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Biomedical subjects

A Wein

Publications and source records attributed to A Wein.

87 records · Page 5Linked to original sources
PubMed1983

Use of nitrofurantoin macrocrystals after transurethral prostatectomy.

A prospective randomized study of 223 consecutive patients with sterile urine undergoing transurethral prostatectomy was undertaken to examine the effects of nitrofurantoin macrocrystals on postoperative urine cultures. Patients were divided into 3 groups; group 1 received no postoperative antibiotics, group 2 received nitrofurantion for 5 days postoperatively and group 3 received nitrofurantoin for 10 days postoperatively. Nitrofurantoin decreases the incidence of short-term (24 hours after catheter removal) postoperative bacteriuria, while having no effect on long-term (4 weeks) bacteriuria following transurethral prostatectomy. The use of postoperative nitrofurantoin is supported by its tendency to reduce the incidence of short-term urinary infection in patients with the same organisms found in cultures of the prostatic tissue. However, there was no long-term advantage in prolonging therapy for greater than 5 days. There was no difference in morbidity in the immediate postoperative period among the 3 groups.

Bacteriuria↗
PubMed1982

Phase II trial of tamoxifen in metastatic carcinoma of the prostate.

Fifty-one patients with advanced metastatic carcinoma of the prostate were treated with the antiestrogen tamoxifen. Thirty-eight of these patients were refractory to prior hormonal manipulation with estrogens and/or orchiectomy, and five (13%) achieved an objective response (partial regression or stable disease using the National Prostate Cancer Project criteria). Median survival of the responders was significantly longer than that of the nonresponders (P less than 0.05). An additional 13 patients who had not previously received hormonal manipulation were treated with tamoxifen; one partial response and three disease stabilizations were noted. Response was separately evaluated for 15 patients with objectively measurable lesions using standard Phase II response criteria. Only 1/15 (7%) partial response and 3/15 (20%) disease stabilizations were documented. Subjective benefit in terms of significant pain relief was noted in 17/50 (34%) of patients. Toxicity was mild, but two possible "tumor flares" were noted. These results do not support the continued investigation of tamoxifen in advanced carcinoma of the prostate.

Aged↗
PubMed1981

Prospective analysis of the value of scrotal ultrasound.

Ultrasound was evaluated in 69 patients for its usefulness in distinguishing scrotal abnormalities requiring surgery from those that may have clinical follow-up only. Distinction was possible in the majority of cases. On imaging, tumor showed decreased echogenicity within the testicle, which was usually enlarged. Epididymal enlargement, marked increase in peritesticular fluid, and skin thickening suggest a non tumorous condition. The ultrasound characteristics of various scrotal abnormalities are described.

Dysgerminoma↗
PubMed1979

Polygraphic analysis of sleep in dystonia musculorum deformans.

The functional state of non-specific brain systems was studied in 27 patients with torsion dystonia through a complex of techniques, which included clinical, experimental psychological and electrophysiological examination of night sleep. Changes of involved nature have been identified in the various elements of non-specific systems in different clinical forms of the disease in its early and advanced stages, which allows to consider torsion dystonia as a functional organic psychomotor syndrome in the origination of which a great role belongs to non-specific integrative systems of the brain.

Adolescent↗
PubMed1979

Polygraphic analysis of sleep and wakefulness in patients with Parkinson's syndrome.

The present work is an analysis of 30 patients with Parkinsonian syndrome and 10 healthy persons during different functional states (aroused wakefulness, relaxed waking state, various phases and stages of nocturnal sleep, hypnosis). By means of polygraphic recordings and the Minnesota Multiphasic Personality Inventory (MMPI) it has been shown that motor, emotional and autonomic activity during sleep as well as EEG changes in parkinsonism are uniformly related to the nature and extent of the pathologic alterations in the non-specific, predominantly activating brain systems.

Brain↗
PubMed1978

Testicular germ cell tumors: diagnosis, management, and the potential for cure.

