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Biomedical subjects

H H Euler

Publications and source records attributed to H H Euler.

At least 55 records · Page 3Linked to original sources
PubMed1987

Synchronization of plasmapheresis and pulse cyclophosphamide in severe systemic lupus erythematosus.

Two patients with severe systemic lupus erythematosus, who had not responded to conventional therapy, were treated with plasmapheresis and subsequent pulse cyclophosphamide. This approach uses the plasmapheresis-induced proliferation of pathogenic clones for partial clonal deletion by giving large doses of cytotoxic drugs during the assumed period of increased B-cell vulnerability. Both patients had a rapid and distinct improvement in clinical symptoms and laboratory parameters, including the control of a life-threatening case of lupus pneumonitis. Their conditions were stabilized by giving low-dose cyclophosphamide for the next 6 months. At 14-month follow-up, there were no clinical signs of relapse.

Administration, Oral↗
PubMed1987

Synchronization of plasmapheresis and pulse cyclophosphamide therapy in pemphigus vulgaris.

Long-lasting and complete remission was obtained in a 48-year-old patient with refractory pemphigus vulgaris by an experimental treatment protocol that tries to synchronize plasmapheresis with subsequent pulse cyclophosphamide therapy. The rationale of the approach tries to utilize the plasmapheresis-induced increased proliferation of pathogenic cell clones for partial deletion of these clones through application of maximum pulse immunosuppression treatment during the period of assumed maximum proliferation and, thus, maximum vulnerability of the antibody-producing cells. The treatment schedule consisted of initial withdrawal of immunosuppressive drug therapy, repeated large-volume plasmaphereses substituted with immunoglobulin-free albumin solutions, subsequent application of high-dose (36 mg/kg of body weight) cyclophosphamide therapy, and low-dose maintenance immunosuppression for several months. As a result, our patient remained disease free over a follow-up period of 40 months without any further immunosuppressive treatment. Stimulation of postexchange antibody production and subsequent application of high-dose cytotoxic drugs might be a valuable tool in the management of refractory pemphigus vulgaris and, possibly, in the management of other autoantibody-mediated diseases.

Administration, Oral↗
PubMed1986

[Cyclophosphamide stosstherapy synchronized with plasmapheresis in rapidly progressive glomerulonephritis].

High-dosage stosstherapy of cyclophosphamide was administered, as far as possible optimally synchronized with plasmapheresis, to 12 patients with rapidly progressive glomerulonephritis. The basis for such synchronization lies in experimental data pointing to an increased antibody production after plasmapheresis (antibody rebound). Initial large-volume plasmapheresis was followed by high-dose immunosuppression in the phase of likely maximal proliferation of antibody-producing cells. The serum creatinine level in the 12 patients was 7.7 +/- 3.3 mg/dl before treatment. Eight patients required dialysis. After a period of observation of one year, ten patients are still alive. In one patient treatment had to be discontinued because she did not tolerate it. In the other nine patients renal function stabilized on a dialysis-free level. After one year the serum creatinine level averaged 2.5 +/- 1.2 mg/dl. With one exception no maintenance immunosuppressive treatment is required after one year. These preliminary results suggest that this treatment concept further improves the prognosis of rapidly progressive glomerulonephritis.

Combined Modality Therapy↗
PubMed1985

Membrane plasmapheresis technique in rats. Confirmation of antibody rebound.

A simple continuous flow method is described that transfers hollow fiber membrane plasmapheresis technology to rats. The technique is applied in an experimental approach that confirms the existence of a distinct overshooting antibody rebound mechanism after plasma exchange. Anti-SRBC antibody levels exceeded the baseline within 48 h and reached their maximum during the first 2 weeks after exchange.

Animals↗
PubMed1985

[Allogeneic bone marrow transplantation after fractionated whole body irradiation. Results at the Kiel transplantation center].

