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Biomedical subjects

H Brenner

Publications and source records attributed to H Brenner.

At least 253 records · Page 14Linked to original sources
PubMed1988

Meningeal melanocytoma. Report of a case and review of the literature.

A primary localized, partly encapsulated melanotic tumour broadly attached to the occipital dura and tentorium was removed from a 27 year-old woman. It recurred almost four years later in the posterior fossa and was resected again. Although grossly resembling a meningioma, the tumour lacked the histological, immunocytochemical and ultrastructural features of meningiomas and was characterized by the presence of numerous melanosomes and premelanosomes in the cytoplasm of tumour cells and macrophages and was, therefore, classified as "meningeal melanocytoma". The clinical and pathological features of this and 15 other cases in the literature are reviewed. The neoplasm, mainly occurring in the posterior cranial fossa and spinal canal, may cause neurological deficits through expanding, but non-invasive growth. Its biological behaviour is variable, and recurrence may occur after incomplete resection, but transition into malignant melanoma has not been observed. Total resection of this rare pigmented tumour arising from the pial melanocytes is recommended.

Adult↗
PubMed1987

Cerebral ischemia in children and young adults.

Cerebral ischemia is very rare in children and young adults. There can be a multitude of causes; in many cases etiology remains undetermined. We report here on 7 cases, 11 to 25 years of age. Pathogenetic factors (lupus erythematodes, endocarditis, fibromuscular dysplasia) and risk factors (cigarette smoking, oral contraceptives) were found in 5 patients whereas in 2 cases the etiology was not determinable. Three patients were treated with low weight dextrans, two patients received prostaglandin E1, and in 2 cases regional thrombolysis was performed. Three female patients died, two with occlusions of the rostral part of the basilar artery and one with an occlusion of the carotid artery and lupus erythematodes as the primary disease. Long-term observations of the surviving patients showed good recovery from neurological deficits. Prognosis quoad sanationem seems better in this age group than in elderly patients.

Adolescent↗
PubMed1987

Technique for external beam treatment for mesothelioma.

A combined photon-electron beam treatment for diffuse pleural mesothelioma is discussed in this paper. The technique consists of parallel opposed 10 MV X rays prescribed to 4250 cGy using customized blocks to shield the lung. The pleura is then boosted with electrons to a dose of 3600 cGy. The combination yields a TDF of 74 ret to the pleura. As discussed in an earlier paper, this treatment method when combined with subtotal pleurectomy and I-125 implantation leads to improved survivals with minimal complications. The details of this 3-dimensional radiation treatment method were not described in detail. To improve target coverage and local control, the technique has been modified. CT is now used along with simulation plane films to define the entire pleural surface. The target volume has also been extended from the dome to the base of this diaphragm. These changes have led to improved pleural dose distributions; by blocking the liver or stomach, and boosting the crus of the diaphragm with electrons, there is little added morbidity. As is demonstrated by dose volume histograms, we have been able to deliver 4250 cGy +/- 10% to most of the pleura with 1/3 of the lung parenchyma receiving less than 2100 cGy.

Brachytherapy↗
PubMed1987

Validity of continuous-wave Doppler sonography of the vertebrobasilar system.

To assess the value of continuous-wave Doppler sonography for detection and exclusion of lesions in the vertebrobasilar system, the ultrasonic and angiographic findings were compared in a prospective study. Altogether, 200 vertebral arteries in 176 patients were evaluated by both methods. Insonation of the vertebral arteries was performed at the mastoid slope and at the origin of the vessel. Of 62 angiographically proven lesions, 45 were detected by ultrasound. Of 138 normal vertebral arteries, 129 were correctly diagnosed. Sensitivity for all lesions was 72.5%, and for hemodynamically relevant lesions it was 91%. Overall specificity was 93.5%. A positive predictive value of 83.3% and a negative predictive value of 88.4% for all lesions shown by angiography demonstrate the high reliability and accuracy of doppler ultrasound of the vertebrobasilar system.

Arterial Occlusive Diseases↗
PubMed1987

[Experiences with an integrated psychological therapy program for training communication and cognitive abilities in the rehabilitation of severely ill chronic schizophrenic patients].

A therapy study was conducted with 17 seriously chronically ill schizophrenic patients. Ten patients (Experimental Group) received a psychological therapy program of training in cognitive and communication/social skills (58 sessions of 60 min.). Seven further patients constituted a Control Group. Researched was the question of the potential for change of basic disorders respectively symptoms, and its effect on social behavior. In individual cases significant changes were recorded. As to the therapeutic effects, significant findings were obtained only conditionally. Implications and consequences are discussed in the résumé.

Adult↗
PubMed1986

[Acute occlusion in the vertebrobasilar circulatory system in children and young adults].

Within four years ten patients (six women and four men) under 50 years of age (13-49 years) were observed who presented occlusions of the vertebrobasilar artery. Eight patients were admitted from other hospitals, on an average 41 hours after the acute occlusion; only in one case had a correct first diagnosis been made. In all cases diagnosis was confirmed by means of selective angiography. Conservative treatment comprised in two patients low-molecular dextranes and heparin, in another two prostaglandin E1. In the remaining six patients local fibrinolysis was performed. In the group receiving conservative treatment a 33-year-old female patient survived and her neurological deficits subsided except for an organic psychosyndrome of minor degree. Local fibrinolysis yielded complete recanalization in three cases and partial recanalization in two. Three patients survived, in two patients near-complete recovery was achieved.

