Biomedical subjects

S Maune

Publications and source records attributed to S Maune.

54 records · Page 3Linked to original sources

PubMed1999

Technical problems with protein extraction of chemokines featuring RANTES.

Chemokines are known to be one of the sources for eosinophilic tissue infiltration in eosinophilic inflammation. Detection of beta-chemokines such as RANTES was possible in nasal tissue with or without eosinophilic infiltration. The concentration of chemokines which has been measured in the same tissue differs often in the literature. Aim of this study was to compare the different techniques of protein extraction and help to understand and interpret the investigation on RANTES secretion. Tissue of nasal polyps, inferior and middle turbinate was cut into halves and every half on its own pulverized using liquid nitrogen. The protein extraction was performed either with citric acid solution (pH 2.5) or phosphate buffered saline (PBS). The samples were then lyophilized. The concentration of RANTES was measured by a specific double sandwich ELISA. Using the citric acid technique the average concentration of RANTES in middle turbinates was 1.3 ng/mg, in inferior turbinates 1.6 ng/mg and in polyps 2.6 ng/mg tissue, using the PBS technique respectively 0.6 ng/mg, 0.5 ng/mg and 0.8 ng/mg tissue. Our data revealed a mismatch of 3.3:1 for polyps (citric acid: PBS), 3.2:1 for inferior and 2.2:1 for middle turbinates, respectively. Consequent comparison between the results of different techniques was not possible. Of special interest was also the fact that different techniques had different efficiencies of protein extraction in different tissues. Present statements on RANTES concentrations as a prognostic factor in nasal tissues need a technically careful standardization as far as this study shows.

Cells, Cultured↗

PubMed1998

RANTES production by cytokine-stimulated nasal fibroblasts: its inhibition by glucocorticoids.

Nasal fibroblasts play an important role in both nasal polyposis and nasal allergic diseases and they are known to release a number of proinflammatory cytokines, including GM-CSF, IL-8 and IL-6. The aim of this present work was to investigate whether cytokine-stimulated nasal fibroblasts release biologically active RANTES as well as to study the effect of corticosteroids on the ability of nasal fibroblasts to produce the cytokine. Measurements of RANTES by ELISA demonstrated that RANTES is constitutively secreted spontaneously (21+/-4 vs. 19+/-6 ng/ml, respectively p>0.05). Stimulation of these cells with either TNF-alpha, IL-1beta or IFN-gamma induce further release of RANTES in a dose-dependent manner with TNF-alpha being the most potent stimulus. RANTES mRNA expression in nasal fibroblasts correlated with the amount of protein released in the culture supernatant upon cytokine stimulation. Moreover, chemotaxis studies demonstrated that the nasal-derived RANTES was biologically active on eosinophils. Betamethasone and hydrocortisone were found to downregulate RANTES mRNA expression in TNF-alpha-stimulated fibroblasts. These observations suggest that RANTES released by nasal fibroblasts may regulate eosinophil recruitment in nasal disease while glucocorticoids may inhibit the influx of these cells by suppressing the production of RANTES.

Cells, Cultured↗

PubMed1997

[Endonasal coagulation of the sphenopalatine artery in severe posterior epistaxis].

