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Biomedical subjects

W Fischbach

Publications and source records attributed to W Fischbach.

At least 73 records · Page 4Linked to original sources
PubMed1996

Occurrence of multiple lymphoepithelioma-like carcinomas and MALT-type lymphoma in the stomach: detection of EBV in carcinomas but not in lymphoma.

A multifocal lymphoepithelioma-like carcinoma and a low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-type) were found simultaneously in the stomach of a 65-year-old patient. Carcinoma and lymphoma were intimately associated forming complexes resembling lymphoepithelial lesions at the primary gastric site and in lymph node metastases. The two tumours had developed on a background of severe chronic-atrophic gastritis of the mucosa of antrum and fundus. Autoantibodies to normal gastric glandular tissue could be demonstrated in the patient's sera. Using non-radioactive in situ hybridization (ISH), Epstein-Barr virus (EBV) sequences were detected in virtually all carcinoma cells but neither in the non-neoplastic mucosa nor in the lymphoma. These findings suggest that a focal EBV infection occurred early in the development of the carcinoma followed by a subsequent clonal expansion of the EBV-containing tumour cells. A neoplastic transformation in MALT-type lymphoma is not EBV-related but might be triggered by altered immune mechanisms.

Aged↗
PubMed1996

[Standard intervention in primary lymphoma of the stomach--initial results of a prospective multicenter study].

An R0 resection seems to be a rather aggressive treatment, but can be achieved in 80% of localized gastric lymphomas and should be seen in contrast to other effective treatment modalities. For curative treatment at stage EI1-EII1, total gastrectomy with systematic lymphadenectomy (D2) seems to be necessary. Basic information about the clear diagnosis, tumor dissemination and the individual prognosis only becomes available by a standardized operation as part of multimodal therapeutic concepts.

Aged↗
PubMed1995

[Primary non-Hodgkin lymphoma of the stomach--internal medicine aspects].

Primary gastric malignant non Hodgkin lymphomas occupy a special position, which is documented in the new histologic classification according to the MALT-concept. Our knowledge about the pathogenesis of this entity, its clinical and biologic behaviour and its morphologic and molecular biologic characteristics is increasing. Endosonography might be of outstanding value for the differentiation between the stages EI1, EI2 and EII1. The adequate treatment of these lymphomas is still under debate. Prospective multicenter studies were not performed. Our multicenter study has a stage adapted treatment schedule. We hope to answer some of the open questions.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

Comparison between high dose 5-aminosalicylic acid and 6-methylprednisolone in active Crohn's ileocolitis. A multicenter randomized double-blind study. German 5-ASA Study Group.

BACKGROUND: The value of 5-aminosalicylic acid (5-ASA) in Crohn's disease (CD) is still under discussion. In a previous study 2 g 5-ASA per day were inferior to a standard glucocorticoid treatment with 6-methylprednisolone (6-MPred) (Can J Gastroenterol 1990; 4: 446-51). In the present study we tested whether in active CD response rates to 4.5 g 5-ASA/day were not different from those to 6-MPred. METHODS: Multicenter randomized double-blind double-dummy trial. 34 patients with active CD (CDAI > 150) were included. 17 patients were in the 5-ASA group (Salofalk, 4.5 g/day), 17 patients in the 6-MPred group (Urbason, initial dose 48 mg/day, weekly tapering). Duration of treatment was 8 weeks. Main outcome measure was remission of CD (CDAI < 150) and decrease of at least 60 points. RESULTS: Both groups were comparable with respect to demographic and clinical parameters. The median CDAI decrease in the 5-ASA group was 85, in the 6-MPred group 122 (p = 0.7437). The median AUC of the CDAI in the 5-ASA group was 1027, in the 6-MPred group 950 (p = 0.137). The median AUC of the CDAI per treatment day was 22.94 in the 5-ASA group, and 17.33 in the 6-MPred group (p = 0.0555). On an intention-to-treat basis remission rates after 8 weeks were 40.0% in the 5-ASA group and 56.3% in the 6-MPred group (p = 0.5867). CONCLUSIONS: Response rates to 5-ASA or 6-MPred were not significantly different although there was a trend towards a higher efficacy of 6-MPred. 5-ASA may be considered as alternative treatment in patients with activer CD who are intolerant to or refuse glucocorticoids.

