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Voß N, Sadok N, Goretzki S, Dohna-Schwake C, Meyer MF, Mattheis S, Lang S, Stähr K. [Increased rate of complications of pediatric acute otitis media and sinusitis in 2022/2023]. HNO 2024; 72:83-89. [PMID: 38108853 PMCID: PMC10827887 DOI: 10.1007/s00106-023-01393-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Acute mastoiditis and orbital complications of acute rhinosinusitis are among the most common complications of pediatric infections in otolaryngology. OBJECTIVE The aim of this study was to investigate the frequency of pediatric acute mastoiditis in the setting of acute otitis media as well as pediatric orbital complications in the setting of acute rhinosinusitis. Data from before the pandemic were compared to data after the end of the COVID-19 restrictions. MATERIALS AND METHODS Included were hospitalized children who presented with acute mastoiditis from acute otitis media or with orbital complications from acute rhinosinusitis during the period from April 2017 to March 2023. Compared were three periods using descriptive statistics: April 2017 to March 2020 (before the pandemic in Germany), April 2020 to March 2022 (during the contact restrictions of the pandemic), and April 2022 to March 2023 (after the contact restrictions were lifted). RESULTS A total of 102 children (43 with acute mastoiditis, 42%, and 59 with orbital complications of acute sinusitis, 58%) were included. During the 2022/2023 period, more than twice as many children with acute mastoiditis and approximately three times as many children with orbital complications of acute rhinosinusitis were hospitalized compared to the average of the periods 2017/2018, 2018/2019, and 2019/2020. In the 2021/2022 period, the number of these patients was below the average of previous years. CONCLUSION This year's seasonal cluster of upper respiratory tract infections is associated with a higher-than-average incidence of orbital complications and mastoiditis.
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Affiliation(s)
- Noemi Voß
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Essen (AöR), Hufelandstraße 55, 45147, Essen, Deutschland.
| | - Nadia Sadok
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Essen (AöR), Hufelandstraße 55, 45147, Essen, Deutschland
| | - Sarah Goretzki
- Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen (AöR), Hufelandstraße 55, 45147, Essen, Deutschland
| | - Christian Dohna-Schwake
- Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen (AöR), Hufelandstraße 55, 45147, Essen, Deutschland
| | - Moritz F Meyer
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Essen (AöR), Hufelandstraße 55, 45147, Essen, Deutschland
| | - Stefan Mattheis
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Essen (AöR), Hufelandstraße 55, 45147, Essen, Deutschland
| | - Stephan Lang
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Essen (AöR), Hufelandstraße 55, 45147, Essen, Deutschland
| | - Kerstin Stähr
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Essen (AöR), Hufelandstraße 55, 45147, Essen, Deutschland
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Peters N, Jansen S, Klußmann JP, Meyer MF. Intraindividual variability of the Eustachian tube function: a longitudinal study in a pressure chamber. Diving Hyperb Med 2023; 53:24-30. [PMID: 36966519 PMCID: PMC10325792 DOI: 10.28920/dhm53.1.24-30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/11/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION The Eustachian tube (ET) is essential for fast and direct pressure equalisation between middle ear and ambient pressure. It is not yet known to what extent Eustachian tube function in healthy adults changes in a weekly periodicity due to internal and external factors. This question is particularly interesting with regard to scuba divers among whom there is a need to evaluate intraindividual ET function variability. METHODS Continuous impedance measurement in a pressure chamber was performed three times at one-week intervals between measurements. Twenty healthy participants (40 ears) were enrolled. Using a monoplace hyperbaric chamber, individual subjects were exposed to a standardised pressure profile consisting of a 20 kPa decompression over 1 min, a 40 kPa compression over 2 min, and a 20 kPa decompression over 1 min. Measurements of Eustachian tube opening pressure (ETOP), opening duration (ETOD), and opening frequency (ETOF) were made. Intraindividual variability was assessed. RESULTS Mean ETOD during compression (actively induced pressure equalisation) on the right side was 273.8 (SD 158.8) ms, 259.4 (157.7) ms, and 249.2 (154.1) ms (Chi-square 7.30, P = 0.026) across weeks 1-3. Mean ETOD for both sides was 265.6 (153.3) ms, 256.1 (154.6) ms, and 245.7 (147.8) ms (Chi-square 10.00, P = 0.007) across weeks 1-3. There were no other significant differences in ETOD, ETOP and ETOF across the three weekly measurements. CONCLUSIONS This longitudinal study suggests low week-to-week intraindividual variability of Eustachian tube function.
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Affiliation(s)
- Nele Peters
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Stefanie Jansen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Jens P Klußmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Moritz F Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Corresponding author: Dr Moritz F Meyer, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany,
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Nachtsheim L, Mayer M, Meyer MF, Oesterling F, Kajueter H, Arolt C, Quaas A, Klussmann JP, Wolber P. Incidence and clinical outcome of primary carcinomas of the major salivary glands: 10-year data from a population-based state cancer registry in Germany. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04278-6. [PMID: 35994118 DOI: 10.1007/s00432-022-04278-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/10/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this project was to provide an overview of the epidemiology of primary salivary gland carcinomas (SGC) in terms of incidence, distribution of clinicopathological features and survival in one of the largest cancer registries in Europe. METHODS Data were collected from patients with SGC of the major salivary glands registered in the population-based state cancer registry (Landeskrebsregister LKR) in North Rhine-Westphalia (NRW), Germany from 01/01/2009 to 12/31/2018. Age standardization of incidence was performed and relative survival estimates were computed by sex, histological group, age group and T-, N-, and M-stage. RESULTS A total of 1680 patients were included in this analysis. The most frequent tumor localization was the parotid gland (78%). Adenocarcinoma (not otherwise specified) was the most common tumor entity (18.5%). Most tumors were found in stages T1-T3 (29% T1; 29% T2; 28% T3). The age-standardized incidence rate (ASR) for SGC was 0.65/100,000 and remained stable during the observation period. There was an age-dependent incidence increasing especially from the age 70 years and onwards. The overall 5-year relative survival (RS) for all patients with SGC was 69.2%. RS was 80-95.6% for T1-2 stage tumors, 60.3% for T3, 47.3% for T4 stage, 87.4% for N0 and 51.2% for N1-2, 74.4% for M0 and 44.9% for M1. CONCLUSION Age-standardized incidence for SGC has been stable for the observed 10-year period. Smaller tumors and those without lymph node or distant metastases had a better RS than more advanced tumors.
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Affiliation(s)
- Lisa Nachtsheim
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany.
| | - M Mayer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany
| | - M F Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Duisburg-Essen, Medical Faculty, Essen, Germany
| | - F Oesterling
- Cancer Registry North Rhine-Westphalia, Bochum, Germany
| | - H Kajueter
- Cancer Registry North Rhine-Westphalia, Bochum, Germany
| | - C Arolt
- Institute of Pathology, University of Cologne, Medical Faculty, Cologne, Germany
| | - A Quaas
- Institute of Pathology, University of Cologne, Medical Faculty, Cologne, Germany
| | - J P Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany
| | - P Wolber
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Cologne, Germany
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Meyer MF, Knezic K, Jansen S, Klünter HD, Pracht ED, Grosheva M. Effects of freediving on middle ear and eustachian tube function. Diving Hyperb Med 2020; 50:350-355. [PMID: 33325015 DOI: 10.28920/dhm50.4.350-355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/07/2020] [Indexed: 11/05/2022]
Abstract
INTRODUCTION During descent in freediving there is exposure to rapidly increasing pressure. Inability to quickly equalise middle ear pressure may cause trauma to the ear. This study aimed to evaluate the occurrence of pressure-related damage to the middle ear and the Eustachian tube during freediving and to identify possible risk factors. METHODS Sixteen free divers performed diving sessions in an indoor pool 20 metres' freshwater (mfw) deep. During each session, each diver performed four own free dives and up to four safety dives. Naso- and oto-endoscopy and Eustachian tube function tests were performed on the right and left ears before diving, between each session and after the last session. The otoscopic findings were classified according to the Teed classification (0 = normal tympanic membrane to 4 = perforation). Additionally, ENT-related complaints were assessed using a questionnaire. RESULTS Participants performed 317 dives (on average 20 dives per diver, six per session). The average depth was 13.3 mfw. Pressure-related changes (Teed 1 and 2) were detected in 48 % of ears. Teed level increased significantly with an increasing number of completed sessions (P < 0.0001). Higher pressure-related damage (Teed 2) occurred in less experienced divers, was associated with significantly lower peak pressures in the middle ear and led to more ear-related symptoms. A preference for the Frenzel technique for middle ear pressure equalisation during freediving was shown. CONCLUSIONS Pressure exposure during freediving had a cumulative effect on the middle ear. Factors such as diving depth, diving experience and number of diving sessions correlated with the occurrence of higher Teed levels.
