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Biomedical subjects

J Wolter

Publications and source records attributed to J Wolter.

At least 55 records · Page 3Linked to original sources
PubMed1978

Treatment of histiocytic and mixed lymphomas: a comparison of two, three and four drug chemotherapy.

The Eastern Cooperative Oncology Group has studied 187 patients with generalized progressive malignant lymphoma classified as having the histologic sub-types histiocytic or mixed. Histology review by the Pathology Panel for Lymphoma Clinical Trials demonstrated a 31% disparity with contributing institution's pathologists in regard to cell type, but good agreement with interpretation of nodular or diffuse nodal pattern. Patients were assigned at random to treatment with cyclophosphamide 1 g/m2 on day 1 and prednisone 100 mg/m2 daily for five days (CP); CP plus vincristine 1 mg/m2 on day 1 (CVP); or CVP plus BCNU 60 mg/m2 on day 1 (BCVP). Chemotherapy was given for nine, twenty-one day cycles. The observed complete remission rates were CP-21%, CVP 34%, BCVP 34%. Both CVP and BCVP had significantly more complete remissions than CP, but survival following CVP (118 weeks) was significantly longer than that following either BCVP (76 weeks) or CP (74 weeks). Histologic sub-type, lymph node pattern, response to chemotherapy, performance status and stage of disease were also found to influence survival.

Adult↗
PubMed1977

"To select better--to shunt better" prerequisites for better shunt therapy in liver cirrhosis. Review.

Essentially 3 facts are responsible for the poor clinical outcome after porta-caval shunt in liver cirrhosis today: 1. Further reduction of hepatic blood flow, 2. total or nearly complete deprivation of the liver of portal venous blood supply with essential substances and functions and 3. insufficient criteria for selection. Since there exists no alternative procedure in decompressing bleeding varices in the end, porta-caval anastomoses will have to be performed also in the future. Therefore all efforts must be undertaken to improve the operative and longterm results, including a better preoperative selection and a better shunting. Determination of "functional" liver volume, knowledge of hepatic arterial reaction and preoperative determination of the intrahepatic shunt-flow might be very promising aspects in the selection today. In porta-caval surgery a differentiated choice of the available shunting methods to be applied, especially techniques for selective decompression and liver arterialization, may improve the results. Finally, the aim in each case should be a porta-caval shunt adapted to the individual situation of the cirrhotic patient.

Blood Pressure↗
PubMed1977

Results with methyl-CCNU and DTIC in metastatic melanoma.

This report is the result of an Eastern Cooperative Oncology Group (ECOG) study. Four hundred and 15 patients with inoperable metastatic malignant melanoma, excluding those with cutaneous metastases only, were randomized to one of three drug treatments: DTIC alone, methyl-CCNU alone, or the combination DTIC plus methyl-CCNU. Responses were seen in 14% of DTIC patients (19/127), 15% of methyl-CCNU patients (18/119) and 14% of DTIC plus methyl-CCNU patients (18/122). Duration of response was the same (14 weeks) for all three treatment groups. There was no difference among the treatments in achieving complete responses. Survival was improved significantly for responders (50 weeks) compared with nonresponders (15 weeks) regardless of treatment regimen. Toxicities were generally tolerable. DTIC caused significantly more gastrointestinal toxicity than methyl-CCNU. Methyl-CCNU caused significantly more bone marrow toxicity than DTIC. There were three drug-related deaths. All occurred in patients on combination DTIC plus methyl-CCNU. Important pretreatment characteristics that favor response are ambulatory status, female, less than 50 years old, no prior chemotherapy and no liver or brain metastases. Patients with favorable characteristics combinations had a 30% response rate, while those with unfavorable characteristic combinations had only a 9% response rate.

Brain Neoplasms↗
PubMed1977

[Angiographic studies of kidney failure in endotoxinemia].

Exogeneous endotoxaemia caused vasoconstriction of the juxtaglomerular arteries in otherwise healthy minipigs. This supports the view that reduced renal cortical blood flow in patients with liver disease can be caused by endotoxin. After portocaval anastomosis the efficacy of the liver RES to clear endotoxin was decreased due to the haemodynamic disorder. Thus, a dose of endotoxin, which was sublethal to healthy animals, became lethal owing to decreased RES-function. The increased endotoxin toxicity leads to a Shwartzman-Sanarelli-reaction. A dose of toxin which caused death in all animals with a portocaval shunt alone was not lethel in any animal in which an arterialization procedure was simultaneously performed, suggesting a possible improvement of RES function. These findings are of clinical importance for patients with renal failure in liver cirrhosis and hepatic failure. They suggest that endotoxaemia is of pathogenetic relevance in the development of functional renal failure.

Animals↗
PubMed1976

Results of a randomized study comparing DTIC with TIC mustard in malignant melanoma.

This prospective randomized Eastern Cooperative Oncology Group (ECOG) study (1071) was designed to compare a new and promising cytotoxic agent TIC Mustard (triazeno imidazole carboxamide mustard, NSC 82196) with DTIC (dimethyl triazeno imidazole carboxamide, NSC 45388) in the treatment of inoperable melanoma. One hundred and seventy-eight patients were randomized to receive either DTIC (150 mg/m2/day X 5) or TIC Mustard (800 mg/m2/day X 5). Of this group 145 patients were evaluable for tumor response at the completion of the study. Objective responses were seen in 15/79 (19.0%) DTIC patients and 4/66 (6.1%) TIC Mustard patients. Adjustment of crude response rates yielded final response rates of 18.2% for DTIC patients and 5.8% for TIC Mustard. These differences were significant at the p less than or equal to .03 level. Median response duration was 15 weeks for the DTIC responders and 4 weeks for the TIC Mustard responders. Responders and nonresponders did not differ significantly in any of the standard prognostic categories. However, responders had a significantly longer median survival (47.5 weeks) compared to that for nonresponders (17.8 weeks). Toxicity was tolerable for either drug and no deaths were ascribed to either. We conclude that TIC Mustard has limited usefulness in the treatment of malignant melanoma and is less effective than DTIC.

Clinical Trials as Topic↗