Even in advanced stages, testicular germ cell tumors are now curable. Pathologic classification proposed by W.H.O. affords more precise histologic definition; nevertheless, an improved staging classification more relevant to combination chemotherapy is required. Diagnostic evaluation should include the newer serum protein markers, lymphangiography as well as ultrasound and/or computerized axial tomography when clinically indicated. Combination chemotherapy drug regimens have made a major impact on survival of patients with testicular germ cell tumors because they can induce a high percentage of durable complete remissions. Only prospective trials can define the optimum number of drugs needed and the length of time of treatment to obtain cure. The role of combined modality therapy (radiation, reductive surgery, chemotherapy) needs to be further defined. It is hoped that ongoing clinical trials will answer many of these important questions.

Antineoplastic Agents↗
PubMedDate not supplied

The use of clinical parameters in an interactive statistical package to predict pathological features associated with local failure after radical prostatectomy for prostate cancer.

The capability of an interactive statistical package (ISP) to predict the patients whose pathologic findings at the time of radical prostatectomy for prostate cancer would require postoperative radiation therapy to prevent local failure is investigated. A retrospective review of the clinical pretreatment factors and pathologic findings of 174 patients with adenocarcinoma of the prostate treated from 1989 to 1993 with radical retropubic prostatectomy was performed and served as a knowledge base of the ISP. The pathologic findings of seminal vesicle involvement, gross transcapsular disease, and positive surgical margins are defined as outcomes associated with a high risk of local failure after radical prostatectomy and, thereby, requiring postoperative radiation therapy to decrease this risk. By using the pretreatment clinical factors including prostate-specific antigen (PSA), Gleason score, clinical stage, and endorectal magnetic resonance imaging (MRI) findings as input to the ISP, patients are identified from a test group of 50 cases with known pathologic outcome who would require postoperative radiotherapy to decrease local failure. Low- (0% to 33%), intermediate- (34% to 67%), and high-risk groups (68% to 100%) for pathologic features associated with local failure were predicted accurately (r > .95) by the ISP for the 50 test cases. Factors identified on univariate analysis by the ISP as significant predictors of local failure postoperatively include PSA > 20 (p < .001), clinical stage (p < .001), MRI finding of gross transcapsular disease (p < .001), MRI finding of seminal vesicle involvement (p < .001), and Gleason score (p < .003).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMedDate not supplied

Mismatch repair deficiency in sporadic synchronous colorectal cancer.

BACKGROUND: Hereditary non-polyposis colorectal cancer (HNPCC) patients frequently develop synchronous colorectal cancer (SCRC) which also occurs sporadically in other patients. Recent studies on microsatellite instability (MSI) in sporadic SCRC diverge completely in their findings (0%-100%). In the present study MSI and mismatch repair (MMR) proteins were evaluated according to standardised criteria (exclusion of a family history, MSI analysed according to NCI recommendations) METHODS: Paraffin embedded sections of SCRC of 30 patients were evaluated for MSI and the loss of protein expression of hMLH1 and hMSH2. RESULTS: 3 out of 30 (10%) patients exhibited MSI-H which 5 out of 30 (17%) showed MSI-L. Loss of protein expression of either hMLH1 or hMSH2 was found in all cases of MSI-H and none of the MSI-L cancers. CONCLUSION: MSI is found in sporadic cases of SCRC to about the same extent as it is mentioned in the literature on sporadic single colorectal cancers. Immunohistochemistry with mismatch repair proteins could be used as a pre-screening for MMR deficiency in sporadic SCRC.

Adaptor Proteins, Signal Transducing↗
PubMedDate not supplied

Ki-67 expression and residual tumour (R) classification are associated with disease-free survival in desmoid tumour patients.

