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Biomedical subjects

O Oelz

Publications and source records attributed to O Oelz.

At least 73 records · Page 4Linked to original sources
PubMed1989

Tolerance and effectiveness of recombinant interleukin-2 (r-met Hu IL-2 [ala-125]) and lymphokine-activated killer cells in patients with metastatic solid tumors.

The tolerance of a recombinant human interleukin-2 (rIL-2, r-met Hu IL-2 [ala-125], Ortho Pharmaceutical) and its antitumor effectiveness in combination with lymphokineactivated killer (LAK) cells was examined in 26 patients with metastatic solid tumors, including 14 renal cell carcinomas, seven melanomas, three extragonadal germ cell tumors refractory to chemotherapy and two colon carcinomas. rIL-2 was administered as a bolus at 30,000 U/kg every 8 h on days 1-5 and days 12-19. Leukapheresis was done on days 8-12, lymphocytes were incubated with rIL-2 for 3 or 4 days in vitro and reinfused on days 12, 13 and 15. The mean number of reinfused cells was 5.1 x 10(10) per patient. IL-2 dose and schedule were adjusted according to toxicity. Patients received a median of 100% (range 87-100%) of planned rIL-2 on days 1-5 and a median of 71% (range 13-100%) on days 12-19. Capillary leak syndrome with hypotension and impaired renal function and CNS toxicity were the major reasons for dose modification. Patients with renal cell carcinoma, most of whom underwent a prior nephrectomy, had a reduced tolerance to rIL-2. Partial responses were documented in three renal cell carcinomas and one melanoma. The median response duration was 5.5 (range 1-6) months.

Adult↗
PubMed1989

Contact phase of blood coagulation is not activated in edema of high altitude.

To examine whether bradykinin generated by the activation of the contact phase of blood coagulation is involved in the pathogenesis of edema occurring after acute exposure to high altitude, 15 mountaineers were examined at 490 m and 1, 3, and 5 days after arrival at 4,559 m. The clotting activity levels of factor XII, factor XI, plasma prekallikrein, and high-molecular-weight kininogen (HMWK) were measured, and plasma kallikrein-induced proteolytic cleavage of HMWK was assessed by ligand blotting by use of radiolabeled factor XI. After an ascent on foot from 1,170 to 4,559 m in 3 days, three subjects developed high-altitude pulmonary edema, and four subjects presented facial edema. There was no evidence for activation of the contact system in any subject as demonstrated by the lack of proteolytic cleavage of HMWK at high altitude. The absence of contact system activation was further supported by stable plasma levels of the individual factors of contact activation. Therefore, we conclude that bradykinin generated by plasma kallikrein-induced cleavage of HMWK is not involved in the pathogenesis of edema due to acute exposure to high altitude.

Altitude Sickness↗
PubMed1989

Persistent cognitive impairment in climbers after repeated exposure to extreme altitude.

We performed neuropsychological testing in eight world class climbers who had reached summits higher than 8,500 meters without supplementary oxygen. Five had mildly impaired concentration, short-term memory, and ability to shift concepts and control errors. There were no defects in perception or other cognitive activities. The pattern of impairment suggests malfunctioning of bifronto-temporo-limbic structures. Repeated extreme-altitude exposure can cause mild but persistent cognitive impairment.

Adult↗
PubMed1988

Reduction of systemic fungal infections in patients with hematological malignancies, neutropenia, and prolonged fever by early amphotericin B therapy.

A rate on autopsy of up to 30% systemic fungal infections and difficulties in diagnosing systemic mycosis antemortem have led to the empiric use of amphotericin B in patients with hematological malignancies, prolonged fever, and neutropenia. Routine empiric antifungal treatment was initiated in our institution in 1982. Amphotericin B was given to granulocytopenic patients with hematological malignancies with (a) unremitting fever after 48-72 h of antibiotic treatment, (b) recurrent fever during antibiotic treatment, or (c) with newly detected pulmonary infiltrates, sinusitis, skin and retinal lesions suggestive of a fungal infection. With this approach the rate of systemic fungal infections decreased significantly from 10% (27 of 270 patients; 1973-1981) to 4% (6 of 153 patients; 1982-1986, P less than 0.02). The reduction of systemic fungal infections was most prominent in patients with acute myelogenous leukemia, where its proportion decreased from 16% (16 of 98 patients; 1973-1981) to 4% (2 of 50 patients; 1982-1986, P less than 0.023). Our data support the hypothesis that the incidence of systemic fungal infections in patients with hematological malignancies and especially in acute myelogenous leukemia can be reduced significantly by empirical treatment with amphotericin B.

Adult↗
PubMed1988

[Immunotherapy of tumors using interleukin-2 and lymphokine-activated killer cells].