Allogeneic bone marrow transplantations were carried out between March 1983 and July 1985 in 31 patients aged 7 to 45 years (median 18 years). Acute lymphoblastic leukaemia in 1st to 5th remission was present in 8 patients, acute myeloblastic leukaemia in 1st and 2nd remission in 4 patients, chronic myeloid leukaemia, with various remission status, in 6 patients, 3 patients had severe aplastic anaemia and there were single cases of myelodysplasia and immature cell megakaryocytic myelosis. Transplantation was carried out during relapse in 8 patients with either acute myeloid or lymphoblastic leukaemia. Phenotypic HLA-identical mothers (n = 2) as well as genotypic HLA-identical siblings (n = 27), and in two cases HLA-non-identical mothers, served as bone marrow donors. In leukaemia patients the conditioning treatment consisted of fractionated total body irradiation and high dose cyclophosphamide or etoposide. Patients with severe aplastic anaemia received cyclophosphamide (4 X 50 mg/kg) and fractionated total nodal irradiation (total dose 8 Gy). 19 patients (61%) survived 14 to 605 days after bone marrow transplantation. 15 patients (48%) continue to remain in complete remission with Karnofsky indices of greater than or equal to 90%. Causes for death were infection (n = 3), interstitial pneumonia (n = 3), relapse (n = 3) as well as single cases involving acute graft-versus-host-disease, non-engraftment of donor marrow and veno-occlusive disease of the liver.

Acyclovir↗
PubMed1985

Danazol in acquired amegakaryocytic thrombocytopenic purpura: a case report.

Acquired amegakaryocytic thrombocytopenic purpura is a rare disease. Most reported patients did not respond to any therapeutical approach. Recently we observed a striking improvement of this disorder in a female patient shortly after therapy with danazol had been initiated. This observation and its possible implication for the treatment of amegakaryocytic thrombocytopenia are reported herein.

Adult↗
PubMed1985

Plasmapheresis in paraproteinemia.

Indications, results, techniques, laboratory monitoring and complications of therapeutic plasmapheresis in patients with symptomatic paraproteinemia are reviewed. In paraproteinemia associated with severe complications plasma-pheresis has been used successfully as an emergency treatment, as a treatment that reduces temporarily the paraprotein level until reduction of resynthesis is reached by cytotoxic therapy, or as a longterm adjuvant therapy in cases of slowly proliferating plasmacytoma or lymphoma. Plasmapheresis has not been shown to influence the underlying malignant process. Paraprotein-related complications that can be reduced by plasmapheresis are hyperviscosity, hypervolemia, haemorrhagic diathesis, cryoglobulinemic symptoms, rapidly deteriorating renal insufficiency, visual impairment, and neurologic disturbances. Technically, large-pored plasma filters have some advantage as compared to centrifugation techniques. Paraprotein-specific complications of therapeutic plasmapheresis are rare. As an ancillary treatment, therapeutic plasmapheresis has expanded the therapeutic tools in the management of paraproteinemia.

Acute Kidney Injury↗
PubMed1985

Precipitable immune complexes in healthy homosexual men, acquired immune deficiency syndrome and the related lymphadenopathy syndrome.

Increased levels of 3% PEG precipitable circulating immune complexes (CIC) were found in healthy homosexual men, in homosexual patients with the acquired immune deficiency syndrome (AIDS), and in the AIDS related lymphadenopathy syndrome (LAS). The degree of CIC elevation increases from healthy homosexual men to LAS and AIDS. Patients suffering from AIDS associated with opportunistic infections had a more pronounced increase in CIC than patients with AIDS associated Kaposi's sarcoma. In LAS and AIDS the amount of CIC correlated with the degree of inversion of the T4/T8 lymphocyte ratio, whereas in healthy homosexual men with increased levels of CIC the T4/T8 ratio was not significantly altered. Laser nephelometric partial components analysis revealed that these complexes were of a complement poor subtype with low component levels of C4, C1q and C3c. IgM and IgG were found to be the major components. It is suggested that these CIC might represent a marker of the total antigenic burden of the immune system. Possibly, they are of prognostic and monitoring value for clinical handling of patients at risk for AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1984

[Analysis of prognostic factors in plasmacytoma].

