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Biomedical subjects

A Trojan

Publications and source records attributed to A Trojan.

At least 37 records · Page 2Linked to original sources
PubMed2001

Inflammatory myofibroblastic tumor with CNS involvement.

BACKGROUND: Inflammatory myofibroblastic tumors (IMT) represent a spectrum of neoplasms that occur in the mesentery and retroperitoneum and less frequently in the mediastinum of children and young adults. Transformation into inflammatory fibrosarcoma and metastases are rare. CASE REPORT: We report the case of a 16-year-old patient with an inflammatory myofibroblastic tumor of the mesentery with mediastinal metastases. Partial remission was obtained by chemotherapy with ifosfamide, dactinomycine, and vincristine. Two months later, relapse with infiltration of the meninges developed, and the patient died. CONCLUSION: This case demonstrates unusual features of an IMT: presentation with metastases, excellent response to chemotherapy, dissemination to the CNS.

Adolescent↗
PubMed2000

Real-Time polymerase chain reaction of immunoglobulin rearrangements for quantitative evaluation of minimal residual disease in multiple myeloma.

The majority of patients with multiple myeloma (MM) have persistence of minimal residual disease (MRD), as determined by polymerase chain reaction (PCR) detection of clonal immunoglobulin H (IgH) gene rearrangements. As a result, PCR analysis has not provided clinically useful prognostic information in myeloma patients. Instead, quantitative PCR approaches are required to predict patient outcomes and assess response to novel treatment strategies. We adapted real-time PCR technology to quantify myeloma cells using the IgH rearrangement and then assessed the utility of this approach in 29 patients with myeloma who had undergone autologous stem cell transplantation. Because of the high cost of producing a specific reporting probe for each patient, H-chain V-region family-specific consensus probes were used in association with allele-specific oligonucleotides for PCR amplification. Because of the high frequency with which somatic hypermutation at the immunoglobulin locus occurs in MM, a number of mismatches occurred between the patient sequences and the consensus probe. However, construction of a limited number of probes allowed real-time PCR with a sensitivity of 10(-4) to 10(-5). To validate this method, we extensively evaluated assay accuracy and reproducibility. Results indicate that real-time PCR using consensus probes provides a feasible, accurate, and reproducible method for evaluating MRD in M M and possibly in other differentiated B-cell malignancies, and one that is less expensive than the use of patient-specific probes. This technique is being used to assess tumor depletion after immunologic purging and changes in tumor burden in patients undergoing stem cell transplantation and novel treatment approaches.

Gene Rearrangement, B-Lymphocyte, Heavy Chain↗
PubMed2000

Immunoglobulin framework-derived peptides function as cytotoxic T-cell epitopes commonly expressed in B-cell malignancies.

Although the idiotypic structures of immunoglobulin from malignant B cells were the first tumor-specific determinants recognized, and clinical vaccination trials have demonstrated induction of tumor-specific immunity, the function of immunoglobulin-specific CD8+ cytotoxic T lymphocytes in tumor rejection remains elusive. Here, we combined bioinformatics and a T cell-expansion system to identify human immunoglobulin-derived peptides capable of inducing cytotoxic T-lymphocyte responses. Immunogenic peptides were derived from framework regions of the variable regions of the immunoglobulin that were shared among patients. Human-leukocyte-antigen-matched and autologous cytotoxic T lymphocytes specific for these peptides killed primary malignant B cells, demonstrating that malignant B cells are capable of processing and presenting such peptides. Targeting shared peptides to induce T-cell responses might further improve current vaccination strategies in B-cell malignancies.

B-Lymphocytes↗
PubMed1998

[Liver changes in AIDS. Retrospective analysis of 227 autopsies of HIV-positive patients].

