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Biomedical subjects

F Bootz

Publications and source records attributed to F Bootz.

106 records · Page 6Linked to original sources
PubMed1990

Ploidy as a prognostic indicator in end stage squamous cell carcinoma of the head and neck region treated with cisplatinum.

We measured tumour cellular DNA in 102 patients entered into two phase III trials of chemotherapy for end stage squamous carcinoma of the head and neck. The median survival of untreated patients with aneuploid tumours was 55 days compared with 224 days for patients treated with cisplatinum. This difference was highly significant. In contrast the median survival of untreated patients with diploid tumours was 74 days compared with 118 days for treated patients. Although this difference is statistically significant, the increased survival of 6 weeks is of no clinical benefit compared with the prolongation of survival of 6 months in patients with aneuploid tumours. Multivariate analysis showed that the significant predictors of survival were Karnofsky status, response to chemotherapy and ploidy.

Aged↗
PubMed1990

Repair of salivary fistulae after laryngectomy.

A new surgical technique is described for the repair of salivary fistulae. It has been used in three patients. The fistulae occurred after laryngectomy and had been unsuccessfully treated with local and regional flaps. The principle of the technique is to use a bipedicled jejunal patch as a free microvascular transfer. One patch is used for reconstruction of the pharynx and after excising the mucosa the skin defect is closed with the other patch. The mucosa is excised to expose the muscle and to create a recipient site for a split skin graft.

Humans↗
PubMed1990

[Computerized tomography imaging of laryngocele. Its importance in the differential diagnosis of tumors of the larynx and pharynx].

The laryngocele is a dilatation of the laryngeal ventricle and represents a rare condition. In most cases there is a typical history. Patients with an internal laryngocele usually complain of hoarseness, dyspnea and cough. Laryngoscopy shows a swelling of the false cord on one side. The external laryngocele presents as a swelling in the neck. In some cases the clinical presentation is not that typical, so that computed tomography (CT) can be a helpful, additional investigation. CT scans show either an air- or mucus-containing tumor at the level of the false cord. This internal laryngocele may proceed into an external one, which presents as a swelling at the level of the hyoid bone. We now present 13 cases of laryngoceles with special regard to the CT and intraoperative findings. In the differential diagnosis other tumors of the larynx are considered, since the mucus-filled laryngocele is difficult to distinguish.

Adult↗
PubMed1989

[Radial forearm flap. Its versatile application in plastic surgery reconstruction of the head and neck].

The radial forearm flap is a versatile tissue transfer in the head and neck. It can be raised either from the distal or the proximal aspect of the volar forearm, and can also include the whole volar forearm skin. The flap is ideal for reconstruction of superficial defects in the head and neck, for the pharynx and oral cavity, as well as for skin defects of the face and the neck. The distal flap is thin and pliant due to the small amount of subcutaneous tissue and the fairly long vascular pedicle. A proximal flap is more bulky due to subcutaneous fat. Since the vascular pedicle of the distal flap is very long, it can also be anastomosed in the contralateral neck. Different applications and indications for the tissue transfer of the radial forearm flap are presented.

Combined Modality Therapy↗
PubMed1988

[Chemodectoma of the larynx (2 case reports)].

We report two cases of chemodectoma of the larynx. A 70-year-old man underwent a laryngectomy in April 1984 for a tumor diagnosed as a squamous cell carcinoma but which postoperatively proved to be a chemodectoma. Ipsilateral cervical metastases appeared 2 years later and were removed by local excision. Shortly thereafter he presented with recurrent nodes in both sides of the neck as well as cutaneous metastases on the trunk. He was given chemotherapy using a DTIC regime (5-3,3-dimethyl-1-triazino imidazole-4-carboxamide). A 53-year-old lady underwent a total laryngectomy in May 1984 for an extensive chemodectoma of the larynx. The tumor had already invaded the trachea and thyroid gland. Distant metastases were not found. So far she is free of recurrence. We discuss the histology, site, clinical course and therapy of this extremely rare tumor.

