Biomedical subjects

H Maier

Publications and source records attributed to H Maier.

At least 163 records · Page 9Linked to original sources

PubMed1995

[The problem of radiogenic and chemotherapy-induced mucositis of the mouth and and oropharynx exemplified by accelerated radiochemotherapy with carboplatin in patients with inoperable squamous epithelial carcinomas of the head-/neck area. Heidelberg experiences].

Despite numerous treatment measures mucositis of the mouth and pharynx due to radiochemotherapy frequently remains refractory to therapy. In most cases high doses of pain medications are till required. However, mucositis as a strong early reaction may be controllable by limiting cancer therapy. Within the current framework of accelerated radiochemotherapy with carboplatin, 50 patients with inoperable squamous cell carcinomas of the head and neck were followed from 1992 to 1994. Acute toxicity was documented from the first through eighth week after starting therapy. From the fifth week on, the degree of mucositis found was > 3 (WHO scale) in 24 patients. The extent of mucositis in 5 patients required interrupting therapy for 10 days on average. In 14 cases the average stay in hospital had to be prolonged by 10.2 days because of severe inflammation. In all, the average duration of mucositis after the end of the therapy amounted to 9.6 weeks. Twenty patients required bypass feedings with transnasal stomach tubes or percutaneous gastrostomy (PEG) tubes that were later removed. In addition, the incidences of dysphagia, xerostomia, hoarseness, skin reactions, nausea or vomitus and myelotoxicity were recorded. Descriptions of the supportive care concepts used at the University of Heidelberg are given and the supportive care concepts available scientific literature is updated.

Adult↗

PubMed1995

[Sensitivity and specificity of the Heidelberg retinal tomograph for imaging nerve fiber bundle defects in glaucoma patients with localized visual field defects. Clinical study].

In order to verify whether nerve fiber bundle defects can be detected by the confocal technique of the Heidelberg Retina Tomograph (HRT), we compared the localization of localized visual field defects with the localization of the expected corresponding nerve fiber bundle defect. We examined 105 patients: 49 with primary open-angle glaucoma (POAG), 26 with low-tension glaucoma (LTG) and 10 with ocular hypertension (OH), and as a control-group 20 healthy eyes. The glaucoma stage had been defined by examination of the central visual field with the Octopus Perimeter 201 program 31 or 32 and/or the Humphrey Perimeter GG program. In healthy eyes, eyes with OH and POAG stage I (n = 19), no nerve fiber bundle defect could be found. In stage II (n = 15) and stage III (n = 14) we found nerve fiber bundle defects in all patients with POAG and LTG (except for one patient with POAG stage III). In stage IV (n = 27) no localized nerve fiber bundle defects were detected in eyes with POAG, but in 4 of 7 patients with LTG, defects could be seen. In glaucoma stages II and III, nerve fiber bundle defects can be detected with the HRT. The control group shows, that the appearance of a nerve fiber bundle defect is no artifact caused by the HRT. However, examination of eyes with OH and POAG stage I also shows that this method is not sensitive enough to be useful for early diagnosis of glaucoma. Nevertheless, it may be possible to develop the confocal HRT method further as a nerve-fiber diagnostic method for glaucoma.

Glaucoma↗

PubMed1995

[Cellular immune defect caused by postoperative irradiation in patients with squamous epithelial carcinomas of the upper aerodigestive tract].

The effect of locoregional postoperative radiation therapy on cellular immunity was investigated in 11 patients with head and neck cancer. During the course of the radiation therapy, total lymphocyte counts, CD8+ lymphocyte counts and especially CD4+ lymphocyte counts decreased significantly. The mean CD4+ lymphocyte counts dropped from 739/microliters to 183/microliters (p < 0.001) and the average CD4+/CD8+ ratio also decreased significantly. In addition all patients showed impaired in vitro lymphocyte stimulation responses to several mitogens, with reductions found to be 10% to 50% of normal responses. Within 3-4 weeks after radiation therapy there was a slight increase of CD4+ lymphocyte counts and the in vitro lymphocyte stimulation responses showed a tendency to normalization. These results indicate that locoregional postoperative radiation therapy in patients with head and neck cancer can induce a severe impairment of cellular immunity.

CD4 Lymphocyte Count↗

PubMed1995

Carotenoid, retinoid and vitamin E status of the oropharyngeal mucosa in the alcoholic.

