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Biomedical subjects

H Maier

Publications and source records attributed to H Maier.

At least 145 records · Page 8Linked to original sources

Skin tumors in photochemotherapy for psoriasis: a single-center follow-up of 496 patients.

BACKGROUND: The significance of oral psoralen photochemotherapy (PUVA) for the development of nonmelanoma skin cancers (NMSC) is still controversial. OBJECTIVE: We evaluated 496 psoriatics, who received PUVA treatment according to the European PUVA protocol in order to reassess the influence of the cumulative UVA dose on the development of NMSC and to answer the question if there is a UVA threshold dose above which the carcinogenic risk is increased. METHODS: The study was conducted as a retrospective investigation. All patients were seen personally. Age, sex, skin type, cumulative UVA dose and carcinogenic risk factors (arsenic, X-rays, tar, UVB, methotrexate) were recorded and investigated by marginal (MA) and partial effects analyses (PA) according to the Cox regression model. RESULTS: In 14 patients (2.8%), one or multiple histologically confirmed NMSC were diagnosed. Nine patients (1.8%) had squamous cell carcinoma (SCC), 5 patients (1.0%) had basal cell carcinoma (BCC). No patient had both types of NMSC. None of the SCC had metastasized. By taking the appearance of BCC and SCC as the endpoint, arsenic [MA: relative risk (RR) = 7.62; PA:RR = 5.36], tar (MA:RR = 4.51; PA:RR = 3.83) and methotrexate (MTX; MA:RR = 4.97; PA:RR = 4.07) appear to produce strong and significant effects (p < 0.05), both in MA and PA. Using the endpoint SCC only, the effect of the natural logarithm of UVA (ln UVA; RR = 2.47), arsenic (RR = 11.2), tar (RR = 9.92) and MTX (RR = 7.1) is significant (p < 0.05) in MA. In PA, only the effect of arsenic (RR = 5.19) is strong and significant (p < 0.05) while the effects of tar (RR = 7.85), MTX (RR = 3.22) and ln UVA (RR = 2.77) are strong but of borderline significance (p = 0.05-0.11). Nonlinear effects of ln UVA on the risk of SCC were far from significant (p > 0.2). CONCLUSION: PUVA with the European treatment protocol appears to be only a weak carcinogen by itself for SCC with a linear increase in tumor risk but not for BCC development.

Administration, Oral↗

Twenty-four-hour analysis of lymphocyte subpopulations and cytokines in healthy subjects.

Fourteen healthy male subjects were studied under resting conditions for 24 or 48 h. The 24-h variations of ACTH and cortisol with peaks in the morning were confirmed. Interleukin-2 release was profoundly reduced at 8: 00. A cosine function could be fitted to lymphocyte subpopulations including populations such as T helper-memory cells (CD4+/CDw29) and HLA-DR-bearing cells displaying peak values during the night and minimal values at 9:00. Numbers of natural killer cells (CD57) were not correlated to other cell populations and no rhythm could be detected. Interleukin- 1 beta was detectable in some plasma samples only with an interleukin- 1 ELISA kit (Quantakine HS(R)), but neither a 24-h rhythm nor reproducible results could be obtained for day 1 and 2 of the study. We conclude that there might be a temporal relation between the parameters analyzed: Higher levels of endogenous cortisol in the morning hours probably inhibit the cellular interleukin-2 synthesis and are responsible for an enhanced migration of lymphocytes from the blood into the tissues of the reticuloendothelial system. These results might be indicative of a circadian organization of the immune system which may play a role in both physiological and pathological functioning.

Adrenocorticotropic Hormone↗

[Distant metastasis and incidence of second carcinomas in patients with oropharyngeal and hypopharyngeal carcinomas].

