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Biomedical subjects

M Wolf

Publications and source records attributed to M Wolf.

At least 271 records · Page 15Linked to original sources
PubMed1995

[Proteins in uterine secretions of fertile and sterile patients using SDS polyacrylamide gel electrophoresis (SDS-PAGE)].

Aim of the presented study was to find out whether there are any differences in the protein patterns of uterine secretions of fertile and sterile women. Analysis was made by polyacrylamide gel electrophoresis (SDS-PAGE). Uterine secretions and sera of 11 sterile and 8 fertile patients were investigated. Utilizing the reducing SDS-electrophoresis, the comparison of all uterine secretions revealed an additional protein band of molecular weight of 33,000 Dalton in the uterine secretions of the fertile women. Secretions of the sterile women showed a protein band which was of significantly lower weight. The significance of this additional protein band as a possible factor of fertility is discussed.

Adult↗
PubMed1995

Antibodies to macromolecular platelet factor 4-heparin complexes in heparin-induced thrombocytopenia: a study of 44 cases.

As heparin-PF4 (H-PF4) complexes are the target for antibodies associated to heparin-induced thrombocytopenia (HIT), an ELISA has been developed and optimised for testing antibodies binding to H-PF4. This test was consistently negative in 50 healthy subjects (A492 < 0.3) and 35 patients with other causes of thrombocytopenia (A492 < 0.5). In contrast, 43 out of 44 HIT patients showed antibodies to H-PF4 (A492 = 1.70 +/- 0.81) including 5 patients with a negative platelet aggregation test. In one patient with HIT, antibodies to H-PF4 were already present at day 7, whereas platelet counts dropped < or = 100 x 10(9)/l only at days 11-12. Surprisingly, among 41 patients under heparin for > 7 days, 5 showed antibodies to H-PF4, without HIT. These findings underline the major interest of this ELISA for the early diagnosis of HIT. We also showed that LMWH as well as other sulphated polysaccharides can bind to HIT antibodies in the presence of PF4 and that their reactivity is dependent on the molecular weight and the sulphation grade. The mechanism for HIT involves platelet PF4 receptors which bind the macromolecular H-PF4 complexes formed in the presence of a well defined heparin/PF4 ratio.

Adolescent↗
PubMed1995

[Arterial and venous alcohol elimination in 10 polytrauma patients].

Alcohol elimination was examined in 10 patients involved in accidents while intoxicated. The influence of trauma, particularly polytrauma resulting in haemorrhage shock and its therapeutic treatment were analysed. The blood alcohol concentrations were determined according to the usual forensic criteria (2 alcohol dehydrogenase and 2 gas chromatography measurements). Observation periods ranged from 3 hours 45 minutes to 12 hours 35 minutes, with blood being drawn at intervals ranging from 45 minutes to 185 minutes (on average 70 minutes). Results of two patients (delta 60 = 0.22/1000/h and 0.28/1000/h) who only had 3 venous drawn and results of a deceased patient from whom only four arterial samples could be obtained (beta 60 = 0.21/1000/h) were disregarded when working out the average values. The blood alcohol curve plateaued in the case of the deceased patient as well as in the case of a patient whose hepatic circulation was curtailed for approximately half an hour during surgery. The blood alcohol curves for the remaining patients for uniformly linear with beta 60 values between 0.17/1000/h and 0.21/1000/h (mean = 0.18/1000/h +/- 0.01) in arterial samples and 0.18/1000/h and 0.21/1000/h (mean = 0.18/1000/h +/- 0.01) in venous samples. Given our results and the existing literature, we feel that retrograde calculations of the BAC can be justified in patients with polytrauma, despite the small number of patients included in the study. Naturally, the usual forensic criteria have to be taken into account, as well as individual situations. Examples that can be mentioned here are liver failure or curtailment of hepatic circulation during surgery.

Accidents, Traffic↗
PubMed1995

[Medical aid according to the asylum application regulation--a report of experiences after the first year].

In 1993 the Law Concerning Social and Medical Aid for People Asking for Political Asylum in the Federal Republic of Germany (Asylbewerberleistungsgesetz) was promulgated. In so far the main political aims of the new law are concerned it is to say that in the case of dental treatment they have failed at least in the first year. The author believes it to be more serious from a medical point of view that there is a tendency towards a medicine having two different "classes".

Adult↗
PubMed1995

[Gynecological laparoscopy in sheep. 1. Foundations].

