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Biomedical subjects

H Ziegler

Publications and source records attributed to H Ziegler.

At least 55 records · Page 3Linked to original sources
PubMed1993

Clinical epidemiology of bilateral breast cancer.

BACKGROUND: The clinical epidemiology of bilateral breast cancer was assessed in a population-based study from Saarland, Germany. METHODS: Clinical aspects of breast cancer, including age and tumor spread at diagnosis and survival, were compared between 251 patients with bilateral breast cancer and all 9585 patients with a first diagnosis of breast cancer registered with the population-based cancer registry of Saarland, Germany, between 1968 to 1987. RESULTS: The patients with bilateral breast cancer were on average considerably younger at the time of diagnosis of the first breast cancer than the total group of patients with breast cancer (mean age, 55.7 years versus 60.5 years). Overall, the distribution of tumor spread at diagnosis of the second breast cancers was similar to the corresponding distribution of first breast cancers, but a much less favorable distribution was observed among second breast cancers that developed in women younger than 50 years of age. The survival rates after diagnosis of a second breast cancer were much worse than the survival rates after a first breast cancer diagnosis. These differences persisted after control for important covariates such as age and tumor spread and were more pronounced if the first tumor was diagnosed in an advanced stage and if the time interval between diagnosis of the first and second cancers was short. Nevertheless, tumor spread at diagnosis of the second cancer was by far the most important predictor of survival among patients with bilateral breast cancer. CONCLUSIONS: The differences in clinical aspects of first and second breast cancers should be considered in clinical management of patients with breast cancer. Further research is required to explain these differences.

Adult↗
PubMed1993

Characterization of BIBN 99: a lipophilic and selective muscarinic M2 receptor antagonist.

The present study was designed to characterize the receptor selectivity profile of the novel muscarinic M2 receptor antagonist BIBN 99 (5,11-dihydro-8-chloro-11-[[4-[3-[(2,2-dimethyl-1- oxopentyl)ethylamino]propyl]-1-piperidinyl]acetyl]-6H- pyrido[2,3-b][1,4]benzodiazepin-6-one). In radioligand binding studies BIBN 99 showed high affinity for m2/M2 sites (pKi = 7.52/7.57), intermediate affinity for m4 sites (pKi = 6.76) and low affinity for m1/M1 (pKi = 5.97/6.17), m3/M3 (pKi = 6.11/6.04) and m5 sites (pKi = 5.84). Functional studies in vitro showed BIBN 99 to be a competitive antagonist and to have an 11- to 25-fold higher affinity for M2 receptors than for putative M1 receptors in the rabbit vas deferens or M3 receptors in guinea-pig trachea. In vivo studies revealed that BIBN 99 is able to cross the blood-brain barrier, and although showing an approximately 3-fold higher affinity for M2 binding sites BIBN 99 appeared to be 7- to 18-fold less potent than AF-DX 116 in inhibiting muscarinic agonist or vagally induced bradycardia in rats and guinea-pigs. The results show that BIBN 99 is the first lipophilic muscarinic M2 receptor antagonist to have remarkable M2 versus M1 selectivity (30-fold). In addition, BIBN 99 possesses central nervous system activity and only minor peripheral cardiac effects.

Animals↗
PubMed1993

Second primary malignancies following gynecological tumours in Saarland, Germany, 1968-1987.

The occurrence of second primary malignancies was assessed among 2922 women with cervical cancer, 2721 women with endometrial cancer and 1745 women with malignant neoplasms of the ovaries, who were notified to the cancer registry of Saarland, Germany, between 1968 and 1987. Analyses are presented for second primary malignancies at any site and at the most important single sites. Among women with cervical cancer, 98 second primary malignancies were observed, slightly fewer than the 99.3 cases that would have been expected on the basis of the incidence rates of the general population (standardized incidence ratio, SIR = 0.99). More second malignancies were observed than expected in the urinary bladder (SIR = 3.51) while the opposite applied to second neoplasms in the breast (SIR = 0.56). Among women with endometrial and ovarian cancer, the numbers of observed cases slightly exceeded the expected numbers for second primary neoplasms at any site (SIR = 1.19 and 1.41 respectively). More second primary neoplasms were observed than expected in the colon, breast, urinary bladder and kidneys among these women. We discuss our results, which are in agreement with findings among North European and North American populations, from clinical and etiological points of view.

