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Biomedical subjects

K Buser

Publications and source records attributed to K Buser.

At least 37 records · Page 2Linked to original sources

[The prevalence of neurodermatitis among school children in the Hannover administrative district].

A special questionnaire was developed to obtain up-to-date data on the prevalence of atopic dermatitis among children. It was validated by specialist diagnosis in 320 children, providing a diagnostic sensitivity and specificity of 97%. This questionnaire was used for all school entrants in 1990 in the Hanover District. A total of 4,916 children were examined and the questionnaire satisfactorily completed by a relative or guardian (usually the mother) of 4,651. The prevalence of atopic dermatitis was 11.8%, ranging from 8.4% to 17.3% among the 20 constituent communities. The regional differences were smaller than the scatter of diagnostic classifications by the school doctors and the reports of a positive history by the parents. The results demonstrate the validity of a systematic enquiry employing relevant diagnostic and anamnestic items.

Child↗

Cytostatic drug resistance: parallel assessment of glutathione-based detoxifying enzymes, O6-alkylguanine-DNA-alkyltransferase and P-glycoprotein in adult patients with leukaemia.

The levels of several potential indicators of resistance to cytostatic drugs were measured in leukaemic cells of a total of 64 adult patients with acute or chronic leukaemias before and during treatment and at relapse or recurrence of disease and compared with those of mononuclear cells from the bone marrow of healthy donors. The resistance factors included glutathione (GSH) and its associated enzymes glutathione-S-transferase (GST) and glutathione peroxidase (GPx) as well as O6-alkyguanine-DNA-alkyltransferase (ATase) and P-glycoprotein. Median values for most parameters were significantly higher in leukaemic cells than in those of normal donors although wide interindividual variation in the values of the various parameters, particularly GST, were seen. P-glycoprotein was measurable in 12.5% of untreated leukaemias but in none of the normal donors. The values of the parameters in untreated leukaemic patients were not statistically different from those at relapse or during disease progression. However, the median values for GSH, GST and GPx but not ATase in samples from untreated patients were significantly higher than those in samples taken during drug treatment. Patient response, disease-free survival or duration of remission did not correlate with the values of any of the parameters studied.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

[Leiomyosarcoma of the breast 16 years following successful treatment of a rhabdomyosarcoma of the orbit in childhood].

A case of a mammary leiomyosarcoma in a 23-year-old woman is presented. The tumor appeared 16 years after successful treatment of an embryonal rhabdomyosarcoma of the orbit. Rhabdomyosarcomas are the most frequent soft tissue tumors of childhood, the orbit and the paratesticular region being the most common primary site for this tumor. In contrast, leiomyosarcomas other than those evolving from the viscera or the urogenital organs are rare neoplasms at any age. With the improvement of cancer treatment and survival rates, the risk of late effects after successful treatment for malignant tumors during childhood is increasing. Growth, development and fertility may be impaired and cosmetically disturbing facial and dental complications are common. Development of novel primary tumors is a known further consequence of successful treatment of brain tumors, retinoblastoma and acute leukemias. This is the case when high dose local radiation therapy and/or chemotherapy, especially alkylating agents, were used. Development of novel primary tumors is also known after treatment of childhood rhabdomyosarcomas. This report is intended to show that a second primary tumor may occur many years after a first successfully treated malignant neoplasm, and that young people are at risk for development of tumors at sites that are uncommon to this age group.

Adult↗

Comparison of the anti-emetic efficacy of different doses of ondansetron, given as either a continuous infusion or a single intravenous dose, in acute cisplatin-induced emesis. A multicentre, double-blind, randomised, parallel group study. Ondansetron Study Group.

A total of 535 chemotherapy naive, hospitalised patients (263 male/272 female) scheduled to receive cisplatin (50-120 mg m-2)-containing regimens participated in a randomised, double-blind, parallel group study to evaluate the efficacy and safety of three intravenous dose schedules of ondansetron in the prophylaxis of acute nausea and emesis. One hundred and eighty two patients received a loading dose of 8 mg of ondansetron followed by a 24 h infusion of 1 mg h-1 (group 1); 180 and 173 patients received single doses of 32 mg (group II) and 8 mg (group III) respectively, followed by a 24 h placebo infusion. Complete and major control (less than or equal to 2 emetic episodes) of acute emesis was achieved in 74% of patients in group I, 78% in group II and 74% in group III. Seventy seven per cent of the patients in group I, and 75% of patients in groups II and III respectively experienced no or mild nausea during the 24 h observation period. A retrospective stratification of the efficacy data on the basis of patient gender showed the response rate in females to be significant lower (43% vs 67%; less than 0.001). Ondanestron was well tolerated; mild headache was the most commonly reported adverse event (11% of patients) with a similar incidence in the three groups of patients. In conclusion, a single intravenous dose of 8 mg of ondansetron given prior to chemotherapy is as effective as a 32 mg daily dose given as either a single dose of a continuous infusion in the prophylaxis of acute cisplatin-induced emesis.