BACKGROUND: Until a few years ago the surgical method of choice in treating uncontrollable nosebleeds from the posterior part of the nose was the transantral ligation of the maxillary artery as described by Seiffert (Caldwell-Luc approach). We introduce a surgical method to expose and coagulate the sphenopalatine artery through an endonasal approach. METHOD: The middle meatus of the nose is exposed with a self supporting nasal speculum under the microscope (focus: 300 mm) and the maxillary sinus is opened through the posterior fontanelle. The medial wall of the maxillary sinus is removed from this opening to its end. Three to five millimeters posterior to this site, the foramen sphenopalatinum is exposed. The osseous lateral margin of the foramen is resected with the drill and the fossa pterygopalatina is thereby opened from the nose. The sphenopalatine artery can be exposed all the way to its origin from the maxillary artery and then coagulated. RESULTS: Thirty-one patients with severe epistaxis have been operated by this method since October 1993. No postoperative complications were observed in any cases. Thirty patients have had no further nosebleed since than (average follow-up 22.9 months). In one case of a patient with renal insufficiency a nose bleed occurred 15 day postoperatively following dialysis. It was controlled by ligation of the anterior ethmoid artery and of the peripheral branches of the external carotid artery. CONCLUSION: The endonasal coagulation of the sphenopalatine artery is the safest method to control bleeding from the posterior parts of the nose. It can be performed by anyone who is familiar with endonasal surgery. The disadvantages of the transanteral ligation of the maxillary artery as described by Seiffert (Caldwell-Luc approach, ligation not sufficiently peripheral) are avoided. The only competing method would be the embolization of the sphenopalatine artery which can not be applied in every hospital and which has a higher complication and failure rate. Since October 1993 when this method was introduced no additional bellocq tamponade was required in epistaxis.

Adult↗

PubMed1997

[Complications of endonasal surgery of the paranasal sinuses. Incidence and strategies for prevention].

BACKGROUND: Complications of endonasal surgery continue to occur despite improved optical instruments and surgical techniques. The clinical course of our patients was analysed to develop strategies for a safer surgical technique. PATIENTS: At the Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, 1172 patients (2010 operated sides) were treated between 1986 and 1990 for chronic sinusitis by endonasal paranasal sinus surgery. RESULTS: The following intraoperative complications were observed: dural injury in 0.8% of the patients (0.5% of the operated sides), retrobulbar hematomas in 0.25% of the patients (0.15% of the operated sides), and hemorrhages requiring transfusion in 0.8% of the patients (0.5% of the operated sides). No injuries of the orbital muscles, the optic nerve, or the carotid artery were observed. Endonasal dacryocystorhinostomy was performed in 195 patients, 15% of whom had previously had paranasal sinus surgery. Endonasal frontal sinus surgery type II or III was performed in 40 patients between 1953 and 1993. A past surgical history-mostly extranasal frontal sinus surgery according to Ritter-Jansen and Lathrop-was found in 80% of these patients. Of 12 mucoceles of the frontal sinuses, 10 had developed after extranasal procedures whereas two developed spontaneously. CONCLUSION: This analysis shows that the occurrence of severe intraoperative complications can be minimized if certain guidelines are followed. When operating in an anterior-posterior direction, one should, to the extent possible, preserve the ethmoid bulla and the middle turbinate as anatomical landmarks as long as possible. The ethmoid bulla indicates the upper margin of the infundibulum even after removal of the uncinate process. There is no danger of injuring orbital structures if one identifies the maxillary ostium on a line going parallel to the floor of the main nasal cavity from the lowest point of the bulla in a posterior direction. The anterior wall of the bulla also forms the posterior wall of the frontal recess. As long as it is preserved it protects the base of the skull when identifying the frontal ostium. The endonasal enlargement of the frontal sinus ostium as a frontal sinus drainge type II or III is safe if the spina nasalis frontalis and the base of the frontal sinus are removed with a drill in an anterior direction. When opening the ethmoid sinus in an anteroposterior direction, an additional imaginary line through the ethmoid bulla running parallel to the floor of the nasal cavity and therefore also to the base of the skull should be observed and not crossed cranially. The medial blade of the middle turbinate represents an important guide to protect the rima olfactoria. It must therefore be preserved. Exposure of the sphenoid sinus should always be performed transnasally near to the septum and below the sphenoid ostium but never through the ethmoid to prevent damage of the optic nerve or the carotid artery. Observation of these guidelines and anatomical structures will prevent mistakes and wrong approaches in the context of endonasal surgery.

Chronic Disease↗

PubMed1997

[Toxic inner ear damage in topical treatment of psoriasis with salicylates].

