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Biomedical subjects

A Thom

Publications and source records attributed to A Thom.

At least 19 recordsLinked to original sources
PubMed1992

Experience with high-dose radiation therapy and the intestinal sling procedure in patients with rectal carcinoma.

BACKGROUND: Surgery for Dukes' Stage B2 or C rectal carcinoma has a locoregional recurrence rate of 15-67%; this rate is significantly reduced when postoperative radiation therapy (RT) is given. However, RT contributes to radiation-associated small bowel injury in a dose-dependent manner. METHODS: Polyglycolic acid mesh used as an intestinal sling is able to keep the small bowel out of the pelvis during RT, thereby preventing radiation-associated small bowel injury. RESULTS: The authors reviewed the perioperative experiences and acute toxic effects of RT in 53 patients in whom the polyglycolic sling was placed from May 1985 through May 1990 during laparotomy for rectal malignancies (47 primary and 6 recurrent). There were 26 men and 27 women whose ages ranged from 34 to 88 years (mean, 64.7 years). Mild postoperative ileus occurred in most patients, and one patient had an anastomotic leak with a pelvic abscess. Bowel displacement from RT portals was confirmed using radiologic contrast studies. Forty-three patients with primary tumors have completed postoperative RT, and a mean of 5174 cGy has been administered. CONCLUSIONS: After 1-6 years of follow-up (mean, 2.1 years), eight patients have died of systemic disease. There were no cases of radiation-associated small bowel injury and only two cases of pelvic recurrence from primary rectal adenocarcinoma (5%).

Adult↗
PubMed1991

[Changes in the effects and functions of medical-scientific societies during the time of fascist dictatorship in Germany].

The characteristics of the politics in science of the NS-regime included the desire for a central management of the medical-scientific societies. The paper is devoted to the authorities established for this purpose and their influence in staffing, such as the formation of new structures. The scientific organizations, however, also got freedom and possibilities of influence. A further analysis of these is to be recommended.

Germany↗
PubMed1988

Immune and metabolic effects of arginine in the surgical patient.

Arginine enhances immune function and promotes nitrogen retention in animal models, but its immunomodulatory effects in surgical patients are unknown. This randomized, prospective trial evaluated the immune and metabolic effects of supplemental L-arginine (25 g/day, n = 16) or isonitrogenous L-glycine (43 g/day, n = 14) in 30 cancer patients undergoing major operation. Two groups of patients received either arginine or glycine for 7 days after surgery as a supplement to a graduated enteral diet. Nitrogen balance was measured daily, and immune parameters were determined both before and after surgery, on Days 1, 4, and 7. The T-lymphocyte response to concanavalin A (con A) and PHA and dual marker phenotype analysis of lymphocyte (CD2, CD4, CD4/DR, CD8, CD8/DR) and macrophage (M3/DR) subsets were determined. Mean age, degree of preoperative weight loss, disease stage, number of perioperative transfusions, and calorie and nitrogen intake were similar for the groups studied. Mean daily nitrogen balance (-2.3 g/day in the arginine group vs. -3.9 g/day in the glycine group) was not significantly different between the two groups, but positive mean nitrogen balance was achieved only in the arginine group between Days 5 and 7 after surgery. Supplemental arginine significantly enhanced the mean T-lymphocyte response (stimulation index) to con A from 45 +/- 26 on postoperative Day 1 to 72 +/- 47 and 87 +/- 49 on postoperative Days 4 and 7, compared with the values of 29 +/- 15, 27 +/- 20, and 33 +/- 34 in the glycine group at the same time points, respectively. Supplemental arginine increased mean CD4 phenotype (% T-cells) on postoperative Days 1 and 7 from 25 +/- 9 to 43 +/- 14, compared with the values of 30 +/- 14 and 29 +/- 13 in the glycine group (p less than 0.05). The beneficial effect of arginine on the immune system appeared distinct from its more moderate effect on nitrogen metabolism. As a nutrient substrate, arginine was nontoxic, and may benefit surgical patients who are at increased risk of infection.

