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Biomedical subjects

M Kaufmann

Publications and source records attributed to M Kaufmann.

At least 271 records · Page 15Linked to original sources
PubMed1991

[Outcome prognosis in severe craniocerebral trauma: important predictors in the early phase].

An early prognosis may influence the management of severely head-injured patients. Clinical aspects (age, Glasgow Coma Score, pupil reaction) and neuroradiological findings (basal cysternes, midline shift) are the most important facts for prognosis; evoked potentials, stress parameters and the quality of resuscitation also correlate with definitive outcome. Despite a clear correlation between these single factors and outcome, prognosis during the first 48 hours remains too uncertain to justify an influence on initial management.

Aged↗
PubMed1991

Utilization of the greater omentum in surgery: a historical review.

Up to our century, the surgical approach to the greater omentum was mainly confined to resectional techniques of the prolapsed organ following abdominal injuries. The present contribution highlights the early searches for the nature of the greater omentum in the discovery of an organ which has for so long been disregarded, but now attracts increasing consideration as useful plastic material in surgery. This structure, used at various sites of the body to repair defects and provide blood supply, also opened new clinical and experimental fields of both surgical and immunological aspects.

Europe↗
PubMed1990

Chronic stimulation-induced effects point to a coordinated expression of carbonic anhydrase III and slow myosin heavy chain in skeletal muscle.

Chronic low-frequency stimulation of rat fast-twitch muscle induces 3.7-fold elevations in cytochrome c oxidase activity, but remains without effect on carbonic anhydrase III (CAIII) mRNA and protein. This is in contrast with the situation in the rabbit where chronic stimulation elicits more than 10-fold elevations in CAIII activity and mRNA content which coincide with an enhanced expression of the slow myosin heavy chain (HCI). Since chronic stimulation of rat muscle does not enhance the expression of HCI, we conclude that CAIII is expressed in parallel with HCI and, therefore, is present only in type I and C fibers.

Animals↗
PubMed1990

Ifosfamide combination chemotherapy in advanced breast cancer.

The objective of our clinical studies was to develop an effective combination chemotherapy regimen (CHT) with acceptable side effects, consisting of the two most potent drugs used as single agents in breast cancer. We tested the combination of an anthracycline, epirubicin (A) at 70 mg/m2 i.v. on day 1 or (B) at 120 mg/m2 i.v. on day 1 with an alkylating drug ifosfamide (IFO), (C) at 2.5 g/m2 in an i.v. infusion given over 4 h on days 1-3 or (D) at 5 g/m2 in a 24-h i.v. infusion given on day 1. Courses were repeated every 4 weeks. The combinations were given as first-line therapy as follows: CHT (A, C) in six cases and CHT (B, C) in five cases of advanced breast carcinoma, and CHT (B, D) in seven patients with primary inflammatory breast cancer. Due to side effects (e.g., stomatitis, mental disturbances) and applicability, CHT regimen (B, D) was preferred. Responses (12/18) occurred 1-3 cycles earlier than those previously achieved using the conventional epirubicin/cyclophosphamide CHT. We conclude that 5 g/m2 IFO given i.v. over 24 h with uroprotection (mesna) in a two-drug regimen is an effective dose with tolerable toxicity. Alopecia was seen in all cases. However, according to our experience, myelotoxicity is the dose-limiting factor for both of these drugs.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Ifosfamide/etoposide and mesna uroprotection in advanced breast cancer.

