Search PubMed⌕ Search

Biomedical subjects

W Wagner

Publications and source records attributed to W Wagner.

At least 163 records · Page 9Linked to original sources
PubMed1994

[Treatment results of soft tissue sarcomas in adults].

PURPOSE: An appropriate therapeutical concept for soft tissue sarcomas is unknown particularly since that our knowledge about these neoplasms is considerably incomplete partly resulting from a low incidental rate distributed to many subentities. Children and adolescents were aggressively and multimodally treated. The standard therapy of the adults is an resection as radical as possible followed by adjuvant radiotherapy. The aim of our study was to show the treatment results of our clinic and to investigate survival rates, local tumor control and prognostic factors. PATIENTS AND METHODS: Between 1965 and 1989, a total of 51 male and 49 female were treated for soft tissue sarcoma at the University Hospital of Münster. RESULTS: The overall five-year survival rate (actuarial survival) was 43.1%. 27% of the patients developed a local recurrence, 45% distant metastases. Lymph node metastases occurred in 4% of the patients. Tumor size was a prognostic factor for the five-year survival rates (T1 = 59.8%, T2 = 44.0%, T3 = 26.0%). The best results were achieved after combined treatment using surgery (wide resection) and postoperative high dose radiotherapy. Compared to wide resection alone, the combined treatment had a significantly higher five-year survival rate (59.7% vs. 26%). There was no significant improvement using adjuvant postoperative chemotherapy. CONCLUSION: In our study we could show a remarkable improvement of the five-year survival rate by adjuvant radiotherapy after surgical resection versus surgery alone and demonstrate the importance of radiotherapy in the treatment of soft tissue sarcoma.

Adolescent↗
PubMed1993

Preserved cortical somatosensory evoked potentials in apnoeic coma with loss of brain-stem reflexes: case report.

A comatose patient suffering from diffuse cerebellar haemorrhage developed apnoea and brainstem areflexia, i.e. the clinical signs of brain death. However, median nerve somatosensory evoked potential testing 2.5 h and 22 h after the onset of this clinical syndrome showed cortical potentials partly preserved; these were abolished 46 h after the beginning of the clinical signs of brain death. This case report underlines the need for electrophysiological confirmation of brain death in patients with primarily infratentorial lesions.

Aged↗
PubMed1993

EGFR and PCNA expression in oral squamous cell carcinomas--a valuable tool in estimating the patient's prognosis.

We investigated 100 cases of oral squamous cell carcinomas immunohistologically with respect to the expression of the epidermal growth factor receptor (EGFR) and the proliferating cell nuclear antigen (PCNA). The results were correlated with a new malignancy grading of the invasive tumour areas and the clinical outcome of the patients to estimate the individual prognosis. In conclusion, the amount of antigen expression of both antigens increases with the increasing grade of malignancy of the oral squamous cell carcinoma. Furthermore, there is a statistically significant correlation between the amount of antigen expression and the patient's prognosis. An overexpression of EGFR and PCNA is associated with a short survival of the patient. Both antigens detect relevant tumour biological parameters and are worthy factors in estimating the individual prognosis in patients suffering from oral squamous cell carcinomas.

Adult↗
PubMed1993

Safety database on fluvoxamine: analysis and report.

A review was conducted of the safety and tolerability of fluvoxamine in 54 worldwide marketing studies that enrolled 24,624 patients, the majority of whom were treated with fluvoxamine in uncontrolled studies in depression. In accordance with the general epidemiologic distribution of depressive disorder, female patients and patients aged between 30 and 50 years predominated. The majority of patients were treated for 6 weeks, the most frequent, or modal, total daily dose being 100 mg. Overall, 57.4% of the patients exposed to fluvoxamine did not have any adverse experiences. The greatest proportion of adverse experiences, as defined using COSTART body systems, affected the digestive system (24.1%), the nervous system (23.7%), and the body as a whole (15.3%). The only adverse experience with an incidence greater than 10% was nausea (15.7%); somnolence (6.9%) and asthenia (6.2%) were the next most frequent adverse experiences. Notably, the rates of agitation and anxiety were only 1.4% and 1.3%, respectively. The incidences of adverse experiences generally increased with age and were slightly higher in females than in males. In total, 15.1% of patients discontinued treatment prematurely as a result of adverse experiences, principally nausea, dizziness, vomiting, somnolence, abdominal pain, and headache. The overall incidence of serious adverse events in association with fluvoxamine treatment was 2.5% when U.S. Food and Drug Administration criteria and the most conservative approach, without causality judgments, were used.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Clinical outcome and brain MRI four years after carbon monoxide intoxication.