Confidence Intervals↗
PubMed1993

Second primary neoplasms following breast cancer in Saarland, Germany, 1968-1987.

A statewide cohort study on the occurrence of second primary neoplasms was conducted among 9678 women first diagnosed with breast cancer in Saarland, Germany between 1968 and 1987. A total number of 409 second primary neoplasms was observed compared to 328 cases that would have been expected based on the incidence rates of the general population (standardised incidence ratio, SIR = 1.25). This elevation in incidence of second neoplasms was primarily due to increased occurrence of cancer of the opposite breast (SIR = 2.48), which was most pronounced for patients below the age of 50 (SIR = 4.20) and within the first 5 years after diagnosis (SIR = 2.91). There was a moderate elevation in incidence of malignant tumours of the ovaries (SIR = 1.46), while the incidence of most other malignancies was lower than in the general population. Our results, which are in agreement with previous findings from Northern Europe, the U.S.A. and Japan provide valuable background information for aetiological research, as well as for surveillance of breast cancer patients.

Breast Neoplasms↗
PubMed1993

[Projection of new cancer diseases to the year 2002--a contribution to health planning in public health by the Saarland cancer registry].

This paper provides projections of incident cases of malignant neoplasms in Saarland, Germany, between 1988 and 2002. The analyses are based on population forecasts by the National Statistical Office and on age-cohort analyses of cancer incidence data from the population-based cancer registry of the Saarland. Due to dramatic demographic changes and increasing age-specific cancer incidence rates, the average yearly number of total incident cases of malignant neoplasms is projected to increase by 63.1% between 1983-1987 and 1998-2002 in men, with the strongest increase projected for colon cancer (+114.6%). In women, a modest increase (+7.1%) is projected for all malignant neoplasms, with stronger increases for colon cancer (+50.1%), lung cancer (+44%) and breast cancer (+27.4%), whereas decreasing annual numbers of cases are projected for cervical cancer (-51.6%), stomach cancer (-18.5%) and endometrial cancer (-10.2%). The results provide a quantitative basis for health care planning in the Saarland. They may also serve as a rough guide for other parts of Germany for which reliable cancer incidence data are not available.

Adolescent↗
PubMed1992

Monitoring and projecting cancer incidence in Saarland, Germany, based on age-cohort analyses.

STUDY OBJECTIVE: The aims were (1) to monitor and compare incidence rates of cancer from successive birth cohorts in Saarland over the period from 1968 to 1987; (2) to project cancer incidence in Saarland in 1988-2002 in order to provide guidelines for health policy planning. DESIGN: This was an ecological study of overlapping birth cohorts of women and men. SETTING: The study was population based involving the whole state of Saarland. PATIENTS: 80,028 cases of malignant neoplasms (other than non-melanoma skin cancer) diagnosed from 1968 to 1987 and reported to the cancer registry of Saarland were included. MEASUREMENTS AND MAIN RESULTS: Age specific, sex specific, and period specific cancer incidence rates were analysed and extrapolated by multiplicative age-cohort models. Due to a steady rise in birth cohort specific cancer incidence rates in males, a substantial rise in incidence of total cancer is projected, while a moderate decline is expected for females. Analogous analyses are presented for the most common single forms of cancer in women and men. Alternative strategies of analysis, such as age-period-cohort modelling, are discussed. CONCLUSIONS: The age-cohort model is well suited for monitoring incidence of most forms of cancer. The projections provide quantitative guidelines for planning of health care resources and underline and quantify the challenge for primary and secondary cancer prevention in Saarland.