BACKGROUND: Whereas cochlear impairment after intravenous ingestions of salicylates is well known, reports of cochlear symptoms after topical application are quite rare. The extent of the ototoxic salicylate impact is increased by diabetes, renal insufficiency, and alcoholism. PATIENT: This study presents a case report of a female patient who suffered a repeated, symmetric, pancochlear, reversible inner ear impairment after two treatments with salicylate containing ointment for psoriasis. The correlation of the salicylate therapy with the observed inner ear lesions is obvious due to the close interval between these incidences and to the audiologic criteria typical for salicylate intoxication. CONCLUSION: Audiologic controls should be carried out during extended local application of salicylate containing ointment.

Adult↗

PubMed1997

Indication, incidence and management of blood transfusion during sinus surgery: a review over 12 years.

The number of reports about blood transfusion-related HIV and hepatitis virus infections is increasing, presently. Thus, it should seriously be considered to inform the patient of any anticipated blood loss necessitating a transfusion of blood products. This is especially necessary for surgical procedures with only a low risk for high blood loss, such as endonasal surgery as a common otorhinolaryngological procedure. However, reports about the incidence of blood transfusion during this kind of surgery are very rare. The medical histories of 6,296 patients who underwent sinus surgery between 1982-1993 in the Department of Otorhinolaryngology at the University of Kiel were analyzed. Twenty-nine of these patients received a transfusion. Risk factors for required blood, the necessity of pre-operative information and the recommendation policy for pre-operative donation of autologous blood are discussed. The intra-operative blood losses of 120 patients who did not require a transfusion and who underwent sinus surgery in 1986 and 1989, were analyzed. The transfusion rate was 0.46% on average during the 12-year period. The incidence of blood transfusion and the amount of intra-operative blood loss decreased after combination of endonasal surgery with controlled intra-operative hypotension (0.07%; p < 0.01). Risk factors for the necessity of a transfusion in these cases were extensive polyposis and purulent exacerbation of the disease. There are risks for a blood transfusion in endonasal surgery. Every transfusion carries a certain risk for the infection with HIV or hepatitis, therefore every patient should be informed about the possibility of a blood transfusion prior to the operation. Endonasal microscopic sinus surgery performed by well-trained surgeons, combined with controlled intra-operative hypotension lowered the risk for a transfusion significantly (p < 0.01).

Adolescent↗

PubMed1997

Fibroblasts obtained from human nasal, laryngeal and tracheal mucosa produce the chemokine RANTES.

RANTES is a chemokine that was already found in tissues obtained from nasal polyps of patients suffering from chronic polypous sinusitis and in lung biopsies of patients suffering from bronchial asthma. Nasal fibroblasts could be shown to be a cellular origin of RANTES. The aim of this study was to investigate whether human nasal, laryngeal and tracheal mucosa fibroblasts are differentiated in production of RANTES. Fibroblasts obtained from healthy human nasal, laryngeal and tracheal mucosa, were cultured. Secretion of RANTES-protein in supernatants was investigated after stimulation with 50 ng/ml tumor necrosis factor-alpha (TNF-alpha), interleukin-1-beta (IL-1-beta), lipopolysaccharide (LPS), phorbolmyrisate acetate (PMA), interferon-gamma (IFN-gamma) and serum-free medium (SFM) for 24 hours. Cultivated nasal, laryngeal and tracheal fibroblasts secreted RANTES-protein upon TNF-alpha, IL-1-beta and IFN-gamma stimulation. The amounts of RANTES-protein production ranged from 10 ng/ml (PMA) to 198 ng/ml (TNF-alpha). Secretion of significant amounts of RANTES-protein were detected in the supernatants from either nasal, laryngeal or tracheal fibroblasts. There was no significant difference between the differential fibroblasts. We conclude that nasal, laryngeal and tracheal fibroblasts could be a cellular source of RANTES in nasal and bronchial mucosa or in secrets of patients suffering from diseases where eosinophilic tissue infiltration represents a characteristic histopathological feature. Results suggest that additional local factors are needed to develop asthma bronchiale and chronic polypous sinusitis.

