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Biomedical subjects

D Fischer

Publications and source records attributed to D Fischer.

At least 235 records · Page 13Linked to original sources
PubMed1986

Disseminated intravascular coagulation and hypopotassemia associated with blast lung injury.

Forty six people were injured by a large explosive charge detonated in a Jerusalem bus. Four were killed instantaneously and 22 needed hospital care. We describe our experience in five patients with blast lung injury (BLI), all of whom survived in spite of severe respiratory failure requiring mechanical ventilation. Disseminated intravascular clotting (DIC) developed in three of the five patients and significant hypopotassemia ranging from 2.2 to 2.9 mEq/L in four. These two complications have not been previously described in association with BLI. Both DIC and hypopotassemia responded to replacement therapy. Vigorous treatment of respiratory failure, early recognition, and prompt correction of hemostatic and electrolyte abnormalities may have contributed to the avoidance of fatalities among the five patients with severe blast injury.

Adult↗
PubMed1986

[Sclerosing cholangitis, chronic pancreatitis and Sjögren's syndrome].

A 63 year old man was followed up for chronic pancreatitis. After 2 years, he developed features of primary sclerosing cholangitis associated with Sjögren's syndrome. A review of the literature revealed 38 previous cases of chronic pancreatitis associated with sclerosing cholangitis; a sicca complex was also demonstrated in 3 of these cases. Chronic pancreatitis is mostly asymptomatic and the diagnosis is usually made at laparotomy or postmortem. Retrograde pancreatograms are abnormal in 15-75 p. 100 of patients with primary sclerosing cholangitis. The relationship between the two diseases is not a coincidence. On the other hand, the significance of the association with the Sjögren's syndrome remains controversial.

Cholangitis↗
PubMed1986

[Discovery of hemoglobin J Baltimore in an episode of methemoglobinemia in an infant].

A case of a heterozygote for Hb J Baltimore is reported in a French family. This variant hemoglobin was coincidentally discovered during an episode of methemoglobinemia in a 6-week-old baby. The father and one of the brothers were also carriers of the trait. Hematological findings for all of them were normal. As Hb J Baltimore is a frequently occurring hemoglobin variant, we discuss: its possible role in the appearance of methemoglobin, and whether this mutation in different racial groups (Caucasians of West Europe, Canadians, and American blacks) has a common origin or more probably arises from a number of independent mutations.

Electrophoresis↗
PubMed1985

[Granulopoiesis in the alcoholic and cirrhotic patient. Exploration of neutropenia in cirrhosis using bone marrow cultures and a hydrocortisone test].

Twenty per cent of 60 patients with cirrhosis (55 alcoholic patients) had neutropenia (defined as neutrophil polymorphonuclear (NP) count under 2,000/mm3). The authors tried to define the mechanism of this neutropenia and compared it with the acute bone marrow cytotoxicity of alcohol. They found that bone marrow neutrophil colony growth was normal in 7 cases of cirrhosis compared to 7 controls (with and without cirrhotic serum incubation). On the other hand, the granulocyte response to hydrocortisone test was less marked than in controls. This result suggests involvement of the late maturation process of NP and delayed release from bone marrow.

Agranulocytosis↗
PubMed1984

A follow-up of a randomized study comparing two chemotherapy treatments for advanced diffuse histiocytic lymphoma.

In 1976 we began a randomized study for the treatment of patients with stage III and IV diffuse histiocytic lymphoma. The therapy was either ACOMLA (doxorubicin, cyclophosphamide, vincristine [oncovin], methotrexate with leucovorin rescue, and cytarabine) or CHOP-B (cyclophosphamide, doxorubicin [hydroxydaunorubicin], vincristine [oncovin], prednisone, and bleomycin). A complete response (CR) was achieved in 13 (65%) of 20 patients treated with ACOMLA and in 20 (71%) of the 28 patients treated with CHOP-B. Four patients achieving CR with ACOMLA and three patients treated with CHOP-B have relapsed for an overall relapse rate of 21%. Partial response (PR) was obtained in four patients treated with ACOMLA and five patients treated with CHOP-B. Median follow-up time is 36 months for the combined treatment groups. Multiple regression analysis demonstrated that those patients who were classified by the Lukes-Collins criteria as having histiocytic lymphoma not of follicular center-cell origin (combined T- and B-cell immunoblastic sarcoma) had a significantly worse survival as compared to patients classified with follicular center-cell origin lymphoma (large cell noncleaved, large cell cleaved, and large cell unclassified) with a 40% five-year survival versus an 80% five-year survival (P = .011). The CR rate however for these two large categories of patients was 63% v 73% respectively, and the relapse rates were equivalent. The increased survival in the follicular center-cell origin lymphomas may be related to a longer survival of PRs and relapsed patients as compared to the patients with nonfollicular center-cell lymphomas.

Adolescent↗
PubMed1984

Preliminary report on macroscopic age changes in the human prosencephalon. A stereologic investigation.

