Biomedical subjects

J Hermans

Publications and source records attributed to J Hermans.

At least 487 records · Page 27Linked to original sources

PubMed1987

Radiation-induced skin cancer and radiodermatitis of the head and neck.

From a cohort of 2400 patients who had been irradiated 19 to 48 years previously for benign diseases in the head and neck region a randomly selected group of 605 patients was selected and traced back. From the 360 patients alive, 257 were examined clinically and 49 were examined by questionnaire for radiation-induced skin tumors and radiodermatitis. In 21 patients, a total of 30 skin tumors were diagnosed. In 8 of 21 patients, 10 skin carcinomas were detected at recall. A dose-effect relationship of 40 carcinomas/10(4) persons/Gy for a median follow-up period of 41 years for the area exposed was calculated. The severity of radiodermatitis is associated with a higher prevalence of skin cancer. The number of radiation-induced skin cancers rises with the post-treatment time. Because of these late radiation effects, radiotherapy of benign skin lesions is contraindicated, especially now that other therapy modalities are available.

Age Factors↗

PubMed1987

Tumor ploidy as a major prognostic factor in advanced ovarian cancer.

Tumor ploidy was determined by flowcytometry (FCM) in paraffin-embedded tissue of 74 patients with advanced ovarian cancer (International Federation of Gynecology and Obstetrics [FIGO] 2B, 3, 4). Significant differences in survival and progression-free survival were found between classes of tumor ploidy as well as for several clinical parameters, including FIGO stage, histologic grade, diameter of the largest metastases, presence of ascites, peritoneal carcinomatosis, and size of residual tumor. In a Cox regression analysis, tumor ploidy and presence or absence of ascites were the only significant factors for survival, whereas ascites and residual tumor proved to be the significant parameters for progression-free survival. Tumor ploidy was strongly associated with tumor bulk, size of residual tumor, and histologic grade. Tumor ploidy was the same within different tumor sites in the majority of the cases. On the basis of these findings tumor ploidy is considered to be a major prognostic factor for survival in advanced ovarian cancer.

Adult↗

PubMed1987

DNA ploidy and survival in breast cancer patients.

Flow cytometric DNA ploidy measurements using frozen or deparaffinized tumor specimens were performed on 565 primary breast cancers from patients treated in the period 1975-1984. Twenty-nine percent of the cases were diploid, 61% had a single aneuploid stemline, and 10% were multiploid. Aneuploid tumors more often had negative estrogen receptor values than diploid tumors, but no significant correlation was found between ploidy class and TNM stage. Patients with more than ten positive axillary lymph nodes had predominantly aneuploid tumors. Overall and distant relapse-free survival were higher for patients with diploid tumors and low-aneuploid tumors. Stratification of the patients according to degree of lymph node involvement, TNM stage, and menopausal stage showed that the prognostic effect of aneuploidy was apparent predominantly in patients with locally advanced disease. Postmenopausal node-positive patients with diploid tumors had a significantly better prognosis than those with aneuploid tumors, but this difference was not found for the comparable premenopausal group. Multivariate analysis with the Cox proportional hazards model indicated that ploidy is an additional, independent prognostic factor in postmenopausal patients.

Aneuploidy↗

PubMed1987

An evaluation of routine follow-up for detection of breast cancer recurrences.

Four hundred patients who were radically treated for breast carcinoma during the period May 1974 to December 1980 were followed for a minimum of 4 years. The outcomes of the 128 patients with recurrences were studied. A differentiation into two groups was made: those in whom recurrences were detected as a real result of follow-up (27%) and those in whom this was not the case (73%). Both groups were comparable as regards age, period "at risk," nature and site of recurrence, type of therapy instituted, and their response to it. No differences could be found in any of these factors. The recurrence-free interval, the survival after institution of therapy, and the total survival after the primary procedure were the same in both groups.

Breast Neoplasms↗

PubMed1987

The relation between plasma and tissue concentrations of antibiotics. Description of a method.

