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Biomedical subjects

K Sommer

Publications and source records attributed to K Sommer.

At least 19 recordsLinked to original sources
PubMed2002

Effects of Porphyromonas gingivalis on the activation of mouse macrophages by lipopolysaccharide.

Porphyromonas gingivalis (PG) is a micro-organism that is suggested to play an etiologic role in acute and chronic periodontitis. The present study was undertaken to evaluate the question whether PG is capable of inducing interleukin (IL)-1beta, IL-6, macrophage inflammatory protein (MIP)-2, and granulocyte-macrophage colony-stimulating factor (GM-CSF) production in macrophages. Furthermore, the effect of PG on the activation of macrophages by Escherichia coli-lipopolysaccharide (LPS) was studied. The cytokines were analyzed by detection of specific mRNA. The mRNA was amplified by RT-PCR and semi-quantitatively analyzed by high performance liquid chromatography and densitometrically, respectively. These studies demonstrate that LPS was more active than PG in inducing mRNA expression of IL-1beta, IL-6, MIP-2 and GM-CSF. Moreover, PG reduced the mRNA expression of the macrophages stimulated with LPS, especially the IL-1beta and IL-6 mRNA expression was decreased.

Animals↗
PubMed2001

[Transplants from the shoulder-back region].

BACKGROUND: In spacious or multilayered tissue losses and cases of multiple locations of defects, a large amount of tissue with different components such as skin, fatty tissue, and muscle is required for proper reconstruction. A donor area which can meet these demands is the shoulder-back region with the subscapular vessel, which arises from the axillary artery. PATIENTS AND METHODS: We report our clinical experience with 12 patients in whom we reconstructed defects with transplants from this region. RESULTS: Our anatomic investigation and measurements provided proof of a constant anatomy of the vessels with a length of the vascular pedicle and a vascular diameter suitable for microvascular anastomosis. Based on our clinical experience, the scapular, parascapular, and latissmus dorsi muscle transplants are very suitable for the reconstruction of very large superficial defects or for the augmentation of multilayered defects of the upper aerodigestive tract. CONCLUSIONS: A main advantage of the transplants from the shoulder and back region is the possibility of combining several transplants with a wide variety of tissue combinations with one vascular pedicle for a single-step reconstruction of multiple defects of the oral cavity and the pharynx.

Anastomosis, Surgical↗
PubMed2001

[Lymph node metastasis in head-neck tumors].

BACKGROUND: One of the most important criteria of malignancy of head and neck cancer are the cervical lymph metastases. Being significant for the therapeutical plan is how tumor depending parameters like T-stage, degree of differentiation and tumor localisation will influence the N-stage and therefore the extension of neck dissection. METHOD: To evaluate the pattern of formations of metastases and the success of therapy a retrospective study was performed on 405 patients with carcinoma of the oral cavity (n = 47), the oropharynx (n = 117), the hypopharynx (n = 47) and the larynx (n = 193). RESULTS: By the time of surgery carcinoma of the hypopharynx were most frequently accompanied by cervical metastases (80%), followed by carcinoma of the oropharynx (70%), the oral cavity (52%) and the larynx (26%). Occurrence and extension of regional lymph node metastases correlated well with T-stages and degree of differentiation. After surgical therapy locoregional recurrence could be observed in 5.2% of the patients. Five-year-survival rate was reduced to 50% on patients with positive lymph nodes. The different tumour sites showed preferred patterns of metastatic spread, without complete avoidance of certain levels. CONCLUSION: For the decision on indication and extent of neck dissection the preoperative diagnostic (ultrasound, CT-scan, MRI), localisation of tumour, T-stage, degree of differentiation and the knowledge of typical metastatic spread must be considered.

Carcinoma, Squamous Cell↗
PubMed2001

A preclinical model for experimental chemotherapy of human head and neck cancer.

We developed a mouse model in a representative human derived head and neck cancer cell line for preclinical studies to evaluate antitumor response, tumor-free survival and host toxicity of alkylating agents, antimetabolites, platinum analogs and taxanes alone or in combination. Ninety athymic NMRI mice were inoculated with human derived oral squamous cell carcinoma cells growing on the hind paw to an average volume of 180 +/- 80 mm3. Animals were stratified according to tumor volume into 10 groups (n=6-10) and treated with ifosfamide (65 mg/kg b.w.), docetaxel (24 mg/kg b.w.), cisplatin (2 mg/kg b.w.), carboplatin (6 or 10 mg/kg b.w.), methotrexate (1 mg/kg b.w.), and fluorouracil (15 mg/kg b.w.) intravenously in single agent or combination (ifosfamide plus docetaxel or ifosfamide plus carboplatin) treatment schedules or controls. Tumor volume was measured 3 times per week for 60 days. The average tumor volume, the overall survival time and the response rates (CR, PR) of the treated animals were compared with the data obtained from untreated controls and statistically evaluated. Untreated tumors showed rapid and exponential tumor growth. Single agent therapies with ifosfamide, cisplatinum, and docetaxel lead to significant tumor regression and improved overall survival. Low dose carboplatin monotherapy induced significant tumor growth delay, but not significant tumor regression. Most impressive tumor-free survival was achieved by combination treatment with ifosfamide and docetaxel. This preclinical study demonstrates an animal model capable of differentiating various chemotherapy regimens.

