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Biomedical subjects

P Birner

Publications and source records attributed to P Birner.

46 records · Page 3Linked to original sources
PubMed1999

[Torticollis spasmodicus, blepharospasm and hemifacial spasm. Subjective evaluation of therapy by patients].

Injections with botulinum toxin type A (BTX) are considered the first-line treatment for spasmodic torticollis (ST), blepharospasm (BL) and hemifacial spasm (HFS). Because BTX brings only temporary and partial relief, patients frequently try other additional therapies to minimize their symptoms. The subjective rating of all therapies ever tried by patients with ST, BL and HFS was evaluated by using a simple questionnaire. Two hundred questionnaires were considered (112 TS, 54 BL, 34 HFS). BTX was rated subjectively the best therapy in all three diagnostic groups (median: 2 = good effect). Despite Citalopram and physiotherapy (median: 3 = average effect), all other therapies were rated with a median of > or = 4 (= minimal effect). Patients with ST tried 7.7, patients with BL 2.4 and patients with HFS 2.6 different types of therapy. In conclusion, BTX is the most effective treatment for patients with ST, BL and HFS, as rated subjectively. Further evaluation of therapies additional to BTX injections is recommended.

Blepharospasm↗
PubMed1999

A randomized, double-blind, placebo-controlled trial of botulinum A toxin for severe axillary hyperhidrosis.

Excessive axillary hyperhidrosis is a socially embarrassing condition which severely reduces quality of life and may result in psychological disturbance. Available treatment strategies do not resolve the problem in all cases. Intracutaneous injections of botulinum A toxin have been shown to be effective in patients with local sweating disorders. We performed a randomized, double-blind, within-group comparison in 13 individuals (nine women and four men) with severe axillary hyperhidrosis resistant to conventional treatment, to study the effect of intracutaneous injections of botulinum toxin on sweating. A total dose of 200 mouse units of botulinum A toxin (Dysport(R)) was injected into six different sites in one axilla, whereas the other was injected with sterile saline. Objective quantification of sweat production was performed using digitized ninhydrin-stained sheets. Three weeks after treatment, the mean difference in ninhydrin staining between botulinum-treated and placebo-treated axillae was -34.5% (P < 0.001), after 8 weeks -36.9% (P < 0.001) and after 13 weeks -28.4% (P < 0.001). Subjective rating of sweat production was evaluated on a visual analogue scale (0, no sweating, to 100, most severe sweating). Three weeks after treatment the difference between the botulinum-treated and placebo-treated axillae was -56.5% (P < 0.001), after 8 weeks -67.4% (P < 0.001) and after 13 weeks -62.5% (P < 0.001). No serious side-effects were observed.

Adult↗
PubMed1999

Dimensions of quality of life and self-monitoring therapy with oral anticoagulants--still research or everyday practice?

In correlation with increased life expectancy of patients, quality of life (QOL) has become a factor of increasing interest by the patient himself and also of importance in health-care planning and recruitment of financial resources. In this context, self-monitoring of long-term anticoagulant treatment might be a strategy that could mean a step forward in health-related as well as general life satisfaction for patients participating in self-monitoring programs. Also, the new strategy of increased home-control of anticoagulant treatment illustrates the complexity of multiple factors that can lead to changes in the subjective feeling and objective aspects of QOL. Our intention in a pilot study was to probe the feasibility of QOL research and relevant factors of influence by retrospectively evaluating data from two groups of outpatients seen in a large treatment center. The high frequency (n = 8 in sample 2) of disturbed sleep as a simple screening indicator stresses the probable importance of undetected depression, which might require treatment and could confound research as to QOL. Instruments to measure QOL in oral anticoagulation self-monitoring should therefore be adapted to the heterogeneous structure of factors in the target population, and include psychological parameters, especially in regard to health-related locus of control and mood.

Administration, Oral↗
PubMedDate not supplied

Lymphatic microvessel density in epithelial ovarian cancer: its impact on prognosis.

BACKGROUND: The influence of lymphatic microvessel density (MVD) on survival in epithelial ovarian cancer is still unknown, owing to the fact that until recently no reliable immunohistologic markers for lymphatic endothelium were available. MATERIALS AND METHODS: By using a polyclonal antibody staining podoplanin, a novel marker for lymphatic endothelium, lymphatic MVD in tissue samples of 90 patients with epithelial ovarian cancer treated by radical surgery and chemotherapy was investigated. Survival analysis was performed using univariate and multivariate analysis. Furthermore, lymphatic MVD was compared to MVD assessed by CD34 immunostaining. RESULTS: Lymphatic MVD was significantly lower than CD34 MVD (p < 0.0001). There was no significant association between lymphatic MVD and various histological and clinical parameters. Lymphatic MVD had no influence on overall survival and disease free survival (p = 0.4627 and p = 0.4337, respectively; log-rank test). CONCLUSION: The formation of lymphatic vessels has no influence on the progression of epithelial ovarian cancer.

