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Biomedical subjects

H Rudert

Publications and source records attributed to H Rudert.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Serum soluble interleukin 2 receptor in patients with squamous epithelial carcinomas of the upper aerodigestive tract].

BACKGROUND: Several investigations showed increased levels of the soluble interleukin-2 receptor (sIL-2 R) in chronic and malignant diseases. A correlation between elevated sIL-2 R levels and disease activity or tumor size was observed in some patients. At present, there are no studies of sIL-2 R serum levels in patients with squamous cell carcinomas of the upper aerodigestive tract. METHODS: SIL-2 R levels were measured in sera of 86 patients with squamous cell carcinoma of the head and neck and of 25 healthy controls with a sandwich ELISA. RESULTS: Significantly elevated serum levels of sIL-2 R were detected in 49 out of 86 patients (56.9%) with squamous cell carcinoma of the head and neck. The mean serum level in the healthy controls was 437 U/ml compared to 895 U/ml in carcinoma patients. A correlation was found between tumor size, number of metastases and the sIL-2 R level. There was no correlation with histological type or tumor localization. DISCUSSION: The physiological role of sIL-2 R is still unknown. Elevated levels of sIL-2 could be a sign of activation of the immune system. But they also might be involved in causing the disease. The sIL-2 R serum levels in patients with squamous cell carcinoma of the head and neck may serve as an unspecific indicator for tumor size and dissemination. CONCLUSION: Posttherapeutic titer controls could be of prognostic value. Additionally, sIL-2 R may help to select appropriate patients for an immunotherapy with recombinant IL-2.

Adult↗
PubMed1995

[Animal experiment studies of laser effects on lymphatic vessels. A contribution to the discussion of laser surgery segmental resection of carcinomas].

BACKGROUND: The potential effect of laser surgery on the process of lymphogenic metastases is subject to controversy. In this context it would be of interest to identify a morphological basis for an increased intraoperative entry of tumor cells into the lymphatic system during resection of advanced carcinomas in two or more pieces via laser surgery. METHODS: The tissue effect of laser incisions (CO2 laser: 3030 W/cm2; Nd:YAG-laser: 3180 W/cm2) on the lymphatics of the buccal mucosa in 60 Wistar rats was studied by light microscopy, histochemistry, and lymphography during surgery and subsequent wound healing. These incisions were compared to conventional scalpel incisions. RESULTS: No lymphatic vessels were detected in the zone of carbonization, they were mostly dilated whereas in the zone of edema. In the zone of necrosis, the lymphatic were occluded by coagulation. The mid and long-term effect of the laser light on the regeneration of lymphatics was mainly correlated to wound healing which--when compared to conventional surgery--is delayed after laser surgery. Following scalpel incision, the first lymphatics enter the wound region after 4 days, a opposed to 10 days following laser surgery. Intact continuity of the lymphatic vasculature was detectable 15 days after scalpel incision and 42 days after laser incision. The regeneration of lymphatics was slightly more delayed after CO2 laser incision than after Nd:YAG laser incision. CONCLUSION: The results of this study do not indicate that the laser resection of carcinomas facilitates an intraoperative entry of tumor cells into the lymphatic vasculature. These experimental results verify clinical reports which do not observe an increased frequency of postoperative metastases after laser resection of carcinomas in two or more pieces.

Animals↗
PubMed1994

Primary papillary carcinoma of the thyroglossal duct: case report and review of the literature.

Primary malignancies of the thyroglossal duct are rare. Around 150 cases are described in the world literature, most of them being papillary thyroid carcinomas. Other types of tumors are squamous cell carcinomas, mixed follicular-papillary carcinomas, or adenocarcinomas. Women are affected more often than men, the ratio being 2:1. Preoperative diagnosis of primary malignancies of the thyroglossal duct is uncommon. Initial treatment of primary malignancies of the thyroglossal duct is usually sufficiently done operatively by the so-called Sistrunk's procedure which, however, was first described in 1893 by Schlange. Some patients may need further treatment such as wider excision, thyroidectomy, radioiodine therapy, or neck dissection. In this report the case of a papillary carcinoma of the thyroglossal duct in a 63-year-old man is presented. It is intended to remind the reader of this pathology which is often forgotten because of its rarity. The problems that occur during the process of evaluation regarding ideal treatment of the individual case are discussed. The literature is reviewed.

Antibodies, Monoclonal↗
PubMed1994

[Partial endoscopic resections with CO2 laser in laryngeal cancer. I. Resection techniques].

The laser surgical technique as used in more than 250 laryngeal carcinomas since 1979 is described. The CO2 laser is always used as a cutting instrument and not to vaporize the tumour, since this would not enable a control of complete tumour removal. The vaporisation technique is used only in combination with the cutting technique for laser surgical debulking of large laryngeal tumours. Five cutting techniques are differentiated: 1) excisional biopsy; 2) excision of the tumour in several portions; 3) incision of large tumours for staging purposes; 4) palliative excision of primary tumours in inoperable lymph node metastases; 5) palliative reduction of large tumours (debulking). T1a vocal cord carcinomas and circumscribed carcinomas of the border of the epiglottis are resected by means of a so-called excisional biopsy. This means that the tumour is resected in toto with a small line of adjoining healthy tissue. For the removal of large carcinomas of the vocal cord, or of tumours that cross the anterior commissure, or of larger supraglottic tumours, an unusual technique is employed. The tumorous tissue is cut with the laser and resected in several fragments. This may seem to contradict current oncological principles and is only possible because of laser-specific tissue reactions. When using a modern micromanipulator (711 Acuspot, Sharplan, London; diameter of the laser beam: 0.25 mm at 400 mm working distance) at low power levels (1-2 watts) and continuous wave mode, very slight or no bleeding is caused on the surface of the dissected tissue allowing differentiation between tumour and healthy tissue with the operating microscope.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗
PubMed1994

[Experiences in Kiel with the cochlear implant].

