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Biomedical subjects

J A Werner

Publications and source records attributed to J A Werner.

At least 19 recordsLinked to original sources
PubMed1995

Endoscopic resections of glottic and supraglottic carcinomas with the CO2 laser.

Clinical experiences with transoral CO2 laser resections of glottic and supraglottic carcinomas are presented. 47 patients with variously sized supraglottic tumors and 114 patients with early glottic cancers were treated at the University of Kiel from 1979 to 1993. Although 10 patients with glottic tumors developed recurrences, curative treatment was possible with either repeat laser surgery (3 cases), irradiation (3 cases) or salvage laryngectomy (3 cases). One patient refused further treatment. Among the 30 patients with supraglottic lesions treated for cure 18 are currently alive and free of disease. 6 patients died with no evidence of disease, 2 patients died from secondary malignancies and 3 patients succumbed to their tumors. Present findings justify routine use of laser resections of laryngeal neoplasms, although patients must still be carefully selected for treatment.

Aged↗
PubMed1995

[Partial endoscopic resection with the CO2 laser in laryngeal carcinomas. II. Results].

This study presents the results of CO2 laser surgery in the curative treatment of 114 carcinomas of the vocal cord (Tis:8, T1a:88, T1b:10, T2:8) and 30 supraglottic carcinomas (T1:4, T2:11, T3:8, T4:7). In 21 patients with supraglottic carcinomas, additional radiotherapy was applied. Eleven patients underwent neck dissection. For the group of vocal cord carcinomas, 104 of 114 patients were free of recurrences after laser surgery. The ten recurrences were treated by irradiation (n = 3), repeated laser surgery (n = 3), and salvage laryngectomy (n = 3). One patient refused further treatment and died tumor related. 113 of 114 patients with glottic are without evidence of disease. For the group of patients with supraglottic carcinomas, six patients died without evidence of local disease. Two patients died of secondary malignancy without evidence of local recurrence. Four patients died of their tumor. Today, eighteen patients are without evidence of local or metastatic disease. In fourteen of these patients, the follow-up is longer than two years. Our data indicate that the oncological outcome after laser surgery is comparable to conventional open partial resection, whereas the functional outcome especially in supraglottic carcinomas is superior following laser surgery. In comparison to radiotherapy, the oncological outcome after laser surgery is better and functional results are only slightly inferior. Laser surgery should therefore take its place as an established treatment of supraglottic and glottic carcinomas.

Aged↗
PubMed1995

[Serum soluble interleukin 2 receptor in patients with squamous epithelial carcinomas of the upper aerodigestive tract].

BACKGROUND: Several investigations showed increased levels of the soluble interleukin-2 receptor (sIL-2 R) in chronic and malignant diseases. A correlation between elevated sIL-2 R levels and disease activity or tumor size was observed in some patients. At present, there are no studies of sIL-2 R serum levels in patients with squamous cell carcinomas of the upper aerodigestive tract. METHODS: SIL-2 R levels were measured in sera of 86 patients with squamous cell carcinoma of the head and neck and of 25 healthy controls with a sandwich ELISA. RESULTS: Significantly elevated serum levels of sIL-2 R were detected in 49 out of 86 patients (56.9%) with squamous cell carcinoma of the head and neck. The mean serum level in the healthy controls was 437 U/ml compared to 895 U/ml in carcinoma patients. A correlation was found between tumor size, number of metastases and the sIL-2 R level. There was no correlation with histological type or tumor localization. DISCUSSION: The physiological role of sIL-2 R is still unknown. Elevated levels of sIL-2 could be a sign of activation of the immune system. But they also might be involved in causing the disease. The sIL-2 R serum levels in patients with squamous cell carcinoma of the head and neck may serve as an unspecific indicator for tumor size and dissemination. CONCLUSION: Posttherapeutic titer controls could be of prognostic value. Additionally, sIL-2 R may help to select appropriate patients for an immunotherapy with recombinant IL-2.

Adult↗
PubMed1995

[Morphology and histochemistry of lymphatic vessels of the upper aerodigestive tract: a clinically oriented study].