Concentrations of carotenoids, retinoids and tocopherols were determined in the homogenate of macroscopically normal appearing oropharyngeal mucosa from 10 chronic alcoholics and from 11 control patients. All the alcoholics except one had oropharyngeal cancer. No significant difference was found in tissue levels of carotenoids and tocopherols between alcoholics and controls. Furthermore, in seven of 11 controls, retinol was undetectable in the oropharyngeal mucosa, while in the alcoholics only two out of 10 had unmeasurable retinol levels. These results do not support the concept that ethanol-associated oropharyngeal carcinogenesis is due, at least in part, to local deficiencies in retinoids, carotenoids or alpha-tocopherols.

Adult↗

PubMed1995

[Precancerous condition of the mouth mucosa: lichen ruber planus].

We report the case history of a 60-year-old male caucasian with lichen ruber planus of the oral cavity. After having this condition for 5 years, a medium-grade differentiated squamous cell carcinoma developed on the same side. Since a history of tobacco and alcohol abuse was negative, the Lichen ruber planus was considered to be a precancerous lesion without any other concomitant condition.

Carcinoma, Squamous Cell↗

PubMed1995

[Do employees in the rubber industry have an increased risk of laryngeal cancer?].

Blue collar workers in the rubber industry are exposed to a number of toxic and potentially carcinogenic substances. In the last years an increased incidence of laryngeal cancer has been found in this group of workers. Besides naphthylamine, asbestos, vulcanization fumes and especially nitrosamines have been considered as possible causative agents. The present paper reviews the most relevant epidemiological studies on this topic published within the last 12 years and includes 17 cohort studies and 5 cases control studies. Only some of these papers indicate an increased risk for head and neck cancer due to employment in the rubber industry. Further in most studies the reported standard mortality ratios or relative risk ratios were not increased significantly. In nearly all of these studies an adjustment was not made for alcohol and tobacco consumption to compromise findings.

Carcinogens↗

PubMed1994

Association of IgA-anti-Fab autoantibodies with disease stage in head-and-neck cancer.

Patients with head-and-neck cancer commonly have immune defects. It was reported that these patients have raised serum IgA levels. We investigated whether IgA-anti-Fab autoantibodies, which occur in association with immune dysfunction, are present in patients with head-and-neck cancer. Sera of 101 patients with squamous-cell carcinoma (SCCHN) and 8 patients with adenoid cystic carcinoma (ACCHN) of the head and neck were tested in ELISA for IgA-anti-Fab autoantibody activity. IgA-anti-Fab serum activity was significantly higher in both SCCHN and ACCHN patients than in healthy controls. In patients with SCCHN, an association between disease stage and IgA-anti-Fab activity was established. Stage-IV patients had significantly higher IgA-anti-Fab than stage-I patients or healthy controls. Stage-II and stage-III patients had intermediate levels. Extremely high IgA-anti-Fab activity was observed in 7 patients who died within 6 months following testing, suggesting a relationship of autoimmunity with terminal disintegration of physiological body functions. IgA-anti-Fab autoantibodies may explain the occurrence of immune defects in patients with head-and-neck cancer.

Adult↗

PubMed1994

Pleomorphic adenoma of the larynx.

Tumors arising from minor salivary glands are extremely rare neoplasms in the larynx. Of the few reports of pleomorphic adenomas in this site, most have subglottic locations while only one case has involved the true vocal cord and seven cases have had supraglottic locations. We present a case of benign mixed tumor located in the posterior commissure which, to our knowledge, is the first reported in the world literature.

Adenoma, Pleomorphic↗

PubMed1994

Immunohistochemical metallothionein expression in colorectal adenocarcinoma: correlation with tumour stage and patient survival.

Metallothioneins (MTs), a set of ubiquitous low-molecular-weight proteins essential for the protection of cells against heavy metal ion toxicity, were demonstrated immunohistochemically using a monoclonal antibody (E9) against a conserved epitope of I and II isoforms in a series of 109 colorectal adenocarcinomas. In a semiquantitative analysis strong MT expression in the majority of tumour cells was observed in 34 (31%) cases, 24 (22%) tumours showed a focal MT positivity, and 51 (47%) almost completely lacked MT expression. These differences in MT expression were statistically significantly (P < 0.05) associated with the tumour stage (Dukes classification) and the lymph node involvement at the time of operation (pN stages). However, in contrast to previous findings obtained on a variety of tumours, MT positivity was associated with a favourable clinical outcome in colonic carcinoma, which may indicate their different biological behaviour. Survival curves of cases with MT-positive and MT-negative status differed from each other in a univariate analysis (Mantel-Haenszel: 8.9, P < 0.05) but lost significance when a multivariate analysis was carried out by means of the Cox proportional regression model with Dukes' stages as a stratification factor. It is concluded that immunohistochemically demonstrated MT expression is significantly associated with tumour stages but does not represent an independent prognostic variable in colorectal cancer. However, it may provide important information about some of the biological mechanisms underlying progression in colorectal cancer.

