[Sensitization to chlorhexidine].
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Anaphylaxis↗
Biomedical subjects
W Heppt
Publications and source records attributed to W Heppt.
Nitric oxide synthase in the innervation of the human nasal mucosa: correlation with neuropeptides and tyrosine hydroxylase.
Nitric oxide (NO) is a powerful mediator in the central and peripheral nervous system. In the present study the authors have examined the human nasal mucosa innervation for the presence of the neuronal isoform of the NO-generating enzyme, NO-synthase (NOS), and its correlation with other neuronal mediators and markers by means of double-labeling immunohistochemistry. NOS-immunoreactive nerve fibers were observed to be numerously present around glands and venous sinusoids and, less frequently, around small arteries and veins. Few fibers were seen in the lamina propria. NOS appeared to be frequently colocalized in nerve fibers with vasoactive intestinal peptide and, occasionally, with substance P and tyrosine hydroxylase, a marker for catecholamine biosynthesis. These findings suggest that neurally released NO is an important regulatory mediator of glandular secretion and blood flow in the nasal mucosa.
Adult↗
Tree-pollen allergy is efficiently treated by short-term immunotherapy (STI) with seven preseasonal injections of molecular standardized allergens.
The efficacy and tolerance of short-term immunotherapy (STI) by seven preseasonal injections of tree-pollen allergens (ALK7 Frühblühermischung) was investigated in a double-blind, placebo-controlled, multicenter study with 111 rhinoconjunctivitis patients. Nasal and bronchial symptoms simultaneously analyzed, and nasal symptoms as a single end point, but not the overall score of nasal, bronchial, and conjunctival symptoms, showed a significantly lower increase with STI during birch-pollen exposure (both P=0.033, n=105, Mann-Whitney U-test). However, a selective analysis with patients from centers with high recruitment figures (n> or =10 patients, n=29 STI, n=32 placebo) showed a significantly lower increase of nasal, bronchial, and overall symptom score (STI 11.0 vs placebo 18.0, P=0.001, U-test). STI had equidirected effects on conjunctival, nasal, and bronchial symptoms analyzed as multiple end points, although conjunctival symptoms were not significantly different as a single end point. The seasonal increase in drug use was reduced by 62% in the STI group compared with placebo (P=0.032, t-test). Specific IgG4 increased only after STI (P<0.001); IgE was not significantly different. Eosinophil cationic protein remained unchanged with STI, but significantly increased with placebo in the pollen season (P=0.003). STI was well tolerated. In conclusion, STI was shown to be efficacious and safe for the treatment of patients with tree-pollen rhinoconjunctivitis.
Adolescent↗
[Drug therapy in allergic rhinitis].
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Anti-Allergic Agents↗
Development of an in vitro human nasal epithelial (HNE) cell model.
The upper respiratory tract is mainly involved in reactions to airborne substances. So the primary culture of human nasal tissue may provide an application model for assessment of toxic or inflammatory processes caused by environmental pollutants. HNE cells were isolated from nasal tissue biopsies by protease digestion and cultured in serum-free hormone-supplemented medium. When grown on porous membranes at the air-liquid interface, a higher portion of ciliated cells developed within 2 weeks compared with cells maintained submerged. Submerged grown cultures on collagen gel matrix maintained a cuboidal epithelial-like morphology and stained positive for cytokeratin. The primary cultures of nasal cells exhibited a marked activity for acid phosphatase. Second passage HNE cells exhibited marked enzymatic reactivity upon treatment with particulate matter. Induction of the lysosomal marker enzyme acid phosphatase was stronger in cells treated with toluene-extracted diesel exhaust particles compared with cells treated with native diesel exhaust particles. Non-specific esterase activity was increased more than 7-fold by native diesel particles, whereas the induction of esterase activity by extracted particles was relatively low compared with the control group.
Acid Phosphatase↗
[Reconstructive surgery in the head-neck area with regional and free tissue transfer].