Age Factors↗
PubMed1991

Cs-134/137 contamination and root uptake of different forest trees before and after the Chernobyl accident.

The Cs-134/137 activities were measured from different tree organs of spruce, larch and sycamore maple. Two locations in South Bavaria were monitored during a period of 2.5 years following the Chernobyl accident. Samples taken in 1985 allow to determine the Cs-137 contamination before the accident. Increasing Cs-137 activities from older to younger needle years of Picea abies caused by root-uptake of the global weapons' fallout are due to the high phloem mobility of this element and the remaining of the needles at the tree for about 6-7 years. In contrast, the Cs-137 activity was much smaller in leaves of larch and sycamore maple. After the Chernobyl accident, the higher contamination of spruce greater than larch greater than sycamore maple is dependent on the roughness of bark, absolute bark surface and the existence of leaves during the deposition of Chernobyl-derived radioactivity. The Cs-134/137 activity (Bq/kg d.w.) was about 25-times higher in bark compared to wood of Picea abies and 1.5-4.7 times higher in directly contaminated twig-axes than in leaves. Till the end of the investigation the major contamination of the shoots was due to direct deposition of cesium on the trees. A maximum of 5-15% of the total activity of the directly contaminated branches of the plants was calculated to be part of root-uptake, depending on the amount of initial retention. 20% of the translocated cesium into new leaves of larch and about 50% into sycamore maple resulted from root-uptake 2.5 years after the accident.

Accidents↗
PubMed1991

[Do cancer patients survive longer today than before? Survival analysis of cancer patients in the Saar region from 1972 to 1986].

In the Saarland there is a population-based cancer registry, which has collected information about cancer cases over a long period. An important task of population-based cancer registries is the analysis of its data in respect to incidence, mortality and survival of cancer patients. Not all patients who have been diagnosed with cancer die of that disease. In order to evaluate the survival of cancer patients in respect of their particular disease, survival rates are calculated after the determination of the influence of other causes of death. The so-called relative survival rates (calculated for the first five years after diagnosis) are also used in order to evaluate simultaneously the prognostic importance of variables such as sex, age and year of diagnosis. This analysis with data from the cancer registry of the Saarland deals with 9 tumor localizations: stomach, colon, rectum; breast, cervix uteri and corpus uteri; prostate, lung, malignant skin melanoma. In general the 5-year relative survival rates slightly increased when the time period 1972-1976 was compared with 1982-1986. Cancer of the corpus uteri was one exception, in that the relative survival rate was constant over time, and cancer of the cervix uteri was another, in that a decrease of relative survival rate was found, which together with the decreasing incidence might be ascribed to a successful early detection program. There was no significant improvement in the relative survival time for lung or breast cancer patients.

Adult↗
PubMed1991

The role of socioeconomic factors in the survival of patients with colorectal cancer in Saarland/Germany.

The role of socioeconomic factors in the survival of patients with colorectal cancer was assessed using data from the cancer registry of Saarland/Germany, and census information. Among 2627 patients with colorectal cancer diagnosed from 1974 to 1983, patients from communities in the lowest of three categories defined by socioeconomic factors showed significantly lower survival rates than patients from other communities. After adjustment for potential biological and other sociogeographic risk factors in multivariate analyses, relative hazard of death associated with low socioeconomic status (SES) compared with high SES was estimated to be 1.22 (95% CI: 1.01-1.47) for colon cancer and 1.32 (95% CI: 1.09-1.60) for rectum cancer. The results are in agreement with earlier studies from North America, Hawaii and Sweden and indicate that an attempt to improve health care services and acceptance and possibly other relevant general living conditions in socioeconomically less privileged communities may be a rewarding approach towards increasing survival of patients with colorectal cancer.

Aged↗
PubMed1991

[Fluoride excretion in schoolchildren with differing systemic fluoride care].

