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Biomedical subjects

B Fröhlich

Publications and source records attributed to B Fröhlich.

At least 19 recordsLinked to original sources
PubMed2006

Comparison of Venae Sectio vs. modified Seldinger Technique for totally implantable access ports; Portas-trial [ISRCTN:52368201].

BACKGROUND: The insertion of a Totally Implantable Access Port (TIAP) is a routinely employed technique in patients who need a safe and permanent venous access. The number of TIAP implantations is increasing constantly mainly due to advanced treatment options for malignant diseases. Therefore it is important to identify the implantation technique which has the optimal benefit/risk ratio for the patient. STUDY DESIGN: A single-centre, randomized, controlled superiority trial to compare two different TIAP implantation techniques. SAMPLE SIZE: 160 patients will be included and randomized intra-operatively. ELIGIBILITY CRITERIA: Age equal or older than 18 years, patients scheduled for primary elective implantation of a TIAP in local anaesthesia and a signed informed consent. Primary endpoint: Primary success rate of the randomized technique. INTERVENTION: Venae Sectio in combination with the Seldinger Technique (guide wire and a peel away sheath) will be used to place a TIAP. Reference treatment: Conventional Venae Sectio will be used with a direct insertion of the TIAP without guide wire or peel away sheath. Duration of study: Approximately 20 months. ORGANISATION/RESPONSIBILITY: The trial will be conducted in compliance with the protocol and in accordance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989) and Good Clinical Practice (GCP). The trial will also be carried out in keeping with local and regulatory requirements. The Klinisches Studienzentrum Chirurgie (KSC)--Centre of Clinical Trials in Surgery at the Department of Surgery, University Hospital Heidelberg is responsible for planning and conduction of the trial. Documentation of patient's data will be accomplished via electronical Case Report Files (eCRF) with MACRO-Software by the KSC. Randomization, data management, monitoring and biometry are provided by the independent Koordinierungszentrum für Klinische Studien (KKS)--Coordination Centre for Clinical Trails at the University of Heidelberg.

Journal Article↗
PubMed2005

Clinical impact of cachexia on survival and outcome of cancer patients.

Approximately one half of all cancer patients experience a complex metabolic status involving progressive exhaustion of adipose and skeletal muscle tissue. This condition, known as cachexia, is responsible for more than 20% of the overall deaths in cancer patients. Although its main mechanisms remain unknown, several hypotheses have been proposed. One of the pathogenic mechanisms involves leptin and hypothalamic neuropeptide-containing pathways. Orexigenic and anorexigenic neuropeptides are down-regulated respectively upregulated as a result of cancer. Other pathogenic theories consider tumour derived factors, such as LMF (Lipid Mobilising Factor) and PIF (Proteolysis-inducing Factor), to be responsible for the weight losing pattern of cancer patients via activation of various catabolic pathways (e.g. ubiquitin-proteasome proteolytic-pathway, etc.). Despite the controversial discussion of cachexia-inducing mechanisms it is clear that proinflammatory cytokines, such as TNFalpha, IFNgamma, IL-1, IL-6 and IL-8, are linked to all pathways that induce cachexia. Although only limited treatment exists for patients with cancer cachexia, recent studies with eicosapaentanoic acid showed promising effects in reversing weight losing pattern of cachectic patients. Cytokine targeted monoclonal antibodies, cytokine traps and genetic therapies are also evaluated for future therapeutic strategies.

Cachexia↗
PubMed2003

Raman spectroscopic study of spatial distribution of propolis in comb of Apis mellifera carnica (Pollm.).

Micro-Raman spectroscopy and Raman mapping are applied to investigate the spatial distribution and chemical composition of wax and propolis in the comb of Apis mellifera carnica (Pollm). A thick layer of propolis at the rim of some cells is identified by Raman spectroscopy. Raman mapping is applied to resolve the distribution of propolis and wax on a micron scale. Both components are connected at the rim of the cell with a mixture of wax and propolis. A layer of almost pure propolis is found on top of the mixture. It appears that even in the mixture, where both components come into close contact, the propolis and the wax remain separated and keep their chemical identity.

