1
|
Issa M, Kalliri V, Euteneuer S, Krümpelmann A, Seitz A, Sommerburg O, Westhoff JH, Syrbe S, Lenga P, Grutza M, Scherer M, Neumann JO, Baumann I, Unterberg AW, El Damaty A. The association of COVID-19 pandemic with the increase of sinogenic and otogenic intracranial infections in children: a 10-year retrospective comparative single-center study. Neurosurg Rev 2024; 47:205. [PMID: 38713418 PMCID: PMC11076320 DOI: 10.1007/s10143-024-02442-9] [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] [Received: 10/08/2023] [Revised: 03/26/2024] [Accepted: 04/27/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVE Otitis media and sinusitis are common childhood infections, typically mild with good outcomes. Recent studies show a rise in intracranial abscess cases in children, raising concerns about a link to COVID-19. This study compares a decade of data on these cases before and after the pandemic. METHODS This retrospective comparative analysis includes pediatric patients diagnosed with otitis media and sinusitis, who later developed intracranial abscesses over the past decade. We collected comprehensive data on the number of cases, patient demographics, symptoms, treatment, and outcomes. RESULTS Between January 2013 and July 2023, our center identified 10 pediatric patients (median age 11.1years, range 2.2-18.0 years, 60% male) with intracranial abscesses from otitis media and sinusitis. Of these, 7 cases (70%, median age 9.7 years, range 2.2-18.0 years) occurred since the onset of the COVID-19 pandemic, while the remaining 3 cases (30%, median age 13.3 years, range 9.9-16.7 years) were treated before the pandemic. No significant differences were found in otolaryngological associations, surgical interventions, preoperative symptoms, lab findings, or postoperative antibiotics between the two groups. All patients showed positive long-term recovery. CONCLUSION This study reveals 5-fold increase of pediatric otogenic and sinogenic intracranial abscess cases in the last three-years since the onset of the COVID-19 pandemic. While further investigation is needed, these findings raise important questions about potential connections between the pandemic and the severity of otitis media and sinusitis complications in children. Understanding these associations can improve pediatric healthcare management during infectious disease outbreaks.
Collapse
Affiliation(s)
- Mohammed Issa
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany.
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.
| | - Vasiliki Kalliri
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Sara Euteneuer
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Otorhinolaryngology, Heidelberg University Hospital, Heidelberg, Germany
| | - Arne Krümpelmann
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Center for Pediatric and Adolescent Medicine, Department I, University Hospital Heidelberg, Heidelberg, Germany
| | - Angelika Seitz
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Deptartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Olaf Sommerburg
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Center for Pediatric and Adolescent Medicine, Department I, University Hospital Heidelberg, Heidelberg, Germany
| | - Jens H Westhoff
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Center for Pediatric and Adolescent Medicine, Department I, University Hospital Heidelberg, Heidelberg, Germany
| | - Steffen Syrbe
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Center for Pediatric and Adolescent Medicine, Department I, University Hospital Heidelberg, Heidelberg, Germany
| | - Pavlina Lenga
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Martin Grutza
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Moritz Scherer
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Jan-Oliver Neumann
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Ingo Baumann
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Otorhinolaryngology, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas W Unterberg
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Ahmed El Damaty
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| |
Collapse
|
2
|
Plath M, Sand M, Appel M, Euteneuer S, Praetorius M, Baumann I, Zaoui K. [Validity of the German Menière's Disease Patient-Oriented Symptom Severity Index]. Laryngorhinootologie 2023; 102:856-866. [PMID: 37072009 DOI: 10.1055/a-2047-3806] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
BACKGROUND The MD POSI is a disease-specific questionnaire to determine the health-related quality of life (HRQoL) of patients with Menière's disease (MD). OBJECTIVES Validity and reliability of the German translation of the MD POSI. MATERIAL AND METHODS Prospective data analysis of a patient group with vertigo (n = 162), which was treated in the otorhinolaryngology of a University Hospital from 2005-2019. A clinical selection was made according to the new Bárány classification in a "definite" and "probable" Menière's disease. HRQoL was assessed using the German translation of the MD POSI, the Vertigo Symptom Score (VSS) and the Short Form (SF-36). Reliability was measured by Cronbach's α and test-retesting after 12 months and again 2 weeks later. Content and agreement validity were examined. RESULTS Cronbach α values greater than 0.9 indicated good internal consistency. There was no statistically significant difference from baseline to 12 months, except for the subscore "during the attack". There were significant positive correlations between the VSS overall/VER/AA and the overall index of the MD POSI and negative significant correlations with the SF-36 domains physical functioning, physical role functioning, social functioning, emotional role functioning, mental well-being. There were low SRM (standardized response mean) values below 0.5. CONCLUSIONS The German translation of the MD POSI is a valid and reliable instrument to evaluate the impact of MD on patients' disease-specific quality of life.
