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Biomedical subjects

W Schmidt

Publications and source records attributed to W Schmidt.

At least 253 records · Page 14Linked to original sources
PubMed1997

Malignant gastrointestinal lymphomas in patients with AIDS.

HIV-associated malignant lymphomas are a common complication in late HIV infection, and there is a high percentage of gastrointestinal tract involvement. Non-Hodgkin's lymphoma was found in 108 of 2,750 HIV-positive patients (3.9%) in our institution, whereas gastrointestinal manifestation was diagnosed in 48 of 108 patients (44.4%). 44 of these cases were found during endoscopy of the upper and lower gastrointestinal tract (or by laparotomy or laparoscopy in 4 cases). Endoscopy is a reliable procedure for the diagnosis of lymphoma. Unusual manifestations such as oral, esophageal or perianal lesions and multifocal disease were common findings. Life-threatening complications such as gastrointestinal bleeding, perforation, and obstruction occurred in 37.5%. High-grade B-cell lymphomas were found in all cases including mainly lymphoblastic, immunoblastic, centroblastic and Burkitt subtypes. 52% of the patients had disseminated lymphoma with Ann Arbor stage III or IV. Standard chemotherapy with cyclophosphamide, adriamycin, vincristine and prednisone was started in 25 patients and resulted in a mean survival time of 4.8 months. The prognosis of AIDS patients presenting with malignant gastrointestinal lymphoma depends mainly on the presence or absence of previous AIDS-defining diseases, not CD4 cells, lymphoma-associated gastrointestinal complications or the histopathologic lymphoma type at the time of diagnosis.

Adult↗
PubMed1997

[Primary fallopian tube carcinoma. Report of a single case with review of the literature].

With an incidence of 0.1-1.0% of all genital malignancies, primary fallopian tube carcinoma is an extremely uncommon neoplasm of the female genital tract. We report a 58-year-old postmenopausal woman with primary fallopian tube carcinoma confined to the right fallopian tube in primary stage pT2a pN0 G3 M0, who is alive without evidence of disease 2 years after abdominal hysterectomy, bilateral adnexectomy, omentectomy and lymphonodectomy followed by an adjuvant cisplatin (70 mg/m2) and treosulfan (5 g/m2) chemotherapy. An accompanying literature review indicates that clinical signs and symptoms of fallopian tube neoplasms are usually nonspecific and include lower abdominal pain. The primary treatment remains surgical resection followed by adjuvant chemotherapy or radiation. Prognosis is poor, although long-term survivors have been reported.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

[Changes in the structure of an Alzheimer family group].

The family of Alzheimer patients is in general deeply engaged in caring for the patient and is faced by enormous physical and psychological stress. Today in Germany there are more than 100 groups of family members caring for Alzheimer patients. These groups are either headed by an expert, layman, or supported by experts. The Tübingen Alzheimer group has gone through all three stages since its foundation in 1991. Experience gathered with these different forms of organisation are reported.

Adaptation, Psychological↗
PubMed1997

[Standardized interfaces in gynecologic-obstetric documentation].

Since the introduction of the German GSG-law the usage of software for data recording in clinical departments has substantially grown. These systems should be able to exchange or replicate data, but in most cases the corresponding interfaces are absent or only incompletely implemented. The existence of functional, system-independent interfaces in a CSV-or HL-7-compatible format is a minimal requirement for modern software and should be considered.

Data Collection↗
PubMed1997

[Urodynamic parameters and continence after radical Wertheim-Meigs-Okabayashi hysterectomy].