A mathematical approach to calculate rate constants of the distribution of antibiotics between plasma and tissue is described. The calculations are based on the assumption that the drug moves between plasma and tissue passively according to the law of diffusion. Corrections can be made for binding to tissue and to plasma proteins. Two mathematical procedures are compared, one based on multiple regression analysis of areas under the curves of the plasma and tissue concentrations and the other on simultaneous curve-fitting to plasma and tissue concentration curves. The method is illustrated for amoxycillin and erythromycin in murine thigh muscle. The half-life of distribution to this tissue is less than 2 min for amoxycillin and about 10 min for erythromycin, and the ratio between the free extracellular tissue concentration and the total tissue content is 4.25 for the former and 0.35 for the latter.

Amoxicillin↗

PubMed1987

Percentage of S-phase cells in bone marrow aspirates, biopsy specimens and bone marrow aspirates corrected for blood dilution from patients with acute leukemia.

For 14 patients with acute leukemia flow cytometry was used to determine the percentage of cells in S-phase flushed out of a bone marrow biopsy compared with the percentage in a bone marrow aspirate; there was a statistically significant difference (p less than 0.01) between the two. The percentage dilution of the bone marrow aspirate by peripheral blood was then calculated, according to Holdrinet et al. [1], in order to correct the percentage S-phase cells in the aspirate. The data presented show that when the percentage S-phase cells in the aspirate is corrected for blood dilution, it closely approaches the percentage S-phase cells in the biopsy (p greater than 0.10).

Biopsy↗

PubMed1987

Assessment of patient-staff and intrastaff problems in psychiatric consultations.

In a study of 249 consecutive inpatient consultations, the occurrence of patient--staff or intrastaff problems as determined by the psychiatric consultation team was compared with questionnaire answers, provided by the consultant following each consultation, and interpreted as indications for such staff problems. According to the consultation team, staff problems played a role in 33% of the consultations. In the questionnaires, of the nine criteria statistically significantly related to the occurrence of staff problems, the following were the most relevant: 1) emotional tone or wording of request; 2) abnormal timing of referral; 3) request unclear; 4) unjustified urgency of referral; and 5) existence of hidden questions. If none or only one of these criteria were positive, then there was little chance that staff problems were present. If three or four criteria were positive, then the probability of staff problems was much higher. If the first three criteria were negative, then staff problems were hardly ever encountered.

Hospital Bed Capacity, 500 and over↗

PubMed1987

Non-gonococcal infectious arthritis: a retrospective study.

In a retrospective study the outcome of non-gonococcal infectious arthritis was evaluated in 76 adult patients admitted to the Leiden University Hospital between 1970 and 1984. The mortality rate was 12%, and complete recovery was achieved in only 19 of the 76 patients (25%). Each of the following had a significantly unfavourable influence on the residual joint function: duration of infection more than 14 days, female sex, presence of rheumatoid arthritis, and presence of a joint prosthesis.

Adolescent↗

PubMed1987

The penetration of erythromycin into human bronchial mucosa.

1 In this paper the pharmacokinetic relation between concentrations of erythromycin in plasma and in bronchial mucosa was established. 2 Sixteen patients undergoing bronchoscopy received 1 g erythromycin by continuous infusion in 30 min. 3 Two bronchial mucosal samples were taken from each patient sometime after drug administration. Concentrations were determined in the mucosal sample and in several plasma samples collected at different times before the mucosal sample. 4 Rate constants for the distribution between plasma and tissue were calculated on the basis of the assumption of passive diffusion of the free drug. 5 Mean values of the distribution rate constants, calculated by a nonlinear curve fitting procedure, were 2.40 h-1 for distribution from plasma to tissue and 1.28 h-1 for that from tissue to plasma. 6 These values correspond to a half-life for the distribution of the free drug of 33 min and a free fraction of the drug in mucosal tissue of 0.20.

Bronchi↗

PubMed1987

Utility of the FAB classification for myelodysplastic syndromes: investigation of prognostic factors in 237 cases.

