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Biomedical subjects

J Alberty

Publications and source records attributed to J Alberty.

At least 37 records · Page 2Linked to original sources
PubMed2001

Histomorphologic reaction patterns in cervical lymph nodes of different neck sites.

Immunologically based studies of host-tumor interactions have gained popularity in head and neck oncology and histopathological determination of lymph node reactivity has been shown to correlate with survival. However, little is known about lymph node reaction patterns in the "normal" neck. In a prospective histomorphologic study 1,024 cervical lymph nodes (CLN) were dissected at autopsy from 25 selected cadavers free of head and neck disease. To investigate regional differences of immune reactivity, these lymph nodes were grouped according to neck levels. 242 CLN groups of 50 neck sites were microscopically classified into one of four distinct histomorphologic immune reaction patterns (RP). 14.5% of CLN groups showed lymphocyte predominance (RP 1), 12% showed germinal center predominance (RP 2), 63.2% were unstimulated (RP 3) and 10.3% displayed regressive changes (RP 4). Distribution of RP was highly significant according to neck level (p<0.001): RP 1 and RP 2 were common in the submandibular (Level I) and the upper parajugular groups (Level II) whereas RP 4 was more typical in the inferior parajugular groups (Level IV) and posterior triangle (Level V). RP 2 and RP 4 showed significant correlation to age and general condition. These findings suggest that tumor independent lymph node reactivity related to neck site, age and general condition of the patient needs to be differentiatedfrom tumor induced patterns in future morphologic investigations of cervical lymph nodes in patients with head and neck carcinoma.

Age Factors↗
PubMed2000

[Diagnosis and treatment modalities in sinonasal inverted papillomas].

BACKGROUND: Today, etiology and pathogenesis of sinunasal inverted papillomas (IP) remain unknown. Surgical approaches and extension of surgical resections are still controversial. PATIENTS AND METHODS: In a retrospective study we reviewed the charts of 90 patients with sinunasal IP. Using external (n = 78) or endonasal (n = 12) approaches the tumors were completely resected in all cases. 57 cases were investigated for human papilloma virus (HPV) by immunohistochemistry. RESULTS: 60% of IP extended beyond one single paranasal sinus or the nasal cavity. 7% infiltrated adjacent anatomical structures (subcutis, orbit, anterior skull base). The recurrence rate was 19% after a mean interval of 8.2 month. Associated malignancy was found in 7 cases (7.7%). HPV was detected in 9% of IP. Postoperative complaints were noticed by 27% of endonasal and 35% of trans-facial operated patients. CONCLUSIONS: Because of the advanced tumor stage in the majority of cases, usually a radical trans-facial surgical excision of IP is required. Endonasal approaches are feasible in selected cases, but surgery has to be more extensive compared to surgery for sinunasal polyposis. In the literature and in our experience IP is rarely associated with carcinoma (10% in literature) and the incidence of malignancy is not increased in recurrent IP. Using PCR, the prevalence of HPV ranges from 7 to 69% in the literature. Our immunohistochemical results support a rather low prevalence of HPV in IP.

Adult↗
PubMed2000

Efficacy of botulinum toxin A for treatment of upper esophageal sphincter dysfunction.

OBJECTIVES: To investigate the efficacy of botulinum toxin A (BTA)-induced chemodenervation of the upper esophageal sphincter (UES) in patients with dysphagia and UES dysfunction. STUDY DESIGN: Prospective clinical trial in 10 selected patients with pure UES dysfunction. METHODS: In each patient 30 units of BTA were injected into the UES under brief general anesthesia. Videofluoroscopic swallowing study (VSS) was done and a clinical symptom score was determined before and after treatment. RESULTS: On VSS relative opening of the UES improved in all patients (mean +/- SD: 47 +/- 14% before versus 71 +/- 24% after treatment; P < .01). Hypopharyngeal retention or laryngeal penetration of barium was significantly reduced in four of seven patients. Clinical symptom scores improved in all patients. One patient was free of symptoms, mild dysphagia persisted in six patients, and moderate dysphagia persisted in three patients. CONCLUSIONS: Our results support the use of BTA in selected patients with pure UES dysfunction. Its efficacy is limited by the possibility of a persistent structural stenosis of the UES and the risk of BTA diffusion into the larynx or hypopharynx.

Adult↗
PubMed1998

The effect of antiallergic intranasal formulations on ciliary beat frequency of human nasal epithelium in vitro.