Chemokine CCL5↗

PubMed1997

Alpha 1-receptors at pre-capillary resistance vessels of the human nasal mucosa.

The aim of the present study was to further characterise the alpha-adrenoceptors in pre-capillary arteries of the human nasal mucosa. Mucosa was obtained from patients undergoing endonasal surgery. From the isolated conchae small arteries (diameter: 90-220 microns) were dissected, avoiding any direct traumatisation. The arteries were mounted to a Mulvany-Halpern wire myograph allowing isometric registration of the vessel constriction. Receptor subtypes were characterised using the agonists noradrenaline, phenylephrine and oxymetazoline, and the antagonists prazosine and yohimbine. The EC50 values of the three agonists were in the micromolar range, whereas the Emax values differed. When maximal responses to the agonists were expressed as a percentage of a potassium-induced constriction, values for noradrenaline, phenylephrine and oxymetazoline amounted to 110%, 78% and 21%, respectively. The agonist effects were almost completely blocked by the alpha 1-receptor antagonist prazosine, whereas yohimbine, the alpha 2-receptor antagonist, did not affect the agonist responses. From these results it is concluded that the adrenoceptors in pre-capillary arteries of the mucosa in human central concha are of the alpha-type. Since the decongestive effect of alpha 2-receptor agonists is beyond any doubt, this subtype of the adrenoceptor must be present on the venous capacitance vessels.

Adrenergic alpha-1 Receptor Antagonists↗

PubMed1997

Increased eotaxin-mRNA expression in non-atopic and atopic nasal polyps: comparison to RANTES and MCP-3 expression.

Eosinophilic tissue infiltration of nasal mucosa typical for allergic rhinitis and chronic polypous sinusitis may be due to chemotactic activity of chemokines specific for eosinophils. The CC-chemokines eotaxin, RANTES and MCP-3 have been postulated to be involved in the recruitment of eosinophils to certain inflamed tissues. To explore their possible role in chronic polypous sinusitis we examined eotaxin-, RANTES- and MCP-3-gene expression in human nasal polyps and normal human nasal mucosa of patients undergoing endonasal surgery for treatment of chronic polypous sinusitis. Using gene-specific primers in semi-quantitative reverse-transcriptase polymerase-chain-reaction experiments we found elevated expression of eotaxin- and RANTES-mRNA but no MCP-3-mRNA in non-atopic and atopic nasal polyps when compared to normal nasal mucosa.

Adult↗

PubMed1996

[Effect of postoperative endonasal mucous membrane care on nasal bacterial flora: prospective study of 2 irrigation methods with NaCl solution after paranasal sinus surgery].

BACKGROUND: Endonasal irrigation with saline solution is a widely used constituent of mucosal care after sinus surgery. This procedure could explain a repeatedly observed phenomenon: contamination of the endonasal mucosa by facultative skin pathogens from the palm during paranasal sinus irrigation. METHOD: For this reason the effect of nasal rinses with saline solution on the endonasal bacterial flora was investigated (use of so-called nasal douche [Siemens & Co., Bad Ems] compared to rinsing by hand). In 36 patients (23 m., 13 f., 36 +/- 19.5 years of age) with chronic sinusitis, a total of 288 swabs was collected before, during, and after surgery. The collected specimens were transferred to a Port-A-Cul transport medium and processed within four hours. RESULTS: Two hundred sixty-six cultures of 325 bacterial strains were aerobic (82%), while 59 were anaerobic (18%). Staphylococcus aureus (33%) and representatives of the Enterobacteriaceae family (31%) were the most common enriched germs. The number of times that enterobacteriaceae could be isolated was significantly (p < 0.05) lower (13%) when a nasal douche was used than when irrigation was done using the palm (38%). An irrigation technique-related effect was found on neither the spectrum of the pathagonic organisms nor the wound healing process. CONCLUSION: The frequent isolation of enterobacteria in nasal swabs of individuals rinsing by hand constitutes the difference between irrigation by nasal douche and by hand in the postoperative care of the endonasal mucosa. These pathogens can sustain the paranasal sinus system.