The aim of the present study was to collect data on urinary fluoride output in 8-16-year old students exposed to either drinking water fluoridation (DWF), or domestic salt fluoridation (DSF). Spot urine samples were collected in the canton of Basel-Stadt (DWF, n = 123), in the canton of Berne (DSF, n = 264), in the county of Davos (DSF, n = 241), and in the city of Winterthur (DSF, n = 40). Furthermore, fluoride concentrations were determined in plasma samples drawn from 33 students from Winterthur. The urinary fluoride concentrations were higher in Basel and Davos (0.62 +/- 0.35 mg/l; 0.61 +/- 0.42 mg/l) than in Berne and Winterthur (0.46 +/- 0.42 mg/l; 0.50 +/- 0.31 mg/l). A relatively high natural fluoride content (0.3 mg/l) in the drinking water explained the difference in urine fluoride concentration between students from Davos and the two other regions with domestic salt fluoridation (Berne, Winterthur). The average fluoride concentration in plasma was 12.7 +/- 3.8 ng/ml. We concluded that, in general, the supply with fluoride consumed with fluoridated domestic salt is close to the level obtained with drinking water fluoridation. However, in areas with very low systemic fluoride supplementation through the drinking water this level might not be reached with salt as the only source of systemic fluoride. Also, the data confirmed the safety of domestic salt fluoridation.

Adolescent↗
PubMed1991

Management of severe hepatic trauma by two-stage total hepatectomy and subsequent liver transplantation.

Even today major hepatic trauma remains a formidable surgical challenge with considerable deaths from exsanguination. Apart from conservative operative techniques that allow successful management in most cases, liver transplantation may be indicated in a more severe injury. This is a report on a patient with massive, unsalvageable liver trauma on whom the first two-staged procedure was successfully performed. After total hepatectomy as the first step and a prolonged anhepatic period of more than 14 hours, liver replacement by an allograft was carried out in a second operation. The patient recovered completely from the potentially lethal hepatic trauma and is alive more than 17 months later.

Accidents, Traffic↗
PubMed1990

[Antinuclear antibodies as early diagnostic criteria of developing collagen disease in quartz dust exposure--a case report].

One and a half years antinuclear autoantibodies (ANA) against Scl-70 and U1-RNP were found in the serum of a quartz dust exposed worker before the clinical manifestation of the progressive systemic sclerosis (PSS). Only a discrete lung fibrosis and an enlargement of the heart was seen at the time of the first autoantibody detection. Because workers with an intensive and long-lasting quartz dust exposition take a high risk to develop PSS a sensitive ANA-screening is indicated at minimum suspicion of chronic collagen disease. The detection of a high ANA-titer in a clinical healthy person may give a hint for the possible future development of such a disease and requires the observation of the clinical course and the paraclinical and immunological parameters. A lung fibrosis and/or an enlargement of the heart in X-ray photographs would indicate visceral early manifestations of the PSS before skin symptoms appear.

Antibodies, Antinuclear↗
PubMed1990

Alteration of physiological parameters in needles of cloned spruce trees (Picea abies (L.) Karst.) by ozone and acid mist.

Three-year-old clonal spruce trees, kept in growth chambers, were treated with ozone and acid mist during a period of 14 months. One half of the trees were grown on an acidic sandy soil, the other half on a calcareous soil rich in carbonate. At the end of the fumigation period, carbohydrates (glucose, fructose, sucrose, raffinose, starch, glucose-1-phosphate and fructose-6-phosphate) and parameters of the energy status (ATP-, AdN-(ATP + ADP + AMP)- levels, ATP/ADP-ratios and adenylate-energy-charge-(AEC)-values) were determined in the current-year's needles. The results indicate that the metabolic status of a plant tissue is not only influenced by the nature of the air pollutants. Soil factors play an important role in metabolic changes within the plant and are thus of relevance in the manifestation of damage symptoms.

Journal Article↗