The nasal mucociliary clearance is an important defense mechanism of the upper respiratory tract. It is known to be influenced by many pharmacologic substances. We investigated the effects of three topical intranasal antiallergic formulations containing disodium cromoglycate (DNCG), dimethindene maleate (DMM), and azelastine-HCL (AZL) on nasal ciliary beat frequency (CBF) in vitro. Nasal ciliated cells were harvested from 16 healthy volunteers. Cells were diluted 1:10 in culture medium and incubated with a placebo formulation (PLAC), containing 0.022% benzalkonium chloride, which was part of all formulations, a registered 2% formulation of DNCG, a 0.1% formulation of DMM, and a registered 0.1% formulation of AZL. After an incubation period of 20 min, CBF was registered by a photoelectric measurement device. Under control conditions (CONTROL), CBF was 11.4 +/- 1.3 Hz. PLAC reduced CBF to 9.7 +/- 2.3 Hz (NS). DNCG reduced CBF to 9.7 +/- 2 Hz (NS). DMM reduced CBF to 7.2 +/- 1.7 Hz (P < or = 0.05 vs CONTROL, NS vs PLAC), and AZL reduced CBF to 0.9 +/- 1.8 Hz (P < or = 0.001 vs CONTROL, P < or = 0.001 vs DNCG, P < or = 0.001 vs PLAC). In conclusion, a possible influence of antiallergic intranasal formulations on nasal ciliary function has to be considered in clinical application.

Anti-Allergic Agents↗
PubMed1996

[Use of high frequency cinematography in diagnosis of globus sensation].

BACKGROUND: Globus pharyngis is a frequent symptom in patients who consult an otolaryngologist. In many cases, routine diagnostic work-up including history, clinical examination, and barium swallow fail to revealing the underlying pathogenesis. PATIENTS AND METHOD: In a retrospective study, we present 51 selected patients suffering from globus pharyngis of unknown origin who were investigated by high-speed cineradiography in a standardized manner. RESULTS: Twenty-four of the patients enrolled in the study (47.1%) showed functional and/or structural swallowing disorders. In 13 cases (25.5%) dyskinesias of the superior esophagus sphincter muscle were found. Five of these patients (9.8%) also had an inconstant hypopharyngeal diverticulum. Six cases (11.8%) showed laryngeal penetration or tracheal aspiration. In four cases (7.8%) functional disorders of pharyngeal, and in three cases (5.9%) functional disorders of oral bolus transport were found. Furthermore one hypopharyngeal web (1.9%) and two benign tumors (3.9%) were detected. In many cases, varying combinations of these findings occurred. CONCLUSION: Using high-speed cineradiography for evaluation of globus pharyngis results in an increased incidence of pathologic findings, and thus is an important method for interdisciplinary diagnostic work up of patients suffering from this symptom.

Adult↗
PubMed1992

Nd:YAG laser-photocoagulation: acute electrophysiological, hemodynamic, and morphological effects in large irradiated areas.

Laser-photocoagulation (LPC) of arrhythmogenic myocardium has been reported to successfully ablate ventricular tachycardia. The purpose of this study was to investigate the acute hemodynamic and electrophysiological effect of continuous laser energy (Nd:YAG, 1060 nm) applied via a 0.4-mm quartz fiberoptic on the epicardial surface of the heart in nine dogs. A total of 51 +/- 2.3 pulses was delivered in each animal to induce homogeneous tissue necrosis. Applied energy was 12.3 +/- 2.7 J/mm2, irradiated surface measured 12.6 +/- 3.0 cm2, lesion depth was 6.3 +/- 1.2 mm (range: 5.0-8.1 mm), lesion volume was 8.1 +/- 2.8 cm3 (6.8% of left ventricular [LV] mass). After LPC, epicardial stimulation threshold significantly rose from 1.0 +/- 0.3 to 10.2 +/- 4.9 mA in the border zone to nontreated tissue and from 0.9 +/- 0.4 to 32 +/- 15.7 mA in the center of the lesions. Loss of epicardial activation in the irradiated areas could be demonstrated by epicardial mapping. Ventricular extrasystoles during LPC were seen in all dogs, ventricular tachycardia in seven, and ventricular fibrillation in two dogs. After LPC, cardiac output and LV dP/dtmax significantly decreased by 14.2% and 11.2%. LPC induced predictable homogeneous tissue edema, eosinophilic staining, contraction band necrosis, and sharp demarcated hemorrhagic border zones with a sharp electrical border zone to nontreated tissue and loss of epicardial activation. During LPC, various arrhythmogenic effects could be observed. However, no persistent arrhythmic activity developed after LPC. The results confirm the feasibility of epicardial LPC of the myocardium. Although not rested in this study, LPC of arrhythmogenic tissue may also be feasible as a treatment modality of ventricular tachycardia.

Animals↗