[Nanomedicine in otorhinolaryngology--future prospects]. / Nanomedizin in der HNO-Heilkunde--ein Ausblick.

BACKGROUND: Nanotechnology becomes more and more important in the world of today. Equally, it does generally in medicine and of course specifically in otorhinolaryngology. Essentially, there are the following fields: Diagnostics, new therapies and agents, drug delivery and medical implants. MATERIAL AND METHODS: An extensive literature research on nanomedicine in otorhinolaryngology was carried out in the standard online medical reference databases "PubMed/Medline" and "Web of Science". Furthermore, we are giving an overview of the work of the Department of Otorhinolaryngology, Head and Neck Surgery, Section of Experimental Oncology and Nanomedicine (SEON), University Hospital Erlangen. RESULTS: A lot of new and innovative studies on nanotechnology in diagnostics and therapy were recovered. Depending on the variety in otorhinolaryngology, there are numerous versatile approaches, according to the different areas. The main part is engaged in drug delivery. CONCLUSIONS: The efforts to exploit the potential of nanotechnology in otorhinolaryngology are multifaceted, innovative and seminal. The best perspective of success is attributed to nanoparticulate drug delivery systems.

Emergency cricothyrotomy in infants--evaluation of a novel device in an animal model.

BACKGROUND: According to different algorithms of airway management, emergency cricothyrotomy is the final step in managing an otherwise not accessible airway. As an alternative to an open surgical procedure, minimally invasive approaches exist. Quicktrach baby™ is a commercially available set for a minimal invasive cricothyrotomy in infants. The set consists of a plastic cannula over a metal needle for direct placement in the trachea. So far, this device has not been evaluated for its intended use. OBJECTIVES: We hypothesize that Quicktrach baby™ allows the establishment of an emergency airway. The aim was to prove that the device is easy to handle and the cricothyrotomy fast to perform. METHODS: After approval of the local ethics committee, the study was performed on the cadavers of 10 adult rabbits. Cricothyrotomy was performed with Quicktrach baby™. Successful placement, performance time, and complication rate were documented. Possible ventilation with a breathing bag was evaluated. Data are reported as mean and interquartile range. RESULTS: Successful placement of Quicktrach baby™ was possible in all attempts. The placement took 31 [23-43] s. In two cases, a fracture of the cricoid's cartilage was seen. In one animal, damage to the posterior wall mucosa was observed. In all cases, sufficient ventilation was possible. CONCLUSIONS: Quicktrach™ baby proved to be a reliable technique. In the animal model, it is easy and fast to perform. Only a few minor complications occurred. Sufficient ventilation was possible in all attempts.

[Nanomedicine : Magnetic nanoparticles for drug delivery and hyperthermia - new chances for cancer therapy]. / Pharmakotherapie mittels Nanomedizin : Magnetische Nanopartikel für Drug Delivery und Hyperthermie - neue Chancen für die Krebsbehandlung.

The application of nanotechnology for the treatment, diagnosis, and monitoring of illnesses is summarized under the term nanomedicine. A particularly promising application is attributed to nanoparticular drug delivery systems. The goal of these new carrier systems is the selective enrichment of active substances in diseased tissue structures, an increase in bioavailability, the decrease of the active substance degradation and, above all, the reduction and/or avoidance of unwanted side effects. Apart from numerous nanosystems acting as carriers, the use of iron oxide nanoparticles has to be particularly emphasized. On the one hand, those particles are the carriers of the active substance and, on the other hand, can also be visualized with conventional imaging techniques (x-ray tomography, magnetic resonance imaging), called theranostic. In addition, they can be used for hyperthermia, another important supporting pillar of nanomedicine. Both procedures should lead to a personalized and goal-oriented therapy, which is of special medical and socioeconomic importance in view of the increasing number of cancer patients worldwide.

Magnetorelaxometric quantification of magnetic nanoparticles in an artery model after ex vivo magnetic drug targeting.

In magnetic drug targeting a chemotherapeutic agent is bound to coated magnetic nanoparticles, which are administered to the blood vessel system and subsequently focused by an external applied magnetic field. The optimization of intra-arterial magnetic drug targeting (MDT) requires detailed knowledge about the biodistribution of particles in the artery and the respective surrounding after the application. Here, we demonstrate the potential of magnetorelaxometry for quantifying the distribution of magnetic nanoparticles in the artery. To this end, we present a magnetorelaxometry investigation of a MDT study in an artery model. In particular, the absolute magnetic nanoparticle accumulation along the artery as well as the uptake profile along the region around the MDT-magnet position was quantified.