Adult↗

Nicotine gum assisted group therapy in smokers with an increased risk of coronary disease--evaluation in a primary care setting format.

Smoking cessation with the aid of nicotine chewing gum in a primary care setting format is reported to be more effective when additional behavioural training is introduced. We developed a standardized comprehensive treatment programme using nicotine chewing gum (Nicorette 2 mg) in conjunction with nutritional information for the prevention of weight gain, behavioural training for the promotion of self-management techniques and the prescription of a date when to quit. The programme was conducted by 11 family physicians in a group setting format with 12 weekly 90 min sessions and three booster sessions. After an introduction to the programme, each physician selected smokers with additional risk factors for coronary heart disease from the files. Experimental and control subjects were matched for age, gender, cigarette consumption and duration since smoking onset. Complete data were obtained from 86 treated and 53 control subjects. The drop-out rate among the treated subjects was 5.8%. After the 3 month follow-up, data assessment shows an abstinence rate of 63.9% in the experimental subjects, a fact verified by CO measurements. Compared to the control group, blood pressure, heart rate, cholesterol and glucose levels did not change significantly during treatment. Weight increased by 1.7 kg. After a 12 month follow-up, abstention rates decreased to 52.3%. Abstainers reported less physical complaints and increased well-being when compared to control subjects or to treatment failures at both follow-up assessments. Changes in the risk profile, apart from smoking, were not verified.

Adult↗

Assessment of P-glycoprotein, glutathione-based detoxifying enzymes and O6-alkylguanine-DNA alkyltransferase as potential indicators of constitutive drug resistance in human colorectal tumors.

Drug resistance is a major problem in cancer chemotherapy. Treatment protocols generally include a number of different cytotoxic drugs given in combination. Therefore, drug resistance in the tumor is likely to result from the coexpression of several cellular activities able to prevent cell killing by any of the drugs used. In this study we have measured several potential drug resistance mechanisms consisting of the multidrug resistance gene product P-glycoprotein, glutathione, glutathione-transferase and -peroxidase, and the DNA repair enzyme O6-alkylguanine-DNA-alkyltransferase in samples of colon carcinoma and normal adjacent mucosa from 23 untreated patients. All of these, with the exception of P-glycoprotein, showed significant increases in tumor tissue levels when compared with normal tissue from the same patient. The significance was highest for glutathione peroxidase (P less than or equal to 0.0005). Individual patients, however, showed very different patterns, with none, several, or all monitored resistance mechanisms elevated in the tumor. The implications both in the choice of drugs and in the use of resistance modifying agents to improve therapy for the individual patient are discussed.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

[Ovarian carcinoma: current therapeutic aspects. A review].

Ovarian cancer is the leading cause of gynaecologic cancer death and the fourth most frequent cause of cancer death in women. 70% of all ovarian cancers will be diagnosed only at an advanced stage of the disease despite the improvements in diagnostic tools. Standard therapeutic concepts and new therapeutic modalities are discussed. Staging laparotomy with cytoreductive surgery is the most important part of initial patient management. Second-look operation has recently come under criticism, as it probably offers only minor therapeutic benefit. However, it remains the golden rule for evaluating different therapy modalities in the setting of a clinical trial. After surgery, chemotherapy is indicated for all patients with ovarian cancer FIGO stage III and IV. The question whether all patients with stage I and II disease need additional treatment remains unresolved. The standard regimen for patients with advanced ovarian cancer consists of six months' chemotherapy with a combination of cisplatin and an alkylating agent. Current cisplatin containing regimens achieve a clinical response rate of 60-80% and a documented pathologic complete response rate of 30% overall. Despite higher overall response rates and increased disease-free survival rates with cisplatinum combinations, long term survival is not significantly altered. Investigative approaches with intraperitoneal chemotherapy, biologic response modifiers and drug resistance modifiers may open new therapeutic avenues for this challenging disease. Radiotherapy (open field technique) also represents a highly active and curative treatment modality for certain ovarian cancer patients. Nowadays radiotherapy is mainly used as adjuvant treatment for patients with low risk early stage disease and as consolidation treatment for patients with complete remission after chemotherapy and second-look operation.