Collapse
Affiliation(s)
- Michaela Plath
- Hals-, Nasen- und Ohrenklinik, Heidelberg University Hospital Head Clinic Center, Heidelberg, Germany
| | - Matthias Sand
- GESIS, GESIS - Leibnitz-Institut für Sozialwissenschaften in Mannheim, Mannheim, Germany
| | - Maximilian Appel
- Mund-, Kiefer- und Gesichtschirurgie, Heidelberg University Hospital Head Clinic Center, Heidelberg, Germany
| | - Sara Euteneuer
- Hals-, Nasen- und Ohrenklinik, Heidelberg University Hospital Head Clinic Center, Heidelberg, Germany
| | | | - Ingo Baumann
- Hals-, Nasen- und Ohrenklinik, Heidelberg University Hospital Head Clinic Center, Heidelberg, Germany
| | - Karim Zaoui
- Hals-, Nasen- und Ohrenklinik, Heidelberg University Hospital Head Clinic Center, Heidelberg, Germany
| |
Collapse
|
3
|
|
4
|
Euteneuer S. [Chronic dysfunction of the eustachian tube: diagnosis and results of balloon dilatation of the eustachian tube]. HNO 2013; 61:460-1. [PMID: 23670680 DOI: 10.1007/s00106-013-2714-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
5
|
Kondo K, Pak K, Chavez E, Mullen L, Euteneuer S, Ryan AF. Changes in responsiveness of rat spiral ganglion neurons to neurotrophins across age: differential regulation of survival and neuritogenesis. Int J Neurosci 2013; 123:465-75. [PMID: 23301942 DOI: 10.3109/00207454.2013.764497] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Developmental changes in responsiveness of rat spiral ganglion neurons (SGNs) to neurotrophin-3 (NT-3) and brain-derived neurotrophic factor (BDNF) were examined using an explant culture system. Spiral ganglion (SG) explants at embryonic Day 18 (E18), postnatal Day 0 (P0), P5, P10 and P20 were cultured with the addition of either NT-3 or BDNF at various concentrations (0.1-100 ng/ml) and analyzed the dose-response characteristics of three parameters: SGN survival, the number of neurites emanating from the explants and the length of neurite extension. In E18 cultures, SGN survival and neurite number were enhanced more strongly by NT-3 than by the BDNF. As the explants became more mature, the effects of NT-3 decreased, whereas those of BDNF increased, peaking at P0. Although the intrinsic capacity of SGNs to produce and extend neurites declined considerably by P20, they still retained the capacity to respond to both NT-3 and BDNF. These temporal patterns in responsiveness of SGNs to neurotrophins correspond well to the expression pattern of the two neurotrophins in cochlear sensory epithelium in vivo and also correlate with the time course of developmental events in SGNs such as cell death and the establishment of mature hair cell innervation patterns.