BACKGROUND: In order to evaluate prognostic factors in the long-term survival of desmoid tumour patients, analysis of clinicopathological, immunohistochemical and follow-up data was performed. PATIENTS AND METHODS: Between 1969 and 1998, 54 patients underwent resection of aggressive fibromatosis (desmoid) and 33 of them (10 patients with FAP and 23 sporadic) were followed-up with a median time of 130 months (range 10-355 months). Additionally, immunohistochemical analysis of the desmoid tumours using Ki-67 was performed. RESULTS: In univariate analysis, curative resection (R0) (p<0.001) and low proliferation of Ki-67 (p=0.002) were of significant positive prognostic value concerning disease-free survivaL R0 and absence of Ki-67 staining were significantly associated with each other (p=0.004). CONCLUSION: Ki-67 seems to serve as a predictive marker concerning disease-free survival of desmoid tumour patients. In patients presenting with Ki-67 positive desmoids, which are unlikely to be resected in a curative manner, alternative treatment (e.g. sulindac) may be preferable.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

Relationship between microsatellite instability, response and survival in palliative patients with colorectal cancer undergoing first-line chemotherapy.

BACKGROUND AND AIMS: The aim of this work was to investigate the relationship between microsatellite instability (MSI), treatment response and survival in palliative patients with colorectal cancer (CRC) undergoing first-line treatment with weekly 24-hour infusion (24-h inf.) of high-dose 5-fluorouracil (5-FU) and folinic acid (FA). PATIENTS AND METHODS: Tumour material from the colorectal primary carcinomas was analysed for 43 patients. MSI analysis was carried out and immunohistochemistry was performed with hMLH1 and hMSH2. RESULTS: Tumours of 7 patients (16%) were highly instable (MSI-H). These patients had a better response rate (72% vs. 41%; p = 0.072) and a significantly better median survival (33 months, [95% CI 20-46] vs. 19 months, [95% CI 10-28]; p = 0.021) than microsatellite stable (MSS) patients (n = 36). Furthermore, MSI status was shown to be an independent predictive marker for survival (p = 0.037). CONCLUSION: These data provide further support for the hypothesis that MSI-H CRC might have a better response and survival than (MSS) CRC in palliative first-line treatment.

Adaptor Proteins, Signal Transducing↗
PubMedDate not supplied

Palliative second-line treatment with weekly high-dose 5-fluorouracil as 24-hour infusion and folinic acid (AIO) plus oxaliplatin after pre-treatment with the AIO-regimen in colorectal cancer (CRC).

BACKGROUND AND AIMS: The aim of this work was to evaluate the efficacy and safety of second-line treatment with weekly high-dose 5-Fluorouracil (5-FU) as a 24-hour infusion (24-h inf.) and folinic acid (FA) (AIO-regimen) plus Oxaliplatin (L-OHP) after pre-treatment with the AIO regimen, focusing in particular on the efficacy of palliative first- and second-line treatment in colorectal carcinoma (CRC). PATIENTS AND METHODS: Patients with non-resectable distant CRC metastases were enrolled in a prospective phase II study for palliative second-line treatment after previous palliative first-line treatment in accordance with the AIO regimen. On an outpatient basis, the patients received a treatment regimen comprising biweekly 85 mg/m2 L-OHP in the form of a 2-hour intravenous (i.v.) infusion and 500 mg/m2 FA as a 1 to 2-hour i.v. infusion, followed by 2,600 mg/m2 5-FU administered as a 24-h inf. i.v. once weekly. A single treatment cycle comprised 6 weekly infusions followed by 2 weeks of rest. RESULTS: During second-line treatment, a total of 26 patients received 340 chemotherapy applications. As the main symptom of toxicity, diarrhoea (NCI-CTC toxicity grade 3+4) presented in 5 patients (19%; 95% CI: 4-34), followed by nausea (CTC grade 3) in one patient (4%; 95% CI: 0-11). Twenty-three patients were evaluable for treatment response. The remission data can be summarised as follows: Complete remission (CR): n=1 (4%; 95% CI: 0-13); partial remission (PR): n=3 (13%; 95% CI: 0-27); stable disease (SD): n=11 (48%; 95% CI: 27-68) and progressive disease (PD): n=8 (35%; 95% CI: 15-54). The median progression-free survival (PFS) rate (n=26) was 3.3 months (range 0-11.5), the median survival time counted from the start of second-line treatment (n=26) 11.6 months (range 2.1-33.0) and the median survival time counted from the start of first-line treatment (n=26) 19.9 months (range 7.7-49.8). CONCLUSION: Palliative second-line treatment according to the AIO regimen plus L-OHP is feasible in an outpatient setting and well tolerated by the patients. Tumour control (CR + PR + SD) was achieved in 65% of the patients, the median survival time being 11.6 months. The AIO regimen followed by the 'AIO regimen plus L-OHP' therapy sequence led to a promising median survival time of 19.9 months (range 7.7-49.8).