For analysis of prognostic factors the clinical course of 109 patients with multiple myeloma was evaluated. Survival curves of immunoglobulin (Ig)G- and IgA-myelomas were identical (Fig. 1) with median survival times of 52 and 42 months, respectively, whereas patients with IgD- and Bence-Jones-myeloma had short survival times (median 3 months). Most important risk factors were anemia, renal insufficiency, and hypercalcemia (Figs. 7 and 8). Median survival time dropped from 52 months (Hb above 100 g/l) to 22 (Hb 85-100 g/l) and 1 month (Hb below 85 g/l). Patients with serum creatinine values below 2 mg/dl lived significantly longer than those with values above. Median survival times were 52 and 1 month, respectively. All seven hypercalcemic patients had a renal insufficiency and were in a very poor condition; their median survival time was 1 month. Analysis of the widely used staging system of Durie and Salmon gave disappointing results. Survival curves of the three A-stages ran close together with median survival times of 58, 51, and 36 months. Only the A-B classification according to renal function (A: creatinine under 2 mg/dl; B: creatinine above 2 mg/dl) proved prognostically relevant.

Aged↗
PubMed1983

Precipitable immune complexes in Hodgkin's disease.

Sera from 28 untreated patients with Hodgkin's disease and from 120 healthy controls were investigated for the presence of circulating immune complexes using a modified 3% polyethylene glycol precipitation method with subsequent quantification of the precipitated protein. Elevated levels of precipitable protein were found in 79% (p less than 0.005) of Hodgkin's disease sera. The degree of elevation was associated with disease activity including the presence of B-symptoms. Constant and pronounced increase of precipitable protein was found in six patients with stage-III B nodular sclerosis subtype, thus exceeding the average amount of precipitable protein in healthy controls by a factor of 3-4. The erythrocyte sedimentation rate in 20 patients correlated with the amount of precipitable protein (r = 0.79). Additionally, partial component analysis of the precipitates was carried out by laser nephelometry. Immunoglobulins and complement components were identified as being major components of the precipitated material in sera both from patients and healthy controls, thus confirming the probability of the immune complex nature of the precipitates. Significant differences between patients and healthy controls concerned the amount of precipitable components. Elevation of precipitable IgM was found to be the most sensitive parameter (86% above means + 2 SD of normal controls, p less than 0.005). Increased amounts of precipitable IgG, C4, and Clq were found in 57-46% of patients' sera. Elevation of precipitable IgA and C3c were identified less often. The results suggest the quantification of precipitable immune complexes and their components to be of value as adjuncts in determining disease activity in Hodgkin's disease.

Adolescent↗
PubMed1983

[Successful conservative treatment of bronchial carcinoid with Cushing's syndrome due to ectopic ACTH production].

In a 53-year-old female patient with typical clinical Cushing's syndrome increased blood sugar levels, hypokalaemia, increased non-dexamethasone suppressable plasma cortisol levels and increased ACTH values in serum were observed. CAT scanning revealed bilateral adrenocortical hyperplasia. The endocrine anterior pituitary function was normal. Radiographically and bronchoscopically a rightsided parahilar tumour was found. Histology showed an atypical metastatic bronchial carcinoid with ectopic ACTH production. Conservative treatment with metyrapone suppressed the Cushing syndrome. The ACTH producing tumour responded to combined chemo- and radiotherapy. The patient is symptom free two years after onset of treatment.

ACTH Syndrome, Ectopic↗
PubMed1978

[The carcinoembryonic antigen (CEA) in bronchial carcinoma before and after operation (author's transl)].

In 53 p.c. of 175 patients with bronchial carcinoma the carcinoembryonic antigen (CEA) was elevated at the time of diagnosis. In patients with small well bordered tumors (T 1/2) 31 p.c. proved pathological CEA-values in comparison to 80 p.c. in patients with heamatogenic metastases. After radical tumor resection (36 patients) elevated CEA-levels returned to normal ranges within 5 weeks. No decrease could be observed after palliative operations (16 patients). If there existed haematogenic metastases normal CEA-values increased postoperative. Such an increase occured up to ten weeks before metastases could be found by other methods. In cases of bronchial carcinoma CEA-measurements are usefull to evaluate the effect of operation and in the follow up time. It should be carried out on principle in those patients which can be considered for a surgical therapy.

Bronchial Neoplasms↗