Collapse
Affiliation(s)
- Kenji Kondo
- Division of Otolaryngology and Neurosciences, Department of Surgery and Veterans Administration Medical Center, University of California, San Diego School of Medicine, La Jolla, CA 92093, USA
| | | | | | | | | | | |
Collapse
|
6
|
Leichtle A, Hernandez M, Ebmeyer J, Yamasaki K, Lai Y, Radek K, Choung YH, Euteneuer S, Pak K, Gallo R, Wasserman SI, Ryan AF. CC chemokine ligand 3 overcomes the bacteriocidal and phagocytic defect of macrophages and hastens recovery from experimental otitis media in TNF-/- mice. J Immunol 2010; 184:3087-97. [PMID: 20164426 DOI: 10.4049/jimmunol.0901167] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Innate immune mechanisms are crucial in defense against bacterial illnesses in humans, as evidenced by abnormal antibacterial responses due to defects in TLR signaling, seen in children with MyD88 or IL-1R-associated kinase 4 deficiency. Otitis media (OM) is the most common disease of childhood, and the role of innate immune molecules in this disorder remains unclear. In a murine model of OM, we show that, in the absence of TNF, a key effector of innate immunity, this disease is prolonged after middle ear infection with nontypeable Haemophilus influenzae (NTHi). In the absence of TNF, mice fail to upregulate both TLRs and downstream genes and proteins, such as CCL3, resulting in defects in both inflammatory cell recruitment and macrophage function. Peritoneal macrophages of mice lacking TNF have a diminished ability to phagocytose and kill NTHi, and this defect is partially corrected in vitro by exogenous rTNF. Addition of rCCL3 alone or in combination with rTNF restores phagocytosis and killing by TNF-deficient macrophages to that of unstimulated wild-type macrophages. In vivo administration of rCCL3 to animals deficient in TNF fully restores the ability to control OM due to NTHi, whereas a CCL3-blocking Ab impaired the ability of wild-type mice to recover from OM. Thus, CCL3 is a potent downstream effector of TNF-mediated inflammation in vitro and in vivo. Manipulation of CCL3 and/or TNF may prove to be effective therapeutic approaches in OM or other conditions associated with defective TNF generation.
Collapse
Affiliation(s)
- Anke Leichtle
- Division of Otolaryngology, Department of Surgery, University of California, San Diego, La Jolla, CA 92093, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Leichtle A, Yamasaki K, Euteneuer S, Wasserman SI, Wollenberg B, Ryan AF. Impaired antibacterial function is restored via CCL3. Otolaryngol Head Neck Surg 2009. [DOI: 10.1016/j.otohns.2009.06.252] [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: 10/20/2022]
|
8
|
Hernandez M, Leichtle A, Pak K, Ebmeyer J, Euteneuer S, Obonyo M, Guiney DG, Webster NJ, Broide DH, Ryan AF, Wasserman SI. Myeloid differentiation primary response gene 88 is required for the resolution of otitis media. J Infect Dis 2009; 198:1862-9. [PMID: 18986247 DOI: 10.1086/593213] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Signaling defects in the Toll-like receptor (TLR) pathway, such as interleukin-1 receptor-associated kinase 4 deficiency, highlight the prominence of TLR signaling in the defense against bacterial disease. Because myeloid differentiation primary response gene 88 (MyD88) can transduce signals from almost all TLRs, we studied its role in otitis media (OM), the most common upper respiratory tract bacterial infectious disease in young children. METHODS The middle ears (MEs) of wild-type (WT) and MyD88(-/-) mice were inoculated with nontypeable Haemophilus influenzae (NTHi). ME infection and inflammation were monitored for 21 days after surgery. Bone marrow-derived macrophages from WT and MyD88(-/-) mice were infected with NTHi in vitro to assess their interaction with bacteria. RESULTS In WT mice, MyD88 expression was detected in the ME stroma at baseline. MyD88(-/-) mice displayed prolonged ME mucosal thickening and delayed recruitment of neutrophils and macrophages. Although WT mice cleared NTHi within 5 days, viable NTHi were isolated for up to 21 days in MyD88(-/-) mice. The interaction between macrophages and NTHi was significantly altered in MyD88(-/-) mice. CONCLUSIONS In this mouse model, MyD88-mediated signaling was important for clearance of infection and resolution of inflammation in acute OM due to NTHi. The role played by innate signaling in children susceptible to chronic or recurrent OM deserves further study.
