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Biomedical subjects

T Schmitt

Publications and source records attributed to T Schmitt.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Oculomotor paralysis as the leading symptom of meningovascular syphilis. Report of two patients and review of the literature].

A brain stem infarction in the area of the nerve fascicle of the oculomotor nerve could be demonstrated by NMR to be the cause of a complete oculomotor nerve palsy in a patient with neurosyphilis. A second case presented the very rare finding of an isolated bilateral incomplete oculomotor nerve paresis with external paresis on the right and internal paresis on the left side.

Brain Stem↗
PubMed1992

Initial combined cryotherapy and irradiation for unresectable non-small cell lung cancer. Preliminary results.

In unresectable non-small cell lung cancer (NSCLC) with a patent mainstem bronchus, some studies of obstructive tumors, showed (1) a poor role for irradiation in obtaining efficient debulking and (2) an interest in preliminary laser treatment in these patients. Cryotherapy is another method to obtain debulking. Moreover, several studies showed that cryotherapy would increase the radiosensitivity of a tumor. We performed a preliminary protocol combining successively initial cryotherapy followed by irradiation in inoperable NSCLC (either for local or functional contraindications). Thirty-eight patients were included and treated first by cryotherapy performed under general anesthesia and then with external irradiation in a curative intent. The efficiency of cryotherapy assessed on bronchoscopy was found to be volume-efficient (VE) in 26 of the 38 patients and non-volume-efficient (NVE) in the other 12 patients. After irradiation in the VE group, 17 of the 26 patients had no bronchial residual tumor (NRT). In contrast, all of the patients in the NVE group had a bronchial residual tumor (RT). Survival in the VE group (median, 397 days) was significantly higher than the survival of the NVE group (median, 144 days). Survival was found to be independent of the surgical contraindication (local or functional). The best survival was associated both with the efficiency of the initial debulking (VE) by cryotherapy and with the local control (NRT) induced by the irradiation (median, 560 days). Local control was obtained in 65 percent (17/26) of the cases in the VE group and was never observed in the NVE group. In our study the VE group's local control is better than the 35 percent usually reported after irradiation alone. These results argue for the efficient potentiation of irradiation by cryotherapy.

Adult↗
PubMed1990

Hyperfractionated radiotherapy alternating with multidrug chemotherapy in the treatment of limited small cell lung cancer (SCLC). Groupe Lyonnais d'Oncologie Thoracique.

From January 1986 through December 1988, 227 patients were included in a multi-institutional pilot study for small cell lung cancer (SCLC). Out of the 211 patients who fully completed the staging procedures, 77 (35%) appeared to have SCLC limited to the thorax. All patients received combination therapy consisting of AVI (Adriamycin, VP-16 and Ifosfamide), except during radiotherapy when the Adriamycin was omitted, plus twice daily fractionated 18 MV radiotherapy. Treatment protocol consisted of 4 initial courses of AVI, followed by 3 courses of radiotherapy alternating with modified chemotherapy (VP-16 and Ifosfamide), completed by 2 courses of initial chemotherapy (AVI). Radiotherapy consisted of 1.5 Gy/fraction, 2 fractions/day, 5 days/week in the first course, and 1.8 Gy/fraction, 2 fractions/day, 5 days/week, in the second and third courses, for a total tumor dose of 51 Gy, felt to be equivalent to 60 Gy at normal fractionation. CT treatment planning was employed to design a treatment consisting of multiport radiotherapy, using AP-PA and laterals or obliques beams. During the first course, the homolateral hemithorax received 9 Gy total dose on days 1, 3, 5. During the third course, 360 degrees arctherapy was generally used to boost the reduced tumor volume to a 51 Gy. Besides chest X ray and CT scan, staging and restaging procedures included fiberoptic bronchoscopy. Response rate after irradiation is 61%, with 46% complete responders and 51% local control. The median survival is 14 months, and disease-free survival 42% at 1 year. Complications consisted of cardiac toxicity in 2 patients, 1 death of acute pulmonary toxicity, and 4 instances of moderate chronic radiation pneumonitis. Thus, high doses of radiation can be delivered combined with chemotherapy using this protocol, with an acceptable toxicity and encouraging results in response rate and local control. A longer follow-up is needed to evaluate the impact of these results on survival.

Adult↗
PubMed1990

Choice of number of doses for maximum likelihood estimation of the ED50 for quantal dose-response data.

We address the question of how to choose the number of doses when estimating the median effective dose (ED50) of a symmetric dose-response curve by the maximum likelihood method. One criterion for this choice here is the asymptotic mean squared error (determined by the asymptotic variance) of the estimated ED50 of a dose-response relationship with qualitative responses. The choice is based on an analysis of the inverse of the information matrix. We find that in many cases, assuming various symmetric dose-response curves and various design densities, choice of as many doses as possible, i.e., the allocation of one subject per dose, is optimal. The theoretical and numerical results are supported by simulations and by an example concerning choice of design in an adolescence study.

Animals↗
PubMed1989

[Peroperative radiotherapy and cancer of the base of tongue. Technic, indications and preliminary results].

This study involved 15 patients suffering from large volume squamous carcinomas of the base of the tongue, who were likely to benefit from curative therapy (tumours graded T3, T4, N0, N1, N2, TNM UICC 1987). In 13 patients, treatment included transmaxillary bucco-pharyngectomy (TMBP) carried out either as first intention (10 cases), or as a second stage procedure after radiotherapy (3 cases). 2 patients underwent total laryngectomy with secondary basi-glossectomy. Per-operative radiotherapy was performed on the basi-lingual resection site, delivering a boost of 15 to 20 Gy using adapted localisers. A pectoralis major musculo-cutaneous flap procedure was carried out for the TMBP. Post-operative external radiotherapy to the tumour zone for patients treated as first intention was limited to 50 Gy with a boost of 15 Gy to the cervical lymphatic clearance wound in the event of capsular rupture. The aim of this method was to deliver an elective basi-lingual boost allowing better loco-regional control, while reducing the complications of high dose external oro-pharyngeal irradiation. The technique (reliability-tolerance) and the preliminary results are presented.

