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Biomedical subjects

W Helbig

Publications and source records attributed to W Helbig.

At least 55 records · Page 3Linked to original sources
PubMed1983

[Therapy results of acute leukemia 1965-1980].

At the instance of 174 patients with leukemia is demonstrated that the development to a more aggressive cytoreductive chemotherapy during the last 15 years achieved success without increasing the risk of treatment. A decisive improvement of prognosis for the acute leukemia of adult age is, however, to be expected only from new methods.

Acute Disease↗
PubMed1983

[Prognosis-oriented therapy of aplastic anemia].

From catamnestic examinations of the prognosis of patients with aplastic anaemias and the modern international level of the treatment is to be derived that in all severe forms the most favourable results of the therapy are to be achieved by the transplantation of bone marrow. Therefore, in the tentative diagnosis "severe aplastic anaemia" an immediate transfer into a haematologic centre for the purpose of aseptic care, further diagnostics and therapy is indicated. On the basis of a short review of the level of the modern possibilities of therapy further recommendations relevant to practice are derived.

Anemia, Aplastic↗
PubMed1982

[Prognostic significance of histobiopsy findings in bone marrow of malignant lymphomas in adults].

Issuing from the fact that the histobiopsy of the bone marrow is the most sufficient method for the proof of infiltrates of malignant lymphomas in the marrow, in 41 patients with Hodgkin's disease and 89 patients with malignant non-Hodgkin-lymphomas was tested whether already may be rendered prognostic conclusions from the histologic findings of the marrow. In these cases could be shown by the different course in patients with Hodgkin's disease in stage IV with and without affection of the marrow that a specific infiltration of the marrow is accompanied by a significant deterioration of the prognosis, which should be taken into consideration in the therapy planning. In the malignant non-Hodgkin-lymphomas those with a high degree of malignity showed a significantly worse prognosis than those with a low degree of malignity. Thus in the individual case the coordination of a lymphoma to one of these groups of malignity which is possible at the histobiopsy of the iliac crest may already be of prognostic significance also without consideration of the type of lymphoma. The prognostic significance of the type of lymphoma itself could be confirmed by the different course of the survival curves in the histologic subtypes of the immunocytoma. Since finally patients with a lymphoplasmocytic immunocytoma in diffuse affection of the marrow show a significantly worse prognosis than in the focal affection may be concluded that apart from the degree of malignity and the type of lymphoma also the type of affection of the marrow which is to be established histologically seems to have a decisive prognostic significance from which the necessity of a different therapeutic approach may be derived. Further examinations on larger numbers of patients including multivariant analyses will yield still more evident results.

Adult↗
PubMed1982

[Value of Beckenkamm histobiopsy in the diagnosis of malignant lymphoma infiltrates in bone marrow].

In order to find out the optimum method for the proof of infiltrates of malignant lymphomas in the bone marrow the frequencies of positive findings of the marrow in 41 patients with Hodgkin's disease and 89 patients with a malignant non-Hodgkin-lymphoma which were established by sternal puncture, cytology of the iliac crest and histology of the iliac crest were compared. It could be elaborated that the histobiopsy of the bone marrow is the only sufficient method for proving a specific affection of the marrow in Hodgkin's disease, since the gain of positive findings in the cytology of the iliac crest and in the sternal puncture was significantly lower in Hodgkin's disease as well as in the malignant non-Hodgkin-lymphomas. In these cases the inferiority of the cytologic methods could be explained on the one hand by the often only focal spreading of the lymphoma infiltrates in the bone marrow and on the other hand by an increased inclination to fibrosis in the focal as well as in the diffuse infiltrates. By comparison with present findings of post-mortem-examinations the representation of the biopsy cylinder of the iliac crest could be derived for the whole marrow organ, as far as the biopsy was performed technically correct.

Biopsy, Needle↗
PubMed1982

[Indication for prophylactic and therapeutic thrombocyte substitution].

The substitution of thrombocytes is on principle indicated only when a disturbance of the formation is present. The prophylactic application, i.e. before the occurrence of a haemorrhage, which is sometimes life-limiting, is to be preferred, however, on account of the danger of sensitization it is bound to particular conditions: temporarily limited need of substitution, decreased immune reagibility of the recipient (basic disease, therapy), medico-therapeutically induced thrombocytopenia (cytostatic drugs); example: haemoblastoses. Prerequisites are subtile control of clinical effectiveness and formation of antibodies. In planned bone marrow transplantation only preparation of individual donors (not related!) with HLA-A/B match are to be used. The same is applied to already alloimmunized patients, in which case a negative lymphocytotox cross test must still be present. Patients without option to transplantation or without HLA-antibodies may receive also random preparations of individual donors or mixed preparations. AB0-minor-incompatibilities are without significance, AB0-major-incompatibilities are not permissible. The introduction of thrombocyte-specific testings is urgently to be aspired to.--Exclusively therapeutic substitution of thrombocytes, i.e. in manifest haemorrhage, is performed in a primarily not limited period of substitution, in a completely immune competent recipient with regularly low values of thrombocytes without cytoreductive therapy (example: aplastic anaemia). In these cases on account of high danger of sensitization only preparations of individual donors with HLA-A/B-match should be used. In cases of exception in thrombocytopenic, life-threatening haemorrhages on account of metabolic disturbances (immune thrombocytopenia, massive transfusions) the substitution with thrombocytic mixed concentrates is satisfied.--The substitution of thrombocytes is a common task of clinic and blood donation service, which opens new possibilities of therapy (e.g. transplantation of bone marrow).

