Biomedical subjects

W Habermann

Publications and source records attributed to W Habermann.

At least 19 recordsLinked to original sources

PubMed2003

Effect of pantoprazole on the course of reflux-associated laryngitis: a placebo-controlled double-blind crossover study.

BACKGROUND: The optimal management of patients with reflux-associated laryngitis is unclear. We performed a placebo-controlled crossover trial in patients with proven reflux disease and associated laryngitis to determine the effect of pantoprazole and to gain information on the natural course of the disease. METHODS: Sixty-two consecutive non-smoking patients with hoarseness and proven laryngitis were examined. Scores with respect to the larynx and for subjective complaints were determined and 24-h pH-metry to assess acid reflux in the lower oesophagus and pharynx was performed. Patients with pathologic reflux were given the chance to enter a double-blinded randomized crossover trial with pantoprazole 40 mg b.i.d. and placebo for a duration of 3 months each, separated by a 2-week washout period. RESULTS: Twenty-four of 62 patients showed pathological reflux; 21 patients were included in the study and 14 concluded all parts of the study. Both pantoprazole and placebo resulted in a marked improvement in laryngitis scores (decrease of 8.0 +/- 1.4 versus 5.6 +/- 2.6; no significant difference between the 2 treatments) and symptoms after the first 3 months (decrease of oesophageal symptom score of 2.2 +/- 1.4 versus 5.4 +/- 2.8; decrease of laryngeal scores of 8.3 +/- 3.6 versus 10.3 +/- 3.9; also no significant difference between the 2 treatments). A second pH-metry 2 weeks thereafter proved the persistence of reflux in most of these patients. Switching to pantoprazole led to a further improvement of scores. In the group switched to placebo there was recurrence only in a minority of patients. CONCLUSIONS: The self-limited nature of reflux-associated laryngitis in non-smokers is largely underestimated. Laryngitis improves despite the persistence of reflux. Pantoprazole may be helpful especially in relieving acute symptoms, but the advantage of long-term treatment over placebo has been greatly overestimated.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed2003

Fungal biodiversity--as found in nasal mucus.

The biodiversity of fungi isolated from the nasal mucus of patients suffering from chronic rhinosinusitis and from healthy persons was monitored over 28 months. Mucus samples were obtained by flushing the noses of patients with saline or by endoscopic sinus surgery. Fungi from mucus were cultivated on agar plates. Identification was performed microscopically and by polymerase chain reaction with subsequent sequencing of the ribosomal internal transcribed spacer region. Altogether, 619 strains of fungi were cultivated from 233 subjects. Eighty-one species were identified, with a maximum of nine different species per person. The most prevalent isolates belonged to the genera Penicillium, Aspergillus, Cladosporium, Alternaria and Aureobasidium. Whereas Aspergillus and Penicillium spp. occurred in more or less the same numbers throughout the year, Cladosporium spp., Alternaria spp. and Aureobasidium pullulans showed a significantly higher occurrence during late summer and early autumn.

Adolescent↗

PubMed2002

Combination of surgery and gamma knife radiosurgery--a therapeutic option for patients with tumors of nasal cavity or paranasal sinuses infiltrating the skull base.

UNLABELLED: The purpose of this study was to investigate whether patients operated for skull base-infiltrating malignant tumors of the nasal cavity and/or the paranasal sinuses benefit from an additional Gamma knife radiosurgery. CASE SERIES: eight consecutive patients, (male: female ratio = 1:1, mean age = 52 years, range 34 to 79 years) presented with 2 cyclindric cell carcinomas, 2 adenocarcinomas, 2 malignant neuroblastomas, 1 squamous cell carcinoma, 1 amelanotic melanoma. Tumor stages (UICC) were: 1 T1, 3 T2, 3 T3, 1 T4, all N0, all M0. All patients were primarily treated surgically and 4 weeks later received additional stereotactic radiosurgery. Follow-up was based on computerized tomography (CT), magnetic resonance imaging (MRI), endoscopy, and biopsy. The course of disease was compared to tumor courses with surgery but without radiosurgery reported in literature. Four times endoscopic endonasal surgery (EES), once EES in combination with fluorescein technique, once EES plus external approach of frontal sinus, once lateral rhinotomy was performed. All 8 cases underwent radiosurgery (Leksell gamma knife) 4 weeks after surgery. Thirty six months after radiosurgery 6 patients were alive (4 patients without evidence of disease, 1 patient with pulmonary metastasis but without local recurrence, 1 patient with regional metastasis but no local recurrence), 1 patient died 11 months after treatment due to disease, 1 patient died due to a second malignancy. No negative or adverse effects due to radiosurgery were observed. The combination of microsurgery with Leksell Gamma knife radiosurgery appears to be an encouraging therapeutic option. To date no adverse effects have been observed in the presented cases.

