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Biomedical subjects

M Smola

Publications and source records attributed to M Smola.

15 recordsLinked to original sources
PubMed2000

Selective decrease of serum immunoglobulin G1 as marker for early stages of invasive breast cancer.

The diagnostic value of the decrease in percentage of immunoglobulin G1 (%lgG1) in breast cancer was analyzed with special emphasis on early tumor stages. IgG1 and total IgG were preoperatively measured in the sera of a total of 801 individuals using a modified quantitative affinity chromatography. Group A consisted of 174 healthy individuals of both sexes, group B of 324 female patients with benign breast disease, and group C of 303 patients with invasive and non-invasive breast cancer. Within group C, 13 patients presented with intraductal carcinoma, and 22 patients with a pT1a-tumour (diameter less than 0.5 cm). The %IgG1 values were compared among groups A, B and C. In addition, correlations were sought between %IgG1 values of group C and tumor size, stage (UICC), histopathological grade and oestrogen (ER) and progesteron receptor (PR) expression. The mean value of %IgG1 in group A was 63.3 +/- 0.5 s.e.m., in group B 57.75 +/- 0.4 s.e.m. and in group C 52.37 +/- 0.5 s.e.m. The differences of mean values were highly significant between all three groups. Sensitivity and specificity of %IgG1 to discriminate between group A and C were 75% and 87%, and between group B and C 62% and 63%, respectively. The significant decrease of %IgG1 in total serum IgG is able to distinguish patients with breast cancer of more than 5 mm in diameter from healthy controls and patients with benign breast diseases. Finally, calculated posterior probabilities revealed that within certain concentration limits %lgG1 may provide predictive information with high probabilities.

Adolescent↗
PubMed1997

[Primary malignant non-Hodgkin's lymphoma of the breast: breast preserving therapy in 3 patients].

Primary malignant non-Hodgkin lymphoma is rare. The mammographic appearance is unspecific. The final diagnosis can usually be made after examination of paraffin-embedded tissue only. There exists no therapeutic standard for this disease. In the case of 3 patients treated at our institution, tumorectomy only and adjuvant therapy have been performed because there is no survival advantage for patients who underwent radical surgery.

Aged↗
PubMed1997

[Dual-chamber rate-regulated cardiac pacing is aiming toward automatic pacemakers].

DDDR cardiac pacemakers meet the demand of the two main goals of modern cardiac pacing enauring both the synchronization of atriums and ventricles and the frequency response to physical exercise. In this way they simulate the normal heart rhythm behaviour best of all pacemakers in use. Since 1992 through 1995 the DDDR pacemakers were implanted in 27 patients aged 20-79 (mean 59.9) years in our pacemaker centre. The follow-up period has amounted to 46 months. 26 patients suffered from advanced sinus syndrome with the chronotropic incompetence and with the atrioventricular block, the remaining young man was given the pacemaker because of congenital atrioventricular block. In one patient epicardial leads implanted by thoracotomy have been used. After the wound had healed and the pulse energy had been reduced, the pacemaker bearers underwent the stepwise symptoms limited bicycle or treadmill stress test. During the follow-up the incidence of particular complications was assessed. In comparison with the DDD mode without the sensor, the DDDR pacemakers exhibiting the rate adaptation did improve the working capacity in particular patients in the stress test. (Tab. 1, Fig. 5, Ref. 16).

Adult↗
PubMed1997

[Is the response to cardiac pacing controlled by central venous temperature physiological?].

Rate responsive cardiac pacemakers are capable of adapting their pacing rate according to metabolic demands in the physical effort and some of the sensors in use even according to such physiological stimuli in which the level of metabolism remains unchanged. Central blood temperature (CVT) could possibly represent a much-needed and searched ideal sensor, which truly reflects physiological processes. In order to verify the response of the thermistor sensor under various physiological conditions, 10 single-chamber VVIR pacemakers Thermos M 02 (Biotronik) were implanted since 1993 through 1995. Our group of patients consisted of 9 men and 1 women. 8 patients had chronic atrial fibrillation with bradycardia and ventricular chronotropic incompetence, 2 patients suffered from the 3rd degree atrioventricular block. The mean age at the time of implant was 62.4 (52-72) years, the mean follow-up period has amounted to 23 (2-32) months. The CVT response to physical exercise was proportional and smooth, especially in the strenuous physical effort. In contrast to some other sensors, CVT exhibited the physiological reaction also in situations in which the metabolic level did not change. It displayed a physiological circadian fluctuation of the pacing rate. Nevertheless, a markedly prolonged reaction time at the onset of physical exercise in the patients who were still "cold" was a shortcoming of this principle. The special sensor lead is a must and only the ventricular pacing is possible. Isolated CVT is not the ideal sensor but it be combined with fast sensors. It will undoubtedly be one of the sensors within the automatic multisensor pacemaker in the forseeable future. (Tab. 1, Fig. 1, Ref. 15.)

