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Biomedical subjects

M Wolf

Publications and source records attributed to M Wolf.

At least 307 records · Page 17Linked to original sources
PubMed1994

Non Hodgkin's lymphoma--diagnosis and management.

Major advances have been made in the treatment of NHL but many problems still remain. New and improved forms of treatment are required for patients with low-grade NHL, most of whom cannot be cured. For patients with aggressive NHL, the haematopoietic growth factors offer the chance of reducing the morbidity and maintaining the intensity of treatment. This should translate to improved long-term outcome. Well designed clinical trials need to be done to answer many remaining questions in the treatment of this potentially curable group of diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Familial occurrence of Warthin's tumour.

A rare occurrence of Warthin's tumour in the parotid glands of three brothers is presented. The only two reports of familial Warthin's tumour are mentioned and pathophysiologic mechanisms are suggested.

Adenolymphoma↗
PubMed1994

Radiotherapy alone versus chemotherapy with ifosfamide/vindesine followed by radiotherapy in unresectable locally advanced non-small cell lung cancer.

In a German multicenter trial, previously untreated patients with unresectable stages IIIA and IIIB non-small cell lung cancer were randomly assigned to receive either radiotherapy alone (arm A) or chemotherapy followed by radiotherapy (arm B). Chemotherapy in arm B consisted of ifosfamide 1,500 mg/m2 intravenously on days 1 to 5 and 29 to 33, and vindesine 3 mg/m2 intravenously on days 1 and 5 and 29 and 33. Radiotherapy started on day 1 in arm A and on day 56 in arm B. Single doses of 2 Gy were given 5 days a week for 3 weeks and after a 2-week interval for an additional 2 weeks. The total radiation dose was 50 Gy. Concurrent to radiotherapy, cisplatin was given as a radiosensitizer at a dose of 20 mg/m2 once a week. From July 1986 to March 1989, 85 patients were randomized, of whom 78 were evaluable. Main prognostic factors were well balanced. Of the patients receiving chemotherapy, 25% had a partial remission after two cycles, 46% showed no change, and 29% had progressive disease. After radiotherapy, response rates were 49% in arm A and 58% in arm B, including a 10% complete remission rate in both groups. After two thirds of the projected sample size had been included, an analysis of survival was performed and showed a statistically significant advantage for the treatment group including chemotherapy (P = .016). Median survival was 9.0 months versus 13.7 months and 2-year survival was 12% versus 24%, both in favor of the group receiving chemotherapy. These results caused premature discontinuation of patient accrual according to the study protocol and the recommendations of the Ethics Review Board of the Philipps-University Hospital. The results of this trial indicate that chemotherapy is able to prolong survival of patients with locally advanced unresectable non-small cell lung cancer and should be considered for treatment of these patients.

Adult↗
PubMed1994

[Teamwork and communication in implantology: dentist--technician--implant surgeon].

The importance of presurgical communication and cooperation between the restorative dentist, dental technician, and the implant surgeon is well recognized in modern implantology. The predictable outcome of function and aesthetics of intraoral rehabilitation can and must be determined and controlled prior to the surgical procedure, with the entire restorative team cooperating from treatment planning to the completion of the prosthetic procedure. The paper reviews the assessment of bone height and width by intraoral measurements and preexisting formulae, the use of radiographs, model analysis, and implant placement on model. A particular implant system (Steri-Oss, Yorba Linda, CA) is used. The rationale for angulating implants, originating from the shape of the bone is discussed. The optimal implant position can be determined only by a set-up; the drill jig copies the information from the articulator to the intraoral arch and provides the surgeon with a maximum assurance of the outcome. The try-in and changes are discussed, followed by the actual surgical procedure. After the healing period, use of the jig can assist in implant recovery. The wax-up can be used to maintain silicone vestibular walls and help to model the gold frame of the laboratory work. The emphasis is placed upon the cooperative teamwork of the restorative team, especially the contributions of the laboratory and other technology to the functionally and aesthetically successful final result.

Communication↗
PubMed1993

Comparison of functional assays for protein S: European collaborative study of patients with congenital and acquired deficiency.