Adult↗

PubMed2001

Laryngeal manifestation of gout: a case report of a subglottic gout tophus.

A subglottic tophaceous deposition of urate crystals is a rare finding. We report on a case of a male Caucasian who had a moderate dysphonia without any further laryngeal symptoms. The laryngoscopy revealed a hemispheric lesion on the left subglottic region. An excision biopsy was performed, and the histopathological examination of the dissected specimen showed a tophus. Diagnostic and therapeutic strategies are discussed.

Arytenoid Cartilage↗

PubMed2001

[The effect of a bacterial immunostimulant (human Enterococcus faecalis bacteria) on the occurrence of relapse in patients with].

The following double-blind, placebo-controlled, multicenter study investigated the influence of a bacterial immunostimulant (Symbioflor 1, cells and autolysate of human Enterococcus faecalis) on the occurrence of relapses in patients with chronic recurrent bronchitis (n = 136; placebo n = 66, verum n = 70) in a 6 months treatment period and a follow-up period of 8 months, compared to placebo. Under verum 39 incidents of relapses were recorded, which was about 60% the number observed among the patients treated with placebo (66 incidents). The verum preparation exhibited superior clinical efficacy compared to placebo (p = 0.001) in the Kaplan-Meier test. This better clinical efficiency of the test preparation was particularly observed during the treatment period, with 12 vs. 27 relapses (p = 0.013), but less during the follow-up observation period, with 27 vs. 39 relapses (p = 0.127). In addition, the time span until occurrence of the first relapse was clearly longer under verum (699 days) than under placebo (334 days) and after the end of the observation period 91% of patients under verum experienced only one relapse compared to 62% in the placebo group (p = 0.01). Severity of relapses under verum was also reduced significantly (chi 2; p = 0.001. Only 4 patients under verum required antibiotic therapy compared to 13 patients under placebo. Verum was equally well tolerated as placebo, with no serious side effects in either group. No changes in laboratory tests--haematology and clinical chemistry--were observed. It can be concluded, that previously demonstrated immunomodifying effects of the test preparation have clinical relevance for the treatment of chronic recurrent bronchitis because not only the number but also the severity of acute relapses could be clearly reduced. This is discussed in view of the current literature.

Adjuvants, Immunologic↗

PubMed2001

Carcinoma of the larynx: predictors of diagnostic delay.

OBJECTIVES: In tumors of the upper aerodigestive tract a dose-response relationship between tumor stage and its prognosis raises the chance of a reduction in the diagnostic delay. The interval between the first symptom and the start of tumor-specific therapy and the influencing factors is not well known. The goals of this study were to investigate the diagnostic delay and the influencing factors and to predict the factors that prolong the diagnostic process. STUDY DESIGN: Prospective, nonrandomized study. METHODS: The intervals between first symptom and first consultation of a physician (patient delay) and between first consultation and first tumor-specific therapy (doctor delay) were investigated. Predictors for increased patient or doctor delay were evaluated, and a multiple logistic regression model for increased doctor delay was developed. RESULTS: The total diagnostic delay (sum of patient and doctor delays) was 3 to 4 months. A multifactorial model for the ratio of odds revealed that for women and glottic cancers (1.73) the chance was twice as high for a doctor delay greater than 30 days, whereas subjects with an increased patient delay (>30 d) had reduced odds of being delayed by the physician. CONCLUSIONS: The higher chance of extended doctor delay for glottic tumors compared with supraglottic tumors should be reflected in differential therapeutic strategies. Even unspecific lesions of the vocal folds should be followed up at the end of the therapy, at least. Therapies of glottic lesions without final control have the chance of resulting in delays in treatment. Women, especially, should be included in a follow-up examination. On the other hand, patients with increased patient delay have lower odds of longer doctor delay, which may be the result of tumor growth and, consequently, easier diagnosis.

Carcinoma, Squamous Cell↗

PubMed2001

Contrast-enhanced helical CT of the head and neck: improved conspicuity of squamous cell carcinoma on delayed scans.