Aged↗
PubMed1996

Sequential treatment of recurrent mesenteric desmoid tumor.

BACKGROUND: The optimal management of inoperable desmoid tumors is still unclear. We report a 26 year-old female patient with familial adenomatous polyposis suffering from a recurrent inoperable intraabdominal desmoid tumor and its sequential treatment. METHODS: Treatment strategies included low-dose tamoxifen (30 mg orally per day), high-dose tamoxifen (90 mg orally per day), and a subsequent combination of goserelin acetate (3.6 mg subcutaneously once every four weeks) plus low-dose tamoxifen, medroxyprogesterone acetate (1000 mg orally per day) and interferon gamma (3 Mio IU subcutaneously 3 times a week). RESULTS: The combination of goserelin acetate and low-dose tamoxifen resulted in a decrease in tumour size and a complete relief of symptoms for 17 months. Thereafter the tumor progressed and again growth was stopped with interferon gamma therapy for another 6 months. All other treatment modalities had no effect. CONCLUSIONS: This study demonstrates long-term regression of a desmoid tumor with combined endocrine therapy using goserelin acetate plus tamoxifen. Tumor progression after 17 months was again stopped by a combination of interferon-gamma and goserelin acetate.

Adenomatous Polyposis Coli↗
PubMed1992

[Modern cardiac pacing. I. Dual-chamber pacemakers: 10 years' experience].

Dual chamber cardiac pacemakers restoring an impaired atrioventricular synchrony meet a demand of contemporary so-called physiologic cardiac pacing. 39 dual chamber (DDD) pacers were implanted in 1982-1991 in our center. They improved both well-being and hemodynamic values (doppler echocardiography) more distinctly than common ventricular demand devices did. P-wave driven ventricular pacing in normal sinus node function (in 40 per cent of our DDD patients) made a frequency response in physical exercise possible. A short atrioventricular delay in DDD pacing proved to be helpful in the treatment for reentry tachycardias refractory to antiarrhythmic drug administration. Demanding implant, high price, lengthy programming as well as a higher incidence of complications (30.7 per cent) as compared to ventricular pacemakers (7.6 per cent) were the main problems of DDD ones.

Adult↗
PubMed1992

[Modern cardiac pacing. II. Rate responsive pacemakers: clinical experience].

Rate responsive cardiac pacemakers adapting their pacing frequency according to physical effort are able to solve not only a bradycardia, but a chronotropic incompetence too. 23 rate responsive pulse generators, implanted in 1987-1991 in our center, simulated the physiological conditions and in this way they significantly improved both working capacity in bicycle stress test (p < 0.0001) and well-being in comparison with ordinary demand pacers. The incidence of complications did not exceed that in simple common pacemakers, but the rate adaptive ones were expensive and their programming was time consuming. In all three rate adaptive principles used their non-specific response revealed some imperfection of sensor driven devices. In addition, both in QT and in respiratory dependent systems their pretty proportional frequency response was delayed, while the irregular pacing rate in body activity sensor was not very proportionate to the physical exercise. The non-specific sensor response may be reduced by a combination of biologic sensors.

Adult↗
PubMed1991

Prednimustine combined with mitoxantrone and 5-fluorouracil for first and second-line chemotherapy in advanced breast cancer.

A total of 60 patients with advanced breast cancer were treated with a combination of prednimustine (P: 110 mg/m2, days 1-5), mitoxantrone (M: 12 mg/m2, day 1) and 5-fluorouracil (F: 500 mg/m2, day 1) (PMF). Treatment was repeated every 3 weeks. In all 53 patients were evaluable for response. A total of 12 subjects had failed prior chemotherapy for metastatic disease. In response to PMF treatment we observed 21 partial remissions and 3 complete remissions, amounting to a total response rate of 45%. The median duration of response was 39 weeks, and median survival was 56 weeks. Dose-limiting side effects were leukopenia (40 cases) and thrombocytopenia (11 patients). Nausea and vomiting was experienced by 93% of subjects; in 56% of cases it reached WHO stage II-III. Alopecia occurred in 18% of our patients. Our results suggest that PMF represents an active regimen in the treatment of advanced breast cancer and yields a response rate of 45%. Considering that the majority of our patients had not received prior chemotherapy, the question remains open as to whether a 45% response rate outweighs the observed toxicity.

