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S Sailer

Publications and source records attributed to S Sailer.

At least 19 recordsLinked to original sources
PubMed2000

Preliminary report of toxicity following 3D radiation therapy for prostate cancer on 3DOG/RTOG 9406.

PURPOSE: A prospective Phase I dose escalation study was conducted to determine the maximally-tolerated radiation dose in men treated with three-dimensional conformal radiation therapy (3D CRT) for localized prostate cancer. This is a preliminary report of toxicity encountered on the 3DOG/RTOG 9406 study. METHODS AND MATERIALS: Each participating institution was required to implement data exchange with the RTOG 3D quality assurance (QA) center at Washington University in St. Louis. 3D CRT capabilities were strictly defined within the study protocol. Patients were registered according to three stratification groups: Group 1 patients had clinically organ-confined disease (T1,2) with a calculated risk of seminal vesicle invasion of < 15%. Group 2 patients had clinical T1,2 disease with risk of SV invasion > or = 15%. Group 3 (G3) patients had clinical local extension of tumor beyond the prostate capsule (T3). All patients were treated with 3D techniques with minimum doses prescribed to the planning target volume (PTV). The PTV margins were 5-10 mm around the prostate for patients in Group 1 and 5-10 mm around the prostate and SV for Group 2. After 55.8 Gy, the PTV was reduced in Group 2 patients to 5-10 mm around the prostate only. Minimum prescription dose began at 68.4 Gy (level I) and was escalated to 73.8 Gy (level II) and subsequently to 79.2 Gy (level III). This report describes the acute and late toxicity encountered in Group 1 and 2 patients treated to the first two study dose levels. Data from RTOG 7506 and 7706 allowed calculation of the expected probability of observing a > or = grade 3 late effect more than 120 days after the start of treatment. RTOG toxicity scores were used. RESULTS: Between August 23, 1994 and July 2, 1997, 304 Group 1 and 2 cases were registered; 288 cases were analyzable for toxicity. Acute toxicity was low, with 53-54% of Group 1 patients having either no or grade 1 toxicity at dose levels I and II, respectively. Sixty-two percent of Group 2 patients had either none or grade 1 toxicity at either dose level. Few patients (0-3%) experienced a grade 3 acute bowel or bladder toxicity, and there were no grade 4 or 5 toxicities. Late toxicity was very low in all patient groups. The majority (81-85%) had either no or mild grade 1 late toxicity at dose level I and II, respectively. A single late grade 3 bladder toxicity in a Group 2 patient treated to dose level II was recorded. There were no grade 4 or 5 late effects in any patient. Compared to historical RTOG controls (studies 7506, 7706) at dose level I, no grade 3 or greater late effects were observed in Group 1 and Group 2 patients when 9.1 and 4.8 events were expected (p = 0.003 and p = 0.028), respectively. At dose level II, there were no grade 3 or greater toxicities in Group 1 patients and a single grade 3 toxicity in a Group 2 patient when 12.1 and 13.0 were expected (p = 0.0005 and p = 0.0003), respectively. Multivariate analysis demonstrated that the relative risk of developing acute bladder toxicity was 2.13 if the percentage of the bladder receiving > or = 65 Gy was more than 30% (p = 0.013) and 2.01 if patients received neoadjuvant hormonal therapy (p = 0.018). The relative risk of developing late bladder complications also increased as the percentage of the bladder receiving > or = 65 Gy increased (p = 0.026). Unexpectedly, there was a lower risk of late bladder complications as the mean dose to the bladder and prescription dose level increased. This probably reflects improvement in conformal techniques as the study matured. There was a 2.1 relative risk of developing a late bowel complication if the total rectal volume on the planning CT scan exceeded 100 cc (p = 0.019). CONCLUSION: Tolerance to high-dose 3D CRT has been better than expected in this dose escalation trial for Stage T1,2 prostate cancer compared to low-dose RTOG historical experience. With strict quality assurance standards and review, 3D CRT can be safely studied in a co

Adult↗
PubMed1999

[Secondary prevention following coronary intervention. Survey of 13 intervention centers in Austria].