Acute Disease↗
PubMed1986

A comparison of low- and high-dose cisplatin-based combination chemotherapy as initial postoperative treatment in advanced ovarian adenocarcinoma.

Cyclophosphamide, Adriamycin, and cisplatin were given as the initial postoperative treatment to 35 patients with Stages II through IV ovarian cancer of epithelial origin during two time periods. During the first period the dose of cisplatin was 60 mg/m2 and during the second period it was 120 mg/m2, while the dose of cyclophosphamide and Adriamycin remained unchanged. No differences with regard to survival, progression-free interval, rate, and outcome of second-look laparotomy between 18 consecutive patients who received the low-dose and 17 consecutive patients who received the high-dose cisplatin were observed. The complication rate was significantly higher in the high-dose treatment group. Low-dose cisplatin-based combination chemotherapy seems therefore to be the preferable initial postoperative treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Abdominopelvic irradiation for stage II-IV ovarian carcinoma patients with limited or no residual disease at second-look laparotomy after completion of cisplatinum-based combination chemotherapy.

Abdominopelvic irradiation was given to 18 stage II-IV ovarian carcinoma patients who completed cisplatinum-based combination chemotherapy, were in complete clinical remission, and who underwent second-look laparotomy. The survival as well as the progression-free interval (PFI) was significantly longer in patients with a negative second-look laparotomy than in those with limited residual disease at this operation. Abdominopelvic irradiation was not effective in patients with limited residual disease at second-look laparotomy (3 year survival--34.3% and median PFI from second-look laparotomy--4.8 months). Even in patients with a negative second-look laparotomy the median PFI was only 13 months from this operation and the 3-year survival was 87.5%. The results were similar to other comparable series in which no treatment was administered to patients with a negative second-look laparotomy.

Adult↗
PubMed1984

[Regional lysis of acute basilar artery occlusion--case report].

Thrombosis of the basilar artery is not a rare disease, and the mortality is reported to be 60 to 80%. Present standard therapy with heparin infusions yields poor results. The high risk of intracerebral haemorrhage prohibits systemic fibrinolytic therapy. Due to these facts and good experience in our department with the use of local intracoronary lysis in acute myocardial infarction, the method of local thrombolysis was applied in a case of acute basilar artery thrombosis. Fibrinolytic therapy was started via an angiography catheter placed in the vertebral artery in a 28 year-old woman with hemiplegia and severe brain stem symptoms. The patient received 200,000 IU streptokinase within 2 hours and subsequently 300,000 IU urokinase within 10 hours. The vessel re-opened completely. The neurological symptoms decreased during the following weeks. Based on this experience and according to rare reports in the literature we believe local low-dose thrombolysis to be a causal therapy promising success for acute thrombosis of the basilar artery. This therapy can be carried out in every medical centre able to perform selective angiography and experienced in the administration of fibrinolytic drugs.

Adult↗
PubMed1984

A comparison of postoperative radiotherapy with postoperative chemotherapy in stage II-IV ovarian cancer patients.

A retrospective comparison between 28 stage II-IV ovarian cancer patients who received postoperative abdominopelvic irradiation and 15 such patients who received postoperative cis-platinum, Adriamycin, and Cytoxan chemotherapy was made. In both treatment groups there was a trend for a longer progression-free interval and 3-year survival in patients with residual tumor masses of less than 2 cm in diameter. In these patients there was also a trend favoring radiotherapy. However, all differences were not significant. Criteria for the choice of either modality of postoperative therapy of ovarian cancer patients remain to be determined. Nevertheless, the efficacy of both modes of treatment does not differ greatly.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

[Self healing attempts by schizophrenic patients].

There has effectively been no investigation, at a systematic empirical level, whether schizophrenics possess self-help capability. Clinical observation and self description would seem to make its existence likely. This will first be shown on hand of the pertinent clinical literature. In an own investigation, which was based on a "Model of Vulnerability" (Zubin and Spring, 1977), 40 schizophrenics were questioned in accordance to the formulation provided in the Frankfurt Complaint Questionnaire (Süllwold, 1977) about their compensatory efforts concerning subjectively experienced basic disorders Reaction time measurements served as indicators of schizophrenic vulnerability. All 40 patients reported awareness about compensatory efforts in regard to experienced disorders which they conceived to be danger signals. A clearly greater number of problem solving oriented (active) than non problem solving (passive avoidance) attempts were reported. They can provisionally be classified as "reinterpretation", "restructuring", "reality testing", "action displacement" or "search for action stereotypes".

Adaptation, Psychological↗
PubMed1983

Survival data of Israeli Jewish patients with squamous cell carcinoma of the cervix treated by irradiation.

During a 9-year period 61 Israeli Jewish Patients with histologically confirmed invasive squamous cell carcinoma of the uterine cervix (SUC) were treated by irradiation alone. A large proportion of the patients (44.2%) were more than 60 years old and only 27.9% were diagnosed as having stage IB disease. This is attributed to low awareness and infrequent cytologic screening. There is a trend for a large proportion of stage IB patients among those younger than 59 compared to those older than 60 years. The overall 5-year survival rate was 52.2% and the survival of patients with stage IB (72.6%) was significantly higher than in more advanced stages. In addition to clinical stage, age at diagnosis and method of irradiation also influenced survival rates.

Adult↗