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Biomedical subjects

R Sauer

Publications and source records attributed to R Sauer.

At least 235 records · Page 13Linked to original sources

[Peri-implantation enzymes and mineralization in bone tissue after implantation of bioactive vitroceramic material--a method for biomaterial testing for hard tissue substitutes. 2. Results of studies of vitroceramics and their modification by the admixture of metal oxides].

The activities of the alkaline and the acid bone phosphatases as well as the concentrations of calcium and phosphorus were measured in the periimplantal tissue of the rat femur bone after implantation of the vitroceramic Ap 40, the metal oxide stabilized vitroceramics Ap 40 A and Ap 40 Z, as well titanium after 2, 10, and 15 weeks. The incorporation of the vitroceramic Ap 40 turns out like a primary bone fracture healing. The implants Ap 40 A and Ap 40 Z are a compromise with a higher stability and the osteogenesis induced effect is preserved, but is belated in contrast to Ap 40.

Acid Phosphatase↗

[Dealing with cancer--conversations with radiotherapy patients].

Thirty in-patients treated by radiotherapy were questioned in qualitative interviews about the information they had received from the physicians and their way to deal with the disease and the physicians. Furthermore 18 persons out of this group were accompanied continuously. The confidential relationships between the patients and the author of the study brought about spontaneous conversations showing some new aspects of the way to experience disease and therapy. Despite a poor prognosis and an initially insufficient information, the patients formulated their questions openly. Generally they desired a clearer communication. They criticized above all the lack of information and attention from the physicians. A need for confidence, frankness, and the conveyance of a justified hope was expressed. The physician's stress and resulting lack of time was complained of. During the time of accompanying which lasted several weeks, it became evident that information means a way to deal with the disease to which the patient can make his individual contribution. The majority of questions as well as emotional reactions as fear or depression came from those patients who seemed to be quiet persons.

Adaptation, Psychological↗

[Function-preserving treatment of anal cancer using simultaneous radio- and chemotherapy].

Since 1985, twelve patients with anal carcinoma underwent simultaneous radiation and chemotherapy as primary treatment. The primary tumor region and the regional lymph drainage area received a total dose of 30 Gy over three weeks or 50 Gy over five weeks. During the first week of radiotherapy, 5-fluorouracil (1000 mg/m2 daily for four days by continuous infusion), and mitomycin (10 mg/m2 on day 1) were administered; four weeks later, a second cycle at the same dosage followed. This treatment schedule was well tolerated by all patients and all tumors responded. In only one patient was the tumor still palpable at the end of the treatment period. In eight patients a biopsy was obtained from the primary tumor region four weeks after treatment had ended: in six of them no further operative treatment was necessary, because no evidence of tumor was found in the biopsy. It is concluded from these results that simultaneous radiation and chemotherapy is the best primary treatment of anal carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗

Fluorine-19 NMR spectroscopic studies of the metabolism of 5-fluorouracil in the liver of patients undergoing chemotherapy.

Fluorine-19 nuclear magnetic resonance allows direct observation of fluorinated drugs and their metabolites in the human body without background signal from the tissue. A well-known fluorinated chemotherapeutic drug, 5-fluorouracil, and its metabolites were observed noninvasively in the liver of three patients undergoing cancer chemotherapy. Spectra were obtained at 1.5 T with a surface coil centered over the right lobe of the patient's liver. Administration of 1.5 gm of 5-fluorouracil was done after positioning in the magnet. Serial spectra, collected over a 2-h period, revealed both the nature of the metabolites present in the liver, and the time course of each patient's metabolism. These observations represent the first noninvasive NMR study of drugs in human patients and show the feasibility of using in vivo F-19 NMR spectroscopy for human studies of fluorinated compounds.

Female↗

Prognostic factors in the treatment of Ewing's sarcoma. The Ewing's Sarcoma Study Group of the German Society of Paediatric Oncology CESS 81.