The aim of this study was to analyse the effects of radical hysterectomy on urodynamic parameters (urethral resistance, functional urethral length, pressure gradients, bladder capacity, residual urine volume, stress urethral pressure profile), on bladder function (detrusor pressure, urgency sensation, flow pattern) and on continence. We reviewed 33 patients who underwent a radical abdominal hysterectomy as described by Wertheim-Meigs-Okabayashi. They were investigated by urodynamic examination preoperatively and 4 resp. 8 months postoperatively. To ascertain bladder dysfunctions and changes of urinary continence as a long term effect of operative procedure a standardized questionnaire was mailed to all patients. The radical abdominal hysterectomy did not alter significantly the urethral resistance, functional urethral length or pressure gradients. The maximal bladder capacity decreased postoperatively from 615 ml to 503 ml (SD 148.5: p = 0.04). The maximal urine flow and the detrusor pressure decreased temporarily (p = 0.01). The residual urinary increased five-fold (p = 0.01) and the first sensation of bladder filling was recognized later, at 4 as at 8 months postoperatively (p = 0.07). Preoperatively 75% of the patients voided by detrusor activity, postoperatively only 16%. 20% of the preoperative continent patients were incontinent during the second measurement (8 months postoperatively). 47% of the previous continent patients complained about incontinence in the questionnaire (4 years postoperatively). Although the patients complained about pollakiuria, urgency (60%) and urge incontinence (39%), 73% of the patients were content with their situation. Although the urethral pressure profile showed no significant alteration, the clinical situation and the deterioration of the parameters bladder capacity, residual urine and flow pattern verified the postoperative disturbances of the lower urinary tract function and the negative effects on continence behaviour.

Adult↗
PubMed1997

[Interprofessional cooperation in home care of disabled elderly patients. Results of a model project].

As is well known from experience, physicians, nurses, and other not-medical professions in ambulant care for elder people generally do not co-operate intensively, although there are many points of contact. With regard to this situation and the growth of the group of very old people, which request the further development of geriatric medicine and rehabilitation, a research project was realized in order to build up, improve and, as far as necessary, systematize inter-professional co-operation; this process was evaluated referring to the conditions and the effects of more intensive co-operation. This project led to several agreements concerning the improvement of co-operation; especially there are indications that the elder people in question are better cared for on the basis of intensive inter-professional co-operation and that avoidable expenses can be saved.

Aged↗
PubMed1997

Protocol design considerations that relate to demonstrating the safety and effectiveness of chemopreventive agents.

As with other drugs, applications for marketing approval of new chemopreventive agents in the United States must include data from adequate and well-controlled clinical trials that demonstrate effectiveness and safety for the intended use. Knowledge of a drug's pharmacologic actions and metabolism may benefit protocol design, by identifying the patient populations and dosing schedules associated with a favorable risk/benefit profile. With availability of appropriate preclinical data, including standard assessments of an agent's toxicology, effects on reproductive performance, and genotoxicity, initial Phase I studies of 1-3 months may be performed in normal volunteers or an appropriate higher risk population. For chronic dosing studies of longer duration, preclinical toxicology studies of longer duration are relevant. Enrollment in chemoprevention studies should be directed toward individuals at sufficient risk of developing cancer so that potential benefit may counterbalance the unpredictable and possibly serious adverse effects that may be observed with prolonged administration of a study drug. Phase I and II studies with clinical dosing lasting up to 12 months often afford opportunities to assess drug effect on surrogate endpoint biomarkers that may correlate with endpoints of clinical effectiveness. Phase III and late phase II chemopreventive investigations should routinely utilize a prospective, randomized study design (double-masked and placebo-controlled, when possible). To support marketing approval, there must be evidence that a chemopreventive agent significantly delays or prevents the occurrence of malignancy, with acceptable safety. In some circumstances, modulation of a surrogate marker may provide a basis for marketing approval, before more definitive endpoint data become available. However, the acceptability of a surrogate depends on the nature and quality of the data supporting its predictive value. Given the considerations of large study size, long duration, and high cost that may hamper development of potential agents, studies designed to examine the predictive value of surrogate endpoint biomarkers are of great importance to the future development of chemoprevention research.

Anticarcinogenic Agents↗
PubMed1996

Transloading of tumor cells with foreign major histocompatibility complex class I peptide ligand: a novel general strategy for the generation of potent cancer vaccines.