Adult↗

PubMed1996

Fibroblasts but not epithelial cells obtained from human nasal mucosa produce the chemokine RANTES.

RANTES is a chemokine that was already found in tissues obtained from nasal polyps of patients suffering from chronic polypous sinusitis. Its cellular origin is as yet unknown. The aim of this study was to investigate whether human nasal mucosa fibroblasts and epithelial cells are capable to produce RANTES. Fibroblasts and epithelial cells, obtained from healthy human nasal mucosa, were cultured. Expression of RANTES-mRNA and secretion of RANTES-protein in supernatants was investigated after stimulation with 50 ng/ml Tumour Necrosis Factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), interferon-g (IFN-gamma), lipopolysaccharide (LPS), phorbolymyristate acetate (PMA) and serum-free medium (SFM) for 24 h. Cultivated nasal fibroblasts either expressed RANTES-mRNA or secreted RANTES protein upon TNF-alpha, IL-1 beta and IFN-gamma stimulation. The amounts of RANTES-protein production ranged from 23 ng/ml (PMA) to 198 ng/ml (TNF-alpha). Nasal epithelial cells expressed RANTES-mRNA only after stimulation with PMA. Secretion of significant amounts of RANTES protein were not detected in the supernatants from nasal epithelial cells. We conclude that nasal fibroblasts but not epithelial cells could be a cellular source of RANTES in nasal mucosa or in secretions of patients suffering from diseases, where eosinophilic tissue infiltration represents a characteristic histopathological feature.

Cells, Cultured↗

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

[Genetic disposition to chronic polypoid sinusitis and alpha 1-proteinase inhibitor deficiency types].

Chronic polypoid sinusitis is often accompanied with bronchitis, asthma and various allergies. All of these disorders have immunologic defects in common. The present study was devised to measure the genetically determined parameter of alpha-1-protease inhibitor by isoelectric focusing. Genetic polymorphism of alpha-1-antitrypsin is the source for biochemically less active types of the protease inhibitor. In this investigation the alpha-1-protease inhibitor type of 86 patients from Niedersaxony and 95 patients from Schleswig-Holstein was determined. All patients required sinus surgery as treatment for chronic polypoid sinusitis. The alpha-1-protease inhibitor deficiency types PI-MS and PI-MZ were found five times more frequently in patients from Niedersachsony and three times more often in patients from Schleswig-Holstein than in a control (normal) group of 127 subjects (p < 0.01). These findings were comparable to data in other publications. Results clearly showed a connection between alpha-1-protease inhibitor deficiency types and chronic polypoid sinusitis. These findings indicate that a genetic predisposition to chronic polypoid sinusitis is somehow correlated with the gene locus for alpha-1-protease inhibitor.

Adolescent↗

PubMed1981

Hearing loss of Down syndrome adults.

Audiological hearing-test data were obtained for 51 Down syndrome adults. Depending upon hearing-loss criteria, from 51 to 74 percent of the subjects had some degree of hearing impairment. Correlation coefficients between these hearing-acuity measurements and receptive hearing vocabulary scores suggest a moderate relationship. These data indicate that Down syndrome adults are prone to a wide variety of hearing difficulties that may reflect a variety of ear pathologies. These data and other studies have shown that both Down syndrome adults and children need frequent hearing screening and, when indicated, otological and/or audiological management. When otological treatment will be of long duration, aural rehabilitation, including prescription amplification, may be indicated as an adjunctive therapeutic procedure.

Adolescent↗

PubMedDate not supplied

Cyfra 21-1: a serological help for detection of distant metastases in head and neck cancer.

