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Biomedical subjects

U Gunzer

Publications and source records attributed to U Gunzer.

At least 19 recordsLinked to original sources
PubMed1991

[The diagnostic assessment of enlarged lymph nodes by the qualitative and semiquantitative evaluation of lymph node perfusion with color-coded duplex sonography].

Perfusion of enlarged lymph nodes by colour-coded sonography was studied prospectively in 105 benign and 115 malignant lymph nodes. The diagnosis was confirmed histologically in 158 and clinically in 62. Spectral analysis in the benign lymph nodes provided normal values for pulsatility and resistance indices. A pulsatility index greater than = 1.8, or a resistance greater than = 0.9 indicate lymph node metastases with positive prediction of 93% and specificity of 97%. In addition, subjective, semiquantitative classification of lymph node perfusion in relation to the surrounding fat or connective tissue improves the diagnosis of lymph node metastases and of malignant lymphomas.

Axilla↗
PubMed1991

[Therapeutic cytapheresis].

In myeloproliferative disorders many complications are caused by circulatory problems due to high leukocyte or platelet numbers and by hyperviscosity. With cytaphereses and mild cytostatics like Azathioprine, these problems are solved quickly and without major side effects. We report about plateletaphereses for polycythemia vera and megacaryocytic myelosis and leukocytaphereses for chronic myelogenous leukemia. In addition, erythrocytaphereses were carried out successfully in a patient with a combination of heterozygous sickle cell anemia and thalassemia minor.

Adult↗
PubMed1989

Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase II study with etoposide, doxorubicin, and cisplatin.

Thirty-four patients with locally advanced, nonresectable gastric cancer (staged by laparotomy) received etoposide, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and cisplatin (EAP). Thirty-three patients were evaluable for response and toxicity. Second-look surgery with removal of residual tumor by gastrectomy and lymphadenectomy was performed in case of complete/partial remission (CR/PR) after EAP. After successful resection (R0- and R1-resection), two cycles of EAP were administered for consolidation therapy. Patients refusing reoperation received up to six cycles of EAP. The response rate (CR/PR) after EAP was 70% (23/33), including a 21% (7/33) rate of clinical CRs (CCRs). Two patients had minor remission (MR)/no change and seven had progressive disease. There was one early death. Nineteen of 23 responders (5 CCRs, 14 clinical PRs [CPRs]) and one patient with MR underwent second-look surgery. Five CCRs were pathologically confirmed; 10 patients with CPR were without evidence of disease (NED) after resection. In three patients (CPR), R1-resections (microscopically tumor-cell positive proximal margin) were performed; two patients are disease-free, 22+ and 33+ months after consolidation chemotherapy. In two patients, the tumor was again considered nonresectable. Twenty patients were disease-free after EAP +/- surgery +/- consolidation chemotherapy. Toxicity was primarily hematologic. Leukopenia and thrombocytopenia of World Health Organization (WHO) grade 3 occurred in 30% and 9%, respectively and grade 4 in 18% and 9% of the patients, respectively. There was no increased peri- or postoperative morbidity. After a median follow-up of 20 months for disease-free patients, the relapse rate is 60% (12/20). The median survival time for all patients is 18 months and for disease-free patients 24 months. EAP is highly effective in locally advanced gastric cancer, and offers a chance for surgery with curative intention in patients with an otherwise fatal prognosis.

Adult↗
PubMed1988

Etoposide and split-dose cisplatin in small-cell lung cancer.

Forty-seven untreated patients with small-cell lung cancer (SCLC) were treated with a combination of etoposide (170 mg/m2 intravenously, i.v., days 3-5) and cisplatin (50 mg/m2 i.v., days 1 and 7). Responding patients with limited disease received four cycles followed by irradiation (delivered to the primary site, mediastinum, and supraclavicular region) with 50 Gy. Prophylactic cranial irradiation (PCI) with 30 Gy was performed in patients who achieved complete remission. Responding patients with extensive disease received four to six cycles of chemotherapy. The overall objective response rate (complete response plus partial response, CR + PR) was 94% (44 of 47). CR rate (all patients) was 57% (27 of 47), 51% (19 of 37) in extensive disease and 80% (8 of 10) in limited disease. The median remission duration is 13 months (12 months in extensive disease and 26 months in limited disease). The median survival is 16 months for all patients (15 months in extensive disease, 28 months in limited disease). Mean follow-up is 13 months. Toxicity was primarily hematologic. Twelve of 47 patients had leukopenia of WHO grade 4, 30 of 47 of grade 3. Thrombocytopenia of WHO grade 3 and 4 occurred in 6 of 47 and 2 of 47 patients, respectively. There were four severe infections in neutropenic patients, but no chemotherapy-related lethal complications. The only treatment-related death was that of one patient who died in CR of progressive neurologic dysfunction 11 months after PCI. This schedule of etoposide and cisplatin induces high CR rates and a prolonged survival, especially in patients with extensive disease.

Adult↗
PubMed1986

Leukemia-related morphological features in blast cells.

