[Differentiation between the rheumatoid and non-rheumatoid antiglobulin factors in the agglutination inhibition test].
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Adult↗
Biomedical subjects
B Rau
Publications and source records attributed to B Rau.
[Synchronization of motor neuron discharges during shivering].
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Animals↗
A pilot study of a new therapeutic approach in the treatment of locally advanced stages of rectal cancer: neoadjuvant radiation, chemotherapy and regional hyperthermia.
The synergistic effects of hyperthermia (temperatures > or = 41 degrees C) when combined with radiotherapy or cytotoxic drugs, as well as a modulation of tumour-related immunological phenomena have been demonstrated preclinically. Local or regional hyperthermia in combination with radiation or chemotherapy has been studied in patients during recent years, and has convincingly demonstrated that hyperthermia is feasible and tolerated by patients. Furthermore, there is strong evidence that hyperthermia may provide an improvement in local control as compared with radiotherapy or chemotherapy alone. Systems based on radiowave irradiation allow sufficiently tolerable and effective regional hyperthermic therapy in patients with rectal carcinomas. Used as part of curative pre-operative and postoperative multimodal therapeutic strategies in high-risk patients with locally advanced rectal carcinomas, hyperthermia may result in improved local control and a higher rate of sphincter-sparing procedures. 20 patients with non-resectable, locally advanced primary or recurring rectal carcinoma T3/4 entered a phase I/II study of pre-operative radiochemothermotherapy with folinic acid and 5-fluorouracil, radiation (45 Gy HD), as well as regional hyperthermia once a week followed by chemotherapy after surgery. The regimen proved to be sufficiently tolerable. Acute grade III or IV toxicities did not occur after hyperthermia. Tumour resections were performed on 14 of the 20 patients, with 13 being complete. In 9 of the carcinomas, downstaging compared with the pretherapeutic stage was achieved. In 3 of 6 patients with persistent non-resectable tumours, local control has now been maintained for more than 12 months. One patient progressed locally during neoadjuvant combination therapy. These results prompted the initiation of a prospective randomised study to evaluate the relative importance of regional hyperthermia in this setting.
Adult↗
[Lobar emphysema. Important differential diagnosis of obstructive lung diseases in childhood].
The lobar emphysema is characterised by a lobe-restricted overinflation combined with dislocation of the neighbouring organs. Surgical treatment is indicated because of the high mortality by waiting and conservative treatment. Differential diagnosis has to exclude other causes for overinflation as atelectasis with compensated emphysema, diaphragmatic hernia, and stenotic changing of the tracheobronchial tree and others. In the course of a retrospective study of 6350 thoracotomies (1978-1988) out of 198 patients with congenital malformations of the lungs 5 (2.5%) children less than 5 years were found to have undergone surgical therapy because of lobar emphysema. Five patients were found with additional malformations in four patients this was held to be the cause. All patients were dyspnoeic at the time of operation. The most important diagnostic procedure was the routine x-ray of the chest and fluoroscopic examination. In 4 patients surgical treatment consisted in lobectomy, in one patient segmental resection was sufficient. There was no 30-day-mortality, postoperative recovery was uneventful in all patients.
Child↗
Temperature data and specific absorption rates in pelvic tumours: predictive factors and correlations.
The system BSD 2000 has been in clinical use for regional hyperthermia for more than 10 years. Several technical details of this hyperthermia system, as well as the results of clinical studies employing this system have been investigated. The intention of this paper is to investigate the correlation between technical efficiency or feasibility of hyperthermia with the BSD 2000, in terms of power densities and temperatures depending upon parameters such as tumour histology, tumour location, patient age, patient sex, and patient cross section. The possible conclusions of predictive factors derived from the above correlations were closely scrutinized. Data acquired from 772 treatment sessions of 190 patients with pelvic tumours, mainly sarcomas and carcinomas of the rectum, cervix, prostate and anus, have been evaluated. For every session, index temperatures T90 (temperature attained at 90% of tumour related measurement points), cumulative minutes for T90 > Tref, tumour related power density (SAR: specific absorption rate, in W/kg) and the effective perfusion Weff (in ml/100 g min) were calculated. Temperatures were measured either invasively or endoluminally. The statistics software SPSS was employed subsequently for univariate, as well as multivariate analyses. The results exhibit that index temperatures mainly depend on the power density SAR and the hyperthermia induced effective perfusion. The total power P (in 100 W) and, complementarily, the relative power density absolute value(SAR) (= SAR/P) seem to have lesser influence. Clear differences between the tumour entities were established regarding their index temperatures and temperature distributions. SAR, Weff and P were correlated with several anatomical, biological and clinical factors. Sessions rendering low index temperatures and SAR values also revealed decreased individual tolerance to the treatment. This clearly displays that power-induced side effects define the limits of the efficiency of regional hyperthermia. Equivalent relationships and correlations are derived from intratumoural and endoluminal thermometry. Individual limitations of regional hyperthermia caused by anatomical, biological and clinical factors are liable to be difficult to overcome with the rather restricted potentials of the BSD 2000 system to control the SAR distribution.
