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Biomedical subjects

B Brandt

Publications and source records attributed to B Brandt.

174 records · Page 10Linked to original sources
PubMedDate not supplied

Frequent detection and immunophenotyping of prostate-derived cell clusters in the peripheral blood of prostate cancer patients.

BACKGROUND: Recent scientific studies have failed to determine parameters for the assessment of prostate cancer aggressiveness. The present study deals with the detection of blood-borne cancer cells based on polymerase chain reaction (PCR) and cell enrichment methods. The contradictory results reported in the literature have called into question the clinical usefulness of this diagnostic method in the preoperative staging of clinically localized prostate cancer. METHODS: We established a combined method of density gradient centrifugation and immunomagnetic separation using epithelium-specific antibodies, i.e. cytokeratins, to isolate prostate-derived circulating cells from the peripheral blood of patients with prostate cancer. Isolated cells were characterized by DNA staining and immunocytochemistry using antibodies for the detection of prostate-specific antigen (PSA), proliferation-associated proteins (MIB-1, H1 and H3) and apoptosis-associated proteins (M30, c-FasR). RESULTS: We applied these methods to 68 prostate cancer patients and were able to isolate cell clusters in 98%. Immunophenotypic and morphological characterization of PSA-positive prostate-derived cell clusters found in the peripheral blood of prostate cancer patients showed two main populations: 1) in 35% of the investigated prostate cancer patients we detected rounded cell aggregates of probable cancer cells expressing proliferation-associated proteins and lacking apoptosis-associated protein expression; 2) in all cases there was a high frequency of circulating dysmorphic cell clusters positive for apoptosis-associated protein expression. CONCLUSION: Our results demonstrate the existence of at least two different types of blood-borne prostate-derived circulating cell clusters. Of these, only the less frequent, round, small cell clusters harbor features that are probably necessary for the cells to survive for metastatic spread.

Biomarkers, Tumor↗
PubMedDate not supplied

The biologic lower detection limit of six ultrasensitive PSA assays.

BACKGROUND: The benefit of monitoring patients with prostate cancer (PCA) by ultrasensitive measurement of prostate specific antigen (PSA) is frequently discussed. Usually, the analytic lower detection limit of an ultrasensitive assay is determined by the manufacturer. As the analytic lower detection limit does not take into account interfering factors of human serum, the biologic lower detection limit, which is defined as PSA concentration detected in PSA-free human serum, plus 3 standard deviations, is of greater interest. MATERIALS AND METHODS: We investigated the biologic lower detection limit of six ultrasensitive PSA assays. Sera from 15 men with bladder cancer after radical cystoprostatectomy and from 30 healthy women were applied. Hence, we expected no PSA of prostatic origin. RESULTS: The biologic lower detection limit obtained using these sera was up to 30 fold higher (men, 0.29-0.63 ng/ml; women, 0.03-0.69 ng/ml) than the analytic lower detection limit (0.01-0.09 ng/ml). CONCLUSIONS: PSA measurement in sera obtained from men without prostate and women results in PSA values above the ultrasensitive range. Therefore, advantages provided by ultrasensitive PSA measurement in monitoring PCA patients after radical prostatectomy are limited.

Environmental Monitoring↗
PubMedDate not supplied

Acute appendicitis in pregnancy: complications and subsequent management.

OBJECTIVE: To establish guidelines for the management of a pregnancy that is complicated by acute appendicitis. DESIGN: Retrospective study. SETTING: University Hospital, Copenhagen, Denmark. SUBJECTS: 16 patients operated on for symptoms of acute appendicitis during the 15 year period 1974-1988. RESULTS: In 12 patients (75%) the diagnosis was confirmed histologically. The signs and symptoms were classic, and three patients had contractions. One fetus died, in a patient with appendicitis complicated by intraperitoneal abscess. In all uncomplicated cases the pregnancy proceeded to term and the deliveries were normal. CONCLUSIONS: Pregnancy should not deter a surgeon from removing an appendix, once the diagnosis is suspected; no pregnancy was affected by removal of a normal appendix. We recommend that prophylactic antibiotics and tocolytic drugs be given in all cases. Simultaneous caesarean section should be done only if there are obstetric indications.

Acute Disease↗
PubMedDate not supplied

An epidermal growth factor receptor intron 1 polymorphism in healthy women in Poland.

The frequency of CA allele combinations was assessed in healthy women from Poland and compared to previously published polymorphism data of individuals from Germany and a Caucasian reference group. There were close similarities between these three geographically and ethnically similar populations. By contrast, the distribution of these alleles in European and Asian (Japan) populations proved to be different. There might therefore be major ethnic differences in allelic frequencies of EGFR intron 1 polymorphism. Our results provide new data on EGFR microsatellite instability and may contribute to the understanding of EGFR gene expression regulation. The clinical relevance of these findings warrants further evaluation.