Animals↗
PubMed2001

Ewing tumour: incidence, prognosis and treatment options.

Ewing tumours, i.e. Ewing's sarcoma and malignant peripheral neuroectodermal tumours, are the second most common primary malignant tumours of bone in childhood and adolescence, with an annual incidence rate in Caucasians of 3 per 1 million children <15 years of age. Histopathologically small blue round cell tumours, Ewing tumours show a typical chromosomal rearrangement in >95% of cases linking the EWS gene on chromosome 22q12 to a member of the ETS transcription gene family, most commonly to Fli-1 on 11q24. This fusion contributes to the malignant potential of Ewing tumour cells, indeed antisense oligonucleotides may prevent tumour growth in vitro. After open biopsy, and histological and possibly molecular biological confirmation of the diagnosis, treatment consists of several months of multidrug cytostatic therapy and local therapy. Both surgery and radiotherapy may control local disease, but without consequent cytostatic chemotherapy all patients will eventually succumb to distant metastases. With the use of alkylating agents including doxorubicin, cyclophosphamide and/or ifosfamide, and other cytostatic drugs such as actinomycin D (dactinomycin), vincristine and etoposide, long-term survival can be achieved in >50% of patients with localised disease. Patients with clinically detectable metastases at diagnosis, patients not responding to therapy and patients with disease relapse have a significantly poorer prognosis. Maximum supportive care and local therapy managed by an experienced physician are required in all patients, and inclusion of high-risk patients in phase I and II studies is warranted. Hence, treatment of patients with Ewing tumours should be performed in experienced centres only and preferably within controlled clinical trials.

Antineoplastic Agents↗
PubMed2000

[Subclinical arteriosclerosis in patients with newly diagnosed type 2 diabetes mellitus. Demonstration by high-resolution ultrasound measurements of intima-media thickness of the common carotid and femoral arteries].

BACKGROUND AND OBJECTIVE: Type 2 diabetes mellitus is an important risk factor for the development of atherosclerosis. Early subclinical manifestation of atherosclerosis can be reliably recognized by measuring the thickness of the intima and media (IMT). The aim of this study was to examine vessel changes and the extent of possible risk factors in patients with newly diagnosed type 2 diabetes (interval since diagnosis < or = 1 year) and control persons without DM. PATIENTS AND METHODS: Maximal IMT was measured by high resolution ultrasound of the common carotid (CCA) and femoral arteries (FA) in 51 type 2 diabetics and 18 controls. Various clinical and laboratory data (urinary excretion of albumin and protein, blood lipids) as well as amount of smoking, frequency of eating fruit and amount of sport activity were obtained in a standardized manner. RESULTS: The patients' body-weight was markedly greater and blood pressure significantly higher than that of the controls. Hypertension was present in 43% of patients (control group 11%) microalbuminuria in 26%. Mean IMT of the CCA was 0.76 +/- 0.20 mm in the patients and 0.64 +/- 0.16 mm in the controls (p < 0.01). The IMT of the FA, however, was not significantly different in the two groups (patients: 0.80 + 0.30 mm, controls: 0.75 +/- 0.31 mm). The IMT of the CCA was correlated with the patients' age (r = 0.55; p < 0.001), with the level of total cholesterol (r = 0.39; p < 0.01), and with the presence of hypertension (r = 0.38; p < 0.01). Patients who daily eat fruit had a significantly lower IMT of the FA than those who did not eat fruit regularly (no such difference was found regarding the CCA). Linear multiple regression analysis indicated that these variables were factors that independently affected the IMD of the CAA and the FA. CONCLUSIONS: An increase in subclinical atherosclerosis was demonstrated in type 2 diabetics already during the first year after diagnosis. The risk factors for the development of atherosclerosis in newly diagnosed diabetics exert a greater effect on the CCA than the FA. Regular eating of fruit seems to have a favourable effect on the progression of atherosclerosis of the FA.

Arteriosclerosis↗
PubMed2000

The effect of pacing-induced heart rate variation on longitudinal and circumferential regional myocardial function after acute beta-blockade--a cardiac ultrasound study.