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Affiliation(s)
- Moritz F Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,Corresponding author: Dr Moritz F Meyer, Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University Hospital of Essen, Hufelandstraße 55, 45122 Essen, Germany,
| | - Kristijana Knezic
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Stefanie Jansen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Heinz D Klünter
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | | | - Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
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Nachtsheim L, Arolt C, Dreyer T, Meyer MF, Brobeil A, Gamerdinger U, Gattenlöhner S, Grosheva M, Wittekindt C, Klußmann JP. [Mucoepidermoidcarcinoma - Importance in molecular pathology]. Laryngorhinootologie 2020; 99:144-148. [PMID: 32120437 DOI: 10.1055/a-1083-6805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Mucoepidermoid carcinoma is the most common primary salivary gland malignancy and its tumor grading has an important prognostic significance. The 5 year overall survival rate is significantly higher for low grade mucoepidermoid carcinomas than for intermediate grade and high grade mucoepidermoid carcinomas. The translocation of t(11;19)(q21;p13) with the resulting CRTC1-MAML2 transfusion appears to be of prognostic relevance in patients with mucoepidermoid carcinoma. The translocation is detectable in 38-82 % of all mucoepidermoid carcinomas. Study results have shown a significantly better prognosis for patients with fusion-positive mucoepidermoid carcinomas than fusion-negative mucoepidermoid carcinomas. The t(11;19)(q21;p13) translocation can be found more often in low and intermediate grade mucoepidermoid carcinomas than in high grade tumors of the same entity. Moreover, fusion positive mucoepidermoid carcinoma were found more frequently in younger patients, smaller tumors, lower tumor stages and less frequently lymph node and distant metastases. Up to now, the translocation has not been of therapeutic importance. In selected cases, the lack of t(11;19)(q21;p13) translocation might facilitate the decision towards further escalation of therapy. More studies will be necessary to evaluate the individual prognostic and therapeutic value of CRTC1-MAML2 transfusion.
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Affiliation(s)
- Lisa Nachtsheim
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universität zu Köln, Medizinische Fakultät der Uniklinik Köln
| | - Christoph Arolt
- Klinik für Pathologie, Universität zu Köln, Medizinische Fakultät der Uniklinik Köln
| | - Thomas Dreyer
- Institut für Pathologie, Universitätsklinikum Gießen & Marburg, Standort Gießen, Justus-Liebig-Universität Gießen
| | - Moritz F Meyer
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universität zu Köln, Medizinische Fakultät der Uniklinik Köln
| | - Alexander Brobeil
- Institut für Pathologie, Universitätsklinikum Gießen & Marburg, Standort Gießen, Justus-Liebig-Universität Gießen
| | - Ulrike Gamerdinger
- Institut für Pathologie, Universitätsklinikum Gießen & Marburg, Standort Gießen, Justus-Liebig-Universität Gießen
| | - Stefan Gattenlöhner
- Institut für Pathologie, Universitätsklinikum Gießen & Marburg, Standort Gießen, Justus-Liebig-Universität Gießen
| | - Maria Grosheva
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universität zu Köln, Medizinische Fakultät der Uniklinik Köln
| | - Claus Wittekindt
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie und plastische Operationen des Universitätsklinikums Gießen & Marburg, Standort Gießen, Justus-Liebig-Universität Gießen
| | - Jens Peter Klußmann
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universität zu Köln, Medizinische Fakultät der Uniklinik Köln
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Silverman DN, Plante TB, Infeld MI, Juraschek SP, Dougherty G, Meyer MF. P1666Do beta-blockers increase the risk for hospitalizations in heart failure with preserved ejection fraction? A secondary analysis of beta-blocker use in the TOPCAT trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The use of beta-blockers for treatment of heart failure (HF) with a reduced ejection fraction (EF) is unequivocally beneficial, but their role in the treatment of preserved EF (HFpEF) remains unclear.
Purpose
In a contemporary HFpEF cohort, we sought to assess the association of HF hospitalizations and the use of beta-blockers in patients with an EF above and below 50%.
Methods
The TOPCAT trial tested spironolactone vs. placebo among patients with HFpEF, including some with mild reductions in EF between 45–50%. The primary outcome was a composite of cardiovascular (CV) mortality, aborted cardiac arrest, or HF hospitalizations. Medication use, including beta-blockers, was reported at each visit and hospitalization. In the 1,761 participants from the Americas, we compared the association of beta-blocker use (vs. no use) and HF hospitalization or CV mortality using Cox proportional hazards models adjusted for baseline demographics, history of myocardial infarction, atrial fibrillation, chronic obstructive pulmonary disease, asthma, and hypertension. The analyses were repeated in the EF strata ≥50% and <50%.
Results
Among patients included in the current analysis (mean age 72 years, 50% female, 78% white), 1,496/1,761 (85%) received beta-blockers and 1,566/1,761 (89%) had an EF ≥50%. HF hospitalizations and CV mortality occurred in 399/1,761 (23%) and 223/1,761 (13%) of participants, respectively. Beta-blocker use was associated with an increase in risk of HF hospitalization among patients with preserved EF ≥50% [HR 1.56, (95% CI 1.09–2.24), p=0.01] and was associated with a reduction in risk of hospitalization in patients with an EF <50% [HR 0.42, (95% CI 0.18- 0.99), p<0.05]. We found a significant interaction for EF threshold and beta-blocker use on incident HF hospitalizations (p=0.01). There were no differences in CV mortality.
Figure 1. Kaplan Meier incidence plots
Conclusions
Beta-blocker use was associated with an increase in HF hospitalizations in patients with HFpEF (EF≥50%) but did not affect CV mortality. Further research is needed to confirm these findings and elucidate causality.
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Affiliation(s)
- D N Silverman
- University of Vermont Larner School of Medicine, Department of Medicine, Burlington, United States of America
| | - T B Plante
- University of Vermont Larner School of Medicine, Department of Medicine, Burlington, United States of America
| | - M I Infeld
- University of Vermont Larner School of Medicine, Department of Medicine, Burlington, United States of America
| | - S P Juraschek
- Beth Israel Deaconess Medical Center, Department of Medicine, Boston, United States of America
| | - G Dougherty
- Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | - M F Meyer
- University of Vermont Larner School of Medicine, Department of Medicine, Burlington, United States of America
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Lechner A, Schlößer HA, Thelen M, Wennhold K, Rothschild SI, Gilles R, Quaas A, Siefer OG, Huebbers CU, Cukuroglu E, Göke J, Hillmer A, Gathof B, Meyer MF, Klussmann JP, Shimabukuro-Vornhagen A, Theurich S, Beutner D, von Bergwelt-Baildon M. Tumor-associated B cells and humoral immune response in head and neck squamous cell carcinoma. Oncoimmunology 2019; 8:1535293. [PMID: 30723574 PMCID: PMC6350680 DOI: 10.1080/2162402x.2018.1535293] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 10/07/2018] [Accepted: 10/09/2018] [Indexed: 01/04/2023] Open
Abstract
B lymphocytes are important players in immune responses to cancer. However, their composition and function in head and neck squamous cell carcinoma (HNSCC) has not been well described. Here, we analyzed B cell subsets in HNSCC (n = 38), non-cancerous mucosa (n = 14) and peripheral blood from HNSCC patients (n = 38) and healthy controls (n = 20) by flow cytometry. Intratumoral B cells contained high percentages of activated (CD86+), antigen-presenting (CD86+/CD21-) and memory B cells (IgD-/CD27+). T follicular helper cells (CD4+/CXCR5+/CD45RA-/CCR7-) as key components of tertiary lymphoid structures and plasma cells made up high percentages of the lymphocyte infiltrate. Percentages of regulatory B cell varied depending on the regulatory phenotype. Analysis of humoral immune responses against 23 tumor-associated antigens (TAA) showed reactivity against at least one antigen in 56% of HNSCC patients. Reactivity was less frequent in human papillomavirus associated (HPV+) patients and healthy controls compared to HPV negative (HPV-) HNSCC. Likewise, patients with early stage HNSCC or MHC-I loss on tumor cells had low TAA responses. Patients with TAA responses showed CD4+ dominated T cell infiltration compared to mainly CD8+ T cells in tumors without detected TAA response. To summarize, our data demonstrates different immune infiltration patterns in relation to serological TAA response detection and the presence of B cell subpopulations in HNSCC that can engage in tumor promoting and antitumor activity. In view of increasing use of immunotherapeutic approaches, it will be important to include B cells into comprehensive phenotypic and functional analyses of tumor-associated lymphocytes.
