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Biomedical subjects

H Sauer

Publications and source records attributed to H Sauer.

At least 253 records · Page 14Linked to original sources
PubMed1989

[Cytostatic drugs--mechanism of action and guidelines for clinical use].

The indication spectrum for the hospital and office use of cytostatic agents is continuing to expand. For such treatment to be successful, a basic knowledge of the mode of action of various cytostatic drugs, and appropriate experience with the application guidelines and side effects are necessary. The various classes of cytostatic drugs are briefly characterized, and attention is drawn to new developments (new substances, overcoming of resistance, growth factors, cytokines). Since adverse reactions can affect not only the patients receiving treatment, but also medical staff handling such medicaments, particular attention must be directed to providing protective measures at the workplace. The specific toxicities of some cytostatic agents are mentioned. Supportive measures required after accidental mis-use (e.g. injection of intravenous drugs into paravascular tissue, overdosage) are described. For some cytostatic drugs there are dose and application restrictions that depend upon disordered organ function--renal, hepatic, cardiac, bone marrow. Employed by experienced doctors in accordance with all the "rules" of application, cytostatic therapy is a safe form of therapy which, in addition to its palliative character, is increasingly showing a curative tendency (e.g. childhood malignancies, malignant diseases of the lymphatic system testicular tumors, adjuvant chemotherapy for certain indications).

Antineoplastic Agents↗
PubMed1989

[Treatment of stage I-IIB nonseminomatous testicular tumors].

Data on 90 patients (median age 26 years, range 15-65) with nonseminomatous testicular tumour (NTT) were analysed retrospectively to evaluate the effectiveness of adjuvant chemotherapy: 55 patients had received postoperatively (semicastration, retroperitoneal lymphadenectomy) adjuvant chemotherapy. They have now lived tumour-free for a median period of 67 (range 8-107) months. These results were compared with a group of 35 patients with recurrence of NTT who, after the primary operation, had been merely followed-up but, on diagnosis of recurrence, had received intensive chemotherapy with removal of the recurring tumour, if indicated. Nonetheless, only 24 of these 35 patients (69%) went into a lasting remission. A favourable factor was regular follow-up examinations with early diagnosis of any recurrence. Thus in a quarter of the patients a possible curative chance was missed despite an initially low tumour stage. The results suggest that omission of operative or chemotherapeutic measures is justified only if careful followup is assured.

Adolescent↗
PubMed1989

[Ingestion of caustic substances in childhood].

Patients who ingest caustic substances continue to pose difficult problems in diagnosis and management. Flexible fiberoptic endoscopy and radiological studies have helped to assess the extent of damage caused by corrosives. A number of non surgical techniques are available for therapy, mainly corticosteroids and antibiotics. In a retrospective study from January 1976 till October 1988 we analysed 86 children aged from 1 month to 11 years. The purpose of our analysis was to check the outcome in patients with corrosive burning treated by standardized therapeutic management. Alkaline household substances caused the injury in 75% of our patients. No lesions were found in 19 patients. There were 21 patients with first degree, 28 with second degree ans 18 with third degree lesions. The diagnosis was confirmed by endoscopy within the first 48 hours. Therapeutic management in 2nd and 3rd degree lesions was based on corticosteroids, antibiotics and early bougienage of the oesophagus over an endless thread. Three patients with 2nd degree and all 18 patients with 3rd degree lesions underwent bougienage. Corticosteroids were given for two to four weeks, depending on the severity of the lesion. Our results demonstrate that early diagnosis and therapy can help to reduce stenosis and prolonged illness of these patients. In addition, public health efforts should be made to educate people about the dangers of caustic substances.

Burns, Chemical↗
PubMed1989

Multiple brown tumors in a patient with nutritional secondary hyperparathyroidism.

For years, brown tumors have been considered to be a characteristic of primary hyperparathyroidism. However, since 1963 several reports indicate the incidence of brown tumors in patients with renal secondary hyperparathyroidism to be 1.5%-1.7%. The appearance of multiple brown tumor lesions is rather uncommon in secondary hyperparathyroidism which is also true for malabsorption as its cause. We report on a 56-year-old man presenting with pain in the bones and multiple osteolyses. A bone biopsy specimen and the laboratory examinations were indicative of secondary hyperparathyroidism caused by malabsorption most likely due to Billroth's II/I gastric resection. Thus, the patient's osteolyses represent brown tumors which have been induced by nutritional secondary hyperparathyroidism.

Bone Neoplasms↗
PubMed1989

A proposal to preserve the ileocecal valve and right colon in total colonic aganglionosis.