In a retrospective study of a 12-year period (1981-1992) liver histology was analyzed in 227 autopsied patients infected with the human immunodeficiency virus. Normal histology could only be documented in 29 patients (13%). In the majority of cases (56%) uncharacteristic changes were seen such as steatosis (34%), hemosiderosis (10%) or non-specific reactive hepatitis (7%). The finding of hepatic peliosis obtained in 4 patients was not associated with inflammatory liver changes, especially infections from Rochalimaea. Within a wide range of opportunistic infections recorded in 50 patients (22%), hepatitis caused by Cytomegalovirus (8%), Toxoplasma gondii (5%), Leishmania donovani (1%), Cryptococcus neoformans and Pneumocystis carinii (each 0.5%) was diagnosed. Among 16 cases (7%) of mycobacterial liver infections typical mycobacteria were found in two patients and atypical mycobacteria in 14 patients, respectively. In 23 patients (10%) chronic viral hepatitis, caused by HBV (7%) or HCV infections (3%), respectively, was observed. Hepatitis was typed as mild only in each 5 patients with HBV or HCV infection, whereas the remaining cases showed a transition towards cirrhosis. Two patients with HBV-associated cirrhosis developed hepatocellular carcinoma. The remaining 32 malignant liver tumors represented secondary neoplasms, including 13 cases of non-Hodgkin's lymphomas.

AIDS-Related Opportunistic Infections↗
PubMed1998

CT appearances of hepatic involvement in systemic varicella-zoster.

In a patient suffering from T-cell non-Hodgkin's lymphoma and systemic varicella-zoster, contrast enhanced CT showed multiple hypodense nodular lesions in the liver which corresponded to areas of focal liver necrosis. This appearance on CT may be characteristic of varicella-zoster involvement of the liver.

Female↗
PubMed1997

[Quality evaluation from the patient viewpoint--exemplary results from the European WHO Project "Health-Promoting Hospitals"].

This article has two objectives: first of all, to present the European WHO project "Health Promotion in Hospitals" in a general way and secondly, to report on results of empirical concomitant research on a sub-project on quality assessment from the patient's viewpoint in a Hamburg member hospital of the international WHO pilot project and to present the essential partial aims of this approach to health promotion. An interim report on the international pilot project showed clearly that among all the realisation projects those are the most frequent ones that aim at promoting the health of patients (87 of a total 181). We report on one of these projects (partly sponsored by the North German Centre of Public Health). Focus is on the results of a quantitative query among patients (n = 157 = 58% response rate). The methods on which the study is based as well as the relevant limitations of its representative nature are outlined. Essential results quoted are the assessments made by the patients themselves taking into consideration 11 dimensions of hospital quality. It becomes evident that action should be taken in the area of several communicative dimensions and in hospital facilities. The results of the inquiry provided the basis for hospital quality improvements. An internal project group within the hospital worked out recommendations that have since been translated into reality to a large extent.

Adolescent↗
PubMed1996

[Strategies for productive collaboration between science and general practice].

My contribution is a systematic account of strategies for cooperation and feedback between public health sciences and research. A feature both areas have in common is their commitment to empirically based knowledge. "Rational" models of cooperation (or rather, models based on belief in rationality) presume simple linear links between research and its application. Diffusion models, however, seem to be far more adequate for translating public health research into reality. The best model is the "Discourse Model" based on continuous communication and feedback between science and practice. It seems to promote the diffusion of public health innovations most effectively. In the second part I give examples of how to translate the Discourse Model into practical reality. Summing up, its strategic elements are: 1. responsive project shaping, 2. interactive running of projects, 3. shared processing of results, 4. active diffusion of results.

Diffusion of Innovation↗
PubMed1995

[Health promotion and prevention by urban renewal?].

