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Biomedical subjects

M Pfeiffer

Publications and source records attributed to M Pfeiffer.

At least 127 records · Page 7Linked to original sources
PubMed1979

Effect of intraperitoneal aprotinin treatment in acute and chronic peritonitis.

Our results demonstrate that peritoneal absorption even of large amounts of fluid is not restricted in either acute or chronic peritonitis. According to investigations reported elsewhere, antibiotics administered intraperitonealy can be found quantitatively in the serum, if peritoneal absorption is not impaired. The retardation effect of proteinase inhibitor TRASYLOL on peritoneal absorption in peritonitis may indicate that proteolytic processes are necessary to break up the protein binding of antibiotics which only then are able to permeate the peritoneal wall. This may also pertain to other substances of pharmacologic activity, like toxins -lipoproteins, lipopolysaccharides- and medicaments. With respect to the clinical relevance of this effect it should be regarded as beneficial. Alternatively, the role of kallikrein/kinin-system for transmembranous absorption of proteins and protein split products has to be considered.

Acute Disease↗
PubMed1979

[Suture insufficiency following BI-resection (author's transl)].

33 out of 135 patients (24.5%) developed suture insufficiency after Billroth I-resection. There was no selection of patients in respect of elective, corrective and emergency surgery. The diagnosis is always possible on the grounds of clinical criteria. On the contrary, the early radiographic postoperative direct proof of suture insufficiency is not always possible (14 out of 24 cases). Indirect radiographic signs, such as gastroatonia, delayed gastric emptying, medio-paragastric atypical fluid levels may be relied upon and likewise on signs of the upper abdominal and intestinal stasis, such as radiographic intestinal fluid level, or more frequently pleural effusion on the left side. Typical laboratory changes are absent in the early phase. The rare, but threatening early insufficiency (first until third postoperative day) requires immediate relaparotomy. Dehiscence comes into existence not before the fourth and sixth postoperative day (late insufficiency). They can be treated conservatively. By adequate drainage late complications should not be expected. The period of hospitalization is prolonged over eight days on an average. If the fistula persists, surgical closure should be considered after 30 days because of the increased possibility of severe arrosive haemorrhage.

Gastrectomy↗
PubMed1978

[Complete colonoscopy with short instruments--results obtained with the ACMI F9S (author's transl)].

Total colonoscopy was performed in 3,740 cases within approximately 4 years. Results show, that total colonoscopy may be used as a primary method of clinical examination in an optimal way, if the technically improved, new class of instruments is used. The new short ACMI F6S is especially suited for this approach, yielding reliable results in about 92% of all patients, if the colon is clean and if there are no organic stenoses present.

Colitis, Ulcerative↗
PubMedDate not supplied

[Osteosarcoma and Ewing's sarcoma--The most frequent malignant bone tumors in children--therapy and outcome].

BACKGROUND: Osteosarcoma and Ewing's sarcoma are the most frequent malignant bone tumors in children and young adults with relatively poor overall survival rates. METHODS: Between January 1980 and December 1994, 175 children with osteosarcoma and 64 children with Ewing's sarcoma were treated at the author's institution. 22 children had synchronous metastases, 19 patients had a pathologic fracture. Both groups were treated systemically with chemotherapy regimens (COSS and CESS). Local therapy was amputation or tumor resection and endoprosthetic replacement or biological reconstruction with wide or radical resection margins. In case of Ewing's sarcoma in 35 patients postoperative radiation therapy was done. RESULTS: Five-year overall survival rate for osteosarcoma and Ewing's sarcoma patients is about 63 %, ten-year survival rate for osteosarcoma patients is 60.2 %, for Ewing's sarcoma patients 54.5 %. Prognostic factors significantly influencing overall survival rates are tumor response to chemotherapy (p values = 0.0056 and 0.013, respectively), surgical treatment with adequate resection margins (p value = 0.0001 for osteosarcoma patients) and development of postoperative metastases (p value = 0.0001 for both groups). CONCLUSION: For both groups of malignant bone tumors systemic chemotherapy as well as adequate surgical therapy are necessary to reduce the rates of local recurrences and to achieve better survival rates.

Adolescent↗
PubMedDate not supplied

[Surgical treatment of osteoid osteoma of the extremities].

AIM: It was the aim of this retrospective study to evaluate the frequency of recurrences and complications in patients treated by conventional surgical methods at our institution between 1980 and 1996 and to compare them to those observed in patients treated by minimal invasive methods reported in the literature. METHOD: 70 patients with osteoid osteomas located at the extremities were treated by conventional surgical treatment. 51 patients underwent curettage and 19 patients had en bloc resection. After curettage an additional stabilising plate was implanted in 12% of the cases, after en bloc resection in 68%. RESULTS: There are 66% event-free patients after curettage versus 47% after en bloc resection. Local recurrence rate after curettage was 7%, after en bloc resection no patient developed a recurrence. In both groups a postoperative fracture was observed. Persistent pain due to the implant was reported by 7% after curettage and by 24% after en bloc resection. CONCLUSION: The rate of complications rises with increasing invasiveness and it is necessary to balance the security concerning a local recurrence and the danger of persistent postoperative pain. Curettage is the surgical method of choice in the therapy of the osteoid osteoma, en bloc resection is justified only for recurrent lesions. Curettage is an alternative to minimal invasive methods in cases of superficially located osteoid osteomas or in cases of unfavourable locations of the nidus (near joint or growth plate, inaccessibility).

Austria↗
PubMedDate not supplied

A comparison between three graft manipulation methods for haploidentical stem cell transplantation in pediatric patients: preliminary results of a pilot study.

