PubMed Health⌕ Search

Biomedical subjects

C Clemm

Publications and source records attributed to C Clemm.

65 records · Page 4Linked to original sources
PubMed1983

[Skin necroses and ergotism after preventive administration of heparin-dihydroergotamine].

About 30 hours after prophylactic subcutaneous administration of heparin-dihydroergotamine to a 77-year-old man with generalized arteriosclerosis, extensive skin necroses developed at the injection sites and, after progressively increasing signs of mental disorientation, three days later there developed acute pulmonary oedema and a large ischaemic infarct of the median cerebral artery with hemiparesis and coma, which ended fatally. Skin necroses and ergotism are rare but serious complications of anticoagulant treatment.

Aged↗
PubMed1982

[Testicular neoplasms with massive tumor invasion. Consequences for diagnosis and therapy].

Cis-(diammine-dichloro-) platinum containing polychemotherapy combined with surgery has markedly improved the prognosis of cancer of the testis even in the metastatic stage. Important is a quickly obtained diagnosis. The histological staging can be rendered more precise by means of immunoperoxidase technique, the clinical staging with the help of tumor markers (alpha FP, beta hCG). Polychemotherapy is indicated in the case of seminoma in stage IV or with elevated beta hCG, teratoma in stage IIB-IV, chorion carcinoma in every stage, and should only be carried out in specialized oncological centers. Delayed and inconsequent treatment must be avoided. Only then more than 75% of patients treated with polychemotherapy can be freed from tumor, even up to 50% of those cases with unfavorable histology and extensive tumor stage.

Adult↗
PubMed1982

The value of ifosfamide in the polychemotherapy of metastasized testicular cancer pretreated with chemotherapy.

Ifosfamide (Holoxan) has an effect as a single drug on testicular carcinoma and shows synergism with cisplatinum in mice. In combination chemotherapy of testicular cancer ifosfamide has great value as an alternative to bleomycin when the total bleomycin dose has reached a toxic level. The VIP regimen is effective on lung nodules (a marked regression can be seen) and tumor markers (the levels fall). In combination with surgery 8 of 14 patients (= 60%) with disseminated disease (Stage IIIa and IIIb) can reach NED status even after having extended tumor manifestations (bulky disease) after more than 4 cycles of previous combination chemotherapy.

Adolescent↗
PubMed1981

[Comparative study on the value of selective decontamination of the digestive tract in acute leukemia patients (author's transl)].

A comparative study of infectious morbidity and mortality in neutropenic patients with acute leukemia receiving chemotherapy was undertaken to test the effects of a suppression of endogenous and ambient microorganisms. Patients were allocated to receive [1] oral antibiotics (neomycin, colistin, and nystatin) in conventional ward isolation; [2] no antimicrobial suppression but conventional ward isolation; [3] strict isolation, filtered air, sterilized food and oral antibiotics. Significantly fewer infections with Gram-negative bacilli were seen in patients with strict isolation plus endogenous microbial suppression versus patients receiving selective gut decontamination versus patients without nonabsorbable antibiotics in simple reverse isolation. The death rate from infection was significantly reduced in patients who received antibiotics for gut flora suppression in conventional ward isolation compared with the corresponding control group. In addition, a significant improvement of leukemic remission rate was seen in this group. The protocol for decontamination was well tolerated.

Adolescent↗
PubMed1981

[Results of treatment of adult acute leukemias: critical analysis in an unselected group of patients].

58 adult patients with acute leukemia were analyzed in respect to the rate of first remission induction, remission duration, survival, and treatment of relapse. A selection of subgroups has been avoided to reflect clinical reality. Although our results of remission induction were slightly under those reported from other groups, the duration of remission and survival was favorably comparable. The prognostic value of LDH and systemic infection on admission for the outcome of the disease has been evaluated. Selective decontamination of the G.I.-tract reduced the rate of life-threatening infections and increased the rate of complete remissions significantly. LDH was of no importance in predicting the likelihood of achieving complete remission or duration of complete remission.

