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Biomedical subjects

V Schwarz

Publications and source records attributed to V Schwarz.

At least 37 records · Page 2Linked to original sources
PubMed1990

Hepatic arterial infusion (HAI) chemotherapy for liver metastases of colorectal cancer using 5-FU.

Thirty-three patients with liver metastases of colorectal cancer were treated by intra-arterial 5-FU chemotherapy. The median survival time of all patients was 14 months. A partial remission could be observed in nine patients, and a further 15 patients had stable disease. Patients were treated on an outpatient basis and the toxicity of treatment was mild. We observed no case of sclerosing cholangitis or chemical hepatitis. Intra-arterial 5-FU chemotherapy provided treatment results similar to those reported for FUdR but with less hepatobiliary toxicity.

Colorectal Neoplasms↗
PubMed1989

Assessment of serial carcinoembryonic antigen: determinations to monitor the therapeutic progress and prognosis of metastatic liver disease treated by regional chemotherapy.

It is difficult, time-consuming, and expensive to evaluate the therapeutic efficacy of regional chemotherapy of metastatic liver disease by means of imaging procedures. Therefore it was the aim of this study to find out whether serial carcinoembryonic antigen (CEA) determinations yield reliable data on the therapeutic progress and the individual prognosis of these patients. Since there exists no generally accepted modality to assess CEA curves of patients receiving chemotherapy, we developed our own criterion and tested it in a group of 35 patients. For each patient an individual reference level (CEA-means) was fixed which was obtained as the arithmetical mean of serial CEA values taken during the first three courses of chemotherapy (reference time). On the basis of CEA-means the marker curves of the 35 patients could be divided into two groups. After the reference time the CEA values of group 1 (12 patients) never decreased below CEA-means. Survival of these patients was significantly (P = 0.00001) shorter than that of the 23 patients (group 2) who showed a decrease in their CEA curves below CEA-means after the reference time. Beyond this it could be observed that the improvement in survival was significantly greater in those patients who showed a CEA decrease below CEA-means for a prolonged period (3 months). This difference in prognosis is not an artefact due to different pretherapeutic conditions but is a sign of different responses to therapy. The decrease in CEA values below the individual reference level (CEA-means) is a certain sign of the efficacy of the chosen chemotherapy. A continuous rise of the CEA curve above CEA-means signifies an ineffective intrahepatic chemotherapy or extrahepatic tumor manifestation. In this case an intensive diagnostic workup of the patient and possibly a modification of the therapy are indicated.

Adult↗
PubMed1989

Setting up a decision support system with decision tables.

The aim of our study was to develop a decision support system using a conventional method which can be used as a shell for different applications. So it was necessary to find a method which allows separation of decision principles and decision algorithms. In addition, documentation of the patient records should be simplified. This could be attained by using the decision table technique and the programming language MUMPS. The general system developed was applied to the therapy decision for patients with liver metastases. The application system was clinically evaluated in a randomized group of patients. In 84% of the study group the therapy proposal of the system concurred with the therapy actually applied. Representation of knowledge in the form of tables is easily understandable by physicians. Since decision tables can be seen as a medium of communication between physician and system manager, knowledge acquisition is simplified.

Algorithms↗
PubMed1988

Reduction or loss of HLA-A,B,C antigens in colorectal carcinoma appears not to influence survival.

Primary colorectal carcinomas of an unselected group of 159 patients 126 of whom could be curatively resected were examined for the expression of MHC class I antigens with monoclonal antibody W6/32 directed against a non-polymorphic determinant of HLA-A,B,C heavy chain. One hundred and nine (68.6%) were found to express HLA-A,B,C antigens in normal quantities, 33 (20.8%) showed a substantial reduction in expression, while 17 (10%) lacked these antigens either completely or incompletely. The loss of HLA-A,B,C was inversely correlated with the degree of differentiation. The tendency of mucinous carcinomas to lack class I antigens was statistically not significant. Tumours with distant metastatic spread at the time of operation tended to be normal with respect to HLA-A,B,C expression. Within the curatively resected group, poor differentiation and mucus production were risk factors for survival as could be shown by life table analysis after a maximum follow-up of 39 months. In contrast, the mode of HLA-A,B,C expression of the primary tumour did not influence survival within this time of observation. We conclude that in spite of increasing experimental data suggesting the contrary, the presence or absence of MHC class I antigens does not seem to profoundly modify tumour biology, at least in human colorectal carcinoma.

Adenocarcinoma↗
PubMed1988

Preoperative chemotherapy in esophageal cancer. A phase II study.

Forty-two patients with localized squamous cell carcinoma of the esophagus were treated according to a phase II study with cisplatin, vindesine and bleomycin (modified Kelsen schedule) prior to surgery. In 17 of these patients partial remission was achieved and in two cases complete remission. Of the 40 patients who were candidates for surgery, 4 were inoperable. In 22 cases the tumor was removed in a potentially curative manner and in 14 patients a palliative resection was performed. There were 4 post-operative deaths among 36 resected patients. Anastomic leakage occurred in 5 and severe cardiopulmonary complications in 4 patients. The side effects of the preoperative treatment were acceptable. A high resectability rate and a comparatively high survival rate in patients who responded to chemotherapy suggest that the preoperative treatment employed might be of value.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Liver resection in patients with metastases of colorectal cancers. Results and prognostic factors].