Adolescent↗
PubMedDate not supplied

Informational needs and selected variables in patients receiving brachytherapy.

The increasing use of brachytherapy in patients with cancer mandates that the informational needs of these patients are met. A nonrandomized sample of 22 patients undergoing brachytherapy participated in a study to determine (1) informational needs, (2) the degree to which patients prefer to be informed about and to participate in their medical care, and (3) the relationship between informational needs and selected variables. Most patients (86.4%) desired maximum information about their illness. The informational needs most frequently identified preimplant were how to manage side effects (54.5%), activity restrictions during implant (54.5%), pain management and comfort measures (54.5%), cause of current symptoms (54.5%), and how the implant could affect symptoms (54.5%). Postimplant needs included when to call the doctor (68%), possible side effects of treatment (64%), and how to manage side effects (63.6%). A significantly lower level of anxiety was found after the implant, compared to before the implant (p less than 0.005). A significant relationship was found between the number of informational needs and the stage of disease. Patients with advanced late disease (stages III and IV) had fewer informational needs than those with early disease (stages I and II), both before and after the implant (p less than 0.05). The results indicate that patients receiving brachytherapy have a variety of informational needs and generally prefer to be fully informed about their condition. The findings indicate possible content areas for educational programs and for counseling of patients undergoing brachytherapy.

Adult↗
PubMedDate not supplied

Nursing protocol for the patient with neutropenia.

Although major advances in the treatment of cancer have resulted in improved survival rates, serious infections continue to be a major source of morbidity and mortality in the immunocompromised patient. Patients may experience prolonged periods of bone marrow suppression accompanied by neutropenia as a result of the underlying disease, and as a result of treatment with myelosuppressive chemotherapy, intensive radiotherapy, or both. Neutropenia is the single most important factor predisposing patients with cancer to infection. The risk of developing infection increases as neutropenia persists, and this risk is consistently greater at lower neutrophil levels. Infection in a patient with neutropenia is regarded as an emergency situation requiring immediate action; progression of localized to disseminated infection leading to sepsis may be so rapid that, if not detected early, mortality is high. In the presence of neutropenia, the manifestation of infection leading to life-threatening septicemia is altered. The usual signs and symptoms of infection may be minimal or absent, hindering early and accurate diagnosis of infection. To provide a means of early and more accurate diagnosis of infection in the patient with neutropenia, a nursing protocol has been developed that incorporates preventive interventions, guidelines for early detection of impending infection, and measures to control infection.

Agranulocytosis↗
PubMedDate not supplied

[Late and multiple endocrine metastases of an adenocarcinoma of the kidney].

Ten years after nephrectomy a renal cell carcinoma of the felt kidney, the patient presented successively pancreatic, adrenal gland, thyroid gland and contralateral renal metastases. Surgical exeresis was performed for the different metastases with a survival period of 7 years. No similar observation (non-necropsic discovery, surgical treatment, prolonged survival) of multiple metastasis of renal cell carcinoma to endocrine glands was found in the literature. The important role of modern imaging techniques are emphasized together with the need for long-term follow-up of operated renal cell cancer since the clinical course can be unpredictable. Long-term remission has been reported and surgical exeresis of metastasis should always be proposed when possible.

Adenocarcinoma↗
PubMedDate not supplied

The use of prostate-specific antigen (PSA) for the monitoring of radiation therapy in prostate cancer.

BACKGROUND: The classic methods for surveilling the efficacy of radiotherapy in prostate cancer are not accurate enough. The objective of this analysis was to determine whether prostate-specific antigen could perform this task. MATERIALS AND METHODS: From 1/95 to 10/95, 16 patients were treated at our clinic. 7 of these underwent primary irradiation, 4 treatment for local recurrence, and 5 had adjuvant radiotherapy. Radiotherapy was carried out with a total dose of 60 Gy in 30 fractions, 10 fractions per week, to the prostate bed plus 2 cm safety margin. RESULTS: PSA levels usually start to decline between the 3rd and the 4th week of radiotherapy with a half-life of 2.5 months. Five patients had equal or rising PSA levels, including all three patients with recurrent tumor. DISCUSSION: In most cases, PSA declined continuously from the 3rd week of therapy. Our median half-life was similar to other reported results. Persisting or rising PSA levels are an indicator for local or distant recurrence; all our patients who developed a recurrence showed a corresponding PSA increase.

Humans↗