Transplantation of hematopoietic stem cells from mismatched related donors makes a potential donor available for every child in need of stem cell transplantation. Here, we compare three different graft manipulation methods in patients with leukemias and lymphomas: positive selection of stem cells with either CD34 (n = 39) or CD133-coated magnetic microbeads (n = 14) and a new strategy which depletes T- and B-cells through the use of CD3- and CD19-coated microbeads (n = 11). Median purity of stem cells was comparable after CD34 (+)-selection and CD133 (+)-selection, whereas stem cells were only slightly enriched after CD3 (+)/CD19 (+)-depletion (97.5 %, 93.4 % and 1.02 %). Indirect depletion of T-cells by positive selection resulted in 1 x 10 (4) (median) residual CD3 (+)-cells/kg (0.7-3 x 10 (4)). Patients with CD3/CD19-depleted grafts received 3.2 x 10 (4) (median) (0.7-16 x 10 (4)) residual T-cells/kg. Those grafts also comprised NK-cells (median number: 86 x 10 (6)/kg), dendritic cells and monocytes/granulocytes. Primary engraftment of the stem cell products was comparable after CD34- and CD133-selection (85 and 72 %). In the CD3/CD19 group, 91 % had a primary engraftment. After reconditioning, all patients (64/64) were finally engrafted. Patients with CD34-selected or CD133-selected grafts had similar incidences of a GvHD II-IV (3 and 7 %), whereas a GvHD was slightly increased in patients receiving CD3/CD19-depleted cells (27 %). Reconstitution of CD3 (+) T-cells was faster in the CD3/CD19 group than in the CD34 or CD133 group. These preliminary results indicate, that CD3/CD19-selected grafts may be advantageous regarding engraftment and immunoreconstitution. Since effector cell with potential antileukemic activity are cotransfused, such grafts may be suited in particular for patients with insufficient remission.

AC133 Antigen↗
PubMedDate not supplied

Adenoviral infections after transplantation of positive selected stem cells from haploidentical donors in children: an update.

UNLABELLED: We present updated results of stem cell transplantation with highly purified stem cells from haploidentical parental donors and infection with human adenovirus (HAdV) post stem cell transplantation (SCT). Survival post SCT is primarily determined by relapse, infections and far less by GvHD or other transplant related mortality. During the immune reconstitution the host is at significant risk for severe viral infections. HAdV infection is especially in children an important complication post SCT, with significant morbidity and mortality despite new antiviral treatment strategies. Although control of infection seems to require T-cells, the characterization of HAdV-specific T-cells post SCT has not been introduced in surveillance and treatment decisions. METHODS: Therefore we evaluated the impact of HAdV-infections on the survival between 1995 and 2004 (n = 63) and studied the occurrence of adenovirus-specific T-cells in children with (n = 9) and without (n = 9) HAdV-infection post allogeneic SCT and in healthy donors (n = 53). After stimulation ex-vivo with HAdV-antigen IFN-gamma secreting T-cells were analyzed by flowcytometry and defined as HAdV-specific T-cells. RESULTS: Until day 180 post SCT the cumulative incidence of all lethal viral infections (HAdV n = 5, cytomegalovirus n = 3, herpes simplex virus n = 1) was 16 % for the whole cohort of patients. Cumulative incidence of HAdV-associated mortality was 8.5 %. Cumulative incidence of all lethal viral infections could be now reduced from 16 % to 8 % in conjunction with new surveillance- and therapeutic-strategies. Children with HAdV-associated mortality all had no specific T-cells, although reconstitution of absolute lymphocyte counts exceeded 300/microl within 30 days post transplant. Patients who cleared HAdV infection had normal frequencies of HAdV-specific T-cells until day 200 post SCT. CONCLUSION: In summary adenovirus specific T-cell reconstitution should be monitored in patients after SCT to limit the use of anti viral chemotherapy and help to identify those patients that would benefit from new therapeutic strategies like adoptive transfer of virus specific T-cells.

Adenovirus Infections, Human↗
PubMedDate not supplied

Haploidentical stem cell transplantation in patients with pediatric solid tumors: preliminary results of a pilot study and analysis of graft versus tumor effects.

Pediatric patients with relapsed metastatic tumors have a poor prognosis and new treatment strategies are warranted. We present preliminary results of a pilot study, evaluating the feasibility and toxicity of transplantation of haploidentical T and B cell depleted grafts with high numbers of NK cells. 6 patients with relapsed metastatic neuroblastomas (n = 4), rhabdomyosarcoma (n = 1) or Ewing's sarcoma (n = 1) after previous autologous transplantation received CD3/CD19 depleted grafts from mismatched family donors with a median number of 16 x 10 (6)/kg stem cells, 167 x 10 (6)/kg Natural Killer cells and only 5.4 x 10 (4)/kg residual T cells. A melphalan-based, reduced intensity conditioning was used. Despite pretransplant chemotherapy, patients entered transplantation with significant tumor burden. Primary engraftment occurred in 6/6 patients. One patient had secondary graft failure. Hematopoietic recovery was rapid (ANC > 0.5 x 10 (9)/L: 11 days (9-12); independence from platelet substitution: 8 days (7-11)). Four patients had acute GvHD grade II, limited chronic GvHD was observed in 2 patients. No transplant-related mortality and only low toxicity occurred. Four patients died from progression, two patients are alive. Overall median survival time is 6 months (2-11) to date. Analysis of posttransplant NK cell function revealed stable cytotoxic activity against K562 targets, whereas activity against neuroblastoma targets was low. Stimulation with cytokines and use of appropriate antibodies clearly enhanced specific lysis in vitro. In summary, these preliminary results indicate the feasibility and low toxicity even in intensively pre-treated patients with neuroblastomas/sarcomas. This approach may form the basis for posttransplant immunomodulation and other therapeutic strategies. Further experience is warranted to evaluate the method.

Acute Disease↗