Collapse
Affiliation(s)
- Michelle Hernandez
- Department of Pediatrics, Division of Allergy, Immunology, Rheumatology, and Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Evans AR, Euteneuer S, Chavez E, Mullen LM, Hui EE, Bhatia SN, Ryan AF. Laminin and fibronectin modulate inner ear spiral ganglion neurite outgrowth in anin vitro alternate choice assay. Dev Neurobiol 2007; 67:1721-30. [PMID: 17600813 DOI: 10.1002/dneu.20540] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Extracellular matrix (ECM) molecules have been shown to function as cues for neurite guidance in various populations of neurons. Here we show that laminin (LN) and fibronectin (FN) presented in stripe micro-patterns can provide guidance cues to neonatal (P5) inner ear spiral ganglion (SG) neurites. The response to both ECM molecules was dose-dependent. In a LN versus poly-L-lysine (PLL) assay, neurites were more often observed on PLL at low coating concentrations (5 and 10 microg/mL), while they were more often on LN at a high concentration (80 microg/mL). In a FN versus PLL assay, neurites were more often on PLL than on FN stripes at high coating concentrations (40 and 80 microg/mL). In a direct competition between LN and FN, neurites were observed on LN significantly more often than on FN at both 10 and 40 microg/mL. The data suggest a preference by SG neurites for LN at high concentrations, as well as avoidance of both LN at low and FN at high concentrations. The results also support a potential model for neurite guidance in the developing inner ear in vivo. LN, in the SG and osseus spiral lamina may promote SG dendrite growth toward the organ of Corti. Within the organ of Corti, lower concentrations of LN may slow neurite growth, with FN beneath each row of hair cells providing a stop or avoidance signal. This could allow growth cone filopodia increased time to sample their cellular targets, or direct the fibers upward toward the hair cells.
Collapse
Affiliation(s)
- Amaretta R Evans
- Department of Surgery/Otolaryngology, University of California San Diego, School of Medicine, and VA San Diego Health Care Systems, 9500 Gilman Drive, MC 0666, La Jolla, California 92093, USA
| | | | | | | | | | | | | |
Collapse
|
10
|
Schwaab M, Euteneuer S, Lautermann J, Sudhoff H. Lysozym und Laktoferrin in Adenoiden, hyperplastischen und chronisch entzündeten Tonsillen - eine quantitative Analyse. Laryngorhinootologie 2005; 84:660-4. [PMID: 16142620 DOI: 10.1055/s-2005-870297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 10/25/2022]
Abstract
BACKGROUND Muramidase and lactoferrin are important components of the antimicrobial defense system. Muramidase has the ability of opsonization and immunopotentiation and therefore a close relation to the lymphatic tissue. Till now there are only immunohistochemical and microbiological studies on the presence of muramidase and lactoferrin in adenoid and tonsil tissue available. METHOD We investigated the concentrations of muramidase and lactoferrin in palatine tonsils and adenoidal hypertrophies quantitatively using ELISA. MATERIAL We investigated tissue of 18 palatine tonsils and 16 pharyngeal tonsils. RESULTS We found a significant difference in the concentration of muramidase but no difference in the concentration of lactoferrin between adenoids and tonsils. There was no significant difference in the concentration of lactoferrin and muramidase between the hypertrophic and chronic infected tonsils. There was no correlation between the age of the patients and the concentration of muramidase and lactoferrin. A connection between the microbial biofilm, the concentration of the proteins and the recurrent tonsillitis is discussed. CONCLUSIONS Due to the production of muramidase and lactoferrin adenoids and tonsils play an important role in the local antimicrobial defense in any age or inflammation.