Four functional assays for protein S were evaluated by 4 different laboratories, each center using its own method. The aim of this study was to compare these different assays and to establish a relationship with results of immunological assays of total and free protein S antigen and C4bBP. The same plasma samples were distributed to each center and tested in blind. In 47 normal subjects, there was no significant difference between the 4 functional assays, with mean values ranging from 93 to 100%. These values were in good agreement with those of free and total protein S antigen. In 34 patients with a quantitative congenital deficiency of protein S the mean values of protein S activity were decreased with the 4 assays, ranging from 25 to 40%. Free protein S antigen was reduced to a similar extent, whereas total antigen was either normal or decreased. The correlation of protein S activity with free protein S antigen was satisfactory for 3 methods, with coefficients of correlation varying from 0.84 to 0.92 whereas it was only 0.70 in one lab. When total protein S antigen was reduced, protein S activity was decreased in all the patients with the 4 assays. In contrast when total protein S antigen was normal an important overlap of protein S activity between normals and patients was observed in one lab with 12 patients misclassified. In 8 patients with a functional defect, results of protein S activity differed substantially according to the assay used and about half of these patients were misclassified.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1993

Evaluation of serum neural cell adhesion molecule as a new tumor marker in small cell lung cancer.

BACKGROUND: Small cell lung cancer (SCLC) is distinguished from other histologic types of lung cancer by possessing a variety of neuroendocrine properties. Neuron-specific enolase (NSE) is the most frequently elevated tumor marker for patients with SCLC at diagnosis. To assess the value of neural cell adhesion molecules (NCAM), another possible tumor marker for small cell lung cancer, NCAM was evaluated in the sera of patients with histologically confirmed SCLC in two prospective multicenter trials. METHODS: The study includes 221 patients with SCLC, normal human blood donors (n = 34), patients with benign lung disease (n = 53), and patients with non-small cell lung cancer (n = 28). NCAM was determined by means of an enzyme immunoassay, NSE by a radioimmunoassay. RESULTS: The data show the following: (1) 51% (113 of 221) of all patients with SCLC had NCAM levels higher than 20 U/ml, 34% (75 of 221) had NSE levels higher than 25 ng/ml; (2) levels of both markers significantly differ between limited and extensive disease patients; (3) patients with pathologic NCAM and NSE levels have significantly shorter survival times; (4) a positive correlation between pretreatment NSE and NCAM levels was found (n = 221, r = 0.60); and (5) a correlation between serum marker levels and clinical status was found in follow-up studies of 19 patients. CONCLUSIONS: From these data, it is concluded that NCAM is, along with NSE, a potential tumor marker for SCLC.

Adult↗
PubMed1993

Characterization of CD7+CD19+ lymphoid cells after Epstein-Barr virus transformation.

The early stages of lymphoid differentiation preceding T and B lineage commitment remain poorly defined. We hypothesized that early lymphoid precursor cells are possibly common progenitors and would express a very early T cell-associated Ag (CD7) and a very early B cell-associated Ag (CD19) simultaneously. We therefore transformed CD7+CD19+ fetal bone marrow lymphoid cells using EBV. Extensive characterization of the resulting cell lines indicated that two cell lines corresponded to pre-B and early B cells co-expressing CD7. The third cell line resembled a thymocyte, which co-expressed a number of B cell-associated Ag including CD19 and the stem cell Ag CD34. The two predominantly B lineage cell lines have their Ig genes rearranged, whereas the predominantly T lineage cell line has TCR and Ig H chain genes rearranged. Cross-lineage Ag were not expressed any more after culturing for a prolonged period of time, i.e., B lineage cells became CD7 negative and the thymocyte lineage became negative for the B cell-associated Ag. However, in all three cell lines TCR and/or Ig gene rearrangements remained unchanged. These observations support the existence of a common lymphoid precursor co-expressing CD7 and CD19 that gives rise to either T or B cells.

Antigens, CD↗
PubMed1993

Alternating combination chemotherapy in patients with extragonadal germ cell tumors. A Southwest Oncology Group study.

BACKGROUND: Extragonadal germ cell tumors (EGGCT) are uncommon, occur primarily in the mediastinum and retroperitoneum, and have been noted to have variable response rates to cisplatin-based chemotherapy regimens. METHODS: The Southwest Oncology Group (SWOG) has completed a prospective trial of combination chemotherapy followed by surgical removal of residual disease in patients with this type of germ cell neoplasm. Chemotherapy consisted of alternating cycles of vinblastine, bleomycin, and cisplatin with etoposide, bleomycin, doxorubicin, and cisplatin. Four cycles of therapy were given followed by surgical removal of residual disease where appropriate. RESULTS: Fifty patients were entered into the trial, and 41 were eligible, with 4 patients excluded by pathology review. Of the 41 eligible patients, 24 had mediastinal tumors, 15 had retroperitoneal tumors, and 2 had unknown primary sites. Complete response rates (chemotherapy +/- surgery) for the various sites were as follows: mediastinum, 18 of 24 (75%); retroperitoneum, 10 of 15 (67%); and unknown primary, 2 of 2 (100%). At 2 years, the disease-free survival rate for all patients was 87%. At a median follow-up of 6.8 years, 26 of 41 patients (63%) are alive. The toxicity of the chemotherapy regimen was substantial, with neutropenic fever developing in 17 of 41 patients (41%) during treatment. Additional side effects included nausea and vomiting (76%), mucositis (27%), and pulmonary toxicity (5%). CONCLUSIONS: This prospective trial of chemotherapy in patients with EGGCT demonstrates a significant response in patients with either mediastinal or retroperitoneal tumors and a 4-year survival rate of more than 60% and 70%, respectively.