Age Factors↗
PubMedDate not supplied

The impact of expression of the metastasis suppressor protein KAI1 on prognosis in invasive squamous cell cervical cancer.

OBJECTIVES: Loss of KAI1 protein is a frequent event in various types of cancer and has been reported to be associated with increased rate of metastasis and shorter survival time. METHODS: Expression of KAI1 and p53 was immunohistochemically determined in 75 biopsy specimens from patients with primary irradiated, invasive squamous cell cervical cancer and 30 cases with CIN I-III. RESULTS: In invasive cancer, 22 cases showed strong expression, 42 cases down-regulation, and 11 cases no expression of KAI1. All specimens with CIN I showed strong KAI1 expression, while in CIN II and III down-regulation was observed in 45% of cases. There was no significant correlation of KAI1 expression with clinical and histopathological parameters. No influence of KAI1 expression on prognosis was observed. CONCLUSIONS: KAI1-down-regulation is a frequent event in cervical cancer occurring early in carcinogenesis. KAI1 expression did not influence the prognosis of patients with primary irradiated cervical cancer.

Antigens, CD↗
PubMedDate not supplied

Lymphatic microvessel density and lymphovascular invasion assessed by anti-podoplanin immunostaining in human breast cancer.

BACKGROUND: The development of an antibody against podoplanin has enabled us to selectively stain lymphatic vessels in breast cancer samples for the first time. MATERIALS AND METHODS: We investigated lymphatic vessels in 45 specimens of invasive breast cancer by immunostaining for podoplanin. Lymphatic microvessel density (LMVD) was correlated with various clinical and histopathological parameters. LMVD was also compared to blood microvessel density (BMVD), assessed by CD34 -immunostaining. RESULTS: LMVD as well as lymphovascular invasion (LVI) correlated significantly with the lymph node status (p=0.001/ p=0.035). Logistic regression revealed that LVI was the more important factor for development of lymph node metastasis (p=0.043). There was no significant association between various clinical and histopathological parameters and LMVD or LVI, nor was a correlation found between LMVD and BMVD (p=0.121). CONCLUSION: High LMVD and the presence of LVI are strongly associated with lymph node metastasis in breast cancer.

Breast Neoplasms↗
PubMedDate not supplied

Inflammatory stromal reaction correlates with lymphatic microvessel density in early-stage cervival cancer.

BACKGROUND: In early-stage cervical cancer, high lymphatic microvessel density (LMVD) indicates favorable prognosis. This unexpected finding was thought to be an effect of local immunological response, although no data supported this thesis. MATERIALS AND METHODS: LMVD and lymphovascular invasion (LVI) were assessed in 85 specimens of cervical cancer stage pT1b by immunostaining for podoplanin, a marker for lymphatic endothelia. Local immunological response, evident by inflammatory stromal reaction (ISR), was determined in H&E-stained slides and rated from grade 1 (absent or weak) to 3 (strong) RESULTS: A good correlation of LMVD and ISR was found (p=0.002). While a strong correlation between LMVD and the presence of LVI was found (p<0.001), no association between LMVD and pelvic lymph node involvement (p=0.732) was observed. ISR indicated favourable prognosis of patients (p=0.0247, log-rank test). CONCLUSION: Our findings suggest that ISR might play a role in the induction of lymphangiogenesis in early stage cervical cancer.

Female↗
PubMedDate not supplied

Algorithm for the standardized assessment of vascular patterns in glioblastoma specimens.

In a recent study, the existence of distinct vascular patterns with prognostic impact has been described in glioblastomas. The bizarre angiogenic subtype was associated with shorter postoperative survival times whereas the classic angiogenic subtype ("microvascular sprouting"; evenly distributed branching capillaries in major tumor parts resembling classic angiogenesis) was associated with a significantly more favorable outcome. Evaluation of angiogenic subtypes of glioblastomas may be relevant for anti-angiogenic therapy strategies. To this end, a method is needed for standardized evaluation of vascular patterns in glioblastomas. Here, we provide a simple algorithm for the standardized assessment of angiogenic patterns in anti-CD34-immunostained glioblastoma specimens, which can be used for research and in the routine diagnostic setting.

Algorithms↗