Collapse
Affiliation(s)
- M Schwaab
- Universitätsklinik für Hals- Nasen- Ohrenheilkunde und Kopf- und Halschirurgie, Ruhr-Universität Bochum.
| | | | | | | |
Collapse
|
11
|
Euteneuer S, Windisch W, Suchi S, Köhler D, Jones PW, Schönhofer B. Health-related quality of life in patients with chronic respiratory failure after long-term mechanical ventilation. Respir Med 2005; 100:477-86. [PMID: 16039838 DOI: 10.1016/j.rmed.2005.06.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [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] [Received: 02/24/2005] [Accepted: 06/09/2005] [Indexed: 11/23/2022]
Abstract
STUDY OBJECTIVES This study was aimed at assessing health-related quality of life (HRQL) in patients with chronic respiratory failure (CRF) and long-term survival following prolonged intensive care mechanical ventilation. DESIGN Observational cohort study. SETTING Patients with CRF who had been transferred to our specialized weaning centre due to prolonged mechanical ventilation (>14 days) and weaning failure. PATIENTS AND PARTICIPANTS Out of 87 long-term survivors (>6 months), 73 patients (mean age: 60.3+/-13.6 years, chronic obstructive pulmonary disease (COPD, 43%), thoraco-restrictive (21%) or neuromuscular disorders (15%), various chronic diseases (22%)) returned the MOS 36-Item Short-Form Health Status Survey (SF-36) and the St. George's respiratory questionnaire (SGRQ). MEASUREMENTS AND RESULTS The total ventilation time was 38.7+/-45.9 days. The time between discharge from ICU and HRQL assessment was 31.0+/-22.2 months. Physical health was markedly reduced compared to general population norm, but mental health was mildly impaired. HRQL was comparable to patients with stable CRF receiving non-invasive ventilation who did not need prolonged invasive MV. In addition, general HRQL was better in patients with restrictive respiratory disease compared to patients with neuromuscular diseases (P<0.05). Physiological parameters such as blood gases or lung function parameters were not correlated to any HRQL measurements. CONCLUSIONS In patients with CRF surviving prolonged ventilation on ICU, the presence of CRF itself is the major determinant of HRQL. Here, the underlying cause of CRF is the major factor which determines the degree of HRQL impairment with patients suffering from restrictive ventilatory disorders reporting the best HRQL when compared to patients with COPD or neuromuscular diseases. Despite severe physical handicaps due to CRF mental health is only mildly compromised.
Collapse
|
12
|
Abstract
INTRODUCTION Chondrosarcomas belong to the most common malignomas of the skeletal system. The vast majority is located at the epiphysis of the long bones or in the pelvis. Less than 10% of chondrosarcomas are located in the head and neck area, most common in the bony viscerocranium and the larynx. Five histological variants can be differentiated: conventional, mesenchymal, myxoid, dedifferentiated and in less than 5% clear cell chondrosarcomas (CCCS). This case report gives the first description of a CCCS originating from the nasal septum. CASE REPORT A 79 year old female complaining about a 6 month history of nasal obstruction revealed a huge ballooning of the basal septum in anterior rhinoscopy. Computed tomography exhibited a septal tumor with amorphous calcification. Histology of the tumor resected via lateral rhinotomy confirmed a diagnosis of CCCS. Because of clear surgical margins no radiation therapy was performed. The patient stayed free of recurrence during follow-up of sixteen months. DISCUSSION The patient presented with typical symptoms of nasoseptal tumors as well as representative CT-scans and histologic findings of CCCS. Because of the complete resection and the CCCS-subtype, the patient is expected to have a positive prognosis.
Collapse
Affiliation(s)
- S Euteneuer
- Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie der Ruhr-Universität Bochum, St. Elisabeth-Hospital, Bochum.
| | | | | | | | | |
Collapse
|
13
|
Affiliation(s)
- H Sudhoff
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie der Ruhr-Universität Bochum am St. Elisabeth Hospital Bochum, Bochum.
