppendorf-maneuver" is depicted for the first time.
Angioneurotic edemas of the upper aerodigestive tract after ACE-inhibitor treatment.
There are rare cases in which inhibitors of the angiotensin-converting enzyme can cause an angioneurotic edema of the upper aerodigestive tract. The pathomechanism of this side effect depends on an interaction of the drug with hormones regulating vascular permeability, such as the kallikrein kinin system and the prostaglandin system. Angioedema is characterized by subcutaneous or submucosal swellings, which usually affect the lips, soft palate, tongue and larynx. Pathomechanisms, differential diagnosis and treatment of ACE-inhibitor-induced edema of the upper aerodigestive tract are described in three case reports.
[Genotoxic effect of PCP and lindane on human epithelial tonsil cells].
BACKGROUND AND OBJECTIVE: Experimental and epidemiological studies have provided evidence that pentachlorophenol (PCP) and gamma-hexachlorocyclohexane (lindane) may pose a potential carcinogenic risk for human epithelial cells of the upper aerodigestive tract. In the past, these two substances have been used for military and nonmilitary purposes, e.g., for impregnation of textiles and uniforms. In this study, we investigated the genotoxic effect of PCP and lindane on human mucosal tissue from the tonsils. METHODS: In epithelia obtained from the tonsillar mucosa removed during surgery, cell viability was evaluated by trypan blue staining. The specimens were incubated for 60 min with PCP (0.3, 0.75, and 1.2 mM) and lindane (0.5, 0.75, and 1.0 mM). The induction of DNA damage (single- and double-strand breaks) caused by PCP and lindane was measured using single-cell microgel electrophoresis. Evaluation was performed with an image analyzer enhanced by fluorescence microscopy. RESULTS: After exposure to PCP and lindane, strong genotoxic effects are apparent. The DNA migration rose from 26 micrometer in the control solution up to nearly 90 micrometer after incubation with PCP and lindane ( p<0.0001). CONCLUSIONS: This study could demonstrate for the first time genotoxic effects of PCP and lindane on human tonsillar epithelium. It has to be considered that chronic exposure to both agents might increase the risk for cancer of the upper aerodigestive tract.
[Early cancer detection in persons exposed to asbestos dust. Is integration of ENT examination into the prevention program according to occupational directive G 1.2 necessary?].
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[Risk of postoperative hemorrhage in tonsillectomy. A comparison between general anesthesia and local anesthesia].
BACKGROUND: Postoperative bleeding after tonsillectomy is still a life-threatening problem. The incidence of postoperative bleeding, as well as many factors (kind of surgery, hemostasic problems) affecting this risk have been investigated. A possible factor that has not been well studied is the used anaesthetic procedure. METHODS: A prospective study was completed comparing the risk of postoperative bleeding in patients operated in local vs. general anaesthesia. RESULTS: The study enrolled 1063 patients, who consecutively underwent tonsillectomy. In 16 (4.12%) of 388 patients operated under general and 51 (7.55%) of 675 patients operated under local anaesthesia postoperative bleeding occurred. After local anaesthesia postoperative bleeding was seen mainly at the day of operation (46 of 51), there was no late bleeding after the 6th postoperative day. After general anaesthesia in 6 of 16 cases postoperative bleeding occurred after the 6th postoperative day. DISCUSSION: Postoperative bleeding occurs more frequent in patients who underwent tonsillectomy in local anaesthesia. The risk of late postoperative bleeding however is higher with tonsillectomy in general anaesthesia.
[Occupational hazardous substance exposure and nutrition. Risk factors for mouth, pharyngeal and laryngeal carcinomas?].
BACKGROUND AND OBJECTIVE: A case-control study was conducted to investigate occupational and other risk factors for squamous cell carcinoma of the oral cavity, the pharynx and the larynx. The study included 209 male cancer patients and 110 male control persons without known malignant disease, matched for age, alcohol consumption and tobacco consumption. PATIENTS/METHODS: Cases and controls were interviewed using a standardized questionnaire which has been used before in the Heidelberg case-control studies. RESULTS AND CONCLUSIONS: The educational level in the cancer group was significantly lower (p < 0.001). 17.2% of the cancer patients and 7.3% of the control persons had not completed their professional training. The percentage of so-called "blue-collar workers" was significantly higher in the cancer group (20.9% vs. 7.3%; p < 0.002). An increased cancer risk was observed for workers exposed to asbestos (OR = 8.7; p = 0.004) and cement dust (OR = 12.9; p < 0.001). A frequent consumption of various vegetable food like carrots (OR = 0.17; p < 0.001), fruits (OR = 0.38; p < 0.001) or green salad (OR = 0.25; p < 0.001) was associated with a significant reduction of cancer risk.
[Patient satisfaction in the hospital. Results of a prospective study exemplified by an ENT department].
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Human leukocyte antigens and prognosis in patients with head and neck cancer: results of a prospective follow-up study.