Adenocarcinoma↗

PubMed1994

Therapeutic efficacy and tolerability of brodimoprim in comparison with doxycycline in acute sinusitis in adults.

OBJECTIVE: To compare efficacy and tolerability of brodimoprim tablets with doxycycline tablets in adults with acute sinusitis. DESIGN: Open, randomized, controlled phase III study, with parallel groups. PATIENTS: Of the 70 enrolled patients, 56 adults of both sexes with a mean age of 33 years were evaluable. STUDY DRUGS: One brodimoprim 200mg tablet or one doxycycline 100mg tablet was administered once daily for 8 to 12 days (on the first treatment day all patients received the loading dose consisting of 2 tablets of the corresponding compound). CLINICAL OUTCOME: In the brodimoprim group 96.4% of the patients were judged cured/improved; in the doxycycline group 96.2%. BACTERIOLOGICAL OUTCOME: Eradication of the causative pathogen/s was achieved in 87.5% of the patients treated with brodimoprim and in 60% of the doxycycline group. SAFETY OUTCOME: Tolerability was judged as very good/good in 89.7% of the patients treated with brodimoprim and in all patients receiving doxycycline. Gastrointestinal skin, CNS and various other reactions were reported by 13 patients; 3 of them had to discontinue treatment. Discontinuation of therapy: 8 more patients withdrew from the study due to inactivity of the compound or reasons unrelated to the drugs. CONCLUSION: Brodimoprim was shown to be effective in the treatment of acute sinusitis in adults, its efficacy being equal to that of doxycycline. The assessments showed a positive clinical response to the medication in 96.4% of the patients treated with brodimoprim and 96.2% of the patients taking doxycycline. Both compounds were well tolerated and all side effects were of mild nature and reversible.

Acute Disease↗

PubMed1994

Effect of chronic alcohol consumption on the morphology of the oral mucosa.

Chronic alcohol consumption is a major risk factor for oral and pharyngeal cancer. Besides other mechanisms a toxic effect of ethanol and/or its metabolite acetaldehyde on the oral mucosa and resulting increased cell regeneration seem to play an important role in tumor promotion. In the present study the effect of chronic ethanol consumption on the morphology of the oral mucosa of 40 male wistar rats that had been fed nutritionally adequate liquid diets containing 36% of total calories either as ethanol or isocaloric carbohydrates for 6 months was investigated. Morphometric analysis showed that in the ethanol rats the size of the basal cell nuclei of the oral mucosa from the floor of the mouth, the edge of the tongue and the base of the tongue were significantly enlarged (p < 0.001). The size of the basal cell layer in these rats was increased, and the stratification of the cells was altered. The percentage of cells in the S-phase of the cell cycle was significantly higher in the ethanol-fed rats (p < 0.01). Mean epithelial thickness of the mucosa from the floor of the mouth was significantly reduced in the ethanol rats (p < 0.01). In conclusion, the reported findings indicate, that chronic ethanol consumption causes oral mucosal atrophy associated with hyper-regeneration, which may result in an enhanced susceptibility of the mucosal epithelium toward chemical carcinogens.

Alcohol Drinking↗

PubMed1994

Chronic alcohol consumption--the key risk factor for pharyngeal cancer.

A case-control study on oropharynx and hypopharynx cancer was carried out in the region of Heidelberg (in the southwest region of Germany). This report presents an analysis of the risk associated with alcohol and tobacco consumption based on 105 cases and 420 controls matched for age, sex, and area of residency.

Adult↗

PubMed1994

Sequential quantification of AgNOR area and number during silver staining by means of an image analysing system.

Standardized AgNOR staining protocols are required to compare results obtained by means of image analysis systems (IAS) in different laboratories. In order to investigate the staining kinetics of the NOR silver staining, we evaluated automatically the area and number of AgNORs of a human transitional-cell carcinoma cell line (HOK-1) by IAS at one minute intervals over a total staining period of 30 minutes. Results showed a constant increase (standard error of estimate: 0.001; R squared: 0.8) of the AgNOR area reaching a plateau after 10 minutes followed by further area increase. In contrast, in all experiments a pronounced variability in the AgNOR number (standard error of estimate: 0.042; R squared: 0.75) was noted, reflecting the aggregation of silver stained spots. Thus the evaluation of the AgNOR area yielded reliable and easily reproducible results, whereas the assessment of the AgNOR number by means of an automated IAS was associated with a marked variability.

Autoanalysis↗

PubMed1994

[Salivary duct cyst of the parotid gland and adenocarcinoma].

