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Biomedical subjects

H Heimpel

Publications and source records attributed to H Heimpel.

At least 253 records · Page 14Linked to original sources
PubMed1979

[Drugs and acute agranulocytosis: analysis of previous drug intake in 42 patients (author's transl)].

An exact account of previous drug intake was obtained in 42 patients with acute agranulocytosis. Because of the multiplicity of administered drugs, often in the form of multiple-drug preparations, it was possible in only a minority of cases to ascribe with any degree of certainty a causative role to any particular drug. But outstanding as possible causes were thyrostatic drugs and pyrazolone. But no conclusion could be drawn as to the incidence of agranulocytosis with regard to these drugs because of the absence of data on the frequency that they are prescribed and the unknown number of fatal cases of agranulocytosis. The results indicate that multiple drug treatment and in particular the unnecessary prescribing of multiple-drug preparations makes it difficult to ascertain side-effects of drugs. They once again point to the need of frequent checks of white cell count in the drug treatment of pyrexial diseases.

Acute Disease↗
PubMed1979

Reaction of human granulopoiesis to high-dose cyclophosphamide therapy.

The reaction pattern of an unperturbed human granulopoiesis to pulses of high-dose chemotherapy (cyclophosphamide 2000 mg/m2 plus vincristine 1.4 mg/m2 or adriamycin 20 mg/m2) was serially studied in 6 patients. The stem cells committed to granulopoiesis (CFU-C) of the bone marrow and the cells of the proliferative granulocytic marrow pool were considerably reduced during the first 8 days. Granulopoietic regeneration was first recognizable by increased proliferative activity of bone marrow CFU-C (3H-thymidine technique). The cytotoxic drug-induced injury to the early compartments of granulopoiesis, and granulocytic regeneration proceed sequentially through the ensuing, increasingly differentiated granulocytic compartments. In the peripheral blood, depletion and repletion of the CFU-C pool precede the corresponding changes of segmented neutrophils by 7 to 9 days; during granulocytic regeneration, peripheral blood CFU-C show a transient greatly overshooting decrease.

Bone Marrow↗
PubMed1979

[A prospective study on course and prognostic criteria in "preleukemia" (author's transl)].

The natural course of disease was followed in 33 patients with so-called preleukemia by a prospective multicentric protocol. Patients with the following criteria were included: Anaemia with granulocytopenia and/or thrombocytopenia, normal or increased cellularity of the bone marrow and exclusion of a known diagnosis of underlying disease. Follow up after assumption of "preleukemia" was 3 years or more. Median survival was 26 months after diagnosis of preleukemia and 36 months after the first unequivocal symptoms of the blood dyscrasia. 40% of the patients changed to the picture of leukemia within 2 years. The most important parameters suggesting subsequent transition to overt leukemia where chromosomal abberations and an increased blast count of the bone marrow.

Acute Disease↗
PubMed1979

Measurement of cell mediated cytotoxicity by post-labeling surviving target cells.

The 51Cr release assay (CRA) is the commonly accepted technique for measurement of cell mediated cytotoxicity. This assay shows some disadvantages when mononucleated cells of human peripheral blood (MNC) are used as effector and target cells. The uptake of 51Cr by PHA stimulated lymphocytes is low compared to the spontaneous release. In an attempt to develop a cytotoxicity assay suitable for human lymphocytes we used 14C-TdR to label target cells surviving after contact with effector cells. Cytotoxic lymphocytes were generated by incubation of MNC with irradiated allogeneic MNC for 6 days. On day 6 the effector cells are irradiated and co-cultured with PHA stimulated target cells. Twenty-four hours later 14C-TdR is added. After an additional 24 h the cultures are harvested and 14C-TdR taken up by target cells is measured. It is shown that the effector cells are still cytotoxic after irradiation. These cells do not take up 14C-TdR. Cell-free supernatants do not influence the uptake of 14C-TdR by target cells. The results obtained with this assay correlate very well with those obtained by the CRA, if the spontaneous release does not exceed 30%.

Adult↗
PubMed1979

[Effectiveness of gnotobiotic measures in the treatment of acute leukemia: the results of a prospective randomized clinical study].

60 adult patients with acute leukemia (AL) previously untreated or in relapse received induction chemotherapy with different types of supportive care. Group A was decontaminated by nonabsorbable antibiotics in strict reverse isolation, group B was isolated only and group C was treated under routine hospital conditions. There were less infections in group A and B compared with group C. 76% of patients in group A achieved remission, in contrast to 57% in group B and 59% in group C. Late evaluation three years after termination of the study showed that all patients were dead except four patients being in first remission after discontinuation of maintenance treatment. Three patients were treated in group A, one patient in group C. However, the differences of survival and remission rates were not significant. Failure to demonstrate significant advantage of isolation and decontamination in treatment of AL was caused by insufficient suppression of microbes by the applied antimicrobial measures. Thus, it is suggested to investigate better antimicrobial treatment before gnotobiotic care is accepted as routine supportive treatment in AL.

Acute Disease↗
PubMed1979

Dysplasia of the lymphatics with lymphoedema, generalized lymphangiectasis, chylothorax and "pseudo-storage-disease".

A patient showing an unusual association of various abnormalities of the lymphatic vascular system is reported. These abnormalities became first evident in early childhood and consisted of lymphoedema of the left leg, lymphangiectasis in various organs and occlusion of the thoracic duct at its entrance into the venous angle. Chylous effusions and subcutaneous chyloedema appeared in adolescence. Diagnostic biopsies of spleen, liver and bone-marrow revealed the presence of multiple foamcells, suggesting the diagnoses of lipid storage disease. The patient died from severe honeycomb-lungs at the age of 20. This case cannot be attributed to one of the wellknown disease entities of the lymphatic system. The "pseudo"-storage disease is regarded as secondary to the backflow of chylus into the tissues.

Adolescent↗
PubMed1978

[Progressive pulmonary fibrosis during combination chemotherapy with BCNU (author's transl)].

In two patients with acute leukaemia, the development of progressive interstitial pulmonary fibrosis was observed following chemotherapy with BCNU, Cytoxan and Ara-C. The x-ray changes were accompanied by restrictive changes of pulmonary function and, later on, by severe hypoxia. Serologic tests did not reveal infection with cytomegaly virus or mycoplasma pneumoniae. These findings, together with reports in the literature, suggest a toxic effect of BCNU on the lung. The combination with Cyclophosphamide may contribute to this toxic reaction.

Acute Disease↗
PubMed1978

[Acute drug-induced agranulocytosis: comparison between openward treatment and antimicrobial decontamination in a plastic isolation bed system (retrospective study of 30 cases) (author's transl)].

Thirty patients with severe drug-induced agranulocytosis were admitted to the Ulm University Hospital between January, 1968 and October, 1976. All of 13 already infected patients treated with antimicrobial decontamination in a plastic isolation bed system survived. But nine of 17 patients treated in the open ward died. The cases were not randomised and there was a difference in age between the two groups, but nevertheless the results suggest that antimicrobial decontamination and isolation is superior to treatment in an open ward.

Adolescent↗