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Biomedical subjects
Publications and source records attributed to W Weber.
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The content of plasmin is significantly reduced in the benign prostatic hypertrophy compared to the normal prostate. Histochemically plasmin is demonstrable by a combined incubation of substrate and inhibitor for plasmin. Plasmin is localized in the connective tissue and its function is to regulate the turnover of glycosaminoglycans. The fibrinolytic activity does not change significantly after prostatectomy because of the reduced content of plasmin in benign prostatic hypertrophy.
In animal experiments silicone rubber bodies of various volumes and weights were implanted under the platysma. The grafts were completely tolerated by 6 rabbits and partially by a minipig, but not at all by 4 dogs. The primary reason for the failures were chronic inflammation by motion of the graft, heaviness of the plastic material, and stromal weakness.
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Advanced bladder carcinoma still has a poor prognosis. While the five-year-survival in stage T1N0M0 is about 80%, less than 50% of the patients in stage T2N0M0 survive 5 years. This prognosis could not be altered by a more radical operation or by radiation therapy. Therefore we started postoperative adjuvant chemotherapy in 1972. First we tested the effect of three different cytostatic drug therapy schedules. Although successful treatment was achieved in several cases, there were other patients who did not respond to one of the three therapy schedules. We then started applying all three schedules, one after the other, in intervals of 4 weeks. Therapeutic procedure now is: After diagnosis by cystoscopy and histology and TNM-classification, urologic therapy is performed (electroresection, cystectomy, etc.). Then in stage T2-4N0-1M0-1 postoperative adjuvant chemotherapy follows. Thus far, we have achieved complete remission in all patients except one (after radiation therapy). No definite comments as to survival can be made at this time.
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A case is reported with pneumomediastinum and mediastinitis complicating lung abscess in the lingula of a 77-year-old man. Causative factors were the association of virulent organisms having necrotizing properties in a host with diminished resistance and location of the cavity adjacent to the mediastinal pleura. A review of 1119 documented patients with lung abscess revealed that this complication has been reported only twice previously. Early surgical drainage combined with systemic administration of antimicrobial agents are the most effective therapeutic measures for mediastinal infection. Therefore, close observation is required of patients with lung abscess adjacent to mediastinal structures.
Mitral regurgiation with atrial fibrillation in a 3-year-old St. Bernard dog was corrected by digitalization, placement of a mitral valve prosthesis, and direct current cardioversion. The atrial fibrillation eventually returned and became refractory to cardioversion.
The pattern of innervation of fibres containing AchE was examined by histochemical methods in fresh frozen sections of normal adult prostate, benign nodular hyperplasia, carcinoma of the prostate and the prepubertal prostate. Significant differences between the four groups investigated have been found.
Female patient, aged 63 died after 5 years of progressive dementia. Autopsy revealed multiple sclerosis, diffuse lymphoplasmocytic encephalitis, and Alzheimer's disease. Possible pathogenetic connections between these disease entities are discussed.
Marrow transplantation was carried out in a patient with acute myelogenous leukemia using a healthy identical twin as donor. The patient was prepared for grafting with combination chemotherapy, high dose cyclophosphamide, and 1,000 rad total body irradiation. Repopulation of marrow did not occur despite a second marrow infusion 21 days following the first attempt. The patient died 44 days after the initial marrow infusion. To our knowledge this is the first patient transplanted from an identical twin who did not achieve engraftment after high dose chemotherapy and supralethal irradiation. The survival time was well in excess of that required for evaluation of engraftment. The possible mechanisms for graft failure are discussed. The use of prophylactic interferon against viral infections is considered as the most likely cause of failure of engraftment.
132 patients with advanced solid malignomas were treated with a combination of four cytostatic drugs (vinblastine, amethopterine, 5-fluorouracil and cyclophosphamid) given on one day. This was repeated once every 2-3 weeks. In every case the diagnosis was made histologically and the tumour was staged according to the TNM-system. The treatment of breast and ovarian cancer brought the best results, improved by a synchronisation therapy. Good results were achieved also in the treatment of special kind of sarcomas and of carcinoma of the urine bladder. The general condition of patients with colon carcinoma could be improved in about 30%. Only one patient died by drug-induced pancytopenia, otherwise severe side-effects were not noted. Before beginning the therapy the cell-mediated immunity of 31 patients was tested by skin-tests with tuberkulin purified protein derivative (PPD) and dinitrochlorbenzole (DNCB). Before and during cytostatic therapy PPD reactions were proven by 23 patients. In accordance to other authors we found that cell-mediated immunity is decreased in the advanced stage of malignoma. Further we noted that delayed hypersensitivity and the number of lymphocytes and monocytes in peripherel blood are important to prognosis and course in patients with cancer.
A case of fatal graft-versus-host disease (GvHD) following blood transfusions is reported. This relatively rare complication of blood and bloodcomponent replacement therapy may occur in recipients with decreased cellular immunity, which may be due to the underlying disease, chemotherapy or radiation therapy, or a combination of both. GvHD is a result of active proliferation of transfused immunologically competent cells which attack host organs. This complication can be prevented by irradiating transfusions with 1500 rads in vitro.
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Thrombocytopenic patients who have become refractory to platelet transfusions from random donors will usually respond to HL-A compatible platelets with normal increments and hemostatic improvement. In our experience with unrelated HL-A typed donors, HL-A identity is unnecessary. Donors without excess antigen are compatible and even many donors with 1 excess antigen can be used, at any rate in immunosuppressed patients. Thus successful substitution of platelet becomes possible in refractory patients when family donors cannot be used.
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