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Affiliation(s)
- Axel Lechner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Grosshadern Medical Center, Ludwig Maximilians University, Munich, Germany
- Gene Center, Ludwig Maximilians University, Munich, Germany
| | - Hans A. Schlößer
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne, Germany
| | - Martin Thelen
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Department I of Internal Medicine, Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
| | - Kerstin Wennhold
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Department I of Internal Medicine, Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
| | - Sacha I. Rothschild
- Department of Internal Medicine, Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Ramona Gilles
- Institute of Transfusion Medicine, University of Cologne, Cologne, Germany
| | - Alexander Quaas
- Institute of Pathology, University of Cologne, Cologne, Germany
| | - Oliver G. Siefer
- Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Cologne, Germany
| | - Christian U. Huebbers
- Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Cologne, Germany
| | - Engin Cukuroglu
- Computational and Systems Biology, Genome Institute of Singapore, Singapore
| | - Jonathan Göke
- Computational and Systems Biology, Genome Institute of Singapore, Singapore
- National Cancer Centre, Singapore
| | - Axel Hillmer
- Institute of Pathology, University of Cologne, Cologne, Germany
| | - Birgit Gathof
- Institute of Transfusion Medicine, University of Cologne, Cologne, Germany
| | - Moritz F. Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Jens P. Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Alexander Shimabukuro-Vornhagen
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Department I of Internal Medicine, Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
| | - Sebastian Theurich
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Gene Center, Ludwig Maximilians University, Munich, Germany
- Department I of Internal Medicine, Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Cancer- and Immunometabolism Research Group, Dept. I of Internal Medicine, University Hospital Cologne, Cologne, Germany
- Department of Medicine III, University Hospital, LMU Munich, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Georg August University, Goettingen, Germany
| | - Michael von Bergwelt-Baildon
- Cologne Interventional Immunology, Department I of Internal Medicine, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Department of Medicine III, University Hospital, LMU Munich, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Georg August University, Goettingen, Germany
- Partner Site, German Cancer Consortium (DKTK), Munich, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
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Grünewald I, Trautmann M, Busch A, Bauer L, Huss S, Schweinshaupt P, Vollbrecht C, Odenthal M, Quaas A, Büttner R, Meyer MF, Beutner D, Hüttenbrink KB, Wardelmann E, Stenner M, Hartmann W. MDM2 and CDK4 amplifications are rare events in salivary duct carcinomas. Oncotarget 2018; 7:75261-75272. [PMID: 27662657 PMCID: PMC5342738 DOI: 10.18632/oncotarget.12127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 09/12/2016] [Indexed: 12/14/2022] Open
Abstract
Salivary duct carcinoma (SDC) is an aggressive adenocarcinoma of the salivary glands associated with poor clinical outcome. SDCs are known to carry TP53 mutations in about 50%, however, only little is known about alternative pathogenic mechanisms within the p53 regulatory network. Particularly, data on alterations of the oncogenes MDM2 and CDK4 located in the chromosomal region 12q13-15 are limited in SDC, while genomic rearrangements of the adjacent HMGA2 gene locus are well documented in subsets of SDCs. We here analyzed the mutational status of the TP53 gene, genomic amplification of MDM2, CDK4 and HMGA2 rearrangement/amplification as well as protein expression of TP53 (p53), MDM2 and CDK4 in 51 de novo and ex pleomorphic adenoma SDCs. 25 of 51 cases were found to carry TP53 mutations, associated with extreme positive immunohistochemical p53 staining levels in 13 cases. Three out of 51 tumors had an MDM2 amplification, one of them coinciding with a CDK4 amplification and two with a HMGA2 rearrangement/amplification. Two of the MDM2 amplifications occurred in the setting of a TP53 mutation. Two out of 51 cases showed a CDK4 amplification, one synchronously being MDM2 amplified and the other one displaying concurrent low copy number increases of both, MDM2 and HMGA2. In summary, we here show that subgroups of SDCs display genomic amplifications of MDM2 and/or CDK4, partly in association with TP53 mutations and rearrangement/amplification of HMGA2. Further research is necessary to clarify the role of chromosomal region 12q13-15 alterations in SDC tumorigenesis and their potential prognostic and therapeutic relevance.
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Affiliation(s)
- Inga Grünewald
- Department of Pathology, University Hospital Muenster, Muenster, Germany
| | - Marcel Trautmann
- Department of Pathology, University Hospital Muenster, Muenster, Germany
| | - Alina Busch
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Muenster, Muenster, Germany
| | - Larissa Bauer
- Department of Pathology, University Hospital Muenster, Muenster, Germany
| | - Sebastian Huss
- Department of Pathology, University Hospital Muenster, Muenster, Germany
| | | | - Claudia Vollbrecht
- Institute of Pathology, University Hospital Cologne, Cologne, Germany.,Current address: Institute of Pathology, Charité University Hospital Berlin, Berlin, Germany
| | | | - Alexander Quaas
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Reinhard Büttner
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - Moritz F Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Cologne, Cologne, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Cologne, Cologne, Germany
| | - Karl-Bernd Hüttenbrink
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Cologne, Cologne, Germany
| | - Eva Wardelmann
- Department of Pathology, University Hospital Muenster, Muenster, Germany
| | - Markus Stenner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Muenster, Muenster, Germany
| | - Wolfgang Hartmann
- Department of Pathology, University Hospital Muenster, Muenster, Germany
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Jansen S, Boor M, Meyer MF, Pracht ED, Volland R, Klünter HD, Hüttenbrink KB, Beutner D, Grosheva M. Influence of repetitive diving in freshwater on pressure equalization and Eustachian tube function in recreational scuba divers. Diving Hyperb Med 2018; 47:223-227. [PMID: 29241231 DOI: 10.28920/dhm47.4.223-227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 09/11/2017] [Indexed: 11/05/2022]
Abstract
INTRODUCTION We investigated the effect of repetitive pressure exposure during freshwater dives on Eustachian tube function and the middle ear, assessed by the Eustachian tube function test (ETFT). METHODS This prospective observational cohort study included 23 divers over three consecutive days of diving in freshwater lakes in Nordhausen, Germany. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp). The peak pressure difference between the R-tymp and the V-tymp (R-VdP) defined effectiveness of pressure equalization after Valsalva manoeuvres. We evaluated the change in compliance and peak pressure and correlated the results to the otoscopic findings and diving experience. RESULTS Twenty-three divers performed 144 dives. Middle ear barotrauma was assessed using the Edmonds modification of the TEED scoring system. In the ETFT, the R-tymp peak pressure displayed a negative shift from day one to three (P = 0.001) and differed significantly between the experience groups (P = 0.01). R-VdP did not change significantly on any of the three days of diving (all P > 0.05). Participants without MEBt showed significantly lower R-tymp values than did those with barotrauma (P = 0.019). CONCLUSION Repetitive pressure exposure during three consecutive days of freshwater diving led to a negative shift of the peak pressure in the middle ear. Less experienced divers showed significantly higher middle ear peak pressure and higher pressure differences after equalization manoeuvres. Higher middle ear peak pressure was also associated with a higher prevalence of barotrauma.
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Affiliation(s)
- Stefanie Jansen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Germany
| | - Manuela Boor
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Moritz F Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Cologne, Kerpener Straβe 62, 50937 Cologne, Germany
| | | | - Ruth Volland
- Department of Paediatric Oncology and Haematology, University Children's Hospital of Cologne, Cologne, Germany
| | - Heinz D Klünter
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Germany
| | - Karl-Bernd Hüttenbrink
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Germany
| | - Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Medical Faculty, Germany
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Meyer MF, Boor M, Jansen S, Pracht ED, Felsch M, Klünter HD, Hüttenbrink KB, Beutner D, Grosheva M. Influence of repetitive diving in saltwater on pressure equalization and Eustachian tube function in recreational scuba divers. Diving Hyperb Med 2017; 47:214-215. [PMID: 29241230 PMCID: PMC6706334 DOI: 10.28920/dhm47.4.216-222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 09/11/2017] [Indexed: 11/05/2022]
Abstract
INTRODUCTION We investigated in a prospective, observational trial the feasibility of using the Eustachian tube function test (ETFT) to measure the effect of repetitive pressure exposure during open seawater dives on Eustachian tube function. METHODS The study included 28 adult divers during six consecutive days of diving in the Red Sea. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp). The R-tymp was obtained as 'baseline' peak pressure. After a Valsalva, the peak pressure should shift (positively), revealing a positive shift of the tympanic membrane. This pressure shift is defined here as R-VdP. The changes in compliance and peak pressure were recorded and correlated with otoscopic findings and diving experience. Middle ear barotrauma was scored using the Edmonds modified TEED scale. RESULTS The 28 participants performed 437 dives. Positive shift of pressure in the middle ear was evident with significant changes from day one to day three (P < 0.0001). Divers with barotrauma showed significantly lower values of R-tymp peak pressure and significantly higher negative R-VdP, compared to divers with normal otoscopic findings (P < 0.05). Diving experience significantly correlated with R-tymp peak pressure and prevalence of middle ear barotrauma. CONCLUSION Significant changes in middle ear pressure and pressure equalization from repeated pressure exposure in saltwater were seen using ETFT. Repetitive, multi-day diving led to significantly decreased compliance and increased R-tymp peak pressure (overpressure) in the middle ear. Most profound changes were observed in less and intermediate experienced divers.