The object of the study was to evaluate the effectiveness of ifosfamide/etoposide and mesna therapy in advanced breast cancer. A total of 44 patients with breast cancer were included in the trial. Eligibility criteria included measurable, refractory disease; prior anthracycline therapy (or its contraindication); a life expectancy of at least 3 months; and adequate hepatic, renal, CNS and bone marrow function. All patients were less than or equal to 70 years of age and had a Karnofsky performance status of greater than or equal to 50%. There were 36 evaluable cases. Sites of metastatic disease included bone (19), skin (18), liver (9), lung (14), lymph node (19), and miscellaneous (7). Treatment consisted of 1,500 mg/m2 ifosfamide given i.v. on days 1-5, 120 mg/m2 etoposide given i.v. on days 1-3, and 400 mg i.v. mesna given with and at 4 and 8 h after ifosfamide. Cycles were repeated every 28 days. Initial doses were reduced by 25% or 50% in patients who had previously undergone both chemotherapy and radiotherapy. A median of 4 cycles (range, 2-8) were given. The myelotoxicity was marked: WHO grades 3/4 leukopenia (n = 37), grades 3/4 thrombocytopenia (n = 12), and grades 2/3 anemia (n = 13). Due to myelotoxicity, dose reduction or prolongation of treatment-free intervals was necessary in 28 cases. Alopecia was seen in 35 patients and CNS toxicity, in 8. Partial remission (PR) was obtained in five cases and complete remission (CR), in three. Sites of response included the lung (5), skin (4), lymph node (5), and peritoneum (1). The duration of response was 4 (n = 2) and 8 (n = 1) months for CR and 2 (n = 2), 6 (n = 2), and 10 (n = 1) months for PR. We conclude that the ifosfamide/etoposide and mesna regimen is effective, but its myelotoxicity is treatment-limiting.

Adult↗
PubMed1990

[Abruptio placentae].

Neither the frequency nor the clinical pattern of abruptio placentae have changed significantly in the past years. In a retrospective study (1979-1988) we found a frequency of 0.55%, that means one abruptio placentae in every 182 births. Important and significant factors which could be correlated with the abruptio placentae were: premature labour, vaginal bleeding and gestosis. The case histories show a high rate of abortions and interruptions (24.3%) of pregnancy, as well as premature rupture of membranes (15.4%) and multiple pregnancies. Ultrasound furnished valuable diagnostic criteria in only 7.7% of the cases. A high rate of breech presentation (1/5 of all cases) is seen in combination with premature birth (37% less than or equal to 33 weeks of gestation). Half of the patients showed disturbances of coagulation. The high rate of perinatal mortality (12%) is related to the prematurity on the one hand and too late diagnosis of abruptio placentae.

Abruptio Placentae↗
PubMed1990

[A rapid test procedure for the detection of B streptococci in the perinatal period].

At the Hospital of the Department of Gynaecology of the University of Heidelberg, a latex agglutination test (Strep B Patho Dx Test) was applied after extraction of antigens from amniotic fluid and gastric aspirate, parallel to the routine screening programme (vaginal and anal swabs) for maternal colonization with B streptococci. The latex agglutination test was applied in 1336 cases. Maternal vaginal colonization was detected in 14%, anal colonization in 17% of the cases. A comparison of the results obtained with the latex agglutination test and with conventional bacteriological procedures (no gradual bacteriology, incubation 48 hours) showed antigen identification in amniotic fluid in 54%, respectively 24%. In gastric aspirates a B streptococcal contamination was detected by bacteriology in 40% of cases, by the rapid latex agglutination test in 22%. If no streptococci were found in the mother, amniotic fluid or gastric aspirates were contaminated in 4% or 6%, respectively (agglutination test or bacteriology, respectively). With a sensitivity of approximately 50% and a specificity of 98%, the latex agglutination test proved superior to routine bacteriology. All clinically contaminated newborn (positive blood specimens) were clearly identified by this test. With this new latex agglutination test, a procedure is now available to detect B streptococcal contamination in newborns within less than half an hour, thus an intra- or postpartal antibiotic therapy can be applied early.

Anal Canal↗
PubMed1990

[Extent of psammoma carcinomas of the ovary--a clinical, DNA flow cytophotometric and morphometric image analysis study].