BACKGROUND: Prognostic information is essential for optimal treatment of patients with head and neck cancer. We studied the relationship of class I and class II human leukocyte antigens (HLA) on prognosis in patients with head and neck cancer. METHODS: HLA-A, -B, -C and -DR antigens were determined in 209 patients with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx. The patients were subjected to follow-up investigations for a period of 5 years. RESULTS: Five-year survival rates in relation to tumor stage varied between 86% for stage I tumors and 28% for stage IV tumors (P <.0001, log-rank trend test). The EBA-A11 antigen showed a significant negative correlation with survival. While the 5-year survival of 124 HELA-A11-negative patients was 58%, none of the 17 HLA-A11-positive patients survived 5 years (P = .0002). A significant negative correlation with survival was also observed for HLA-DR6. While the 5-year survival rate of 106 HLA-DR6-negative patients was 60%, it was only 40% in 35 HLA-DR6-positive patients (P = .0313). CONCLUSIONS: If the findings of our study can be confirmed, HLA-A11 and HLA-DR6 might become clinically important supplemental prognostic markers in head and neck cancer.
Outcome after chronic sciatica as the only reason for lumbar microdiscectomy.
There are only a few long-term studies on microsurgical disc operations, and none concentrated on long-term follow-up of therapy-resistant sciatica. A total of 258 patients whose only neurologic symptoms were sciatica were included in this study. Patients were operated on between 1990 and 1997. All outcome results have been performed by an independent reviewer. The mean follow-up period was 7.3 years (range 4-11 years). At follow-up 25% of the patients were free of pain, 66% demonstrated marked improvement, and 9% had either no improvement or worsening of pain. At follow-up 65% of the patients reported returning to their original occupation or being able to go into retirement without hindrance. A total of 15% required changing of profession following discectomy (75% of these patients applying for early retirement were rejected), 6% were incapacitated and unable to work, and 14% were forced into early retirement. Patients with a history of sciatica longer than 3 months acquired failed back surgery syndrome considerably more often than those <3 months (p = 0.005).
[Genotoxic effect of the insecticides pentachlorophenol and lindane on human nasal mucosal epithelium].
BACKGROUND AND OBJECTIVE: In numerous experimental and epidemiologic studies Pentachlorphenol (PCP) and Hexachlorcyclohexan (Lindane) have been shown to be of potential carcinogenic risk for human epithelial cells. In the past, these two substances have been used for both, military and non-military purposes, e.g. for impregnation of textiles and uniforms. In this study we investigated the genotoxic effect of PCP and Lindane on human mucosal tissue from the middle and lower nasal turbinate. METHODS: In biopsy samples obtained from nasal epithelia during surgery cell vitality was evaluated by trypan-blue-staining. The specimens were incubated for 60 minutes with PCP (0.3; 0.75 und 1.2 mumol/l) and Lindane (0.5; 0.75; and 1.0 mumol/ml). The induction of DNA-damage (single-strand-breaks and double-strand-breaks) caused by PCP and Lindane was measured using single-cell microgel electrophoresis. Evaluation was performed by fluorescence microscopy. RESULTS: Especially in mucosa cells from the middle turbinate severe DNA-damages were recognized after exposition to PCP and Lindane proposing a strong genotoxic effect. In cells from the lower turbinate DNA-changes caused by PCP and Lindane were significantly lower. However a considerable genotoxic effect was also present. CONCLUSION: This study shows for the first time that there are clear facts indicating mutagenic effects of PCP and Lindane on nasal epithelia. Furthermore, this is the first study showing different susceptibility of two anatomic subsites in the nose for different pesticides. Concerning the biological plausibility, this study offers important arguments for evaluating the role of PCP and Lindane in the induction of upper aerodigestive tract cancer.
Chromogranins as markers of altered hippocampal circuitry in temporal lobe epilepsy.
Chromogranins are polypeptides which are widely expressed in the central nervous system. They are stored in dense core vesicles of nerve terminals, from where they are released upon stimulation. Using immunocytochemistry, we investigated the distribution of chromogranin A, chromogranin B, secretoneurin, and, for comparison, dynorphin in hippocampal specimens removed at routine surgery from patients with drug-resistant mesial temporal lobe epilepsy and in autopsy tissues from nonneurologically deceased subjects. In post mortem controls (n = 21), immunoreactivity for all 4 peptides (most prominently for chromogranin B and dynorphin) was observed in the terminal field of mossy fibers. For chromogranins, staining was observed also in sectors CA1 to CA3 and in the subiculum. Chromogranin B immunoreactivity was found in the inner molecular layer of the dentate gyrus, the area of terminating associational-commissural fibers. Secretoneurin and dynorphin immunoreactivity labeled the outer molecular layer and the stratum lacunosum moleculare of sectors CA1 to CA3, where projections from the entorhinal cortex terminate. In specimens with Ammon's horn sclerosis (n = 25), staining for all 3 chromogranins and for dynorphin was reduced in the hilus of the dentate gyrus. Instead, intense staining was observed in the inner molecular layer, presumably delineating terminals of sprouted mossy fibers. Specimens obtained from temporal lobe epilepsy patients without Ammon's horn sclerosis (n = 4) lacked this pronounced rearrangement of mossy fibers. In the stratum lacunosum moleculare of sector CA1, secretoneurin and dynorphin immunoreactivity was reduced in sclerotic, but not in nonsclerotic, specimens, paralleling the partial loss of fibers arising from the entorhinal cortex. Instead, presumably sprouted secretoneurin-immunoreactive fibers were found in the outer dentate molecular layer in sclerotic specimens. These changes in staining patterns for chromogranins and dynorphin mark profound plastic and functional rearrangement of hippocampal circuitry in temporal lobe epilepsy.