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Biomedical subjects

H D Waller

Publications and source records attributed to H D Waller.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Highly malignant non-Hodgkin's lymphoma in hyper-IgE syndrome].

A largely symptom-free swelling of the right submandibular lymph nodes developed in a 23-year-old woman with hyper-IgE syndrome who had suffered from recurrent staphylococcal abscesses since childhood. Histological examination of the lymph nodes revealed highly malignant non-Hodgkin lymphoma of centroblastic type. Extensive staging tests did not reveal any further tumour manifestations. Because granulocyte chemotaxis is abnormal in hyper-IgE syndrome and the patient also had an infection of an old lung cyst, treatment was restricted to local radiotherapy of the cervical lymph nodes. Since 12 months there has been no recurrence. There is probably no connection between the hyper-IgE syndrome and the development of a malignant non-Hodgkin lymphoma, judging by the results of immunological and immunoelectrophoretic findings.

Adult↗
PubMed1990

Plasma vitamin E and beta-carotene concentrations during radiochemotherapy preceding bone marrow transplantation.

Blood from 19 patients was examined for the essential antioxidants alpha-tocopherol and beta-carotene before, during, and after bone marrow transplantation (BMT). Marrow ablation and immunosuppression for BMT conditioning was achieved by treatment with high-dose chemotherapy, mostly combined with total body irradiation. All patients required total parenteral nutrition beginning 1 wk before BMT. After conditioning therapy the concentration of absolute and lipid-standardized alpha-tocopherol and beta-carotene in plasma decreased significantly, presumably as a result of an enhanced breakdown of these antioxidants. The loss of these lipid-soluble antioxidants has to be considered as a possible cause for early posttransplant organ toxicity.

Adolescent↗
PubMed1989

[An unusual course of thoracic actinomycosis].

A 56-year-old farmer who had been suffering from exogenous allergic alveolitis developed, after a long prodromal period of illness, a granulocyte-rich pericardial effusion and bilateral pleural effusions in which Actinomyces aggregates were identified. Despite intensive treatment with clindamycin, erythromycin and tetracycline (he was allergic to penicillin) he died in septic shock.

Actinomycosis↗
PubMed1989

[Remission of cold agglutinin disease following splenectomy].

An anaemia (haemoglobin content 8.3 g/dl) of undetermined cause, accompanied by mild jaundice and nocturnal leg oedema, developed in a 68-year-old woman who also had an increased erythrocyte sedimentation rate (128/135 mm). Primary cold-agglutinin anaemia was established as the cause. After administration of prednisone (2 mg/kg body-weight daily), cyclophosphamide (up to 150 mg daily) and plasmapheresis (twice weekly) had failed to bring about improvement, splenectomy achieved a clear reduction of haemolysis. At last examination the haemoglobin content had risen to 12 g/dl. This report demonstrates that in individual cases splenectomy may be useful, but it needs to be determined first by radioisotope study whether the spleen is in fact the main site of erythrocyte sequestration.

Aged↗
PubMed1989

[Spontaneous remission of lung metastases in renal cell carcinoma].

Pulmonary metastases were first noted in a 47-year-old man, 15 months after a radical right nephrectomy and local radiotherapy. They progressed over the subsequent ten months despite progestagen administration. But they regressed slowly after the progestagen had been discontinued so that eight months later they were no longer demonstrable radiologically. The remission has so far persisted for 3 1/2 years.

Carcinoma, Renal Cell↗
PubMed1989

Decreased essential antioxidants and increased lipid hydroperoxides following high-dose radiochemotherapy.

