Stefan Nitsch | PubMed Health

PubMed2006

Borderline indications for ear reconstruction.

While the indication for an ear reconstruction with rib cartilage is clear in pediatric patients and patients without previous surgery, there are borderline cases in which neither a reconstruction nor a prosthesis seems to be first choice. Within the last 6 years, approximately 120 patients were treated with a reconstruction with rib cartilage and 20 with a prosthesis at our hospital. Patients without extensively scarred periauricular tissue clearly benefit by a reconstruction with cartilage. The classic indication for an ear prosthesis is status post-malignant tumor resection. In borderline cases presenting with heavy scars, the most favorable repair method has to be decided upon individually. Under these circumstances, one of the main criteria for a reconstruction with rib cartilage is a viable temporoparietal fascia flap. A consideration that is important to note is that an unfavorable ear reconstruction can be converted almost always into a prosthesis repair but very rarely vice versa.

Adolescent↗

PubMed2006

Role of cytokines in head and neck squamous cell carcinoma.

Head and neck squamous cell carcinoma is one of the most frequent cancers and standard treatment has only marginally improved the 5-year survival rate of patients with this disease in the last few decades. It is supposed that cytokine alterations in immune, inflammatory and angiogenetic regulatory routes within the head and neck squamous cell carcinoma microenvironment play a critical role in tumor aggressiveness, its response to chemo- and radiation therapies, as well as the development of immune escape mechanisms.

Carcinoma, Squamous Cell↗

PubMed2003

Sex-specific p38 MAP kinase activation following trauma-hemorrhage: involvement of testosterone and estradiol.

Although immune functions are markedly depressed in males and not in proestrous females following trauma-hemorrhage (T-H), the mechanisms responsible for the divergent responses remain unknown. Because sex steroids modulate the activation of p38, our aim was to determine whether differences in the activation of p38 by phosphorylation (p38-P) might contribute to the sex-dimorphic immune response following T-H. The effects of testosterone and estradiol on the activation of p38 were also examined. Intact male mice (C3H/HeN), castrated males treated with vehicle, 5alpha-dihydrotestosterone (DHT), or 17beta-estradiol, and proestrous females were subjected to trauma (i.e., midline laparotomy) and hemorrhagic shock (35 +/- 5 mmHg for 90 min and resuscitation) or sham operation. At 2 h thereafter, splenic (SMphi) and peritoneal macrophages (PMphi) were harvested and cultured (with 10 microg/ml LPS), and Western blot analysis was carried out for quantification of p38 and p38-P. Sex, testosterone and estradiol plasma levels, and T-H did not alter the constitutive expression of p38 in SMphi and PMphi. In contrast, the activated form of p38 (p38-P) was markedly increased in SMphi and PMphi from female shams compared with male shams. Moreover, the phosphorylation of p38-P increased in males after T-H, whereas it decreased in females under those conditions. Castration before T-H prevented the increase in p38-P in males. Castrated animals treated with DHT displayed increased p38-P following T-H, whereas 17beta-estradiol had no effect on p38-P in castrated mice. Thus 1) sex influences the activation of p38 MAP kinase, 2) DHT is responsible for the increased activation of p38 in male mice, and 3) this sex-specific activation of p38 might be responsible for the sexually dimorphic immune response following T-H.

Animals↗