Risk factor control has been shown to reduce the incidence of coronary events in patients with or without preceding infarction. Secondary prevention should therefore be borne in mind by every cardiologist. In order to test this concept and/or to promote secondary prevention in our country, the following survey was conducted by our working group for epidemiology and prevention. All interventional centres of the country (7 million inhabitants) were asked to report relevant data of 50 consecutive patients with PTCA in a structured questionnaire. Thirteen centres responded and we report the data of 650 patients. The mean proportion of women was 28%, the mean age 61.1 years and the mean stent rate 49.8%. The indications for PTCA varied widely: stable angina 10-74%, unstable angina 10-86%, primary PTCA 0-22%. The risk factor history was distributed as follows: diabetes 12-46% (mean 22.3%), hypertension 32-68% (mean 54.2%), current smoking 6-56% (mean 21.9%), and total cholesterol (TChol) > 200 mg/dl: 30-78% (mean 60.3%). Current lipid values were available for T chol. in 44-100% (mean 84.5%) and for LDL in 4-100% (mean 67.1%). Dietary counselling by a dietician was done in 4-100% of patients (mean 35.6%) Information concerning the hazards of smoking was given to 25-100% (mean 83.6%) of current smokers. Drug treatment at hospital discharge was as follows: 84-100% (mean 93.1%) received ASA, 24-74% (mean 49.8%) ticlopidine, 6-84% (mean 53.3%) nitrates, 34-82% (mean 60.2%) beta blockers, 10-70% (mean 39.5%) ACE inhibitors, 4-74% (mean 4 7.2%) lipid lowering drugs, 7-48% (mean 17.8%) calcium antagonists, 0-12% (mean 6.1%) digitalis and 0-28% (mean 13.6%) diuretics. Follow-up data were collected in 4 centres at 6 months post discharge and were available for 174 patients. Here we found an increase in the prescription of calcium antagonists, digitalis and statins. The following conclusions were drawn at a conference in which all centres participated: lipid values should be available for each patient at PTCA, dietary counselling should be initiated for every patient during hospitalisation (and continued by the family physician) and the national cardiac society should promote guidelines for the use of drugs in which the variation in use is too wide at present. It should be ensured that these guidelines are implemented not only in patients after AMI but also in those after PTCA.

Adrenergic beta-Antagonists↗
PubMed1998

[Blood glucose self-monitoring in intensified insulin therapy: acceptance of frequent measurements and effect on quality of diabetic control].

In intensive insulin therapy frequent measurements of blood glucose are necessary for daily insulin adjustments. The aim of our study was to determine acceptance of frequent blood glucose measurements and its relation to quality of glycemic control over a period of 5 years. We report on 57 unselected patients with type 1 diabetes mellitus, who were at least half a year under intensive insulin therapy when entering the study. Mean age was 34 +/- 9, diabetes duration 18 +/- 8 years. The number of daily blood glucose measurements, HbA1c, body mass index, daily insulin dose, routine laboratory values, number of severe hypoglycemic reactions and frequency of retinopathy, nephropathy and neuropathy were determined for year 1 and 5. We found an increase in daily blood glucose measurements from 2.5 to 4.5 per day (year 1 resp. year 5). The frequency of blood glucose measurements at the begin of our study respectively after 5 years was: < or = 2.0/day in 51% vs. 12%, > 2.0 but < 4.0/day in 20% vs. 21% and > or = 4.0/day in 29% vs. 67% of patients. HbA1c decreased from 7.3 +/- 1.2 to 6.4 +/- 1.1% after 5 years (p < 0.001). A comparison of subgroups of patients showed that frequency of blood glucose measurement is not the only cause for this improvement, but adequate education of diabetic patients seems to be most important. Retinopathy and neuropathy increased despite better diabetic control, 2 patients developed microalbuminuria, all other data determined at study entry remained unchanged after 5 years. We conclude that frequent daily blood glucose measurements were accepted by the majority of our patients over a long period of time. Mean blood glucose determined by HbA1c improved under intensive insulin therapy. In our study group with low HbA1c values at baseline this effect was only partly related to the frequency of daily blood glucose measurements.

Adult↗
PubMed1995

[Effectiveness, tolerance and safety of simvastatin in comparison with bezafibrate in treatment of hypercholesterolemia].

