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Biomedical subjects

H Weidauer

Publications and source records attributed to H Weidauer.

At least 37 records · Page 2Linked to original sources

Oral leukoplakias show numerical chromosomal aberrations detected by fluorescence in situ hybridization.

To examine at which stage in the multistep process of head and neck tumorigenesis numerical chromosomal alterations can be detected by fluorescence in situ hybridization (FISH), biopsies and cell smear preparations of clinically healthy oral tissue, premalignant lesions (leukoplakias), and tumors were analyzed by FISH using chromosome-specific centromeric probes. Aberrations found in tumor biopsies and in tumor cell smears consisted of trisomy of chromosomes 1, 7, 10, and 17 and monosomy of chromosomes 1, 7, 9, 10, and 17. In five of eight dysplastic oral leukoplakia biopsies, aberrations were seen consisting of trisomy of chromosome 1, 7, and 17, and monosomy of chromosome 9. No aberrations were found in biopsies of hyperplastic lesions (n = 8), or in oral cell smears of persons at risk. Because numerical chromosomal aberrations seem to be highly specific for malignant cells, FISH may help to identify leukoplakias that have a high risk of malignant conversion.

Adolescent↗

[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↗

[Accelerated hyperfractionated simultaneous radiochemotherapy in advanced head-neck carcinomas in comparison: split course and concomitant boost concept].

PATIENTS: Between 1989 and 1992, 38 patients with advanced squamous cell carcinomas of the head and neck were treated by an accelerated hyperfractionated split-course radiochemotherapy (SCRC). This therapy was carried out at the ENT department and department of radiooncology of the University of Heidelberg. Within 51 days, 70.2 Gy were applied in three courses. In every course, simultaneous chemotherapy with cisplatin (60 mg/m2/week)/5 Fu (bolus: 350 mg/m2/d)/Leucovorin (bolus: 50 mg/m2 + 100 mg/m2/24 h) was carried out. Between 1992 and 1994, 50 patients suffering from advanced head and neck cancer (stage III, V) were also treated with an accelerated hyperfractionated concomitant-boost radiochemotherapy (CBRC) at the same departments. A total dose of 66 Gy, was applied within 33 days. The patients were also treated with simultaneous chemotherapy with carboplatin (70 mg/m2/24 h) in the first and fifth week. RESULTS: In about 50% of the patients treated with SCRC, the therapy was more than 10 days longer than the scheduled period. The lack of compliance due to toxicity was considered as one of the main reasons for this delay. After the first course of SCRC, eight of 38 patients showed mucositis of the upper aerodigestive tract (WHO grade > 3); after the second course, 11 of 38 patients; and after the third course, 15 of 38 patients. Fifty-two percent of the patients developed emesis, 10% leucopenia < 1 nl, 10% nephrotoxicity, 3% pancreatitis, 3% thrombosis, 3% gastritis, and 3% auditory threshold shifts of about more than 10 dB. In about 7.5% of the patients treated with CBRC, the therapy was more than 10 days longer than the scheduled period. The mucositis of the upper aerodigestive tract (50% of the patients showed WHO-grade > 3) was considered to be the main reason for this. In four patients a neutropenia < 1 nl was detected, in one patient anemia < 7 g/dl and n 33 patients thrombocytopenia < 100/nl. CONCLUSIONS: In conclusion, the concomitant boost radiochemotherapy showed a lower toxicity and higher acceptance than the split-course radiochemotherapy. This is documented in lower protocol delays and better results in the two-years survival time in case of concomitant boost radiotherapy.

Adult↗

[Effects of chronic alcohol drinking on mouth mucosa. A morphometric study].

