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Biomedical subjects

M Stahl

Publications and source records attributed to M Stahl.

At least 127 records · Page 7Linked to original sources
PubMed1991

Cisplatin, etoposide, and ifosfamide salvage therapy for refractory or relapsing germ cell carcinoma.

Thirty patients with metastatic progressive germ cell carcinoma who failed to be cured with first-line cisplatin chemotherapy were treated with a salvage regimen consisting of cisplatin 20 mg/m2, etoposide 100 mg/m2, and ifosfamide 1.2 g/m2 (PEI) intravenously (IV), days 1 to 5 every 3 weeks. Ten patients (33%) were tumor-free at the end of therapy. Complete response (CR) was achieved with chemotherapy alone in four patients and with additional surgery in six patients (two necroses, two mature teratomas, two carcinomas). Six patients (20%) had normalization of tumor markers but unresectable residual disease (Rm-), and the remaining 14 patients (46%) failed to respond. Of 10 patients with CR, nine (90%) relapsed again (eight carcinomas, one mature teratoma). The median duration of CR was 3.5 months. The median survival of the whole group was 311 days (range, 110 to 996+). Currently, seven of 30 patients are alive, and five of them are without signs of progressive tumor. The response to prior cisplatin therapy predicted for response and survival after PEI salvage therapy. Of 14 patients with prior CR, eight (57%) achieved a second CR compared with one of 11 (9%) with prior unfavorable response (P = .039). The median survival for patients with prior favorable response was 400 days, compared with 251 days for patients with prior unfavorable response (P less than .001). Myelosuppression was dose-limiting, with leukopenia greater than grade 2 in 84% and thrombocytopenia greater than grade 2 in 51% of all cycles. This three-drug regimen can induce a second CR in one third of patients with relapsed or refractory germ cell carcinoma. Only those patients with prior favorable responses can expect to be cured by this salvage regimen, while patients with prior unfavorable response should be considered for alternative salvage approaches.

Adult↗
PubMed1991

Cortisol increases the susceptibility of rat islets to interleukin 1.

Interleukin 1 beta has been proposed to play an essential role in the pathogenesis of IDDM by direct interaction with the pancreatic beta-cell. Glucocorticoids are widely used as immunosuppressive agents and have been suggested to interfere both with the production and action of interleukin 1. The aim of the present study was to evaluate the interaction between cortisol and interleukin-1 on the pancreatic beta-cell function in vitro. Newborn rat islets were precultured for seven days before they were exposed to interleukin 1 with or without addition of cortisol. The release of insulin to the culture medium was followed and the insulin content and biosynthesis were measured after one week in culture. Cortisol, 10(-6) mol/l, resulted in a 50% lower rate of release during the culture period and a similar reduction in storage and biosynthesis of insulin in the islets at the end of the culture period. In the control islets interleukin 1, 0.5 microgram/l, resulted in an early increase in insulin release followed by a marked reduction. In the cortisol-treated islets interleukin 1 increased the release up to 72 h followed by a moderate decrease. In the control islets, interleukin 1 reduced the insulin content to about 50%, whereas in the cortisol-treated islets interleukin 1 resulted in an even greater reduction, to about 30%. This additional effect of cortisol seems not to be due to an augmented cytotoxic effect of interleukin 1 as indicated by the DNA content of the islets and the viability of the cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[The developmental prognosis of children with 5-day seizures].

We report on the course of development of 23 children with fifth-day fits during the years 1980 to 1985. The age of examination was 4.6 years on average. 21 cases had a neurodevelopmental examination including an EEG-recording. In two further cases developmental data could be obtained by an interview by phone. We obtained the following results: 2 children developed epilepsy. Normal development was seen in 9 children. The developmental abnormalities became manifest in children older than 30 months. There is no homogeneous profile of abnormalities of development. Therefore we suggest to perform differentiated and multidisciplinary investigations in the follow up of children with fifth day fits. Similar to the observations in Australia and Italy, we could not see any more case of fifth-day fit since 1985.