DMBT1 as an archetypal link between infection, inflammation, and cancer

Los estudios epidemiológicos y moleculares indican vínculosentre infección, inflamación y cáncer, que parece que convergena nivel molecular en mecanismos asociados con la inmunidadinnata. Aquí, presentamos un resumen del conocimientosobre la proteína secretada "scavenger receptor cysteine-rich(SRCR)" Deleted in Malignant Brain Tumors 1 (DMBT1), tambiénconocida como glicoproteína-340 o aglutinina de la saliva. DMBT1se expresa diferencialmente en varios tipos de cáncer, en muchoscasos disminuyendo su regulación. Como proteína secretada allumen, tiene funciones en la defensa innata contra los patógenos,y la regulación de la inflamación. En contraste, podría inducir ladiferenciación epitelial y de células madre, como proteína de lamatriz extracelular. Su amplia respuesta a estímulos patofisiológicossugiere un papel general en la protección celular y tisular,probablemente uniendo la defensa contra patógenos y la regulaciónde la respuesta inflamatoria a procesos regenerativos. Existensimilitudes muy interesantes con las funciones de otras proteínasSRCR presentes en metazoos primitivos, como las esponjasy los erizos de mar. Esto sugiere que sus diferentes funcionespodrían basarse en un principio antiguo y simple, que seríala mediación diferencial de adhesión y anti-adhesión. De manerasimilar a las vías de señalización de NF-κB, que también estánreguladas indirectamente por DMBT1, el conocimiento actualindica que DMBT1 no sólo podría tener funciones de prevenciónde enfermedad, sino probablemente también funciones generadorasde enfermedad. En resumen, DMBT1 podría representarun paradigma del vínculo arquetípico entre infección, inflamación,y cáncer. La comprensión de su complejo modo de acciónpromete nuevos puntos de vista sobre el origen y las bases molecularesde las grandes enfermedades humanas

Epidemiological and molecular studies have pointed to linksbetween infection, inflammation and cancer, which appear to convergeat the molecular level in mechanisms associated with innateimmunity. Here, the present knowledge about the secreted scavengerreceptor cysteine-rich (SRCR) protein Deleted in MalignantBrain Tumors 1 (DMBT1), also known as glycoprotein-340or salivary agglutinin, is summarized. DMBT1 is differentially expressed in various cancer types with most of these displayinga downregulation. As a lumenally secreted protein, it exerts functionsin innate pathogen defense and the regulation of inflammation.By contrast, it may trigger epithelial and stem cell differentiationas an extracellular matrix protein. Its broad responsivenessto pathophysiological stimuli points to a general role incell and tissue protection, which possibly is best circumscribedby linking pathogen defense and regulation of the inflammatoryresponse to regenerative processes. Compelling similaritiesto the functions of SRCR proteins in primitive metazoa such assponges and sea urchins exist, which support that its various functionsmay rely on an ancient and simple principle, i.e. the differentialmediation of adhesion and anti-adhesion. Similar to NF-κB signaling pathways, which are also indirectly regulated byDMBT1, the present state of the art indicates that DMBT1 not onlycould exert disease-preventing, but probably also disease-promotingfunctions. Taken together, DMBT1 may represent a paradigmfor an archetypal link between infection, inflammation, andcancer. Understanding its complex mode of action promises novelinsights into the origin and the molecular basis of major humandiseases

Molecular characterisation of non-absorptive and absorptive enterocytes in human small intestine.

BACKGROUND AND AIMS: Perturbation of differentiation of the crypt-villus axis of the human small intestine is associated with several intestinal disorders of clinical importance. At present, differentiation of small intestinal enterocytes in the crypt-villus axis is not well characterised. SUBJECTS AND METHODS: Expression profiling of microdissected enterocytes lining the upper part of crypts or the middle of villi was performed using the Affymetrix X3P arrays and several methods for confirmation. RESULTS: A total of 978 differentially expressed sequences representing 778 unique UniGene IDs were found and categorised into four functional groups. In enterocytes lining the upper part of crypts, cell cycle promoting genes and transcription/translation related genes were predominantly expressed, whereas in enterocytes lining the middle of villi, high expression of cell cycle inhibiting genes, metabolism related genes, and vesicle/transport related genes was found. CONCLUSION: Two types of enterocytes were dissected at the molecular level, the non-absorptive enterocyte located in the upper part of crypts and the absorptive enterocyte found in the middle of villi. These data improve our knowledge about the physiology of the crypt-villus architecture in human small intestine and provide new insights into pathophysiological phenomena, such as villus atrophy, which is clinically important.

Carotid artery stenting in patients with high neurologic risks.

Forty-four patient with high neurologic risks (Mayo class IV) successfully underwent carotid artery stenting with combined major stroke and death rates of 4.5%. Late follow-up at a mean of 23 +/- 1.8 months showed 1 non-neurologic death, but no neurologic events or repeat stenting procedures.

Immediate and late outcomes of subclavian artery stenting.

Stenting for subclavian artery occlusive disease is being increasingly utilized. To determine the immediate and late outcome of subclavian artery stenting, we studied 38 consecutive patients in whom the procedure was attempted. Technical and clinical success was achieved in 35 patients without complications. Failures occurred only in completely occluded arteries. Late clinical success was demonstrated in 31 patients. Three patients had recurrent symptoms. Two had angiographic restenosis within 4 months of the procedure; both were successfully redilated. The third patient had a new lesion, which was successfully stented. One patient died from lung cancer 10 months after the procedure. We conclude that stenting for subclavian artery occlusive disease has favorable immediate and late clinical outcomes and may be considered as a primary therapy.