[Patient satisfaction in the hospital. Results of a prospective study exemplified by an ENT department].
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Adult↗
Biomedical subjects
M Tisch
Publications and source records attributed to M Tisch.
Human leukocyte antigens and prognosis in patients with head and neck cancer: results of a prospective follow-up study.
BACKGROUND: Prognostic information is essential for optimal treatment of patients with head and neck cancer. We studied the relationship of class I and class II human leukocyte antigens (HLA) on prognosis in patients with head and neck cancer. METHODS: HLA-A, -B, -C and -DR antigens were determined in 209 patients with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx. The patients were subjected to follow-up investigations for a period of 5 years. RESULTS: Five-year survival rates in relation to tumor stage varied between 86% for stage I tumors and 28% for stage IV tumors (P <.0001, log-rank trend test). The EBA-A11 antigen showed a significant negative correlation with survival. While the 5-year survival of 124 HELA-A11-negative patients was 58%, none of the 17 HLA-A11-positive patients survived 5 years (P = .0002). A significant negative correlation with survival was also observed for HLA-DR6. While the 5-year survival rate of 106 HLA-DR6-negative patients was 60%, it was only 40% in 35 HLA-DR6-positive patients (P = .0313). CONCLUSIONS: If the findings of our study can be confirmed, HLA-A11 and HLA-DR6 might become clinically important supplemental prognostic markers in head and neck cancer.
Biomarkers, Tumor↗
[Genotoxic effect of the insecticides pentachlorophenol and lindane on human nasal mucosal epithelium].
BACKGROUND AND OBJECTIVE: In numerous experimental and epidemiologic studies Pentachlorphenol (PCP) and Hexachlorcyclohexan (Lindane) have been shown to be of potential carcinogenic risk for human epithelial cells. In the past, these two substances have been used for both, military and non-military purposes, e.g. for impregnation of textiles and uniforms. In this study we investigated the genotoxic effect of PCP and Lindane on human mucosal tissue from the middle and lower nasal turbinate. METHODS: In biopsy samples obtained from nasal epithelia during surgery cell vitality was evaluated by trypan-blue-staining. The specimens were incubated for 60 minutes with PCP (0.3; 0.75 und 1.2 mumol/l) and Lindane (0.5; 0.75; and 1.0 mumol/ml). The induction of DNA-damage (single-strand-breaks and double-strand-breaks) caused by PCP and Lindane was measured using single-cell microgel electrophoresis. Evaluation was performed by fluorescence microscopy. RESULTS: Especially in mucosa cells from the middle turbinate severe DNA-damages were recognized after exposition to PCP and Lindane proposing a strong genotoxic effect. In cells from the lower turbinate DNA-changes caused by PCP and Lindane were significantly lower. However a considerable genotoxic effect was also present. CONCLUSION: This study shows for the first time that there are clear facts indicating mutagenic effects of PCP and Lindane on nasal epithelia. Furthermore, this is the first study showing different susceptibility of two anatomic subsites in the nose for different pesticides. Concerning the biological plausibility, this study offers important arguments for evaluating the role of PCP and Lindane in the induction of upper aerodigestive tract cancer.
Adolescent↗
Laryngeal mucosa of head and neck cancer patients shows increased DNA damage as detected by single cell microgel electrophoresis.
Major risk factors for cancer of the oral cavity, pharynx and larynx are smoking and excess alcohol consumption. Since long-term survival rates of head and neck cancer patients have not substantially been improved, new preventive strategies including the use of cancer chemopreventive agents have to be developed. With the aim of developing biomarkers which can verify the efficacy of chemopreventive interventions, a standardised alkaline microgel electrophoresis (MGE) assay was applied as a sensitive and rapid tool to detect DNA damage on a single cell level. Macroscopically normal laryngeal mucosa biopsies obtained by surgery from head and neck cancer patients (n=29) and from hospital controls (n=22) were analysed by MGE in a pilot study. As compared to controls, cells from head and neck cancer patients showed a significantly elevated DNA damage without any further genotoxic treatment (P<0.01). We conclude that this increased background DNA damage in laryngeal epithelia could result from genetic alterations caused by smoking and alcohol leading, in accord with the field cancerisation hypothesis, to a gradual decrease of genomic stability and malignancy. MGE should now be explored as a rapid screening method in larger clinical studies: (i) to identify high-risk subjects carrying cells with decreased genomic stability and (ii) to verify the efficacy of chemopreventive regimens to prevent or slow down the development of head and neck cancer in high-risk persons.