Child Development↗
PubMed1991

Lonidamine versus high-dose tamoxifen in progressive, advanced renal cell carcinoma: results of an ongoing randomized phase II study.

Sixty patients with metastatic renal cell carcinoma were entered into an ongoing randomized phase II study with lonidamine, 350 mg/m2 orally daily (arm A) and high dose tamoxifen, 150 mg/m2 orally daily for 6 months, afterwards 50 mg/m2 (arm B), until tumor progression. All patients had measurable disease and documented tumor progression prior to treatment. There were 1 complete and 1 partial remission among 19 evaluable patients in arm A (10.5%) and 2 complete and 1 partial remission among 25 evaluable patients (12%) in arm B. Objective responses were observed in pulmonary, nodal, and cutaneous metastases. In addition, in 63% and 64% tumor progression could be stopped in arm A and B, respectively. Median response duration was 100 days (range, 20-361) in arm A and 150 days (range, 28-355) in arm B. One year survival rate was 37.5% with lonidamine and 35% with tamoxifen. In arm A patients with tumor progression within 12 weeks after diagnosis of metastatic disease survived significantly shorter than patients with a longer interval (P less than 0.05). Nephrectomy or number and localization of metastatic sites failed to significantly influence probability of remission or survival. Toxicity was mostly mild to moderate. Four patients in the lonidamine arm had to discontinue treatment because of intolerable myalgias, which were immediately reversible. These data suggest that lonidamine and high-dose tamoxifen are moderately effective in widespread renal cell carcinoma where treatment intention is palliative.

Adult↗
PubMed1990

[Comparison of guar gum, wheat bran and placebo on carbohydrate and lipid metabolism in type II diabetics].

10 non-insulin-dependent (NIDDM) diabetic patients of the University Hospital Basle completed a placebo-controlled open crossover study of three 3-month periods in which the response to 30 g wheat bran and 15 g guar gum daily, respectively, was compared with placebo response. No significant difference occurred in blood glucose or HbA1c. Only postprandial plasma insulin levels were significantly lower in the afternoon at the end of both treatments (p less than 0.05). Serum total cholesterol levels decreased under guar gum by 10% (p less than 0.01), as did LDL cholesterol and the ratio of total to HDL cholesterol (p less than 0.05). Triglycerides were significantly lower (p less than 0.05) after 8 weeks. We conclude that neither guar gum nor wheat bran improves the metabolic control of NIDDM, but guar gum may be useful in patients with high serum total cholesterol levels.

Adult↗
PubMed1990

High dose folinic acid/etoposide/5-fluorouracil in advanced gastric cancer--a phase II study in elderly patients or patients with cardiac risk.

Thirty-four consecutive patients with measurable advanced gastric cancer were treated in a disease oriented Phase II study with high-dose folinic acid (HDFA) 300 mg/m2 10 min. inf., followed immediately by etoposide 120 mg/m2 50 min. inf., followed immediately by 5-fluorouracil (5-FU) 500 mg/m2 10 min. inf., given on day 1,2,3 (ELF). Courses were repeated every 22-28 days. All patients who entered this study were older than 65 years or had underlying cardiac disease. Thirty-three patients were evaluable for response and toxicity (greater than or equal to 1 course). One patient was lost to follow up. The overall response rate was 48% (16/23) including 12% (4/33) complete remissions. Eight patients had minor responses or no change and 9 had progressive disease. Five of six patients with locally advanced and non-resectable disease had an objective response (1 CR, 4 PR's). The response rate in patients with metastatic disease was 41% (11/27). After a median observation time of 6.5 months, the median survival time was 10.5 months, with a median remission (CR + PR) duration of 8 months. Toxicity was manageable and included mild to moderate myelosuppression and gastrointestinal toxicities. One episode of life-threatening (Grade IV) leukopenia, and two episodes of severe diarrhea requiring hydration were noted. No treatment related death occurred. ELF is an effective combination in advanced gastric cancer and can be safely administered to elderly patients and patients with cardiac risk.