The progression of benign cystic lesions of the parotid gland to malignant tumors is an extremely rare event and has been described only for cystadenolymphomas. Here we present a case of malignant transformation to an adenocarcinoma occurring in ductal cells forming the wall of a parotid retention cyst. In addition to clinical and histological findings, we describe the results of immunohistochemical and molecular analyses providing evidence that the cells undergoing neoplastic transformation were latently infected by Epstein-Barr virus (EBV). These results suggest a possible causal relationship between latent EBV infection and malignant progression.

Adenocarcinoma↗

PubMed1994

[Occupational risk factors for pharyngeal cancer. Results of the Heidelberg Pharyngeal Cancer Study].

We carried out a case-control study on the role of occupational factors on the risk of pharyngeal cancer. The study was performed at the Department of Otorhinolaryngology/Head and Neck Surgery of the University of Heidelberg and comprised 105 male patients with squamous cell carcinoma of the oropharynx and/or hypopharynx and 420 randomly selected control subjects who were matched for age, sex and residential area (1:4 matching design). The study showed that 34.3% of the cancer patients and 10.1% of the control subjects worked in the construction industry. As construction workers were 26.7% of the cancer patients and 7.1% of the control subjects employed, the relative risk of pharyngeal cancer in construction workers was estimated to be 2.5 (C.I. 1.1-5.5, adjusted for alcohol and tobacco consumption). After further adjustment for alcohol and tobacco consumption, an increased risk of pharyngeal cancer was found for workers exposed to cutting oils (RR = 3.7; C.I. 1.2-11.8), iron dust (RR = 2.7; C.I. 1.0-7.0) asbestos cement (RR = 2.5; C.I. 1.0-6.1), cement (RR = 2.2; C.I. 0.9-5.2) and coal/tar products (RR = 3.6; C.I. 0.8-17.3).

Adult↗

PubMed1994

[The use of autologous keratinocytes in ear surgery].

To date autologous keratinocyte grafts have been used successfully to treat second- or third-degree burn wounds. This method allows a thin epithelialization of surfaces to take place but has been rarely used in otologic surgery until now. This technique has two possible indications in surgery of the external ear canal and the middle ear. We have currently used this method to cover a wound bed after resection of external ear canal stenosis and to treat large mastoid cavities with chronic secretion. Various aspects of the method as well as initial results of clinical use are shown.

Adult↗

PubMed1994

[Effect of a cisplatin-5-fluorouracil combination chemotherapy on malignant transformation of the epithelium of mouth mucosa].

In a prospective study we examined the effect of preoperative chemotherapy with cisplatinum and 5-fluorouracil (5-FU) in 40 patients with advanced carcinoma of the oral cavity. Histopathologic grading, cell kinetics and immunohistochemical parameters of the mucosa were determined at two different locations. Prior to therapy, histologic dysplasias in the mucosa "close" to the tumor were observed in 75 percent of the patients. Dysplastic changes of the mucosa "far" from tumor were also found in more than one-third of the patients. Our results show that more advanced dysplasias improve only temporarily under the influence of preoperative systemic chemotherapy. Moreover, new dysplasias appearing during chemotherapy and persisting after its termination are probably induced. The results point to a possible carcinogenic potential of the combined chemotherapy schema used.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1994

[Indoor air pollution by emissions from individual fossil fuel stoves. Possibly a so-far underestimated risk factor in development of cancers of the head and neck area].

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 carcinomas of the oral cavity, pharynx and larynx; one thousand, four hundred and seventy-six healthy subjects were used as controls and were matched for sex, age and residential area. The relative risk (RR) of laryngeal cancer related to daily exposure to fossil fuels due to stove heating with oil, coal, gas and wood in a period longer than 40 years was 2.5 [confidence interval (CI): 1.51-4.05]. After adjustment for tobacco and alcohol the RR declined slightly to 2.0 [CI: 1.10-3.46] but was still significant. Increased risks were also found for daily exposure in a kitchen containing air oil, coal or wood oven for a period longer than 40 years (RR = 1.7; CI: 1.01-2.71). In this latter group the RR because 1.4 after adjustments for use of tobacco and alcohol [CI: 0.76-2.41]). The RR of pharyngeal cancer related to daily exposure to fossil fuels due to stove heating with oil, coal, gas and wood in a period longer than 40 years was 3.6 [CI: 2.04-6.41]. After adjustments were made for tobacco and alcohol, the RR declined slightly to 3.3 [CI: 1.43-7.55] but was still significant. Elevated risks were also found for daily presence in a kitchen with oil, coal or wood ovens for a period longer than 40 years (RR = 1.6 [CI: 0.89-2.77].(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