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Biomedical subjects

A Seeber

Publications and source records attributed to A Seeber.

At least 37 records · Page 2Linked to original sources
PubMed1998

Treatment of metastatic malignant melanoma with dacarbazine plus fotemustine.

Despite the poor prognosis of metastatic malignant melanoma, polychemotherapy with dacarbazine and fotemustine has shown promising results in several studies. We report on the clinical efficacy of a new sequential administration regimen with dacarbazine at a dose of 200 mg/m2 followed 24 h later by fotemustine 100 mg/m2 every 4 weeks in 63 patients with metastatic melanoma. A complete response was noted in 3 patients (5%), a partial response in 4 patients (6%), stable disease in 33 patients (5%) and progressive disease in 23 patients (37%). The duration of the 3 complete responses was 5, 14+ and 60+ months, for the 4 partial responses, 3, 4, 6 and 13 months. The median duration for stable disease was 4 months. The best response rates were obtained for lung and lymph node metastases. Toxicity was mild and mainly limited to haematological without pulmonary side-effects. Although there was a relatively low objective response rate, this chemotherapy regimen as a palliative treatment, is potentially valuable for patients with progressive stage IV melanoma.

Adult↗
PubMed1998

Benefit of 6 months long-term physical training in polymyositis/dermatomyositis patients.

OBJECTIVE: The benefit of long-term physical training in patients with chronic polymyositis or dermatomyositis (PM/DM) was studied prospectively. METHODS: Eight patients with chronic PM/DM participated in a training programme for 6 months. A group of five PM/DM patients without any physical training was observed for control purposes. RESULTS: While there was no significant change in serum creatine phosphokinase (CPK) levels, the 'activities of daily living (ADL)' score improved significantly (P < 0.03), peak isometric torque (PIT) generated by muscle groups in the lower extremities rose significantly (P < 0.03) and there was a statistically highly significant increase in peak oxygen uptake (VO2max) relative to body weight (P < 0.02) due to the long-term training. The patients improved their aerobic capacity by 28%, which is clinically significant. In the untrained patients, no improvement in these target parameters was observed. CONCLUSION: In clinically stable DM/PM patients, long-term physical training can safely be performed and is recommended as part of a comprehensive rehabilitation management, particularly in view of the cardiopulmonary risk in these patients.

Activities of Daily Living↗
PubMed1998

Improvement of physical fitness and muscle strength in polymyositis/dermatomyositis patients by a training programme.

In the present investigation, the benefit of physical training in patients with inflammatory myopathy was studied. In this prospective, randomized, controlled study, 14 patients with polymyositis (PM) or dermatomyositis (DM) were investigated. The training, consisting of bicycle exercise and step aerobics, took place over a 6 week period. Baseline and endpoint measurements included an 'activities of daily living' (ADL) score, peak isometric torque (PIT) generated by muscle groups in the lower extremities, peak oxygen consumption (VO2max), and creatine phosphokinase (CPK) levels. There was no significant rise in disease activity in the training group in comparison to the controls. The ADL score for the treatment group, in comparison to the control group, improved (P < 0.02), PIT rose (P < 0.05) and there was a statistically significant increase in oxygen uptake relative to body weight (P < 0.05). No rise in inflammatory activity, but significant improvement in muscle strength, oxygen uptake and well-being, were found in patients with inflammatory myopathy as a result of physical training. Besides medication, a physical training programme consisting mainly of concentric muscle contractions should therefore be an integral part of therapy, particularly in view of the cardiopulmonary risk of these patients.

Adult↗
PubMed1998

Epiluminescence microscopy-based classification of pigmented skin lesions using computerized image analysis and an artificial neural network.

Epiluminescence microscopy (ELM) is a non-invasive technique for in vivo examination which can provide additional criteria for the clinical diagnosis of pigmented skin lesions (PSLs). In the present study we attempt to determine whether PSLs can be automatically diagnosed by an integrated computerized system. This system should recognize the PSL, automatically extract features and use these features in training an artificial neural network, which should--if sufficiently trained--be capable of recognizing and classifying a new PSL without human aid. One hundred and twenty images of randomly selected histologically proven PSLs (33 common naevi, 48 dysplastic naevi and 39 malignant melanomas) were used in this study. The images were digitally obtained and the morphological features of the PSLs were extracted electronically without human assistance. The numerical data were then divided into learning and testing cases and linked to an artificial neural network for training and for further classification of lesions that the system had not been trained on. Our results show that the computerized system was able to automatically identify 95% of the PSLs presented. The sensitivity and specificity of the computerized system were 90% and 74% respectively. In contrast, when differentiating between individual types of lesions, the system performed at true positive rates of only 38% for malignant melanoma, 62% for dysplastic naevi and 33% for common naevi. Our data indicate that (1) ELM images of PSLs provide an excellent source for digital image analysis; (2) the vast majority of PSLs can be correctly identified by a relatively simple (and thus not "intelligent") application of digital image analysis; (3) automatic feature extraction based mainly on ABCD rules provides reliable data on the distinction between benign and malignant PSLs; and (4) there is evidence that artificial neural networks can be trained to adequately discriminate between benign and malignant PSLs.

