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Biomedical subjects

L Bergmann

Publications and source records attributed to L Bergmann.

At least 127 records · Page 7Linked to original sources

Impaired T- and B-cell functions in patients with Hodgkin's disease. Reduced mitogenic responsibility and Il-2 production is not caused by defective CD4+-cells.

The mitogenic response of T-cell subsets, the production of interleukin-1 (Il-1) and interleukin-2 (Il-2) and in vitro immunoglobulin production was investigated in patients with Hodgkin's disease (HD). The mitogenic response of mononuclear cells (MNC) and the OKT4+ and OKT8+ subsets was greatly reduced in advanced disease stages and could only partially be restored with exogeneous Il-2. In untreated patients with HD--except those with highly advanced disease--the OKT4+ lymphocytes showed normal response to phytohemagglutinin in contrast to the MNC suggesting inhibiting agents or cells within in the MNC. These findings corresponded to reduced Il-2 synthesis of MNC, whereas isolated OKT4+--cells produced normal or elevated amounts of Il-2. MNC or monocytes produced normal or even higher amounts of lipopolysaccharide-induced Il-1 than controls. The results do not confirm a defect in this component of the interleukin system in HD. The immunological impairment was not limited to the T-cell system but involved B-cell activation and differentiation as well. The pokeweed mitogen-induced IgM, IgG and IgG production was highly suppressed in untreated HD, whereas the MNC of previously treated patients produced subnormal amounts of immunoglobulin in vitro. It is not yet clear whether this defect is T-cell-mediated or primarily a B-cell deficiency.

Adult↗

Disseminated testicular cancer with bulky disease: results of a phase-II study with cisplatin ultra high dose/VP-16/bleomycin.

This is a preliminary analysis of the AIO-Testicular Tumour Study Group trial in patients with disseminated bulky testicular cancer. Treatment plan: cisplatin 35 mg/m2 days 1-5, VP-16 120 mg/m2 days 1-5 (two daily divided doses), bleomycin 15 mg/m2 days 1, 8, 15. Of 98 patients at present evaluable 63% had complete remission or have no evidence of disease (CR/NED), 30% had partial remission (PR) and 7% had no change or progressive disease (NC/P). Relapse-free survival is 93% for the CR/NED group after a median follow up of 2.2 years: the overall survival for the entire patient population is 70%. Toxicity included predominantly granulocytopenic fever and infection with septicaemia, thrombocytopenia, nausea, vomiting, neurotoxicity and lung toxicity, with 7% fatal toxicity. A prospective randomized trial is warranted to evaluate the apparent superior activity of ultra high dose cisplatin in combination with VP-16 and bleomycin.

Adolescent↗

[Prospective controlled study of therapy of chronic myeloid leukemia (CML)].

The current status of the prospective German multicenter study on the therapy of chronic myelogenous leukemia (CML) is reported. After three years 188 of the projected 300 patients have been randomized. The duration of the study will be 8 years. The clinical characteristics of the randomized patients correspond well to those reported in the literature. Risk factors are distributed equally in both arms. One problem is the relatively high drop-out rate of about 12% thus far. Survival curves for the two treatment arms will be presented, although at present the number of patients having reached the end of the chronic phase is too small to allow definitive evaluation.

Adult↗

[Chemotherapy or chemotherapy and radiotherapy in advanced head and neck tumors. A prospective, randomized study comparing the 2 therapeutic modalities].

Initial combination drug regimens containing Cisplatin in patients with stage III and IV head and neck cancer produce a high percentage of clinical response. We initiated the current trial to assess the role of multimodality treatment (CT plus RT) versus CT alone in eliciting tumour response rates, and the duration of tumour free survival. Patients were randomised to CT followed by RT (arm A: 36 patients) or CT alone (arm B: 44 patients). Of 96 patients entered into this study 80 are evaluable at the time of analysis. There were 13 women and 67 men with a median age of 52 years and a median performance status of 90%. All of them presented measurable stage T4N0-3M0-1 or T3N2-3M0-1 carcinomas. The chemotherapy consisted of Cisplatinum, Bleomycin and Methotrexate and was given in 2 cycles over 35 days. Local radiotherapy with 6,000 rad followed. In arm B, 3 cycles of chemotherapy were given without radiotherapy. The overall tumour responses after CT were 75% in arm B, and 70% in arm A. After RT the tumour response fell to 59%. Median tumour remission was 4 months and median survival 11 months. Toxic effects were mild mainly consisting of alopecia, nausea and vomiting. Myelotoxicity was moderate, but significant renal or ototoxic side effects did not occur. 10 cases of Bleomycin related pulmonary fibrosis were found. Our main findings show that patients receiving 2 cycles of CT do not have a statistically shorter survival compared to those who were treated by CT plus RT.