| | | | | | | | | |
Collapse
|
14
|
Sudhoff H, Liebehenz Y, Aschenbrenner J, Euteneuer S, Ebmeyer J, Bernal-Sprekelsen M, Stark T, Dazert S. [Expression of osteoclast stimulating and differentiating factors in a murine model of localized inflammatory bone resorption]. Laryngorhinootologie 2004; 83:14-9. [PMID: 14740300 DOI: 10.1055/s-2004-814236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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
BACKGROUND The pathology associated to cholesteatoma is predominantly a consequence of osteoclast-mediated bone resorption within the middle ear. To assess its pathogenesis a murine model for dermal-implant induced osteolysis was evaluated for the expression of osteoclast stimulating and differentiating factors. METHODS Mouse calvaria were analysed for the expression of osteoprotegerin ligand (OPGL), osteoprotegerin (OPG) and macrophage-colony stimulating factor (M-CSF) using immunohistochemistry. The detection of osteoclast cell lineage was acquired by immunohistochemistry using markers CD 4, CD 11a, CD 11b, CD 14, CD 51, CD 68 and TRAP. RESULTS An increased expression of the investigated cytokines M-CSF, OPG and OPGL was demonstrated by immunohistochemistry. The presence of osteoclast precursor cells and mature resorbing osteoclasts was confirmed in time-dependent manner triggered by dermal implantation. CONCLUSIONS This study reveals the basic events in osteoclast biology in localized inflammatory bone resorption and provides new insights into the comprehension of cholesteatoma-induced bone resorption.
Collapse
MESH Headings
- Animals
- Bone Resorption
- Cholesteatoma, Middle Ear/immunology
- Cholesteatoma, Middle Ear/metabolism
- Cholesteatoma, Middle Ear/pathology
- Disease Models, Animal
- Glycoproteins/immunology
- Glycoproteins/metabolism
- Immunohistochemistry
- Ligands
- Macrophage Colony-Stimulating Factor/immunology
- Macrophage Colony-Stimulating Factor/metabolism
- Male
- Mice
- Mice, Inbred C57BL
- Microscopy, Electron, Scanning
- Osteoclasts
- Osteoprotegerin
- Receptors, Cytoplasmic and Nuclear/immunology
- Receptors, Cytoplasmic and Nuclear/metabolism
- Receptors, Tumor Necrosis Factor
- Skin Transplantation
- Transplantation, Autologous
Collapse
Affiliation(s)
- H Sudhoff
- Hals-Nasen-Ohrenklinik der Ruhr-Universität Bochum, St. Elisabeth Hospital, Bochum, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Euteneuer S, Sudhoff H, Bernal-Sprekelsen M, Theegarten D, Dazert S. [Malignomas of the nasal cavity and the paranasal sinuses: clinical characteristics, therapy and prognosis of different tumor types]. Laryngorhinootologie 2004; 83:33-9. [PMID: 14740304 DOI: 10.1055/s-2004-814108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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
BACKGROUND Malignomas of the nasal cavity and the paranasal sinuses count for less than 3 % of the ENT-malignancies. PATIENTS AND METHODS This retrospective chart review reports about 46 patients that were first diagnosed and treated with a nasal cavity or paranasal sinus malignancy between 1998 and 2002 in the ENT department of the Ruhr-Universität Bochum. RESULTS 18 of 46 malignomas were squamous cell carcinomas. At initial diagnose, already 52 % of malignomas were staged T4. Accordingly the origin in 17 % of malignomas could not be determined anymore. Additional 43 % of malignomas originated from the nasal cavity, another 20 % from the maxillary sinus. 11 of 46 patients (24 %) showed histological proven nodal involvement at initial diagnose. 92 % of patients underwent surgical therapy. 25 patients were radiated postoperatively. Over-all 1-year-survival-rate was 75 %, over-all 2-year-survival-rate was 47 %. Beside patients age, tumor free margins at initial surgery and absence of nodal involvement correlated to improved survival. 16 (76 %) of the 21 patients who died had local recurrence. Maxillary sinus malignomas recurred more often than malignomas of the ethmoid and the nasal cavity. CONCLUSIONS Malignancies of the nasal cavity and paranasal sinuses are very often diagnosed in advanced T-stages because of unspecific symptoms. The limited prognosis mainly depends on free surgical margins at the first resection and nodal involvement at the first diagnose. For improvement in outcome of nasal and paranasal sinuses malignancies, prospective multi-center trials are necessary.