AIMS: To evaluate the effect of acute beta-blockade in combination with differing heart rates on longitudinal and circumferential regional myocardial function using Doppler myocardial imaging and two-dimensional-echocardiography. METHODS AND RESULTS: In seven pigs the following echocardiographic indices were measured at baseline, after beta-blockade both without and with atrial pacing: wall thickening fraction, fractional shortening, myocardial peak systolic velocity, transmyocardial velocity gradient and systolic velocity time integral of the posterolateral wall in short-axis view; mitral valve plane excursion, myocardial peak systolic velocity and systolic velocity time integral of the posterolateral wall in an apical five-chamber view. Peak systolic velocities and velocity gradients decreased significantly following acute beta-blockade but no further decay occurred at high heart rate due to pacing. The velocity time integrals and mitral valve plane excursion showed a tendency to decrease following beta-blockade but only after pacing were they significantly reduced. The wall thickening fraction and fractional shortening showed a significant reduction after beta-blockade but no further decay after pacing. CONCLUSION: Changes in systolic velocities and velocity gradients were independent of heart rate reduction under high dosage beta-blockade, whereas wall thickening fraction, mitral valve plane excursion and velocity time integrals changed due to pacing.

Adrenergic beta-Antagonists↗
PubMed2000

Comb-wax discrimination by honeybees tested with the proboscis extension reflex.

We used the proboscis extension reflex of honeybees to test their ability to discriminate between comb waxes of different ages (wax scales, 1-week-old wax, 2- to 3-year-old wax, 8- to 10-year-old wax). Such waxes differ in their chemical composition, and an ability to discriminate between them may aid the orientation of the bees in the nest. To train the bees, we used whole extracts of waxes and four different fractions of the whole extract based on different elutions of solid-phase extractions (extract I, fraction A eluted with hexane and fraction B with diethylether; extract II, fraction B further subdivided into fraction C by elution with isopropylchloride and fraction D by elution with diethylether). In a differential training regime (six learning and six test trials) with whole extracts or with the different fractions, we paired one type of wax with a reward and another with no reward. The bees learned to discriminate between all tested pairs of whole extracts. The two subfractions (fractions A and B) gave different results: the bees could discriminate between waxes of different ages when fraction B was used but not when fraction A was used. A further subdivision of fraction B into fractions C and D showed that only fraction D contained the elements that enabled bees to discriminate between old and new wax. Fraction D makes up only 5?8 % of the total wax mass and contains hydroxy alkyl esters (5?6 % of the total wax mass), primary alcohols (0.3?0.5 % of the total wax mass) and acids (0.06?1. 0 % of the total wax mass). Fractions A and C (together forming 62?64 % of the total wax mass), which consist of unbranched and branched aliphatic hydrocarbons and alkyl esters, could not be discriminated by the bees. The remaining wax mass (25?29 %) was eluted with a mixture of chloroform, methanol and water (13:5:1) as fraction E.

Animals↗
PubMed1998

Primary metastatic (stage IV) Ewing tumor: survival analysis of 171 patients from the EICESS studies. European Intergroup Cooperative Ewing Sarcoma Studies.

BACKGROUND: In the multicenter European Intergroup Cooperative Ewing's Sarcoma Studies, localized Ewing tumors of bone were treated by combination chemotherapy with surgery and/or radiotherapy. Patients with primary metastases (pm-pts) were treated in high risk protocols. PATIENTS AND METHODS: One hundred seventy-seven pm-pts were registered from January 1990 to December 1995, 171 were evaluable for survival analyses. Thirty-six pm-pts received myeloablative megatherapy with stem cell rescue following conventional treatment. Bilateral whole lung irradiation (WLI) was administered in 57 pm-pts with pulmonary involvement. Event-free survival (EFS) rates were estimated by Kaplan-Meier analysis. Prognostic factors were identified by log-rank statistics, Cox procedures and logistic regression. RESULTS: Eighty-nine deaths were recorded by 1 February 1997, EFS four years after diagnosis for all 171 pm-pts was 0.27. EFS for isolated lung metastases was 0.34, for bone/bone marrow (BM) metastases, 0.28, and for combined lung plus bone/BM metastases, 0.14 (P < 0.005). WLI improved outcome in case of isolated pulmonary involvement (0.40 vs. 0.19, P < 0.05). In pm-pts with combined pulmonary/skeletal metastases, intensification by megatherapy and/or WLI improved EFS from 0.00 to 0.27 (P = 0.0001). CONCLUSIONS: EFS four years after diagnosis in patients with disseminated Ewing tumors is 0.27. Whole lung irradiation and megatherapy improve outcome in subgroups of patients with disseminated Ewing tumors is 0.27. Whole lung irradiation and megatherapy improve outcome in subgroups of patients with disseminated Ewing disease.