Adult↗
PubMed1990

[Perioperative subjective emotional state].

The aim of adequate preoperative medication is to minimize the patient's anxiety level. Preoperative anxiety can be consciously and specifically orientated or it can be masked. This double-blind study was performed to evaluate the effects of an anxiolytic drug in comparison with a placebo perioperatively and to assess the post-operative course of the important factors anxiety, depression and asthenia. The Mannheim inventory for subjective state and STAI (State-Trait-Anxiety-Inventory) were offered. The study was undertaken in 60 female patients, who were operated for suspected carcinoma of the breast. We conclude that in such a specific group of patients extensive preoperative psychological preparation must be backed up by the administration of an anxiolytic drug.

Adaptation, Psychological↗
PubMed1990

4'-O-tetrahydropyranyl-doxorubicin in advanced breast cancer: a phase II study.

In a phase II study, 35 patients with advanced breast cancer were treated with 4'-O-tetrahydropyranyl-doxorubicin (THP-DXR) (70 mg/m2 i.v. on day 1); treatment was repeated every 3 weeks. Eight patients had failed prior chemotherapy for advanced disease. A total of 34 patients were evaluable for response. After a median of 10 treatment courses (range, 3-15), objective tumor response was seen in 59% (20 of 34 patients) (95% confidence limits, 42%-75%). In all, 17 partial remissions and 3 complete remissions were observed; stable disease occurred in 13 patients. The median duration of response was 42+ weeks (range, 21 - 77+ weeks). The dose-limiting side effects were leukopenia (26 patients, WHO grade III-IV) and thrombocytopenia (9 patients, WHO grade II-IV). Nausea/vomiting was experienced by 34 patients; in 18, it reached WHO grade II-III. Other treatment-related side effects included alopecia (WHO grade II-III) in 26 patients and stomatitis and diarrhea (WHO grade I-III) in 9 patients. At cumulative doses of THP-DXR of at least 700 mg/m2 (range, 700-1,050 mg/m2), no signs of congestive heart failure were observed. We conclude that THP-DXR is effective for first- and second-line chemotherapy in advanced breast cancer and that side effects are manageable.

Adult↗
PubMed1989

Multiprogrammable pacemakers: are their advantages fully employed?

Out of 1265 pacemakers implanted between 1981 and 1987 in our center, 50 (4.0 percent) were of SSI M mode. Utilization of the programming capability of these multiprogrammable single-chamber pulse generators was investigated. All devices were programmed to the "energy saving mode" ensuring the longest lifetime possible. Half of them did not have to be reprogrammed for any other reason, the other half had to be programmed for cardiological and/or technical dysfunctions. Full utilization has been made of the programmability of these sophisticated and expensive units and their wide application is justified.

Arrhythmias, Cardiac↗
PubMed1987

[Complications and failures in free-flap transplantations].

Complications and failures in nine cases of free flap transfer are reported. With increasing experience the number of failures declines. In six of seven cases with total flap necrosis technique and tactics in microsurgical procedure were responsible for the disaster. The failure in the other case was due to thrombosis of an axillary vein and thoracodorsal vein leading to necrosis of a latissimus dorsi flap. A dorsalis pedis flap was saved by arterial inflow through a flap vein. The fact that not one flap could be saved by revision is accounted for by the circumstance that the monitoring looks at capillary filling alone. It is possible that the Laser-Doppler-flowmetry is a useful and practical method for objective monitoring.

Adult↗
PubMed1987

[Stonefish stab injury of the hand].

The authors report a sting injury by a stonefish in the hand. First aid and surgical treatment are discussed. The biology of the stonefish is reviewed.

Adult↗
PubMed1985

[Established and new surgical procedures in the therapy of breast cancer].

The established surgical procedure in the treatment of mammary cancer today is, without any doubt the modified radical mastectomy (Patey, Dyson). The adjuvant radiation therapy, following modified radical mastectomy, could not improve the all over survival of mammary cancer patients. Within the last years the breast conserving surgical procedures went more and more into the field of interest, especially of the patients. That is the reason, why these treatment-schedules should be considered very carefully according to thorough oncological principles. The radiation therapy within the conserving treatment is necessary as primary treatment in addition to surgery.

Breast↗