BACKGROUND: Chronic alcohol consumption is a major risk factor for oral and pharyngeal cancer. Besides other mechanisms a toxic effect of ethanol and/or its metabolite acetaldehyde on the oral mucosa and a resulting increased cell regeneration seem to play an important role in tumor promotion. METHODS: In the present study the effect of chronic ethanol consumption on the morphology of the oral mucosa of 20 male wistar rats that had been fed nutritionally adequate liquid diets containing 36% of total calories either as ethanol or isocaloric carbohydrates for six months was investigated. RESULTS: Morphometric analysis showed that in the ethanol rats, the size of the basal cell nuclei of the oral mucosa from the floor of the mouth, the edge of the tongue, and the base of the tongue was significantly increased (p < 0.001). The size of the basal cell layer in these rats was increased, and the stratification of the cells was altered. Mean epithelial thickness of the mucosa from the floor of the mouth was significantly reduced in the ethanol rats (p < 0.01). CONCLUSIONS: In conclusion, our results indicate that chronic ethanol consumption causes oral mucosa atrophy associated with hyperregeneration, which may result in an enhanced susceptibility of the mucosal epithelium to chemical carcinogens.

Alcohol Drinking↗

[Distant metastasis and incidence of second carcinomas in patients with oropharyngeal and hypopharyngeal carcinomas].

Thirteen per cent of oropharyngeal carcinoma patients (n = 23/178) developed a secondary carcinoma, and 10% of hypopharyngeal carcinoma patients (n = 11/113). The latency time of occurrence of the second carcinoma was 37 months for the oropharyngeal tumors and 25 months for the hypopharyngeal tumors. The main location of the secondary cancers was the oral cavity and oropharynx. Early recognition of secondary cancers by routine follow-up examinations made surgical removal possible in most of the patients. The post-operative survival time for the oropharyngeal lesions was 59 months and was 34 months for the hypopharyngeal cancers. Distant metastases were found in 13% of the patients with oropharyngeal cancers and in 17% with hypopharyngeal cancer and were mainly located in the lungs. After diagnosis of distant metastases patients with oropharyngeal lesions died within 4.5 months and those with hypopharyngeal tumors died within 9 months.

Adult↗

[Alcohol drinking and tobacco smoking are the chief risk factors for ENT tumors. Increased incidence of mouth cavity, pharyngeal and laryngeal carcinomas].

Both chronic alcohol consumption and chronic use of nicotine must be considered major risk factors for carcinogenesis in the oral cavity, pharynx and larynx. In the case of both noxae, increasing consumption correlates with an increase in the cancer risk in the sense of a dose-effect relationship. Smokers of non-filtertip cigarettes have a higher cancer risk than those smoking filtertip cigarettes. The alcohol-associated risk of developing cancer depends decisively on the overall daily consumption, but not on the nature of the alcoholic beverage. With respect to carcinogenesis, alcohol and nicotine consumed together develop a synergistic action and have a multiplicative effect on the cancer risk.

Alcohol Drinking↗

[Rhinosinusitis in AIDS patients].

We examined microbic infections and topical immunity in 36 AIDS patients with rhinosinusitis (AIDS CDC stage IV b-d) who had an average serum CD4 count of 90/microliters. We also examined the presence of the HIV genome in nasal mucous. Microbiological examination revealed an increased number of fungal infections in addition to bacterial infections with multiresistant strains. There was no evidence of CD4-T cells or HIV reverse transcriptase. The size of study was too small to permit generalised conclusions about the infectious risk of nasal mucous.

AIDS-Related Opportunistic Infections↗

[Gas producing anaerobic infection of the neck].

In this article, we report on two cases of gas-forming necrotising fasciitis of the neck admitted to our university hospital. In both patients, large gas-forming abscesses were detected by CT scan. Microbiologic smears revealed a mixed flora of aerobic and anaerobic bacteria, predominantly anaerobic streptococci. Emergency surgery with debridement and drainage, appropriate antibiotic therapy, and intensive care were performed. One 58-year-old patient with no concommittent disease recovered well after fourteen days. The other 71-year-old patient with diabetes mellitus and renal insufficiency died despite adequate therapy as a result of metabolic disturbances.

Abscess↗

[3-dimensional imaging of temporal bone structures using spiral CT. Initial results in normal temporal bone anatomy].