Dysplastic Nevus Syndrome↗
PubMed1997

Solvent exposure and ratings of well-being: dose-effect relationships and consistency of data.

Ratings on analog scales for dimensions of well-being provide information about the acute state of well-being during solvent exposure. In a study of volunteers and workers exposed to solvents, tension, tiredness, complaints, and annoyance were rated on seven-point scales. Dose-effect relationships were analyzed for several scenarios; data were collected in diaries during work hours. In two studies, 40 volunteers in an exposure laboratory were exposed to ethanol by inhalation at levels between 80 and 1900 parts per million (ppm). In two other studies, 32 volunteers were exposed to acetone and ethyl acetate in single exposures (1000 and 500 ppm, respectively) and combined exposures (500 ppm acetone + 200 ppm ethyl acetate). A field study of 8 exposed workers and 8 nonexposed controls involved exposures of up to 2100 ppm acetone. Dose-effect relationships were shown for ratings of annoyance by correlations of 0.36 (ethanol) and 0.58 (acetone). Similar coefficients were found for ratings of complaints. The dimensions tension and tiredness showed no stable relationship with exposure. The consistency of ratings was assessed by means of correlations between the ratings given during periods of nearly equal exposures. Ratings of annoyance for the different studies between the periods of nearly equal exposure showed average correlations from 0.68 to 0.84. For the ratings of complaints, the coefficients were 0.53 to 0.81. The coefficients for tension had similar stabilities; those for tiredness were lower.

Acetates↗
PubMed1997

Standardization of a questionnaire for neurotoxic symptoms.

A new version of the "Psychological-Neurological Questionnaire," designed for screening purposes, was investigated concerning its sensitivity to detect early signs of occupational exposure to potential neurotoxicants. A study population of 361 subjects was stratified into four age groups (<34, 35-44, 45-54, and >54 years) and three exposure groups (no, low, and high). According to dose and exposure history, workers exposed to dioxins and furans in combustion products, to volatile organic compounds, and to chromates were classified as low exposure. Workers exposed to alkyl lead, single solvents, and solvent mixtures were classified as high exposure. Only the group with the oldest age and highest exposure could be separated clearly from other groups, indicating an interaction effect between exposure and age. The low-exposure group could not be separated from the nonexposed controls. The most effective discriminators were neurologic symptoms. Psycho- and neurovegetative lability and irritative disturbances contributed less to the differentiation. Gastrointestinal and sleep disorders, as well as alcohol intolerance, showed no differentiation quality. The observed type of interaction effect fits models of delayed neurotoxicity.

Adult↗
PubMed1997

Solvent Exposure, Shiftwork, and Sleep.

The effects of different conditions of occupational exposure to organic solvents on subjective sleep quality were studied with and without shiftwork. Laboratory studies showed that four hours of daytime exposure to ethanol (400, 800 ppm) by inhalation led to blood ethanol levels below 0.01 per thousand and had marginal effects on the following night's sleep. Exposures to acetone (1,000 ppm), ethyl acetate (400 ppm), and a solvent mixture (acetone 500 ppm, ethyl acetate 200 ppm) increased the subjective depth of sleep. In a field study with eight hours of exposure, during three different work shifts, dose-response relationships between acetone concentrations during the shiftwork and the depth of sleep were found. Nevertheless, the solvent-exposed shift workers reported a reduced sleep quality, mainly in connection with daytime sleep, in comparison with non-exposed shift workers. The effects of solvent exposure during shiftwork on sleep varied with time of day of the exposure.

Journal Article↗
PubMed1996

[Behçet's disease of the uterine cervix--a case report].

Behçet's disease is a chronic disorder of unclear pathogenesis defined by multiple genital and oral ulcers, as well as ophthalmic changes. The patient described in this case report presented clinically with recurrent genital discharge, recurrent mild genital pain and a cervical ulcer. The diagnosis of Bechet's disease was established by the presence of cervical ulceration, two minor aphthous lesions in the vestibulum oris and a positive pathergy test. Although rare, Behcet's disease should be considered in the differential diagnosis of genital ulceration of unknown etiology.

