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Biomedical subjects

D Fuchs

Publications and source records attributed to D Fuchs.

At least 541 records · Page 30Linked to original sources

Elevated urinary neopterin levels in patients with the acquired immunodeficiency syndrome (AIDS). A preliminary report.

Neopterin excretion in urine of patients with AIDS was measured by high pressure liquid chromatography. Urinary neopterin levels in patients with generalized lymphadenopathy, which is considered to be part of the spectrum of AIDS, as well as in severe AIDS cases were significantly elevated, compared to normal controls. This finding may prove useful as a screening test for donors of blood products in order to prevent transmission of AIDS by this route.

Acquired Immunodeficiency Syndrome↗

Pteridines as a new marker to detect human T cells activated by allogeneic or modified self major histocompatibility complex (MHC) determinants.

Evidence is presented that activation of T cells by allogeneic or modified autologous cells leads to the specific production of two distinct molecular compounds of the PT class. One of these two PT has previously been identified as neopterin. The structure of the other is still under investigation. This conclusion was based on the following findings: a) In vitro both PT were produced by T cells proliferating in response to HLA incompatible allogeneic or to autologous EB-virus-transformed or TNP-haptenized cells. b) In vitro stimulation of T cells with mitogenic lectins or protein antigens, of macrophages with zymosan-complement, of B cells with PWM or EB-virus, and of NK effector cells with tumor targets failed to induce comparable release of these PT. c) In vivo increased amounts of both PT were excreted via the urine during allograft rejection and viral infections. It thus appears that the production of these PT is primarily a feature of activated T cells involved in the control of self integrity.

Adult↗

[Lung scintigraphy after tumor therapy in childhood].

Cytostatics- and radiation-induced alterations of the lung were investigated in 18 children after tumour-therapy by means of lung perfusion scintigraphy. 13 patients (Hodgkin- and non Hodgkin lymphoma, acute lymphocytic leukemia with mediastinal tumour, Ewing-sarcoma, and intrathoracal neuroblastoma) received epidiaphragmatical radiation and cytostatics. All 32 lung-scintigrams of these children 1-23 months after cessation of therapy were pathological. 5 patients (acute lymphocytic leukemia, Histiocytosis X) received cytostatics only. 1-6 months after cessation of therapy in these children 6 lung-scintigrams were pathological, one was normal. After cessation of tumour-treatment scintigraphical improvement of disturbed perfusion occurred in 9/18 patients only. In 6 children a deterioration of lung-perfusion was registered. Lung-scintigraphy is a method for testing pulmonary perfusion in diagnosis and therapy control in childhood malignancies. The results of this study indicate that prophylactic provisions against pulmonary damage during oncologic therapy are necessary.

Antineoplastic Agents↗

Significance of urinary neopterine in gynecological oncology: follow-up of patients with ovarian cancer.

In patients with genital cancer (N = 108) significantly higher mean neopterine levels were found than in a healthy control group. Prior to therapy elevated neopterine levels were seen in 60% of the patients with cancer of the genitals varying between 90% (ovarian cancer) and 54% (cervical cancer). Nine patients with ovarian cancer (stages IIb-IV) were followed for a period of 16 months to date. All patients had elevated neopterine values prior to therapy. When the urinary neopterine excretion remained increased over the period of observation, progression of the tumor occurred within a few months. In patients with complete or partial remission of the tumor, the neopterine excretion dropped to normal values. Thus, we feel that neopterine sampling may be helpful in the follow-up of patients with ovarian cancer, as tumor progression is indicated very early, before clinicoroentgenological findings are present.

Adult↗

Determination of neopterine in human urine by reversed-phase high-performance liquid chromatography.