Adult↗
[Neurinoma of the nasal cavity].
A 35 years old male patient presented with serous nasal secretion, relapsing epistaxis and a slowly progredient nasal obstruction. Clinical examination and CT scans showed a tumor occupying the left middle meatus and the whole nasal cavity displosing the nasal septum to the right side. The tumor was resected by a midfacial degloving approach. Histological examination showed a neurinoma. By means of the presented case report and a review of literature, diagnosis and treatment of this rare nasal tumor are discussed.
Adult↗
[Alcohol drinking and cancer of the upper aerodigestive tract in women].
BACKGROUND AND OBJECTIVE: In Germany every year approximately 2000 women die from squamous cell cancer of the oral cavity, pharynx or larynx. Until recently, excessive alcohol consumption and excessive tobacco consumption were blamed as the predominant risk factors. The present study investigated whether alcohol is an independent risk factor even in case of a moderate consumption in increasing the risk of cancer of the mouth, pharynx and larynx in females. PATIENTS AND METHODS: In a hospital based case control study the smoking and drinking patterns of 62 females with squamous cell cancer of the oral cavity, pharynx or larynx and of 248 randomly selected female control subjects were analysed. RESULTS: A regular consumption of alcohol was reported by 59.7% of the cancer patients and by 18.1% of the control subjects. The alcoholic beverages preferred by the cancer patients were beer and spirits. While only 0.8% of the control subjects reported a daily consumption of more than 30 g alcohol, this was the case in 40.3% of the cancer patients. The alcohol-associated risk increasing was dose-dependent. Compared to a daily consumption of less than 10 g alcohol, a consumption of more than 30 g/day has a relative risk of 29 (P < 0.01; adjusted for tobacco) was estimated. CONCLUSION: Even a moderate alcohol consumption (10-20 g/day) causes a significant increasing of head and neck cancer in women.
Adult↗
[Construction workers as an extreme risk group for head and neck cancer?].
BACKGROUND: Workers in the construction industry carry an increased risk for head and neck cancer due to the high consumption of alcohol and tobacco plus exposure to occupational carcinogenic or co-carcinogenic agents. These latter substances include asbestos, tar products, metal dust, wood dust, cement dust and paints. RESULTS: The Heidelberg case-control studies showed a statistically increased risk of pharyngeal cancer (RR=2.5 adjusted for tobacco and alcohol) and laryngeal cancer (RR=2.3 adjusted for tobacco and alcohol) in the construction workers (23.3%) when compared to controls (8.2%). A random sample analysis of patients with head and neck cancer referred by the largest health assurance company in Heidelberg (AOK), revealed that 21.2% were employed in the construction industry. Similar results have been obtained in a number of international epidemiological studies. CONCLUSIONS: Our findings show that male construction workers who regularly consume alcohol and tobacco represent an extreme risk group for head and neck cancer. Measures for early detection are important and must be implemented carefully.
Adult↗
[Reports from the Aachen annual meeting of the German Society for ENT Medicine, Head and Neck Surgery. Alcohol drinking and risk of cancer in the area of the upper digestive tract].
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Alcohol Drinking↗
[Occupation and cancer of the head-neck area].
Head- and neck-cancer is a multifactorial disease. Besides major risk factors like alcohol and tobacco consumption, occupational factors play a significant role. At present it is estimated that in western industrial nations about 4 to 10% of all head- and neck-cancer cases are caused by occupational exposures. Combined exposures to occupational and non-occupational risk factors as well as the interaction of different occupational agents may have a synergistic effect on the cancer risk. It is very likely that the cancer risk due to occupational factors is modulated by host factors like DNA repair capacity and enzymatically controlled activation and inactivation of carcinogens.