OBJECTIVE: We evaluated the impact of delayed scans on the conspicuity of squamous cell carcinoma in helical CT of the head and neck. SUBJECTS AND METHODS: Twenty-seven patients with biopsy-proven squamous cell carcinoma of the head and neck underwent dual-phase helical CT examinations using 100 mL of nonionic contrast material. In all patients, the early phase started 30 sec after the commencement of injection. The patients were assigned to one of two groups in which the delayed phase started either 180 sec (group A, n = 13) or 300 sec (group B, n = 14) after the start of injection. The overall image quality, including vascular opacification and the quality of lesion conspicuity, was determined according to a three-point scoring system. RESULTS: Overall image quality scored better on the early scans (score, 1.4 +/- 0.5) than on the late scans with a 180-sec (score, 1.6 +/- 0.6; p = 0.03) or a 300-sec delay (score, 2.4 +/- 0.5; p = 0.002). Tumor conspicuity scored better on scans with a 180-sec delay (score, 1.4 +/- 0.5) than on the scans with a 30-sec delay (score, 2.3 +/- 0.7; p = 0.02) or the scans with a 300-sec delay (score, 2.3 +/- 0.7; p = 0.03). In eight (62%) of 13 patients in group A and in six (43%) of 14 patients in group B, the tumor was better delineated on the late scans than on the early scans. CONCLUSION: Although early scans provide optimal vascular enhancement and are therefore necessary for helical CT studies of the head and neck, additional delayed scans may improve lesion detection in patients with squamous cell carcinoma of the head and neck.

Carcinoma, Squamous Cell↗

PubMed2001

Alterations in gap junction protein expression in human benign prostatic hyperplasia and prostate cancer.

PURPOSE: Gap junctions composed of connexin proteins have an essential role in intercellular communication and differentiation. Dysregulation of connexin expression is believed to have a role in carcinogenesis. The human prostate has been reported to express connexin 32 and 43. However, the expression pattern in prostate cancer is controversial, while to our knowledge connexin expression has not been reported in benign prostatic hyperplasia (BPH). To understand the potential involvement in prostate disease connexin 32 and 43 expression was evaluated in a series of normal prostate, BPH and prostate cancer specimens that were surgically removed due to bladder outlet obstruction. MATERIALS AND METHODS: Frozen sections of 23 normal, 43 BPH and 40 cancer involved prostates were evaluated for the presence, staining intensity and pattern of connexin 32 and 43 by immunocytochemical testing. RESULTS: In all specimens examined connexin 43 stain was punctate along the borders of the basal epithelial cells, whereas connexin 32 immunolocalized to luminal epithelial cells. In normal prostate connexin 43 and 32 were present in 87% and 65% of specimens, respectively, at low to moderate stain intensity. Importantly none of the normal samples were negative foreach connexin. In BPH specimens there was a marked increase in the incidence and intensity of connexin 43 and 32 immunostaining within epithelial cells. In addition, 23% of BPH samples showed strong connexin 43 expression in stromal cells. In contrast, connexin was decreased in prostate cancer specimens, of which 65% and 38% were negative for connexin 43 and 32, respectively, and 28% were negative for each type. In poorly differentiated tumors connexin 43 and 32 were present in only 10% and 40% of tumors, respectively, at low immunostaining intensity. CONCLUSIONS: In normal human prostate basal cells communicate via connexin 43 gap junctions, whereas luminal cells communicate via connexin 32 gap junctions. In BPH gap junctional intercellular communication is increased in epithelial and stromal cells, which may have a role in BPH pathogenesis. In prostate cancer gap junctional intercellular communication is decreased, is as indicated by decreased expression of connexin 43 and 32 with severe loss in poorly differentiated prostate cancer. These alterations in connexin expression may have a role in dedifferentiation and tumor progression.

Adenocarcinoma↗

PubMed2000

Hypernasality--a rare initial symptom of a cerebellar astrocytoma.

Nasality is a disorder due to nasal resonance, which may be induced by a variety of etiologies. Transitional hypernasality is frequently seen in children after adenoidectomy. The alleged post-surgical hypernasality in the case presented was shown to be related to the late detection of an astrocytoma of the cerebellum and the brain stem in a 6-year-old boy. This case was characterized by increased hypernasality which failed speech therapy. A developing one-sided vocal fold palsy in combination with an ipsilateral soft-palate palsy indicated further investigation. Computerized tomography (CT) and magnetic resonance imaging (MRI) revealed a brain stem-tumor with a maximum size of 6 cm involving parts of the cerebellum. These findings demonstrated the need for a strict follow-up, even after adenoidectomy, in the presence of hypernasality for identifying concurrent etiologies as well as cases suitable for speech therapy.

Adenoidectomy↗

PubMed2000

Correlation between glottal area and photoglottographic signal in normal subjects.