There is no agreement in literature on the biological behavior of psammoma carcinomas of the ovary. The majority of authors consider psammoma bodies to be the result of tumour regression, associating the occurrence of psammoma bodies with longer survival. On the other hand, several studies reveal a poor prognosis for psammoma carcinomas, similar to that of other epithelial malignant tumours. In our study, the psammoma body content in 174 serous carcinomas stage III/IV was morphometrically quantified by image analysis and the results correlated to survival time and progression time. In 20 carcinomas the psammoma body content was extremely high. In such cases, DNA flow cytometry revealed these tumours to be slowly-growing. The DNA index was 1.0 (DNA-diploid) and the number of S phases was low (max. 5.9%). The five year estimate survival was 50%, as opposed to 10% for other tumours. If no methods are available for cell kinetic analysis and for objectification and quantification of psammoma body content in serous carcinomas it is sufficient to make a semiquantitative assessment of the psammoma body content to differentiate tumours with longer survival from carcinomas of poor prognosis.

Cystadenoma↗
PubMed1990

[Therapy of ascites with tumor necrosis factor in ovarian cancer].

The biotechnological production of human recombinant tumour necrosis factor (rHuTNF) makes this drug available for clinical application. This endogenous compound exhibits tumouricidal activity and regulatory functions within the immune system. 20 out of 23 (87%) patients with refractory recurrent malignant ascites from ovarian cancer were successfully treated in a phase-I and II-study. The production of ascites was either completely suppressed or reduced to a minimum for at least 4 weeks after maximally three intraperitoneal (i.p.) applications. Two of the three non-responders were mucinous carcinomas. In the phase-I study the evaluation of a maximal tolerable dose was not possible due to the rapid therapeutic success at low doses of TNF. The effective dosage was 0.08-0.14 mg TNF/m2 given i.p. Side effects which occurred 2 to 24 hours after the application of TNF were flue-like symptoms combined with general malaise. The side effects were not dose related. All concomitant signs and symptoms could be minimized by prophylactic or therapeutic application of indometacine, paracetamol or pethidine. This applied especially for the typical early phase cytokine side effects e.g. chills and febrile temperatures. The side effects were not dose related. The i.p. treatment with rHuTNF appears to be a novel practicable and effective method for palliation in patients with recurrent ascites even in multiple pretreated patients.

Adenocarcinoma, Mucinous↗
PubMed1990

[Clinical aspects and morphology of extra-ovarian serous cancer of the pelvis].

An extraovarian peritoneal serous carcinoma is characterised macroscopically by ovaries without pathology, histologically, however, by a serous carcinomatous structure in the pelvis, in an advanced tumour stage of usually marked peritoneal carcinomatosis. Extraovarian pelvic serous carcinomas are rarely described in literature. In our study on five patients with such carcinomas, laparotomy findings revealed peritoneal carcinomatosis as in advanced ovarian carcinomas, but without ovarian involvement. Histogenesis does not reveal any difference between the extraovarian mesothel, which is of Mullerian origin and the serous ovarian carcinoma. Therapy of extraovarian peritoneal carcinoma is similar to that of ovarian cancer with maximal tumour reduction and cisplatinum or carboplatinum containing chemotherapy. The prognosis is extremely unfavourable with little expectation of lengthy remission and survival rates are short. Extraovarian serous carcinomas deserve better recognition because they are underreported. They must be differentiated from malignant mesotheliomas, which are not of Mullerian origin.

Adult↗
PubMed1990

[The prognostic significance of tumor cell detection in bone marrow of patients with breast cancer].

In 95% of patients with primary breast cancer, the extent of metastases cannot be proven by conventional methods. Nevertheless, more than 50% of these patients have a relapse within five years. To improve the predictive value for recurrency, we examined bone marrow aspirates of 128 patients with primary breast cancer. Bone marrow aspirates from 2-6 sites of the skeleton (iliac crest and sternum) were taken as well as biopsies for histological examination. The immunohistochemical studies were carried out on interphase smears and stained with cytoceratin antibodies (PKK 1) and antibodies against tumor-specific antigen TAG 12 (12 H 12). All patients were screened for distant metastases (X-ray, ultrasound, bone scan). Tumor cells and micrometastases in bone marrow were detected in 41 patients (32%). Their presence was correlated to other prognostic factors (tumor size, lymph node status, oestrogen/progesterone receptors). The median duration of follow-up was 39.5 months. 14 patients (45%) in the tumor cell positive group relapsed, compared to only 4 out of 36 patients in the tumor cell negative group. In 29% we found bone metastases. The relapse free interval was shorter for patients with micrometastases (8 vs. 15.8 months). The presence of tumor cells in bone marrow aspirates detected at the time of primary surgery, is a useful prognostic factor and a good predictor of metastases and may help in selecting patients for systemic adjuvant treatment.