Aged↗
PubMed1988

[Microvascular tissue transplantation of the ear, nose and throat].

Free tissue transfers are a versatile method of reconstruction in head and neck surgery. In the pharynx and oral cavity the functional result dictates the choice of flap. For these sites thin and pliant fasciocutaneous flaps are ideal tissue transfers, and we favour the radial forearm flap which is raised from the distal volar forearm. This flap is easy to dissect and the donor defect, which is grafted with split skin, does not inconvenience the patient. For reconstruction of thicker defects we prefer bulky myocutaneous flaps such as the latissimus dorsi, which has a reliable pedicle of adequate length. The rectus abdominis flap, if taken with peritoneum, is useful for reconstruction of large cheek defects involving all layers; the peritoneum replaces the oral mucosa. For hypopharyngeal reconstruction the free jejunal loop has advantages compared with local skin or myocutaneous flaps, since it is a one-stage procedure with a low rate of post-operative fistulae. In some cases of reconstruction of the oral cavity and oropharynx we have used a jejunal patch, but in general we prefer the radial forearm flap, since it is more resistant to mechanical trauma. The advantage of a free tissue transfer is its excellent blood supply, which makes it possible to apply these flaps in irradiated and infected tissue. It is important in microvascular tissue transfer to choose an appropriate flap for the size and depth of the resection. It is only necessary to be familiar with those transfers most commonly used in this region.

Bone Transplantation↗
PubMed1988

[The free forearm flap in covering defects of the pharynx and oral cavity].

The radial forearm flap is a versatile method for reconstruction of the pharynx and the oral cavity after tumour resection. We prefer the distal volar forearm since the flap is thin, with little subcutaneous fat. The vascular pedicle is rather long. Twenty patients with carcinoma of the oropharynx and the oral cavity have been operated on. Thirteen patients had carcinomas of the oropharynx, 7 of the oral cavity. In all cases the distal flap was used. The size varied from 3 x 5 cm to 10 x 7 cm. Twelve patients underwent radiotherapy which did not do any damage to the flap. Fifteen patients had a good functional result. Two patients suffered recurrences after a few months. One patient died from respiratory problems. One flap underwent a partial necrosis due to venous congestion. The donor defect was closed with split skin from the thigh.

Female↗
PubMed1987

[Radiation-induced damage to the large arteries].

The extracranial arteries of 28 irradiated patients with malignant tumors of the head and neck were examined by continous wave (CW) Dopplersonography and duplex-scan. The results were compared with those obtained from 556 healthy people of the same average age. The mean period between irradiation and examination was 7.3 years. Dopplersonography revealed stenoses or occlusions of the extracranial arteries in 9.1% of normal persons. In the group of irradiated patients 21% had stenoses or occlusions of the extracranial arteries. The results show, that the incidence of stenosis or occlusion of extracranial arteries is much higher in irradiated patients than in the normal population. The noninvasive CW-Dopplersonography should be routinely used in the follow-up of patients who had cervical irradiation in order to detect these carotid lesions while they are still symptomless.

Carotid Arteries↗
PubMed1984

Early stabilization of human posture after a sudden disturbance: influence of rate and amplitude of displacement.

The functional role of short-, medium- and long-latency responses for the maintenance of upright posture was investigated in twenty healthy subjects standing on a platform which could be rotated in pitch around the subject's ankle joints. Tilting the platform toe-up evokes a stretch reflex in the triceps surae muscle (TS, latency 55-65 ms) and at higher speeds and amplitudes of platform displacement a medium-latency response (latency 108-123 ms). Both responses functionally destabilize posture, since they enforce the induced backward displacement of the body. Compensation of body displacement in this situation is achieved by a long-latency EMG response in the anterior tibial muscle (TA 130-145 ms). Platform movement toe-down elicits a rather small medium-latency response in TA (103-118 ms), but no short-latency response. A late compensatory response occurs in the triceps surae muscle (latency 139-170 ms). The mean latency of the late antagonistic EMG response was significantly shorter than that of a voluntary movement triggered by a somatosensory stimulus. Integrals of rectified EMG responses from the two muscles were linearly related to the amplitude and to a smaller degree to the velocity of platform displacement. The slope of this function (gain) varied depending on the direction of ankle displacement and the functional importance of the subsequent EMG responses. Destabilizing short- and medium-latency responses of the stretched muscle had a lower gain relative to amplitude than the late stabilizing response of the antagonist. This functionally adaptive modulation of gain was not seen in relation to the rate of platform displacement.