BACKGROUND: Operative treatment of head and neck cancer requires radical resection of the tumor with not only severe impairment of important functions like swallowing speech, and respiration but also aesthetic mutilation because of the exposed character of the head and neck region. Therefore the rehabilitation from a functional and cosmetic standpoint is an essential goal of treatment in addition to control of the malignant disease. Fortunately regional plastic surgery offers a variety of options for reconstruction of the defects to receive a solution tailored to each individual patient. PATIENTS: Between the years 1986 and 1996, 107 patients with advanced head and neck cancer were treated surgically by radical resection of the tumor and plastic reconstruction. In this study we made a retrospective analysis of the functional and aesthetic outcome of the techniques of reconstructive surgery we used for rehabilitation. The sex ratio was 79 males to 28 females. Average age was 59.4 years (ranging from 39 to 78 years). Most of the patients suffered from squamous cell carcinoma of the upper digestive tract (97 cases). The others included an adenocarcinoma of the paranasal sinuses (three cases), adenoid cystic cancer of the palate (two cases), squamous cell carcinoma of the temporal bone (two cases), two deep infiltrating basaliomas in the area of the nose and forehead and one chondrosarcoma of the neck. Our oncological concept includes a radical resection of the tumor and a onestep reconstruction of the defect, if the patient's general condition enables this approach. The surgical techniques we used include the approved pedicled myocutaneous flaps like the pectoralis major flap, latissimus dorsi flap (which can be also applied as a free microvascular tissue graft), temporalis muscle flap, and the free radial forearm flap. RESULTS: In previous years, the pedicled myocutaneous pectoralis-major- and latissimus-dorsi-flaps were used for reconstruction (n = 67), but the arc of rotation and the huge bulk of the graft are limiting factors for the indication of these techniques. The free forearm flap has increasingly been used to provide an excellent closure of large pharyngeal defects (n = 16), whereas the temporalis flap is useful for restoration after limited resection of the palate (n = 18). Beside these rather invasive procedures, aesthetic rehabilitation may be achieved with bone-anchored epithesis especially after exenteration of the orbit and ablation of the external ear in case of elderly patients with multiple morbidities (n = 5). In most cases, sufficient rehabilitation from the anatomical and functional point of view was possible even after large tumor resections. A main problem can be longstanding aspiration after resection of large areas of the pharyngeal mucosa (n = 8). Complications included eight cases of necrosis of the flaps and seven patients who developed significant seromas at the donor site. CONCLUSIONS: The potential of modern regional reconstructive surgery enables the surgeon to achieve anatomically and functionally rehabilitation in a one-step procedure in most cases, even after extended resection for head and neck cancer. One should be aware of the fact that these techniques do not offer a significant improvement of prognosis. As such, the aggressiveness of surgical therapy should remain in reasonable relation to the prognosis of the malignant disease.
Adenocarcinoma↗
[Rhinosinusitis in AIDS patients].
We examined microbic infections and topical immunity in 36 AIDS patients with rhinosinusitis (AIDS CDC stage IV b-d) who had an average serum CD4 count of 90/microliters. We also examined the presence of the HIV genome in nasal mucous. Microbiological examination revealed an increased number of fungal infections in addition to bacterial infections with multiresistant strains. There was no evidence of CD4-T cells or HIV reverse transcriptase. The size of study was too small to permit generalised conclusions about the infectious risk of nasal mucous.
AIDS-Related Opportunistic Infections↗
[Cytokines in allergic rhinitis].
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Antigen-Presenting Cells↗
[Current aspects of rhinitis research].
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Cytokines↗
[The nasometer. An instrument for the objective study of hyperrhinophonia in cheilognathopalatoschisis patients].
The aim of this study was to evaluate the reliability and validity of the nasometer in diagnosing hypernasality in cleft palate patients. For this purpose the results of the nasometric examination of 30 patients with hypernasality were compared with the results obtained by using the currently taught methods. Sensitivity and specificity of nasometry were high with coefficients, respectively, of 0.80 and 1.00. Overall accuracy reached 0.90. Our results, which correspond almost exactly to those obtained in similar Anglo-American studies, demonstrate that also in German-speaking countries the nasometer can be a reliable instrument for diagnosing hypernasality. Moreover, the nasometer presents the possibility of calculating the extent of hypernasality during routine examination and diagnosis.
Adolescent↗
Clinical experiences with ofloxacin sequential therapy in chronic ear infections.