Animals↗
PubMed1998

[Topographic anatomic study of cells transplanted from the groin region].

We performed 25 fresh cadaver dissections to describe the anatomy of the superficial and deep circumflex iliac artery and the superficial inferior epigastric artery how they can be used as donor vessels for the free transfer of groin flaps and for living iliac bone. With the injection of ink the capillary region of these vessels in the bone (iliac crest), the muscle (internal oblique muscle) and skin (groin and thigh) was stained. The superficial and deep circumflex iliac artery are the main supply vessels of the groin and thigh, they can be found in 96% and 100% of the cases. The venous drainage of this region follows from a superficial (superficial circumflex iliac vein) and a deep venous system (Vv. comitantes accompanying the arterial branches). Both venous systems can always be found. The superficial circumflex iliac artery only supplies the skin and is the main donor vessel for skin and soft tissue transplants. The deep circumflex iliac artery supplies the pelvic bone, the internal oblique muscle and a small constant area of skin above the iliac crest. Bone, bone-muscle and bone-muscle and skin transplants can be obtained with this donor vessels. To enlarge the skin area the two arterial branches can be combined in one transplant. With an average vessel diameter of 1.5 mm (superficial circumflex iliac artery) and 3 mm (deep circumflex iliac artery) both vessels can very well be used for microvascular transplantation. These different tissues (muscle, bone, skin) can be obtained in adequate size and form struct composite defects in the upper aerodigestive tract.

Capillaries↗
PubMed1998

[Esophageal scintigraphy of Zenker's diverticula before and after diverticulotomy].

AIM: The filling and evacuation of Zenker's diverticula were scintigraphically examined before and after operation to quantify their functional relevance. These results were correlated with the symptoms of the patients and the findings of the barium swallow x-ray examination using cineradiography. METHODS: Sequential and static esophageal scintigraphies were performed in 17 patients with Zenker's diverticulum before and after laser surgical diverticulotomy. We used a gamma camera system in 45 degrees LAO-position after application of 15 ml of tea which was marked with 99mTc-DTPA. Filling and evacuation of the diverticulum were expressed in proportion to the administered activity. Relative volumes of the diverticula were obtained from cineradiography by using the height of the neighbouring cervical vertebra, and the clinical symptoms were divided into 4 groups. RESULTS: Zenker's diverticula could be verified visually and quantitatively by scintigraphy. The precise temporal course of the reduction of activity in the diverticulum was exactly determined. The scintigraphic retentions correlated with the x-ray volumes with a coefficient ranging from 0.55 to 0.85. Clinical symptoms also were not very closely related to scintigraphic and x-ray findings, respectively. CONCLUSION: The esophageal scintigraphy allows quantification of the filling and evacuation of Zenker's diverticula, thus it is suitable for objectivization of the functional relevance of the diverticula. That's why the esophageal scintigraphy should be taken to the diagnosis of diverticula in addition to the clinic and the x-ray examinations. The method is especially useful to evaluate the results after diverticulotomy.

Aged↗
PubMed1997

[Topographic-anatomic study of tissue transplants of the inguinal region].

We performed 25 fresh cadaver dissections to describe the anatomy of the superficial and deep circumflex iliac artery and the superficial inferior epigastric artery to determine how they could least to used as donor vessels for the free transfer of groin flaps and living iliac bone. With injection of ink the capillary region of these vessels was stained in (iliac crest) bone, the internal oblique muscle and skin of the groin and thigh. The superficial and deep circumflex iliac artery were shown to be the main supply vessels of the groin and thigh and could be found in 96%-100% of cases. The venous drainage of this region followed from a superficial system (superficial circumflex iliac veins) and a deep venous system (Vv. comitantes accompanying arterial branches). Both venous systems could always be found. The superficial circumflex iliac artery was shown to only supply the skin and was the main donor vessel to the skin and soft tissue transplants. The deep circumflex iliac artery supplied the pelvic bone, the internal oblique muscle and a small constant area of skin above the iliac crest. Bone, muscle and bone, muscle and skin transplants could be obtained with this donor vessel, with enlargement of the skin area possible by combining two arterial branches combined in one transplant. With an average vessel diameter of 1.5 mm (superficial circumflex iliac artery) and 3 mm (deep circumflex iliac artery) both vessels could be used satisfactorily for microvascular transplantation. Different tissues including muscle, bone and skin could be obtained in adequate amounts to replace composite defects in the upper aerodigestive tract.