Photoglottography (PGG) is an established technique for depicting the vibratory patterns of the vocal folds. The present study investigates the correlation between the glottal area and the corresponding PGG signal. Six normal (five male, one female) subjects who did not use their voices professionally were investigated during constantly sustained phonation at spontaneous pitches. Laryngostroboscopy was performed in combination with PGG. The simultaneously recorded laryngostroboscopic images and PGG signals were directly digitized and stored on a computer. The correlation between the glottal area and the corresponding PGG amplitudes across each vibratory cycle of the vocal folds was calculated and they were found to be highly and positively correlated (r = 0.973, p < 0.001). The PGG signal reflects changes in the glottal area during the vibration cycle of the vocal folds. The proposed simultaneous laryngostroboscopic and PGG technique has proved to be useful for facilitating the interpretation of changes in glottal area.

Adult↗

PubMed1999

Ex juvantibus approach for chronic posterior laryngitis: results of short-term pantoprazole therapy.

The aim of this study was to investigate whether patients with chronic posterior laryngitis and symptoms of gastro-pharyngeal reflux benefit from a six-week therapy with pantoprozole. Twenty-nine out-patients with voice disorders (case history of at least two months) and simultaneous symptoms of gastro-pharyngeal reflux were recruited for this study. At the entry to the study a symptom questionnaire and a video-laryngo/stroboscopy were completed. The symptom questionnaire and the video-laryngo/stroboscopy were repeated after the six weeks of therapy with pantoprazole 40 mg once a day and again six weeks and three months after this follow-up, during which time the patient was without therapy. Hoarseness, globus pharyngeus, sore throat, heartburn, and coughing were the symptoms which showed a significant (p < 0.05) recovery at the follow-ups (mean of hoarseness index: 7.28 to 0.92; mean of globus pharyngeus index: 3.14 to 0.58; mean of heartburn index: 2.86 to 0.5; mean of cough index: 1.72 to 0.25; mean of throat soreness index: 1.72 to 0.15). Laryngoscopy scores of the posterior laryngeal region, the glottic and the supraglottic region showed statistically significant improvement (p < 0.05) after the treatment with pantoprazole. The therapeutic effect exceeded the drug administration until the last follow-up (after three months). The medication was tolerated without side-effects in all patients. A primary (ex juvantibus) therapy with proton pump inhibitors seems to be a therapeutic option for patients with long-lasting chronic inflammation of the larynx not responding to common therapy. In this case a six-week course of treatment has been shown to be sufficient.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed1999

The IgG1/G2 subclass shift--a sensitive, tissue non-specific marker for malignancy. Diagnostic performance with squamous cell carcinoma of the head and neck.

A significant decrease in %IgG1 accompanied by an increase in %IgG2 in total serum IgG has been previously reported as a highly sensitive marker for detecting early stages of carcinomas of various localizations. Here we investigated the question as to whether this phenomenon is also observed in sera of patients with squamous cell carcinoma of the head-neck region (SCC-HN), and to evaluate its diagnostic performance in the post-operative monitoring. Using quantitative affinity chromatography, serum concentrations of IgG1, IgG2 and total IgG were determined in 81 patients with different stages of primary and untreated SCC-HN, in 51 SCC-HN patients in post-therapeutical follow up, and in 33 patients with organ matched benign diseases. The data were compared with a total of 174 healthy controls. It was found that (i) 105 SCC-HN patients exhibited a mean value of 56.0 +/- 0.7% IgG1, which likewise differed from healthy controls (63.2 +/- 0.5) and benign diseases (61.5 +/- 1.0) with P < 0.0005, (ii) sensitivities and specificities for discriminating primary malignancies from healthy controls were 70 and 74% respectively, and from benign diseases 65 and 76%, (iii) highest sensitivities and specificities were observed with post-therapeutic cases suffering from tumour recurrence (88% and 75%) or patients with distant metastases (87% and 86%), (iv) apparently tumour-free post-therapeutic patients showed a mean %IgG1 not different from the normal value. The decrease in %IgG1 accompanied by increased %IgG2 is an efficient, sensitive and early marker of SCC-HN, which appears particularly useful for the post-therapeutic monitoring.

Aged↗

PubMed1998

[The SCC antigen is not a reliable tumor marker in the ENT area. Value of squamous cell carcinoma antigen in diagnosis and follow-up of squamous epithelial carcinoma in the head-neck area. Results of a retrospective study over 6 years].