Anemia, Aplastic↗
PubMed1982

[Central venous long-term catheter in the treatment of acute leukemia: implantation of a modified Hickman technic].

Central venous catheters are an essential prerequisite for the supportive ascertainment of highly aggressive cytoreductive therapy programmes in patients with acute leukaemia. From the indications (parenteral nutrition, transfusions, blood taking a. o.) and the particular conditions of the patient with acute leukaemia (granulo- and thrombocytopenia) results the superiority of a subcutaneously tunnelled central venous catheter with a particular occlusion of the place of entry into the skin in contrast to usual techniques.

Catheters, Indwelling↗
PubMed1982

[Thrombocyte substitution in acute leukemia. Effect of histocompatibility on the clinical efficacy].

Thrombocyte substitution is an essential prerequisite for intensive cytoreductive therapy in acute leukemia. Evaluating 228 thrombocyte transfusions in 17 patients shows that the clinical effectiveness of thrombocyte concentrates can be increased by making the coordination of HLA antigens of donor and receiver as good as possible. When measured in the corrected increment (CI) 24 hours after transfusion, the effectiveness of A3/B1 match preparations (CI = 7.0 +/- 1.6) is significantly higher than that of random preparations (CI = 3.0 +/- 0.5). With the presence of HLA antibodies an effective substitution (CI24 greater than or equal to 4.5) can only be achieved by A3/B1 match thrombocytes. This can only be realized by applying the fourfold thrombapheresis of single donors.

Adolescent↗
PubMed1982

[Prognosis in aplastic anemia].

In catamnestic examinations of patients with aplastic anaemia 11 cases had to be excluded from a primarily diagnosed total number of 112 because these proved to be cases of preleukaemia. In the rest of 101 patients there was a highly significant positive correlation (p less than 0.001) of the survival time to the bone-marrow cellularity and to the average values of corrected reticulocytes and granulocytes calculated from findings of 0,4, and 8 weeks. For thrombocytes, however, a slightly significant positive correlation (p less than 0.05) could only be identified in the present material for the 4-weeks value. The fact that the prognosis is deteriorated by a rapid development of the disease could be made probable by means of a positive correlation between the time of the first symptom and diagnosis (p less than 0.01). With patients falling below 2 or 3 limiting values of the peripheral blood cells they were classified to the SAA group according to the proposals made by Camitta, however, by using the average values described above The survival rate which remained constant after 3 years amounted to 16% for SAA patients classified in this way, 44% for non-SAA cases with constant values of 39% beginning from the fourth year. Patients with average values of all three cell parameters falling below those limiting areas had a six months survival time of only 11%. No patients were alive after one year. The latter was also true if reticulocytes and granulocytes were affected by a diminution of only 2 parameters. Those patients, however, who had an average of reticulocytes and thrombocytes only, but no granulocytes below the limiting area within the first 8 weeks showed a mortality curve which did not differ from that of non-SAA patients. Therefore, a classification of these cases can only be made with great caution allowing for a prognosis-oriented therapy, such as indication for bone-marrow transplantation.

Adolescent↗
PubMed1980

[Clinical significance and study of granulocyte function].

Concerning the total defense of the body the function of granulocytes in the determining parts of phagocytosis (motility, chemotaxis, opsonation, ingestion, microbicidia) are described and the congenital and acquired distrubances of phagocytosis are treated as short survey as well as partly explained by clinical examples. Out of the manifold possibilities of examinations of the function of granulocytes the NBT-test is described as an estimation of the function of granulocytes usable in clinical routine wotk and its application is recommended.

Cell Movement↗
PubMed1980

Phagocytosis of inert particles in the reticuloendothelial system in rats with experimental insulinopenic diabetes.

Phagocytosis of inert, radioactive gold particles in the reticuloendothelial system in rats in the case of experimental insulinopenic diabetes was studied. In the spleen, phagocytosis was seen to have fallen to a relatively low level after four weeks from the induction of diabetes. In the liver, there was noted a reduction of phagocytosis per gram of organ, though it remained the same for the total organ which in the case of diabetes mellitus increases in weight relative to body weight. This difference in reaction of the reticuloendothelial system in the liver and spleen has also been observed in mice with tumors. The importance of the findings of the present study for increased sensitivity to infections of poorly controlled diabetic patients is discussed in greater detail.

Animals↗
PubMed1980

[Comparative treatment of acute leukemia in adults].

13 full remissions and 8 partial remissions were achieved in 32 first treatments of acute leukaemia. The average duration of full remissions amounted to 225 days, that of partial remissions was 140 days. The average survival time of responders amounted to 410 days, that of non-responders was 52 days. The results of 18 recidive treatments were distinctly worse. Allowing for alexane permanent infusion, the findings and complications of different therapeutical schemes were compared. Improvements of the results seem to be only possible, if cytostatic treatment is supplemented by taking initial and progress evaluating, prognostic relevant parameters into consideration (e.g. stem cell cultures), and by escalating supportive measures including histocompatible blood cell substitution and reverse isolation as well as transplantation of human bone-marrow.

Adolescent↗