Analysis of Variance↗
Mechanism and role of trypsinogen activation in acute pancreatitis.
In healthy subjects, the 3 known pancreatic trypsinogens, which are endopeptidases belonging to the chymotrypsin superfamily, are activated by enterokinase and partial autoactivation in the duodenum. The premature activation of trypsinogen in the pancreatic interstitium, with the subsequent activation of other pancreatic zymogens, is believed to lead to the autodigestion of the gland, this being the first event in acute pancreatitis. The mechanisms that lead to trypsinogen, activation in acute pancreatitis are largely unknown. However, ischemia, hypercalcemia and the activation of cathepsin B (by cholecystokinin) are thought to be of importance. The easiest and most reliable way to assess trypsinogen activation is the measurement of the activation peptide, TAP, in urine, plasma, pancreatic tissue or ascitic fluid. In the animal model of acute pancreatitis, TAP in ascites and pancreatic tissue has been shown to correlate with the presence and extent of necroses. It has proven to be a good marker for the severity of pancreatitis and is a useful marker in examining the pathophysiology and possible treatment modalities in the animal model of acute pancreatitis. Studies on TAP in human acute pancreatitis were most commonly focused on urinary TAP. Within a 48-hour time frame after the onset of the disease, TAP was a good predictor of the severity of acute pancreatitis. The main advantage over other markers, such as CRP, is that TAP is the earliest marker of necrosis to be increased. Also, increased levels of TAP in ascitic fluid were shown to correlate well with pancreatic necroses. In our experience, plasma TAP was found to have a "diagnostic window" within the first 3 days predicting pancreatic necroses. Positive TAP gave a very good positive prediction and a high specificity towards the development of pancreatic necroses, but did not differ between necrotizing pancreatitis with systemic complications or uncomplicated necrotizing pancreatitis. We therefore think that plasma TAP is a very good marker for local complication in acute pancreatitis and its routine measurements may help to identify patients at a high risk within the first days of the disease.
Acute Disease↗
Necrosectomy and postoperative local lavage in necrotizing pancreatitis.
The severity of acute pancreatitis is correlated to the amount of necroses--pancreatic parenchymal necroses and fatty tissue necroses in the retroperitoneal spaces--the liberation of vasoactive and toxic substances and the bacterial contamination of necroses. The necrotizing pancreatits occurs in around 15 to 25% of all patients with acute pancreatitis; a local infection has been observed in around 40% of patients with necrotizing pancreatitis. Surgical treatment in patients with necrotizing pancreatitis is indicated, if they develop a surgically acute abdomen, a sepsis syndrome or a multisystem's organ failure syndrome despite ICU-treatment over at least 3 days. Bacterial contamination, proved by an ultrasound guided FNP of the necrosis is a strong indicator for surgical management. Careful necrosectomy and a continuous local lavage of the lesser sac and the necrotic cavities are most effective. Conservation of vital pancreatic tissue is a major goal of surgical treatment. The continuous local postoperative closed lavage results in a continuous evacuation of vasoactive and toxic substances, bacteria, local active enzymes and debrid tissue. Among patients with sterile pancreatic necroses only those with major necroses of more than 50% of the pancreas are candidates for surgical treatment. Hospital mortality after necrosectomy and local lavage figures in major leading series between 8 and 20%. Failure of surgical treatment of necrotizing pancreatitis is mostly due to continuing local and systemic sepsis.
Clinical Trials as Topic↗