From 1981 up to February 1985, a total of 93 protocol patients entered the study CESS 81. The protocol recommended an initial 18-week period of polychemotherapy (VACA) followed by local therapy and two additional cycles of chemotherapy. Local therapy consisted either of radical surgery or of incomplete resection plus postoperative irradiation with 36 Gy or of radiotherapy alone (46 and 60 Gy). Centrally located lesions were always irradiated with 60 Gy. This article summarizes the data after 5 years. Data of 93 patients were analysed in October 1986 after a median follow-up of 37 months. The projected 5-year survival is 50%. The relapse rate was 42%, distant relapses occurred in 19%, local (plus distant) relapses in 23%. Most of the relapses occurred during the first 3 years of observation. Failure rate was high in patients undergoing irradiation alone (44%). Initial tumour mass (greater than 100 ml) and histopathologic response to initial chemotherapy were identified as major prognostic factors. Tumour site and type of local therapy were not significant if patients were categorised by tumour volume. In small lesions, surgery and radiotherapy were equally effective. In large lesions greater than 100 ml volume, a trend towards a better prognosis in surgically treated patients was observed. The results of CESS 81 emphasize the importance of permanent local control in Ewing's sarcoma even in the presence of systemic control by an effective multi-drug chemotherapy.

Adolescent↗

[Principles, indications and results of radiotherapy of spinal tumors].

In primary and secondary tumors of the spinal column, radiotherapy is used to effect a cure, but mainly the goal is palliative. In the latter case, the course is either accelerated over less than 2 weeks (e.g., 1 dose of 10 Gy, 5 X 4 Gy, 10 X 3 Gy) or extended over 3 or more weeks (e.g., 40-50 Gy over 4-5 weeks). For teletherapy, megavolt radiotherapeutical devices are mainly used. In addition, supplementary brachytherapy is available with iodine-125 or iridium-192 seeds.

Humans↗

[Combined treatment of hypopharyngeal carcinoma].

From 1978 through 1984, 120 patients with hypopharyngeal carcinomas were treated cooperatively by the University Hospitals of Erlangen. 120 out of these patients were men and 6 women. 96 patients (80%) suffered from cervical lymph node metastases, 91 (76%) were already in UICC stage IV. There were two cases with stage I, eight cases (7%) with stage II, and 19 cases (16%) with stage III. Among the 116 patients treated by causal therapy, 70 (60%) reached complete remission (CR), 34 (29.5%) partial remission (PR), and 12 (10.5%) were non-responders (NC,P). The cumulative survival at five years was 14% in 120 patients and 24% in 70 patients after CR. None of the patients with PR or NC survived more than two years. 111 patients were irradiated. Group 1: radiotherapy alone (41 patients), group 2: surgery and radiotherapy (47 patients), group 3: chemotherapy and radiotherapy (19 patients). The medium treatment period was 76, 107, and 141 days, respectively. The cumulative survival at five years was 3% in group 1, 28% in group 2, the survival at three years in group 3 was 14%. The results of postoperative radiotherapy, amounting to 36%, were better than the rate of 20% achieved by preoperative radiotherapy and surgery. A survival at five years of 46% was obtained after transoral microlaryngoscopic laser resection and postoperative irradiation, which was therefore superior to conventional operation techniques combined with radiotherapy (16%). Moreover, better functional and cosmetic results were achieved with this method. The prognosis is unfavorably influenced by a high stage, lymph node manifestations, and dedifferentiated tumor histology.

Adult↗

Total lymphoid irradiation of intractable rheumatoid arthritis.

Eleven patients with intractable rheumatoid arthritis were treated with fractionated total lymphoid irradiation at a total dose of 20 Gy. Lasting improvement in clinical symptoms was found in four patients during treatment and the remaining patients experienced a similar benefit within 2 months of irradiation. There was marked reduction in exacerbations and the number of joints involved. Morning stiffness, joint swelling and tenderness decreased. Complications included severe fatigue during treatment and acute bacterial arthritis in multiple joints in one patient. Four of the patients have since died, one of renal failure and another of cardiogenic shock following surgery 3 and 24 months after total lymphoid irradiation. Both had generalised amyloidosis. The third patient developed joint empyema and died of toxic cardiac failure. The fourth died 3 months after resection of a Kaposi's sarcoma complicated by wound infection which responded to treatment. Immunologically, total lymphoid irradiation resulted in suppression of the absolute lymphocyte count and a reduction in T-helper cells, while the number of T-suppressor cells remained unchanged. These data provide evidence of T-cell involvement in the pathogenesis of rheumatoid arthritis. Total lymphoid irradiation can induce sustained improvement in clinical disease activity, but severe, possibly fatal, side-effects cannot be ignored.

Aged↗