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Affiliation(s)
- Moritz F Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Cologne, Kerpener Straβe 62, 50937 Cologne, Germany,
| | - Manuela Boor
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Stefanie Jansen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | | | - Moritz Felsch
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany
| | - Heinz D Klünter
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Karl-Bernd Hüttenbrink
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Dirk Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
| | - Maria Grosheva
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
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Meyer MF, Jansen S, Mordkovich O, Hüttenbrink KB, Beutner D. Reliability of Eustachian tube function measurements in a hypobaric and hyperbaric pressure chamber. Clin Otolaryngol 2017; 42:1343-1349. [PMID: 28374944 DOI: 10.1111/coa.12884] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2017] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Measurement of the Eustachian tube (ET) function is a challenge. The demand for a precise and meaningful diagnostic tool increases-especially because more and more operative therapies are being offered without objective evidence. The measurement of the ET function by continuous impedance recording in a pressure chamber is an established method, although the reliability of the measurements is still unclear. METHODS Twenty-five participants (50 ears) were exposed to phases of compression and decompression in a hypo- and hyperbaric pressure chamber. The ET function reflecting parameters-ET opening pressure (ETOP), ET opening duration (ETOD) and ET opening frequency (ETOF)-were determined under exactly the same preconditions three times in a row. The intraclass correlation coefficient (ICC) and Bland and Altman plot were used to assess test-retest reliability. RESULTS ICCs revealed a high correlation for ETOP and ETOF in phases of decompression (passive equalisation) as well as ETOD and ETOP in phases of compression (active induced equalisation). Very high correlation could be shown for ETOD in decompression and ETOF in compression phases. The Bland and Altman graphs could show that measurements provide results within a 95 % confidence interval in compression and decompression phases. CONCLUSIONS We conclude that measurements in a pressure chamber are a very valuable tool in terms of estimating the ET opening and closing function. Measurements show some variance comparing participants, but provide reliable results within a 95 % confidence interval in retest. This study is the basis for enabling efficacy measurements of ET treatment modalities.
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Affiliation(s)
- M F Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - S Jansen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - O Mordkovich
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - K-B Hüttenbrink
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - D Beutner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
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Meyer MF, Seuthe IMC, Drebber U, Siefer O, Kreppel M, Klein MO, Mikolajczak S, Klussmann JP, Preuss SF, Huebbers CU. Valosin-containing protein (VCP/p97)-expression correlates with prognosis of HPV- negative oropharyngeal squamous cell carcinoma (OSCC). PLoS One 2014; 9:e114170. [PMID: 25463965 PMCID: PMC4252085 DOI: 10.1371/journal.pone.0114170] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 11/04/2014] [Indexed: 12/27/2022] Open
Abstract
Valosin-containing protein (VCP)/p97 has been shown to be associated with antiapoptotic function via activation of the nuclear factor-B (NFB) signaling pathway and with metastasizing of tumors in several studies. VCP is located on chromosome 9p13-p12, a region often deleted in oropharyngeal squamous cell carcinoma (OSCC). The clinical significance of VCP expression in OSCC however remains unclear. In this study, expression of VCP was determined in 106 patients (77 male (71.3%) and 31 female (28.7%); age-range: 34–79 years (mean age 57 years)) by immunohistochemistry and in a subset of 15 patients by quantitative PCR. HPV-DNA was detected by polymerase chain reaction and p16INK4a immunohistochemistry. The experimental findings were correlated with clinico-pathological data and survival parameters. 47.2% of all OSCC specimens were analyzed as negative or weak staining intensity for VCP. 52.8% of all specimens showed a high staining intensity for VCP. 73.1% of all patients were tested HPV-negative, 26.9% were HPV-positive. The 5-year disease-free and overall survival probabilities of all patients were 71.2% and 55.7%, respectively. No correlation could be found between HPV-status and VCP expression. VCP overexpression in HPV-negative patients was associated with significantly better 5-year disease-free survival (86.4% vs., 45.6%, p = 0.017). The level of VCP-intensity determined by immunohistochemistry could be an additional prognostic marker in HPV-negative OSCC. VCP expression seems not to correlate with the HPV-status.
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Affiliation(s)
- Moritz F. Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
- * E-mail:
| | - Inga M. C. Seuthe
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Uta Drebber
- Department of Pathology, University of Cologne, Cologne, Germany
| | - Oliver Siefer
- Jean-Uhmacher Institute, University of Cologne, Cologne, Germany
| | - Matthias Kreppel
- Department for Oral and Maxillofacial Plastic Surgery, University of Cologne, Cologne, Germany
| | - Marcus O. Klein
- Clinic for Oral and Maxillofacial Plastic Surgery, Dusseldorf, Germany
| | - Stefanie Mikolajczak
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany
| | - Simon F. Preuss
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany
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Meyer MF, Huebbers CU, Siefer OG, Vent J, Engbert I, Eslick GD, Valter M, Klussmann JP, Preuss SF. Prevalence and risk factors for oral human papillomavirus infection in 129 women screened for cervical HPV infection. Oral Oncol 2013; 50:27-31. [PMID: 24169586 DOI: 10.1016/j.oraloncology.2013.10.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 07/11/2013] [Accepted: 10/08/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Oncogenic human papillomaviruses (HPV) are known to be associated with carcinomas of the uterine cervix. Furthermore, current studies have shown that HPV-infection is also associated with a subtype of oropharyngeal cancers. In general, a sexual transmission of the viruses has been shown by numerous studies in the genital lesions. However, there are unknown factors regarding the prevalence and transmission of HPV in the oropharynx. The aim of this study was to evaluate HPV prevalence in the oropharynx in female participants with and without genital HPV infection. In addition, we analyzed risk factors for an oropharyngeal colonization with HPV in their sexual partners, too. METHODS 129 Female participants were tested for presence of HPV-DNA by oral lavage, brush cytology of the tonsils and of the cervix. In addition, 15 male partners of these patients were included in the study. HPV-DNA was detected by PCR (polymerase chain reaction) amplification. For HPV-genotyping, PCR products were hybridized with type-specific digoxigenin-labeled oligonucleotide probes and discriminated into 14 high risk (HR) and 6 low risk (LR)-HPV types. The 129 female and 15 male participants were interviewed by a standardized questionnaire for socioeconomic details, drinking, smoking and sexual behaviours. RESULTS 59 (45.7%) Female participants were negative for a genital HPV-infection. Of these women, 3 (5.1%) showed a positive HPV-PCR result (HR and LR) in the oropharynx. 70 (54.3%) Female participants were positive for a genital HPV infection. In this group, 4 (5.7%) had a positive HPV-detection (HR and LR) in the oral cavity and oropharynx. Female participants with cervical HPV-infection had no higher risk for HPV-detection in the oropharynx (not significant). The analysis of sexual risk factors revealed no specific risk factor for an oral HPV-infection. CONCLUSION A correlation between cervical and oral colonization by HPV could not be demonstrated in our small cohort. Our limited data suggest that sexual transmission of HPV from the cervix uteri to the oropharynx is a rare and unlikely event.
