Search PubMed⌕ Search

Biomedical subjects

W Kehrl

Publications and source records attributed to W Kehrl.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Reducing late toxicity with amifostine in fractionated irradiation of the rat salivary glands].

Clinical studies show that amifostine can reduce xerostomia and mucositis during radiotherapy of head and neck cancers. The aim of this study was to evaluate the radioprotective potency of amifostine with respect to late toxicity of salivary glands of rats. The head-neck-area of 8 male WAG/RijH rats (295 +/- 7 g) were irradiated with 60Co-gamma-rays (60 Gy/30 f/6 weeks). Amifostine (250 mg/m2 body surface) was applied via a venous port 15 min before each irradiation. Rats of a control group were irradiated with the same schedule with equal volumes of physiological saline. The morphological and sialoscintigraphical findings clearly demonstrate that amifostine has a remarkable cytoprotective effect on the late toxicity of irradiated salivary glands.

Amifostine↗
PubMed2002

[Radioprotective effectiveness of amifostine on the salivary glands of the rat during fractionated irradiation].

BACKGROUND: The aim of this study was to evaluate the cytoprotective potency of amifostine during a fractioned irradiation of salivary glands but also on the tumor response of rhabdomyosarcomas R1H in rats. METHOD: The head-neck-area of male WAG/RijH rats and the tumor in the flank were irradiated with 60Co-gamma-rays (60 Gy/30 f/6 weeks). Amifostine (250 mg/m2) was applicated 15 min before irradiation. The control group was treated with an equal volume of physiologic sodium chloride. The salivary glands were exstirpated and examined histopathologically. Tumour volume was measured, the body-weight of rats determined. RESULTS: A dose dependent radiosialadenitis developed in all salivary glands. Amifostine had no influence on the response of R1H tumours to radiation. The animal weight loss in the amifostine group was higher as compared to control group. CONCLUSIONS: No cytoprotective effects on acute toxicity of salivary glands of rats could be detected under irradiation with synchronous application of amifostine. In addition, no effects on tumor response were observed. The general animal constitution decreased by additional medication of amifostine.

Amifostine↗
PubMed2001

[Extranasal glioma. On the differential diagnosis of frontonasal abnormalities].

A case of extranasal glioma without other heterotopias of brain tissue is presented. The endonasal biopsy of this tumor presented histologic evidence of ectopic glial tissue surrounded by connective and mucosa tissue. Before any surgical procedure can be performed, radiographic (computed tomography and magnetic resonance imaging) examination is essential to rule out possible communication of the tumor with intracranial space. Surgical excision is necessary to prevent deformities of the nasal structure from occurring. Previously reported cases of nasal glioma are reviewed and problems in diagnosis and management are discussed.

Biopsy↗
PubMed2001

Resection of the sternocleidomastoid muscle during radical neck dissection.

BACKGROUND: Surgical therapy of lymph node metastasis is based on accessibility for en bloc resection. First described as "radical neck dissection", this original approach has since undergone various modifications. This has produced controversy about the particular indications for the individual techniques. The aim of this study was to evaluate whether intraoperative macroscopic inspection of the sternocleidomastoid muscle (SCM) in regard to tumor infiltration is sufficient to decide about muscle resection and whether there are prognostic differences between patients undergoing radical-versus modified radical (selective) neck dissection. MATERIALS AND METHODS: In a retrospective study, data on the surgical treatment of cervical lymph nodes and survival rates from 438 patients with head and neck malignancies managed in our department between 1988 and 1994 were analyzed in 1994 and again in 1999. RESULTS: 337 patients (76.9%) underwent unilateral or bilateral selective neck dissection. In 101 patients (23.1%) a radical neck dissection was performed and the SCM was completely resected. Analysis of these cases showed intraoperative macroscopic tumor invasion of the SCM in 12 patients (11.9%), which could be confirmed histologically. In the remaining 89 cases (88.1%), a macroscopically intact muscle was resected; in none of these cases did histopathological examination show tumor infiltration of the SCM. Analysis of radically or selectively neck dissected stage III or IV patients with oral cavity, oropharyngeal, hypopharyngeal or laryngeal carcinomas did not show statistical differences in 2-, 5- and 10-year survival (54.8%, 23.7%, 18.7% versus 62.6%, 25.6%, 21.8%, respectively). CONCLUSIONS: (1) Intraoperative inspection of the SCM constitutes a valid parameter for deciding whether tumor infiltration is present or not. (2) There were no prognostic differences (2-year, 5-year and 10-year-survival) between stage III and IV patients with oral cavity, oropharyngeal, hypopharyngeal and laryngeal carcinomas treated by either radical or selective neck dissection.

