PubMed Health⌕ Search

Biomedical subjects

K Götte

Publications and source records attributed to K Götte.

At least 19 recordsLinked to original sources
PubMed2005

[Current therapeutic options for recurrent respiratory papillomatosis].

The purpose of this review is to describe and to critically discuss recent advances in the management of recurrent respiratory papillomatosis (RRP). The goal of surgery in RRP remains the control of symptoms. A curative therapy cannot be expected. The microdebrider and the CO(2)-laser are currently the most widely used surgical options. Literature reports an increase in adjuvant medical therapies of 10-22%. The most common drugs in adjuvant therapy are interferon, cidofovir and indole-3-carbinole/diindolylmethane. The lack of controlled studies limits our ability to accurately assess the antiviral action of the adjuvant therapies. At the moment, therapeutic interventions remain focused on the surgical removal of papillomas when possible, and additional adjuvant therapy is available for the minority of patients for whom surgical management fails to adequately control their disease. Recent advances in immunologic research offer the hope of immune system modulation as potential future treatment modalities to better control this disease process.

Adult↗
PubMed2005

[Procedure in case of suspected mycobacterial infection of lymph nodes of the neck].

Procedure in Case of Suspected Mycobacterial Infection of Lymph Nodes of the Neck. Cervical lymphadenitis of unknown origin is frequently observed in ENT. Besides metastasis, lymphomas and non specific cervical lymphadenitis, tuberculosis or infection with atypical mycobacteria has to be considered. This article tries to present the state of the art procedure in diagnostics to differentiate tuberculosis and atypical mycobacterial infections from other pathologies of cervical lymph nodes.

Bacteriological Techniques↗
PubMed2005

[Procedure in case of suspected mycobacterial infection of lymph nodes of the neck. 2. Therapy].

In the treatment of tuberculosis the patients normally receive a two month daily treatment with Isoniazid, Rifampicin, Pyrazinamid and Ethambutol, followed by a daily treatment with Isoniazid and Rifampicin for four month. The atypical mycobacterial infections can be addressed as a local infection and are amendable to surgical therapy, eventually followed by a daily treatment with antibiotics for four to twelve weeks. In Germany it is obligatory to inform the local public health department about typical mycobacterial infections. Hygiene procedures following German law are discussed in this review.

Adult↗
PubMed2004

[Intensity modulated radiotherapy (IMRT) of head and neck tumors. Increased biological effectiveness in high-risk situations by "integrated boost" therapy].

Primary tumors of the paranasal sinuses are rare entities which, because of precarious localization and frequently diffuse propagation into neighbouring cavities and the skull base, pose a significant therapeutic problem. Even after complete surgical resection, local relapses are frequent. Postoperative radiotherapy is therefore usually indicated. Intensity modulated radiotherapy (IMRT) is a new technique that helps creating dose distributions that conform closely to the target volume while maximally sparing the organs at risk. This results in the possibility of applying escalated doses to the target while still keeping the incidence of side effects low. What is especially appealing is the possibility of shaping the dose distribution within the target in such a way that areas with a presumably high tumor cell load receive increased doses, a concept which is best described by the term "integrated boost". We present the case of a patient with a sinunasal carcinoma and describe the implications of the clinical implementation of this technique.

Biopsy↗
PubMed2004

Increased cancer risk in heavy drinkers with the alcohol dehydrogenase 1C*1 allele, possibly due to salivary acetaldehyde.

