PubMed Health⌕ Search

Biomedical subjects

H Weidauer

Publications and source records attributed to H Weidauer.

At least 73 records · Page 4Linked to original sources

[Kaposi's sarcoma of the larynx].

Kaposi's sarcoma of the larynx is a rarely observed manifestation of AIDS. Possible concomitant symptoms are hoarseness up to aphonia, urge to cough or stridor. Expectoration of small parts of tissue of Kaposi's sarcoma may be an additional sign. Similar to Kaposi's sarcoma in the oral cavity Kaposi's sarcoma of the larynx is characterised by a purplish, spongy nodule. Its surface can be verrucous due to deposits of dry secretion. Local extirpation of Kaposi's sarcoma removes the laryngeal signs and symptoms.

Acquired Immunodeficiency Syndrome↗

Papillomavirus DNA in human tongue carcinomas.

Seven biopsies from different carcinomas of the tongue were analyzed for human papilloma virus (HPV) sequences by Southern blot analysis. After hybridization with various types of human papilloma viruses, 3 tumors were found to be positive. Whereas DNA from one tumor hybridized with HPV 2 DNA under conditions of high stringency, the 2 other positive biopsies contained HPV 16 DNA. All positive tumors revealed high copy numbers of the respective DNA. The cleavage pattern of the HPV-2-positive tumor differed from the established HPV 2 prototypes. Minor differences from the HPV 16 prototype were also noted in one of the HPV-16-positive tongue carcinomas.

Carcinoma, Squamous Cell↗

Different patterns of cytokeratin expression in the normal epithelia of the upper respiratory tract.

The distribution and type of cytokeratins present in the normal human epithelia of the nasopharynx, oropharynx, tongue, palatine tonsil, epiglottis, vocal cord, and laryngeal ventricle were studied using immunohistochemical techniques and by gel electrophoresis of cytoskeletal proteins microdissected from frozen tissues. Noncornifying stratified epithelia covering the oropharynx, tongue, surface of the palatine tonsil, pharyngeal surface of the epiglottis, and vocal cord were all found to contain cytokeratins nos. 4, 5, 6, 13, 14, and 15, together with minor amounts of cytokeratin no. 19, i.e., a pattern similar to that previously reported for esophageal epithelium. The immunohistochemical reaction with KA4, an antibody specific for cytokeratins nos. 14, 15, 16, and 19, revealed reactivity confined to the basal epithelial cells of the tongue, oropharynx, pharyngeal epiglottis, and two out of five samples of vocal cords. This same antibody reacted with the entire thickness of three out of the five true vocal cords which were shown by gel electrophoresis to also contain cytokeratins nos. 16 and 17. Gel electrophoresis revealed that the pseudostratified columnar epithelium covering the laryngeal ventricle was more complex, in that it contained cytokeratins nos. 5, 13, 14, 15, and 17, which are typical of stratified epithelia, as well as cytokeratins nos. 7, 8, 18, and 19, which are characteristic of simple epithelia. This pattern is similar to that found in bronchial epithelium. The laryngeal surface of the epiglottis exhibited cytokeratins nos. 4, 5, 7, 8, 13, 14, 15, 17, 18, and 19, i.e., a pattern combining features of both esophageal- and bronchial-type epithelia. The reaction of these epithelia containing columnar cells with antibody RGE-53, which is specific for cytokeratin no. 18, revealed a staining reaction confined to the superficial columnar cells, whereas KA1 stained only the basal cells of these epithelia. The results of our study make it possible to distinguish two types of noncornifying stratified squamous epithelium, namely the 'esophageal type' which covers the tongue, oropharynx, and pharyngeal surface of the epiglottis, and another type which overlies the vocal cords and the transitional zone between the pharyngeal and laryngeal surfaces of the epiglottis. Furthermore, there appear to be variants of pseudostratified columnar epithelium, i.e., the usual bronchial type lining the laryngeal ventricle, and a type with a thicker subcolumnar cell compartment that is found on the laryngeal surface of the epiglottis. The patterns of expression of cytokeratins in the respiratory tract are compared with those of other epithelia.

Antibodies, Monoclonal↗

[Neuroendocrine larynx cancer of the small cell (oat cell) type. Morphologic and immunohistochemical findings and their significance for therapy].

