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Biomedical subjects

K Wilms

Publications and source records attributed to K Wilms.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Effects of amalgam on cells of the immune system].

Dental amalgam has been considered to have adverse side effects on the immune system. There are controversial reports, which indicate an increase as well as a decrease in peripheral blood lymphocyte counts due to amalgam fillings. We investigated 2 groups of patients: one group was treated with amalgam restorations for the first time. In the other group all previous amalgam fillings were removed. Before and after treatment we determined the absolute and relative numbers of granulocytes, lymphocytes, monocytes, T cells, B cells, suppressor T cells, helper T cells and NK cells. In addition, functional investigations of T cells were performed. In conclusion, we could not find any effect of amalgam restorations on the immune system regarding the investigated parameters.

Adolescent↗
PubMed1991

What does routine upper gastrointestinal endoscopy contribute to the staging of non Hodgkin's lymphoma?

In view of the discrepancy between the incidence of gastrointestinal involvement by malignant lymphomas, as established in postmortem studies, and the rareness of the corresponding clinical diagnosis, we carried out routine upper gastrointestinal endoscopy in 82 consecutive patients with newly diagnosed non-Hodgkin's lymphoma. 11/40 patients (27.5%) with non-Hodgkin's lymphoma of low-grade malignancy, and 11/42 (26.2%) of those with highly malignant non-Hodgkin's lymphoma revealed involvement of the gastric and/or duodenal mucosa, as diagnosed by oesophagogastroduodenoscopy. Two patients in stage III, two in stage II, and two further patients with presumptive stage I had to be reclassified as stage IV. Due to gastrointestinal involvement, two patients changed from radiation to chemotherapy, and another two patients underwent gastric resections to avoid possible treatment related complications. In the light of these results and the fact that a major basis for the therapeutic strategy in non-Hodgkin's lymphomas represents tumor stage, routine oesophagogastroduodenscopy within the framework of the usual staging examinations should be discussed. In the individual case, this procedure may be of decisive importance for the therapeutic approach and the prevention of complications.

Adolescent↗
PubMed1991

[Benign (reactive) lymphoproliferation or malignant lymphoma?].

Pre-stages and early stages of malignant Non-Hodgkin's-lymphomas mark the border area between benign, reactive lymphoproliferation and neoplastic transformation. The advances of immunological classification of lymphoid cells with monoclonal antibodies and molecular genetic analysis have contributed to our present knowledge of pathomorphology, pathophysiology and nosology of malignant lymphomas. The stepwise evolution between polyclonal reactive lymphoproliferation and clonal autonomous growth in malignant lymphomas are presented by discussion of the mucosa-associated lymphomas (MALT-lymphomas) and typical lymphoproliferative diseases.

Cell Transformation, Neoplastic↗
PubMed1990

[Contribution to the mechanism of the "factor VIII bypassing activity" (FEIBA)-reaction].

The principle of the FEIBactivity hadn't been defined in a sufficient manner up to now. Probably the factor VII or factor VIIa are playing a key role. According to own experiments the factor VII activity increases considerably in activated prothrombincomplex concentrates together with the quotient factor VIIa/VII. Factor VII should be administered in his activated form for bypassing. Fractions with limitation of the activation process to factor VII are of a low thrombogenicity. Among activated coagulation factors factor VIIa persists longest in the circulation and a bypass efficacy can be provoked only by this.

Blood Coagulation↗
PubMed1990

[Activated prothrombin complex preparations for the treatment of anticoagulant hemophilia. Preparation--method of operation--supply possibility].

The mechanism of the bypass activity of prothrombin complex preparatives for treatment of haemophiliacs with circulating anticoagulants remains unclear up to now. The following parameters had been tested with preparatives produced in a different manner (absorption by DEAE-Sephadex A 50, Molselekt A 50, tricalcium phosphate or aluminium hydroxide): Coagulation factors II, VII, IX, X and XII, activated factors VIIa and Xa as well as the FEIB activity. The bypass activity is strongly correlated to the factor VIIa content of the preparatives, however. These results agree with the statements by HEDNER and KISIEL, which had used a factor VII a concentrate for treatment of haemophilia complicated by circulating anticoagulants with success. According to farther investigations factor VII is correlated with the lipid content of the starting plasma. This knowledge is important for optimizing the production procedure of prothrombin complex preparatives with bypassing activity.