BACKGROUND: Chronic ethanol consumption is associated with an increased risk of upper aerodigestive tract cancer. As acetaldehyde seems to be a carcinogenic factor associated with chronic alcohol consumption, alcoholics with the alcohol dehydrogenase (ADH) 1C*1 allele seem to be particularly at risk as this allele encodes for a rapidly ethanol metabolising enzyme leading to increased acetaldehyde levels. Recent epidemiological studies resulted in contradictory results and therefore we have investigated ADH1C genotypes in heavy alcohol consumers only. METHODS: We analysed the ADH1C genotype in 107 heavy drinkers with upper aerodigestive tract cancer and in 103 age matched alcoholic controls without cancer who consumed similar amounts of alcohol. Genotyping of the ADH1C locus was performed using polymerase chain reaction based on restriction fragment length polymorphism methods on leucocyte DNA. In addition, ethanol was administered orally (0.3 g/kg body weight) to 21 healthy volunteers with the ADH1C*1,1, ADH1C*1,2, and ADH1C*2,2 genotypes, and 12 volunteers with various ADH genotypes consumed ethanol ad libitum (mean 211 (29) g). Subsequently, salivary acetaldehyde concentrations were measured by gas chromatography or high performance liquid chromatography. RESULTS: The allele frequency of the ADH1C*1 allele was found to be significantly increased in heavy drinkers with upper aerodigestive tract cancer compared with age matched alcoholic controls without cancer (61.7% v 49.0%; p = 0.011). The unadjusted and adjusted odds ratios for all cancer cases versus all alcoholic controls were 1.67 and 1.69, respectively. Healthy volunteers homozygous for the ADH1C*1 allele had higher salivary acetaldehyde concentrations following alcohol ingestion than volunteers heterozygous for ADH1C (p = 0.056) or homozygous for ADH1C*2 (p = 0.011). CONCLUSIONS: These data demonstrate that heavy drinkers homozygous for the ADH1C*1 allele have a predisposition to develop upper aerodigestive tract cancer, possibly due to elevated salivary acetaldehyde levels following alcohol consumption.

Acetaldehyde↗
PubMed2001

[Dyspnea caused by spontaneous hematoma of the oropharynx and larynx during marcumar therapy].

A patient with a history of tachycardiac atrial fibrillation and pulmonary embolism was admitted to the emergency unit with acute shortness of breath. The patient was on coumarin medication. Pulmonary embolism, heart failure, or pulmonary edema could be ruled out. Laryngoscopy revealed a huge hematoma of both valleculae extending to the lateral pharyngeal wall and the epiglottis. The epiglottic cartilage was displaced to the posterior pharyngeal wall. The INR was > 6. Prothrombin complex, vitamin K1, corticoids, and fresh frozen plasma were administered immediately. The patient was monitored--without tracheotomy--in the intensive care unit and received oxygen. In a patient with dyspnea, impaired ventilation has to be considered besides impaired perfusion or diffusion.

Aged↗
PubMed2001

[Follicular dendritic reticulum cell sarcoma in a cervical lymph node].

Follicular dendritic cells (FDC) constitute an essential component of B cell follicles, normally serving as antigen-presenting cells and as cells regulating the germinal center reaction. FDC sarcoma is a very rare tumor. We report the case of a 55-year-old male patient who showed persistent cervical lymph node swelling. On biopsy the tumor consisted of spindle cells with nuclear atypia. Immunophenotypic investigation of the tumor tissue revealed a FDC sarcoma of a cervical lymph node. The tumor cells were characterized immunohistochemically especially by the expression of CD21 and focal expression of CD68. In conclusion, FDC sarcoma has to be considered in cases of tumors of uncertain origin in cervical lymph nodes, tonsils, soft palate, or nasopharynx. For clinical practice, it is important to note that sarcomas in cervical lymph nodes are not necessarily metastases but can be primary tumors.

Biopsy↗
PubMed2001

The relationship between allelic imbalance on 17p, p53 mutation and p53 overexpression in head and neck cancer.

