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Biomedical subjects

W Weber

Publications and source records attributed to W Weber.

At least 289 records · Page 16Linked to original sources

[Blood transfusions and prognosis following curative resection of colorectal cancer: is there an association?].

More recently a number of retrospective analyses in rather ill defined patient populations demonstrated an association between perioperative blood transfusion and recurrence after curative resection of colorectal cancer. In the randomized trial (SAKK 40/81) (adjuvant cytotoxic intraportal infusion versus no further treatment) we evaluated the transfusion status in a well defined, prospectively documented and controlled patient population. Of 457 patients, 353 (77.2%) received either pre-, intra- or postoperatively blood transfusions. After a median follow-up of 4 years, the transfused patients developed significantly more recurrences (38.2%) than patients without blood transfusions (23.1%), the death-rate being 33.7% versus 23.0%, respectively. Patients without transfusion but treated with adjuvant intraportal chemotherapy are strikingly doing better (10.5% recurrences) than patients with perioperative blood transfusion not having an adjuvant treatment (44.5% recurrences).

Blood Transfusion↗

Intraperitoneal chemotherapy in peritoneal malignancy: impact of intensive system care on practicability.

In a group of 31 patients a port-a-cath-system for intraperitoneal chemotherapy was installed. From 23 evaluable patients 9 showed a tumor remission, but only 1 was a patient with gastrointestinal carcinoma. All others were patients with ovarial carcinoma. The median survival rate of all patients was 9 months after implantation of the intraperitoneal catheter. 50% of all patients with gastrointestinal carcinoma died within the first 6 months, only 1 of 11 patients with ovarial carcinoma died in this period.

Adult↗

[Spontaneous arterial recanalization--a case report].

Spontaneous thrombolysis with recanalisation of peripheral arterial vessels is a well-known, albeit rare phenomenon. The probable mechanisms of this phenomenon is the activation of local fibrinolytic processes by local mediators of the vascular endothelial cells. Vascular stenoses of atherosclerotic origin are also subject to regression, depending on the plasma LDL level. Reangiography is indicated for determining further therapy planning if there is a change in clinical signs towards either improvement or deterioration. Reangiography is imperative if the previous angiography was performed before more than three months.

Arterial Occlusive Diseases↗

[Traumatology and diagnosis of scaphoid fracture].

In 9 years, 1,104 patients had one or more roentgenological studies of the scaphoid; 252 fractures of the scaphoid were found. The most reported traumatic mechanism was a fall on the extended wrist. The form of fracture most seen was transverse fracture of the scaphoid; most of the fractures were found in the middle third of the scaphoid. The primary radiodiagnostic procedure should contain pictures of the wrist in two planes and four special pictures of the scaphoid. The "fat-pad sign" seems to be an unreliable indicator of fracture, but nearly two-thirds of fractures of the scaphoid showed a swelling of the soft tissues in the X-ray picture.

Accidental Falls↗

Periampullary, colorectal and gastric cancer in two siblings.

We describe a sibship affected by subsequent periampullary, colorectal and gastric carcinoma. Three of 4 siblings (2 males, 1 female) developed a periampullary carcinoma at the age of 20, and the 2 brothers subsequently had colorectal and gastric carcinoma. One of them also had familial adenomatous polyposis. There is suggestive evidence of vertical transmission of a gene predisposing to a hereditary colorectal carcinoma syndrome.

Adult↗

[Characteristics of hereditary colorectal carcinoma without pre-existing polyposis].

The report presents two families with inherited predisposition to colorectal carcinoma without preexisting polyposis coli. In these families the disease is characterized by early onset and tumor localization in the right side colon. Screening colonoscopy should be started early. Families of this kind are of greatest value for genetic marker studies.

Adenocarcinoma↗

Shock-wave lithotripsy of gallbladder stones. The first 175 patients.

