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Biomedical subjects

A Roth

Publications and source records attributed to A Roth.

At least 217 records · Page 12Linked to original sources
PubMed1989

Cytostatic treatment of metastatic cervical carcinoma.

The activity of cytostatics in cervical cancer has not as yet been sufficiently investigated. This is especially true for combined cytostatic treatments. The only two cytostatics that have been adequately examined in clinical trials in a larger number of patients are 5-fluorouracil and cis-dichlorodiamineplatinum. The paper presents the results of treatment with single cytostatic agents and the combinations of different cytostatics, emphasizing the role of combined treatment using irradiation and cytostatics. It also describes the preliminary results of a Phase II trial going on at the Central Institute for Tumors in Zagreb, using a combination of cis-DDP, 5-fluorouracil and vincristine. So far the results of 11 out of 14 patients included in the trial have been evaluated. Objective remission (CR + PR) was achieved in 4 patients (33%). Toxic side-effects were mild and tolerable for the patients. In conclusion, the reasons are given why chemotherapy has not as yet gained a more important place in the treatment of advanced forms of cervical cancer.

Antineoplastic Agents↗
PubMed1989

[Recent trends and developments in the clinical study of color vision--the 2-comparison method].

Modern anomaloscopes with four independent light channels (i.e., the Besançon Anomalometer which was presented in 1980 at the DOG) allow accurate examinations of color vision. In our routine clinical examination, we use two metameric equations: the red-green Rayleigh equation and the blue-green Moreland equation. This two-equation method permits the diagnosis of congenital and acquired color vision defects in a precise quantitative way. In both equations the goal of the examination is to measure the absolute matching range. The diagnosis is abnormal color vision if the absolute matching range is shifted and/or enlarged in one or both of the two metameric equations. A computer-controlled clinical examination of color vision, which will make the procedure simpler and shorter for the patient, is presently being developed.

Adolescent↗
PubMed1988

Comparison of nalbuphine hydrochloride versus morphine sulfate for acute myocardial infarction with elevated pulmonary artery wedge pressure.

The hemodynamic and respiratory effects of intravenous nalbuphine hydrochloride and morphine sulfate were compared in a randomized fashion in 20 patients (age 65 +/- 11 years) with acute myocardial infarction and elevated pulmonary artery wedge pressure. Titration of the nalbuphine dose to lower pulmonary artery wedge pressure by greater than or equal to 25% resulted in a decrease of this parameter from 22 +/- 3 to 15 +/- 4 mm Hg, and was associated with a reduction in heart rate from 106 +/- 20 to 96 +/- 19 beats/min (p less than 0.05) and decreases in mean blood pressure (78 +/- 8 to 70 +/- 12 mm Hg, p less than 0.05) and mean pulmonary artery pressure (31 +/- 4 to 22 +/- 5 mm Hg, p less than 0.05), without any remarkable change seen in cardiac index (2.21 +/- 0.43 to 2.22 +/- 0.50 liter/min/m2, difference not significant), stroke volume index (22 +/- 7 to 23 +/- 4 ml/m2, difference not significant), stroke work index (17 +/- 7 to 18 +/- 7 g.m/m2), or systemic and pulmonary vascular resistances (1,675 +/- 333 to 1,513 +/- 508 and 191 +/- 78 to 170 +/- 109 dynes.s.cm-5 respectively, all differences not significant). Nalbuphine also significantly reduced respiratory rate (32 +/- 8 to 26 +/- 8 resp/min, p less than 0.05) and pH (7.45 +/- 0.04 to 7.41 +/- 0.03, p less than 0.05) and increased arterial PCO2 (32 +/- 6 to 35 +/- 6 mm Hg, p less than 0.05) without any major change in arterial PO2 (63 +/- 13 to 66 +/- 17 mm Hg, difference not significant).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

POEMS syndrome presenting as systemic sclerosis. Clinical and pathologic study of a case with microangiopathic glomerular lesions.

A rare form of plasma cell dyscrasia characterized by the various association of polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes has been termed POEMS syndrome. The pathogenesis of the multisystemic features of this syndrome remains unclear. Herein is reported a case of POEMS syndrome with striking clinical similarities with scleroderma, and microangiopathic glomerular lesions, as well as diffuse perivascular non-amyloid deposits, which could explain certain features of the syndrome, including peripheral nerve demyelination. It is proposed that a pathogenic role might be played by a non-immunoglobulin vasculotoxic component.

Adult↗
PubMed1988

Evidence for an enterohepatic circulation of ochratoxin A in mice.