Aged↗
PubMed2001

[Cutaneous malignant melanoma in the area of the head and neck with intermediate tumor thickness: does primary site have prognostic relevance?].

BACKGROUND: Tumor thickness and infiltration of malignant melanoma are the main prognostic factors for recurrence and survival. The sentinel lymph node biopsy may provide a step toward a more individual staging and therapy. It was the aim of this study to investigate the prognostic influence of the primary localization of head and neck melanoma subdivided into scalp, ear, neck, and face. To form a basis for routine sentinel lymph node biopsy in case of intermediate tumor thickness metastatic pattern of the different primary sites were analysed. METHOD: Survival rates depending on primary tumor site of 51 patients with cutaneous malignant melanoma of the head and neck were analysed. Metastatic pattern were evaluated with the help of clinical, intraoperative, pathohistologic data. RESULTS: Scalp and ear melanoma were found to be higher risk lesions with a 5-year survival rate of 28% and 59% respectively. Melanoma of the neck and face had a 5-year survival rate of 75% and 78% respectively. In two cases of ear melanoma lymph node metastases could be demonstrated in unusual sites by skipping the first draining basin. In three cases bilateral metastases could be shown histologically as opposed to clinical prediction. CONCLUSIONS: Localization of cutaneous malignant melanoma of the head and neck is a prognostic factor for survival. Because of the discordancy between clinical prediction and lymphatic drainage pattern sentinel lymph node biopsy improves accuracy of diagnostic and therapeutic procedures.

Follow-Up Studies↗
PubMed2001

[Comparison between the Eppendorf histograph and the Licox system for determination oxygen partial pressure in tumor tissue].

BACKGROUND: The oxygenation of a tumor is certainly one of the major facts influencing the response to treatment. pO2 measurement in tumor tissue can be done by using the Eppendorf-histograph. In recent years the Licox-system (GMS) was developed for oxygen tension measurement in tissues and fluids under clinical routine conditions and for research work. Aim of the present study was to assess the suitability of the Licox-system in drawing up histograms of pO2 values in tumor tissues. METHOD: Histograms of the distribution of oxygen tension in twelve tumors were prepared with both measuring systems in parallel. Investigations were performed on rats with isotransplanted R1H rhabdomyosarcomas in continuous intravenous anesthesia with Fentanyl and Dormicum. Ventilation with a mixture of air and oxygen was applied through a tracheostoma. Arterial pressure and body temperature were analysed and balanced continuously. RESULTS: No correspondence between data of both measuring methods could be found. CONCLUSIONS: Because of constructional advantages the Eppendorf-histograph seems to be comparatively more suitable in drawing up histograms of oxygen tension tumor tissue.

Animals↗
PubMed2000

[Tumor oxygenation in combined whole body hyperthermia and polychemotherapy. Studies exemplified by recurrent carcinoma of the mouth cavity].

BACKGROUND AND OBJECTIVE: Previous studies have reported synergistic effects of combined hyperthermia and chemotherapy and/or irradiation. The response to irradiation and chemotherapy of well-oxygenated and vascularized tumors generally is better than that of hypoxic tumors. Therefore, tumor oxygenation is recognized as an important predictive factor in the therapy of malignant tumors. In practice, the head and neck area remains outside of the hyperthermia chamber during whole-body hyperthermia. It was the aim of this study to evaluate if the head and neck region receives sufficient warmth and, if so, if tumor oxygenation increases accordingly. PATIENTS/METHODS: Whole-body hyperthermia, as heat radiation (Enthermics Medical Systems RHS-7500), was applied to the narcotised 60-year-old male patient with a local recurrence tumor pT3 pN2b M0 squamous cell carcinoma of the oral cavity. Tumor oxygenation and temperature were measured by LICOX catheters via one-point measurement during the entire hyperthermia treatment (3.5 h). Parallelly, chemotherapy (ifosfamide/Carboplatin) was given in four cycles (one cycle/month). RESULTS: With a latency of 10 min the increase of intratumoral temperature was comparable to temperatures achieved in the esophagus. The maximum intratumoral temperature was 41.8 degrees C. The average increase in tumor oxygenation was more than 100%. The clinical outcome in the case presented was a partial tumor remission (PR). CONCLUSIONS: During combined whole-body hyperthermia and polychemotherapy, tumor oxygenation is also significantly improved in the head and neck area, despite the fact that the head and neck area remained outside the hyperthermia chamber. The intratumoral temperature was comparable to esophageal and rectal temperatures.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

[Improving wound healing after nose surgery by combined administration of xylometazoline and dexpanthenol].