Since the analysis of urinary neopterine is important in diagnosing malignancy, a method has been developed for its rapid and sensitive separation and quantitation using high-performance liquid chromatography (HPLC) on reversed phase. Eluted neopterine is monitored by fluorescence at a excitation wavelength of 353 nm and measured at 438 nm. Separation was optimized by elution with 15 mmol/l potassium phosphate (pH 6.4) at a flow-rate of 0.8 ml/min. Urinary neopterine was related to creatinine with the aim of reducing variations due to fluctuating urinary concentrations. The proposed method has good performance characteristics and is not influenced by the presence of reduced neopterine in urine. Using this HPLC method, urinary neopterine related to creatinine was determined for 148 healthy male adults (mean neopterine/creatinine 113 mumol/mol), 146 healthy female adults (mean neopterine/creatinine 140 mumol/mol) 60 healthy children (mean neopterine/creatinine 163 mumol/mol). The neopterine levels for four healthy individuals were measured daily over a period of one month.

Adolescent↗

Urinary neopterine in the assessment of lymphoid and myeloid neoplasia, and neopterine levels in haemolytic anaemia and benign monoclonal gammopathy.

The urinary neopterine levels were measured by HPLC in 417 normal subjects and in 216 patients with haematological diseases. All patients with active malignancies (multiple myeloma, polycythaemia vera. Hodgkin's lymphoma, non-Hodgkin's lymphoma, chronic myelocytic and chronic lymphocytic leukaemia) showed highly elevated mean and median values compared to the control groups. Those of patients with multiple myeloma stage I were only raised to near the upper limit of healthy subjects. Of 123 patients with active disease 105 (85%) were above the upper limit. In contrast, the mean and median values of 56 patients with neoplasias in remission (Hodgkin's and non-Hodgkin's lymphoma, acute leukemia and multiple myeloma) were not different from those of healthy subjects, and only 7 (12.5%) of these patients had levels above the upper limit. In patients with non-malignant diseases (haemolytic anaemia and benign monoclonal paraproteinaemia) the mean and median values were not raised. In patients with non-Hodgkin's lymphoma and with chronic lymphocytic leukemia, the neopterine levels corresponded with the tumor stage. The present data suggest tht neopterine assay may supplement laboratory measurements in haematological diseases, providing helpful information.

Adolescent↗

Urinary neopterine excretion in patient with genital cancer.

Urinary neopterine values in 96 healthy women were compared with those in a group of 63 patients with cancer of the genitals who had not yet undergone treatment. Significantly higher median neopterine levels were found in the patients with carcinoma (p less than 0.001). In the 63 cancer patients who had not yet been treated, the diagnosis was made correctly in 65% of the cases by monitoring neopterine levels. In the follow-up of 72 patients with cancer of the genitals in 74% the neopterine values corresponded with the clinico-roentgenological findings. In 22%, false positive neopterine values (no recurrence of the tumor), and in 4% false negative values (recurrence, or progression of the carcinoma) were observed. These results confirm previous reports concerning the significance of pteridine excretion in patients with cancer. However, more investigations have to be performed to establish the value of neopterine sampling in monitoring patients with malignant tumors.

Adult↗

[Human nonspecific killer cells].

The NK and K-cell activity of human leukocytes was investigated as compared with those cells of the K 562 cell line and murine cells covered by xenoantibodies in Graffi erythroblast leukaemia by means of the 51Cr release test. NK and K-cells could be identified in the blood and bone-marrow. However, they could not be identified in the thymus, lymph-nodes, and tonsils. Attempts of cell fraction with the blood of healthy donors revealed that the K-cells must be attributed to non-T-lymphocytes. NK-cells may be found in the fraction of non-T-lymphocytes as well as in that of T-lymphocytes. Killer cell activity tests in children with acute leukaemia resulted in leukaemia cells having NK and K-cell activity only in very rare cases. ALL patients in remission had strongly lowered NK-cell values under chemotherapy. In comparison to that, chemotherapy had no influence on K-cell activity. On the one hand, NK-cell activities were induced in mixed cultures of allogenous lymphocytes of the blood and, on the other hand, in cells of lymph-nodes. Attempts of fractionation, investigations for determining the influence of chemotherapy and attempts of inducing killer cell activity in vitro lead to the conclusion that NK and K-cells may be regarded as similar cell populations, being, however, not identical.

Acute Disease↗

[Pteridine secretion as a marker for the proliferation of alloantigen-induced lymphocytes (author's transl)].