Quinolones are the drugs of first choice in therapy of chronic ear infections with multiresistant bacteria, especially because of their efficacy against various Pseudomonas species and their lack of ototoxicity. According to clinical experience, best results can be obtained after application of the sequential treatment schedule. To verify this, 61 patients with acute exacerbations of chronic ear infections were treated sequentially with ofloxacin. After a single dose of 400 mg ofloxacin intravenously, the treatment was continued orally with 400 mg once a day over 7 days. Microbiological and serological examination was performed just prior to and 1 week after treatment. Predominant bacteria isolated from the patients' ears were Pseudomonas aeruginosa, Staphylococcus aureus, Proteus spp. and Enterobacteriaceae spp. Following treatment, infections were cured in 23% of cases and 59% showed improvement. Eighteen percent of the cases were persistent, mainly due to epitympanic chronic otitis media, which was an indication for surgical intervention. In general, sequential therapy with ofloxacin revealed encouraging clinical results based on improved patient compliance with the treatment schedule recommended.
Administration, Oral↗
The role of flexible endosonography in diagnostic imaging of carcinomas of the oral cavity and oropharynx.
Currently-used imaging methods often fail to depict carcinomas of the oral cavity and oropharynx properly. Scanning these tumours with recently developed digitally-guided transducers of 5 and 7.5 MHz, we found that diagnosis and assessment are significantly facilitated by flexible endosonography. The demonstration of T1- and T2-tumours was shown to be facilitated by this technique as compared to other imaging methods. The assessment of large tumours is improved in special areas. Nonetheless, we recommend that in such cases flexible endosonography be supported by CT or MRI for a complete demonstration of the extent of the tumour.
Carcinoma↗
[Acute tonsillitis--peritonsillitis--paratonsillar abscess: Differential diagnosis by flexible endosonography].
The role of flexible endosonography in diagnosis of acute tonsillitis and their complications was investigated in 59 patients. Our results show that flexible endosonography enables the examiner to differentiate acute tonsillitis from peritonsillitis and paratonsillar abscess. In particular, abscesses of retrotonsillar spread possibly leading to life-threatening complications can be detected in an early stage.
Acute Disease↗
[Leiomyosarcoma of the mouth floor and oropharynx].
Leiomyosarcomas arise rarely in the head and neck. We report a 41-year-old woman with an extremely rare leiomyosarcoma of the floor of the mouth extending to the oropharynx. This article stresses the value of imaging methods such as CT, MRI and ultrasound for preoperative diagnosis, and emphasises histopathological findings. The therapeutic principles and prognostic factors of leiomyosarcomas are illustrated on the basis of this case.
Actins↗
[Oncogenes and their significance for head and neck cancers].
During the past few decades medical science has accepted the concept that cancer is a fundamental disorder of cellular growth control. A disorder can originate in some cells through changes in genes (DNA level: gene amplification, mutation and rearrangement) or their expression (RNA and protein levels), and stimulates growth in contrast to surrounding cells. Over the last decade genes affected in the cancer cell have been identified as well as the nature of changes undergone. Only a few of the known oncogenes play a role in head and neck cancer. These are epidermal growth factor receptor, c-myc, the ras gene family, int-2, hst-1 and bcl-1. In some clinical disorders, such as childhood neuroblastoma and breast cancer, oncogenes have been shown to play an important role in tumor staging or as a prognostic parameter. The aim for future therapy is the effective application of oncogenes (or "gene therapy") in clinical practice.
Animals↗
[Osteoma of the mid-face area--a rare site].
Osteomas are benign, symptomless, slowly growing tumors that are usually found incidentally. The most frequent site of origin is a paranasal sinus. We report a 17 year old man with an osteoma of the middle face. The history, clinical findings and surgical procedure are described. Aetiological factors and possible complications of paranasal osteomas are discussed.
Adolescent↗
[Laryngeal obstruction due to familial Recklinghausen's disease].
A case of familial multiple neurofibromatosis with laryngeal involvement is described. The patient required surgical treatment because of rapid tumour growth associated with dyspnoea, dysphonia and dysphagia. Whereas the extensive growth prevented entire removal of all tumour lumps, endolaryngeal microsurgery resulted in an important improvement of laryngeal symptoms and of the quality of life.
Child↗