Adolescent↗
PubMed1998

Ewing's tumors with primary lung metastases: survival analysis of 114 (European Intergroup) Cooperative Ewing's Sarcoma Studies patients.

PURPOSE: To analyze event-free survival (EFS) and prognostic factors in patients who present with Ewing's tumors (ET) of bone and synchronous pulmonary and/or pleural metastases (ppm). PATIENTS AND METHODS: Of 1,270 patients (pts) registered at the continental office of the German/European Intergroup Cooperative Ewing's Sarcoma Studies (CESS81, CESS86, EICESS92), 114 were diagnosed ET with ppm. Patients underwent neoadjuvant therapy and local treatment of the primary tumor. Whole-lung irradiation 15 to 18 Gy was applied to 75 ppm-pts. EFS and 95% confidence intervals (CIs) were estimated according to the Kaplan-Meier method, and prognostic factors were analyzed by log-rank tests and Cox and logistic regression procedures. RESULTS: On November 1, 1997, at a median time under study of 5.9 years, the 5-year EFS was 0.36 (95% CI, 0.26 to 0.46) and the 10-year EFS was 0.30 (95% CI, 0.19 to 0.41). Thirty-seven of 59 (63%) first relapses involved lung and/or pleura, and the lungs were the only site of relapse in 26 of 59 (44%) ppm-pts. Risk factors identified in univariate and multivariate tests were poor response of the primary tumor toward chemotherapy, metastatic lesions in both lungs, and treatment without additional lung irradiation. CONCLUSION: Chemotherapy response of the primary tumor is a prognostic factor in patients with ET with ppm. Strategies of treatment intensification warrant further evaluation.

Adolescent↗
PubMed1997

Tomographical anatomy of the pelvis, pelvic floor, and related structures.

The sectional anatomy of the pelvic floor was studied in plastinated sections of adult pelves by computed tomography and by magnetic resonance imaging. In sectional anatomy, the levator ani is composed of three portions that can be clearly distinguished by their planes of cleavage and by the course of their fiber bundles. No muscular connections are found between the levator ani portions and the pelvic organs. The fascia of the levator ani in always interposed between the muscle and the pelvic organs. The sectional anatomy of the sphincter ani externus reveals a subdivision into a subcutaneous and a deep portion. Although the puborectalis portion of the levator ani and the deep portion of the sphincter ani externus are more or less continuous, in sectional anatomy they can be distinguished due to their different origins and attachments.

Adult↗
PubMed1995

The responsive workbench: a virtual working environment for physicians.

The paper describes the concept of the Responsive Workbench (RW). This virtual environment was designed to support end users working on desks, workbenches, and tables as physicians, architects and scientists with an adequate human-machine interface. We attempt to construct a task-driven interface for this class of users by working in an interdisciplinary team from the beginning. The system is explained and evaluated along three medical applications: medical education, a cardiological tutorial with a simulation system for ultrasonographic examinations of the heart and surgery planning. Virtual objects are located on a real "workbench". The objects, displayed as computer generated stereoscopic images are projected onto the surface of a table. The participants operate within a non-immersive virtual environment. A "guide" uses the virtual environment while several observers can also watch events by using shutter glasses. Depending on the application, various input and output modules can be integrated, such as motion, gesture and speech recognition systems which characterize the general trend away from the classical multimedia desktop interface. The RW is compared with other common virtual reality systems as head mounted displays. First experiences of the collaborators are drawn and future enhancements are proposed.