The blood from 19 patients having bone marrow transplantation was examined for the essential antioxidants alpha-tocopherol and beta-carotene as well as lipid hydroperoxides before, at and after bone marrow transplantation (BMT). Conditioning therapy, preceding BMT in order to achieve marrow ablation and immunosuppression, consists of high-dose chemotherapy which is mostly combined with total body irradiation (TBI). In order to see a possible difference between patients with and without additional TBI, we divided the patients up into two groups; patients receiving TBI (RT+) and patients without TBI (RT-). All patients required total parenteral nutrition beginning one week prior to BMT. After conditioning therapy plasma levels of absolute and lipid-standardized alpha-tocopherol and beta-carotene decreased in both groups, presumably as a result of an enhanced breakdown of these antioxidants. The loss of these lipid-soluble antioxidants has to be considered as a possible cause for early post-transplant toxicity. Lipid hydroperoxides increase significantly in the group of patients with additional TBI, whereas the other group, receiving no additional TBI, showed no significant change. We suggest high-dose supplementation of essential antioxidants for patients undergoing BMT.

Adolescent↗
PubMed1988

[Hemolytic anemia caused by echinocytosis in liver cirrhosis].

Severe haemolytic anaemia developed in a 34-year-old patient with histologically proven alcoholic liver cirrhosis. While in the blood smear there were only a few acanthocytes, under light-microscopy of EDTA-blood 70% of erythrocytes in the counting chamber were acanthocytes or echinocytes, a finding confirmed under the electromicroscope. It is likely that the echinocytosis and acanthocytosis were the cause of the haemolytic anaemia. Biochemical investigation of the lipid composition of the erythrocyte membrane and of plasma and of the apolipoproteins in plasma revealed a series of changes whose role in haemolysis is discussed.

Acanthocytes↗
PubMed1988

Significant association of acute lymphoblastic leukemia with HLA-Cw7.

Frequencies of all defined HLA-A, -B, -C (-DR) antigens were determined in 142 (59) Germans suffering from acute lymphoblastic leukemia (ALL) with differentiation of immunologically defined or age-related subgroups of the disease. A highly significant rise of the HLA-C locus antigen Cw7 was found in ALL patients, particularly those over the age of 11 in comparison with local German and Caucasian controls of the Ninth Int. Histocompatibility Workshop (WS). Only slight differences of HLA-Cw7 frequencies were observed within the four immunologically defined ALL subtypes of all or age-related patient groups. HLA-A, -B, or -DR antigens, as well as HLA-ABC three-locus haplotypes were similarly distributed in patients and their local or Caucasian controls. The results indicate HLA-linked genetic factors conferring susceptibility to ALL in adults, particularly those presenting with B-, T-, and Null-ALL.

Adolescent↗
PubMed1988

High frequency of graft-versus-host-like syndromes following syngeneic bone marrow transplantation.

Occurrence of acute graft-versus-host reactivity-like (GvHR) syndromes has been shown in at least 3 and possibly in 4 further cases of 9 patients with bone marrow transplants from identical twin donors. The diagnosis of GvHR-like syndromes is based on clinical, immunologic, and histologic features indistinguishable from those observed in graft-versus-host disease (GvHD) grades I-III of patients receiving allogeneic major histocompatibility complex (MHC) matched bone marrow transplants. Induction of GvHR-like symptoms appeared to be correlated with reactivated viral infections after bone marrow transplantation (BMT) or, like in animal models, was due to specific conditioning therapy with cyclophosphamide. The high incidence of acute GvHR-like syndromes in the first months after syngeneic BMT suggests inability of the immune system to discriminate appropriately self from nonself antigens during a normal tolerance induction period after grafting.

Adolescent↗
PubMed1988

Prevention of CMV infection after BMT in high-risk patients using CMV hyperimmune globulin.