Thirteen per cent of oropharyngeal carcinoma patients (n = 23/178) developed a secondary carcinoma, and 10% of hypopharyngeal carcinoma patients (n = 11/113). The latency time of occurrence of the second carcinoma was 37 months for the oropharyngeal tumors and 25 months for the hypopharyngeal tumors. The main location of the secondary cancers was the oral cavity and oropharynx. Early recognition of secondary cancers by routine follow-up examinations made surgical removal possible in most of the patients. The post-operative survival time for the oropharyngeal lesions was 59 months and was 34 months for the hypopharyngeal cancers. Distant metastases were found in 13% of the patients with oropharyngeal cancers and in 17% with hypopharyngeal cancer and were mainly located in the lungs. After diagnosis of distant metastases patients with oropharyngeal lesions died within 4.5 months and those with hypopharyngeal tumors died within 9 months.

Adult↗

MIB1 in colorectal carcinomas: its evaluation by three different methods reveals lack of prognostic significance.

Immunohistochemically detected MIB1 has been determined in a series of 106 colorectal carcinomas with three different evaluation methods (semiquantitative estimation, evaluation by image analysis, and cell count). Although the semiquantitative estimation correlated significantly with results obtained by image analysis (R = 0.8), both methods were only poorly associated with MIB1 counts (R = 0.5). Additionally, all three methods revealed no statistical correlation of MIB1 with the clinical outcome of the respective patients. Our results indicate a pronounced heterogeneity of MIB1 in colorectal adenocarcinoma, thus leading, irrespectively of the evaluation method used, to non-representative results with lack of clinical relevance.

Adenocarcinoma↗

[Immune status studies after one-time alcohol consumption in healthy subjects].

AIM OF STUDY: To ascertain whether once-only intake of a large amount of alcohol causes measurable effects on the immune system of healthy persons. SUBJECTS AND METHODS: Cytokine levels, lymphocyte subpopulations and mitogen stimulation were measured in eleven healthy nonalcohol drinking volunteers (eight men, three women; mean age 30.5 [26-36] years; mean weight 71.4 kg) after a single intake of 80 g ethanol (corresponding to 1.12 g/kg). RESULTS: There were no changes in the concentrations of tumour necrosis factor alpha, interleukins 1 alpha and 1 beta, 3, 6, 10, soluble interleukin-6 receptor, interleukin-1 receptor antagonist, gamma-interferon and granulocyte-macrophage colony stimulating factor. A tendency towards an increase was measured regarding the CD-4 lymphocyte counts as well as the concentration of soluble interleukin-2 receptors and intercellular adhesion molecules (ICAM-1). Interleukins 4 and 8 were low normal. Lymphocyte activity was slightly reduced in the mixed lymphocyte cytotoxicity test. No clear-cut changes were observed in the results of the other mitogen stimulation tests. CONCLUSION: These data show that once-only intake of a large amount of alcohol does not produce measurable abnormalities in the immune system of healthy persons who ordinarily abstain from drinking alcohol.

Adult↗

[Alcohol drinking and tobacco smoking are the chief risk factors for ENT tumors. Increased incidence of mouth cavity, pharyngeal and laryngeal carcinomas].

Both chronic alcohol consumption and chronic use of nicotine must be considered major risk factors for carcinogenesis in the oral cavity, pharynx and larynx. In the case of both noxae, increasing consumption correlates with an increase in the cancer risk in the sense of a dose-effect relationship. Smokers of non-filtertip cigarettes have a higher cancer risk than those smoking filtertip cigarettes. The alcohol-associated risk of developing cancer depends decisively on the overall daily consumption, but not on the nature of the alcoholic beverage. With respect to carcinogenesis, alcohol and nicotine consumed together develop a synergistic action and have a multiplicative effect on the cancer risk.

Alcohol Drinking↗

Standardized staining and analysis of argyrophilic nucleolar organizer region associated proteins (AgNORs) in radically resected colorectal adenocarcinoma--correlation with tumour stage and long-term survival.