The huge majority of head and neck squamous cell carcinoma (HNSCC) show alterations of p53 either on the genetic level or on the protein level. Allelic imbalance (AI)/loss of heterozygosity (LOH) on 17p at the p53 locus is frequent in HNSCC. However, the complex relationship between these phenomena is poorly understood in HNSCC. We investigated one group of 39 HNSCC for: a) allelic imbalance on 17p using 4 microsatellite markers located throughout this chromosomal arm; b) mutations of p53 in exons 5-9; and c) overexpression of p53 using two antibodies located on opposite ends of the protein. AI/LOH was detected in 44% at the locus TP53, rising to 69% when regarding all 4 markers on 17p. Therefore, our data are in line with the assumption of additional tumour suppressor genes on 17p in HNSCC. A nuclear accumulation of p53 (51%) was independent from the antibody and the recognised epitope. At the first glance there was no correlation between overall p53 mutation (36%) and overexpression. However, it appeared that, with very few exceptions, only nonsense mutations did not lead to p53 overexpression, while missense mutations did. As overexpression of p53 was 15% more frequent than p53 mutations and only 35% of the tumours with p53 overexpression carried a p53 mutation, our data support the hypothesis of additional mechanisms of p53 overexpression. AI/LOH at the p53 locus in 83% of all tumours with a p53 mutation is in line with Knudson's theory of inactivation of tumour suppressor genes.

Allelic Imbalance↗
PubMed2000

Delayed anterior ischemic optic neuropathy after neck dissection.

There are only 2 published cases of anterior ischemic optic neuropathy (AION) occurring after neck dissection, to our knowledge. We report a case of bilateral AION following neck dissection, discuss the differential diagnoses, and compare the features of this case with those of previously described cases. There were none of the previously described risk factors for the development of AION after head and neck surgery (eg, hypotension, facial edema, or sudden massive hemorrhage) in this case, but there was prolonged diffuse postoperative bleeding. Also, the symptoms did not arise before the fifth postoperative day as they did in the other cases. Prolonged, mild postoperative bleeding is a risk factor for AION. Visual loss during the entire first postoperative week has to be regarded as a complication of surgery, requires the exclusion of several differential diagnoses, and must not be confounded with the patient's confusion or symptoms of withdrawal.

Adult↗
PubMed2000

Expression of basic fibroblast growth factor protein and its down-regulation by interferons in head and neck cancer.

BACKGROUND: Angiogenesis is crucial for tumor growth and metastasis. In several tumors, microvascular density has been shown to correlate with metastasis and aggressiveness. Basic fibroblast growth factor (bFGF) has potent angiogenic activity and has been identified in a wide variety of malignancies including head and neck squamous cell carcinomas (HNSCC). Material and Methods Frozen sections of 50 HNSCC were immunostained for von Willebrand factor and bFGF. Microvessels were counted by light microscopy; bFGF expression was studied at the light and electron microscopic level. Laryngeal cancer cell line HlaC79 was incubated with interferon (IFN) alpha and beta. bFGF quantification was performed by ELISA, and antiproliferative effects were determined by BrdU assay. RESULTS: The mean number of blood vessels (77.5 +/- 23.7) is significantly increased in HNSCC compared with controls (17.1 +/- 5.9). bFGF protein expression was detected in all HNSCC but not in control tissue. An correlation between bFGF expression and mean number of microvessels was found (p <.001). However, no correlation between bFGF expression and the main clinicopathologic features was shown. The long-term exposure (144 hr) of HNSCC cells to noncytostatic concentrations of IFN alpha and beta (>10 U/mL) down-regulated the protein production of bFGF. CONCLUSION: bFGF expression and angiogenesis are enhanced in HNSCC. The higher microvessel density in HNSCC with strong bFGF expression supports the importance of bFGF for tumor angiogenesis. IFN alpha and beta treatment leads to a down-regulation of bFGF expression independent of their antiproliferative effects, suggesting that IFN treatment might result in a reduction of angiogenesis in HNSCC.

Adult↗
PubMed2000

Current advances in the basic research and clinical management of juvenile-onset recurrent respiratory papillomatosis.