The distribution and elimination of [3H]ochratoxin A (OTA) from stomach content and tissue, intestine content and tissue, liver, bile, serum and urine of Swiss male mice which had received a single low dose of OTA by intubation was followed as a function of time. The profiles of radioactivity do not show a smooth decline after the absorption period, but an oscillating pattern with rapid declines followed by increases which favour the assumption of an enterohepatic circulation. Between 28% and 68% of conjugated OTA together with OTA cleavage products were found in bile giving evidence for biliary excretion of OTA and its metabolites in mice. When given i.m. to mice [3H]OTA is already found after 30 min in bile and intestine contents and its elimination patterns show several peaks confirming the biliary excretion and the enterohepatic circulation. Cholestyramine, which is known to prevent the enterohepatic circulation of drugs and toxins, changes the profile of elimination of OTA which no longer presents the cyclic pattern. This result is also in favour of an enterohepatic circulation of OTA. When phenylalanine is given together with OTA by oral gavage the toxicokinetics of the mycotoxin change completely in the different body fluids, in stomach and intestine content and tissues. Phenylalanine seems to facilitate the gastric absorption of OTA and the gastro-intestinal transit. It increases also its early excretion into urine and bile. However, its elimination pattern no longer shows the oscillating pattern. Thus phenylalanine seems to inhibit the intestinal reabsorption of OTA conjugates.

Animals↗
PubMed1988

Resistance to isosorbide dinitrate in patients with severe chronic heart failure: incidence and attempt at hemodynamic prediction.

Oral isosorbide dinitrate has been widely used to lower elevated left ventricular filling pressure in patients with chronic heart failure. Although the recommended dose of this drug is 40 mg every 6 h, failure to respond to this dose has been observed in many patients with heart failure. In the present study the incidence of resistance to isosorbide dinitrate was evaluated and an attempt was made to identify baseline hemodynamic predictors for this phenomenon in 50 patients with severe chronic heart failure due to left ventricular systolic dysfunction (mean left ventricular ejection fraction 0.23 +/- 0.08). Twenty-seven (54%) of the 50 patients responded to 40 mg of isosorbide dinitrate (greater than 20% decrease in mean pulmonary artery wedge pressure sustained greater than or equal to 1 h) and 23 patients (46%) failed to respond. Nonresponders to 40 mg of isosorbide dinitrate had a significantly higher baseline right atrial pressure than did responders (14 +/- 5 versus 10 +/- 6 mm Hg, p less than 0.02). In addition, all 7 patients with a baseline right atrial pressure of less than 7 mm Hg and 12 of 14 patients with a baseline right atrial pressure less than 10 mm Hg responded to 40 mg. No significant differences were noted between responders and nonresponders in any other baseline hemodynamic or clinical variables, or in peak isosorbide dinitrate serum levels (32 +/- 19 ng/ml in nonresponders versus 44 +/- 36 ng/ml in responders). Of the 23 nonresponders to 40 mg, 22 received a higher dose (80 to 120 mg).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Sudden cardiac arrest in Israel: factors associated with successful resuscitation.

Out-of-hospital cardiac arrests were studied in Israel from 1984 to 1985. More than 3,500 patients in cardiac arrest received paramedic care. Eighty-three percent of cases were caused by underlying heart disease. Overall, 17% of patients with arrest caused by heart disease were admitted and 7% were discharged from the hospital. There was a wide variation in the percent discharged among the 15 paramedic service areas, ranging from 0% to 13%. Factors associated with successful resuscitation included witnessed collapse, rhythm of ventricular fibrillation, short interval from collapse to cardiopulmonary resuscitation (CPR) and delivery of advanced cardiac life support, collapse at public location, and bystander initiation of CPR. Improvements in survival are likely to result if CPR is more frequently and promptly initiated and the time to arrival of definitive paramedic care can be improved.

Aged↗
PubMed1988

Diagnostic value of liver biopsy in alcoholic liver disease.

Because it remains debatable whether all patients with a clinical diagnosis of alcoholic liver disease should have a liver biopsy to help confirm the diagnosis, we evaluated the diagnostic value of liver biopsy in alcoholic liver disease. Studied were 108 consecutive patients who had a percutaneous liver biopsy for the first time. In all cases the patient's clinical diagnosis recorded before biopsy was compared with the histological diagnosis of an experienced histopathologist. Prebiopsy clinical data (reported alcohol intake, signs of chronic liver disease) and laboratory data (liver function tests, mean corpuscular volume, ferritin, hepatitis B serology) were reviewed. We found that a prebiopsy clinical diagnosis of alcoholic liver disease (n = 35) was confirmed by biopsy in all but one case. The prebiopsy diagnosis of alcoholic liver disease was significantly associated with a histological diagnosis of alcoholic liver disease (specificity 98%, sensitivity 79%). Individually, alcohol intake, signs of chronic liver disease, the alanine aminotransferase (ALT), the aspartate aminotransferase to ALT ratio, and the mean corpuscular volume were significantly associated with a histological diagnosis of alcoholic liver disease. When clinical and laboratory parameters were considered jointly using stepwise logistic regression, only reported alcohol intake and mean corpuscular volume were significant. Liver biopsy may not always be necessary for the identification of that broad group of patients with alcoholic liver disease.