Adult↗
PubMedDate not supplied

Tamoxifen in refractory metastatic carcinoma of the prostate.

Thirty-one patients with advanced metastatic carcinoma of the prostate were treated with the antiestrogen tamoxifen. Of these patients, 29 were refractory to prior hormonal manipulation with estrogens and/or orchiectomy and five achieved an objective response (partial regression of stable disease using National Prostatic Cancer Project criteria). Median survival of the responders was significantly longer than that of the nonresponders (P < 0.05). Two additional patients who had not previously received hormonal therapy both responded, for an overall response rate of 23% (seven of 31 patients). Toxicity was minimal and no tumor flares were reported. These preliminary results support the further clinical trial of tamoxifen in advanced cancer of the prostate.

Adenocarcinoma↗
PubMedDate not supplied

Role of percent positive biopsies and endorectal coil MRI in predicting prognosis in intermediate-risk prostate cancer patients.

PURPOSE: This study was performed to determine the clinical factors that can optimize preoperative staging for clinically localized intermediate-risk prostate cancer patients. MATERIALS AND METHODS: Logistic and Cox regression multivariable analyses were performed on 480 prostate cancer patients whose disease was confined to the prostate to evaluate the ability of clinical stage, prostate-specific antigen (PSA), biopsy Gleason sum, percent positive biopsies, and endorectal coil magnetic resonance imaging (MRI) results to predict pathologic established extracapsular extension, seminal vesicle invasion, and time to postoperative PSA failure in patients with clinically localized prostate cancer. Intermediate risk was defined as PSA 4-10 ng/mL and Gleason sum 5-7; PSA 10-20 ng/mL and Gleason sum < or = 7. RESULTS: Intermediate-risk patients with at least 50%, 67%, 83%, or 100% positive biopsies have disease pathologically confined to the prostate at least 45% of the time; however, if an endorectal coil MRI is positive for either capsular penetration or seminal vesicle invasion, no more than 29% of patients have pathologically determined organ-confined disease. No intermediate-risk patient with both a positive MRI and at least 50% positive biopsies had pathologically determined organ-confined disease. Intermediate-risk patients with less than 50% positive biopsies had pathologically determined organ-confined disease in at least 77% of the cases. CONCLUSIONS: Intermediate-risk patients with an endorectal coil MRI showing extracapsular extension or seminal vesticle invasion are at high risk for early postoperative PSA failure. The concomitant presence of at least 50% positive biopsies increases this risk to unity. Therefore, these patients are not good candidates for surgery alone because of their high risk of extraprostatic disease and should be considered for entry onto phase III trials examining the effect of adding androgen-deprivation therapy to definitive local therapy (external-beam radiation therapy or surgery) on overall survival. The subgroup of intermediate-risk patients likely to benefit from an endorectal coil MRI are those patients with PSA > 10-20 ng/mL; biopsy Gleason score < or = 7, and at least 50% positive biopsies representing approximately 7.5% of the total patient population.

Biopsy↗