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Affiliation(s)
- Moritz F Meyer
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany.
| | | | | | - Julia Vent
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Mannheim, Germany
| | - Iris Engbert
- Department of Obstetrics and Gynecology, Evangelisches Krankenhaus Bergisch Gladbach, Germany
| | - Guy D Eslick
- The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, New South Wales, Australia
| | - Markus Valter
- Department of Obstetrics and Gynecology, University of Cologne, Germany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Germany
| | - Simon F Preuss
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Germany
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14
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Meyer MF, Wedemeyer I, Beutner D. [Bleeding tumor of the auricle]. HNO 2013; 61:875-7. [PMID: 24127049 DOI: 10.1007/s00106-013-2754-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- M F Meyer
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Uniklinik Köln, 50924, Köln, Deutschland,
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15
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Meyer MF, Mikolajczak S, Luers JC, Lotfipour S, Beutner D, Jumah MD. [Characterizing the passive opening of the eustachian tube in a hypo-/hyperbaric pressure chamber]. Laryngorhinootologie 2013; 92:600-6. [PMID: 23824504 DOI: 10.1055/s-0033-1347175] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Beside arbitrary and not arbitrary active pressure equalization systems there is a passive equalization system via the Eustachian tube (ET) at pressure difference between the epipharyngeal space and the middle ear. Aim of this study was to characterize this passive equalization system in a hypobaric/hyperbaric pressure chamber by continuously measuring the tympanic impedance. In contrast to other studies, which are measured only in a hypobaric pressure chamber it is possible to include participants with Eustachian tube dysfunction (ETD). MATERIAL AND METHODS Following a fixed pressure profile 39 participants were exposed to phases of pressure rising and decompression. By continuously measuring the tympanic impedance in the pressure chamber it was possible to measure data of the Eustachian Tube opening Pressure (ETOP), Eustachian Tube closing pressure (ETCP) and Eustachian Tube opening duration (ETOD). In addition it was possible to characterize the gradient of pressure during decompression, while the ET was open. RESULTS Beside the measurement of the arithmetic average of the ETOP (30.2 ± 15.1 mbar), ETCP (9.1 ± 7.7 mbar) and ETOD (0.65 ± 0.38 s) it was obvious that there are recurrent samples of pressure progression during the phase of tube opening. Generally it is possible to differentiate between the type of complete opening and partial opening. CONCLUSION The fundamental characterization of the action of the passive tube opening, including the measurement of the ETOP, ETCP and ETOD, is a first step in understanding the physiological and pathophysiological function of the ET.
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Affiliation(s)
- M F Meyer
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Uniklinik Köln, Germany.
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16
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Meyer MF, Anagiotos A, Hüttenbrink KB, Preuss SF. [Emphysema of the neck accompanied by eyelid swelling]. HNO 2012; 61:256-8. [PMID: 23241866 DOI: 10.1007/s00106-012-2625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M F Meyer
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Uniklinik Köln, Kerpener Str. 62, 50937 Köln, Germany.
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17
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Meyer MF, Anagiotos A, Lüers JC, Löser H, Wardelmann E, Beutner D. [Schwannoma in the epipharynx: a rare differential diagnosis]. HNO 2012; 61:425-8. [PMID: 23241860 DOI: 10.1007/s00106-012-2583-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
There are many benign and malignant tumors of the epipharynx, which makes differential diagnosis difficult. As a very rare differential diagnosis, a schwannoma is possible. The origin of the tumor is most likely a small branch of a sensitive nerve of the glossopharyngeal nerve or the trigeminus nerve. A clear differentiation in the MRI scan is often not possible; especially differentiation from MPNST (malignant peripheral nerve sheath tumors) is difficult. To confirm the diagnosis and exclude malignancy, every tumor in the epipharynx should be surgically excised if possible, even if the patient has no discomfort.
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Affiliation(s)
- M F Meyer
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Uniklinik Köln, Josef-Stelzmann-Str. 9, 50937, Köln, Deutschland.
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Abstract
AIMS To investigate whether Type 1 and Type 2 diabetic patients differ in the effects of short-term improvement in glycaemic control on skin microvascular dysfunction. METHODS Fourteen Type 1 and 14 Type 2 diabetic patients admitted to hospital to improve glycaemic control were investigated. Two age- and sex-matched groups of non-diabetic subjects served as controls. Capillary blood cell velocity (CBV) was assessed at the dorsal middle phalangeal area of the ring finger at rest and after 3-min arterial occlusion using laser Doppler anemometry. RESULTS Comparing the measurements before and after improvement in glycaemic control, there were no significant changes in peak CBV, time to peak CBV and vasomotion amplitudes in Type 1 and Type 2 diabetic patients. On admission to hospital, time to peak CBV was prolonged in Type 1 (20.9 +/- 2.9 vs. 12.3 +/- 1.6 s, P = 0.003) and Type 2 diabetic patients (20.6 +/- 2.6 vs. 11.9 +/- 1.3 s, P = 0.021) compared with control subjects. After improvement in glycaemic control, there was no significant difference in time to peak CBV between Type 1 diabetic patients and their control subjects (17.8 +/- 4.2 vs. 12.3 +/- 1.6 s, P = 0.535). In Type 2 diabetic patients, the time to peak CBV increased non-significantly. CONCLUSIONS Short-term improvement in glycaemic control did not appear to reverse microcirculatory dysfunction in Type 1 and Type 2 diabetes. However, there was an improvement of the delayed reactive hyperaemia in Type 1 diabetic patients.
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Affiliation(s)
- M F Meyer
- Department of Internal Medicine, University Clinic Bergmannsheil, Ruhr-University Bochum, 44789 Bochum, Germany.
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Meyer MF, Rüther W. [Crystal arthropathies]. Z Rheumatol 2007; 66:554-5. [PMID: 17934741 DOI: 10.1007/s00393-007-0228-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- M F Meyer
- Medizinische Klinik I, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Deutschland.
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Aslan N, Yurdaydin C, Wiegand J, Greten T, Ciner A, Meyer MF, Heiken H, Kuhlmann B, Kaiser T, Bozkaya H, Tillmann HL, Bozdayi AM, Manns MP, Wedemeyer H. Cytotoxic CD4 T cells in viral hepatitis. J Viral Hepat 2006; 13:505-14. [PMID: 16901280 DOI: 10.1111/j.1365-2893.2006.00723.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
CD4+ T cells are thought to contribute to antiviral immune responses by secretion of cytokines thereby providing help to CD8+ T and B cells. However, perforin-positive cytotoxic CD4+ T cells have been described in human immunodeficiency virus-positive patients suggesting a role not only of CD8+ but also of CD4+ T cells for killing virus-infected cells. We investigated 76 patients with viral hepatitis [15 hepatitis B virus (HBV), 22 HBV/hepatitis D virus and 17 hepatitis C virus (HCV)] for cytotoxic CD4+ T cells. The frequency of perforin-positive CD4+ T cells in viral hepatitis was highly variable ranging from < 1% to more than 25%. Perforin-positive CD4+ T cells displayed the phenotype of terminally differentiated effector cells (CD28-, CD27-). The highest frequencies of CD4+ cytotoxic T lymphocytes (CTLs) were found in patients with delta hepatitis (P = 0.04 vs HBV and HCV patients), and the presence of CD4+ CTLs was associated with elevated aspartate aminotransferase levels (P = 0.01) and decreased platelet counts (P = 0.03). Perforin-positive CD4+ T cells decreased in two individuals during spontaneous clearance of acute hepatitis C. Significant associations were found between the frequency of perforin-expressing CD4+ cells and age (P = 0.04), perforin-positive CD8+ cells (P < 0.001) and perforin-positive CD4-/CD8- lymphoid cells (P = 0.002). Differentiated CD27- effector CD4+ CTLs can be detected in patients with viral hepatitis. In particular in patients with more advanced liver disease, the accumulation of perforin-positive T cells with age could be one correlate for the more severe course of viral hepatitis in elderly individuals.
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Affiliation(s)
- N Aslan
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
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Meyer MF, Czaplewski H, Braun J, Hellmich B, Schatz H, Klein HH. Lack of a difference in increased capillary blood cell velocity in the skin over proximal interphalangeal joints between rheumatoid arthritis and osteoarthritis. Microvasc Res 2005; 70:1-6. [PMID: 16098542 DOI: 10.1016/j.mvr.2005.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Revised: 07/11/2005] [Accepted: 07/12/2005] [Indexed: 11/29/2022]
Abstract
Early detection of synovitis in rheumatoid arthritis (RA) and distinction from osteoarthritis (OA) are important to establish the most appropriate treatment. Increased perfusion over affected joints observed by laser Doppler perfusion imaging was supposed to arise from the underlying joint, because it was detected only by a near-infrared laser and not by a less penetrating red laser source. Using laser Doppler anemometry, this study addressed two questions: (1) whether capillary blood cell velocity (CBV) is increased in the skin over finger joints affected by RA or OA; (2) whether there is a difference between RA and OA in CBV above affected proximal interphalangeal (PIP) joints. Levels of soluble adhesion molecules were measured, because they indicate rheumatoid vasculitis raising flow resistance. Thirty-one patients with RA and 20 with OA were investigated. Compared to 18 controls, CBV (mean+/-SEM) was elevated above PIP joints clinically affected by RA (0.35+/-0.06 mm/s vs. 0.21+/-0.02 mm/s; P<0.05) and over PIP (0.27+/-0.02 mm/s vs. 0.21+/-0.02 mm/s; P<0.05) and distal interphalangeal joints (0.27+/-0.02 mm/s vs. 0.17+/-0.01 mm/s; P<0.001) affected by OA. Levels of soluble adhesion molecules were not correlated with CBV over PIP joints in RA. These observations demonstrated that elevated blood cell velocity is detectable by laser Doppler anemometry in skin capillaries over interphalangeal joints affected by RA or OA and contradict the previous assumption that there is hyperemia only in the affected joint. The lack of a significant difference in CBV over PIP joints between RA and OA patients might be due to some inflammation also occurring in OA rather than to vasculitic processes in RA associated with elevated levels of soluble adhesion molecules.