Laparoscopy is a gentle and safe method for diagnosis and manipulation of the genital tract in female sheep. After a short history outline the equipment and the fundamental principles of the laparoscopy in sheep are described. Possible laparoscopic incidents and their treatment are explained.

Animals↗
PubMed1995

Paclitaxel and simultaneous radiation in the treatment of stage III A/B non-small cell lung cancer.

In a clinical phase II trial, radiotherapy and escalating doses of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) were given concurrently to patients with stage IIIA/B non-small cell lung cancer. Radiotherapy was given in daily doses of 2 Gy, 5 days a week, in weeks 1 to 3 and 6 to 8 for a total dose of 56 Gy. Paclitaxel was given in 3-hour infusions on day 1, also in weeks 1 to 3 and 6 to 8. The starting dose level was 50 mg/m2; the subsequent dose levels were 60, 72, 86, and 103 mg/m2. Cohorts of three to six patients were assigned to each dose level until intolerable toxicity (eg, World Health Organization grade 3 or 4 leukopenia) occurred in three of the six patients. Currently, 15 patients have entered the study. Twelve patients have finished the treatment protocol and are evaluable for toxicity and response. Hematologic toxicity was mild, and even at 86 mg/m2, the highest evaluable dose level, no severe myelosuppression was noticed. The main clinical toxicity was the occurrence of pulmonary infections, which were seen in five patients. One of these patients had a Pneumocystis carinii infection, but no pathogens were isolated from the four others with interstitial infections. Mild to moderate esophagitis was seen in five patients. All patients showed a decrease of tumor size. Four patients had a major response with nearly complete disappearance of radiologic tumor signs, five patients had a partial remission, and three patients experienced a minor response. Thus, the overall response rate was 75%. In summary, the maximum tolerated dose of paclitaxel has not yet been achieved, the occurrence of pulmonary infections represents the major clinical toxicity, and the extremely high response rate merits further clinical evaluation of this regimen.

Adult↗
PubMed1995

Post-splenectomy lymphocytosis.

We describe post-splenectomy lymphocytosis (PSL) in 23 patients, a majority (20/23) of whom have undergone splenectomy as a staging procedure for Hodgkin's disease. The absolute lymphocyte count ranged from 4.0 to 8.7 x 10(9)/l. The lymphocytosis was noted 4-242 (median 70) months after splenectomy and persisted almost unchanged in most patients on prolonged follow up (median 50 months). Immunophenotyping of the lymphocytes revealed no monoclonal B cell population.

Adult↗
PubMed1994

Filgrastim in patients with chemotherapy-induced febrile neutropenia. A double-blind, placebo-controlled trial.

OBJECTIVE: To determine if filgrastim (recombinant human methionyl granulocyte colony-stimulating factor) used in addition to standard inpatient antibiotic therapy accelerated recovery from infection associated with chemotherapy-induced neutropenia. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Hematology and oncology wards of four teaching hospitals. PATIENTS: 218 patients with cancer who had fever (temperature > 38.2 degrees C) and neutropenia (neutrophil count < 1.0 x 10(9)/L) after chemotherapy. INTERVENTION: Patients were randomly assigned to receive filgrastim (12 micrograms/kg of body weight per day) (n = 109) or placebo (n = 107) beginning within 12 hours of empiric therapy with tobramycin and piperacillin. Patients received treatment and remained in the study until the neutrophil count was greater than 0.5 x 10(9)/L and until 4 days without fever (temperature < 37.5 degrees C) had elapsed. MEASUREMENTS: Days of neutropenia and fever and days in the study (hospitalization); time to resolution of fever and febrile neutropenia; and frequency of the use of alternative antibiotics. RESULTS: Compared with placebo, filgrastim reduced the median number of days of neutropenia (3.0 compared with 4.0 days of a neutrophil count of < 0.5 x 10(9)/L; P = 0.005) and the time to resolution of febrile neutropenia (5.0 compared with 6.0 days; P = 0.01) but not days of fever (3.0 days for both groups). The frequency of the use of alternative antibiotics was similar in the two groups (46% compared with 41%; P = 0.48). The median number of days patients were hospitalized while on study was the same (8.0 days; P = 0.09); however, filgrastim decreased the risk for prolonged hospitalization (> 11 days, 4th quartile) by half (relative risk, 2.1 [95% CI, 1.1 to 4.1]; P = 0.02). In exploratory subset analyses, filgrastim appeared to provide the greatest benefit in patients with documented infection and in patients presenting with neutrophil counts of less than 0.1 x 10(9)/L. CONCLUSIONS: Filgrastim treatment used with antibiotics at the onset of febrile neutropenia in patients with cancer who have received chemotherapy accelerated neutrophil recovery and shortened the duration of febrile neutropenia.