Quantification of silver-stained nucleolar organizer region associated proteins (AgNORs) was introduced in histopathology as a marker of cellular and nucleolar activity. However, due to the poor staining quality obtained on routinely processed archival material, the method yielded controversial and sometimes non-reproducible results. The recent introduction of wet autoclave pretreatment has reliably improved AgNOR staining quality on routinely formalin-fixed and paraffin-embedded tissues. In the present study, 92 routinely processed colorectal carcinomas were investigated, applying this novel staining technique. Subsequent standardized morphometric analysis revealed, irrespective of common tumour staging or grading classifications, a statistically highly significant correlation between AgNOR parameters and clinical course. The usefulness of standardized AgNOR parameters for the independent prediction of patient survival was proven by uni- and multivariate analysis.

Adenocarcinoma↗

Suprasellar meningioma with expression of glial fibrillary acidic protein: a peculiar variant.

A 24-year-old female presented with a 3-year history of a suprasellar and intraventricular solid midline process measuring about 3 x 4 cm. At surgery, this tumour was sharply delineated and of stone-like firmness and was removed completely. Histology suggested meningioma, featuring nests and cords of epithelium-like cells with prominent cytoplasm amidst abundant fibrous stroma with prominent lymphoplasmocellular infiltration. Immunocytochemically, the tumour cells expressed vimentin, S-100 protein, epithelial membrane antigen, cytokeratins, and most surprisingly, glial fibrillary acidic protein (GFAP). Ultrastructural investigation revealed abundant intermediate filaments and occasionally dense secretory granules in tumour cells with short, finger-like cytoplasmic processes joined by very rare small, but well-developed desmosomes. This tumour most likely represents a peculiar variant of meningioma with prominent production of GFAP, as previously described [Budka H (1986) Acta Neuropathol (Berl) 72: 43-54].

Adult↗

[Pyoderma gangrenosum as a precursor of myeloid leukemia].

A 34-year-old woman who was 20 weeks pregnant developed pyoderma gangrenosum while receiving treatment for infarct pneumonia. Because of her septic condition an abortion was performed. The patient received intravenous prednisolone as a pulse treatment for her pyoderma gangrenosum, which was followed by oral methylprednisolone and oral dapsone for 6 weeks. After dose reduction the patient had a severe relapse. The steroid dose was increased and dapsone was replaced by cyclosporin A. The smaller ulcers healed spontaneously, but skin grafting had to be performed for the large ulcer. The steroid therapy was tapered and discontinued. Cyclosporin A was continued for 10 weeks as monotherapy. Subsequently, the patient was free of symptoms for 7 months. Twelve months after the diagnosis of pyoderma gangrenosum the patient developed acute myeloid leukaemia accompanied by a recurrence of the skin disease.

Adult↗

Lipoxygenase products in human saliva: patients with oral cancer compared to controls.

Lipoxygenase products were quantified in human mixed saliva and in saliva fractions obtained from a parotid or submandibular gland using gas chromatography-mass spectrometry and stable isotope dilution. In glandular saliva, only linoleic acid was detected at levels of 20-30 ng/ml. In contrast, mixed saliva showed a linoleic acid concentration of around 300 ng/ml, arachidonic acid levels of around 30 ng/ml, hydroxyoctadecadienoic acid (HODE) levels between 5 and 10 ng/ml, and hydroxyeicosatetraenoic acid (HETE) levels up to 25 ng/ml. By far the most abundant HETE was 12-HETE, and incubation experiments with arachidonic acid showed the presence of a substantial 12-lipoxygenase activity in human mixed saliva, but not in saliva fractions. This activity was identified as 12(S)-lipoxygenase activity by chiral analysis of the reaction product. Investigating mixed saliva and glandular saliva of patients with squamous cell carcinoma in the upper aerodigestive tract and of controls, most patients showed elevated levels of free arachidonic acid and elevated HETE levels. Besides a moderate increase in 12-HETE levels, markedly elevated concentrations of 5-HETE and 15-HETE were observed for the carcinoma patients. The level of free arachidonic acid and the quantitative HETE profile appear to be good markers for the inflammatory processes occurring in the oral mucosa and in saliva in response to the development of squamous cell carcinoma.