The tolerance and effectiveness of an interleukin-2 analog (rIL-2) in combination with lymphokine activated killer (LAK) cells has been studied. 14 patients with metastatic solid tumors, including 8 renal cell carcinomas, 3 melanomas and 3 extragonadal germ cell tumors refractory to standard therapy, were treated for a 3-week period. rIL-2 was administered as a bolus at 30,000 U/kg every 8 hours on days 1-5 and days 12-19. Leukapheresis was done on days 8-12, and lymphocytes were incubated with rIL-2 for 3-4 days in vitro and reinfused on days 12, 13, and 15. rIL-2 dose and schedule were adjusted according to toxicity. The major side effects were constitutional symptoms and a capillary leak syndrome with hypotension and impaired renal function. Partial responses were documented in 2/8 renal cell carcinomas and 1/3 melanomas. The response durations were 1, 5 and 6 months.

Adult↗
PubMed1987

Successful treatment of acute mountain sickness with dexamethasone.

A double blind, randomised, placebo controlled trial of treatment with dexamethasone for acute mountain sickness was performed in the Capanna "Regina Margherita" at an altitude of 4559 m in the Alps Valais. After 12-16 hours of treatment (8 mg dexamethasone initially, followed by 4 mg every six hours) the mean acute mountain sickness score decreased significantly from 5.4 to 1.3, and eight of 17 patients became totally asymptomatic. Mean arterial oxygen saturation rose from 75.5% to 82.0%, and there was a small increase in standard spirometric measurements. In the placebo group none of these variables changed significantly. It is concluded that dexamethasone may be used as emergency treatment for acute mountain sickness to facilitate safe descent to a lower altitude.

Acute Disease↗
PubMed1987

Enhanced fibrin formation in high-altitude pulmonary edema.

Blood coagulation, fibrinolysis, and arterial blood gases were examined in 66 nonacclimatized mountaineers at 4,557 m. Subjects were classified according to a clinical score as healthy (n = 25), having mild acute mountain sickness (AMS) (n = 24), showing severe AMS (n = 13), and suffering from high-altitude pulmonary edema (HAPE) (n = 4). Coagulation times, euglobulin lysis time, and fibrin(ogen) fragment E were normal in all groups without significant changes. Fibrinopeptide A (FPA), a molecular marker of in vivo fibrin formation, was elevated in HAPE to 4.2 +/- 2.7 ng/ml (P less than 0.0001) compared with the other groups showing mean values between 1.6 +/- 0.4 and 1.8 +/- 0.7 ng/ml. FPA was normal in one patient with HAPE, however. Severe AMS was accompanied by a significant decrease in arterial PO2 due to an increase in alveolar-arterial O2 difference, whereas arterial PCO2 did not change significantly. We conclude that activation of blood coagulation is not involved in the pathogenesis of AMS and the impairment of gas exchange in this disease. Fibrin generation occurring in HAPE is probably an epiphenomenon of edema formation.

Adult↗
PubMed1986

[Microangiopathic hemolytic anemias. Clinical pattern, therapy and clinical course in 14 patients with thrombotic thrombocytopenic purpura and hemolytic uremic syndrome].

Thrombotic thrombocytopenic purpura (TTP) and the hemolytic uremic syndrome (HUS) have in common a microangiopathic hemolytic anemia involving disseminated platelet aggregation and endothelial damage of the microvasculature mainly of the brain (TTP) and kidney (HUS). The underlying pathomechanism still remains unclear. The disease takes an acute, dramatic and frequently fatal course. Unfortunately a broadly approved therapeutic regimen is still lacking since the rarity of TTP and HUS makes study of a large group of patients impossible. We have observed and treated 14 patients with TTP and HUS during a period of 9 years. Most of the cases have been triggered by infectious diseases and pregnancy. Diagnostic cornerstones were hemolytic anemia, schistocytes on peripheral blood smears and consumption thrombocytopenia. Renal and cerebral symptoms were observed regularly, whereas lesions of the pancreas, liver and heart were much less frequent. The treatment included plasma transfusion (47%), plasma exchange (42%), high dose corticosteroids (74%), antiplatelet agents (53%), vitamin E (32%) and vincristin (11%). The outcome of 19 episodes of TTP or HUS was as follows: in 78% complete recovery, in 11% persistence of impaired renal function, and in 11% death. From analysis of our cases it is concluded that plasma transfusions and high dose corticosteroids improve the prognosis of TTP and HUS significantly.

Adolescent↗
PubMed1986

[Altitude edema in the Swiss Alps. Observations on the incidence and clinical course in 50 patients 1980-1984].