The efficacy, tolerability and safety of simvastatin was compared to that of bezafibrate in a randomized placebo controlled double-blind trial including 64 patients with primary hypercholesterolemia with total cholesterol levels above 240 mg/dl and low-density lipoprotein (LDL) cholesterol above 195 mg/dl. During a placebo period of four weeks patients were counselled for a diet low in cholesterol (< 300 mg/day) and saturated fat (< 10% of calories). This period was also used for randomization of the individuals into the bezafibrate and simvastatin group, respectively. Patients assigned to bezafibrate treatment took bezafibrate at 600 mg/day throughout the entire 12 weeks of active treatment. Patients assigned to simvastatin took simvastatin at 10 mg/day when LDL-cholesterol was below 195 mg/dl, and at 20 mg/day when LDL-cholesterol was above 195 mg. To compare the lipid lowering effect of both substances total cholesterol, LDL- and high-density lipoprotein (HDL)-cholesterol were measured as well as triglycerides, very low density lipoprotein (VLDL)-cholesterol and the concentrations of apolipoproteins (apo)-AI, apo-AII and apo-B, respectively. These variables were compared between the two study groups with respect to the percentage change from baseline levels obtained during the placebo period. After a 12 week treatment period mean percent reduction of total cholesterol in the simvastatin group was 24% and that of LDL-cholesterol was 36%, both more pronounced than the respective reductions (14% and 17%) observed in the bezafibrate group. The mean percent increase in HDL-cholesterol was similar in both treatment groups (simvastation by 20% vs. bezafibrate by 17%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[HELLP syndrome and manifestation of type I diabetes mellitus in pregnancy].

HELLP syndrome (haemolysis, elevated liver function tests and low platelets) is a multiorganic disease and has been described in combination with pre-eclampsia/eclampsia, but even without symptoms of gestosis. There are signs, that HELLP syndrome represents an "acute status of autoimmunity". Since immune mechanisms play a fundamental role together with other factors in the development of type I diabetes mellitus, a combination of autoimmune reactions could explain the development of type I diabetes during an altered immune status. We report on the course of a pregnancy complicated by HELLP syndrome, which developed type I diabetes mellitus in the same pregnancy. A subsequent pregnancy with adequate diabetes therapy was uncomplicated and without recurrence of HELLP syndrome.

Adult↗
PubMed1994

[Clinical evaluation of the blood glucose monitors Accutrend, Companion 2, Glucometer 3 and One Touch II in comparison with the glucose oxidase reference method].

New small, light-weight and fast-acting meters for measuring blood glucose have been developed recently. To determine their accuracy and precision we compared Accutrend, Companion 2, Glucometer 3 and One Touch II with the reference glucose oxidase method. For determination of accuracy 150 measurements were performed on two meters of each brand, together with measurement on the Beckman 2 Analyzer, which served as our reference. Capillary blood samples were obtained from patients with type 1 and type 2 diabetes attending our outpatient clinic. All measurements were performed by one experienced technician. Precision in series was determined by 15 measurements of venous EDTA samples. The coefficient of variance was used for statistical analysis. Accuracy was evaluated according to recommendations of the American Diabetes Association and clinically useful criteria such as the error grid analysis. We found that One Touch II performed best overall, followed by Accutrend. Companion 2 and Glucometer 3 showed higher deviations in both accuracy and precision, but nonetheless met the clinical criteria of accuracy and reliability measured by error grid analysis in 87% and 90.5% of measurements, respectively. In conclusion, all four blood glucose meters can safely be used, after proper training, by patients and medical staff for self-measurement of blood glucose.

Blood Glucose Self-Monitoring↗
PubMed1991

Recent advances in radiotherapy treatment planning.

Radiation treatment planning is currently in a state of rapid change. Dissatisfaction with past planning technology stems from the growing realization that: (1) Increases in the local regional tumor control rate will increase the cure rate in many malignancies. (2) Even at the best treatment centers geometric tumor misses are commonplace. (3) Traditional constraints on treatment techniques, originally imposed for simplicity and reproducibility, are no longer necessary, and can result in suboptimal treatment. (4) Treatment plans judged "optimal" in two dimensions may be far from optimal when viewed over the entire treatment volume. (5) Lack of treatment reproducibility is also commonplace, and can be demonstrated to adversely affect treatment outcome. On the positive side, recent developments in computer graphics, image processing, radiation physics, and radiation biology are now making it possible to define, design, and deliver sophisticated 3D radiation treatments. However, because many of these technologies are being developed for other disciplines, their applicability to radiation therapy treatment planning is not widely appreciated. We outline the current status and new developments in radiation therapy treatment planning.