Aged↗
PubMed1990

High dose epirubicin in refractory or relapsed non-seminomatous testicular cancer: a phase II study.

Sixteen patients with metastatic nonseminomatous testicular cancer refractory to cisplatinum combination chemotherapy, were treated with epirubicin 100-120 mg/m2 q d 22. One partial remission lasting 6 months was achieved. Two additional patients had stabilisation of disease for 3 and 4 months. Median time to progression was 43 days. Myelosuppression was dose-limiting, with a WBC nadir of 1900/microliters. 4/30 cycles (13%) were associated with granulocytopenic fever. One patient developed a decline in cardiac ejection fraction without clinical signs of congestive heart failure. Epirubicin in this dosage and schedule has no major therapeutic activity in heavily pretreated non-seminomatous testicular cancer.

Combined Modality Therapy↗
PubMed1990

Porcine granulocyte functions: evaluation and modulation.

Functions of porcine polymorphonuclear neutrophils are evaluated with in vitro test systems. Results are compared with those from human PMN and the relevance for in vivo conditions is discussed. Ethanol was inhibitory to all porcine PMN functions investigated here. Influex, a combination product, containing extracts of Echinacea, Aconitum, Apis and Lachesis stimulated adherence, chemotaxis, and phagocytosis, but inhibited chemiluminescence. These results suggest an effect of the product in the generation of reactive oxygen species.

Animals↗
PubMed1990

Complement-dependence of polymorphonuclear yeast cell phagocytosis: a comparison between man and various domestic animals.

The complement-dependence of polymorphonuclear yeast cell phagocytosis of sheep, goat, cattle, horse, dog, pig and man is determined by comparing the opsonizing abilities of untreated sera with complement-inactivated autologous sera at a serum concentration of 2.5% and at different phagocytosis periods. The performed phagocytosis assays only detects incorporated particles and allows for the differentiation of granulocytes with different quantities of phagocytosed particles. In sheep, horse and man the addition of heat-inactivated serum reduces the phagocytosis index to less than -80% of the value obtained at untreated serum addition at a phagocytosis period of 60 min. The other species show a smaller reduction ranging from -66.9% (dog) to 41.4% (cattle). The evaluation of the distribution pattern of granulocytes incorporating a certain number of yeasts offers significant differences in the investigated species.

Animals↗
PubMed1990

Pirarubicin in advanced non-small cell lung cancer. A trial of the Phase I/II Study Group of the Association for Medical Oncology of the German Cancer Society.

Forty-seven patients with advanced non-small cell lung cancer (NSCLC) were treated in a multicentre phase II study with pirarubicin (THP), 4'-O-tetrahydropyranyl-doxorubicin using a dosage of 70 mg/m2 every 3 weeks. The median age of the patients was 59 years (range 45-70) and the performance status grade 0-2 (WHO). Thirty-eight patients had stage IV and 9 stage III (UICC). Twenty-six patients had an adenocarcinoma. 19 a squamous cell carcinoma, and 2 a polymorphocellular carcinoma. Six out of 45 evaluable patients achieved a partial remission leading to an overall response rate of 13%. Eighteen patients showed no change (NC), 12 were progressive (PD), 2 patients had early progression (EP), and 7 patients died during the first course with clinical signs of tumor progression (early death). The median survival time was 4.6 months. Leukocytopenia and thrombocytopenia (WHO grade 4) was experienced in 8.5% and 2.1%, nausea and vomiting (grade 2 and 3) by 32% of the patients. There was no cardiotoxicity or other severe side effects. Pirarubicin has only a moderate antineoplastic activity in patients with advanced NSCLC. Observed response rates are similar to those reported for doxorubicin, but the toxic side effects are milder.

Aged↗
PubMed1990

New developments in the treatment of gastric carcinoma.