Since 1988 22 deaf patients were provided with a 22-channel cochlear implant at the Kiel University Hospital. No surgical or postoperative complications were seen in any of the patients. Side effects like facial stimulation and pain sensation during electrode activation do not reduce the utility. Tinnitus may initially be severe but usually subsides to preop levels after a few days. A tinnitus masking effect is pronounced during stimulation but hardly lasts long after switch off. Besides an individually arranged hearing training the accurate speech processor fitting to the needs of the patient remains the cornerstone of successful rehabilitation. Objective intraoperative measurements such as the electrically evoked brain stem potentials and the middle ear reflexes yield estimates of the threshold values relevant for initial processor programming. Further information needed for the following extensive fine adjustment is obtained by subjective evaluation of loudness growth during electrical stimulation with variable parameters, by loudness scaling of narrow band noises with different middle frequencies and intensities presented under free field conditions and by speech audiometric procedures. The latter include a monosyllabic rhyme test and a logatom test developed at this institution. More speech testing is applied to document the degree of auditive rehabilitation. The results of speech tracking and the Freiburg tests as well as a new sentence test in silence and noise are discussed. In the multisyllable Freiburg test all but two of the adults understand the complete presented material, in the open set monosyllable test an average of 55% correct is achieved. Speech discrimination-oriented ranking showed 95% of all postlingually deaf patients in the highest performance category.

Adolescent↗
PubMed1994

[Adenoid cystic carcinoma of the trachea. Case report and review of the literature on malignant tracheal tumors].

Primary tumours of the trachea are rare. In most cases one finds squamous cell carcinoma or adenoid cystic carcinoma. At the Department of Otolaryngology, Head and Neck Surgery at the Christian-Albrechts-Universität of Kiel only 19 malignant tumours of the trachea were diagnosed between 1949 and 1992 among a total of 6000 malignancies. In most cases the patients suffered from invasive thyroid carcinoma. Only five patients had a primary malignancy of the trachea (2 squamous cell carcinomas, 1 adenoid cystic carcinoma, 1 undifferentiated carcinoma, 1 solid, otherwise not classifiable carcinoma). Of these patients we report on the case of a 57-year old female patient who was diagnosed with an adenoid cystic carcinoma of the trachea and is free of disease eight years after open resection. Since initial symptoms are nonspecific emphasis is on the diagnostic process. The latest publications on therapeutic measures are reported.

Carcinoma, Adenoid Cystic↗
PubMed1994

Laser tissue effects with regard to otorhinolaryngology.

The multitude of medical laser systems with different wavelengths and technical appliances implicates the necessity of fundamental knowledge about the effects of laserbeams on living tissue. This is necessary to allow sufficient and therefore successful results for the patient. In this paper tissue effects of the mostly used lasers in otorhinolaryngology, CO2 laser and Nd:YAG laser will be presented. Influence on blood and lymphatic vessels, wound healing, and several CO2 laser parameters will be discussed.

Animals↗
PubMed1993

[Anthracycline derivatives as photosensitizing agents in photodynamic laser therapy: an in vitro study with squamous epithelial cancer cells of the mouth cavity].

Photodynamic laser therapy performed with hematoporphyrin derivatives has become increasingly important in the treatment of well-defined tumors in superficial sites. Limitations of this procedure result from the side effects of hematoporphyrin derivatives. In searching for possible alternatives to the usual photosensitizing agents, we studied the cytostatic drugs adriamycin and epirubicin. In order to evaluate the photodynamic effects of these agents we conducted in vitro studies on isolated cells from a squamous cell carcinoma of the oral cavity. The light source employed was an argon laser with wavelengths at 488/514 nm. Comparison of the cytostatic effect achieved by these anthracycline derivatives with and without laser light treatment showed a pronounced photodynamic effect. These results may herald new photodynamic therapeutic modalities.

Antibiotics, Antineoplastic↗
PubMed1993

[Giant mucocele of the paranasal sinuses with extension to the contralateral posterior cranial fossa and reversible retrocochlear deafness].

Report on a huge mucocele of the right maxillary sinus extending into the ethmoid and sphenoid sinuses, and protruding into the contralateral left posterior cranial fossa. The patient, a 45-year old male, had no history of paranasal sinus energy, nasal or paranasal symptoms. He went to his physician because of a slowly developing deafness in his left ear and because of episodes of loss of consciousness when blowing his nose. A reversible episode of vertigo and reversible paresis of the left abducent nerve 17 years previously, were later assumed to have been the first symptoms of endocranial extension of the mucocele. The diagnosis of a mucocele was made by MRI. MRI in T2 weighted spin-echo sequences is the best imaging technique for diagnosing a mucocele. The mucocele was treated primarily with endonasal surgery of the paranasal sinuses, using telescopes and an operating microscope. After opening the right maxillary sinus via the middle meatus liquid contents of the mucocele poured into the nasal cavity. The sack of the mucocele was removed partially. Three months later the patient was reoperated with a combined transfacial and endonasal approach, because of progression from partial hearing loss to total deafness. Postoperatively hearing improved nearly completely and compression of the pons and the posterior fossa had disappeared on MRI. It is concluded that in mucoceles no longer the extirpation of the sack, but endonasal marsupialization, using the operating microscope and telescopes, is the therapy of choice.

Audiometry, Evoked Response↗