Artificial Intelligence↗
PubMed1991

[Radiologic and clinical follow-up of central venous indwelling catheters in home parenteral nutrition].

In the course of three weeks we examined 42 patients with central indwelling venous catheters for HPN clinically and radiologically for the development of catheter-related complications. Mean patient age was 48 years. In total 47 catheters were implanted. Their mean dwelling time was 37 weeks with the total dwelling time of all catheters amounting to 1773 weeks. In 26%, obstruction of the upper venous systems was the most frequent clinical catheter related complications. However, radiographs showed thrombotic changes on the vessel walls and/or catheter tips in 51%. In the total survey, 66% of the catheters dislocated from the original application site. Overall, 30% of the catheters dislocated into a peripheral vein. The high flexibility of the silicone catheter is probably responsible for this high dislocation rate. Malposition of the catheter represents a major risk in the development of thrombosis and obstruction of the upper venous system. As the catheter is necessary for the patients' survival and the position of the catheter can be corrected after placement we think that routine chest x-rays should be done at least every four weeks.

Adolescent↗
PubMed1988

[Normalization of perinatal morbidity in gestational diabetes by strict metabolic adjustment].

A prospective study compared the perinatal morbidity of 141 normal pregnancies (group I) with that of 108 pregnancies in whom gestational diabetes had been treated early (group II) and 35 with unsatisfactorily treated gestational diabetes (group III). The therapeutic goal in gestational diabetes was to have a postprandial blood-glucose level of less than 130 mg/100 ml. If this was not achievable through diet alone, insulin was injected once daily. Neonatal macrosomia, dystrophy, acidosis, hyperbilirubinaemia, hypoglycaemia and hypocalcaemia had a normal incidence in group II, but in group III macrosomia was twice as frequent as in group II (P less than 0.02), and acidosis (pH less than 7.20) twice as frequent (P less than 0.05). The results indicate that strict metabolic control in gestational pregnancy will achieve a normal rate of perinatal morbidity.

Apgar Score↗
PubMed1987

Organization of anterogradely labeled spinocervical tract terminations in the lateral cervical nucleus of the cat.

The anterograde transport of horseradish peroxidase following injections into the cervical, thoracic, or lumbosacral spinal cord was used to examine the organization of spinocervical tract terminations in the lateral cervical nucleus (LCN) of the cat. A somatotopic organization of the labeling originating from different spinal levels was observed in the mediolateral dimension. Cervical labeling generally occurred in the ventromedial portion and lumbosacral labeling in the dorsolateral portion of the LCN. Thoracic labeling occurred both in the middle and the most lateral edge of the nucleus. In all cases, labeling was distributed over most of the rostrocaudal extent of the LCN. In addition, distinct patches of labeling were present in the medialmost portion of the nucleus, regardless of the spinal level injected. These observations corroborate the topographical organization of the LCN described previously on the basis of physiological and retrograde labeling data, and support the identification of the medialmost part of the LCN as a distinct portion of the nucleus. Terminal labeling in the LCN always occurred in multiple, longitudinally distributed fields. The afferent input to each terminal field coursed in separate, loose bundles of fibers that descended from the superficial dorsolateral funiculus. Large injections resulted in more extensive, overlapping terminal fields. These observations indicate that collateral projections result in several discrete representations of a given portion of the skin over the longitudinal extent of the LCN, but that topographical relationships are longitudinally maintained. It is suggested that these multiple terminal fields are the anatomical correlate of the functionally selective convergence of spinocervical tract terminations, that has previously been postulated on physiological grounds to explain the generation of LCN receptive fields with homogenous receptor input within a somatotopic framework.

Animals↗
PubMed1985

[Fibrinolytic therapy of peripheral arterial occlusive disease].