Brain damage from carbon monoxide intoxication has not been extensively studied with magnetic resonance imaging. We report the clinical outcome and brain magnetic resonance imaging in three individuals simultaneously exposed to toxic levels of carbon monoxide four years previously. Lesions are seen in multiple locations and do not correlate well with the clinical condition.

Adult↗
PubMed1993

Intra-operative monitoring during syringo-endoscopy: results of median nerve stimulated somatosensory evoked potentials in nine patients.

Intra-operative SEP monitoring was performed in nine patients with cervical syringomyelia undergoing myelotomy and syringo-endoscopy. Several cortical and subcortical SEP components were evaluated. Pathological latency shifts of brain stem P14 were seen in two patients; other SEP components did not worsen nor recover intra-operatively. The clinical and pathophysiological significance of the data is briefly discussed.

Adult↗
PubMed1992

Effect of food and relative bioavailability following single doses of diclofenac 150 mg hydrogel bead (HGB) capsules in healthy humans.

The effect of food on the bioavailability of diclofenac from a 150 mg diclofenac hydrogel bead (HGB) capsule was evaluated in 12 healthy male subjects in a fed and fasted state. Additionally, the fasting bioavailability of diclofenac from a 150 mg diclofenac HGB capsule relative to diclofenac sodium in buffered aqueous solution was evaluated in these same 12 subjects. The study was designed as an open-label, randomized, single-dose, 3 x 3 Latin-square crossover trial balanced for residual effects. A 2-week washout period was maintained between treatments. Blood samples were collected at frequent intervals over a 24-h period with plasma being separated and analyzed for diclofenac using a validated HPLC method. The administration of the 150 mg diclofenac HGB capsule dose within 30 min following a standardized breakfast minimally affected the bioavailability of diclofenac relative to administration under fasted conditions (7 per cent decrease in AUC(0-24), p greater than 0.05). There was, however, a 38 per cent decrease (p less than 0.05) in the Cmax and a three-fold increase (p less than 0.05) in Tmax for the fed HGB capsule administration. Under fasted conditions, significant differences in mean pharmacokinetic parameters were found between the 150 mg diclofenac HGB capsule and diclofenac sodium in buffered aqueous solution. The extent of availability of diclofenac from the HGB capsule was only 59 per cent relative to that from the solution (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1992

The frontoorbital advancement--on the use of 3D-CT and the miniplate osteosynthesis.

Between 1987 and 1991 we performed a unilateral or bilateral frontoorbital advancement to correct trigono- or plagiocephaly in 10 children: Three-dimensional CT provides an exact basis for operation planning. Titanium miniplates allow an already primarily rather stable osteosynthesis. The best time for this intervention is the end of the third month of life.

Bone Plates↗
PubMed1992

Identification of a novel large extrachromosomal DNA (LED) in the Trypanosomatidae.

We have identified a novel 75 kbp large extrachromosomal DNA (LED) which is stably maintained during developmental conversion of Trypanosoma cruzi. It has a covalently closed circular conformation and is not derived from the kinetoplast network. In all T. cruzi strains analysed, LED contains 18S rRNA and spliced leader (sl) sequences. LED from the T. cruzi Y strain contains a minimum of 15 copies of the sl repeat arrayed in a head-to-tail configuration and 50 copies of a 196 bp repeat. LED is also present in Trypanosoma dionisii (subgenus Schizotrypanosoma) and in other members of the family Trypanosomatidae. LED from different T. cruzi strains and from other members of the Trypanosomatidae differ in their content of large ribosomal subunit rRNA sequences and the 196 bp repeat. The presence of LED in four evolutionarily distant trypanosomatid species suggests that it plays an important role in the biology of these parasites.