BACKGROUND: In the early 1970s, progress in chemical analysis allowed the assessment of low concentration substances in blood and other body fluids. These techniques led to development of hitherto unknown diagnostic facilities which were tested with respect to malignant tumors. In those days SCC-A was considered a promising substance for aiding in diagnosis and observation in patients with SCC. METHODS: This retrospective study investigates the correlation between tumor size and tumor progress and the SCC-A level in a group of 322 patients (male: n = 291, age 24-87 yrs, mean 56 yrs: female: n = 31, age 38-82 yrs, mean 70 yrs). RESULTS: The diagnostic value of SCC-A turned out to be poor. In 78%, SCC-A levels were low and neither correlated with tumor size nor the presence of metastases. In follow-up the situation was even worse: A reliable correlation between SCC-A and the course of disease was found in 5.8% of patients only. CONCLUSION: The SCC-A could neither reliably contribute to diagnosis nor to follow-up of patients with squamous cell carcinomas of the head and neck.

Adult↗

PubMed1997

Simultaneous occurrence of metastatic tonsillar squamous cell carcinoma and angioimmunoblastic T-cell lymphoma in a cervical lymph node.

Non-Hodgkin's lymphoma (NHL) is a frequent head and neck malignancy. Squamous cell carcinoma of the tonsil is the second most common head and neck carcinoma. We report a case of a tonsillar carcinoma metastasis in an angioimmunoblastic-transformedlymph node. To our knowledge this is the first description and histopathological documentation of such a case in the literature.

Carcinoma, Squamous Cell↗

PubMed1997

The influence of Roux-Y versus Longmire-Gütgemann reconstruction on the composition of pancreatic juice.

Both methods of reconstruction after gastrectomy lead more or less to an insufficiency of pancreas. Therefore investigations on rats should further clarify which defects are obvious after both operation methods. Wistar rats were divided into 3 groups. In 2 groups a gastrectomy was performed while one was reconstructed according to the method of Roux-Y, the other was treated according to the method of Longmire-Gütgemann. The first group was a sham operated control group. 3 months after this operation pancreatic juice was collected over the time of 6 hours. Volume and protein content were determined as well as a differentiation of the proteins by means of the 2D electrophoresis which separates the molecules according to isoelectric focus and the molecular weight. The results show a significant increase of the volume of pancreatic juice after both operations. Whereas the protein content is also altered the number of proteins is significantly decreased. Especially proteins with an alkaline isoelectric focus are significantly diminished. The molecular weight of the proteins is also changed. Low molecular protein fragments which were not observed in the sham operated group are increased especially in the Roux-Y group. This means that the production of enzymes is changed after both operations. The pH optimum as well as the viability of the protein enzymes is shifted. Since the changes are more pronounced after Roux-Y operation signs of pancreatic insufficiency should be expected more frequently after this operation.

Alkalies↗

PubMed1996

Partially selective semiconductor redox electrodes.

Redox electrodes made of passivated metals of the subgroups IV to VI of the periodic system with a surface coating of n-conducting metal oxides, generated by oxidizing agents or anodic oxidation, are well suited for measuring the concentration of oxidizing agents. Neither oxygen nor reducing agents affect the measurements. There is a correlation between the mean conductivity of the passive layer and its selectivity. The aged n-conducting passive layers permit reproducible potential settings, and the occurring changes in potential are greater than what is to be expected according to the Nernst equation. The potentiometric measuring of nitrosyl ions and chlorine is used as an example to demonstrate the selectivity of these electrodes.

Journal Article↗

PubMed1994

[Biliary pseudocyst as a rare complication of choledocholithiasis].

Biliary pseudocysts, so-called biliomas are reported to be an extreme rarity and mostly arising posttraumatic. We report on a case of symptomatic choledocholithiasis 7 years after cholecystectomy. The course was complicated by formation of a biliary pseudocyst. The 71-year-old, septic patient could not be operated because of pulmonal and cardiac high risks. He could be treated successfully by conservative procedure via endoscopic papillotomy, stone extraction and percutaneous, sonographic controlled drainage of the biliary pseudocyst.

Aged↗

PubMed1977

A review of controlled studies with nomifensine, performed outside the UK.

1. Double-blind controlled comparisons of nomifensine with placebo, imipramine, desipramine, viloxazine, nortriptyline, a combination of amitriptyline and chlordiazepoxide, and diazepam have been carried out in various parts of the world. 2. Dosage ranged from 50-225 mg daily, and treatment lasted from 2-26 weeks. 3. Nomifensine was shown to possess useful antidepressive activity, to counteract inhibition, to restore drive and to relieve anxiety. 4. Adverse reactions were uncommon, particularly anticholinergic effects, and nomifensine was not shown to cause sedation or to interact with alcohol. No withdrawal phenomena were observed after 6 months' treatment. 5. Nomifensine is not suitable for severely agitated patients.

Adult↗