Cause of Death↗
An association of chronic alcohol consumption with morphological alterations of the laryngeal mucosa in rats.
Within the last decades a considerable amount of epidemologic evidence has been built up to implicate chronic alcohol consumption as a major risk factor not only for oral and pharyngeal cancer, but also for laryngeal cancer. The mechanisms that underlie alcohol-related cancers of the larynx have remained largely unclear. Since the epithelium of the glottic region normally has no direct contact with alcoholic beverages, alcohol-related alterations of glottic mucosa have been questioned. In the present study 20 male Wistar rats were fed nutritionally adequate liquid diets containing 36% of the total calories either as ethanol or isocaloric carbohydrates for 6 months. Morphometric analysis of the glottic mucosa in the ethanol-fed rats showed a significant reduction in epithelial thickness of the glottic epithelium of the anterior commissure as well as of the posterior commissure (P < 0.001). Morphometric analysis of the basal cell nuclei of the glottic epithelium did not show any statistically significant differences between ethanol-fed rats and control rats. These findings indicate that chronic ethanol consumption can cause a significant atrophy of the glottic mucosal epithelium in the rat and suggest an enhanced susceptibility toward locally acting chemical carcinogens.
Alcoholism↗
[Metastatic spread of renal cell carcinoma in the area of the ethmoid and frontal sinuses].
Metastatic lesions represent 1-8% of all malignant tumors of the mouth and jaws, with rare sites of metastasis originating from different primary tumors, especially the lung and breast. The vast majority of these lesions (up to 90%) have been observed in the mandible and maxilla (5-20%). Another rare type of cancer that usually metastasizes to the lungs, lymph nodes, bones, liver or brain may occasionally also show spread to the paranasal sinuses. In the present paper we report our management of a 50-year-old male with renal cell carcinoma who developed metastases to the frontal and ethmoid sinuses.
Carcinoma, Renal Cell↗
[Exposed superior bulb of the internal jugular vein. Differential hearing loss diagnosis with pulse synchronous tinnitus].
A case report is presented of a 54-year-old woman with tinnitus synchronous with her pulse and an ipsilateral conductive hearing loss. Otoscopy showed a pulsatile structure behind the right eardrum. Imaging with high-resolution computed tomography of the temporal bone showed an enlarged jugular vein bulb. Magnetic resonance imaging could not be performed because of an implanted pacemaker. Since a glomus jugulare tumor could not be excluded right diagnostic tympanoscopy was performed and revealed a high jugular bulb that filled nearly a third of the tympanum.
Diagnosis, Differential↗
Cellular immune defect caused by postsurgical radiation therapy in patients with head and neck cancer.
The effects of locoregional postoperative radiation therapy (60 Gy on average) on cellular immunity were investigated in 11 patients with squamocellular carcinomas of the oral cavity, pharynx, or larynx. During radiation treatment, the total lymphocyte counts, CD8+ T-lymphocyte count, and especially CD4+ T-lymphocyte count decreased significantly. The mean CD4+ T-lymphocyte counts dropped from an average of 739/microl to 183/microl (p <0.001), and the CD4+/CD8+ quotient also decreased significantly. Not only the lymphocyte counts but also the in vitro lymphocyte stimulation responses to several mitogens decreased, with reductions averaging 10% to 50% of normal responses by the end of radiation therapy. Within 3 to 4 weeks after radiation therapy, the CD4+ T-lymphocyte counts and the in vitro lymphocyte stimulation responses showed a tendency toward normalization. This study shows that postoperative locoregional radiation therapy in patients with head and neck cancer induces a severe generalized impairment of cellular immunity.
CD4 Lymphocyte Count↗
[Occupational exposure to paint, lacquer and solvents, and cancer risk in the area of the upper aero-digestive tract].