To substantiate the early results of extracorporeal shock-wave fragmentation of gallstones, we used this nonsurgical procedure to treat 175 patients with radiolucent gallbladder calculi. Chenodeoxycholic acid and ursodeoxycholic acid were administered as adjuvant litholytic therapy. The gallstones disintegrated in all patients except one and completely disappeared in 30 percent of all patients within 2 months after lithotripsy, in 48 percent at 2 to 4 months, in 63 percent at 4 to 8 months, in 78 percent at 8 to 12 months, and in 91 percent at 12 to 18 months. In patients with solitary stones up to 20 mm in diameter, the corresponding values were 45, 69, 78, 86, and 95 percent, respectively. Shock-wave therapy had no adverse effects except cutaneous petechiae (14 percent) and transient gross hematuria (3 percent). One third of the patients had one or more episodes of biliary colic before all the fragments disappeared. Two patients had mild pancreatitis, which necessitated endoscopic sphincterotomy in one. The patient with insufficient stone fragmentation underwent elective cholecystectomy; no additional operations were necessary. Extracorporeal shock-wave lithotripsy combined with medical therapy for stone dissolution is a safe and effective treatment in selected patients with radiolucent gallbladder calculi.

Adolescent↗

Mutation analysis of the N-ras proto-oncogene in active and remission phase of human acute leukemias.

DNA isolated from blood or bone-marrow samples from 18 patients with acute non-lymphocytic leukemia (ANLL) and 14 patients with acute lymphocytic leukemia (ALL) was analyzed for the presence of mutations in the N-ras gene. Using synthetic oligonucleotide probes we detected mutations in 5 cases of ANLL; 4 GGT----GAT transitions in codon 12 and one CAA----AAA transversion in codon 61. One case exhibited homozygosity for the mutation. No mutations could be detected at these codons in the DNA of the 14 ALL patients. In a follow-up study with 3 of the above 5 patients, the mutation could no longer be detected in 2 cases following successful induction of clinical remission by chemotherapy. However, the mutated N-ras persisted in one patient who did not achieve remission. We show that oligonucleotide hybridization is a sensitive assay for the detection of N-ras point mutations, which in ANLL could be used to follow the fate of the leukemic clone during (and after) therapy.

Acute Disease↗

A randomized comparison of doxifluridine and fluorouracil in colorectal carcinoma.

In a randomized study 52 patients with advanced colorectal cancer and measurable lesions were treated with doxifluridine 4000 mg/m2 or fluorouracil 450 mg/m2 i.v. on 5 consecutive days over 3 weeks. None had prior fluoropyrimidines except two who received adjuvant fluorouracil. Partial responses with a duration ranging from 259 to 406 days were observed in five patients treated with doxifluridine and two patients treated with fluorouracil. Toxic reactions were evaluated in 88 doxifluridine courses and 105 fluorouracil courses. The most frequent adverse effects were neurotoxicity (48% of patients) and mucositis (43%) for doxifluridine, leukopenia (48%) and nausea/emesis (37%) for fluorouracil. Mucositis, diarrhea, nausea, emesis and skin reactions were observed in both treatment groups. Fluorouracil produced neurotoxic effects in 26% of patients. Reversible cardiac dysfunctions were observed in four patients treated with doxifluridine, expressed by ectopic ventricular beats (2) precordial pains (1) and ventricular fibrillation (1). This latter toxicity justified the premature interruption of the study. Doxifluridine is an active agent in colorectal cancer. Compared to fluorouracil it produces, when used i.v., a lower myelosuppression and a greater incidence of neurological and cardiac toxicity.

Adenocarcinoma↗

[Multiple pregnancy following in vitro fertilization and embryo transfer].

In a 32 year old patient 14 eggs were harvested and inseminated with donor semen. Six embryos were transferred resulting in a triplet-pregnancy. In spite of a septic disease three preterm but healthy children were born by caesarean section 199 days after ET (male 1620.0; female 1180.0; male 1560.0). Up to nowadays there is not any handicap. We don't know a general but safe method for avoiding multiple pregnancies.

Adult↗