[A concept for the assessment of quality of life in patients with carcinomas of the upper aerodigestive tract]. / Konzept zur Erhebung der Lebensqualität bei Patienten mit Karzinomen des oberen Aerodigestivtraktes.

BACKGROUND: The quality of life (QoL) of patients with malignant diseases decreases significantly. OBJECTIVE: The evaluation of QoL is generally not part of the management of patients with head and neck cancer. The aim of this study was to develop an additional disease- and treatment-specific questionnaire to evaluate QoL in surgically treated head and neck cancer patients. PATIENTS AND METHODS: The general QoL was evaluated with the QLQ-C30 questionnaire developed by the European Organisation of Research and Treatment of Cancer (EORTC). RESULTS: The disease-specific QoL was evaluated using the EORTC H&N35 module. The new questionnaire "Kiel Head and Neck 17" (KQL H&N-17) is a disease- and treatment-specific addition especially in regard to side effects caused by surgical treatment. CONCLUSIONS: A wide application of this whole concept is needed to obtain comparable results from studies suitable for evaluating QoL in patients receiving different treatments for their malignant diseases. Moreover, the effectiveness and quality of treatment could be controlled better, which would help to increase the QoL of these patients.

[Concepts for measuring quality of life in patients with chronic sinusitis]. / Konzept zur Messung der Lebensqualität bei Patienten mit chronischer Sinusitis.

BACKGROUND: In 1997, Benninger developed the Rhinosinusitis Disability Index (RSBI) for patients who suffered from chronic sinusitis. Its content related validity and construct related validity were established, as were its sensitivity and reliability. The aim of our study is to introduce a concept to measure quality of life in these patients according to circumstances prevalent in Germany. METHODS: The questionnaire (Rhinusitis-Beeinträchtigungs-Index, RSBI) contains 30 questions that describe the 5 aspects of quality of life. Moreover we used a standardized data sheet to acquire further information about history and diagnostic results. Using this method it is possible to specificity more precisely the patients current complaints and condition. Evaluation is possible according to complex of questions as well as simple items. The influence of treatment on quality of life can be measured as the sum of the specific scores and is expressed comprehensively in the total score. The concept of the study includes a prospective inquiry as well as before and after surgical intervention. CONCLUSION: A disadvantage of the American RSDI is that the clinical symptoms are not described in a detailed catalogue which allows the correlation of the clinical factors. Therefore we added a detailed questionnaire concerning the clinical symptoms and the individual treatment of the patient (RSBI). That permits comprehensive analysis of quality of life as it relates to different aspects of disease and different strategies in treatment.

Metalloproteinases and their inhibitors in squamous cell carcinoma of the hypopharynx: indicators of individual tumor aggressiveness.

BACKGROUND: Matrix metalloproteinases (MMP) are proteolytic enzymes capable of degrading connective tissue components. MMP activity is modulated by tissue inhibitors of metalloproteinases (TIMP). Imbalanced secretion of certain MMP or disturbances in the differential control of MMP by TIMP have been implicated in the invasive potential of malignant tumors. METHODS: Thirty-nine surgically obtained specimens of the hypopharynx were immunohistochemically stained with antibodies against MMP-1, MMP-2, MMP-3, MMP-9 and their inhibitors, TIMP-1 and TIMP-2. Thirty-one samples derived from primary tumors (PT-group) and 8 samples from recurrent tumors (RT-group). RESULTS: In the PT-group, MMP-1 was expressed in almost all tumors. Expression of TIMP-1 was rarer than of TIMP-2. Relapse occurred in 8/31 cases expressing MMP-1 or MMP-9 (4 cases each). Staining for TIMP-1 was negative in these patients, while TIMP-2 was expressed in most cases. In the RT-group, MMP-1 and MMP-9 stained positive in an almost equal number of cases. Only TIMP-1 was not expressed in any tumor. Patients who died of tumor were uniformly negative for TIMP-1. CONCLUSIONS: The findings suggest that the presence of MMP-9 and concomitant lack of TIMP-1 serve as prognostic indicators of tumor aggressiveness and increased risk of relapse.

H(+)-K(+)-ATPase contributes to regulation of pHi in frog oxynticopeptic cells.

The effect of intracellular acidosis on luminal H+ secretion and the role of H(+)-K(+)-ATPase in regulation of intracellular pH (pHi) in oxynticopeptic cells (OPC) (measured with a pH-sensitive fluorescent dye) were examined in intact sheets of in vitro frog (Rana catesbeiana) gastric mucosa. Intracellular acidosis of OPC induced by decreasing pH in the serosal solution (pHs) from 7.2 to 6.0 reversibly increased forskolin-stimulated H+ secretion without increasing endogenous histamine release. The observed increase in H+ secretion was unaffected by either 1 mM cimetidine or 1 mM histamine, but was accentuated by 1 mM amiloride, an effect abolished by 0.3 mM omeprazole. Steady-state pHi values in stimulated or resting OPC at pHs 7.2 were not significantly different. However, pHi in OPC was significantly higher in stimulated than in resting tissues at pHs 6.9, a difference accentuated by decreasing pHs to 6.4 or by 1 mM amiloride. Amiloride completely prevented recovery from intracellular acidosis induced by pHs 6.4 or 6.9 in omeprazole-treated tissues, but only partially mitigated recovery in cimetidine- or forskolin-treated tissues. At pHs 6.4, high luminal [K+] (100 mM) increased H+ secretion and hastened recovery of pHi in cimetidine-treated tissues in the presence of amiloride. These results suggest that, in intact sheets of in vitro frog gastric mucosa, 1) intracellular acidosis stimulates luminal H+ secretion via histamine-independent mechanisms and 2) H(+)-K(+)-ATPase contributes to the recovery of OPC from intracellular acidosis.