The studies here reported were performed on the prosencephalons of 12 human brains between 37 and 86 years of age having no signs of neuropathological alteration. The evaluation was carried out on serial frontal sections with a mean thickness of 5 mm with stereological point counting procedures for volume and surface area. The results were mainly given in relative values since the range of variation is very high and the sample small. The aging process was evaluated with the aid of a linear regression function. The stereological investigation regarding the absolute values of volume and surface area (border face) of the macroscopical brain parts show a high interindividual variability. However, the relative volume of brain parts shows only small variations. Changes during aging could consequently only be revealed with the help of the relative values. The relative volumes and surface areas of the frontal lobe and the prosencephalic ganglia decrease with aging, while the parieto-occipital lobe and the striate cortex increase. However, if we refer these relative increases to the absolute decrease of brain volume, corresponding changes cannot be found in the parieto-occipital lobe until old age. The shrinkage of the frontal lobe, of the centrum semiovale and of the prosencephalic ganglia exceeds 10%. In the grays it is probably accompanied by a loss of neurons. The relative sizes of the surface area do not change significantly during aging with exception of the frontal cortex. The thickness of the cortex remains probably constant. The size of lateral ventricles increases with aging.

Adult↗
PubMed1983

Pretreatment prognostic factors in carcinoma of the uterine cervix: a multivariable analysis of the effect of age, stage, histology and blood counts on survival.

From January, 1953 through December, 1977, 910 previously untreated patients with invasive carcinoma of the uterine cervix (Stages IB-IVB) were seen at Yale-New Haven Medical Center and affiliated hospitals. An extensive retrospective analysis was undertaken in an attempt to identify prognostically significant pretreatment factors. The patients studied were uniformly staged according to the current FIGO recommendations and the majority of patients had been treated under standardized protocols combining external beam radiation therapy and intracavitary radium. Pretreatment parameters, including prior medical illnesses, gross tumor characteristics, histology, and blood parameters were studied, employing stepwise Cox regression analyses to identify the possible effects of all factors and all two-way interactions among factors on survival, disease-free survival and freedom from local-regional failure, controlling for stage of disease. FIGO stage, patient age at diagnosis, pretreatment neutrophil count and hematocrit, uterine position, prior subtotal hysterectomy, histology, history of diabetes mellitus and number of pregnancies were all found to have prognostic significance. When other factors including stage of disease were controlled for, increased tumor size was associated with decrease disease-free survival and local-regional control rates.

Adenocarcinoma↗
PubMed1983

Effects of acetate and bicarbonate hemodialysis on cardiac function in chronic dialysis patients.

Previous studies have suggested that acetate hemodialysis causes myocardial depression. This study examines the acute effects of hemodialysis using, alternately, bicarbonate and acetate in the dialysate, on cardiac function in ten patients. These patients were also studied during acetate dialysis using a large surface area (SA) dialyzer. Each patient was dialyzed for 4 hr with: (1) 1.0 m2 SA dialyzer and bicarbonate dialysate; (2) 1.0 m2 SA dialyzer and acetate bath, and; (3) 2.5 m2 SA dialyzer and acetate dialysate. All studies were performed during isovolemic dialysis to separate the effects of changes in cardiac filling volume with hemodialysis, from changes in myocardial contractility. Myocardial function, as assessed by pre- and postdialysis echocardiographically derived fractional shortening (Fs) and mean velocity of circumferential shortening (VCF), improved (P less than 0.05) to the same extent, after all three dialysis treatments. This occurred despite greater increases (P less than 0.002) in pH and bicarbonate after bicarbonate dialysis and decreases (P less than 0.05) in PO2, PCO2 and bicarbonate after acetate dialysis with 2.5 m2 SA dialyzer. These results indicate that diffusive dialysis with both acetate and bicarbonate dialysate improves myocardial function and do not support the view that acetate influx during dialysis can lead to myocardial depression.

Acetates↗
PubMed1983

The effective use of combined modality therapy for the treatment of patients with Hodgkin's disease who relapsed following radiotherapy.

From 1969 to 1977, 124 patients with advanced staged Hodgkin's disease were entered into a treatment protocol which consisted of three cycles of drugs (nitrogen mustard, vincristine, vinblastine, prednisone, and procarbazine) followed by radiation (1500-2000 rad) to previous sites of known disease. After completion of radiation therapy, two more drug cycles were given. There were 63 newly diagnosed patients with Stage IIIB and IVA or B disease and 61 patients who had relapsed from prior radiotherapy. The median follow-up is now in excess of 5 years. Of the relapsed patients, 86.9% entered a complete remission and 90.6% of these patients have remained in complete remission from 1 to 10 years. In comparison, 81% of the newly diagnosed patients entered a complete remission and 78.4% of these patients continue free of disease from 1 to 11 years. These differences were not statistically significant. The 10-year actuarial disease-free survival--79.8% for the 61 relapsed patients compared to 65.6% for the 63 newly diagnosed patients--was not significantly different either. The 10-year actuarial survival for the 40 patients who had relapsed to IIIB and IVA or B was 71.3% and approximated more closely those of newly diagnosed IIIB and IVA or B patients. This drug-radiotherapy protocol is very effective for the treatment of patients who have relapsed from previous radiotherapy.

Drug Therapy, Combination↗