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Biomedical subjects

K Winkler

Publications and source records attributed to K Winkler.

At least 307 records · Page 17Linked to original sources
PubMed1965

Halothane.

Explore the source record for details and available documents.

Adult↗
PubMed1965

Glycerol metabolism in the human liver: inhibition by ethanol.

Glycerol is metabolized predominantly in the liver, the first step presumably being phosphorylation to alpha-glycerophosphate. When ethanol is present in the blood the rate of glycerol uptake by the splanchnic organs is reduced to about one-third of the control value. At the same time glycerophosphate accumulates in the liver. Hepatic blood flow and oxygen consumption are not influenced by the combined infusion of glycerol and ethanol. The phenomenon may be connected with the increased concentration of the reduced form of diphosphopyridine nucleotide present in the liver during ethanol metabolism.

Ethanol↗
PubMedDate not supplied

[The prognostic significance of tumor volume in osteosarcoma with neoadjuvant chemotherapy].

In a retrospective analysis on 128 patients from the trials COSS-80, -82, -85 and -86 initial x-ray pictures were evaluated for tumor diameters in three planes and the prognostic meaning on survival was assessed. In a subset of patients (n = 27) the measured values were compared to values obtained by CT-Scan and a good correlation (r = 0.69) was found. Several parameters for tumor size were defined: absolute tumor length (ATL), relative tumor length (RTL, proportion of tumor to the length of the involved bone), absolute tumor volume (ATV, calculated by the ellipsoid formula) and relative tumor volume (RTL, tumor volume referred to the body surface area) and univariate and multivariate survival analysis were performed. Univariate analysis of metastasis free survival (MFS) revealed a high prognostic significance of the ATL, the ATV and the RTV. The RTL in this patient group demonstrated a tendency only toward an inferior prognosis in larger tumors. None of the patients with a ATV < 70 ml (n = 19) and only one of 33 patients with an ATV < 100 ml relapsed. Cox regression analysis was performed including the variables age, sex, site and response (> 90% tumor necrosis) in 84 patients. ATL and RTL do not enter the model, while the response proves its significance as a valid prognostic factor with a p-value of 0.0004. Adding the ATV as the measure of tumor size to the model it enters as the first term (p = 0.0000) followed by the response (p = 0.0002).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Early neuroblastoma detection in Germany. On the status of the Hamburg-Stuttgart cooperative pilot study].

In Germany, a pilot study for the early detection of neuroblastoma was initiated at the beginning of 1991 in the regions of Hamburg and Stuttgart. The aims of the study are: (1) to develop an infrastructure for neuroblastoma screening, (2) to test the methodology, (3) to determine the compliance rate, (4) to collect data for a future epidemiological study. At 6 months of age, the parents are contacted by general practitioners and private pediatricians within the framework of the routine infant surveillance. The parents are informed about the pilot study and given a sampling kit. A simple urine sample is required, which is collected on a test strip, dried and sent to the test center. From the eluate, the levels of Vanillymandelic acid (VMA) and Homovanillic acid (HVA) are estimated by high performance liquid chromatography (HPLC). The results are sent to the practitioner. In cases of insufficient samples or raised values, the parents are asked for a second sample. If a raised value is comfirmed, clinical investigation including abdominal ultrasound and chest X-ray is carried out. From 2-12/1991, 27,282 samples were examined. There were 1326 (4.86%) insufficient samples and 644 (2.36%) samples retested because of raised initial VMA/HVA levels. 45 (0.15%) children were clinically examined. Until now 2 of them have still elevated levels without evidence of tumor and 2 others have evidence of a tumor which has not been proven to be neuroblastoma. These first results are encouraging with respect to the feasibility of carrying out a neuroblastoma screening program in Germany. It is to early to assess the compliance rate.

Creatinine↗
PubMedDate not supplied

[Recommendations for the structure and equipment of pediatric oncologic centers].

The yearly incidence of cancer in children and adolescents within Germany is about 2200. The regular medical care for these children is effected within prospective multicenter trials of the DAL and GPO respectively. These trials achieved excellent results and gained high international reputation. Following an initial funding by the Bundesministerium für Forschung und Technology the continuation of these trials nowadays is fully dependent on private third parties financial aid especially from the Deutsche Krebshilfe. Guarantee of progress in clinical research and of improvement in patient care as well is closely related to establishing pediatric cancer centers. Accruing about 80 new patients per year such centers have an optimum size justifying establishing stabile substructures. Integrated basic research and organization of special clinical domaines need a differentiated structure of management and a sufficient number of qualified personnel in time nonlimited positions. The recommendation of the Arbeitsgemeinschaft Deutscher Tumorzentren from 1979 for personnel equipment is largely insufficient with respect to the inpatients nursing staff for pediatric oncology units. A basic equipment of 1.75 nurses per patient and additional nursing staff with specific functions would seem appropriate as demonstrated by analyses and calculations within the last part of our recommendations. The ADT recommendations are also insufficient with respect to secretaries and documentation assistants. Concerning the physicians staff the ADT recommendations just need an adaption to the changes in working time in accordance with the tariffe. These recommendations, however, urgently need to be realized. The necessary staff for psycho-social work has been incorporated into our recommendations for the first time. The ratio of patient rooms to function rooms (excluding laboratories) in pediatric oncology centers diposing of an outpatient area and a day clinic should be about 1:3. Deficiencies in the personnel equipment and the generally pronounced lack in function rooms as well are hampering the daily work and have negative impact on the quality of care as experienced by the patient on the safety of medical and nursing practice and on the quality of teaching, medical education and advanced training.

Cancer Care Facilities↗
PubMedDate not supplied

[Treatment of soft tissue sarcomas in childhood and adolescence: results of the CWS-81 multicenter therapy study].

344 previously untreated patients, under 19 years of age, with soft tissue sarcoma (STS) entered the first German STS Study, CWS-81. 218 of them with chemosensitive STS (Group A: rhabdomyosarcoma [RMS], synovial sarcoma, extraosseous Ewing's sarcoma, undifferentiated sarcoma and malignant peripheral neuroectodermal tumor) were evaluable for this analysis after a minimum potential follow-up of 6 years. A staging system based on the extent of disease, defined post-surgically, was used. The chemotherapy for stages I-III (VACA cycle) consisted of vincristine, dactinomycin, cyclophosphamide and doxorubicin. Patients with metastatic disease as well as stage III patients who failed to respond to VACA, were given ifosfamide instead of cyclophosphamide. The definitive local tumor control procedure for patients in stages II-III depended upon the tumor status at second-look surgery after 16 weeks of chemotherapy (no irradiation, 40Gy or 50Gy). The DFS rate after 5 years for group A was 57 +/- 4% and for patients with non-metastatic tumors (Stages I-III), 69 +/- 4%. There was no difference in prognosis between stages I and II (DFS rate 88 +/- 5% and 88 +/- 6% respectively). The DFS rate for stage III was 54 +/- 5% and for stage IV, 11 +/- 5%. Lack of local tumor control was the main cause of therapy failure: 10% of patients with localized disease never achieved CR, 18% relapsed locally. The most important prognostic factors were tumor size (p = .0002) and the degree of tumor regression after primary chemotherapy (p = .02).(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