Absorption↗
PubMed1990

[New aspects of blood component therapy].

The medical demand for factor VIII is increasing through continuously improved therapy of patients suffering from haemophilia A. The most important raw material for the production of factor VIII is fresh frozen plasma (FFP). Its clinical usage increased in the last few years dramatically. An alternative to FFP is the high grade blood component cryo-poor plasma (CPP). CPP is characterized by a deficiency of factor VIII and fibrinogen which is not of clinical relevance. It can be used instead of FFP in 95% of cases. Thus, FFP is more available for the production of factor VIII and the supply of factor VIII for haemophiliacs will improve.

Factor VIII↗
PubMed1989

Granulocytic differentiation of HL-60 cells is not regulated by DNA de novo methylation.

DNA cytosine methylation and transcription of specific genes are inversely correlated. In granulocytic differentiation of HL-60 cells there is a distinct down regulation of the c-myc proto-oncogene expression, which is probably a causal mechanism. With differentiation of HL-60 cells we found no restriction enzyme fragment length polymorphism (RFLP) within the c-myc proto-oncogene, which indicates that there is no loss of regulatory elements (e.g., TATAA boxes within the first exon). Furthermore, we found no de novo methylation in this region. Methylation of other DNA regions, which could influence c-myc expression, is also not necessary for differentiation, as was shown by inhibition of DNA methylase. L-Ethionine and S-adenosyl-L-homocysteine are both potent inhibitors of DNA methylase and do not influence proliferation of HL-60 cells, as shown by FACS analysis.

Cell Cycle↗
PubMed1989

[When is fresh frozen plasma indicated?].

Fresh frozen plasma is a biological drug for the treatment of selected coagulation disturbances, a valuable substance for therapeutic plasma exchange and for the therapy of surgical haemorrhages within the blood component treatment programme. Since fresh frozen plasma is simultaneously the basic substance for the production of containing factor VIII preparations, a non-indicated excess consumption in hospitals should be avoided in order not to endanger the supply of haemophilia A patients with factor VIII.

Blood Coagulation Disorders↗
PubMed1986

Lung diseases after bone marrow transplantation. Results of a clinical, radiological, histological, immunological and lung function study.

The case histories of 72 subsequently treated patients - 44 with acute leukemia, 10 with chronic myeloid leukemia, 16 with severe aplastic anemia and 2 with neuroblastoma - were analyzed after bone marrow transplantation (BMT) with respect to pulmonary diseases. Thirty-eight patients suffered from a total of 51 pulmonary complications, which led to death in 20. Of 13 patients, 3 died of bacterial pneumonia, all of them during granulocytopenia; 2 of 6 patients died of fungal pneumonia and 2 out of 3 of a mixed bacterial-mycotic infection. Adult respiratory distress syndrome (ARDS) led to death in 2 patients. A granulocyte count under 500/microliter correlated significantly (P less than 0.002) with the fatal outcome of bacterial, fungal and ARDS pneumonia as well as with bronchitis. Viral pneumonia led to death in 8 of 9 patients; in each there was a significant correlation (P less than 0.05) with graft-versus-host disease (GvHD). Patients with repeated episodes of pulmonary illness had significantly more chronic GvHD (P less than 0.05); several of these patients displayed a reduction in helper T cells and an increase in suppressor T cells in the peripheral blood. The natural killer (NK) cells were reduced and the percentage of activated NK cell level lay between 6% and 69%. B-cells were absent or deficient. These findings explain in part the absence of specific antibody reactivity. Five of these patients also contracted GvHD-associated obstructive bronchiolitis, which did not respond to therapy. Pulmonary infiltrates of unknown origin (including idiopathic interstitial pneumonia) occurred in 8 of the patients (11.1%), with a fatal outcome in 3 patients. Significant changes (P less than 0.05) in lung function after BMT appeared in the form of reduced vital capacity (VC) increased residual volume (RV) and an increase in RV expressed as the percentage of total lung capacity. Pulmonary diseases were the most common complication and cause of death in our patients after BMT.

Adolescent↗
PubMed1986

[Effective treatment of peritoneal carcinosis by intraperitoneal cis-diamminedichloroplatinum (c-DDP) administration with systemic sodium thiosulfate protection. Clinical results and pharmacokinetics].