Juvenile-onset recurrent respiratory papillomatosis is a relatively uncommon disease that presents clinically with symptoms ranging from hoarseness to severe dyspnea. Human papilloma viruses type 6 and 11 are important in the etiology of the papillomata and are most probably transmitted from mother to child during childbirth. Although spontaneous remission is frequent, a rare fatal course because of pulmonary spread or malignant transformation has occurred. CO2 laser evaporation of papillomas and adjuvant drug therapy using lymphoblastoid alpha-interferon are the most common treatment modalities at present. However, several other treatment modalities have been tried with varying success. Recent advances in basic research and different therapeutic approaches are reviewed.

Chemotherapy, Adjuvant↗
PubMed2000

Serum levels of vascular endothelial growth factor in patients with head and neck cancer.

Angiogenesis is now considered to be crucial for tumor growth and metastasis. In several tumors, microvascular density has been shown to be correlated with metastasis and aggressiveness. Vascular endothelial growth factor (VEGF) is a secreted endothelial cell-specific mitogen, which is induced by hypoxia and is angiogenic in vivo. VEGF has been identified in a wide variety of malignancies including head and neck squamous cell carcinomas (HNSCC). We investigated the circulating level of VEGF in sera from patients with various head and neck squamous cell carcinomas (n = 71) as well as from healthy normal controls (n = 47). Serum VEGF concentrations were determined as serum immunoreactivity by using a quantitative sandwich enzyme immunoassay technique. For statistical analysis, the Wilcoxon 2-sample test and Kruskal-Wallis test were performed. The majority of the patients with HNSCC were found to have high concentrations of serum VEGE The levels of VEGF in the sera of patients with cancer ranged from below the detection limit to 937.1 pg/ml (mean, 144.5 pg/ml). In contrast, the VEGF serum levels in 47 healthy individuals ranged from below the detection limit to 168.1 pg/ml (mean, 32.7 pg/ml), VEGF serum concentration being significantly higher in HNSCC patients (P = < 0.001). These findings indicate that a positive angiogenesis regulator such as VEGF might function as an endocrine growth factor, particularly for solid HNSCC tumors and may be a useful marker for clinical monitoring.

Adult↗
PubMed2000

Salivary gland carcinosarcoma: immunohistochemical, molecular genetic and electron microscopic findings.

Salivary gland carcinosarcoma, or true malignant mixed tumor, is a very rare and extremely aggressive neoplasm. The clonality and clonal origin of this tumor are discussed controversially. We report a carcinosarcoma of the left parotid gland in a patient who subsequently died of cutaneous, lymphatic and pulmonary metastases. Immunohistochemical staining, electron micrograph analysis, loss of heterozygosity (LOH) analysis and sequence analysis were performed on this tumor with an adenocarcinomatous and a predominant spindle cell-like component. While smooth muscle actin was undetectable by immunohistochemistry, cytoplasmatic myoepithelial structures could be detected by electron microscopy. LOH analysis at 12 genomic locations detected complete deletion of one allele at 17p13.1, 17q21. 3, and 18q21.3 indicating allelic loss in both components of the tumor. Double strand sequencing of the remaining allele of the p53 tumor suppressor gene revealed a wild-type allele. Based on our results, we favor the hypothesis of monoclonal origin of this salivary gland carcinosarcoma with a common stem cell that could be the myoepithelial cell and an inactivated tumor suppressor gene on chromosome 17 other than p53.

Aged↗
PubMed2000

[Coexpression of VEGF and bFGF is associated with increased vascular density in head and neck carcinomas].