This paper investigates the use of image-processing methods to detect leukemia-related morphological differences in mononuclear blast cells. Routinely prepared Pappenheim-stained blood smears were scanned in a high-resolution color TV-microscope system. Eleven blast-cell classes (OMSBC, T-ALL, OMS, ALL, LBL, IBL, AUL, AML, AMOL, AMMOL, and CML) were analyzed with the nonparametric statistical software program "Classification and Regression Trees" (CART). This paper documents the initial statistical evaluation of 62 leukemia-related morphological features that directly measure and analyze the cell-related quantifiable differences occurring in the various blast cells. The 62 cell image features include both common cytophotometric features, and new texture and color features developed for this project. This study found that each leukemia specimen contains a dominant class of blasts that correlates with the specific leukemia, plus a distribution of blasts from related diseases. The present data suggest the existence of a distribution fingerprint pattern for each leukemia.

Cell Nucleus↗
PubMed1986

Segmentation of stained blood cell images measured at high scanning density with high magnification and high numerical aperture optics.

In hematological morphology, it is necessary to resolve and analyze the smallest possible cellular details appearing in the light microscope. A prerequisite for computer-aided analysis of subtle morphological features is measuring the cells at a high scanning density with high magnification and high numerical aperture optics. Contrary to visual observations, the information content in a measured picture can be increased by setting the condensor's numerical aperture (NA) greater than the objective's NA. The complexity and heterogeneity of such cell images necessitate a new segmentation method that conserves the morphological information required in the subsequent image analysis, feature extraction, and cell classification. In our segmentation strategy, characteristic color difference thresholds for each nucleus and cytoplasm are combined with geometric operations, probability functions, and a cell model. All thresholds are repeatedly recalculated during the successive improvements of the image masks. None of the thresholds are fixed. This strategy segments blood cell images containing touching cells and large variations in staining, texture, size, and shape. Biological inconsistencies in the calculated cell masks are eliminated by comparing each mask with the cell model criteria integrated into the entire segmentation process. All 20,000 leukocyte images from 120 smears in our leukemia project were segmented with this method.

Blood Cells↗
PubMed1986

[Clinical and prognostic relevance of the Kiel classification of non-Hodgkin lymphomas].

The Kiel classification provides a new subdivision of non-Hodgkin lymphomas into distinct entities showing different clinical and prognostic properties. In comparison with earlier classifications this system defines additional types of lymphoma (e.g. CC lymphoma, LP immunocytoma) (for abbreviations see text) which are to be considered separate entities also from a clinical point of view. By data derived from a multicenter prospective observation study (1,127 patients recruited from 1975 to 1980, follow-up until 1985) a precise definition of the clinical features of each lymphoma entity (e.g. frequency, age and sex distribution, patterns of initial involvement and spread of disease) was possible. In addition, the effect of radio- and/or chemotherapeutic measures was evaluated. Strictly localized disease (stage I/IE according to the Ann Arbor classification) occurred in 1.5 to 8% of patients with NHL of low-grade malignancy (comprising 69.4% of cases studied) and in 8 to 17% of patients with high-grade malignant NHL (comprising 30.2% of cases studied). Loco-regional irradiation alone was able to induce complete remission in 86 to 89% (CB and IB lymphomas) and in 100% (LP immunocytoma, CB-CC and CC lymphomas), respectively, of stage I/IE patients. Only CC and IB lymphomas showed a relevant risk of relapse (40% and 50%, respectively). Total lymphoid irradiation as able to induce stable complete remissions in about 50% of patients with stage III of CB-CC lymphoma. Probabilities of survival of patients with initial stages III and IV treated by several types of chemotherapy reflect different prognostic features of individual lymphoma entities.(ABSTRACT TRUNCATED AT 250 WORDS)

Combined Modality Therapy↗
PubMed1979

Computer aided analysis of chromatin network and basophil color for differentiation of mononuclear peripheral blood cells.

Computer aided differentiation of plasmoblasts, Pfeiffer cells, immunoblasts, lymphocytes and centrocytes is achieved with the parameters of chromatin network arrangement and structure, and multispectral cytoplasm color. The digital methods involve: (a) segmenting the nuclear image into topographic sections and analyzing the optical density distribution from the chromatin in these sections; (b) determining the nuclear structure with a 7 x 7 median filter, gradient filter and contour following algorithms; and (c) clustering two-dimensional chromatic data from panoptically stained cellular components. The parameters reported here are a subset of those needed for the automated diagnosis of many hematologic diseases especially the leukemias.

Blood Cells↗
PubMed1978

Postheparin-diamine oxidase (histaminase) in anaphylaxis.

The level of plasma postheparin-diamine oxidase was determined in two patients three days after an anaphylactic shock and was controlled four weeks, and also six months later. A decrease of the enzyme levels to about 10% of a control group was found and a slow enzyme increase to about 40% observed six months later. It seems probable that in anaphylaxis a depletion of the enzyme in liver and small intestine occurs as could be shown in animals after heparin load.

Adolescent↗
PubMed1977

Bone marrow cell scene segmentation by computer-aided color cytophotometry.

Computer scene segmentation of touching cell images in bone marrow, on the basis of color information, is achieved using digitized scans at three different wavelengths of light. With trivariate histograms and Euler's coordinate transformation, it is possible cytophotometrically to isolate, on the basis of chromatic differences, individual heterogeneous cells located in cell groups. The ability of the described computer methods to isolate correctly the touching cell images is determined by visual comparison of the cells as seen in the microscope and the computer-generated displays of the scanned and segmented scenes.

Bone Marrow Cells↗