Alanine Transaminase↗
PubMed1988

Behavioral evidence and supporting electrophysiological observations for electroreception in the blind cave salamander, Proteus anguinus (Urodela).

Conditioning experiments revealed that Proteus perceives a back-and-forth moving (approximately 1 Hz) direct-current field and its polarity. Minimum behavioral thresholds occurred at a current density of 0.15 microA/cm2, corresponding to a voltage gradient of 0.5 mV/cm. Recordings from afferent nerve fibers showed that ampullary electroreceptors in Proteus respond as do other nonteleost receptors, i.e. with an increase in discharge rate to cathodal current and a decrease to anodal current (threshold: approximately 1 mV/cm).

Afferent Pathways↗
PubMed1988

Combined cis-platinum plus radiation antitumor activity in locoregionally advanced squamous cell esophageal cancer.

The synergistic activity we have observed in vitro in V-79 hamster lung cells after treatment with cis-platinum combined with irradiation, stimulated a pilot study of 31 patients with inoperable locoregionally advanced squamous cell esophageal cancer. The 27 evaluable cases (22 men and 5 women--mean age 59 years) had undergone no prior radiation or cytostatic drug therapy. Histological evidence of the tumor (26 squamous cell, 1 adenocarcinoma) was obtained by endoscopy in all patients before treatment began. The patients were irradiated in two opposite thoracic fields with a total dosage of 3,000-4,000 cGy (200 cGy daily, 1,000 weekly) concurrently with 2 cycles of cis-platinum in the dosage of 30 mg/m2 iv. daily X 4 (120 mg/m2 per cycle). The results showed that cis-platinum combined with radiation showed an evident antitumor activity which included 4 complete clinical remissions and 11 partial remissions with a response rate of 56% (15/27). In two complete responders even a pathologic remission was evident (biopsy specimen) and they are now 16+ and 18+ months free of the disease. The median remission duration has been 8+ months (14+ months in complete responders) and the median survival period for the entire group is 10+ months (for responders 15+ months, p less than 0.05). Toxicity was moderate and reversible, and mainly accounted for radiation mucositis, retrosternal pain and vomiting. A mild bone marrow suppression was observed. In 2 cases esophagotracheal fistulae occurred. The results of this study show that the combination of cis-platinum and radiation might constitute successful palliative or neoadjuvant treatment for squamous cell esophageal cancer.

Carcinoma, Squamous Cell↗
PubMed1987

Hemodynamic and volumetric effects of venodilation with nitroglycerin in chronic mitral regurgitation.

To evaluate the potential value of nitrate therapy in patients with chronic mitral regurgitation, the hemodynamic and angiographic effects of intravenous nitroglycerin were studied in 10 such patients. Nitroglycerin infusion, titrated to reduce mean pulmonary artery wedge pressure at least 20%, resulted in a significant reduction in mean blood pressure (from 91 +/- 12 to 77 +/- 13 mm Hg, p less than 0.0001), mean right atrial pressure (12 +/- 6 to 7 +/- 4 mm Hg, p less than 0.001), left ventricular end-diastolic pressure (22 +/- 7 to 13 +/- 5 mm Hg, p less than 0.0001) and peak V wave of indirect left atrial pressure (34 +/- 9 to 20 +/- 10 mm Hg, p less than 0.001). Changes in systemic vascular resistance (1,986 +/- 468 vs 1,582 +/- 534 dynes s cm-5) and forward stroke volume (39 +/- 14 vs 45 +/- 8 ml) were not statistically significant. Angiographic data showed a decrease in both end-diastolic and end-systolic left ventricular volumes (248 +/- 51 to 216 +/- 54 ml, p = 0.06 and 127 +/- 69 to 99 +/- 48 ml, p less than 0.05, respectively) and an improvement in ejection fraction, from 0.52 +/- 0.15 to 0.55 +/- 0.15 (p less than 0.05). There was no significant change in the group values for mitral regurgitant volume and fraction (from 85 +/- 32 to 72 +/- 32 ml and 67 +/- 10 to 64 +/- 5%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