Adolescent↗
PubMed1993

Human naive T cells are preferentially stimulated by crosslinking of CD3 and CD45RA with monoclonal antibodies.

To analyze the role of CD45 molecules in CD3-mediated activation of T cells, we analyzed the effect of crosslinking different CD45 isoforms with mAbs on the proliferation of various T cell subsets in vitro. Crosslinking of CD3 and CD45RA molecules with the mAb 2H4 or WR16 resulted in the preferential stimulation of enriched naive (CD45RA+) T cells, whereas crosslinking of CD3 alone led to stimulation of enriched memory (CD45RO+) T cells. In contrast, proliferation of memory T cells was not enhanced by additional crosslinking with the memory T cell marker CD45RO. To induce the costimulatory effect on naive T cells, an intense crosslinking of the TcR/CD3 complex and CD45RA molecules by immobilized secondary antibody is necessary because enhanced proliferation did not occur when the antibodies were directly immobilized. The same differences in reactivity of CD45RA-enriched naive and CD45RO-enriched memory T cell subset could be shown by using a mAb to common CD45, indicating that the effects are not mediated by a particular antibody or by binding to different epitopes. The CD45RA-induced differences in proliferation of naive and memory T cells could not be abolished by the addition of exogenous IL2. In contrast, naive T cells were more responsive to exogenous IL2 than memory T cells independently of CD45RA crosslinking, indicating that IL2 is not responsible for the observed differences in T cell proliferation.

Antibodies, Monoclonal↗
PubMed1993

[Auditory achievements of cochlear implantation].

The cochlear implant, which stimulates the auditory nerve electrically, is a rehabilitative solution for the severely deaf who cannot benefit from a hearing aid. The implant enables them to rejoin the world of sound from which they were disconnected. We present the process of auditory diagnosis which determines the patient's suitability for cochlear implantation, the implant's tuning program and the rehabilitation process it entails. Each of the 22 implanted electrodes is checked through a computer program, and the specifications of the electrical stimulation are established to provide the most comfortable hearing level for the implanted device. These stimulation specifications determine the number of active electrodes and the ideal stimulation model. During the 8-week hearing-training program which follows implantation, the patients acquaint themselves with the new world of sound through which they will communicate with their environment. Of the 16 implanted patients 7 heard only via the implant, without the aid of lipreading, a result which is considered excellent. These patients are able to talk on the telephone with the aid of the implant. 1 patient refused to use the implant, while the others have had good to moderate results. Noteworthy is the fact that even those with only moderate results greatly benefit from the implant, and are not willing to function without it for even a single day.

Adolescent↗
PubMed1993

Adult T cell leukaemia lymphoma in a non-aboriginal Australian woman with no apparent risk factors.

OBJECTIVE: To present a case of adult T cell leukaemia lymphoma (ATLL) in a non-Aboriginal Australian woman with no apparent risk factor. CLINICAL FEATURES: A 43-year-old Australian woman of European descent presented with a febrile illness associated with generalised lymphadenopathy and splenomegaly. INVESTIGATIONS: There was lymphocytosis in the peripheral blood with a T helper cell phenotype. There were also lytic bone lesions with associated hypercalcaemia. HTLV-1 antibody was detected by agglutination assay and confirmed by western blot test. TREATMENT AND OUTCOME: After initial response to CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisolone), she relapsed and died with central nervous system involvement eight months after the initial diagnosis. CONCLUSION: To our knowledge this is only the third case of ATLL in a non-Aboriginal person in Australia.

Adult↗
PubMed1993

Cytogenetic diagnoses after chorionic villus sampling are less reliable in very-high-or very-low-risk pregnancies.