Local and neck recurrences of squamous cell carcinoma of the head and neck (SCCHN) can mostly be detected early when the patient has regular follow-ups. Distant metastases though usually remain undiscovered until they produce clinical symptoms. Since Cyfra 21-1 correlates with the tumor size and stage in SCCHN, we looked for possible connections between Cyfra 21-1 increases and the development of distant metastases. The sera of 830 patients with SCCHN were tested for Cyfra 21-1. The levels were compared with the clinical run of the patients. When Cyfra 21-1 levels rose above the threshold of 3.3 ng/ml (71 out of 830) staging procedures were performed. Tumor growth was found in 50 out of 71 patients with elevated Cyfra levels (70.4%). Cyfra serum levels in those cases either represented development of distant metastases (27 out of 71), or local and neck recurrences. The results of this study show that Cyfra 21-1 is a suitable and helpful serological parameter for the follow-up of patients with SCCHN. In the event of an elevation of Cyfra 21-1 above the threshold during follow-up, we would recommend the performance of a thoracal CT-scan and abdominal omi ultrasound as staging procedures.

Antigens, Neoplasm↗

PubMedDate not supplied

p53 analysis of laryngeal cancer in exon 4 to 9.

p53 gene mutations are a common genetic alteration in human cancer and codon 72/exon 4 polymorphism of the p53 gene has been implicated in cancer risk. Therefore in this study the p53 gene status of 32 shock-frozen tumor specimens from larynx carcinomas was analyzed by PCR and sequencing of exon 4 through 9. Four mutations (12.5%) in exon 5, 7, 8 and 9 were detected in the carcinoma specimen. Analysis of codon 72 revealed in eight cases a homozygosity for proline (CCC) and in 24 cases heterozygosity or homozygosity for arginine (CGC). The group with the proline/proline genotype had a median age 10.3 years lower than the remaining patients and included the only two non-smokers. Firstly, these results confirm the p53 mutational status of laryngeal cancer without any clinical correlation and secondly may suggest an oncogenic potential for the proline/proline genotype of codon 72 for laryngeal cancer as has already been assumed for lung cancer.

Adult↗

PubMedDate not supplied

A comparative study of chemokine rantes detection using ELISA and Western blot.

Chemokines in biological sample are frequently found at very low level. Further, concentrations of chemokines which were measured in the same tissue detected with different methods often differ in literature. Therefore, RANTES concentrations were quantified by application of sandwich enzyme-linked immunosorbent assay (ELISA) and Western blot analyses. The sensitivity of ELISA was found to be much higher than that of Western blot. Additionally, the detection time differed considerably as well. For biological and biochemical characterization of chemokines it is essential to implement the optimal purification and detection techniques. With an understanding of the technical procedures and some pitfalls, chemokine detection can be applied more reliably.

Blotting, Western↗

PubMedDate not supplied

Overexpression of the human myosin-binding protein-C1 mRNA in laryngeal squamous cell carcinoma cells.

BACKGROUND: To compare gene expression patterns between laryngeal squamous cell carcinoma (SCC) cells and their normal phenotypes to identify genes showing differential expression. MATERIALS AND METHODS: Messenger RNA was isolated from both kinds of cells, reversely transcribed and subjected to differential display reverse transcription (DDRT)-PCR. Gene fragments showing difference in the expression were recovered, reamplified, cloned and sequenced, enabling homology search. Total RNA was isolated from laryngeal SCC cells and adjacent normal mucosa and subjected to Northern hybridization. RESULTS: A 159 bp gene fragment was detected, revealing 96% homology with the human myosin-binding protein-C1 (MYBPC-1) gene. Compared to the benign phenotypes the expression of MYBPC-1 was particularly increased in SCC cells, confirmed by Northern hybridization. CONCLUSION: The results presented in this work may help to extend the diagnostic panoply available for the evaluation of laryngeal tissue conspicuous for malignancy.

Base Sequence↗