Adult↗

[The effect of radio- and chemotherapy on survival in advanced head and neck tumors].

Inoperable cases of advanced squamous cell carcinomas in the head and neck area which have a very poor prognosis are often treated by a combined radio- and chemotherapy. Tumor remissions up to 70% are induced by both radiotherapy and chemotherapy alone; an increase of the survival time is not reported. The present randomized study investigates the efficacy of two therapy schemes, i.e. chemotherapy alone and chemotherapy combined with irradiation. Tumor remissions of 75% were achieved in 80 evaluable patients, the median remission period was four months and the median survival period eleven months. The survival curves do not show any dependence of the survial time on the size of tumor or metastases. Only responders had a significantly longer survival time than non-responders.

Antineoplastic Combined Chemotherapy Protocols↗

Metabolic consequences of high protein intake in premature infants appropriate for gestational age.

The metabolic consequences of different levels of protein intake were studied in premature infants appropriate for gestational age (birth weight between 1500 and 2000 g) during the third week of life. The different protein intake was the result of different nutrition, human milk and two formulae containing 1.7 and 2.1 g protein/100 ml, respectively. The increasing protein intake causes an increase in the alpha-amino-nitrogen as well as the urea concentration in the serum, an elevation of total and alpha-amino-nitrogen losses in urine, increased amounts of stool accompanied by increased total nitrogen as well as fat excretion. The results indicate that a protein intake of more than 2.5 g/kg X 24 h creates a metabolic overloading without any advantages. Thus, human milk of mothers delivering preterm is a sufficient nutrition for these infants, also with regard to protein requirements, if feeding volumes of 180 to 200 ml/kg X 24 h are tolerated. Supplementation of human milk or nutrition with high protein formulae can be justified only in infants who cannot tolerate sufficient feeding volumes.

Amines↗

[Orchitis and epididymitis caused by Salmonella cholerae suis in a premature infant].

It is reported on a premature infant who fell ill with an orchitis and epididymitis by Salmonella cholerae suis in the fourth week of life. The proof of the germs was carried out by means of two blood cultures as well as in the smear from the periorchium. The most important informations from literature concerning this subject are briefly reviewed.

Epididymitis↗

[Spontaneous course of LAV/HTLV-III infection. Follow-up of persons from AIDS-risk groups].

543 persons in AIDS risk groups were examined for LAV/HTLV-III infection. Antibodies against LAV/HTLV-III were demonstrated in 377, during an observation period of 3 months to 3 years. Patients were divided into 5 groups, according to clinical, serological and immunological criteria. Severity of symptoms and incidence of recurrences of the lymphadenopathy syndrome correlated positively with an increase in cellular immune deficiency. At the end of the observation period only 30 of 307 antibody-positive patients were well. The AIDS incidence of all antibody-positive patients increased with time from 3% (6-11 months) to 19.4% (24-36 months). If one takes into account only those patients who had marked immune deficiency (stage 2b) at the initial examination, the AIDS incidence during the same periods was 10 and 57%, respectively. At the same time, the condition worsened by at least one stage in half of all patients in stages 1b-2a observed for 1-2 years. A change of stage was observed in up to 80% of patients followed for longer periods. Long-time prognosis of LAV/HTLV-III infection is remarkably bad.

Acquired Immunodeficiency Syndrome↗

[Acute exanthematous eruption of multiple Kaposi sarcomas of the AIDS type in a female drug-addict. Successful chemotherapy with vincristine, bleomycin and dactinomycin].

In a 30-year-old German women who appeared to be in good general health, numerous Kaposi sarcomas of the AIDS type appeared on her face and trunk within a few days. Her arms, legs and oral mucosa were also affected. The patient has been a prostitute for more than 10 years and an i.v. drug addict for 5 years. Her face and upper trunk were densely covered with livid red tumors that were up to the size of coffee beans, with a longitudinal axis that followed the relaxed skin tension lines. HTLV III antibodies were present. No severe cellular immune defect could be demonstrated (OKT4 + to OKT8 + cell ratio 1.15; later control = 2.4). Recall antigens were negative. Since no severe immune defect was present, cytostatic therapy with vincristine, bleomycin and dactinomycin was carried out. Infiltrates began to regress after just one cycle. After four cycles, the facial lesions had completely disappeared. On the chest slight erythemas remained, but there were no histological signs of Kaposi sarcoma. On the legs there were still some solitary brown infiltrates. It was shown that the AIDS type of Kaposi sarcoma responds to combined chemotherapy.