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Affiliation(s)
- M F Meyer
- Department of Internal Medicine, University Clinic Bergmannsheil, Ruhr-University Bochum, Bürkle-de-la-Camp-Platz 1, D-44789 Bochum, Germany.
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Meyer MF, Menken KU, Zimny S, Hellmich B, Schatz H. Pitfall in diagnosing growth hormone deficiency in a hypochondroplastic patient with a delayed puberty. Exp Clin Endocrinol Diabetes 2003; 111:177-81. [PMID: 12784193 DOI: 10.1055/s-2003-39780] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Hypochondroplasia is a clinically and genetically heterogeneous skeletal dysplasia with less obvious disproportion in childhood and a reduced pubertal growth spurt. We report on a young hypochondroplastic man who had been misdiagnosed and treated as being growth hormone (GH) deficient in the early phase of puberty. The delay of his puberty which is unusual in hypochondroplasia might have confused the results of provocative GH testing. At the age of 17 years measurement of body proportions revealed an increased upper to lower body segment ratio. Skeletal radiographs showed a lack of increase in the interpedicular distance from the first to the fifth lumbar vertebra, anteroposterior shortening of the lumbar pedicles, short femoral necks, a fibula longer than the tibia, and short tubular bones. As the clinical and radiographic features suggested the diagnosis of a skeletal dysplasia, a DNA sequence analysis of the fibroblast growth factor receptor 3 gene on chromosome 4 p16.3 was performed, which identified the missense mutation C1620 G in the tyrosine kinase domain resulting in an Asn540Lys substitution. Hypochondroplastic children with this common mutation (N540K) were previously found to respond to GH treatment with an increase in sitting height compared to leg length, which accentuated the existing disproportion. We want to emphasise that in children with normal serum IGF-I and IGFBP-3 levels accurate measurements of body proportions and skeletal radiographs in disproportionate cases are more important than reiterative GH stimulation tests, which prepubertally and in the early phase of puberty often show subnormal responses.
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Affiliation(s)
- M F Meyer
- Department of Internal Medicine, University Clinic Bergmannsheil, Bochum, Germany
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Abstract
Arteriolar vasomotion, the cyclic contraction/dilation of terminal arterioles, is disordered in diabetes. The aim of the present study was to characterize the impairment of cutaneous vasomotion in type 1 and type 2 diabetes, especially with regard to the influence of metabolic control and to the response to shear stress. Twenty type 1 and 23 type 2 diabetic patients were investigated. Vasomotion waves were recorded in single capillaries at the dorsal middle phalangeal area of the left ring finger during rest, after warming the skin temperature to 33 degrees C, and after 3-min arterial occlusion by means of laser Doppler anemometry. Suprasystolic occlusion caused an increase in amplitudes of vasomotion only in type 1 diabetic patients (0.12 +/- 0.04 mm/s vs. 0.36 +/- 0.06 mm/s, p = 0.001). In type 1 but not in type 2 diabetic patients, both systolic and diastolic blood pressure correlated positively with amplitudes of resting vasomotion (r = 0.62, p = 0.002 and r = 0.65, p = 0.001, respectively). Amplitudes of vasomotion after warming up at frequencies of 5 - 8 cycles per minute (0.08 - 0.13 Hz) correlated inversely with the levels of glycated hemoglobin (HbA 1c ) (r = - 0.56, p = 0.005) only in type 1 diabetic patients. In conclusion, we found suprasystolic occlusion and increasing blood pressure to provoke vasomotion with a concomitant decrease in effective vascular resistance only in type 1 diabetic patients. The impaired vasomotion response to shear stress in type 2 diabetes might favour the development of skin lesions and arterial hypertension. Insufficient glycemic control seems to be an important factor in the pathogenesis of impaired vasomotion in type 1 diabetes.
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Affiliation(s)
- M F Meyer
- Department of Internal Medicine, University Clinic Bergmannsheil, Ruhr-University Bochum, Germany.
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Meyer MF, Rose CJ, Hülsmann JO, Schatz H, Pfohl M. Impaired 0.1-Hz vasomotion assessed by laser Doppler anemometry as an early index of peripheral sympathetic neuropathy in diabetes. Microvasc Res 2003; 65:88-95. [PMID: 12686166 DOI: 10.1016/s0026-2862(02)00015-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Impairment of 0.1-Hz vasomotion, which was found in diabetic patients, was suggested to be an early index of sympathetic dysfunction. We studied the relationships between alterations in vasomotion and both cardiac autonomic and sensory neuropathy. Twenty type 1 and 22 type 2 diabetic patients were investigated. Vasomotion was recorded in single capillaries at the dorsal middle phalangeal area of the left ring finger by means of laser Doppler anemometry. Cardiac autonomic neuropathy was assessed by spectral analysis of heart rate variation during rest and recording heart rate responses to deep breathing and Valsalva manoeuvre. Sensory neuropathy was investigated by measuring heat pain, vibration, and thermal sensory thresholds. Impaired vasomotion was more often (82.4%) found in diabetic patients with at least one altered cardiac autonomic test, but also in 47.1% of those with all of these tests being normal (P = 0.035). Both heart rate variation coefficient during rest (r = 0.40, P = 0.045) and Valsalva ratio (r = 0.41, P = 0.037) correlated positively with amplitudes of vasomotion in type 1 diabetic patients. The prevalence of impaired vasomotion was not higher in patients with sensory neuropathy compared to those with normal sensory functions. A disturbed warm sensation was only found in 2 patients and none had an abnormal heat pain threshold. Our data indicate that impairment of 0.1-Hz vasomotion precedes parasympathetic neuropathy, assessed by heart rate variation tests, and abnormalities in warm and heat pain sensation. Reduction of arteriolar vasomotion, detected by laser Doppler anemometry, might be an early index of sympathetic dysfunction, because it correlates with disturbances in those cardiac autonomic tests, which are at least in part under sympathetic control.
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Affiliation(s)
- M F Meyer
- Department of Internal Medicine, University Clinic Bergmannsheil, Ruhr-University Bochum, D-44789, Bochum, Germany.
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Hellmich B, Hering S, Duchna HW, Schultze-Werninghaus G, Freitag L, Schatz H, Meyer MF. [Airway manifestations of relapsing polychondritis: treatment with cyclophosphamide and placement of bronchial stents]. Z Rheumatol 2003; 62:73-9. [PMID: 12624807 DOI: 10.1007/s00393-003-0419-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We report the case of a 41-year-old female patient with relapsing polychondritis and severe respiratory involvement. The patient presented with acute respiratory failure requiring endotracheal intubation. Bronchoscopy revealed tracheal collapse and inflammatory stenoses with dynamic collapse of the major airways. We describe a multidisciplinary therapeutic approach, consisting of immunosuppressive treatment, bronchoscopic placement of self-expandable stents into the collapsing bronchi, and tracheotomy. In addition, we report the effectiveness of oral cyclophosphamide for treatment of relapsing polychondritis with severe respiratory involvement after failure of other immunosuppressive agents. The problem of severe respiratory complications in patients with relapsing polychondritis and the need for a multidisciplinary approach is discussed.
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Affiliation(s)
- B Hellmich
- Medizinische Klinik und Poliklinik, Rheumatologische Ambulanz, BG Kliniken Bergmannsheil, Universitätsklinik, Ruhr-Universität Bochum, Bürckle-de-la-Camp-Platz 1, 44789 Bochum.
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Zimny S, Meyer MF, Schatz H, Pfohl M. Applied felted foam for plantar pressure relief is an efficient therapy in neuropathic diabetic foot ulcers. Exp Clin Endocrinol Diabetes 2002; 110:325-8. [PMID: 12397530 DOI: 10.1055/s-2002-34988] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The application of felted foam is a promising method for plantar pressure reduction in the ulcer region of neuropathic diabetic foot ulcers, but the knowledge of its impact on the wound healing and healing times in foot ulcers compared to conventional methods of pressure relief is sparse. The aim of this study was to assess the effects on the wound healing of felted foam dressings for plantar pressure reduction in the therapy of neuropathic foot ulcers. This prospective cohort study evaluates healing times and wound healing in 61 diabetic patients with neuropathic foot ulcerations. Ulcer healing was assessed by planimetric measurement of the wound area at beginning of the study and after 10 weeks and at least until wound healing. The patients were consecutively enrolled in the study, 27 patients were randomized to the felted foam therapy, and 34 patients were randomized to conventional therapy. In the felted foam group, the initial average wound area was 110.8 +/- 14.4 mm 2 (mean +/- SE), and 2.1 +/- 0.5 mm 2 after ten weeks (p < 0.0001), with an average healing time of 79.6 (95%-CI 75-84) days. In the conventional therapy group, the initial average wound area was 119.2 +/- 13.8 mm 2, and 3.4 +/- 0.7 mm 2 after ten weeks (p < 0.0001). The average healing times was 83.2 (95%-CI 77-90) days. Both with respect to the wound healing process and the healing times, the felted foam technique appears to be as effective as conventional plantar ulcer treatment. We conclude that the felted foam technique is an useful alternative in the therapy of the neuropathic diabetic foot syndrome, especially in patients who are not able to avoid weight-bearing reliably.