BACKGROUND: The aim of this study was the examination of efficacy and tolerability of an application-form of the new combination of Xylometazoline with Dexpanthenol (Nasic) versus Xylometazoline alone. PATIENTS AND METHODS: Randomized verum controlled parallel-group-comparison of two weeks treatment of a nasal-spray. 61 inpatients with the diagnosis Rhinitis following nasal operation were included in this study and 30 patients were treated with verum and placebo each. The assessment of nasal-breathing-resistance according to scores was defined as target-parameter. Confirmatory statistical analysis was carried out according to Wilcoxon-Mann-Whitney-U two-sided at alpha < or = 0.05. MAIN OUTCOME MEASURE: The superiority of the combination of Xylometazoline-Dexpanthenol nasal-spray versus Xylometazoline nasal spray could be proven for the target-parameter as clinically relevant and statistically significant. The clinically proven efficacy is emphasized by good tolerability of both treatments. Due to easy handling of the nasal-spray a good compliance was confirmed. CONCLUSION: Distinct improvement of symptoms in patients following nasal operations underlines the efficacy of both medications. With respect to the tolerability therapy with the combination is more beneficial in comparison to the alternative therapy. The result of this controlled clinical study confirms that the combination Xylometazoline-Dexpanthenol is an enlargement and improvement of effective medicinal treatment of rhinitis following nasal operation in comparison to therapy with Xylometazoline alone.

Adrenergic alpha-Agonists↗
PubMed1999

[Fistula between the trachea and innominate artery--a rare complication following tracheostenosis treatment with silastic tubes].

BACKGROUND: Fistulas between the trachea and innominate artery are rare but devastating complications that usually occur following tracheotomies. METHODS: One case a fistula after long-term treatment of a tracheal stenosis with an Montgomery silastic tube was analyzed. A literature review of the different strategies in diagnosis and treatment of this complication was undertaken. RESULTS: In the present case, the fistula occurred after long-term treatment of tracheal stenosis with silastic tubes (Montgomery). Summarizing our experience with this case and a review of the literature, it can be concluded that: Fistulas most frequently occur following tracheostomy or tracheal reconstructive surgery. Frequent bronchoscopic examination during long-term treatment of tracheal stenosis with silastic tubes is essential. Even minor tracheal hemorrhage in such cases must be thoroughly examined. In case of fistula hemorrhage, the most effective treatment consists of direct local compression, best obtained with a well placed respiration tube. CONCLUSION: Fistulas between the trachea and innominate artery constitute a rare but possible complication after tracheal stenosis treatment.

Adult↗
PubMed1998

[Dexpanthenol nasal spray as an effective therapeutic principle for treatment of rhinitis sicca anterior].

BACKGROUND: Controlled clinical studies on medical treatment of rhinitis sicca anterior have not yet been published. Therapy recommendations are based on experiences but not on results of controlled clinical studies. The aim of this study was to examine the efficacy and tolerance of a new form of application of Dexpanthenol in physiologic saline solution (Nasicur). PATIENTS AND METHODS: A randomized comparison of parallel groups was performed. One group was treated with the nasal spray while the control group received a placebo. The assessment of nasal breathing resistance and the extent of crust formation according to scores were defined as target parameters. Statistical analysis was carried out according to Wilcoxon at alpha < or = 0.05. RESULTS: Forty-eight outpatients diagnosed with rhinitis sicca anterior were included in this study. Twenty-four received the medication, and 29 were treated with a placebo. The superiority of the dexpanthenol nasal spray in comparison to the placebo medication was demonstrated for both target parameters as clinically relevant and statistically significant. The placebo spray showed clinical improvement of the other treatment outcome parameters. Dexpanthenol nasal spray showed no statistically significant difference in comparison to placebo. The clinically proven efficacy is emphasized by good tolerance of both treatments which was validated by the objective rhinoscopy findings. Good compliance was confirmed. CONCLUSION: The result of the controlled clinical study confirms that the dexpanthenol nasal spray is an effective medicinal treatment of rhinitis sicca anterior and is more effective than common medications.

Administration, Intranasal↗
PubMed1998

[Variations in the course of the internal carotid artery: possible risks in so-called standard operations in the area of the pharynx].