Acquired Immunodeficiency Syndrome↗

Seroepidemiology of HTLV-III (LAV) in the Federal Republic of Germany.

In 1984 10,281 sera were collected in the FRG and examined for antibodies to HTLV-III (LAV) with an enzyme-linked immunosorbent assay and confirmative tests. Of the German AIDS patients 81% have antibodies. Individuals belonging to AIDS risk groups, homosexuals, haemophiliacs and i.v. drug abusers, have antibody frequencies between 25%-72%. The detection of HTLV-III antibodies in blood donors indicates that the virus is being transmitted by blood transfusions.

Acquired Immunodeficiency Syndrome↗

Chronic thrombocytopenia in an immunodeficient patient with hemophilia A.

Coincident hemophilia and idiopathic thrombocytopenia has been rarely observed. We report here on a young man with severe hemophilia A who was treated with concentrates of lyophilized antihemophilic factor for several years before he developed thrombocytopenia. An isolated thrombocytopenia coincident with reduced platelet survival, ample megakaryocytes in the bone marrow, elevated platelet-associated IgG, as well as remission after treatment with prednisone and splenectomy, suggest the idiopathic form of thrombocytopenia. In addition, defects in cellular immunity became obvious. A causal relationship between the application of blood-derived products and the development of the platelet disorder as well as the impairment of the T-cell system remain to be demonstrated.

Adult↗

T-cell subsets in malignant lymphomas and monoclonal gammopathies.

159 patients with malignant lymphomas or monoclonal gammopathies were investigated for lymphocytes and their subsets using conventional surface markers and a panel of monoclonal antibodies. In untreated patients with Hodgkin's disease, non-Hodgkin lymphomas and multiple myeloma, (MM) a reduction of T-cells and especially of the "helper/inducer" subset (OKT4+) was found to be a common phenomenon. The major abnormalities occurred in advanced stages of disease. Patients previously treated by chemo- and/or radiotherapy had a further decrease of T-cells, whereas the loss of OKT4+ cells was more pronounced than that of the "suppressor/cytotoxic" lymphocytes (OKT8+). The alterations of lymphocyte subsets persisted even in long-term remitters. Comparing the lymphocyte subsets in MM and benign monoclonal gammopathies (BMG), patients with BMG showed a significant reduction in OKT8+ cells, whereas the OKT4+ population was within normal range, resulting in a significant elevation of the OKT4/OKT8-ratio compared to the controls and untreated multiple myeloma.

Adult↗

Prognostic value of chest radiograph, serum-angiotensin-converting enzyme and T helper cell count in blood and in bronchoalveolar lavage of patients with pulmonary sarcoidosis.

We studied the prognostic value of the initial radiologic stage, the serum-angiotensin-converting enzyme (SACE) and T helper cells in blood (OKT-4-Bl) and in bronchoalveolar lavage (OKT-4-BAL) for patients with biopsy-proven pulmonary sarcoidosis. Thirty-seven patients without prior treatment were followed up for a period of 2 years. A BAL was performed in 22 of them as part of the diagnostic workup. Clinical examination, chest radiographs, vital capacity, diffusion capacity for CO, airway resistance and PaO2 at rest and during exercise were determined initially and after 6, 12 and 24 months. According to these results, patients were classified as having progressive or nonprogressive disease. The radiologic stage and the initial SACE (38.3 +/- 10.2 vs. 43.7 +/- 13.0 nmol/ml/min) could not discriminate between the two groups. Patients with progressive disease had significantly fewer OKT-4-Bl cells (403.3/microliter +/- 146.7/microliter vs. 842.0/microliter +/- 430.1/microliter) and more OKT-4-BAL cells (24.5 +/- 15.4% vs. 7.0 +/- 2.6%) than patients with stable disease (p less than 0.01). A negative correlation between OKT-4-Bl and OKT-4-BAL cells was shown (Rs = -0.79; p less than 0.001). We conclude that the number of OKT-4-Bl and OKT-4-BAL cells can be used as prognostic parameter for patients with sarcoidosis.

Adult↗

[Soot lung as occupational disease].

Lung findings among 13 workers employed in a carbon black plant are presented. The concentrations of respirable dust at the work place exceeded the MAC for dust free of quartz. X-rays show disseminated small irregular and large shadows with slow progress. In two cases lung tissue was examinated histologically. Both accumulation of carbon black and development of collagen fibers were seen. According to x-rays and histological findings the lung disease can be estimated as a pneumoconiosis. Legal recognition of carbon black lung as an occupational disease can be achieved in a special procedure called "Sonderentscheidverfahren".

Aged↗