3D reconstruction of the temporal bone using spiral CT techniques was performed in 51 patients with various otological diseases during routine clinical work evaluation. The 3D display was optimized by a reduced study time and improved detail accuracy by special algorithms. We were able to demonstrate comprehensively in a 3D mode the normal anatomy of the inner ear and adjacent middle ear structures, such as the modiolus of the cochlea, the semicircular canals, the cochlear and vestibular aqueduct and the ossicles. We suggest routine 3D delineation of the substructures of the temporal bone prior to otologic surgery to provide the surgeon with a 3D view of individual anatomy and specific otosurgical sites.

Cochlea↗

[Pressure-volume analysis of wound suction drainage containers and suction capacity of drainage tubes].

Four low-vacuum systems and eight high-vacuum systems were examined with special reference to the pressure-volume relations. The maximum filling volume for adequate transport of wound secretion was determined for each type. The use of a synthetic wound fluid instead of water resulted in a smaller aspiration volume. Enlargement of the tube diameter resulted in a reduced initial vacuum for the low-vacuum systems, whereas the high-vacuum systems were not affected. Normal drain tubes were compared with "Ulm drains" and silicon tubes for suction capacity. The suction maximum of normal tubes and silicon tubes was located at the proximal holes of the perforated tubes. The "Ulm drain," with perforation diameter increasing continuously to the distal end of the tube, was found to exert suction even at the more distal part of the tube. It is estimated that this tube allows locally more balanced vacuum in the wound.

Animals↗

Therapeutic efficacy and tolerability of brodimoprim in comparison with doxycycline in acute sinusitis in adults.

OBJECTIVE: To compare efficacy and tolerability of brodimoprim tablets with doxycycline tablets in adults with acute sinusitis. DESIGN: Open, randomized, controlled phase III study, with parallel groups. PATIENTS: Of the 70 enrolled patients, 56 adults of both sexes with a mean age of 33 years were evaluable. STUDY DRUGS: One brodimoprim 200mg tablet or one doxycycline 100mg tablet was administered once daily for 8 to 12 days (on the first treatment day all patients received the loading dose consisting of 2 tablets of the corresponding compound). CLINICAL OUTCOME: In the brodimoprim group 96.4% of the patients were judged cured/improved; in the doxycycline group 96.2%. BACTERIOLOGICAL OUTCOME: Eradication of the causative pathogen/s was achieved in 87.5% of the patients treated with brodimoprim and in 60% of the doxycycline group. SAFETY OUTCOME: Tolerability was judged as very good/good in 89.7% of the patients treated with brodimoprim and in all patients receiving doxycycline. Gastrointestinal skin, CNS and various other reactions were reported by 13 patients; 3 of them had to discontinue treatment. Discontinuation of therapy: 8 more patients withdrew from the study due to inactivity of the compound or reasons unrelated to the drugs. CONCLUSION: Brodimoprim was shown to be effective in the treatment of acute sinusitis in adults, its efficacy being equal to that of doxycycline. The assessments showed a positive clinical response to the medication in 96.4% of the patients treated with brodimoprim and 96.2% of the patients taking doxycycline. Both compounds were well tolerated and all side effects were of mild nature and reversible.

Acute Disease↗

Effect of chronic alcohol consumption on the morphology of the oral mucosa.

Chronic alcohol consumption is a major risk factor for oral and pharyngeal cancer. Besides other mechanisms a toxic effect of ethanol and/or its metabolite acetaldehyde on the oral mucosa and resulting increased cell regeneration seem to play an important role in tumor promotion. In the present study the effect of chronic ethanol consumption on the morphology of the oral mucosa of 40 male wistar rats that had been fed nutritionally adequate liquid diets containing 36% of total calories either as ethanol or isocaloric carbohydrates for 6 months was investigated. Morphometric analysis showed that in the ethanol rats the size of the basal cell nuclei of the oral mucosa from the floor of the mouth, the edge of the tongue and the base of the tongue were significantly enlarged (p < 0.001). The size of the basal cell layer in these rats was increased, and the stratification of the cells was altered. The percentage of cells in the S-phase of the cell cycle was significantly higher in the ethanol-fed rats (p < 0.01). Mean epithelial thickness of the mucosa from the floor of the mouth was significantly reduced in the ethanol rats (p < 0.01). In conclusion, the reported findings indicate, that chronic ethanol consumption causes oral mucosal atrophy associated with hyper-regeneration, which may result in an enhanced susceptibility of the mucosal epithelium toward chemical carcinogens.