The major hurdle to be cleared in active immunotherapy of cancer is the poor immunogenicity of cancer cells. In previous attempts to overcome this problem, whole tumor cells have been used as vaccines, either admixed with adjuvant(s) or genetically engineered to express nonself proteins or immunomodulatory factors before application. We have developed a novel approach to generate an immunogeneic, highly effective vaccine: major histocompatibility complex (MHC) class I-positive cancer cells are administered together with MHC class I-matched peptide ligands of foreign, nonself origin, generated by a procedure we term transloading. Murine tumor lines of the H2-Kd or the H2-Db haplotype, melanoma M-3 and B16-F10, respectively, as well as colon carcinoma CT-26 (H2-Kd), were transloaded with MHC-matched influenza virus-derived peptides and applied as irradiated vaccines. Mice bearing a deposit of live M-3 melanoma cells were efficiently cured by this treatment. In the CT-26 colon carcinoma and the B16-F10 melanoma, high efficacies were obtained against tumor challenge, suggesting the universal applicability of this new type of vaccine. With foreign peptide ligands adapted to the requirements of a desired MHC class I haplotype, this concept may be used for the treatment of human cancers.

Animals↗
PubMed1996

Comment on R.A. White's v function.

The v function has been defined for the purpose of determining the potential doubling time (Tpot) from bivariate flow cytometric data based on pulse labeling of the S-phase cells by bromodeoxyuridine (BrdUrd) or other related substances (White et al.: Cytometry 11:314-317, 1990). One of the immediate applications of that method is the derivation of the S-phase duration by using relative movement (RM) analysis (Begg et al.: Cytometry 6:620-626, 1985). With the v function the potential doubling time Tpot can be derived if exponential growth with stable age distribution and constant phase durations can be assumed. The v function is based on subpopulations of the labeled cells and depends, at least weakly, on time. I show that this function can be derived from a simpler expression based on the DNA distribution in the population, also including the possible quiescent cells. As a consequence, Tpot can be calculated from Ts (S-phase duration) and the phase fractions of the total population, i.e., without use of the v function.

DNA↗
PubMed1996

Induction of cytosolic NADPH-diaphorase/nitric oxide synthase in reactive microglia/macrophages after quinolinic acid lesions in the rat striatum: an electron and light microscopical study.

Induction of nitric oxide synthase and increased production of nitric oxide in microglia may play a crucial role in neuronal damage and neurodegenerative disorders. In the present study we have used light and electron microscopical NADPH-diaphorase histochemistry as the visualization procedure for nitric oxide synthase to investigate the time-course and subcellular patterns of NADPH-diaphorase expression in microglia/macrophages of quinolinic acid-lesioned rat striatum. For light microscopy, NADPH-diaphorase histochemistry sections were stained with nitroblue tetrazolium, while for ultrastructural analysis the tetrazolium salt 2-(2'-benzothiazolyl)-5-styryl-3(4'-phthalhydrazidyl) tetrazolium chloride (BSPT) was applied. Light microscopical inspection revealed a progressively increasing number of positive cells with increasing intensity of NADPH-diaphorase staining in microglia/macrophages from day 1 after quinolinic acid injection onward. Electron microscopical examination revealed a membrane bound NADPH-diaphorase in quiescent microglia as well as in activated microglia/macrophages through all stages of the lesion studied. Predominantly membranes of the nuclear envelope and the endoplasmic reticulum were labeled with BSPT-formazan, while in advanced stages selective membrane portions of mitochondria, Golgi apparatus and plasmalemma were also stained. From day 5 onward after lesion induction, a very distinctive type of NADPH-diaphorase was observed, forming accumulations of electron-dense grains that were distributed differentially throughout cytoplasmic areas and phagocytic vacuoles. Dynamics of expression, unique cytosolic localization and occurrence exclusively in activated microglia/macrophages suggest that this particular NADPH-diaphorase activity probably reflects the inducible isoform of nitric oxide synthase, whereas the membrane-bound precipitate may represent the neuronal and/or the endothelial isoform of the enzyme.

Animals↗