Computer Graphics↗
PubMed1994

Development of the levator ani muscle in human fetuses.

The development of the levator ani muscle was studied in 300- to 700-microns thick sections through the pelves of 9- to 37-week-old fetuses and newborn children. During early fetal development, the anlage of the levator ani muscle can already be subdivided into three portions. The planes of cleavage between them become clearly evident in fetuses during the middle trimester when all points of origin and insertion of the levator ani muscle can be recognized. The tendinous arch of the pelvic fascia plays an important role in the differentiation between the pubococcygeus and the iliococcygeus parts of the levator ani muscle. The funnel-shaped form of the pelvic diaphragm is completed by about the 14th week of fetal development. Differences between the male and female levator ani muscles are already marked before birth.

Embryonic and Fetal Development↗
PubMed1992

[Neuropsychiatric manifestations of Saethre-Chotzen syndrome].

Four psychiatric patients with SCS are described. All exhibited essential tremor, minimal cerebral dysfunctions, speech disorders, bradyphrenia, disorders of personality with psychasthenie and suspicious traits, restrictions, increased irritability and depressivity, one case of mutism due to abnormal reaction and one of alcohol hallucinosis. The possibility of cosmetic handicap caused by craniofacial dysplasia should be taken into mind and perhaps surgically corrected. Because the craniofacial dysplasia is mostly moderate and the syndactylies are slight the SCS remains often unrecognized, but apart from psychic maldevelopment it is significant as the result of frequent association with other malformations.

Acrocephalosyndactylia↗
PubMed1989

Staib agar supplemented with a triple antibiotic combination for the detection of Cryptococcus neoformans in clinical specimens.

It was demonstrated that the in vitro growth of a mucoid Escherichia coli strain from the urine of an AIDS patient could disturb the concurrent growth of Cryptococcus neoformans and the development of its brown colour effect (BCE) on Staib agar (syn. Guizotia abyssinica creatinine agar, bird seed agar, niger seed agar etc.) supplemented with penicillin + streptomycin. Owing to the supplementation with the triple antibiotic combination of penicillin + streptomycin + gentamicin and the resulting inhibition of E. coli growth, the formation of an intense BCE of the Cr. neoformans colonies after 3 d at 26 degrees C could be observed. On the same medium supplemented with this triple antibiotic combination 40 Cr. neoformans strains tested showed growth with an intense BCE after 3 d at 26 degrees C; but on Emmons' neutral Sabouraud's dextrose agar (NSDA) supplemented with the same triple antibiotic combination, inhibition of growth was found. For the examination of clinical specimens for Cr. neoformans contaminated with gram-negative rod-like bacteria, Staib agar supplemented with this triple antibiotic combination is proposed. Various antibiotic supplements to primary recovery media for fungi are discussed and ecological interrelations of bacteria and fungi are emphasized.

Acquired Immunodeficiency Syndrome↗
PubMed1987

The brown colour effect (BCE) of Cryptococcus neoformans in the diagnosis, control and epidemiology of C. neoformans infections in AIDS patients.

Cryptococcus neoformans was found as the causative agent of cryptococcosis in 7 (3.6%) out of 195 HIV-positive persons, most of them being hospitalized. These 7 persons included 6 homosexuals and 1 heroin addict. The examinations were performed at the Mycology Unit of the Robert Koch Institute in Berlin (West) between 1984 and 1986. The brown colour effect (BCE) of the C. neoformans colonies on Guizotia abyssinica creatinine agar (with 0.1% glucose) within 2-5 days at 26 degrees C facilitated the diagnosis of disseminated cryptococcosis. In all 7 cryptococcosis cases, the antigen of C. neoformans was detected in serum and CSF by the latex agglutination test. The initial titres ranged from 1:100,000 to 1:160 in the serum and from 1:1280 to 1:10 in the CSF. In comparison to the progressive stage of the infection with the involvement of the various organs and high antigen titres, the fungus may be detected at an early stage in the respiratory tract only where low antigen titres are observed. All the C. neoformans isolates were found to belong to the variety neoformans. Proposals for an effective control of cryptococcosis are made.

Acquired Immunodeficiency Syndrome↗