Alcohol Drinking↗

Chronic alcohol consumption--the key risk factor for pharyngeal cancer.

A case-control study on oropharynx and hypopharynx cancer was carried out in the region of Heidelberg (in the southwest region of Germany). This report presents an analysis of the risk associated with alcohol and tobacco consumption based on 105 cases and 420 controls matched for age, sex, and area of residency.

Adult↗

[The use of autologous keratinocytes in ear surgery].

To date autologous keratinocyte grafts have been used successfully to treat second- or third-degree burn wounds. This method allows a thin epithelialization of surfaces to take place but has been rarely used in otologic surgery until now. This technique has two possible indications in surgery of the external ear canal and the middle ear. We have currently used this method to cover a wound bed after resection of external ear canal stenosis and to treat large mastoid cavities with chronic secretion. Various aspects of the method as well as initial results of clinical use are shown.

Adult↗

[Surgical voice rehabilitation after laryngectomy by a modification of the Asai procedure].

A new technique of primary neoglottic reconstruction for surgical restoration of voice following total laryngectomy is described in detail. The procedure is based on the principle of Asai's technique, but can be performed as a one-step procedure. Within the last 2 years, the technique has been used in 20 patients with T2-T4 tumors without subglottic extensions and without extensive infiltration of the hypopharyngeal mucosa. The mean period of observation was 14.2 +/- 5.5 months. In two patients the speech fistula had to be removed because of aspiration problems, while six patients required dilatations of the fistula because of stenosis. As a long-term result a satisfactory voice was achieved without aspiration problems in 17 of 20 patients.

Follow-Up Studies↗

Expression of the histone H3 gene in benign, semi-malignant and malignant lesions of the head and neck: a reliable proliferation marker.

To search for a reliable proliferation marker in epithelial head and neck lesions, we have analysed the expression of the histone H3 gene by in situ hybridisation and compared this with the immunoreactivity of the widely used monoclonal antibody Ki-67. In many lesions, the Ki-67 staining failed to delineate proliferation. In contrast, the H3 hybridisation signals were in accordance with the histopathology of the biopsies: in hyperplastic epithelia, significant H3 mRNA levels were only seen in areas with inflammation. Dysplastic cells showed distinctly elevated H3 expression. Benign and semi-malignant tumours, i.e. basal cell carcinomas, showed moderate H3 signals at the periphery. In squamous cell carcinomas, H3 expression was always high at the expanding zone of the tumour and was most extensive in undifferentiated carcinomas. Thus, the expression of the histone H3 gene closely reflected the dynamics of neoplastic growth within and around head and neck tumours.

Biomarkers, Tumor↗

Efficacy and safety of cefotiam hexetil in the treatment of ear, nose and throat infections.

In 60 patients suffering from acute ear, nose and throat infections the efficacy and safety of cefotiam hexetil (SCE-2174, CAS 61622-34-2) which is a pro-drug of cefotiam was studied. The clinical success rate (improvement/cure) achieved with a daily administration of 600 mg was 90%. In 63% of the cases being evaluable for bacteriological response an eradication of the causative pathogens at the end of the treatment period was found. The majority of the patients tolerated well the compound. Side effects which were possibly, likely or definitely related to the treatment were observed in 12 patients. In 7 of these patients the treatment had to be stopped due to side effects which is equivalent to an intolerance rate of 12%. The data obtained in the present study indicate that cefotiam hexetil is a potent drug for the treatment of acute and acute on top of chronic infections of the upper aerodigestive tract.

Adult↗