By combining immunohistochemical, biochemical, and light and electron microscopy techniques, the following original observations concerning the rare and highly malignant small cell ("oat cell") carcinoma of the larynx were made: The typical electron microscopic feature was the presence of neurosecretory granules in some cells. This indicates that this tumour was a carcinoma with endocrinal differentiation. The demonstration of cytokeratins as major cytoskeletal components, as well as the presence of desmosomes, confirmed the epithelial origin of the tumour cells. The detection of neuroendocrinal markers such as calcitonin and neuronspecific enolase (NSE) in some of the tumour cells, as well as the presence of neurosecretory granules allow us to classify this tumour as a neuroendocrinal carcinoma of the small-cell type. This is in accordance with the latest classification of neuroendocrine carcinomas of the lung. The rapid clinical evolution of the disease is typical for patients with anaplastic carcinomas. Laryngectomy followed by adjuvant chemotherapy and radiotherapy is indicated only in cases without metastases. The detection of regional metastases suggests haematogenous spread with distinct metastases, restricting treatment to chemotherapy and radiotherapy.

APUD Cells↗

[Kaposi sarcoma in acquired immune deficiency syndrome (AIDS). I: Clinical findings and laboratory diagnosis].

In addition to the classical type of Kaposi's sarcoma, a new, aggressive and prognostically ominous variant occurs since 1980: the AIDS-associated Kaposi's sarcoma. This aggressive variant is associated with viral infection by the lymphotropic retrovirus HTLV-III, identical to LAV. In the U.S.A. and in Europe, this virus is transmitted mainly by homosexual contact, whereas in Central Africa the characteristic mode of transmission is heterosexual promiscuity. The authors present for the benefit of the ENT-specialist, case-reports of an American/European and of an African AIDS-associated Kaposi's sarcoma of the palate illustrating the major symptoms of generalized lymphadenopathy, opportunistic infections, and the relevant immunological and serological features.

Acquired Immunodeficiency Syndrome↗

[Kaposi sarcoma in acquired immune deficiency syndrome (AIDS). II: Light and electron microscopic and immunohistochemical peculiarities including the cytoskeleton].

AIDS-related lymphoadenopathy is characterised by follicular hyperplasia with irregularities in the dendritic network, a loss of the follicular mantle zone and an enhanced influx of T-suppressor cells into the germinal centres. The histological features of AIDS-associated epidemic Kaposi's sarcoma are spindle-like tumour cells and a source vascularisation, which is of clinical relevance for the biopsy. Since immunohistochemical markers specific for blood vessel endothelium can not be detected within the tumour cells an origin from this cell type gets unlikely. An origin from lymphatic endothelium however can still be discussed.

Acquired Immunodeficiency Syndrome↗

[Diagnosis and therapy of median blow-out fractures].

Isolated medial blow-out fractures are rare. This report presents such a case in which blunt trauma to the orbit due to a ski accident was followed by herniation of the orbital fasciae and the nasal orbital tissue into the ethmoid and nasal cavity resulting in ptosis, enophthalmos, and total motility impairment in all directions. In particular, an incomplete abduction could be detected. To avoid recurrent infections, because of communication with the pneumatic cells of sinuses, a composite graft from the nasal septum was used for the reconstruction of the medial orbital wall.

Adolescent↗

[Helium-neon laser--a possibility for the topodiagnosis of tracheal stenoses].

Exact knowledge of the upper and lower border of a tracheostenosis is important for success or failure in a transverse resection of the trachea. Using an angular optical equipment of 90 degrees, the upper margin of the stenosis can be focussed endoscopically in case of localisation problems, and projected on the front side of the trachea by the helium-neon laser beam. Even in case of tracheal displacement caused by a tumour, or induration of the soft tissues of the neck due to x-rays, the helium-neon laser beam will be an important orientation aid.

Endoscopes↗

[Contact therapy in the pharynx and oral cavity areas: after-loading technic, irradiation planning and results].

The contact irradiation in the region of pharynx and mouth with an afterloading unit is presented. Twelve patients with recurrent carcinomas of the squamous cell epithelium have been treated. A stable and reproducible positioning of the source probes in the tumor region is made possible by special applicator prostheses which are adapted to the post-operative situation. The irradiation scheme is based on the transformation of the source co-ordinates from the stereoradiographic localization system into the co-ordinate system of the computed tomogram. At least three fixed metal points which are inserted in the applicator prostheses and visualized by stereoradiography as well as by computed tomography serve as mutual reference points for both co-ordinate systems. The source positioning in the tumor region is optimized by CT irradiation planning. Three cases are presented in order to describe the principles of the method. Preliminary results are discussed.

Brachytherapy↗

[Therapy of esophageal stenoses in recessive epidermolysis bullosa dystrophica].

Stenosis or complete occlusion of the oesophagus are potentially life-threatening complications of recessive dystrophic epidermolysis bullosa. Consequences are malnutrition, growth retardation, aspiration, or cachexia. Total replacement of the oesophagus by colon interposition has been recommended in such patients. We report on successful conservative management. We applied recently developed knowledge concerning the defective collagenase involved in this disorder and oesophageal dilatation. Phenytoin has been shown to reduce the excessive production of collagenase and thereby to diminish blistering of skin and mucous membranes and stricture formation of the oesophagus. Stepwise dilatation of oesophageal strictures instead of bouginage represents a less traumatic way to restore the oesophageal lumen. The lumen can be maintained by soft nasogastric feeding tubes which may be removed later on after successful dilatation. Oesophageal passage has been maintained for up to 4 years. The management of these severe complications of recessive dystrophic epidermolysis bullosa requires interdisciplinary efforts of dermatologists, internists and otorhinolaryngologists.