Pteridine levels from supernatants of mixed lymphocyte cultures and from urinary samples of allogeneic kidney transplant recipients were measured by high-pressure liquid chromatography. Marked proliferation of alloreactive lymphocytes was paralleled by an increased release of pteridines. In human allograft recipients rejection episodes were preceded at least 1-2 days by increased urinary neopterin levels. Thus, the urinary neopterin estimation is useful in the early detection of immunological rejections.

Cells, Cultured↗

Urinary neopterine as marker for haematological neoplasias.

Urinary neopterine levels were studied in 79 normal subjects and in 112 patients with haematological neoplasias. The mean values in 79 patients with active disease were significantly raised compared to the control group. Results obtained in 79 patients with active disease indicate that 91% had neopterine levels higher than the mean value of 79 normal individuals +3 SD. There is only a little overlap between the range of neopterine levels in cancer patients and the range in healthy subjects. No significant difference was found between the mean urinary neopterine levels of 33 patients with non-Hodgkin's or with Hodgkin's lymphoma in remission and the healthy group. Only 15% of these patients had elevated neopterine levels. The mean urinary neopterine levels correlated well with the tumor stage in patients with chronic lymphocytic leukaemia and with non-Hodgkin's disease. In patients with chronic leukaemia those without hepatosplenomegaly excreted significantly more neopterine than controls, and patients with hepatosplenomegaly significantly more than those without hepatosplenomegaly. It is concluded that urinary neopterine levels are of value for following the progression of haematological neoplasias.

Adolescent↗

[Juvenile malignant lymphomas. 1. Hodgkin's lymphoma].

From 1970 to 1978 22 children with Hodgkin's lymphomas at the age of 4-15 years were treated at the university children's hospital of Jena. There were 16 patients with the first appearance of the disease and 6 with relapses. The stage classification was carried out after the Ann-Arbor-classification. A "staging" operation with laparotomy and splenectomy was performed in 17 children. The histological material was classified after the Rye-modification of the Lukes-Butler-classification. The clinical staging showed 8 patients in stage I, 7 in stage II, 6 in stage III and one child was in stage IV. The therapy consisted of a telecobalt irradiation extended field irradiation, total nodular and local irradiation) with a focal dose of 4500 rad and a chemotherapy (6 cycles COPP). The life-table-analysis for those patients who were primarily treated in Jena showed a complete five-year-remission rate of 92 per cent. The five-year-survival-rate for all patients (with the first appearance of the disease and with relapses) amounts to 77 per cent. After splenectomy we observed two overwhelmingly progressing aetiologically not clear infections and a pneumococcal meningitis.

Adolescent↗

[Juvenile malignant lymphomas. 2 Non-Hodgkin lymphomas].

Between 1970 and 1978 33 children with Non-Hodgkin-lymphomas at the age of 2-15 years were treated at the university children's hospital of Jena. 27 patients showed the first appearance of the disease, 6 patients had already been treated in other hospitals and were admitted with relapses. The biopsy material was classified or re-classified after the Kiel-classification. Beside the histological classification the surface markers of the malignant cells of NHL-patients were determined. 20 of 33 children were already in stage IV (Ann-Arbor-classification). Among our patients were 6 lymphoblastic NHL of Brukitt type, 10 of the convoluted cell type and 16 unclassified and one lymphoblastic lymphoma. The main localization of the NHL were mediastinum [15] and the gastrointestinal tract [10]. The therapy consisted of irradiation and chemotherapy (2 protocols) and, in case of an abdominal localization, in the attempt at a radical operation. Patients of stage I and stage II showed a complete remission rate of 50 per cent for 3 years; patients of stages III and IV of 20 per cent only. NHL of the convoluted cell type and of the Burkitt-type proved to have worse three-year-remission rates (16 per cent and 27 per cent) than unclassified lymphoblastic NHL (42 per cent).

Adolescent↗

Quantitation of urinary uric acid by reversed-phase liquid chromatography.

The proposed isocratic liquid-chromatographic method for uric acid has good performance characteristics. Results by this procedure and by an enzymic method for uric acid correlated well (r = 0.986). Our method is inexpensive, rapid, and considerably simpler than other techniques for determining uric acid in urine.

Chromatography, High Pressure Liquid↗