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Biomedical subjects

R Steinmetz

Publications and source records attributed to R Steinmetz.

23 records · Page 2Linked to original sources

Foscarnet treatment in various cytomegalovirus infections.

We examined the effect of foscarnet (Foscavir) in 15 AIDS patients with cytomegalovirus infection. Cytomegalovirus infection was presented as retinits (n = 8), colitis (n = 3), oral (n = 1) and perianal ulcers (n = 3) and pneumonitis (n = 1). Induction therapy with foscarnet showed a complete response in 9 and a partial response in 6 patients after a medium therapy of 3.5 weeks. Three patients showed progressive disease under ganciclovir and were treated subsequently with foscarnet. Main side effects were ulcers of the glans penis (n = 6) and a rise of creatinine (> 1.5 mg/dl; n = 4). Therapy was changed to ganciclovir because of renal toxicity in 1 patient receiving induction therapy with foscarnet. Within a period of foscarnet therapy between 5 and 9 months (median: 7 months) no clinical progression occurred. Medium survival after diagnosis of cytomegalovirus infection was 7.4 months. We describe our experience with foscarnet and compare treatment results of cytomegalovirus infection at certain locations.

Acquired Immunodeficiency Syndrome↗

Rectosigmoid obstruction caused by ovarian cancer.

Out of a total of 379 patients with ovarian carcinoma a rectosigmoid stenosis was detected in 44 (12%). A barium enema was available in 27 cases, which revealed a severe stenosis (less than 1/2 lumen open) in 23, with an average length of 17 cm (5-40 cm). Five characteristic types of stenosis were found: solitary stenosis (n = 6), large spherical impression (n = 6), multiple stenoses (n = 4), long narrow tract (n = 6) and a total obstruction (n = 5). Desmoplastic reaction with tethering and/or parallel folds (n = 16) or fixation and/or angulation (n = 18) were frequently found, but tumour invasion was rare (n = 3). A sigmoid resection (n = 1) or colostomy (n = 3) was seldom needed, due to beneficial response to combined therapy.

Adult↗

The spectrum of gastrointestinal metastases of breast carcinoma: I. Stomach.

In a 15-year period at the Netherlands Cancer Institute, 27 patients were found with breast carcinoma metastatic to the stomach. Presenting symptoms were non-specific, mainly nausea, vomiting, dysphagia, epigastric pain, and melena. Endoscopy, performed in 22 of these patients, yielded a correct diagnosis in 13. Lobular rather than ductal breast carcinoma was the predominant source of gastric metastases in this series. Non-surgical treatment was rewarded by a favorable, palliative response in 32% of cases.

Breast Neoplasms↗

The spectrum of gastrointestinal metastases of breast carcinoma: II. The colon and rectum.

In a 15-year period at the Netherlands Cancer Institute, 17 patients were found with breast carcinoma metastatic to the colon or rectum or both. The presenting symptoms and signs were non-specific and included diarrhea, crampy pain, vomiting, and palpable tumor. Endoscopic examination, possible in only 10 of the 17 patients because of luminal obstruction, yielded a correct diagnosis in seven cases. Biopsy was confirmatory in five cases. Lesions metastatic to the colorectum originated predominantly in lobular carcinoma of the breast. Systemic hormonal or chemotherapy or x-irradiation, either alone or as an adjunct to surgery, produced a favorable response in over half the patients so treated.

Breast Neoplasms↗