We report two cases of total colonic aganglionosis in which the ileocecal valve and right colon were preserved. The aganglionic ileal segment is removed leaving behind only a very short prececal remnant, which is anastomosed end-to-back to the remaining ileum. An ileal loop (of approximately 20 cm in length) is isolated and interposed between the right colon and rectum. The operation can be performed as a staged procedure. The advantage of preserving the ileocecal valve with respect to physiology is discussed.

Anastomosis, Surgical↗
PubMed1989

[Results and experiences with several methods for the immunodiagnosis of amebiasis].

Results and experiences of some immunodiagnostic methods for amebiasis. Experiences concerning the laboratory diagnosis of invasive amebiasis are described and discussed. Technics used include the Passive Hemagglutination Test with E. histolytica antigen (Behring FRG) and sheep erythrocytes as carrier and the Indirect Fluorescence Antibody Reaction (IFAR) with corpuscular antigen prepared from cultures of E. histolytica strain HK 9. Comparatively for a part infected hamster liver (Dr. Richle strain) has been used as antigen. We conclude that IFAR with HK 9 antigen is more sensitive than the other tests. It has been proved useful in the diagnosis of extraintestinal amebiasis (antibody titer greater than or equal to 1:160).

Amebiasis↗
PubMed1989

Relation between cell cycle stage and the activity of DNA-synthesizing enzymes in cultured human lymphoblasts: investigations on cells separated according to DNA content by way of a cell sorter.

Exponentially growing human lymphoblasts (culture LS-2) were separated by cell sorting (FACS II, Becton Dickinson) according to their deoxyribonucleic acid (DNA) content, designating them at particular phases of the cell cycle. Prior to cell sorting the DNA has been fluorochrome-labeled with the Hoechst stain H 33342. Maximum cell enrichments of 94% for G0 + G1 cells, 96% for S cells and 74% for G2 + M cells could be achieved. The enzyme activities of thymidine kinase (TK), thymidylate synthase (TS), DNA polymerase (DNA-P), dihydrofolate reductase (FH2-R), methionine synthase (MS), and hexokinase (HK) were determined in the obtained cell fractions. Although incorporation of 3H-thymidine (3H-dTR) and the 3H-dTR labeling index were significantly inhibited by the dye, no evidence of cell staining's having a significant effect on the enzyme activities was found. The enzyme activities for approximately 100% pure G0 + G1, S, and G2 + M cells were computed. With exception of TK, all the enzymes under study were shown to exhibit activities--although of differing degree--in the G0 + G1, S, and G2 + M cells. No TK activity was shown in G0 and G1 cells; its activity, however, was approximately the same in S and G2 + M cells. This applies likewise for TS which, in contrast to TK, exhibits minor activity in G0 + G1 cells. DNA-P was highly active in G0 + G1 cells, but maximum activity was in S cells. FH2-R exhibited maximum activity in S cells, although the difference in activity between S and G2 + M cells was not significant. None of the observed differences in MS activity was significant, indicating equally high activity in cells of all cell cycle phases. HK activity is approximately twice as high in G2 + M cells as in G0 + G1 cells.

Benzimidazoles↗
PubMed1989

[Preliminary results of 99mTc-HMPAO-SPECT studies in endogenous psychoses].

18 psychopharmacologically treated patients (7 schizophrenics, 5 schizoaffectives, 6 depressives) were studied using 99mTc-HMPAO-SPECT of the brain. The regional cerebral blood flow was measured in three transversal sections (infra-/supraventricular, ventricular) within 6 regions of interest (ROI) respectively (one frontal, one parietal and one occipital in each hemisphere). Corresponding ROIs of the same section in each hemisphere were compared. In the schizophrenics there was a significantly reduced perfusion in the left frontal region of the infraventricular and ventricular section (p less than 0.02) compared with the data of the depressives. The schizoaffectives took an intermediate place. Since the patients were treated with psychopharmaca, the result must be interpreted cautiously. However, our findings seem to be in accordance with post-mortem-, CT- and PET-studies presented in the literature. Our results suggest that 99mTc-HMPAO-SPECT may be helpful in finding cerebral abnormalities in endogenous psychoses.

Adult↗
PubMed1988

[A tumor after-care schedule: information content--use--optimization].

Follow-up schedules for cancer patients define standards for post treatment care. They give informations about (1) the group of patients at risk, (2) the location of metastasis, (3) the adequate diagnostic procedures, (4) the frequency of examinations, and (5) the overall duration of follow-up. Such recommendations are a concise compilation of knowledge about the course of the disease, the tumor growth kinetics, and characteristics of the diagnostic tests. The validity of routine follow-up schedules will be discussed and explained using data about liver metastases in breast cancer patients. Simple calculations and simulations about the frequency of metastatic events demonstrate that strategies oriented on prognosis should be mandatory. The frequency of the detection of secondary cancers, the therapeutic possibilities etc. should define limits for the search of metastases. The effectiveness of follow-up programs must be evaluated just as the screening for the detection of early cancers in order to optimize the cost-benefit-relations.