In the Swiss Alps 50 patients with high altitude edema (high altitude pulmonary edema and/or high altitude cerebral edema) had to be rescued by helicopter during the period 1980-1984. The development, clinical picture and clinical course have been analyzed retrospectively. The patients were 49 men and one woman, generally in good health and well trained. They had ascended from the low-lands to an altitude above 2500 m and subsequently climbed higher. The climbers developed symptoms of acute mountain sickness on the second to third day of high altitude exposure and had to be evacuated by air on the fourth to fifth day. 70% of the cases occurred in the Valais Alps and the rest in the region of the Bernese Alps and the Bernina. The highest incidence of high altitude edema was observed in the Capanna Margherita (4559 m), where one of 588 climbers who stayed overnight had to be air-rescued. This ratio was about one in 4000 mountaineers at the Finsteraarhorn hut (3050 m) and the Monte Rosa hut (2795 m). Evacuation by air was the most successful therapeutic measure and resulted in immediate amelioration of clinical symptoms in 16 patients. 34 climbers had to be admitted to local hospitals due to severe high altitude pulmonary and/or cerebral edema. The pulmonary edema was bilateral in two thirds of these patients and unilateral in one third. Arterial blood gases showed moderate to severe limitation of oxygen diffusion capacity. All patients recovered completely within a few days.

Adult↗
PubMed1986

Persisting myocardial sinusoids of both ventricles as an isolated anomaly: echocardiographic, angiographic, and pathologic anatomical findings.

The persistence of myocardial sinusoids in both ventricles as an isolated anomaly is described. A 21-year-old patient had progressive heart failure considered as cardiomyopathy of obscure etiology. Two-dimensional echocardiography demonstrated channel-like structures in the thickened myocardium of both hypokinetic ventricles. Angiography showed a honeycomblike inner contour in both ventricles. Autopsy proved the diagnosis of persistent sinusoids in a thickened myocardium.

Adult↗
PubMed1986

Physiological profile of world-class high-altitude climbers.

The functional characteristics of six world-class high-altitude mountaineers were assessed 2-12 mo after the last high-altitude climb. Each climber on one or several occasions had reached altitudes of 8,500 m or above without supplementary O2. Static and dynamic lung volumes and right and left echocardiographic measurements were found to be within normal limits of sedentary controls (SC). Muscle fiber distribution was 70% type I, 22% type IIa, and 7% type IIb. Mean muscle fiber cross-sectional area was significantly smaller than that of SC (-15%) and of long-distance runners (LDR, -51%). The number of capillaries per unit cross-sectional area was significantly greater than that of SC (+ 40%). Total mitochondrial volume was not significantly different from that of SC, but its subsarcolemmal component was equal to that of LDR. Average maximal O2 consumption was 60 +/- 6 ml X kg-1 X min-1, which is between the values of SC and LDR. Average maximal anaerobic power was 28 +/- 2.5 W X kg-1, which is equal to that of SC and 40% lower that that of competitive high jumpers. All subjects were characterized by resting hyperventilation both in normoxia and in moderate (inspired O2 partial pressure = 77 Torr) hypoxia resulting in higher oxyhemoglobin saturation levels in hypoxia. The ventilatory response to four tidal volumes of pure O2 was similar to that of SC. It is concluded that elite high-altitude climbers do not have physiological adaptations to high altitude that justify their unique performance.

Adaptation, Physiological↗
PubMed1985

[Controversy on platelet-inhibiting drugs].

The only well established, clinically useful platelet inhibiting drug is aspirin, though the optimal dose is unknown. Experimental findings, the virtual absence of side effects and, so far, four clinical studies favour a dose of 100-300 mg per day. The majority of clinical studies, however, and particularly those involving patients with cerebrovascular diseases, have employed doses of aspirin of 1000-1200 mg per day. Aspirin reduces mortality and infarction rates in patients who have already had myocardial infarction by 0-30%. The efficacy of additional dipyridamol or of sulfinpyrazone is not proven either. So far the effects of aspirin in patients with unstable angina and in patients after aortocoronary bypass surgery are more favourable. The best evidenced indication for aspirin treatment is transient ischemic attacks and status post stroke. The beneficial effect of aspirin in these conditions may also extend to women. Additional dipyridamol is also useless in this condition.

Angina, Unstable↗
PubMed1985

[Hypercalcemia in non-Hodgkin lymphoma].

In a retrospective study, hypercalcemia was found on one or more occasions in 14 of 156 patients with newly detected, still active or relapsing non-Hodgkin's lymphoma (NHL). The incidence of hypercalcemia correlated with the histological grade of malignancy: patients with high grade NHL had a hypercalcemia incidence of 23%. Half of the patients had hypercalcemia-related symptoms, and 4 of 14 had hypercalcemia-induced renal impairment. The occurrence or recurrence of hypercalcemia correlated with progression of NHL. Remission-inducing chemotherapy and symptomatic treatment of hypercalcemia corrected the serum calcium.

Antineoplastic Agents↗