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Affiliation(s)
- S Zimny
- Berufsgenossenschaftliche Kliniken Bergmannsheil, Universitätsklinik Bochum, Germany
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Meyer MF, Schnabel A, Schatz H, Gross WL. Lack of association between antiphospholipid antibodies and thrombocytopenia in patients with Wegener's granulomatosis. Semin Arthritis Rheum 2001; 31:4-11. [PMID: 11503134 DOI: 10.1053/sarh.2001.25060] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVE In patients with Wegener's granulomatosis (WG), thrombocytopenia is less common than thrombocytosis. An increased prevalence of antiphospholipid antibodies (aPL), which is associated with thrombocytopenia, has been noted in patients with WG. The aim of this study was to examine the relationship between thrombocytopenia and aPL in patients with WG. METHODS Thrombocytopenic episodes were searched for in a random sample of 83 patients with WG. Stored sera obtained during thrombocytopenia, which was defined as platelet count below 130 x 10(9)/L, were examined by 2 different enzyme-linked immunosorbent assays (ELISA) for IgG and IgM anticardiolipin antibodies (aCL) and for IgG antiphosphatidylserine antibodies (aPS). Screening for lupus anticoagulant was performed by use of activated partial thromboplastin time (aPTT). Results were compared with the prevalence of aPL in 20 consecutive nonthrombocytopenic patients with WG. RESULTS Six cases with thrombocytopenic episodes were found in the group of 83 patients with WG. Increased IgG and IgM aCL were detected in 1 patient, who also had elevated IgG aPS. A positive test result solely for IgM aCL was found in another patient. These findings were consistent in both ELISA for aPL. Five patients were being treated with cyclophosphamide when thrombocytopenia occurred. In the group of nonthrombocytopenic patients with WG, elevated IgG aCL and IgG aPS were consistently detected in 1 patient in both ELISA. Three other patients had positive results in single tests, which were not confirmed by the second assay. In all patients, aPTT was normal. CONCLUSIONS Thrombocytopenia is a rare finding in patients with WG. A similar prevalence of aPL in thrombocytopenic and nonthrombocytopenic patients with WG provides no evidence that aPL play a major role in the pathogenesis of these events. Thrombocytopenia in WG is more likely caused by the myelotoxic effect of preceding cyclophosphamide treatment. We found a frequency of aPL in WG that exceeds frequencies seen in the general population but does not approximate those detected in systemic lupus erythematosus and closely related disorders. Semin Arthritis Rheum 31:4-11.
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Affiliation(s)
- M F Meyer
- Department of Rheumatology, Medical University of Lübeck, Germany
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Meyer MF, Gerresheim F, Pfeiffer A, Epplen JT, Schatz H. Association of polycystic ovary syndrome with an interstitial deletion of the long arm of chromosome 11. Exp Clin Endocrinol Diabetes 2001; 108:519-23. [PMID: 11149629 DOI: 10.1055/s-2000-11023] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Several pathways have been implicated in the etiology of the polycystic ovary syndrome (PCOS). The observation of familial aggregation of PCOS is consistent with a genetic component of this disorder. We report on a 21-year-old woman with menstrual irregularity, hirsutism, elevated serum androgen levels and polycystic ovarian morphology on ultrasonography, meeting the diagnostic criteria of PCOS. A cytogenetic investigation was performed because of a congenital heart defect, craniofacial anomalies in infancy (quadricephaly with protruding forehead, flat nasal bridge, low set ears with attached earlobes, small mouth, high arched palate with submucous palatal cleft, retrognathia), broad neck, motor and speech developmental delay. Chromosomal analysis revealed an unbalanced interstitial deletion of one of the chromosomes 11 [del (11) (q21q23.1)]. Interstitial deletions of the long arm of chromosome 11 have been reported in at least 18 patients. Candidate genes for PCOS have not been suspected at this chromosomal location so far. Follistatin and CYP11A, the genes with the strongest evidence for linkage with PCOS, are located on chromosomes 5 and 15. In the chromosomal region deleted in our patient a progesterone receptor gene is located in band q22. Lowered progesterone receptor concentration is associated with retardation of endometrial development. A disturbance of the hypothalamic-pituitary gonadal axis, due to a reduction of hypothalamic and pituitary progesterone receptors might be a component in the etiology of PCOS.
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Affiliation(s)
- M F Meyer
- Department of Internal Medicine, University Clinic Bergmannsheil, Bochum, Germany
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Meyer MF, Pfohl M, Schatz H. [Assessment of diabetic alterations of microcirculation by means of capillaroscopy and laser-Doppler anemometry]. Med Klin (Munich) 2001; 96:71-7. [PMID: 11253285 DOI: 10.1007/pl00002181] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Only minor changes of skin capillary morphology have been described in diabetic patients by means of capillaroscopy, whereas cutaneous microvascular dysfunction is well known. We examined correlations between functional and morphological abnormalities of the capillaries in Type 1 and 2 diabetic patients and the influence of diabetes duration on capillary morphology. PATIENTS AND METHODS Density, diameters and morphology of nailfold capillaries were investigated in diabetic patients, 16 Type 1 and 19 Type 2, and compared to age- and sex-matched control groups. Capillary blood cell velocities (CBV) during rest and after 3-minute arterial occlusion were measured in the dorsal middle phalangeal area of the left ring finger by means of laser Doppler anemometry. RESULTS Capillary density, width and arterial limb diameter were similar in Type 1 and 2 diabetic patients compared to their controls. Capillary diameters of the apical part and the venous limb were enlarged in the combined analysis of Type 1 and 2 diabetic patients compared to the control group (apex: 19.2 +/- 0.6 microns vs 17.4 +/- 0.6 microns, p = 0.0243; venous limb: 17.3 +/- 0.5 microns vs 15.9 +/- 0.4 microns, p = 0.0238). Tortuous capillaries were more often observed in Type 1 (n = 13 vs n = 7, p = 0.028) and 2 diabetic patients (n = 16 vs n = 9, p = 0.019) than in controls. In Type 1 diabetic patients an inverse correlation (r = -0.52; p = 0.019) was found between capillary density and resting CBV. In Type 2 diabetic patients capillary apex diameter correlated positively with peak CBV (r = 0.49; p = 0.017). Disease duration correlated inversely with arterial limb diameter (r = -0.48; p = 0.020) and width of the capillaries (r = -0.48; p = 0.018) in Type 2 diabetic patients. CONCLUSION Tortuous and dilated capillaries, indicating microangiopathy, were found in the skin of diabetic patients by means of capillaroscopy. Using laser Doppler anemometry it is possible to assess impairment of postocclusive reactive hyperemia, due to diabetic microvascular dysfunction, in single capillaries. Correlations between morphological and functional microcirculatory alterations in diabetes may be explained by hemodynamic changes, depending on diabetes duration.
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Affiliation(s)
- M F Meyer
- Medizinische Klinik, Universitätsklinik Bergmannsheil, Ruhr-Universität Bochum
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Meyer MF, Hellmich B, Kotterba S, Schatz H. Cytomegalovirus infection in systemic necrotizing vasculitis: causative agent or opportunistic infection? Rheumatol Int 2000; 20:35-8. [PMID: 11149660 DOI: 10.1007/s002960000063] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We report on a 69-year-old woman who presented with myalgia, hearing impairment, fever, night sweats, weight loss, muscular weakness, paresthesia, hypesthesia, and hypalgesia. Sural nerve biopsy showed demyelinative and axonal polyneuropathy due to necrotizing vasculitis with fibrinoid necrosis. A positive test for antineutrophil cytoplasmic antibodies (ANCA) with a perinuclear immunofluorescence pattern directed against myeloperoxidase was more suggestive of microscopic polyangiitis (MPA) than of polyarteritis nodosa (PAN), the possible differential diagnoses. In addition, positive tests for cytomegalovirus (CMV) antibodies (immunoglobulin (Ig)M and IgG) and the detection of CMV-DNA in sputum specimens by polymerase chain reaction (PCR) were indicative of active CMV infection. Treatment with ganciclovir and anti-CMV immunoglobulin in addition to prednisolone medication for 6 months resulted in rapid improvement of the clinical symptoms without relapse. CMV infection has been described to be related to ANCA-associated vasculitis in non-immunocompromized patients and may be either a causative agent or an opportunistic infection. Identification of a viral etiology in patients with atypical ANCA-associated vasculitides may lead to different, less aggressive treatment approaches, including antiviral therapy.
