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Biomedical subjects

Bernd Freigang

Publications and source records attributed to Bernd Freigang.

6 recordsLinked to original sources

Retention of the arginine allele in codon 72 of the p53 gene correlates with poor apoptosis in head and neck cancer.

The allele constitution at codon 72 of the p53 gene (CGC-arginine or CCC-proline) plays a major role in inducing apoptosis in p53 mutant cells. To verify this, we determined GC-status, p53-mutations, and p53-loss of heterozygosity (LOH) in a group of 54 squamous cell carcinomas of the head and neck (SCCHN). A novel approach, using a one-step real-time PCR analysis with fluorescent hybridization probes, was applied to detect the GC status in tumors and corresponding blood samples. p53 mutations in exons 4 to 8 were detected by PCR-SSCP-sequencing analysis. Apoptosis was determined immunohistochemically using antibodies against Fas, FasL, p53, Bcl2, and terminal deoxy-transferase-mediated dUTP nick end labeling (TUNEL) staining. The overall frequency of p53-LOH in SCCHN was 45.2%. In cases of LOH, there was a preferential loss of the proline allele, which was associated with an up-regulation of Bcl2 and lack of co-expression of Fas/FasL and, thus, impaired apoptosis (P < 0.001). Apoptosis was not observed in tumors carrying the arginine allele. p53 mutations were detected in 29.6% of SCCHN and preferentially occurred at the arginine allele (P = 0.01). p53 alterations were more frequently observed in tumors of the oral cavity, oropharynx and hypopharynx, whereas they were rare in larynx carcinomas (P = 0.07). The p53-LOH status was not found to be significantly correlated with sex, age, TNM-status, or tumor grading. We conclude that apoptosis is correlated with the allelic status of codon 72 in SCCHN. Homozygous proline 72 appears to be an important regulator of apoptosis via the Fas/FasL pathway in SCCHN.

Adult↗

Fasciitis ossificans of the paranasal sinus.

We report a case of fasciitis ossificans of the nasal cavity and paranasal sinus in an infant who was surgically treated in our department. Fasciitis ossificans is a rare benign reactive lesion and a variant of the more commonly known entity nodular fasciitis. We present the radiographic appearance and discuss the surgical resection, which was performed by a paranasal section, as well as the histologic and immunohistochemical results. To the best of our knowledge, no other case of fasciitis ossificans of the paranasal sinus has yet been reported. It is important to publish cases such as this, because their recognition as benign entities can prevent aggressive surgical procedures.

Diagnosis, Differential↗

Results achieved in the treatment of patients with vestibular schwannoma.

Personal experience gathered with the treatment of 264 vestibular schwannoma (VS) at the Magdeburg University ENT Hospital is analysed. ABR Audiometry is useful as a screening, even though it yielded false-negative values in 12.7% (n = 33) for intrameatal VS and 16.9% for all VS, despite accurate evaluation. Latency increases of Waves I, III and V and their intraaural comparison exhibited a statistically significant difference for the VS levels proposed by TOS. The mean of intrameatal VS too was found to have longer latencies compared with the normal-hearing ears of the patients. In the individual case, with threshold hearing normal, anamnestic findings as well as otoneurological evidence provide an early indication for enhanced MRI, CISS imaging, or individual 3D reconstruction of the pontocerebellar cisterna. Adopting intraoperative monitoring of the facial nerve and the cochlea as well as the Pars acustica by means of far-field and near-field electrodes, a good facial 'mobility' was achieved in 95.3%, and a useful audition (AAO-HNS Types A and B) in 60%. Monitoring is beneficial as it enhances the reliability and improves the subtle preparation during surgery. The power of hearing improved postoperatively within six months and remained at a good level over two years. From our perspective, otorhinolaryngologists are the right specialists to attend to VS.

Aged↗

Prognostic value of MMP-2, -9 and TIMP-1,-2 immunoreactive protein at the invasive front in advanced head and neck squamous cell carcinomas.

In head and neck cancer as well as in other carcinomas, tumor expansion and spread to distant sites require the secretion of destructive enzymes that degrade the extracellular matrix. A variety of proteases contribute to matrix destruction. Characteristics of the invasive tumor front may reflect tumor prognosis better than do other parts of the tumor. Therefore, it was the aim of the present study to (i) compare central and peripheral tumor zones for differences in the expression of matrix-metalloproteinases (MMP) -2 and -9 and their naturally occurring inhibitors (tissue inhibitor of matrix-metalloproteinases (TIMP) -1 and -2), (ii) examine the morphological potential of malignancy, and (iii) correlate these findings with clinicopathological parameters. The study population consisted of 106 surgical specimens of advanced head and neck squamous cell carcinomas. The invasive front was graded for malignancy, and immunohistochemical staining with MMP-2, MMP-9, TIMP-1 and TIMP-2 antibodies was performed. Both MMP-2 and MMP-9 were found to be significantly overexpressed at the tumor front. The MMP-2-positive invasive front exhibited diminished overall survival times. In multivariate analysis, MMP-2 expression retained its correlation with overall survival in addition to nodal status and total malignancy score. Expression of TIMP-2 correlated with local tumor invasion. We conclude that the expression of MMP-2 at the invasive front is a marker of poor survival and appears to be associated with early recurrence in initially lymph node-negative patients.

Carcinoma, Squamous Cell↗

Multislice computed tomographic imaging in temporal bone dysplasia.

OBJECTIVES: To evaluate the impact of multislice computed tomographic (MSCT) imaging, a recently developed computed tomographic technique, on imaging of temporal bone malformations. STUDY DESIGN: Retrospective case review. SETTING: The study was performed at a tertiary referral center. PATIENTS: High-resolution temporal bone studies of 168 consecutive patients were reviewed for various temporal bone malformations. MAIN OUTCOME MEASURES: Visualization of various dysplastic conditions of the temporal bone without the need for supplementary scan procedures or additional imaging techniques. INTERVENTION: MSCT imaging was performed on a scanner with four detector rows by using the following parameters: 120 kV, 50 mA/s, 0.5-mm slice thickness, 0.2-mm reconstruction increment, pitch factor of 0.75, and a field of view of 160 mm. Two-dimensional and three-dimensional image reconstructions were performed subsequent to data transfer to a workstation. In one patient suspected of having a vascular dysplasia, high-resolution MSCT imaging was supplemented by multislice computed tomographic angiography. RESULTS Temporal bone dysplasias were encountered in 28 patients (16.7%), affecting the external auditory canal (n = 15), the middle ear (n = 18), the inner ear (n = 5), and the vascular system (n = 3). All temporal bone dysplasias were visualized by two-dimensional and three-dimensional images of excellent detail resolution. In none of the patients were supplementary computed tomographic scans necessary, except for one patient with evidence of an aberrant course of the internal carotid artery. Multislice computed tomographic angiography obviated the need for invasive diagnostic procedures. CONCLUSION: MSCT imaging of the temporal bone allows for comprehensively assessing various dysplasias through high-quality two-dimensional and three-dimensional image reconstructions.

Adolescent↗