Animals↗
PubMed1992

Unstable amplification of two extrachromosomal elements in alpha-difluoromethylornithine-resistant Leishmania donovani.

We describe the first example of unstable gene amplification consisting of linear extrachromosomal DNAs in drug-resistant eukaryotic cells. alpha-Difluoromethylornithine (DFMO)-resistant Leishmania donovani with an amplified ornithine decarboxylase (ODC) gene copy number contained two new extrachromosomal DNAs, both present in 10 to 20 copies. One of these was a 140-kb linear DNA (ODC140-L) on which all of the amplified copies of the odc gene were located. The second was a 70-kb circular DNA (ODC70-C) containing an inverted repeat but lacking the odc gene. Both ODC140-L and ODC70-C were derived from a preexisting wild-type chromosome, probably by a conservative amplification mechanism. Both elements were unstable in the absence of DFMO, and their disappearance coincided with a decrease in ODC activity and an increase in DFMO growth sensitivity. These results suggest the possibility that ODC70-C may play a role in DFMO resistance. These data expand the diversity of known amplification mechanisms in eukaryotes to include the simultaneous unstable amplification of both linear and circular DNAs. Further characterization of these molecules will provide insights into the molecular mechanisms underlying gene amplification, including the ability of linear amplified DNAs to acquire telomeres and the determinants of chromosomal stability.

Animals↗
PubMed1992

Review of fluvoxamine safety database.

A review of the safety and tolerability of fluvoxamine in worldwide marketing studies involving 24,624 patients, predominantly receiving fluvoxamine treatment in uncontrolled studies in depression, has been conducted. There was a marked preponderance of female patients and patients aged between 30 and 50 years. The majority of patients were treated for 6 weeks, with the most frequent modal total daily dose being 100mg. The greatest proportion of adverse experiences occurring, by COSTART body system, affected the digestive system (24.1%), the nervous system (23.7%), and the body as a whole (15.3%). The only adverse experience with an incidence greater than 10% was nausea (15.7%), with somnolence (6.9%) and asthenia (6.2%) as the next most frequent experiences. Notably, the rates of agitation and anxiety were only 1.4 and 1.3%, respectively. The incidences of adverse experiences increased with age, and were slightly higher in females than males. 15.1% of patients discontinued treatment prematurely as a result of adverse experiences, principally nausea, dizziness, vomiting, somnolence, abdominal pain, and headache. The overall incidence of serious adverse events associated with fluvoxamine treatment was 2.5%, and the incidence of overall suicidality, including suicidal ideation, overdose, and intentional overdose as well as attempted and completed acts of suicide, was remarkably low at 0.8%.

Adolescent↗
PubMed1992

The effect of epinephrine on ciliary process vasculature and IOP studied by intraocular microendoscopy in the albino rabbit.

The effect of epinephrine on intraocular pressure (IOP) and the hemodynamics of the ciliary process vasculature in albino rabbits was studied by intraocular microendoscopy. Intraarterial application of epinephrine (15, 50, 250 ng/kg bw) lead to an immediate vasoconstriction and a reduction in blood flow velocity (BFV) in the iridial and major ciliary processes lasting from 30 to 120 sec. This anemic phase was followed by a hyperemic phase of about 60 to 240 sec. showing a vasodilation up to 150% of the initial diameters and an increase in BFV. The hyperemic phase can be prevented by pretreatment with indomethacin. Simultaneously measured IOP decreases in the anemic and increases in the hyperemic phase parallel with the changes in vascular diameter. After topical administration of epinephrine (25-50 micrograms/kg bw) a marked vasoconstriction followed by a vasodilatory phase was similarly found. However, the reactive changes of the ciliary process vasculature lasted considerably longer. The anemic phase lasted 15 minutes, the hyperemic phase 40 to 60 min. Again, this hyperemia can be prevented by indomethacin-pretreatment. In the iridial processes the anemic phase persisted till 70 minutes. No hyperemia and no substantial influence of indomethacin-pretreatment was found in this territory. In the anemic phase the IOP decreased in average from 20 mmHg to 15 mmHg. However, in contrast to the reactive changes of the IOP after intraarterial epinephrine application, the IOP did not increase again in the hyperemic phase, but decreased further to about 12 mmHg. After pretreatment with indomethacin the IOP remained at the level of 15 mmHg. The short-term IOP-changes after i.a. application of epinephrine, mirror the vasoconstrictory and vasodilatory reactions in the ciliary processes and might be due to volume changes in the eye (plethysmographic effect). However, the long lasting IOP reduction after topical epinephrine in the hyperemic phase can not be due to vascular reactions in the ciliary processes. There must be other factors responsible for the long lasting pressure reducing effect of epinephrine.