This article is based on a study using different approaches to examine the links between urban development on the one hand and health promotion on the other. The background and basic concepts underlying this study are briefly explained. Programmatic papers from both spheres of approach result in the basic thesis that both urban development and health promotion are aiming at improving the quality of life in city districts (objective conditions of living and subjective feeling tone, i.e. subjective well-being) in the overall sense of a health-promoting general policy. Because of these common goals cooperation between both spheres is hypothesised. However, the study as a whole shows (especially an analysis of the documents of the files of the sanitation committee) that this is not so. To understand this finding better the freedom of both parties concerned to act as they should, is analysed, namely, that of the sanitation committee and of the regional health and environmental office. It becomes evident that in both these spheres the requisite monitoring capacities, such as legal support, finances, information service and counselling activities, are fundamentally lacking or indeed limited. Hence, there are limited chances of success in the spheres of health promotion and preventive care by means of sanitation of city districts. Finally, the authors point to long-term trends and developments that would make a future approach between the two spheres mandatory and (at least partially) possible.

Environmental Exposure↗
PubMed1994

Control of skin blood flow in pre- and full-term infants.

The response of skin blood flow to local ischemia, heating and cooling was investigated at different intervals after birth in 10 healthy full-term babies and 10 preterm postincubator infants using 2 noninvasive and locally neutral methods of microcirculatory measurement: laser Doppler flowmetry and cutaneous oxygen partial pressure (cPO2) estimation with a probe temperature of 37 degrees C. Both groups of infants were capable of myogenic and neural control of skin blood flow. Higher cPO2 values under basal conditions and during reactive hyperemia suggest a raised nutritive capillary blood flow in the preterm group. The increase in cutaneous blood flow during local warming and reactive hyperemia shows that even in neonates on the first day of life no maximal skin vasodilatation is present. An increase in the periodic flow waves attributed to arteriolar vasomotion in 19- to 22-day-old infants, compared to the preterm group and younger babies, indicates that myogenic activity in skin arterioles increases with advancing age.

Blood Flow Velocity↗
PubMed1994

[Role of the public health (and environmental) office in urban development--current status and perspectives].

Our central question is how the local public health services can influence urban development and urban renewal policies. The need for a three-way cooperation between departments of urban planning and development, environmental affairs and health is now being widely acknowledged. In practice, however, it has to face manifold and serious problems. We suggest that there are basically three essential "instruments" which could lead to a new and defined role of health departments in urban development: environmental and health audits, local health profiles and "health promotion committees" or similar bodies for closer cooperation at the local level. These three "instruments" are described in terms of the present state of development and dissemination by analysing empirical studies from public health research. The results indicate that the "new role" of local health services in urban planning and development is presently fulfilled only in a few pilot cases. The lack of basic requirements particularly in terms of resources, motivation and qualifications is the main cause for the inability to implement the three "instruments" on a broader level in local health services.

City Planning↗
PubMed1989

Benefits of self-help groups: a survey of 232 members from 65 disease-related groups.

This paper gives a report on the benefits of self-help groups as depicted by 232 members from 65 different disease-related groups. Intensive interviews and participant observation enabled us to formulate a questionnaire with 125 mostly standardized questions. The questions referred mainly to motives for membership, working procedures within the groups, goals and effectiveness, outcome of participation and need for outside support. The focus of this paper will be on what the members reported about the changes and effects induced by their participation in self-help groups. The interviewed group members reported a wide variety of goals. These were classified into two categories according to their range. Goals directed towards the group or group members were achieved (at least partly) by more than 90%. Goals directed towards persons outside the group (e.g. to change opinions of the family or of the professional system) were mentioned by about two thirds of the interviewed members. About three quarters of them achieved these goals at least partly. The effects of participation were grouped into the following categories. 1--Impact on disease-related stress (positive health effects, general enlargement of competence, general social activation); 2--impact on the relationship with family and friends (relationship with partner, changes in personal network); 3--impact on patient behaviour and professional services (general enlargement of competence in relation to the professional care system, social activation in relation to the professional care system, utilization of professional services). Most of the members reported considerable positive changes in these dimensions. Negative impacts were mentioned by a very small minority (between 1 and 4%).(ABSTRACT TRUNCATED AT 250 WORDS)

Health Behavior↗