The utility and prognostic significance of the FAB classification was studied in 237 patients with a myelodysplastic syndrome. No significant differences in actuarial survival and probability of transformation to acute leukaemia were found in patients with RA, AISA or CMML. The median survival time for the RA group was 50 months, for the AISA and CMML subclasses more than 60 months. The probability of transformation for the RA, AISA and CMML subgroups showed a linear trend with a probability of 25% for the RA, 16% for the AISA and of 18% for the CMML groups after a 5 year observation period. A uniformly poor prognosis was found for the RAEB and RAEB/t subgroups with median survival times of respectively 9 and 6 months. Chromosomal abnormalities were found in 68 out of 155 patients (44%). Patients with only normal metaphases or with abnormal metaphases together with karyotypic normal cells had a longer median survival time and a lower probability for transformation as compared to those with only abnormal metaphases. The most important factor in prognosis is the number of blast cells in blood and bone marrow. Age and sex, and certain quantitative and qualitative abnormalities in the peripheral blood appear of limited prognostic value for patients with RA, AISA and CMML. The longer life expectancy of 35 patients with CMML as compared to other series seems to be related to the percentage of blast cells at the time of diagnosis.

Adult↗

PubMed1987

Staging and treatment of non-Hodgkin's lymphoma of intermediate-grade malignancy: a retrospective study of 102 cases.

Since the introduction of the Working Formulation for Clinical Usage, 3 different prognostic groups are recognized among the various histological classifications of non-Hodgkin's lymphomas. We looked at the lymphomas of intermediate-grade malignancy and studied retrospectively the staging and treatment of 102 patients. Almost half of the patients with clinical stage I disease, who therefore received radiotherapy only, later appeared to have had more extended disease. For patients with stage II, III and IV disease the complete remission rate was significantly higher with CHOP than with CVP (76% versus 36%). However, once complete remission was achieved there was no difference in disease-free survival between the 2 groups (at 4 yr, 50% of the patients were in complete remission). As far as the amount of cytostatic drugs given during the initial courses of chemotherapy is concerned, no difference was found between patients who achieved complete remission and those who did not. Most patients did not receive the full dosage. For those patients who did not respond well to initial therapy, or who suffered a relapse, second line therapy was disappointing.

Adult↗

PubMed1987

Prospective evaluation of prognostic value of morphometry in patients with primary breast cancer.

In a prospective study the predictive value of a multivariate morphometric prognostic index was evaluated in 195 patients with primary breast cancer who had not been treated with any form of chemotherapy or hormonal treatment. The presence or absence of distant tumour recurrence combined with the scores of the prognostic index were compared with the survival curves predicted in a previous study. The value of the presence of lymph node metastases, number of positive nodes, tumour size, mitotic activity index, and oestrogen receptor status in prediction of prognosis were also investigated. In agreement with the results of the previous retrospective study, the prospective use of the index had the strongest predictive prognostic value, followed by the mitotic activity index. Statistical analysis showed that the actual prognoses of 43 of the 195 patients (22%) were more accurately determined by the prognostic index rather than by using the presence of the lymph node metastases as the classifying variable. The prognostic index is consistently reproducible by different technicians; it is a reliable method of predicting distant recurrence of tumour and hence the prognosis of patients with primary breast carcinoma. It provides more prognostic information than the presence of lymph node metastases alone, and the index should be incorporated in routine pathology reports.

Adult↗

PubMed1987

Hemostatic agents: brain tissue reaction and effectiveness. A comparative animal study using collagen fleece and oxidized cellulose.

In a series of 26 young rabbits, three cortical lesions were made in each hemisphere. Two of these holes were filled with collagen fleece (CF) and oxidized cellulose (OC), respectively, while the third was left empty as a control. The bleeding time was measured. Hemostasis with CF was statistically significantly faster than with OC, which in turn was statistically significantly faster than with no hemostatic agent. The animals were killed successively on Days 7, 14, 28, 42, and 241 after operation. Histopathological investigation showed that CF did not induce more tissue reaction that the control lesion and that CF was resorbed faster than OC. The removal of OC occurred from the borders of the material, moving gradually inward. With CF, there was an immediate ingrowth of reactive cells throughout the material. In contrast to OC, CF did not induce the formation of polynucleated giant cells. From these results, it can be concluded that CF is a fast, safe, and absorbable topical hemostatic agent suitable for use in neurosurgical procedures.

Animals↗

PubMed1987