Adult↗
PubMed1995

[Primary gastric lymphoma of the MALT type. The current knowledge on its etiology, therapy and prognosis].

Primary gastric lymphoma are nowadays considered as a distinct lymphoma entity. They are mostly classified as low or high grade malignant B-cell-lymphoma of the MALT (mucosa-associated lymphoid tissue). Within the gastrointestinal tract, the stomach is most frequently involved. In the pathogenesis of gastric lymphoma, Helicobacter pylori-associated gastritis plays an important conditioning role. Histological grading, stage and resectability of lymphoma are considered as major prognostic factors. Options in the therapy of gastric lymphoma are based on their histological grade and stage of the disease. They include surgical resection and/or radiotherapy for local tumor control as well as chemotherapy in the case of disseminated disease or high malignancy. Currently, special interest focuses on the effect of Helicobacter pylori eradication.

Combined Modality Therapy↗
PubMed1994

[Imaging methods in diagnosis of malignant lymphoma].

Modern diagnostic imaging has improved the evaluation of malignant lymphomas during the last years. Most of the invasive examinations were replaced by non-invasive tomographic imaging. The most important examinations for the evaluation of lymph nodes are nowadays ultrasound, computed tomography and magnetic resonance imaging. The sequence of their use is depending on the region of examination. The immediate use of the method of choice for a certain body region instead of a protracted step-for-step diagnostic has led to a distinct shortening of diagnostics, diminishing of radiation dose exposure and cost reduction.

Adult↗
PubMed1994

[Primary stomach lymphoma. An assessment of the current status].

The gastrointestinal tract represents the most frequent extranodal manifestation of Non-Hodgkin's lymphoma. Primary gastrointestinal lymphoma which are classified according to the concept of MALT (mucosa-associated-lymphoid-tissue) have to be differentiated from lymphoma involving secondarily the digestive tract. Primary gastric lymphoma which appear at an advanced age can be usually diagnosed endoscopic-bioptically. Representing the major prognostic factors options in the therapy of gastric lymphoma are based on the histologic grading and the stage of disease. Surgical resection and radiotherapy allow a good local tumor control while chemotherapy is the treatment of choice in case of disseminated disease or high malignancy. Characterizing the morphology and molecular biology of primary gastric lymphoma of the MALT, evaluating the role of endoscopic ultrasound in the local staging (EI1, EI2 and EII1), and optimating the therapeutic modalities are main topics of an ongoing prospective multicenter trial.

Combined Modality Therapy↗
PubMed1994

[Primary stomach lymphoma of the MALT type. Diagnosis and therapy. Gastrointestinal Lymphoma Study Group].

Primary gastric lymphoma are nowadays considered as a distinct lymphoma entity. Their classification is based on the concept of MALT (Mucosa-associated lymphoid tissue). Within the gastrointestinal tract, the stomach is most frequently involved. In the pathogenesis of gastric lymphoma, Helicobacter pylori-associated gastritis plays an important, conditioning role. Usually, the diagnosis of gastric lymphoma can be established on the basis of endoscopic biopsies. Endoscopic ultrasound seems highly useful for differentiating the depth of lymphoma infiltration and for evaluating the perigastric lymph nodes. Options in the therapy of gastric lymphoma are based on their histological grade and stage of the disease. They include surgical resection and/or radiotherapy for local tumor control as well as chemotherapy in the case of disseminated disease or high malignancy. Currently, special interest focuses on the effect of Helicobacter pylori eradication.

Cell Transformation, Neoplastic↗