BACKGROUND: Angiogenesis is crucial for tumor growth and metastasis. In several tumors, microvascular density has been shown to correlate with metastasis and aggressiveness. Vascular endothelial growth factor (VEGF) and basic Fibroblast Growth Factor (bFGF) are known to have potent angiogenic activity. Their expression has been identified in a wide variety of malignancies including head and neck squamous cell carcinoma (HNSCC). Aim of our study was to investigate the role of co-expression of VEGF and bFGF for angiogenesis in HNSCC. MATERIAL AND METHODS: Cryostat sections of 51 primary HNSCC were immunostained for VEGF and bFGF using a standard streptavidin-biotin complex procedure. To evaluate angiogenesis, endothelial cells were stained immunohistochemically using anti-vWF polyclonal antibody. Microvessels were quantified by counting vessels in a x200 field in the most vascular area of the tumor. RESULTS: 25/51 (49%) of the investigated carcinomas showed co-expression of both factors (VEGF+/bFGF+), while 6/51 (11.7%) carcinomas only expressed VEGF and 13/51 (25.5%) carcinomas expressed bFGF. 7/51 (13.7%) tumors showed no expression of these factors (VEGF-/bFGF-). Carcinomas with a co-expression of VEGF and bFGF showed a significantly increased mean microvessel density (88.3 +/- 24.4) compared to tumors expressing only VEGF (77 +/- 16.8) or bFGF (71.1 +/- 15.8) (p = 0.022) or tumors with no expression of both factors (51.1 +/- 13.4) (p < 0.001). The association of VEGF and bFGF expression level was not significant (p = 0.178). CONCLUSIONS: The positive correlation of the co-expression of angiogenic VEGF and bFGF with increased microvessel density underlines the importance of both factors for tumor angiogenesis in HNSCC. VEGF and bFGF might act cooperatively in the process of neovascularization in human head and neck cancer.

Adult↗
PubMed2000

Vascular endothelial growth factor expression correlates with p53 mutation and angiogenesis in squamous cell carcinoma of the head and neck.

Vascular endothelial growth factor (VEGF) has potent angiogenic activity and has been identified in a wide variety of malignancies, including head and neck squamous cell carcinoma (HNSCC). The tumour-suppressor gene p53 has been thought to regulate VEGF. Cryostat sections of 33 head and neck squamous cell carcinomas (HNSCC) were immunostained for VEGF using a standard streptavidin-biotin complex procedure. To evaluate angiogenesis, microvascular density was counted by staining endothelial cells immunohistochemically using anti-vWF monoclonal antibody. The p53 gene status was analysed using a PCR-SSCP analysis and direct sequencing. VEGF positive staining was detected in 18 (55%) out of 33 tumours. VEGF immunoreactivity did not correlate with the main clinicopathological characteristics of the patients (localization, T-stage, N-status, histological grading). Statistical analysis gave a clear correlation between the tumour vascularity and the VEGF protein expression (p = 0.0036). VEGF negative tumours showed a lower mean number of microvessels per microscopic field (60.3 +/- 15.5) than VEGF positive tumours (79.6 +/- 22.9). P53 mutations were identified in 12 (36.4%) of 33 tumours. The association of p53 mutations and VEGF expression level was significant (0.027). The higher microvessel density in VEGF positive tumours supports the importance of VEGF for tumour angiogenesis in HNSCC. Our results support the hypothesis of a p53 regulation on the angiogenic process through a VEGF up-regulation.

Adult↗
PubMed2000

Argon plasma coagulation for inferior turbinate reduction.

Surgical reduction of the inferior turbinate remains a widely used therapy for nasal obstruction caused by hyperplastic turbinates. Current methods are costly and time-consuming, require nasal packing, and cause extended postoperative swelling. Argon plasma coagulation (APC) is a new, innovative technique in otorhinolaryngological surgery that is based on high-frequency electrical current. The current is transmitted through ionized argon gas (plasma) contact-free to the tissue surface and creates a coagulation and devitalization zone with limited penetration. Forty-five patients with nasal obstruction were treated under local anesthesia for reduction of the inferior turbinates with APC. Seventy-six percent of the patients reported an improvement of postoperative swelling within the first week. After 3 months, 86% reported having better nasal airflow than they had before the operation. Macroscopically, after 4 weeks the turbinate was covered by normal mucosa in 51% of the patients. Crust formation was minimal, and no bleeding occurred. Turbinate reduction with APC is an alternative technique with many advantages, and the results are comparable to those of standard techniques. Ninety-five percent of the patients were satisfied with the operation.

Argon↗