Antibodies, Monoclonal↗
PubMed1990

Fatal intestinal pseudo-obstruction in brown bowel syndrome.

A 52-year-old man, suffering for years from malabsorption due to endemic sprue, developed progressive bowel dysfunction, ie, recurrent ileus and intestinal pseudo-obstruction. Because of partial volvulus formation, ileocecal resection was performed. Histopathologic examination of the resected specimen revealed signs of advanced brown bowel syndrome, with excessive deposits of ceroid-lipofuscin in, and a considerable loss of, smooth-muscle cells and myofibrils. The patient died after surgery, and at autopsy a systemic ceroid lipofuscinosis of smooth-muscle cells was detected. Neuronal ceroid lipofuscinosis was not observed. Serious and eventually fatal bowel dysfunction is rarely seen in brown bowel syndrome, but may occur in advanced stages. Since treatment with vitamin E appears to exert a favorable effect, early diagnosis of brown bowel syndrome seems to be very important.

Ceroid↗
PubMed1990

[Total average values of transient visual evoked cortical potentials in tests of the pressure tolerance of the optic nerve].

Transient visually evoked cortical potentials were recorded during an artificial stepwise rise of intraocular pressure. At each pressure step one average was taken. The reversal rate was 1.9 Hz. Two groups of 30 healthy volunteers each were examined: in group one 25 sweeps were averaged and in group two 50 sweeps. Thus the recording time in group two was doubled compared to group one. When all subjects were examined the evoked potentials of the 30 subjects were averaged at each pressure step: the results was a "Grand Average" at the different pressure steps applied. The amplitudes of N2-P2 were plotted versus the intraocular pressure. It is seen that a not monotone or weakly monotone function in the amplitude/pressure curve is more clearly seen in the averages of 25 sweeps. We interpret this result as follows: a not monotone or weakly monotone behaviour is a sign of autoregulation in the optic nerve head. This sign is more clearly shown at a short recording time. The majority of healthy persons show autoregulation, the majority of glaucoma patients do not. According to the results presented here it is advisable to apply short recording times in clinical pressure tolerance testing of the optic nerve head. A short recording time enhances the accuracy of the test.

Adult↗
PubMed1989

Fast liquid chromatographic assay of androgen aromatase activity.

A rapid, sensitive nonradiometric assay method for the enzymatic aromatization of androgens has been developed using reversed-phase fast liquid chromatography. The use of a 3-microns-particle, 5-cm-long column allowed analysis of androstenedione, estrone, testosterone, and estradiol within 1 min. The reliability of the method was demonstrated by measuring the aromatase activity of human placental microsomes and that of the purified reconstituted aromatase system using both substrates. The rapid analysis enabled the processing of a large number of samples in a short time, which makes the present method especially suitable for the analysis of chromatographic fractions obtained during enzyme purifications and for enzyme kinetic studies.

Androstenedione↗
PubMed1989

Electrostimulation-induced increases in fatty acid-binding protein and myoglobin in rat fast-twitch muscle and comparison with tissue levels in heart.

Chronic stimulation of rat fast-twitch muscle increased the content of both fatty acid-binding protein (FABP) and myoglobin. The increases in FABP, which reached values close to that of cardiac muscle, exceeded those in myoglobin and those in citrate synthase and 3-hydroxyacyl-CoA dehydrogenase activities.

3-Hydroxyacyl CoA Dehydrogenases↗