Arteries↗
PubMed1997

[Clinical comparison between radial and lateral forearm flap].

BACKGROUND: Free fasciocutaneous flap transplantation is a versatile method for soft tissue reconstruction. This clinical study points out differences between the radial forearm flap and the lateral arm flap. METHODS: We used the radial forearm flap in 36 patients following tumor ablation and in 11 patients we used the lateral arm flap for soft tissue reconstruction. We studied the arterial and venous vessel calibers of the flaps, the vessel pedicle length, and the size of the skin paddle. Motor and sensory function tests of the upper/ lower arm and hand were performed after surgery. Recipient and donor site morbidity was noted. RESULTS: Compared to the forearm flap the lateral arm flap is bulky (1-5 cm vs. 0.5-1.5 cm), its vessel calibers are smaller (Art.: 1.4 vs. 1.8 mm, Ven.: 1.8 vs. 2.0 mm), flap size and maximum vessel pedicle length (10 vs. 12 cm) are equal. Raising the lateral arm flap is more demanding and needs more time due to the deep location of the vessel pedicle and the accompanying radial nerve within the intermuscular septum. On the other hand the lateral arm flap is advantageous because of primary wound closure of the donor site. The donor site of the forearm flap had to be covered with skin graft in all cases. We found sensory deficits of the proximal lower arm in 50% after dissection of the lateral arm flap and in 14% on the distal lower arm and thumb joint after dissection of the radial forearm flap. CONCLUSIONS: Both transplants are fasciocutaneous and optional innervated, they offer a constant anatomy and can be harvested simultaneously without interference to the head and neck team. Because of the specific characteristics of these flaps we prefer the radial forearm flap for soft tissue reconstruction. We use the lateral upper arm flap, if a forearm flap cannot be harvested, for head or neck augmentation and for reconstruction of large and deep defects.

Forearm↗
PubMed1997

[Plastic reconstructive surgery of soft palate defects--functional and oncological aspects].

BACKGROUND: Resection of the soft palate in tumor surgery can lead to significant swallowing disorders. Therefore rehabilitation needs a functional reconstruction of the remaining defects. MATERIALS AND METHODS: In four years, nine patients received a partial removal, and six patients a total removal of the soft palate including adjacent parts of the oropharynx in six cases due to oropharyngeal carcinoma. Partial defects were reconstructed with a neurovascularized infrahyoidal muscle flap, total defects with fasciocutaneous flaps of the lateral arm, radial forearm or scapula region. The function of the new palate was evaluated by interview, cinematography, and pressure measurements of the pharynx. RESULTS: These investigations demonstrated proper swallowing without aspiration or regurgitation in all cases. Values of 60% of normal pressure behind the palate have been achieved after palate reconstruction with a pressure slope directed into the hypopharynx. Decannulation was possible on average 34 days postoperatively, removal of the feeding tube on average 29 days postoperatively. Now 87% of our patients are free of tumor after a mean observation time of 24 months. In light of the fact that two-thirds of all patients suffered from advanced carcinoma, results can be considered as good. This study shows good functional and oncologic results after tissue reconstruction of the soft palate.

Adult↗
PubMed1997

[Perfusion manometry in the evaluation of postoperative swallowing function following various reconstructive procedures of the upper aero-digestive tract].

BACKGROUND: The swallowing function can be restored after large oncologic resections in the upper aerodigestive tract with microvascular anastomosed transplants. PATIENTS AND METHODS: With the help of the perfusion manometry we would like to demonstrate the functional advantages of this reconstruction method. We examined three reconstructed regions: tongue with 15 patients, soft palate with 11 patients, and the laryngeal and pharyngeal complex after total laryngopharyngectomy with 17 patients. RESULTS: Patients with reconstructed tongue or soft palate reached 69% or 74% of their pressure compared to normal values. CONCLUSIONS: We demonstrated that although normal pressure values were not reached after reconstruction of large defects with microvascular anastomosed transplants; these reconstruction methods restored the pressure gradient essential for swallowing, with a higher pressure of the soft palate and a lower pressure of the base of tongue.