BACKGROUND: Exact knowledge of lymphatic morphology and histochemistry is required to understand the clinical importance of the lymphatic system of the upper aerodigestive tract. Publications in this field are rare. METHODS: Light and electronmicroscopic examinations were carried out on lymphatics of the upper aerodigestive tract. Enzyme, immune and histochemical investigations were also performed on 764 tissue specimens from this region. RESULTS: The discontinuous basement membrane surrounding the initial lymphatic contains laminin, type IV collagen, and fibronectin and is usually continued by a fibrillar elastic apparatus that is less developed than dermal lymphatics. 5'-nucleotidase, adenylatcyclase, and guanylatcyclase activity in lymphatics is not as high as it is in blood capillaries. The endothelium of collecting lymphatics contains high concentrations of factor VIII associated antigen, while it is found in the endothelium of initial lymphatics only in small amounts or not at all. Histochemical studies of the endothelium of lymphatics show a positive lectine binding reaction for UEA I, PNA, DBA, GS I, MPA, and RCA I. CONCLUSIONS: The histochemical results obtained allow easy differentiation of lymphatics and blood capillaries. The vessel type differentiation is relevant for the examination of organ-related lymphatic systems, to determine whether tumor cell nests are located in lymphatics, blood capillaries, or artificial tissue gaps.

5'-Nucleotidase↗
PubMed1995

[Churg-Strauss syndrome. A differential diagnosis in chronic polypoid sinusitis].

BACKGROUND: The Churg-Strauss syndrome (CSS) is a rare multiple organ disease, that belongs to the group of systemic granulomatous vasculitis. The initial symptoms are often bronchial asthma and allergic rhinitis; later in the course of the disease, the patients exhibit lung, heart and kidney manifestations. PATIENTS: We report on a thirty-one year old female patient who initially presented with asthma and polypous sinusitis. Three years later, after undergoing endonasal sinus surgery three times, she was diagnosed with CSS. Within a review of the literature, we discuss symptomatology, differential diagnosis, and therapy of the CSS. RESULTS: Worldwide about 200 cases are published. The patient presented in this case report is now in a good health condition after a four-year therapy with steroids. The patient is free of sinusitis symptoms without the need of renewed surgical intervention. CONCLUSIONS: CSS should be considered in the differential diagnosis if bronchial asthma and resistant polypous sinusitis occur coincidentally. Often it is very difficult to diagnose CSS. Frequently it is only diagnosed after several years. Therapy of choice is the treatment with steroids, sometimes supplemented by cytotoxical drugs.

Adult↗
PubMed1995

[Results and surgical experiences in web transsection of hypopharyngeal (Zenker) diverticulum with the CO2 laser].

Since 1984 at the Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, 34 patients with hypopharyngeal diverticular have been operated microendoscopically using the CO2 laser. Results and complications of this technique were compared to a group of patients in whom standard (non-laser) diverticulotomy was carried out from 1976 to 1993. Ninety per cent of the patients treated endoscopically with laser surgery have not had complaints and the rate of postoperative complications has been low. Three patients developed pharyngeal stenoses while one case incurred a mediastinitis. Intraoperative bleeding was not observed. In comparison to the microendoscopic procedure serious complications were more frequently observed in patients treated with the standard diverticulotomy. In eight of these cases paralysis of the recurrent laryngeal nerve occurred. A mediastinotomy was performed in another three patients because of mediastinitis. In two cases stenosis occurred after surgery and one patient developed a fistula. Endoscopic diverticulotomy utilizing a CO2 laser was found to be an excellent treatment for Zenker's diverticulum because of the good functional results achieved and low complication rate. The procedure was easy to perform because of the short duration and could be repeated frequently without significant additional risks.

Adult↗
PubMed1995

[The laryngeal lymph vessel system of the human. A morphologic and lymphography study with clinical viewpoints].