12-Hydroxy-5,8,10,14-eicosatetraenoic Acid↗

Indoor air pollution by emissions of fossil fuel single stoves: possibly a hitherto underrated risk factor in the development of carcinomas in the head and neck.

We have carried out three case-control studies on the relative risk of head and neck cancer in association with indoor air pollution. The studies performed at the Department of Otorhinolaryngology of the University of Heidelberg comprised 369 male patients with squamous cell carcinoma of the oral cavity, pharynx, and larynx and 1476 healthy control subjects matched for sex, age, and residential area. The OR of laryngeal cancer related to daily exposure to fossil fuels due to stove-heating with oil, coal, gas, and wood for longer than 40 years was 2.5 (CI = 1.51 to 4.05). After adjustment for tobacco and alcohol, the OR declined slightly to 2.0 (CI = 1.10 to 3.46) but still was significant. Elevated ORs were also found for daily presence in a kitchen with an oil, coal, or wood oven for longer than 40 years (OR = 1.7, CI = 1.01 to 2.71; after tobacco and alcohol adjustment, OR = 1.4, CI = 0.76 to 2.41). The OR of pharyngeal cancer related to daily exposure to fossil fuels due to stove-heating with oil, coal, gas, and wood for longer than 40 years was 3.6 (CI = 2.04 to 6.41). After adjustment for tobacco and alcohol the OR declined slightly to 3.3 (CI = 1.43 to 7.55) but still was significant. Elevated ORs were also found for daily presence in a kitchen with an oil, coal, or wood oven for longer than 40 years (OR = 1.6, CI = 0.89 to 2.77; after tobacco and alcohol adjustment, OR = 2.5, CI = 1.03 to 6.30).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Immunohistochemically detectable bcl-2 expression in colorectal carcinoma: correlation with tumour stage and patient survival.

The bcl-2 gene encodes for a mitochondrial membrane proto-oncoprotein, the expression of which is known to suppress programmed cell death (apoptosis). In the present study the prognostic value of bcl-2 proto-oncoprotein was immunohistochemically investigated in a series of 104 colorectal carcinomas. The bcl-2 staining patterns were semiquantitatively assessed and correlated with the pTNM stage, Dukes' classification, lymphocytic infiltration (Jass classification) and tumour grade as well as parameters not associated with prognosis (gender, age, tumour site, histological tumour type). Statistical analysis was carried out using the Kaplan-Meier method, the log-rank test, hazard ratios and their confidence intervals. Fifty-five out of 104 cases completely lacked immunohistochemical bcl-2 expression. Fewer than 5% of bcl-2-positive cells were found in 25, 5-50% in 17 and more than 50% in five cases. The extent of bcl-2 expression by tumour cells decreased significantly with respect to increasing tumour size (P < 0.05), decreasing lymphocytic infiltration (P < 0.05) and chance of poor clinical outcome (P < 0.05), but not with worsening of Dukes stages. In multivariate analysis (Cox regression model) bcl-2 expression remained as an independent prognostic parameter with Dukes' classification as stratification factor (P < 0.001). Although the biological functions of bcl-2 protein are not yet well understood, our results provide further evidence that bcl-2 oncoprotein appears to be associated with favourable clinical outcome. Thus immunohistochemical bcl-2 phenotyping of colorectal carcinoma may contribute in future to the clinical management of these patients.

Adult↗

[Gas producing anaerobic infection of the neck].

In this article, we report on two cases of gas-forming necrotising fasciitis of the neck admitted to our university hospital. In both patients, large gas-forming abscesses were detected by CT scan. Microbiologic smears revealed a mixed flora of aerobic and anaerobic bacteria, predominantly anaerobic streptococci. Emergency surgery with debridement and drainage, appropriate antibiotic therapy, and intensive care were performed. One 58-year-old patient with no concommittent disease recovered well after fourteen days. The other 71-year-old patient with diabetes mellitus and renal insufficiency died despite adequate therapy as a result of metabolic disturbances.