Prophylactic administration of an intravenous cytomegalovirus hyperimmune globulin in bone marrow transplant recipients provided protection against primary as well as reactivated CMV infection in patients considered to be at high risk for cytomegalovirus infections. Forty-one patients were divided in six subgroups according to factors considered to increase the incidence and severity of CMV infections following bone marrow transplantation. All of these patients received blood products from donors not screened for active or latent CMV infections. In spite of this, patients undergoing intensified conditioning therapy or mismatch transplantation, as well as those transplanted in relapse of their leukemia and even patients receiving granulocyte transfusions from donors unscreened for CMV serostatus, were found not to develop primary or secondary CMV infections. Only in the group of patients older than 35 years and among those suffering from severe GVHD six patients were found to have CMV infections, only two a symptomatic form. Intravenous administration of CMV hyperimmune globulin effectively protected even patients at high risk for CMV infection against severe complications of primary infection or reactivation of this virus.

Adult↗
PubMed1988

Significant reduction of cytomegalovirus (CMV) disease by prophylaxis with CMV hyperimmune globulin plus oral acyclovir.

The effect of prophylactic intravenous administration of a cytomegalovirus (CMV) hyperimmune globulin with a high titer of neutralizing antibodies plus oral acyclovir was studied in 93 consecutive bone marrow transplant recipients. In spite of receiving blood products unscreened for CMV only six patients developed CMV infections during the time they received passive immunization. Five patients reactivated virus after hyperimmune globulin infusions were stopped; four of them suffered from chronic graft-versus-host disease (GVHD) Among the patients suffering from acute GVHD grade III/IV and/or chronic GVHD the incidence of CMV infection (10/38) was significantly higher than among those with no or milder forms of GVHD (1/55) (p less than 0.01). Only three patients suffered from symptomatic CMV infections; two with gastrointestinal manifestations and one with fatal CMV pneumonia. Thus CMV prophylaxis as used here proved highly effective in combating one of the major difficulties encountered in BMT.

Acyclovir↗
PubMed1987

Stability and pharmacokinetics of m-[131I]iodobenzylguanidine in patients.

A pharmacokinetic study was done to elucidate the body distribution, elimination, and metabolism of m-[131I]iodobenzylguanidine (m-[131I]IBG). For this purpose, an analytical method using solid phase extraction columns was developed. m-[131I]IBG was administered as an i.v. infusion according to different schedules with doses of 7,055 to 13,580 MBq/m2. At the start of the infusion m-[131I]IBG accounted for 93.0 +/- 2.3% (SD; n = 10) of the total radioactivity. At the end of the infusion m-[131I]IBG accounted for 88.0 +/- 7.4%. The non-m-IBG-bound radioactivity was predominantly 131I. The pharmacokinetic parameters (n = 7) are adequately described by a three compartment model. The parameters for m-[131I]IBG were determined with a mean terminal half-life of 37.0 h, a volume of distribution of 307 liters/m2, and an area under the curve value of 1091 kBq x h/ml. The total body clearance was 189 ml/min/m2. The values for 131I showed a terminal half-life of 71.6 h, a volume of distribution of 190 liters/m2, and an area under the curve value of 1537 kBq x h/ml. The total body clearance was 70 ml/min/m2. The selectivity of the m-[131I]IBG treatment might be improved by a reduction of 131I in the infusion fluid and further investigations are warranted.

3-Iodobenzylguanidine↗
PubMed1987

[Phenotypic heterogeneity of cardiac myxomas].

Histogenesis of cardiac myxoma is still unclear. Beside endothelial cells a variety of different cell types were detected in this benign cardiac tumor. Cryostat sections of four myxomas were analysed in the indirect immunoperoxidase technique using monoclonal antibodies (MoABs) directed against MHC class I and II antigens, as well as different surface determinants specific for endothelial cells or monocytes/macrophages. Tumor cells forming cell clusters and blood vessel like structures differed in their expression of endothelial antigens suggesting cellular heterogeneity within single and different myxomas. Like in fetal cardiac tissue vascular channels rarely carried HLA-class II antigens. Tumor cells carrying antigens of monocytes/macrophages, as well as intracellular alkaline phosphatase of endothelial cells could represent subpopulations of an early differentiation stage. This analysis further supports previous hypothesis of an endothelial origin of myxomas.

Adult↗