Laryngeal carcinomas have different metastatic characteristics depending on their locations. Although these changes could be explained by differences in density of the lymphatic system, studies of the laryngeal lymphatic system have been controversial. To clarify these differences the lymphatic systems of 184 organ specimens were investigated with light and electron microscopy, histochemistry and injection techniques. Three types of lymphatic vessels were found in the larynx: lymph sinuses, precollectors and collectors. The highest density of lymphatics was found in the supraglottic larynx. From this region, lymph drained via 3-6 collectors to a hypopharyngeal collector. The subglottic lymph mainly drained via 2-4 collectors to paratracheal and mediastinal lymph nodes. The lymph system of the vocal folds was sparse but drained mainly to the supraglottic larynx. No lymph collector was found in the mucosa of the vocal fold. According to these results, the incidence of lymphatic spread correlated first with the density of the initial lymphatics in the various laryngeal regions and secondly (and probably of greater significance) with nearness of tumor to the laryngeal collectors.

Endothelium, Lymphatic↗
PubMed1995

[Effect of various culture media on growth behavior of human squamous epithelial carcinoma cells of the upper aerodigestive tract].

Sera containing media are frequently used for cultivation of epithelial cells, but the influence of serum on analytic methods can be significant. For this reason the development of serum-free media is of great significance. We investigated the influence of serum-free medium on growth characteristics of human squamous cell carcinoma (SCC) cells of the upper aerodigestive tract and compared these in serum-containing media, using cloned SCC cell lines HLaC-78 and HCFMK-1. Three serum-containing culture media were used: MEM-Instamed, RPMI-1640 and MCDB-153, each containing 10% fetal calf serum. Serum-free culture medium was MCDB-153 supplemented with bovine hypophysis extract, insulin and ethanolamine. Results showed that supplement-enriched, serum-free medium was suitable for culturing SCC cells. When compared to serum-containing media, cell growth of the SCC cell lines was significantly higher in the serum-free medium.

Animals↗
PubMed1995

[Spherulocytosis (myospherulosis) of the paranasal sinuses].

Spherulocytosis (myospherulosis is a disease resulting from the physical emulsion phenomenon between lipid-containing materials and blood. It can be caused by the application of lipid-based ointments with or without antibiotics to wounds. This "foreign-body" reaction appears as a granulation tissue that will cause symptomatic when developing under closed wounds or in such cavities as the middle ear or paranasal sinuses. Poor healing after paranasal sinus surgery may be due to spherulocytosis. This occurred in several cases managed at the University Hospital in Kiel as the result of postoperative nasal packs sensitizing sinus mucosa. These experiences led the authors to conclude the nasal ointment packs should be avoided in paranasal sinus surgery.

Adult↗
PubMed1994

The encephalomyocarditis virus 3C protease is a substrate for the ubiquitin-mediated proteolytic system.

The encephalomyocarditis virus 3C protease has been shown to be rapidly degraded in infected cells and in vitro in rabbit reticulocyte lysate. The in vitro degradation, at least, is accomplished by a virus-independent, ATP-dependent proteolytic system. Here we identify this proteolytic system as the ubiquitin-mediated system. Incubation of the 3C protease in rabbit reticulocyte or cultured mouse cell lysate preparations, alone or in the presence of added ubiquitin or methylated ubiquitin, resulted in the generation of new higher molecular weight species. These new products were shown to be 3C protease-ubiquitin conjugates by their ability to bind antibodies against both the 3C protease and ubiquitin. Supplemental ubiquitin also stimulated the degradation of the 3C protease in these preparations. Large 3C protease-polyubiquitin conjugates were observed to accumulate in reticulocyte lysate in the presence of adenosine 5'-O-(3-thiotriphosphate), an inhibitor of the 26 S multicatalytic protease. This, combined with the fact that the proteolytic activity could be removed from the lysate by sedimentation, implicates the multicatalytic protease in the degradation of the 3C protease-ubiquitin conjugates. It was also found that the slow rate of degradation of a model polyprotein, which resembles the stable viral 3CD diprotein produced in vivo, is likely due to the fact that the polyprotein is a poor substrate for the ubiquitin-conjugating system.

3C Viral Proteases↗