Aftercare↗
PubMed1988

Biochemical and cytokinetic characterization of leukemic cells: prediction of treatment results and early diagnosis of relapse.

Selected key-steps in the biochemical pathways of DNA-synthesis and cytokinetic parameters were measured in human bone marrow cells: Thymidine kinase (TK), incorporation of nucleosides (thymidine = dTR and deoxyuridine = dUR), % cells in DNA-synthesis-phase of the cell division cycle (%S). 26 normal marrow and a total of 369 marrow specimens from patients with acute leukemia were assayed either at first diagnosis, during remission or at relapse. A significant 5-fold increase of TK was found in leukemic cells, thus, being a suitable marker for follow-up of these patients. The sensitivity to detect a high TK at primary diagnosis of acute leukemia is 83%. An increase of TK during remission can indicate an imminent relapse before an increase of blast cells can be detected in the bone marrow. The incorporation-rates of dTR and dUR were also significantly increased in leukemic cells. Patients who did not achieve complete remission after induction treatment had higher incorporation-rates. In contrast to the enhanced biochemical activity of DNA-metabolism, %S-phase-cells were significant lower in leukemic cell populations. %S-phase cells did not correlate with treatment results. An inhibition of DNA synthesis, estimated by the incorporation rates of dTR and dUR for more than 50% during the first 3-4 days after start of induction treatment corresponds with cytoreduction in the leukemic bone marrow which does not predict complete remission in all cases.

DNA↗
PubMed1988

Azathioprine lymphocytotoxicity. Potentially lethal damage by its imidazole derivatives.

The immunosuppressive agent 6-(1-methyl-4-nitroimidazole-5-yl)-thiopurine (azathioprine, AZA) is metabolized to the purine antagonist 6-mercaptopurine (6-MP) and to 5-substituted 1-methyl-4-nitro-5-thioimidazoles or- aminoimidazoles. Besides the cytostatic (growth inhibition) and cytocidal (cell killing) effect of the anti-metabolite 6-MP, which can be antagonized by exogenous purine supplementation, AZA has an additional effect, which cannot be antagonized by purines. This effect is due to electron-affine imidazole derivatives, which are generated by a nucleophilic attack on the AZA molecule. A synthetic imidazole derivative (1-methyl-4-nitro-5-chloro-imidazole, MNCI) develops cytostatic and cytocidal effects in two different permanent human lymphoblastoid cultures (LS2 and CH4) with threshold concentrations of 8 x 10(-5) and 6 x 10(-5) mol/l, respectively. This imidazole derivative with the nitro- and chloro-group in ortho-position seems to be more reactive than other imidazole derivatives. It interferes with the redox potential of the cells. It causes glutathione depletion and sublethal conditioning of the cells (reduced repair capacity = potentially lethal damage = PLD = chemosensitization). The immunosuppressive action of AZA depends on the synergistic cooperation of the relatively weak cytostatic effect of low doses of 6-MP and the chemosensitizing effect of PLD which is induced by highly reactive imidazole derivatives.

Azathioprine↗
PubMed1988

[Neck-induced myoneural irritation pain--a recommendation for therapy by the ENT physician].

A number of typical ENT complaints which do not involve organic signs or symptoms are presented, such as sinusitis-like headache, otitis-like earache and tonsillo-pharyngitis-like dysphagia. Since patients with such complaints usually visit an ENT specialist first, an introduction of additional diagnostic and therapeutic measures is imperative. Without having been trained in chirotherapy, it is possible to identify painful locations, myogeloses and functional disorders in the craniocervical area. In many cases treatment of these disorders leads to disappearance of associated irritational complaints. In addition to local treatment of the neck, the ENT specialist may employ a procedure as described. Superficial infiltration of the mucous membrane is performed with a local suprarenin-free anaesthetic in an area around the upper wisdom tooth and on the palatoglossal arch. This procedure often leads to spontaneous and lasting relief of symptoms. It is assumed that this has the effect of inhibiting the pathologically irritated afferents and thus of interrupting an altered reflex arc. Relief from the complaints is improved by physiotherapy and by avoiding the detrimental influence of bad posture, nervous stress, air draughts, cold chills etc. Extensive massage therapy can result in worsening of complaints.

Humans↗