Aged↗
PubMed1987

Regional infusion for colorectal hepatic metastases. A randomized trial comparing the hepatic artery with the portal vein.

To evaluate which site of infusion maximizes tumor response to regional hepatic chemotherapy, 25 patients were randomized preoperatively to receive chemotherapy administration via hepatic artery or portal vein catheters. Of the 25 patients, five did not have catheters placed due to extrahepatic disease, and one patient did not receive infusion chemotherapy. Continuous floxuridine infusion was given at a dosage of 0.3 mg/kg/d, alternating with saline solution every two weeks. The mean percentage of hepatic tumor replacement (36% vs 41%), mean serum alkaline phosphatase level (218 vs 179 IU/mL), and mean plasma carcinoembryonic antigen level (689 vs 563 ng/mL) were similar in both groups. Four (50%) of eight hepatic artery patients responded to treatment compared with 0/11 portal vein patients. Ten of 11 portal vein patients showed progressive tumor growth; nine of these patients were crossed over to arterial infusion. Three (33%) of these nine patients had an objective tumor response with the hepatic arterial infusion. This prospective, randomized clinical trial demonstrates significantly improved tumor response after hepatic arterial infusion compared with portal vein infusion.

Adenocarcinoma↗
PubMed1986

[Max Bürger--achievements in conflict-laden times--on his 100th birthday].

Max Bürger (1885-1966) is one of the most outstanding German internists in our century. His special merit is the application of modern scientific methods to his special field and the founding of gerontology as a new field of research. During the time of fascism in Germany Max Bürger has retained his fidelity to an humanistic engagement of the medical profession and, in contrast to many other distinguished representatives of medicine, he didn't succumb the various corruptions for participation in misuse of authority. In spite of the hard conditions in 1945 Max Bürger decided to carry on his activities in Leipzig. Here he achieved in the following years significant results for the reconstruction of Public Health and medical university education. The underlie of these commendable decisions was a humanistic professional ethos, to whom the engagement for suffering individuals was more important than the personal prosperity.

Geriatrics↗
PubMed1986

[Euthanasia in the Third Reich--only a problem of psychiatry? On the development of the euthanasia debate 1933-1941 in Germany].

The devastating consequences of the Fascist dictatorship in Germany for the ethical thinking of the physicians are particularly clearly recognizable by the mass killings of severely damaged children and patients with chronic psychic diseases which were performed at that time. Recent investigations of the developments which began in 1938 show that by way of intensive efforts for a juridicial legalization of the "active euthanasia" an enlargement of this killing practice has been striven after. References to a motive of compassion and the free decision of the affected persons should cover the real intention for reducing welfare services. A bill presented in 1940 for a law "on euthanasia for incurable ill persons" found the unanimous consent of the renowned physicians consulted for this purpose. Though this law finally did not become legal beginning with 1941 the medical practice showed further forms of the repressive and antihumane association with ill persons who were regarded as incurable, which must be valuated as practical consequences of an unadmissible relativation of the life-preserving task of medicine.

Euthanasia↗
PubMed1978

[Critical comments on the theory and practice of behavior therapy from the viewpoint of Marxist-Leninist philosophy].

By analyzing previous critical studies of the theoretical and methodological positions of behavioral therapy, which were conducted on Marxist-Leninist principles, the authors discuss the complex relationship of one-sided philosophical assumptions, simplifying elements of psychological theories, and radional moments of successful practical application in certain fields. Both critical delimitation from untenable theoretical interpretations and the inclusion of rational forms of therapy in a complex system of psychotherapy are considered essential.

Behavior Therapy↗
PubMed1978

[Marxist-Leninist philosophical personality theory and the development of the theory and practice of psychiatry].

This is a concise presentation of the essential positions of the Marxist-Leninist philosophical theory of personality. Its consequences to modern psychiatry are discussed. Particular emphasis has been placed on establishing practical relations with mental patients and creating optimum conditions for promoting the distinctive qualities or characteristics of persons within the framework of therapy. Also discussed by the author in his present paper are questions associated with pathogenesis. Integration of clinical and sociopsychological research into the development of psychoses is considered necessary.

Communism↗