Adult↗
PubMed1983

Variability of postural "reflexes" in humans.

The functional role of spinal and supraspinal EMG-responses for the maintenance of upright human posture was investigated in ten healthy subjects standing on a force measuring platform, which could be rotated in pitch around an axis aligned with the subject's ankle joint. Voluntary changes of body posture prior to the platform movement by leaning forward or backward led to a change in the amplitude and temporal organization of EMG-responses as compared to platform movements starting from a neutral position. Tilting the platform toe-up while leaning backward led to an increase of the latency of the short- and medium-latency responses in the triceps surae muscle and to a decrease of the latency of the stabilizing response in the anterior tibial muscle. Functionally, a cocontraction of both antagonistic muscles could be observed which partly compensated for the destabilizing action of the "reflex" response in the stretched triceps surae muscle. In analogy, leaning forward and tilting the platform toe-down led to a cocontraction of the two antagonistic muscles. The observed changes of latencies of short-, medium-, and long-latency response show the functional variability of segmental and suprasegmental "reflex" mechanisms. EMG-activities, which are functionally destabilizing posture, can be suppressed or compensated by reflexive cocontractions of antagonists.

Adult↗
PubMedDate not supplied

Acute mastoiditis--relevant once again.

During recent years, a significantly increased incidence of acute mastoiditis was observed at the University Children's Hospital, Tübingen, Germany (1975-1979: 1.4 patients/year; 1987-1992: 4.2 patients/year; p < 0.05). We therefore reviewed the records of all patients with acute mastoiditis (n = 58) that had been treated at the Children's Hospital between 1975 and 1992 and at the Clinic of Otorhinolaryngology between 1978 and 1992. The male to female ratio was 1.8:1 and 60.4% of the patients were younger than 24 months. Retroauricular swelling was more often observed (n = 49) than protrusion of the pinna (n = 45) and retroauricular redness (n = 38). Streptococcus pneumoniae was the most frequently isolated pathogen. Several factors predisposing for the development of acute mastoiditis were identified. These included withholding antimicrobials for treatment of the preceding episode of otitis media; use of suboptimal agents for therapy of otitis media (penicillin and, possibly, erythromycin ethylsuccinate); and insufficient duration of treatment.

Acute Disease↗
PubMedDate not supplied

A crucial role for B cells in neuroinvasive scrapie.

Although prion proteins are most efficiently propagated through intracerebral inoculation, peripheral administration has caused the diseases kuru, iatrogenic Creutzfeldt-Jakob disease (CJD), bovine spongiform encephalopathy (BSE) and new-variant CJD. The development of neurological disease after peripheral inoculation depends on prion expansion within cells of the lymphoreticular system. Here we investigate the identity of these cells by using a panel of immune-deficient mice inoculated with prions intraperitoneally: we found that defects affecting only T lymphocytes had no apparent effect, but that all mutations that disrupted the differentiation and response of B lymphocytes prevented the development of clinical scrapie. As an absence of B cells and of antibodies correlates with severe defects in follicular dendritic cells, a lack of any of these three components may prevent the development of clinical scrapie. However, we found that scrapie developed after peripheral inoculation in mice expressing immunoglobulins that were exclusively of the M subclass and without detectable specificity for the normal form of the prion PrPC, and in mice which had differentiated B cells but no functional follicular dendritic cells. We conclude that differentiated B cells are crucial for neuroinvasion by scrapie, regardless of the specificity of their receptors.

Animals↗