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Biomedical subjects

V Wahn

Publications and source records attributed to V Wahn.

At least 145 records · Page 8Linked to original sources
PubMed1980

[Peripheral blood changes infections and supportive care under intensive chemotherapy for solid tumors CT2 and T6 protocol) (author's transl)].

Two combination chemotherapy protocols are compared for their toxicity. As expected the T6 protocol is more toxic to the bone marrow when compared to the T2 protocol. The incidence of blood transfusions is increased two to three fold. There is no increased incidence of other severe side effects or acute complications. Both chemotherapy protocols are tolerable if intensive supportive care including platelet transfusions can be provided.

Adolescent↗
PubMed1979

Coagulation studies on umbilical arterial and venous blood from normal newborn babies.

Coagulation studies using conventional methods and chromogenic substrates were performed on umbilical arterial and venous blood from 33 newborns after delivery. In the arterial samples, thrombin time (TT) was significantly prolonged and the activities of factors I, II, V and VII, as well as the inhibitors heparin, antithrombin III and antiplasmin, were significantly decreased. This could probably be explained by a mild form of disseminated intravascular coagulation (DIC) occurring in the baby during delivery.

Blood Coagulation↗
PubMedDate not supplied

Partial in vivo response to corticosteroid treatment in common variable immune deficiency.

The case of a 13-year-old girl with CVI is presented who required steroid treatment for myositis. After three weeks of treatment, the serum IgM level increased about ten-fold. Specific antibodies to vaccination antigens, which despite adequate vaccination were absent prior to any kind of treatment, could be synthesized following steroid treatment. The effects observed were only transient. Steroid influences on immunoregulatory T cell may have contributed to the improvement of humoral immunity in this patient.

Adolescent↗
PubMedDate not supplied

S-fimbriae mediated adhesion of Escherichia coli to human buccal epithelial cells is age independent.

S-fimbriated Escherichia coli, which cause sepsis and meningitis in the newborn, bind to sialic acid-containing glycoprotein structures on the surface of human buccal epithelial cells. The dependence of this binding on host age was examined. S-fimbriated E. coli adhered in comparable numbers to cells in newborns, infants, children and adults (23.0 +/- 8.6; 23.1 +/- 11.5; 24.7 +/- 7.9; 28.9 +/- 8.8). Thus, the increased susceptibility of neonates to infections caused by S-fimbriated E. coli cannot be explained by enhanced adhesion to epithelial cells.

Age Factors↗
PubMedDate not supplied

Pharmacokinetics of orally administered zidovudine in HIV-infected children and adults.

The pharmacokinetics of oral zidovudine in HIV-infected children and adults are reported. Fourty-six patients were investigated. For data analysis three groups of similar size were formed: young children 4 months-4 years, n = 15 (group 1), older children up to 13 years, n = 16 (group 2) and young adults, n = 15 (group 3). After a single oral dose repeated blood samples were taken 1/2 hourly during a period of 4 hours and zidovudine concentrations in plasma were determined by high performance liquid chromatography. For better comparison of dose dependent parameters peak concentrations (Cmax) and the area under the time-concentration curves (AUC) were normalized either to the dose/body weight (bw) or the dose/body surface area (bs), respectively. Time to reach peak concentrations and mean terminal elimination half-life times (t1/2 beta = 63.4 +/- 47.6, 74.9 +/- 54.9 and 56.9 +/- 16.4 min in group 1, 2 and 3, respectively, mean +/- SD) were not significantly different between the three groups. With normalization to dose/bw young children in comparison to adults had significantly lower Cmax (2.7 +/- 1.3 vs. 4.6 +/- 2.4 mumol/l, p = 0.016) and AUC (226 +/- 108 vs. 373 +/- 224 mumol.min/l, p = 0.038). Group 2 gave intermediate values. However, with normalization to dose/bs differences in Cmax (6.5 +/- 3.3, 7.3 +/- 4.2 and 6.8 +/- 3.6 mumol/l, in group 1, 2, and 3, respectively) and AUC (563 +/- 313, 691 +/- 351 and 555 +/- 342 mumol.min/l, in group 1, 2 and 3) were not significant between the three groups. It is likely that changes in body water content with age may account for most of these differences observed. In conclusion, a similar pharmacokinetic profile was found in children older than 3 months as compared to older children or adults.

Administration, Oral↗
PubMedDate not supplied

Preliminary experiences with ritonavir in children with advanced HIV infection.