Child↗

[Differential diagnosis of tinnitus and vertigo. A review].

Tinnitus and vertigo, two common neurological complaints, often challenge the physician's ability with respect to possible etiology. Objective tinnitus can result from an abnormally patent eustachian tube, from tetanic contractions of the muscles of the soft palate, or from vascular abnormalities within the head or neck. Subjective tinnitus refers to lesions involving the external ear canal, tympanic membrane, ossicles, cochlea, auditory nerve, brainstem, and cortex. As many as 50% of patients with tinnitus do not exhibit associated hearing loss; in these patients, the cause of the tinnitus is rarely identified. An illusion of movement is specific for vestibular system disease--a peripheral or central location depending upon associated audiologic and neurologic symptoms, respectively. However, a presyncopal, light-headed sensation is most commonly associated with diffuse cerebral ischemia: in the young patient, this may be caused by a hyperventilation syndrome; in the aged individual, this can result from diffuse atherosclerotic cerebrovascular disease and decreased cardiac output. Postural and gait imbalance associated with acute vertigo indicates a unilateral peripheral vestibular or a central vestibular lesion; if vertigo is absent, either a cerebellar, proprioceptive, or bilateral peripheral vestibular lesion is likely. Transient oscillopsia suggests unilateral peripheral vestibular lesions. Permanent oscillopsia indicates a bilateral peripheral vestibular lesion or--in the absence of severe vertigo--brainstem or cerebellar damage.

Brain Diseases↗

Management of esophageal stenosis in recessive dystrophic epidermolysis bullosa.

Total replacement of the esophagus by colonic interposition has been recommended as the treatment of esophageal obstruction in recessive dystrophic epidermolysis bullosa. We report our experience in the conservative management of esophageal blisters, strictures, and complete occlusion in 5 patients (aged 2-61 yr). Our therapy consists of a combination of the following principles: (a) inhibition of collagenase formation by oral phenytoin to reduce epithelial detachment; (b) pureed or semiliquid food because minor trauma by hard food particles may induce blistering and result in scarring of the upper esophagus, and larger food particles may obstruct an esophageal stricture; (c) avoidance of tangential shearing forces induced by bougienage and endoscopy and instead use of inflatable dilatator balloons which produce vertical pressure that seems to be less harmful; and (d) long-term nasogastric tube feeding, which may relieve even tight strictures. Our observations suggest that successful long-term conservative management of esophageal stenoses in dystrophic epidermolysis bullosa is possible.

Adolescent↗

[Kearns-Sayre syndrome from the otorhinolaryngologic viewpoint].

External ophthalmoplegia, retinal pigmentary degeneration and heart block constitute the trias of Kearns-Sayre's syndrome. The aetiology of this disorder of oxidative metabolism is unknown. This syndrome must be more frequent than described. In the ENT field there is an extensive lack of differentiated data. Central neural and peripheral hearing disorders and vestibular disorders are in fact significant, as are also dysphagia, hoarseness and dysarthria in consequence of central and peripheral disorders in muscular function. The authors report on ENT findings in 4 patients with verified Kearns-Sayre's syndrome. Progression of central disorders enhances an unfavourable prognosis. Histochemical, biochemical and electron microscopic data are still lacking for the proper grading and assessment of clinical findings.

Adolescent↗

[The carcinoma of the ear - indication for antineoplastic chemotherapy (author's transl)].

The therapeutic results of squamous cell carcinoma of the external auditory meatus and the middle ear by operation and radiation are subject to an unfavourable prognosis: the 5 years' survival time represents 25% of the external auditory meatus and 15% of the middle-ear carcinoma cases. In comparison to the improved median survival time of carcinoma of the oral cavity and oropharynx by means of a combination of primary antineoplastic chemotherapy (Heidelberg Scheme), surgery and radiation, an improved median survival time should be expected even in keratinizing squamous cell carcinoma of the external auditory meatus and the middle ear. The stages of remission of a carcinoma of the external auditory meatus and the middle-ear carcinoma are demonstrated at different times of the antineoplastic treatment (Heidelberg Scheme). The field of indication is outlined. Primary antineoplastic chemotherapy extends the possibilities of intended curative therapy. As a palliative therapy it is an alternative to petrosectomy which has a high mortality in very advanced carcinoma of the middle ear.

Aged↗