Thirteen patients with cytologically or histologically confirmed ascites from various malignancies have received 37 courses of intraperitoneal cis-platinum (cDDP). The tumor had to be confined to the peritoneal cavity or cause major symptoms by peritoneal carcinosis. cDDP (90-150 mg/m2 in 21 saline) was administered intraperitoneally with concurrent i.v. infusion of sodium thiosulfate. Courses were repeated in 4-week intervals. Total platinum was assayed by flameless atomic absorption spectrophotometry. With a dwell of 4 h 31.5 +/- 17.2% of platinum was recovered. Mean peak platinum concentration in the peritoneal cavity was 54.6 +/- 21 micrograms/ml and that in serum was 2.6 +/- 1.1 micrograms/ml. The ratio of peritoneal to serum platinum concentration dropped from 41 +/- 18.2 after 1 h to 6.9 +/- 4.7 after 5 h. The area under the curve for the peritoneum was approximately 11-fold greater than the area under the curve for serum. Within 12 h 31.7 +/- 10.7% of the administered dose was excreted in urine. Ten patients had disappearance of ascites lasting 6-135 + weeks. The treatment was generally well tolerated, no serious side effects were observed. This study demonstrates a pharmacokinetic advantage of intraperitoneal chemotherapy with cDDP and an effectiveness against peritoneal carcinosis from various malignancies with minimal systemic toxicity.

Adult↗
PubMed1986

Acute folic acid deficiency after bone marrow transplantation.

After bone marrow transplantation (BMT), megaloblastic bone marrow changes are often observed that can only be partially explained by drug effects. Our goal was to find out whether folic acid deficiency represented an additional factor. The serum folic acid concentrations of 41 patients were determined regularly before and after BMT. A 2nd degree polynomial regression analysis revealed a clear and acute drop in folic acid concentrations within 7-9 days after BMT. In 19 patients the level fell below 3.0 ng/ml, the range of folic acid deficiency. The mean folic acid values without oral administration of folic acid after BMT lay significantly below the mean values with substitution (P less than 0.001). If a case of acute graft versus host disease (GvHD) was more severe than grade I, the mean folic acid levels were significantly lower (P less than 0.01). Patients with megaloblastic bone marrow changes after BMT had significantly lower folic acid values than those without such changes (P less than 0.01). The 18 patients with folic acid deficiency had a significantly higher rate of megaloblasts, binucleate erythropoietic precursors, Howell-Jolly bodies, giant myelocytes, and giant metamyelocytes in bone marrow smears than the remaining 23 patients (P less than 0.05). Folic acid deficiency did not slow down the increase in leukocytes, granulocytes, thrombocytes, or reticulocytes after BMT. There were 8.2%-9.7% hypersegmented neutrophils in the blood (normal 5%) after BMT both with and without folic acid deficiency. Folic acid deficiency after BMT was caused by insufficient intake combined with simultaneous decreased intestinal resorption and increased requirements for the regeneration of bone marrow and intestinal mucosa.

Adolescent↗
PubMed1986

TAD-induction therapy for 175 adults with acute myeloid leukemia, followed by consolidation and maintenance therapy. The joint study of Ulm and Tübingen.

175 patients with acute myeloid leukemia were treated between February 1980 and March 1985 with a TAD-induction therapy, three intensified consolidation cycles (COAP, COAP, AD), and a two-year mild maintenance therapy. The median age of the patients was 44 years, range 15-68 years. 62.3% of all patients attained complete remission and 13.7% partial remission. The median duration of remission was 10 months and the median survival time of patients in complete remission was 20 months. Patients older than 50 years had a higher early death rate (17.6) than younger patients (8.9%), but no difference was found in remission rates or in the median duration of remission and of survival. These results are in line with those of comparable studies.

Adolescent↗
PubMed1986

[Quality parameters of cryoprecipitates from stored blood preservation].

The investigations of a series of 281 cryoprecipitates produced from blood stored at 10 degrees C for 12-18 hours resulted in equal values as compared with those preparations from a control group of 53 preparations which had been prepared from blood maximally stored for 4 hours. Thus, international experiences could be confirmed. An improvement in the quality of erythrocyte concentrates simultaneously produced can be regarded as an additional advantage with respect to the formation of microaggregates during the time the stored blood can be made use of.

Blood Preservation↗