Acute Disease↗
PubMedDate not supplied

Rh antibodies against the pretransplant red cells following Rh-incompatible bone marrow transplantation.

A 22-year-old, blood group O, Rh-positive (R2r) man received bone marrow from his blood group A, Rh-negative (rr), HLA-identical sister for treatment of acute lymphocytic leukemia. The patient's pretransplantation serum contained anti-A in a low concentration; therefore, plasmapheresis was not done prior to transfusion of bone marrow. To prevent graft-versus-host disease, bone marrow was incubated with absorbed rabbit antithymocyte globulin prior to infusion, and the patient was treated with methotrexate in the posttransplantation period. After transplantation, the patient received 6 units of group O, Rh-negative (rr) packed red cells from random donors and 6 units of platelets from the marrow donor. Three months after transplantation, 0.5 percent of his red cells were still of the host's type (group O, Rh-positive), as detected by immunofluorescence technique in blood smears. Four months after transplantation, three different Rh antibodies--anti-D, -E, and -G--were detected. Since the patient received only Rh-negative red cell transfusions, it is concluded that he was immunized to his original red cells.

Adult↗
PubMedDate not supplied

Repeated blast crisis (BC) of changing morphology, immunologic phenotype and cytogenetics in chronic myeloid leukemia (CML).

The clinical course of a 66 year old male with CML who experienced several " relapse " BC of changing morphology, immunologic phenotype and cytogenetics is reported. The first BC was of lymphoblastic phenotype, the second of myeloid, the third again of lymphoblastic, and the fourth, terminal BC was not further characterized or treated. Whereas a phenotypic switch from lymphoblastic to myeloid has been documented twice, the sequence of myeloid followed by a lymphoblastic BC has, to our knowledge, not been reported so far. Lymphoblastic BC responded to a combination of vindesine/prednisone and 6-mercaptopurin. Myeloid BC was controlled by an AML-type induction regimen consisting of daunorubicin and cytosine arabinoside. This unusual case demonstrates that relapse BC is not necessarily of the same morphologic and phenotypic lineage as the preceding BC. Moreover, treatment should be adjusted to the predominant cell type in order to prolong survival.

Aged↗
PubMedDate not supplied

Is serum tumor marker half-life a guide to prognosis in metastatic nonseminomatous germ cell tumors?

BACKGROUND: The value of serum tumor marker kinetics of AFP and HCG assessed by marker half-life (MHL) analysis for diagnosis and in the follow-up of patients with nonseminomatous germ cell tumors (NSGCT) is still debated controversally. The aim of this retrospective study was therefore to investigate the influence of serum MHL during the first two cycles of chemotherapy on the long-term outcome in metastatic NSGCT. MATERIAL AND METHODS: 147 patients with at least 2 abnormal marker values > 7 days after start of chemotherapy were investigated for HL analysis (HL cut off 3.5 days for HCG and 7 days for AFP). HCG and AFP determinations were performed by a double monoclonal IRMA (HCG) and conventional RIA (AFP) developed by our laboratory. RESULTS: According to these cut offs 35/108 patients (32.4%) had a prolonged HCG HL and 41/114 patients (36%) a prolonged AFP HL. Patients with either MHL prolonged had a significantly inferior overall survival (OS; 10 year OS 37% vs. 75%, p = 0.0005) and progression-free survival (PFS; 10 year PFS 29% vs. 69%, p < 0.0001) than those with a prolonged HCG MHL (OS; 10 year OS 36% vs. 65%, p = 0.003; 10 year PFS 28% vs. 56%; p = 0.001) and even more than those with a prolonged AFP MHL (10 year OS 39% vs. 70%, p = 0.02; 10 year PFS 32% vs. 56%, p = 0.01). CONCLUSION: The remarkable prognostic information assessed by MHL analysis in this retrospective study merits further confirmation by a prospective study for its appropriateness in selecting patients for high dose chemotherapy.

Biomarkers, Tumor↗