The aim of this study was to obtain information on the feasibility (tolerance, safety) of antiretroviral combination therapy, including ritonavir, in children. In eight children (median age 8.9 years; range 3 to 13 years) with advanced HIV disease (median CD4+ lymphocyte count at baseline, 80 cells/microliter; range 0 to 280 cells/ microliter), drug combinations including ritonavir (approximately 300 mg/m2 b.i.d.) were administered. In seven children, previous therapy using a combination of at least two nucleoside reverse transcriptase inhibitors (NRTI) had failed. Four patients had ritonavir added to an already existing regimen of two NRTI; two patients had one NRTI replaced by a new one; and in two patients two new NRTI were initiated. The number of CD4 T cells, plasma HIV RNA concentration, CBC and blood chemistry profile were monitored. Medication had to be discontinued in two children because of severe nausea and vomiting. In the remaining six children, ritonavir was tolerated and treatment was maintained for at least 6 months. The number of CD4 cells increased in five of six patients. The median number of CD4 cells increased from 66 +/- 110 cells/microliter at baseline to 92 +/- 99 cells/microliter, 161 +/- 88 cells/microliter, and 252 +/- 25 cells/microliter after 1, 3 and 6 months of therapy, respectively. The plasma HIV RNA concentration decreased below the detection limit of 500 copies/ml in three children. In the remaining children a maximum reduction of 0.8, 1.0 and 1.8 log10 was observed. In one child the HIV RNA concentration reincreased after 6 months by 0.7 log10 above the nadir. Antiretroviral combinations including ritonavir were tolerated by six of eight children and produced substantial benefits with respect to increased numbers of CD4 cells and a decline in plasma viral RNA concentration. It can be concluded that the administration of ritonavir is possible in a significant proportion of HIV-infected children, and leads to improvement of the CD4 cell count and viral load.

Adolescent↗
PubMedDate not supplied

[Mollusca contagiosa in HIV-infected children receiving optimal antiretroviral therapy].

Two children with symptomatic HIV-infection suffered from extended mollusca contagiosa. Intensified antiretroviral therapy including a protease inhibitor, resulted in a decrease of HIV RNA plasma concentration and a dramatic increase of CD4 T cells. Mollusca contagiosa nearly completely disappeared. These cases demonstrated that newly generated CD4 T cells during sufficient antiretroviral treatment have functional abilities. Therefore, sufficient antiretroviral treatment should be offered to HIV infected children with extended mollusca contagiosa before surgical intervention is considered.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[In-vivo activation of the 4th component of the complement system (C4) in premature and term infants with generalized bacterial infections].

The concentrations of the complement components C3 and C4 and their activation products C3dg and C4d were determined in EDTA-stabilized serum of 25 premature and term infants. EDTA plasma and EDTA serum obtained from 30 normal blood donors were used as controls. According to clinical, laboratory and/or microbiological findings, six of the 25 children had infections. The mean scatter range of the C3 and C4 values was from 30% (in the 30th week of pregnancy) to 80% (in term infants) of the normal value for adults. In all the children, irrespective of gestational age, the C3dg concentrations were of the same order of magnitude as in healthy adults. As regards the C3, C4, and C3dg values, there was no difference between the newborns with and without infections. The C4d values of the newborns without infections, on the other hand, (range 0.1-1.4 mg/dl, mean 0.8 mg/dl, n = 19) were significantly lower than those of the newborns with infections (range 1.3-2.4 mg/dl, mean 1.95 mg/dl, n = 6). Observation of the course and comparison with CrP showed that elevated C4d values may occur earlier. In the authors' view, these findings indicate that in bacterial infections of premature and term infants the fourth complement component is activated, while the extent to which the third complement component is involved in the activation process is not measurable. Further studies are needed to establish whether early diagnosis of neonatal sepsis can be improved by determining C4d.

Bacterial Infections↗
PubMedDate not supplied

[Acute-phase reaction in children with leukemia at the time of diagnosis].

Using clinical criteria 29 children with acute leukemia were divided into two groups, one with and the other without evidence of infections. As part of the initial laboratory work up acute-phase reactants alpha 1-glycoprotein (alpha 1GP ), ceruloplasmin (CP), C-reactive protein (CRP) and haptoglobin (HP) were determined by single radial immunodiffusion. In children without infections moderately elevated levels of alpha 1 GP and CP were observed while CRP and HP were almost normal. The levels in children with infections, however, for CRP and HP were markedly elevated. We conclude that determinations of acute phase reactants are of considerable importance for evaluation of infections in leukemic children. Clinical signs of infections associated with markedly elevated CRP and HP-levels require - in analogy to the infected newborn - immediate proper antibiotic treatment.

Adolescent↗
PubMedDate not supplied

[Immune complex formation and complement changes in osteosarcoma patients treated with high-dose methotrexate].