Adolescent↗
PubMed1994

Interleukin-8 processing by neutrophil elastase, cathepsin G and proteinase-3.

Activated neutrophils secrete two forms of IL-8 with 77 and 72 amino acids, IL-8(77) and IL-8(72), along with proteinases that could process these cytokines. Significant conversion of IL-8(77) to more potent, N-terminally truncated forms was observed upon incubation with neutrophil granule lysates and purified proteinase-3. IL-8(72) was considerably more resistant to proteolytic processing than IL-8(77). The present observations indicate that neutrophil proteinases released in inflamed tissues convert IL-8 to more active forms and therefore tend to conserve or enhance, rather than decrease IL-8 activity.

Amino Acid Sequence↗
PubMed1994

Evaluation of low dose continuous infusion 5-fluorouracil in patients with advanced and recurrent renal cell carcinoma. A Southwest Oncology Group Study.

BACKGROUND: The response rate of metastatic renal cell cancer to cytotoxic therapy over the last 10 years has been 5.6%. Low dose continuous 5-fluorouracil (5-FU) has demonstrated efficacy in other cytotoxic refractory tumors, such as pancreas, colorectal, and recurrent breast. The Southwest Oncology Group undertook a Phase II trial of low dose, continuous 5-FU in metastatic renal cell cancer. METHODS: Sixty-one patients were entered in the study to receive 300 mg 5-FU/m2/day for 7 days via a central venous catheter and external programmable pump. The pump was refilled every 7 days. Pyridoxine (50 mg, orally) was administered prophylactically three times a day. RESULTS: A response of 5.2% (one complete response [CR] and two partial responses [PRs]) was achieved. The overall survival was 12 months. The duration of the CR is more than 30 months. Both PRs lasted 6 months. No survival advantage was noted with either prior nephrectomy or biologic therapy. The majority of toxicities were Grade 2: anemia, anorexia, diarrhea, nausea/vomiting, and stomatitis. No toxic deaths occurred. CONCLUSION: Low dose, continuous 5-FU demonstrated minimal activity in metastatic renal cancer.

Carcinoma, Renal Cell↗
PubMed1994

Artifactual pulse-oximetry estimation in neonates.

Two sources of artifactual pulse-oximetry estimation were investigated in 20 neonates. Increased pressure on tissue due to inappropriate sensor fixation was mimicked with a blood pressure cuff. The error in arterial oxygen saturation (pSO2) exceeded 2 SD (> 3%) in 25% subjects at 50 mm Hg which in an ancillary experiment was produced by 11 of 26 nurses fixing the sensor. Venous congestion at 30 and 40 mm Hg permitted normal detection of pulse rate but induced errors in pSO2 over 2 SD in 15% and 30% of subjects, respectively. Pulse-oximeter values need to be scrutinised for these common errors.

Artifacts↗
PubMed1994

Phase II evaluation of merbarone in renal cell carcinoma.

The Southwest Oncology Group (SWOG) studied the response rate and toxicity of merbarone (1,000 mg/m2 IV continuous infusion days 1-5, q 21 days) in patients with advanced metastatic renal cell carcinoma. Among 36 eligible patients, there was one partial response for a response rate of 3% (95% C.I. 0.1-15%). There were no mixed responses. There were no treatment related deaths or adverse drug reactions. Significant anemia, diarrhea, and hypercalcemia were observed. Mild to moderate degrees of malaise/fatigue/lethargy, dizziness/vertigo, hyperglycemia, creatinine increase, nausea, vomiting, weight loss, pedal edema, dyspnea, and granulocytopenia were noted. Merbarone does not have significant activity as a single agent in advanced renal cell carcinoma.

Antineoplastic Agents↗
PubMed1994

Effect of aminophylline on cerebral haemodynamics and oxidative metabolism in premature infants.