So far, only few studies exist that have investigated the influence of occupational exposure to paint and lacquer on the risk of cancer in the upper aerodigestive tract. Based on data from the Heidelberg case control study which enrolled 369 patients with carcinomas of the upper aerodigestive tract and 1476 randomized control subjects, the relative risk of head and neck cancer in patients exposed to paint, lacquer and varnish was analyzed. The relative risk (RR) of squamous cell cancer (after adjustment for possible alcohol and tobacco effects) was significantly increased for the larynx (RR = 2.3) and the oral cavity (RR = 3.6). However, this risk was not increased for the pharynx. Our findings and a critical analysis of the literature provide evidence that chronic exposure to paint, varnish and lacquer is a definite risk factor for cancer of the upper aerodigestive tract. Further studies are required to confirm these findings, and to identify more precisely toxic substances encountered in the workplace.
Carcinoma, Squamous Cell↗
[Angioedema of the mucous membranes of the upper aerodigestive tract after administration of ACE inhibitors].
Inhibitors of angiotensin converting enzyme may rarely cause an angioneurotic oedema of the upper aerodigestive tract. The pathomechanism of this side effect depends on an interaction of the drug with hormones regulating the vascular resistance such as the kallikrein kinin system and the prostaglandin system. Anglo-oedema is characterised by subcutaneous or submucosal swelling, which preferably affects the lips, the soft palate, the tongue and the larynx. Pathomechanisms, differential diagnosis and treatment of ACE-inhibitor induced oedema of the upper aerodigestive tract are described by means of 3 case reports.
Airway Obstruction↗
[Chondroma of the petrous bone. A contribution to differential skull base tumor diagnosis].
INTRODUCTION: Cartilaginous tumors of the mid-face and the skull base are rare. CASE REPORT: For the first time, a case report of a chondroma of the base of the ear in a 56-year-old woman is presented. In 1974 the patient developed a facial nerve paralysis while she was pregnant. Twenty-two years later the patient developed persistent headache and CT studies of the head were obtained, which showed an extensive tumorous lesion located at the base of the ear. A tumor was resected through an otoneurosurgical approach. The histological examination showed a chondroma. CONCLUSIONS: Even the rare diagnosis of a chondroma should be considered for a differential diagnosis of skull base tumors.
Chondroma↗
Epidemiology of laryngeal cancer: results of the Heidelberg case-control study.
Squamous cell carcinoma of the larynx is a multifactorial disease which predominantly is found in males aged 50-70 years. Chronic consumption of alcohol and tobacco independently increase the relative risk of this type of cancer in a dose-dependent manner. Low educational standards and occupational training are associated with high risk. The majority of the cancer patients are blue collar workers who are exposed to a variety of hazardous working materials like polycylic aromatic hydrocarbons, cement dust, metal dusts, asbestos, varnish, lacquer, etc. Environmental exposure to airborne carcinogens like fossil fuel single stove emissions may increase the relative risk of laryngeal cancer. The regular consumption of fruit, salad and dairy products which contain considerable amounts of tumor protective micronutrients may decrease the risk of laryngeal cancer.
Alcohol Drinking↗
[Squamous epithelial carcinoma of the tongue after occupational exposure to chromium VI compounds].
BACKGROUND: The major key risk factors of head and neck cancer are chronic alcohol and tobacco consumption. There ist further increasing evidence that exposure to hazardous occupational agents increases the cancer risk substantially. CASE REPORT: By means of a case report and an overview of the literature, the role of occupational exposure to hexavalent chromium compounds as a risk factor of head and neck cancer is analysed. RESULTS AND CONCLUSIONS: The mechanisms of chromium carcinogenesis are outlined. Possible interactions of life-style factors and occupational factors which may influence the cancer risk in a synergistic manner are also discussed. Critical analysis of the literature provides evidence of a possible role of occupational exposition to hexavalent chromium compounds as a risk factor for oral squamous cell cancer.
Carcinogens, Environmental↗