Adult↗
PubMed1988

Type I protein is a slow isoform of troponin T.

Type I protein, a myofibrillar protein thought to be specific to slow-twitch skeletal muscle fibers, was purified. Two-dimensional electrophoresis indicated its identity with the purified slow troponin-T1s isoform. Immunochemical analyses using antibodies raised against type I protein and slow Tn-T1s, further substantiated the identity of the two proteins.

Animals↗
PubMed1988

[Side effects of external ophthalmologic drugs].

43 patients with suspected adverse reactions to ophthalmic medicaments were tested using three different methods: normal patch test on back skin (ENH), patch test on stripped back skin (HSA) and on scarified skin of the forearm (SKT). The ENH was positive in only 9 patients (20.0%) with one of the used preparations whereas on stripped skin positive reactions were observed in another 14 patients (32.6%). The SKT was solely positive in 10 patients (23.7%). Clinical relevance of these test results has been ascertained in most cases. However, reactions on stripped skin as well as on scarified skin may be false positive. The antibiotics neomycin and gentamicin were the major allergens (13.9% and 9.3%). Some ophthalmic medicaments produced rather severe irritant reactions on scarified skin, confirmed by a positive conjunctival exposure test. In order to detect weak sensitizations or cumulative irritant reactions in patients with long term use of eye medicaments, the application of a method with increased sensitivity such as the patch test on stripped skin or the scarification technique is recommended.

Adult↗
PubMed1988

[Congestive heart failure in a newborn infant with arteriovenous malformation of the vein of Galen: diagnosis using color-coded Doppler image echography].

Arteriovenous malformations of the vein of Galen are rare disorders that may appear in the newborn period with severe congestive heart failure mimicking many intrinsic cardiac defects. Using combined two-dimensional ultrasound and color-coded blood flow mapping arterio-venous aneurysm of the vein of Galen and congenital atrial septal defect could be diagnosed in an newborn with congestive heart failure. In addition to the presented clinical value of the new two-dimensional color Doppler echography physiological aspects of intracranial arteriovenous fistula in infancy discussed.

Cerebral Veins↗
PubMed1987

Identification of infants at risk for infantile spasms by neonatal polygraphy.

Reevaluation of neonatal EEGs and polygraphic tracings of 40 infants with infantile spasms and/or hypsarrhythmia resulted in the constitution of a compound score for the identification of infants at risk for infantile spasms by neonatal EEG. The score comprises 8 distinct items: 2 concern behavioral characteristics, 6 abnormality of EEG background activity and paroxysmal events. A tracing registered at conceptional age 36 to 44 weeks (eventually up to 50 weeks) presenting at least 4 of these 8 items is scored positive for the risk of evolving hypsarrhythmia. In a prospective study the polygraphic tracings of 941 newborn infants were evaluated for risk: 18 infants suffering from perinatal distress and 7 newborns with malformations of the brain were scored positive and all 25 developed infantile spasms and/or hypsarrhythmia. One infant with later infantile spasms was missed by the scoring system. None of the remaining infants scored negative manifested infantile spasms. Thus, correct positive prognostication was 100% and false negative 0.1%. By conventional EEG 5 out of 8 patients with infantile spasms were correctly predicted. The high validity of the risk-score based on polygraphic tracing between conceptional age 36 to 44 weeks may allow pre-onset treatment preventing secondary mental deterioration due to hypsarrhythmia and infantile spasms.

Electroencephalography↗
PubMed1985

Increased mitochondrial creatine kinase in chronically stimulated fast-twitch rabbit muscle.

Fractional extraction and isozyme electrophoresis revealed the presence of small amounts (2.5% of total cellular activity) of mitochondrial creatine kinase (CK) in rabbit fast-twitch muscle. Chronic nerve stimulation resulted in a decrease of extramitochondrial MM-CK to 60% of its normal value but induced an approx. 4-fold increase in mitochondrial CK. This increase occurred in parallel with the rise in enzyme activities of terminal substrate oxidation.

Animals↗
PubMed1985

[Effect of physical training on blood flow properties in patients with intermittent claudication].

Abnormal blood flow in patients with intermittent claudication can be normalized by physical training. We found a decrease in blood viscosity with a decrease in the erythrocyte-aggregation tendency and significant simultaneous improvement in erythrocyte filtrability. Improvement in these haemorheological properties led to a significant increase in physical performance after training. This positive result can be obtained by regular physical training; the application of rheologically effective medicaments is not necessary.

Adult↗
PubMed1985

[Efficacy of troxerutin on the flow properties of blood under defined conditions of circulation. A double-blind study of patients with diabetic retinopathy and arteriosclerotic retinopathy].

In a clinically controlled double-blind study it was demonstrated that tri-(hydroxyethyl)-rutin is not capable of significantly improving blood viscosity or one of its constituent factors. On the basis of data from 58 patients, none of whom was under 43 years old, it was possible to show that the substance tested has no favorable influence on plasma viscosity, erythrocyte deformability and aggregation, or on the concentration of plasma proteins which promote aggregation. Thus, in the very group of patients for whom an improvement in blood flow properties by means of oral administration of tri-(hydroxyethyl)rutin had been hoped for, no therapeutic effect could be demonstrated.

Adult↗