Patients with osteosarcoma frequently have elevated immune complex levels, which are correlated with disease activity and tumor volume. During treatment with high-dose methotrexate (MTX) some patients develop specific immune complexes containing MTX. These patients suffered from anaphylactic reactions. To study the influence of MTX on immune complex formation we looked for polyethyleneglycol (PEG) precipitable and C3b-binding immune complexes in the sera of 10 children with osteosarcoma during treatment according to the COSS 80 protocol. Sera were obtained before, 24, 48 and 72 hours after MTX-infusion. Furthermore we analysed changes of the complement system in the same way. The minority of the patients developed PEG-precipitable immune complexes. C3b-binding IgG complexes were observed at the beginning and at the end of treatment. High levels of immune complexes at the end of chemotherapy were correlated with a poorer prognosis. There was no relationship between MTX-infusion and immune complex formation. No significant changes of the complement system during MTX-infusion were found. The complement analysis were of no prognostic value concerning the osteosarcoma.

Adolescent↗
PubMedDate not supplied

[Lupus erythematodesus profundus].

A 4 year old boy with lupus panniculitis since the third month is presented. Typical discoid lupus erythematosus lesions were also present. There were no signs of systemic involvement. Lupus panniculitis is an uncommon subtype of cutaneous lupus erythematosus. Our case is very unusual as the lesions developed already 3 month after birth. Clinical manifestation, therapy and histopathology of lupus panniculitis are discussed.

Adipose Tissue↗
PubMedDate not supplied

[High-dose chemotherapy: principles, indications and complications].

Cure rates of children and adolescents with malignant diseases have improved since the introduction of systemic chemotherapy in cooperative trials in the recent 10 to 15 years. Tumors resistant to conventional doses have responded to high dose regimens. The rationale for the use of high dose regimens is discussed as well as adequate methods of protecting against severe and often lifethreatening complications.

Antineoplastic Agents↗
PubMedDate not supplied

[Clinical experiences with polyethylene glycol-bound E. coli L-asparaginase in patients with multiple recurrences of acute lymphoblastic leukemia].

The efficiency and toxicity of E. coli-L-Asparaginase coupled to polyethyleneglycol (PEG-ASP) was investigated in 5 patients with second relapse of acute lymphoblastic leukemia. PEG-ASP was administered at a dose of 2000 U/m2 as infusion over 2 hrs. every 2 weeks. Following an initial single agent phase, PEG-ASP was combined with prednisone, vincristine, adriamycin and methotrexate i.t. Following induction, all 5 patients were in third remission. The remissions lasted from 3 to 9 months, median 4 months. The toxicity was transient and mild. Also in patients sensitized against native L-Asparaginase no anaphylactic reactions were observed.

Adolescent↗
PubMedDate not supplied

[Significance of immune complexes in children with severe hemophilia A in substitution treatment with factor VIII concentrates].

Sera and EDTA-Plasma of patients with severe Haemophilia A were analysed for immune complexes and the hemolytic activity of complement in relation to Factor VIII replacement, in order to confirm or possibly exclude a relationship to allergic reactions. Immune complexes were isolated by PEG precipitation and quantitated. In addition a solid phase ELISA assay was used to detect complement-binding complexes. Total hemolytic complement activity of the classical and the alternate pathway was measured in addition to the C3 splitproduct C3d. The results obtained from 12 patients with severe Haemophilia A showed slightly increased immune complex titers, no changes of the immune complex levels during Factor VIII replacement and no alteration of the complement system following the infusions. One patient developed an allergic reaction without evidence of complement activation.

Adolescent↗
PubMedDate not supplied

[Delayed-type skin reaction in children with malignant diseases].

The delayed type hypersensitivity reaction has been employed in order to study the cell-mediated immunity in 103 children and adolescents with malignant tumors, using the Multitest system (Mérieux). This skin test allows the simultaneous application of seven various recall-antigens in a standardized fashion and proved to be very predicative in normal children and adolescents at the age of 1-30 years, since beyond infancy no major variations of the test results has been observed in older age groups and a complete anergy has only been seen in 1.8%. The tumor patients were divided in three groups (50 patients with leukemia and malignant lymphoma, 23 patients with malignant bone tumors and 30 patients with other malignant diseases) and studied at the beginning or under chemotherapy. A significant decrease of skin reactions or a total anergy were found in all tumor groups compared to the normal control group and regardless the duration of chemotherapy. This was more pronounced in patients with systemic malignancies than in solid tumors. The largest group of the ALL- and NHL-patients showed a severely depressed cell-mediated immunity or complete anergy at the beginning of chemotherapy and subsequently improved already during the induction phase of chemotherapy. If improvement was missing, it was highly suspicious for relapse. In addition, such an increase of skin reactivity could not be demonstrated in few relapse patients during reinduction therapy. Patients with malignant bone tumors did not show such a dramatic depression of cell-mediated immunity at the beginning of chemotherapy and the results correlated with the course of the intervall chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