Occluded arterial segments can be recanalized by fibrinolytic drugs. In addition to systemic fibrinolysis another method of thrombolytic therapy has been established: Local thrombolytic therapy is carried out by infiltration of low dose of streptokinase into the thrombotic occlusion. According to the low dose streptokinase used and the short duration of therapy local thrombolysis is applicable in patients with high risks too. Therefore the range of indications to non-surgical recanalisations could be extended. The differential therapy depends on location, pathogenesis and clinical stage of the arterial occlusion.

Administration, Topical↗
PubMed1985

A prospective study of the immunogenicity of porcine insulin in HLA-typed new insulin-treated diabetics.

Fifty-four diabetics were started on insulin therapy with highly purified porcine insulin (Velosulin, Insulatard, Mixtard) and treated for at least 1 yr with blood samples drawn at regular intervals for insulin antibody determinations. In 43 patients the insulin antibody response was correlated with HLA A, B, and DR antigens. Approximately half of the patients formed insulin antibodies within 6 months of treatment, and this incidence remained constant for up till 2 yr. In those patients who developed insulin antibodies a plateau of 12% insulin binding capacity was reached after 9-12 months which remained constant for up till 2 yr. Formation of antibodies to proinsulin and pancreatic polypeptide proved completely avoidable, and no local reactions at the injection sites were observed. There was indication of a positive association between HLA DR4 tissue types and the tendency to immune response to injected insulin (p = 0.07).

Adolescent↗
PubMed1984

Lack of correlation between serum cholesterol levels, lymphocyte plasma membrane fluidity and mitogen responsiveness in young and aged chickens.

Chickens were studied in an attempt to demonstrate correlations between serum lipid levels and peripheral blood lymphocyte (PBL) plasma membrane fluidity and mitogen responsiveness: (a) in the laying hen; (b) during aging; and (c) following dietary manipulation of serum cholesterol of young and aged chickens. The membrane fluidity of PBL from laying hens was significantly greater than that of immature birds. However, no direct correlation was found between serum lipid levels, nor the serum free cholesterol/phospholipid (FC/Pl) mole composition and PBL membrane fluidity in any of the age-groups tested. Likewise, no correlation was found either between serum FC/Pl mole ratio or membrane fluidity and mitogen responsiveness of PBL from birds up to 5 years of age nor was there any evidence for a decline in mitogen responsiveness up to this age. Supplementation of diets with 1% cholesterol induced hypercholesterolemia, mainly in the very low density lipoprotein (VLDL) fraction, but membrane fluidity and mitogen responsiveness remained unaffected.

Aging↗
PubMed1983

[Glibenclamide in type II diabetes as compared with placebo].

60 non-insulin-dependent diabetics (type II) were controlled in our outpatient clinic from the 1st February to the 31st May 1981 for investigation of the effect of glibenclamide on blood glucose. They had been treated with glibenclamide during the preceding 12 months at least. Satisfactory control of blood glucose [1, 9] was obtained in only 22 patients (37%) although primary failure of sulphonylurea therapy had been excluded in all patients. After being changed from glibenclamide to placebo, only 19 patients (32%) exhibited a significant increase in blood glucose. Altogether only six out of all sixty patients (10%) satisfied the criteria of adequate blood glucose control under glibenclamide with a significant increase in blood glucose on substituting placebo in place of glibenclamide. It is concluded that treatment with glibenclamide is indicated only if the fasting blood glucose is under satisfactory control (less than 120 mg%) and the efficacy of glibenclamide is confirmed at least once a year by a comparison with placebo.

Aged↗
PubMed1983

[Diagnosis of diabetes in pregnancy. Accuracy and prognostic value].

Pregnancy can impair glucose tolerance severely enough to increase the perinatal mortality rate. In the presence of easily recognizable signs pointing to diabetes mellitus we have performed an oral glucose tolerance test. Among 634 patients who were investigated, 151 or 23.8% had impaired glucose tolerance. As there were 11,017 pregnancies in the observation period from January 1976 to May 1981, the detection rate of impaired glucose tolerance was 1.37%. The patients were treated by diet or by diet plus insulin (105 patients). The observed favourable fetal outcome justifies and promotes the proposed diagnostic procedures.

Adult↗