The recent successes being achieved with combination chemotherapy regimens, such as FAMTX (fluorouracil [5-FU], doxorubicin, methotrexate), EAP (etoposide, doxorubicin, cisplatin), and ELF (etoposide, leucovorin, 5-FU), strongly indicate that gastric cancer is chemosensitive. With these regimens, objective remission rates of more than 50% were recorded, including approximately 10% complete remissions (CRs). Moreover, some of these CRs were histopathologically confirmed. The finding that locally advanced disease (LAD) and technically unresectable disease could be rendered resectable by preoperative chemotherapy (EAP) was important. Thirty-six patients with LAD had been treated in a phase II trial with preoperative EAP, inducing 24 (70%) overall remissions (two clinical CRs, six pathologic CRs, 16 partial remissions [PRs] in 35 evaluable patients. Twenty-one patients were disease-free after chemotherapy with or without second-look surgery. The median survival time was 18 months for all patients and 24 months for disease-free patients. At 30+ months, 21% of all patients are still living disease-free. The expected survival of patients with unresectable LAD is approximately 4 to 6 months without any treatment and 6 to 9 months with standard chemotherapy. Compared with the latter results, the preoperative use of effective regimens (eg, EAP) seems to improve prognosis of patients with LAD. Moreover, such a multimodal approach may increase the number of long-term survivors among patients with resectable gastric cancer, especially those whose stage indicates a high risk of relapse (stages IIIa or IIIb). However, partly because of the severe toxicities (myelosuppression, nausea/vomiting), a considerable number of patients cannot be treated with these new regimens for the following reasons: Two of three patients with gastrointestinal disease are older than 60 years. Nontumorous diseases of the cardiovascular system, kidney, and others are frequent in this age group and may complicate or even prevent treatment with aggressive regimens. Considering the predominantly palliative treatment intentions in far advanced (metastasized) gastric cancer, regimens with low toxicities and acceptable activity should be preferred. For these reasons, we developed and investigated the combination ELF in a phase II trial in elderly patients (greater than 65 years) and in patients with cardiac risks who could not be treated with anthracyclines. The overall response rate in 51 evaluable patients was 53% (27 of 51) including six clinical CRs (12%). The median remission duration was 9.5 months and the median survival time was 11 months. Tolerability was excellent. Only 16% and 4% of patients, respectively, experienced WHO grades 3 and 4 leukopenia. Nausea/vomiting and mucositis/stomatitis were mild.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1989

Quantitative characterization of yeast cell incorporation in phagocytes: microscopic methods for differentiation between adherent and ingested particles.

A light- and a fluorescence-microscopic method for quantitative assessment of yeast cell incorporation in phagocytes were developed. The light-microscopic method offers methylene blue prestained yeast cells as phagocytosis particles and counterstains nonincorporated yeasts with eosine. The fluorescence-microscopic method works by acridine orange staining of phagocytosis assays. Fluorescence of nonincorporated yeast cells is suppressed by addition of methylene blue. Different ways of evaluating the results of microscopic quantitation of phagocytosis are discussed.

Acridine Orange↗
PubMed1989

Granulocyte isolation from whole blood of goat, sheep, cattle, horse, dog, pig, and man.

A simple two step procedure for the isolation of caprine, ovine, bovine, equine, canine, porcine and human peripheral blood granulocytes is described. After enrichment of granulocytes by centrifugation, contaminating erythrocytes are lysed hypotonically. Recovery, purity, and viability of the granulocyte suspensions are determined. FACScan analysis of the cell suspensions measuring cellular size by forward and sideward light scatter is compared with the corresponding analysis of whole blood leukocytes. Constituencies of the isolated cell suspensions and loss of granulocyte subpopulations through isolation procedure is discussed with regard to granulocyte function assays.

Animals↗
PubMed1989

[The prognosis of the very small premature infant. Catamnestic studies of premature infants with a birth weight up to 1,000 grams].

29 of 50 premature infants with a birth weight up to 1,000 g survived and were examined between 2-9 years of age. 13 children showed no or only minimal abnormalities. 11 children were felt to require treatment but to have a good prognostic outcome. 3 children had multiple disabilities. From the total of 16 children requiring treatment only 5 were under treatment before our evaluation. The quality of life is good for 24 of the 29 survivors.

Birth Weight↗