Adult↗

[Preventive and therapeutic measures in cytostatic-associated toxicity].

Strategies (both prophylactic and therapeutic) to reduce side effects of chemotherapy are reviewed. In particular, issues concerning proper patient information are discussed which should help to increase patient compliance. Chemotherapy, especially regimens with a curative intent, must normally be administered under the guidance of an oncologist. However, close cooperation with the general practitioner is essential in order to ensure high quality counselling and treatment of the outpatient.

Alopecia↗

[BRL 43694A--a 5-hydroxytryptamine receptor blocker as an antiemetic in cytostatic therapy].

An open study of the new antiemetic BRL 43694A, a 5-hydroxytryptamine-3-receptor antagonist, was performed in 29 patients undergoing highly emetogenic cancer chemotherapy (25 patients received cisplatin in a dose greater than or equal to 50 mg/m2). Patients received BRL 43694A as a 30-minute infusion one hour after the administration of chemotherapy. 7 patients were treated with 40 micrograms/kg and 13 patients with 100 micrograms/kg BRL 43694A; the last 9 patients received an initial dose of 40 micrograms/kg with a provision for two additional interventional doses over 24 hours in the event of prolonged nausea or vomiting. 14 patients experienced no vomiting (48%) and 13 patients (45%) had 1-5 vomiting episodes over 24 hours following administration of the cytostatic agents. BRL 43694A did not cause major side effects. Based on our preliminary experience the new 5-HT3-receptor antagonist BRL 43694A is a potent antiemetic drug for the treatment of chemotherapy-induced nausea and vomiting.

Adult↗

[Chemotherapy of bronchus carcinoma].

The use of chemotherapy will eventually be discussed in most patients with lung cancer, due to the systemic nature of the disease. In small cell lung cancer combination chemotherapy will achieve a response in the majority of patients and will lead to a five-fold increase in median survival. A small proportion of these patients will survive disease-free for a prolonged period of time and may be cured of their disease. In non-small cell lung cancer about one third of all patients will achieve an objective tumor response with the use of cisplatin-based combination chemotherapy. There is a small, but definite increase in median survival with the use of combination chemotherapy compared to best supportive care alone. Also in non-small cell lung cancer a small proportion of patients will survive after combination chemotherapy for a prolonged period of time. The use of cytotoxic treatment in lung cancer is associated with considerable toxicity so that optimal supportive care is mandatory.

Antineoplastic Combined Chemotherapy Protocols↗

Geographical distribution of mortality rates for cerebrovascular disease in Lower Saxony (Federal Republic of Germany).

Using the official mortality statistics for the 46 districts of Lower Saxony (Federal Republic of Germany) for the years 1975-1977, the geographical distribution of mortality from cerebrovascular disease was studied. Only in women was a slight tendency towards higher rates in rural areas found. There were only moderate correlations with the rates for ischaemic heart disease and no statistically significant correlations with the rates for diseases of peripheral vessels.

Cerebrovascular Disorders↗

Ovarian cancer and tumor markers: sialic acid, galactosyltransferase and CA-125.

In an effort to correlate the serum values of potential markers, including CA-125, galactosyltransferase, and total sialic acid, with residual tumor mass after initial surgery, 43 patients with FIGO stage IIb and c, III and IV ovarian cancer were studied. The sensitivity of galactosyltransferase and sialic acid levels was sufficient to correlate their serum values with the corresponding residual tumor mass. Furthermore, 28 patients were histopathologically evaluated for their response to chemotherapy. Determination of these tumor markers did not permit discrimination between small residual disease (less than or equal to 1 cm) and a state of 'no evidence of disease'. Conversely, progression of disease has been associated with a sensitive increase in the level of all three markers. CA-125 has been found to be the most useful of the three for distinguishing between responders and nonresponders.

Antigens, Neoplasm↗

The human c-Kirsten ras gene is activated by a novel mutation in codon 13 in the breast carcinoma cell line MDA-MB231.

We have detected amplified human Ki-ras sequences in tumorigenic NIH 3T3 cells transfected with genomic DNA from the human breast carcinoma cell line MDA-MB231. Hybridization of synthetic oligonucleotides specific for human Ki-ras sequences showed a mutation at codon 13. The polymerase chain reaction with Ki-ras specific amplimers revealed a guanosine to adenosine transition at the second position of codon 13, resulting in a substitution of glycine by aspartic acid. The codon 13 mutation is also detected in one Ki-ras allele of the MDA-MB231 cell line.

Animals↗