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Affiliation(s)
- M F Meyer
- Department of Internal Medicine, University Clinic Bergmannsheil, Bochum, Germany
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Meyer MF, Pfohl M, Schatz H. Correlations between morphological and functional microcirculatory alterations in diabetes and the impact of metabolic control and disease duration. Microvasc Res 2000; 59:186-9. [PMID: 10625588 DOI: 10.1006/mvre.1999.2210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- M F Meyer
- Department of Internal Medicine, University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
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Meyer MF. Improving job interview skills. Healthc Financ Manage 1999; 53:64-6. [PMID: 11066710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- M F Meyer
- Hadelman & Lloyd, Phoenix, Arizona, USA
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Meyer MF, Schatz H. Influence of metabolic control and duration of disease on microvascular dysfunction in diabetes assessed by laser Doppler anemometry. Exp Clin Endocrinol Diabetes 1998; 106:395-403. [PMID: 9831305 DOI: 10.1055/s-0029-1212005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A reduced and delayed postocclusive reactive hyperaemia has been demonstrated in diabetic patients using videophotometric capillaroscopy and laser Doppler fluxmetry. The aim of the present study was to examine by means of the new technique of laser Doppler anemometry whether impairment of skin microcirculation differs between type 1 and type 2 diabetic patients especially with regard to metabolic control and duration of diabetes. Sixteen type 1 and 19 type 2 diabetic patients were investigated and subdivided in patients with "good" (HbA1c < 7.5%) or "bad" (HbA1c > 7.5%) metabolic control and in patients with a diabetes duration of less or more than 10 years. Two age- and sex-matched groups comprising 16 and 19 non-diabetic subjects served as controls. The capillary blood cell velocity (CBV) was measured in the dorsal middle phalangeal area during rest and after 3-min arterial occlusion. In type 1 diabetic patients we found a reduced peak CBV (0.69 +/- 0.08 mm/s vs. 0.96 +/- 0.07 mm/s, p < 0.05) and a prolonged time to peak CBV (33.8 +/- 4.8 s vs. 13.6 +/- 1.9 s, p < 0.001). The delay of the postocclusive reactive hyperaemia was shown not only in patients with a diabetes duration of more than 10 years and HbA1c values above 7.5% but also in patients with a shorter disease duration and better metabolic control. In type 2 diabetes time to peak CBV (46.8 +/- 8.5 s vs. 16.4 +/- 2.2 s, p < 0.001) was also prolonged already in the first 10 years of the disease. However with regard to metabolic control a reduced peak CBV (0.54 +/- 0.04 mm/ s vs. 0.70 +/- 0.04 mm/s, p < 0.05) and a prolonged time to peak CBV (56.6 +/- 14.8 s vs. 13.7 +/- 2.7 s, p < 0.01) was found in type 2 diabetes only in the group of patients with HbA1c > 7.5%. The results indicate that in type 2 diabetes actual metabolic control might be of greater importance for the microvascular dysfunction than in type 1 diabetes and that the skin capillary circulation is impaired already in the first 10 years of both diabetes types.
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Affiliation(s)
- M F Meyer
- Department of Internal Medicine, University Clinic Bergmannsheil, Ruhr-University Bochum, Germany
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Abstract
The membrane-bound PH-20 hyaluronidase is known to be essential for fertilization. Here we addressed the question whether the soluble hyaluronidase from bull teste is related to the PH-20 polypeptide. The sequence of the membrane-bound PH-20 hyaluronidase from bovine sperm was determined via cDNA cloning. In parallel, from a commercial preparation of bovine hyaluronidase the major 60-kDa form was purified to apparent homogeneity. The soluble enzyme was digested with two different proteases and with cyanogen bromide and the amino acid sequence of 44 different fragments was determined. All the peptide sequences could be aligned to the sequence deduced from the cloned cDNAs. Our results thus show that the soluble 60-kDa hyaluronidase from bovine testes is a glycoprotein derived from the sperm PH-20 enzyme. As compared to the primary translation product of the PH-20 mRNA, it lacks the signal peptide at the amino terminus and 56 amino acids at the carboxyl end. These results demonstrate that the soluble 60-kDa enzyme is a fragment of the PH-20 hyaluronidase. It is currently not known whether the soluble testes hyaluronidase has a distinct biological function.
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Affiliation(s)
- M F Meyer
- Institute of Molecular Biology, Austrian Academy of Sciences, Salzburg
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35
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Abstract
DG42 is one of the main mRNAs expressed during gastrulation in embryos of Xenopus laevis. Here we demonstrate that cells expressing this mRNA synthesize hyaluronan. The cloned DG42 cDNA was expressed in rabbit kidney (RK13) and human osteosarcoma (tk-) cells using a vaccinia virus system. Lysates prepared from infected cells were incubated in the presence of UDP-N-acetylglucosamine and UDP-[14C]glucuronic acid. This yielded a glycosaminoglycan with a molecular mass of about 200,000 Da. Formation of this product was only observed in the presence of both substrates. The glycosaminoglycan could be digested with testicular hyaluronidase and with Streptomyces hyaluronate lyase but not with Serratia chitinase. Hyaluronan synthase activity could also be detected in homogenates of early Xenopus embryos, and the activity was found to correlate with the expression of DG42 mRNA at different stages of development. Synthesis of hyaluronan is thus an early event after midblastula transition, indicating its importance for the ensuing cell movements in the developing embryo. Our results are at variance with a recent report (Semino, C. E. & Robbins, P. W. (1995) Proc. Natl. Acad. Sci. USA 92, 3498-3501) that DG42 codes for an enzyme that catalyzes the synthesis of chitin-like oligosaccharides.
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Affiliation(s)
- M F Meyer
- Institute of Molecular Biology, Austrian Academy of Sciences, Salzburg, Austria
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36
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Meyer MF, Tinucci CM, Otto KE. Human resources managers in managed-care organizations. J Health Care Benefits 1993; 3:44-6. [PMID: 10130349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- M F Meyer
- Witt/Kieffer, Ford, Hadelman & Lloyd
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37
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Meyer MF, Taher A, Krah H, Staubesand J, Becker AJ, Kircher M, Mayer B, Jonas U, Forssmann WG, Stief CG. Intracavernous application of SIN-I in rabbit and man: functional and toxicological results. Ann Urol (Paris) 1993; 27:179-182. [PMID: 8352581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The mode of action of the active metabolite SIN-I of the vasodilator prodrug molsidomine was studied in vitro and in vivo in corpus cavernosum of rabbit and man. SIN-I produces a dose-dependent relaxation of isolated human cavernous smooth muscle strips. In the rabbit, the intracavernous application of SIN-I increased the intracavernous pressure to a full erection (approximately 100 cm H2O). This response was highly reproductible. SIN-I was also injected intracavernously 6 times in five rabbits over 2 weeks; no inflammatory or fibrotic reactions were found on histology. SIN-I may be a reliable drug for the treatment of impotence without side-effects.
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Affiliation(s)
- M F Meyer
- Urologische Klinik, Medizinischen Hochschule, Hannover, Germany
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Bikker H, Meyer MF, Merk AC, de Vijlder JJ, Bolhuis PA. XmnI RFLP at 5q13 detected by a 0.49 kb Xmn I fragment of human hexosaminidase (HEXB) cDNA. Nucleic Acids Res 1988; 16:8198. [PMID: 2901717 PMCID: PMC338540 DOI: 10.1093/nar/16.16.8198] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- H Bikker
- Department of Neurology and Pediatrics, Academic Medical Center, Amsterdam, The Netherlands
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Minch DA, Meyer MF, Eller R. Information systems--audit is first step in planning. Hospitals 1982; 56:85-6, 88. [PMID: 7037605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Meyer MF. [From carate gold to platinum gold]. Rev Fr Odontostomatol 1967; 14:1375-82. [PMID: 5235422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Meyer MF. SPACE PERCEPTION BY RADIO. Science 1939; 89:389. [PMID: 17742782 DOI: 10.1126/science.89.2313.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Meyer MF. "The" South and "the" North. Science 1934; 80:428-9. [PMID: 17816042 DOI: 10.1126/science.80.2080.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Meyer MF. Musical Pitch and Physical Pitch. Science 1930; 72:503. [PMID: 17796218 DOI: 10.1126/science.72.1872.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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