Deglutition↗
PubMed1996

[Neurovascular infrahyoid muscle fascia flap for tongue and pharynx reconstruction. Postoperative histologic long-term follow-up].

After surgical treatment of cancer, reconstruction of large defects in the oral cavity or pharynx with myocutaneous island flaps will often lead to cicatrical shrinkage of the transplant. To avoid further loss of function we used a neurovascular infrahyoid muscle flap for reconstruction of large muscular defects in the mouth or pharynx. The advantages of this neurovascular flap were voluntary muscular contractions and reduced shrinkage of the flap's volume compared with myocutaneous island flaps alone. In this study we examined the characteristics of the transplanted muscles at 6 weeks, 7 months and 11 months after surgery. Biopsies were taken from the transplanted infrahyoid muscles and examined with light and electron microscopy. To identify nerves an immunofluorescence method was used. In the specimens taken several months postoperatively no atrophy or degeneration of the musculature could be seen. As a possible consequence of tenectomy an irregular arrangement of the myofibrils was noted. Nerves were found in all biopsies that served as further evidence for a functioning musculature.

Adult↗
PubMed1996

[Smoking behavior and views on the smoking topic in the Styrian population--results of a survey at the Graz autumn convention].

Cigarette smoking has been identified as a major risk factor for cardiovascular diseases apart from hypercholesterolemia and arterial hypertension. Diseases of the respiratory system and several neoplasms as well as complications of pregnancy are considered to be "smoking-related", too. In order to survey the smoking habits and views on smoking in the Styrian population, a questionnaire was issued to 1034 visitors of the Graz Autumn Fair 1992. Pleasure proved to be the main motivation for smoking both in men and in women, habit, addiction, stress and boredom being further motivations. Not only non-smokers, but also smokers were assessed to be aware of smoking being a health hazard. Prohibition of tobacco advertising was accepted most widely as a mean of anti-smoking campaign. About half the non-smokers are exposed to environmental tobacco smoke, at place of work more frequently than at home. Percentage of smokers differs with age and job classes, however, no geographical variations were found. Further anti-smoking measures should be considered. Smoking restrictions at place of work and in public could prevent passive smoking. Ban on advertising seems to be the most effective anti-smoking campaign.

Adolescent↗
PubMed1994

[Voice rehabilitation with the jejunum speech siphon: the biventer rein, a modification for prevention of aspiration].

The principle of operative voice rehabilitation after laryngectomy consists in forming a shunt between trachea and hypopharynx. The results of voice rehabilitation are generally good. Aspiration is the main disadvantage of this method, which negatively affects the quality of life. We modified the jejunum siphon of Ehrenberger and used this shunt operation mostly in total pharyngolaryngectomies. To avoid aspirations we formed a rein from both sides of the neck using the m. biventer. This rein hold the knee of the siphon and acts as a sphincter when the patient swallows, because the contractility of this muscle is preserved. We present this new method and compare the results of the first seven patients with those of the patients who were operated on without a rein from the m. biventer.

Adult↗
PubMed1994

[A new method of tongue reconstruction with neurovascular infrahyoid muscle-fascia flaps].

Surgical treatment of tongue cancer can lead to extended defunctionalization, depending upon the size and localisation of the defect. Great problems of swallowing arise after total glossectomy or extensive resections of the base of the tongue even after reconstruction with myocutaneous island flaps or free flaps. We developed a neuromuscular island flap derived from the infrahyoidal musculature to reconstruct a total tongue or large defects of the tongue base. This fasciomuscular flap is formed by the M. sternothyroideus, M. sternohyoideus and the upper part of the M. omohyoideus. The axial blood supply arises from the A. thyroidea sup. The innervation is derived from the Ansa cervicalis N. hypoglossi. In case of total glossectomy we took this flap from both sides of the neck. With this new method we reconstructed total tongues after glossectomy in two patients and large defects of the tongue base in six patients. In the present paper the new surgical method and the functional results are described.

Electromyography↗
PubMed1994

[First aid measures by lay persons in cardiovascular arrest].

The efficiency of first aid resuscitation is affirmed by many publications. In a questionnaire of the division of Cardiology of the Department of Internal Medicine, Graz and the Styrian Heart Patient Society distributed during the course of the Graz spring fair 1993 the population was approached as to first aid in cardiac arrest. 550 subjects responded to answer this circular for assessment dividing the population statistically in 4 different age groups showing differences among male and female and country and city dwellers. It has been shown that general first aid resuscitation has been known sufficiently, whereas special cardiorespiratory procedures (such as artificial respiration or cardiac massage) were unknown to most.

Adolescent↗