Collapse
MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/mortality
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Adenoid Cystic/diagnosis
- Carcinoma, Adenoid Cystic/mortality
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/radiotherapy
- Carcinoma, Squamous Cell/surgery
- Chi-Square Distribution
- Combined Modality Therapy
- Disease-Free Survival
- Esthesioneuroblastoma, Olfactory/diagnosis
- Esthesioneuroblastoma, Olfactory/mortality
- Ethmoid Sinus
- Female
- Follow-Up Studies
- Frontal Sinus
- Humans
- Lymphatic Metastasis
- Male
- Maxillary Sinus Neoplasms/diagnosis
- Maxillary Sinus Neoplasms/mortality
- Maxillary Sinus Neoplasms/radiotherapy
- Maxillary Sinus Neoplasms/surgery
- Middle Aged
- Neoplasm Recurrence, Local
- Nose Neoplasms/diagnosis
- Nose Neoplasms/drug therapy
- Nose Neoplasms/mortality
- Nose Neoplasms/radiotherapy
- Nose Neoplasms/surgery
- Paranasal Sinus Neoplasms/diagnosis
- Paranasal Sinus Neoplasms/mortality
- Paranasal Sinus Neoplasms/radiotherapy
- Paranasal Sinus Neoplasms/surgery
- Prognosis
- Retrospective Studies
- Sphenoid Sinus
- Survival Analysis
- Time Factors
- Treatment Outcome
Collapse
Affiliation(s)
- S Euteneuer
- Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie der Ruhr-Universität Bochum, Germany.
| | | | | | | | | |
Collapse
|
16
|
Rogowski M, Olszewska E, Euteneuer S, Chodynicki S, Chyczewski L. Angiogenese im Cholesteatom des Mittelohres. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823431] [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: 10/19/2022]
|
17
|
Euteneuer S, Gronemeyer J, Sudhoff H, Dazert S. Wachstum von Spiralganglienneuriten in vitro unter CO2-freier Atmosphäre in Leibowitz's L-15-Medium. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
18
|
Schönhofer B, Euteneuer S, Nava S, Suchi S, Köhler D. Survival of mechanically ventilated patients admitted to a specialised weaning centre. Intensive Care Med 2002; 28:908-16. [PMID: 12122529 DOI: 10.1007/s00134-002-1287-5] [Citation(s) in RCA: 123] [Impact Index Per Article: 5.6] [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: 07/16/2001] [Accepted: 03/11/2002] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Hospital mortality and survival rates of long-term ventilated patients.DESIGN. Retrospective cohort study. SETTING Specialised national weaning centre. INTERVENTION Protocol-directed liberation from ventilator. PATIENTS Four hundred three of 640 patients with prolonged mechanical ventilation (MV) who were admitted to our respiratory intensive care unit (RICU) were studied. MV lasted longer than 2 weeks and patients had failed more than two weaning trials in the referring ICUs. The majority of patients (59.3%) had chronic obstructive pulmonary disease (COPD). RESULTS After a mean duration of 41 days of MV prior to transfer, 68% of patients were liberated from the ventilator. In total, 98 of 403 patients (24.3%) died during the stay in our hospital, 305 patients (75.7%) were discharged. Compared to the non-survivors, the survivors were characterised by younger age, longer length of stay in our RICU, lower severity of illness scores at admission, fewer cardiac illnesses and a higher rate of weaning success. In 31.5% of the discharged patients non-invasive MV (NIV) was initiated during the stay at our unit. We gathered follow-up data on 293 patients (96.1%). Post-discharge survival rates were 67.6% at 3 months, 49.4% at 1 year and 38.1% at 3 years. Length of survival was significantly dependent on age, weaning success and main diagnosis (i.e., prognosis in COPD is worse compared to thoracic restriction, neuromuscular disease and others) in the multivariate analysis. CONCLUSIONS Difficult-to-wean patients have a high hospital mortality rate and poor long-term prognosis. Age, main diagnosis, severity of illness, weaning success and institution of NIV predict survival.
Collapse
Affiliation(s)
- B Schönhofer
- Krankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmungs- und Schlafmedizin, 57392 Schmallenberg, Germany.
| | | | | | | | | |
Collapse
|