BACKGROUND: Many abnormalities in the course of the major vessels of the head and neck have been described. Special care must be taken in case of deviation of the internal carotid artery bulging the pharyngeal wall. PATIENTS: In two cases we demonstrate internal carotid arteries partially running underneath the posterior pharyngeal wall. RESULTS: Those variations are often asymptomatic, only requiring surgical treatment when causing neurologic complaints. On the other hand, they may be very dangerous, if operations in the upper pharynx are carried out. CONCLUSIONS: The surgeon (in special the younger surgeon) must be well-informed about potential vascular abnormalities, before performing "routine-operations" (tonsillectomies, adenotomies) in the upper pharynx.

Adenoidectomy↗
PubMed1998

[Effect of various forms of metastatic lymph node involvement on prognosis of squamous epithelial carcinomas of the upper aerodigestive tract].

BACKGROUND: Based on a new histo-morphological rating scheme, we assessed the impact on patient prognosis of lymph node metastasis of squamous cell carcinoma (SCC) in the head/neck area. Special attention was given to possible capsular rupture. METHOD: In a retrospective study, 111 patients with squamous cell carcinoma of the head and neck with concomitant cervical lymph node metastases were evaluated to determine the importance of lymph node capsular rupture on the occurrence of disseminated disease, loco-regional recurrence as well as survival rate. To cover the broad morphological spectrum of cervical metastatic disease, a newly developed scheme (differentiating seven different histo-morphological types of lymph node metastasis) was applied. On the basis of this scheme, every single metastatic lymph node received a score from one to seven. These single scores were then added to obtain a total score for every individual patient. These total scores were then divided into four groups. RESULTS: Synthesis of histo-morphological pattern of metastasis in combination with the number of metastatic lymph nodes showed highest concordance/significance in respect of disseminated disease (p = 0.0029), local recurrence (p = 0.0008) and regional lymph node metastasis (p = 0.0000) as well as survival rate (p = 0.0000). CONCLUSION: The newly introduced histological scheme seems to provide more accuiate and detailed information on the prognosis of SCC in the head and neck area.

Aged↗
PubMed1996

[Significance of sternocleidomastoid muscle resection in radical neck dissection].

Surgical therapy of cervical lymph node metastasis is based on their accessibility for en bloc resections. First described by Crile in 1906 as a radical neck dissection, this original approach has since undergone various modifications. This has produced an ongoing controversy with regard to the indications of the individual techniques. In a retrospective study, the data of 438 patients with head and neck malignancies managed at the ENT Department of Hamburg University between 1988 and 1994 were analyzed after surgical treatment of cervical lymph nodes. Results showed that 337 patients (76.9%) required unilateral or bilateral selective neck dissections. In 101 patients (23.1%) in whom a radical neck dissection was performed, the sternocleidomastoid muscle was resected completely. Analysis of these cases showed that intraoperative macroscopic invasion occurred in 12 patients (11.9%) and was confirmed histologically. The vast majority of cases (n = 89; 88.1%) had an intact muscle resected without tumor involvement. Further analysis showed no difference between radically or functionally neck-dissected stage III or IV patients with oral cavity, oropharyngeal, hypopharyngeal and laryngeal carcinomas. On the basis of these findings, resection of the sternocleidomastoid muscle is not mandatory in patients undergoing primary surgery without previous (cervical) radiation and when the muscle is found to be macroscopically intact.

Adult↗
PubMed1994

[Status of interventional angiography procedures in refractory epistaxis].

In cases of severe bleeding of the nose, besides sufficient packings further steps like surgical exploration and closure of vessels like maxillary or ethmoidal arteries or even the external carotid artery are described in most textbooks. Superselective angiographical embolisation is also mentioned, mostly as an alternative method, while often pointing out the danger of severe thromboembolic complications. In the last two years, we had excellent experiences with this method in 15 cases, without any of the complications mentioned above. We do feel that attempts at superselective angiological embolisation should be made prior to surgical intervention. Of course, technical and personal prerequisites must be adequately met besides excellent individual experience in interventional angiography.

Adult↗
PubMed1993

[Clinical aspects and histopathology of middle ear tuberculosis].

During the past few decades the clinical features of middle ear tuberculosis have changed. Hence, clinical differentiation between tuberculous and non-specific proliferative otitis media and mastoiditis is now difficult. Between 1986 and 1992 five cases of tuberculous otitis media were treated surgically in the ENT-Dept. of the University of Hamburg, representing 0.2% of all performed middle ear operations. According to our experience the therapy of choice is the open mastoid cavity with subsequent chemotherapy to avoid recurrent infections. The advantages of this procedure are proven by actual histopathological findings as well as by the analysis of historical microsections of the Wittmaack temporal bone collection: according to these findings, two different types of histopathological alterations can be differentiated.

Adult↗