An increasing number of cytogenetic prenatal diagnoses are performed on chorionic villus samplings. The accuracy of this method is influenced by chromosomal mosaicism, mostly confined to direct preparation methods. Especially those investigators who have experienced false-negative and false-positive findings propagate the combined use of direct and culture methods. Yet large collaborative studies have shown that in approximately two-thirds of diagnostic cases only one procedure is applied. Moreover, the accuracy of a cytogenetic investigation depends not only on the ontogenetic origin of the tissues investigated, but also on interacting factors such as the 'a priori risk' and the 'predictive value of a cytogenetic finding'. On this basis a differentiated prenatal diagnostic procedure is discussed, including either sole short-term culture (STC), combined STC and long-term culture (LTC), primary amniocentesis (AC), or primary percutaneous umbilical blood sampling (PUBS). The predictive value of the cytogenetic diagnosis from CVS varies significantly dependent on the a priori risk of a chromosome aberration and, in the case of an abnormal karyotype, on the specific chromosome involved. A non-mosaic and 'non-lethal' trisomy detected in STC is highly representative of the embryo/fetus, but there are exceptions of limited predictive value, e.g., trisomy 18. Guided by the strategy of an optional follow-up by LTC, AC, or PUBS in 1317 successive CV samplings, we are not aware of a false-negative diagnosis, but probably had one false-positive diagnosis: 47,XXY after STC; 46,XY after LTC. When referring to the rate of fetuses with an unbalanced karyotype expected in the different indication groups, a relative increase of false-positive findings in the very-low-risk group (maternal age < or = 35 years of age) and of false-negative findings in the very-high-risk group (abnormal ultrasonographic findings) of pregnant women when only performing CVS becomes obvious. Because of this dilemma, AC or--especially in the latter group--PUBS might be primarily offered to these indication groups instead of CVS.

Adult↗
PubMed1993

Pili in microspheres protect rabbits from diarrhoea induced by E. coli strain RDEC-1.

We tested whether pilus proteins of rabbit diarrhoeagenic Escherichia coli (RDEC-1), incorporated into biodegradable microspheres, could function as safe and effective oral immunogens in the rabbit diarrhoea model. The RDEC-1 adhesin, AF/R1, incorporated into poly(D,L-lactide-co-glycolide) microspheres, was administered intraduodenally. Vaccinated and unvaccinated rabbits were challenged with RDEC-1 and killed 1 week later. Vaccination with AF/R1 in microspheres did not cause diarrhoea or weight loss. After challenge, rabbits given AF/R1 in microspheres, in contrast to unvaccinated animals, remained in good health. RDEC-1 attachment to caecal epithelium of vaccinated rabbits was reduced (p = 0.02), whereas numbers of RDEC-1 in intestinal fluids were little affected. Also, in vaccinated animals, biliary anti-AF/R1 IgA levels were increased, and AF/R1-induced blast-cell transformation was vigorous in spleen cell cultures. We conclude that vaccination with AF/R1 in microspheres was safe and protected rabbits against RDEC-1 disease, probably by interfering with adherence of the bacteria to the intestinal mucosa. The interference might have been due to the presence of specific antibodies secreted in bile.

Animals↗
PubMed1993

Activation of coagulation and fibrinolysis in patients with lung cancer: relation to tumour stage and prognosis.

Activation of coagulation and fibrinolysis within tumour tissues is thought to be associated with tumour growth, angiogenesis, and metastasis. The plasma levels of markers of thrombin and plasmin generation are sensitive tools for monitoring activation of coagulation and fibrinolysis. We studied 47 patients with histologically confirmed lung cancer, 15 with small cell (SCLC) and 32 with non-small cell lung cancer (NSCLC). The plasma levels of the following markers were assessed:thrombin-antithrombin III complex (TAT), prothrombin activation fragment F1 + 2, plasmin-alpha 2-antiplasmin complex (PAP) and the split product from cross-linked fibrin, D-dimer. The first sample was obtained before receiving any specific antineoplastic treatment. The patients were followed thereafter until treatment was terminated. There was no difference in activation markers between patients with SCLC and NSCLC. Comparing patients with limited disease to those with extensive disease, there were significant differences in TAT (median 3.0 (1.9-9.8) vs 5.3 (1.8-35.6) micrograms/l,P = 0.021) and D-dimer (569 (135-1948) vs 1288 (120-2221) micrograms/l, P = 0.014). According to the response to subsequent treatment, those who achieved complete or partial tumour remission had significantly lower baseline levels samples than non-responders (TAT 2.9 (1.9-4.0) vs 4.7 (1.8-35.6) micrograms/l,P = 0.0047;D-dimer 527 (135-1149) vs 1242 (120-2221) micrograms/l, P = 0.0013). Thus, the increase of TAT and D-dimer appears to be related to tumour spread. The results suggest that high levels of these markers might be a sign of unfavourable prognosis in patients with lung cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