Administration, Topical↗
PubMed1992

Microendoscopic observations of the hemodynamics in the rabbit ciliary processes.

The in vivo hemodynamics of the ciliary process vasculature in the albino rabbit were studied with an improved technique of intraocular microendoscopy. The spreading pattern and velocity of the dye front has been observed in defined vessel segments following intracarotid injection of Evans Blue. In the anterior portion of the ciliary processes a "thoroughfare channel" (bypass) was found leading from the arteriolar tree directly into the marginal venule bypassing the capillary network of the ciliary processes. This bypass is characterized by a higher blood flow velocity (1.5-3mm/sec) than was found for the capillary network (0.8-1mm/sec). A stoppage of blood flow was observed in the capillary network at 45-50mmHg after step-wise elevation of intraocular pressure (IOP): blood flow was not stopped in the thoroughfare channel until IOP values of 55-60mmHg were reached. Intraarterial administration of vasoconstrictive agents could lead to a complete stoppage of blood flow in the capillary net whereas the marginal route often remained patent.

Animals↗
PubMed1992

[Recurrent urethral strictures in men. Modern diagnosis and therapy using ultrasound and laser].

The new method of urethral sonography allows visualization of urethral strictures preoperatively in more detail than conventional X-ray urethrogram. Poor results of urethrotomies can thus be avoided in patients who have peristrictural scars. These patients can be treated by the newly developed technique of laser incisions of urethral strictures. The success rate is so promising that wall-stent implantations and even open procedures may well become very rare. Diagnostic and therapeutic techniques are discussed and described in detail with reference to illustrations.

Cicatrix↗
PubMed1992

Potential protective effect of vitamin C on carcinogenesis caused by nitrosamine in drinking water: an experimental study on Wistar rats.

In an experiment with Wistar rats the question of whether oral vitamin C application has a protective effect in liver carcinogenesis caused by N-nitrosodiethylamine in drinking water (n = 104) was studied. When comparing four groups (without carcinogen, with carcinogen and carcinogen plus vitamin C alternately and concomitantly) significant statistical differences in the linear regression were noted. Ninety per cent of the rats developed hepatocellular carcinomas when only carcinogen was administered whereas the rate with additional administration of vitamin C alternately and concomitantly was 68% and 55%, respectively. Without carcinogen no tumour developed. The results suggest that vitamin C may delay the development of liver cancer upon oral administration of N-nitrosodiethylamine. The explanation for this fact is still hypothetical.

Adenoma, Bile Duct↗
PubMed1992

[Pseudotumor orbitae--a chameleon in diagnosis and therapy?].

Between 1972 and 1988, 25 patients were diagnosed and treated for "pseudotumor orbitae" in the Departments of Radiotherapy and Ophthalmology of Münster University Clinics. All cases had been initially confirmed by histology. Later in seven cases (28%) the histology showed a definitive alteration, and eventually turned to malignancy in five patients. Criteria indicating such a shift are seen in higher age, subacute onset of the disease, low pain, minor signs of inflammation, low echoes in ultrasound diagnostics, and the absence of "Dutcher bodies" in histiocytes, if these are evident in histology. These patients at increased risk of malignant transformation should be considered for radiotherapy at an earlier stage than prescribed by the current routine.

Age Factors↗