From October 1981 until July 1987 82 patients underwent hepatic resection for liver metastases of colorectal primary tumors. Operative mortality was 4.8%. This included, the median survival time was 25 months in a group of patients followed-up for at least one year postoperatively. Factors showing statistically significant influence on survival are: node-negative primary tumor, less than four metastases resected, only one liver lobe involved and decrease of CEA below 5 micrograms/ml if preoperatively elevated. Factors showing only a tendency to result in improved survival rates are the grading of the primary tumor and the percentage of liver involvement by tumor. The survival time after liver resection is similar in patients with synchronous and metachronous metastases. Thus, the time interval between the removal of the primary tumor and the detection of liver metastases seems to be gained lifetime.

Adult↗
PubMed1987

Carcinoembryonic antigen, CA 19-9, and CA 125 in normal and carcinomatous human colorectal tissue.

In 115 primary colorectal carcinomas and 64 normal colorectal mucosa specimens the concentrations of carcinoembryonic antigen (CEA), CA 19-9, and CA 125 were measured. The determinations were performed in cytosols by use of radioimmunometric and enzymeimmunometric assays and related to the wet tissue weight. In the cancer tissue the CEA levels ranged from 5.5 to 1990 micrograms/g tissue and were significantly higher (P less than 0.0001) than those found in the normal mucosa (1.2-58.6 micrograms/g). The CA 19-9 content in carcinoma specimens (120-72660 U/g) was also significantly higher (P = 0.011) than in the normal mucosa (37-5800 U/g). In contrast, no significant difference of the CA 125 concentrations between the normal and the cancer tissue was found. The relative operating characteristic (ROC) curves for the three markers corroborate CEA as the marker superior to CA 19-9. On the other hand is shown that CA 125 is completely unable to discriminate between normal and cancer tissues. A decreasing CEA tissue concentration and an increasing dedifferentiation of colorectal cancers were significantly (P = 0.018) related with each other. Higher tumor stages implied significantly higher tissue marker values of CA 19-9 (P = 0.027) and CA 125 (P = 0.0008). The findings correspond quite well with serum examinations of the three markers which have been reported earlier.

Antigens, Neoplasm↗
PubMed1987

[Preoperative chemotherapy in esophageal cancer: an advantage or danger for surgical intervention?].

42 patients with localized squamous cell carcinoma of the esophagus were treated according to a phase II study with cisplatin, vindesine and bleomycin (Kelsen-Schema) prior to surgery. In 18 of these patients partial remission was achieved and in two cases complete remission. Of the 40 patients which were presented to surgical treatment, 4 were inoperable, in 22 cases the tumor was removed in a potentially curative manner and in 14 patients a palliative resection was performed. The postoperative mortality was 4 of 36 resected patients. Anastomotic leakage was found in 5 patients and severe cardiopulmonary complications in 4 patients. The side effects of the preoperative treatment were acceptable and seem justified by the high resectability rate and the significant improvement in survival of patients who responded to chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Drug level monitoring: chromatography of some minor groups of drugs.

Some important facts about the chromatographic separation of a number of selected categories of drugs are summarized. The data refer to the chromatographic method of choice, stationary phase, mobile phase (carrier gas), detection procedure and (where available) method sensitivity. Also, fundamental instrumental parameters, namely injector, column and detector temperature, carrier gas and mobile phase flow-rate and gradient set-up are reported here. In all cases also the source material used for analysis is specified. The data are presented in table form, each table dealing with a particular category of drugs. The following categories of drugs are being dealt with: anthelmintics, antiarteriosclerotics, antibacterials, anticholinergics and cholinergics, anticoagulants, antidiabetics, antiemetics, antimycotics, antihistamines, antimalarials, antiparasitics, antiparkinsonics, antitussives, antiulcer drugs, antiviral compounds, appetite depressants and immunosuppressives.

Anthelmintics↗
PubMed1985

The human eccrine sweat gland adenylate cyclase system: response to agonists.

Cyclic AMP accumulation has been measured in whole human sweat glands. The mean rate in glands from 19 subjects was 0.519 +/- 0.316 pmol of cyclic AMP formed 5 min-1 micrograms-1 of DNA, which is comparable with that reported for other tissues. Cyclic AMP accumulation in the sweat gland is stimulated fourfold by prostaglandin (PG) E1 and fivefold by PGE2 (0.1 mmol/l), in accord with stimulation in renal tubules and medullary membranes. Bradykinin (10 micrograms/ml) increases the rate threefold and this is substantially prevented by indomethacin (1.5 X 10(-5) mol/l), as also is a fivefold stimulation by cyclic GMP (10(-5) mol/l). Mecholyl (10(-2) mol/l) and isoprenaline (6 X 10(-6) mol/l) increase the rate five- and four-fold respectively, and these agonist effects are largely abolished by atropine and propranolol. The stimulation and inhibition pattern suggests a direct action of PGE, enhancement of prostaglandin synthetase by cyclic GMP and stimulation of guanylate cyclase by mecholyl and bradykinin. Isoprenaline presumably stimulates adenylate cyclase directly. This complex chain of events, from cholinergic stimulation to an enhancement of adenylate cyclase, demonstrated in vitro, constitutes a potential for flexible and fine control of sweat gland function.

Adenylyl Cyclases↗
PubMed1985

Is salt reabsorption in the human sweat duct subject to control?

There is a time lag between the beginning of sweat secretion and fully effective production of fluid of minimum salt content. It is suggested that changes in permeability to water or electrolytes have to be effected and may account for the time lag. The composition of thermal and pilocarpine sweat indicates that pharmacological stimulation does not wholely reproduce the physiological mechanism: pilocarpine sweat contains more sodium and more cyclic AMP, irrespective of the secretory rate. The sweat obtained from patients with cystic fibrosis has been compared with that from normal children: the concentrations of cyclic AMP and cyclic GMP are the same. Defective sodium reabsorption in the patients is therefore unlikely to be due to inadequate or excessive synthesis of these cyclic nucleotides.

Absorption↗