The effect of aminophylline on cerebral blood volume and oxidative metabolism in newborn infants was investigated with near infrared spectroscopy (NIRS). Thirteen mechanically ventilated premature infants who received aminophylline to facilitate weaning from the respirator were selected. Gestational age ranged between 26 and 34 weeks, postnatal age between 1 and 7 days and birth weight between 760 and 2300 g. A bolus of 6 mg aminophylline/kg body weight was infused within 2 min. NIRS was performed continuously across the head to monitor changes in cerebral blood volume and cytochrome c oxidase. Heart rate, transcutaneous carbon dioxide tension (tcpCO2) and arterial haemoglobin oxygen saturation (SO2) were recorded simultaneously. The infusion of aminophylline was associated with an increase in heart rate (median 12, interquartile range 5-20 beats per min, P = 0.0004) and a drop in tcpCO2 (median -0.4, interquartile range -0.1 to -0.5 kPa, P = 0.015). Oxygen saturation remained stable (+/- 3%). A decrease in cerebral blood volume was measured with NIRS in 9/13 patients (median -0.15 ml/100g brain tissue, interquartile range +0.08 to -0.28, P = 0.10). Oxidized cytochrome c oxidase decreased in 11/13 patients (median -0.27 mumol/l, interquartile range -0.19 to -0.44, P = 0.01). Our findings demonstrate an immediate step-response of heart rate and tcpCO2 to aminophylline in premature infants. The simultaneous reduction of cytochrome c oxidase in the brain cannot be explained as a consequence of changes in tcpCO2 or changes in cerebral blood volume. We therefore speculate that aminophylline interferes directly with cerebral metabolism.

Aminophylline↗
PubMed1994

Tissue characterization using intelligent adaptive filter in the diagnosis of diffuse and focal liver disease.

In ultrasonic imaging an adaptive two-dimensional filter (ATDF) can suppress randomly generated speckle using the ratio of the local variance to the local mean as the speckle recognition feature (R). The degree of smoothing depends on the difference between the recognition feature in the region to be filtered and the selected reference tissue. We have investigated the clinical application of ATDF for ultrasound B-mode images of liver abnormalities. Using the R values of normal liver as reference values, the ATDF images were displayed. Normal livers (n = 17, R = 2.19 +/- 0.14 M +/- SEM), fatty livers (N = 16, R = 1.89 +/- 0.15) and those with acute hepatitis (N = 10, R = 2.25 +/- 0.18) appeared smooth after application of the adaptive filter, but those diseases with higher R values, such as chronic hepatitis (N = 10, R = 3.04 +/- 0.30), cirrhosis (n = 16, R = 4.44 +/- 0.30), metastases (N = 16, R = 6.43 +/- 0.53) and hepatocellular carcinomas (N = 8, R = 7.92 +/- 0.85), were largely unsmoothed. In conclusion, ATDF allows differentiation of some forms of liver disease and may be helpful in the detection of microfocal echogenic textural lesions.

Adult↗
PubMed1994

A randomised double blind crossover study of domperidone and prochlorperazine suppositories for controlling emesis in outpatients receiving chemotherapy.

Patients receiving outpatient chemotherapy, without cisplatin, were randomised to receive four doses of either domperidone 60 mg or prochlorperazine 25 mg suppositories every 4 h, starting 30 min before the chemotherapy. They were crossed over for the next chemotherapy cycle. To enable analysis of 100 patients who had received identical chemotherapy in each course, 136 patients were randomised. Patients experienced a higher grade of nausea on domperidone (P = 0.05). Only 18% of patients vomited on domperidone and 14% on prochlorperazine, but the number of vomits was higher on domperidone (P = 0.003) and the duration was significantly increased (P = 0.02). Patients experienced significantly more diarrhoea on domperidone (P < 0.0001), although it was predominantly mild. Patients were significantly more sedated on prochlorperazine on the second course (P = 0.006), but not on the first course (P = 0.9). More patients preferred their second course (P < 0.0001), and were significantly less anxious (P = 0.0002). Patients reported tolerating their treatment similarly for both antiemetics, but more patients preferred prochlorperazine (P = 0.003), mainly due to reductions in nausea and vomiting and other side-effects, particularly diarrhoea.

Adult↗
PubMed1994

Self-perception and adolescent psychopathology: a clinical-developmental perspective.

The relationship between self-perception and adolescent psychopathology was examined on nine domains of self-perception in a group of adolescent psychiatric inpatients and a comparison group of nonpatients. Inpatients rated themselves significantly lower in four domains, and correlations between symptom reports and domains of self-perception supported a relationship between negative self-perception and psychopathology. Further analysis suggested less differentiated self-perceptions among inpatients than among nonpatients. Implications for developmental assessments and clinical interventions are discussed.

Adolescent↗