Abscess↗

[Puncture of the maxillary sinus with the Sinojet].

A method is presented by which "blind" puncture of the maxillary sinuses can be performed and which is based on the use of the Sinoject puncture set. This technique has been applied so far in 36 patients. It enables puncture of the maxillary sinus with minimum trauma and hardly any pain. The fact that the puncture needle is pushed via a spring coil to a depth of only 1 cm greatly reduces the risk of injuring neighbouring structures such as the posterior wall of the maxillary sinus. Contrary to the classical procedure a small drainage tube is introduced into the maxillary sinus simultaneously with the puncture. Due to the low tendency to bleeding when this procedure is applied, the method is particularly suitable for use with patients with disturbed coagulation, as well as for AIDS patients.

AIDS-Related Opportunistic Infections↗

[Comparison of the measurement values of the laser tomography scanner and optic nerve head analyzer. A clinical study].

INTRODUCTION: With the Laser Tomographic Scanner (LTS) and the Optic Nerve Head Analyzer (ONHA) a quantifying investigation of the optic disc is possible. Both work with different principles: The LTS receives the information about the three dimensional structure with 32 transversal cuts, taken with the confocal principle, the ONHA with simultan stereopictures, taken from a different point of view. PATIENTS AND METHODS: We examined 36 eyes (18 patients) with the LTS and the ONHA. The aim of the study is to examine, whether there are differences in the measurement values taken with the LTS and the ONHA investigating the same optic disc. RESULTS: 1. There are no significant differences in the measurement value of the area of the total disc and the horizontal and vertical diameter of the optic disc. 2. The measurement values of the area of the excavation and the quotient of the area of excavation to the area of the total disc are systematically greater in investigation with the LTS than in investigation with the ONHA. This is explained by the different definition of the boundary of the excavation. 3. There are significant differences in the measurement values of the volume of the excavation, the upper volume of the optic disc, and the maximum depth of the excavation. The measurement value of the volume of the excavation is systematically greater in investigation with the ONHA than in investigation with the LTS. CONCLUSION: Measurement values of the parameters of the optic disc, which have the same definition in the LTS and the ONHA--such as the area of the total disc and the horizontal and vertical diameter of the optic disc--show no significant differences. Thus these parameters are comparable in the LTS and the ONHA.

Glaucoma↗

Immunohistochemically detectable p53 and mdm-2 oncoprotein expression in colorectal carcinoma: prognostic significance.

Aims-To investigate the correlation between the expression of the p53 and mdm-2 oncoproteins and to assess their prognostic value in colorectal cancer.Methods-Using a polyclonal (CM1) and a monoclonal antibody directed against p53 and mdm-2, respectively, these oncoproteins were stained immunohistochemically in 109 colorectal adenocarcinomas.Results-p53 was detected in less than 10% of tumour cells in 11 of 109 adenocarcinomas, in 10-50% of tumour cells, in 17 of 109 adenocarcinomas, and in more than 50% of tumour cells in 32 of 109 adenocarcinomas. Expression of mdm-2 was detected in 22 of 109 (20%) cases investigated, of which 19 showed concomitant p53 expression. In most cases mdm-2 immunoreactivity was strongly associated with a small proportion of p53 positive tumour cells. Both p53 and mdm-2 expression lacked statistical significance when correlated with common staging and grading parameters.Conclusions-Detection of p53 and mdm-2 oncoprotein expression, detected using immunohistochemistry, is of no prognostic value in colorectal cancer. However, the close correlation between mdm-2 immunoreactivity and the proportion of p53 positive cells provides further evidence that the mdm-2 gene product interacts with p53 protein.

Journal Article↗