Adult↗
PubMed1995

Effect of sex, age and transmission category on the progression to AIDS and survival of zidovudine-treated symptomatic patients.

OBJECTIVE: To evaluate the effect of transmission category and demographic, clinical and immunological characteristics on the progression to AIDS and survival of zidovudine-treated patients. DESIGN: Prospective multicentre cohort study of symptomatic non-AIDS patients. SETTING: Eighty-three clinical centres reporting data to the National Zidovudine Registry. PATIENTS: A total of 1468 patients enrolled between July 1987 and January 1991 were analysed. MAIN OUTCOME MEASURES: Three-year AIDS-free survival probability estimates since therapy start. Cox proportional hazards regression analysis was used to identify independent predictors of progression to AIDS and survival. RESULTS: Faster progression was associated with increasing age (8% risk increase for a 5-year increase), low baseline CD4+ count (39% risk increase for 100 x 10(6)/l cells decrease), and zidovudine > 1000 mg/day (20% risk increase compared with < or = 1000 mg/day). Homosexual men had a 33% risk increase compared with other risk groups. The presence of fever and oral candidiasis at enrolment were also independently associated with a higher risk of progression. Differences in the risk of progression were not significant between men and women. Older age, baseline CD4+ count, homosexual behaviour, fever and oral candidiasis were independently associated with a shorter survival. CONCLUSIONS: Our results confirm that age and baseline CD4+ count are independent predictors of progression, but do not provide evidence for differences in clinical outcome between the sexes. The higher risk of progression to AIDS and shorter survival for homosexual men appears to be correlated with the higher risk of developing Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Acute exposure to acetone in a factory and ratings of well-being.

Eight workers occupationally exposed to acetone and eight nonexposed controls were investigated on nine shift days both during work and leisure. The mean exposure to acetone was near 1000 ppm (2400 mg/m3). Acetone in urine was moderately correlated to acetone in the air. Ratings on scales of well-being and acute symptoms (SPES) correlated significantly with concentrations of acetone in urine but not with concentrations of acetone in the air.

Acetone↗
PubMed1992

[Goiter epidemiology in South Tirol].

To ascertain the prevalence of goitre among schoolchildren in South Tyrol (uncontrolled voluntary iodine salt prophylaxis), the size of the thyroid gland was determined by palpation and ultrasound in 1,013 of 1,224 children, aged 6 to 14 years (547 boys, 466 girls), selected by statistically criteria. At the same time, to assess thyroid function, total and free fractions of T3 and T4, and TSH were measured, while iodine supply was determined by measuring urinary iodine. Stage Ia goitre was diagnosed by palpation in 157 children, stage Ib in 18 and stage II in two (goitre prevalence of 1.97% according to WHO criteria). Mean thyroid volume as determined by ultrasound was 4.26 (0.8-23.4) ml. As expected, it increased with age and body surface area: it was 2.55 +/- 0.49 ml in 6-year olds, 3.83 +/- 0.42 ml in 10-year olds and 6.42 +/- 0.69 ml in 14-year olds. Iodine excretion (143.8 [4.1-984.8] micrograms iodine/g creatinine) indicated adequate iodine supply to the tested subjects. South Tyrol is thus, according to WHO criteria, no longer an endemic goitre area. The voluntary use of iodinated cooking salt and changed food habits have probably effected this change in goitre epidemiology.

Adolescent↗
PubMed1992

Correlations between subjective disturbances due to acute exposure to organic solvents and internal dose.

A general tendency to minor subjective disturbances ("susceptibility") were measured by questionnaire scores of psycho-/neurovegetative lability in 32 subjects independent of any experience with solvents. In series of experiments interrelations between subjective and biological variables during experimental exposures for 4 or 8 hr to acetone (1000 ppm), ethyl acetate (400 ppm), acetone/ethyl acetate mixture (500/200 ppm), or filtered air were investigated. Every two hr ratings of "tension", "tiredness", "complaints" and "annoyance" were reported and samples of urine were collected in order to analyse the internal dose of the substances. In exposures to ethyl acetate and to the mixture, the mean levels of urinary excretions of the substances show significant cross-correlations to rated complaints and annoyance, but not to rated tension and tiredness. Those subjects who showed higher susceptibility reported higher ratings of complaints and annoyance in those exposure conditions containing ethyl acetate. In exposures to acetone these relations were not found. Both, the quality of the substances and the individual tendency to report slight health impairments influence the variability of subjective reactions on exposure to solvents.

Acetates↗