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Biomedical subjects

C Kettelhack

Publications and source records attributed to C Kettelhack.

25 records · Page 2Linked to original sources
PubMed1990

[Improved intraoperative leak control in cytostatic drug isolation perfusion of tumors of the extremities].

The success of extremity perfusion and the protection from systemic side effects largely depend upon the prevention of systemic drug leakage from the extremity circulation. The use of autologous 111-Indium labelled erythrocytes for leakage control allows a continuous exact surveillance and timely correction of the tourniquet position in case a major leak should occur. A total of 97 patients were studied. In 6 patients (= 6%) the perfusion had to be discontinued within the first 30 min due to an uncorrectable leak of greater than 20%. In 31 patients (= 32%), a major leak could be reduced by manipulation of the tourniquet. No systemic side-effects could be observed in any of our patients. Applying leakage control by means of 111-Indium labelled erythrocytes extremity perfusion has proved to be a safe procedure in patients with high risk or recurrent malignant melanoma and soft tissue sarcoma.

Adolescent↗
PubMed1990

Hyperthermic limb perfusion for malignant melanoma and soft tissue sarcoma.

From 1982-1989, 113 hyperthermic limb perfusions were carried out in 102 patients. Ninety-three patients were treated for malignant melanoma and nine for soft tissue sarcoma. 47/93 patients had high-risk stage I melanoma with a 5-year survival rate of 89%. For the 46 patients treated for recurrent and metastatic melanoma the projected 5-year survival rate was 40%. The nine patients with soft tissue sarcoma were perfused for local recurrences or because of anatomically difficult tumor locations. 3/9 patients subsequently developed recurrent disease of the extremity; two of these patients had to be treated by amputation. The rate of major complications was low: no patient died in the postoperative course, an amputation due to toxic reaction was never required. Erythema and oedema (57%), severe skin reaction (6%) and transient nerve palsy (15%) were common side effects of therapy. Only two cases of leucopenia were observed (2%). The favourable results after hyperthermic limb perfusion show the efficacy of this method in the treatment of malignant melanoma and selected cases of soft tissue sarcoma.

Adolescent↗
PubMed1989

[The surgical treatment of patients treated with cytostatic chemotherapy].

Surgical interventions during or immediately following cytostatic therapy carry an increased risk of complications such as healing disturbances, septic complications or organ insufficiencies. These complications can also be expected if chemotherapy follows the surgical treatment. As the possible complications depend on the class of substances used as well as the time of application these risks can be taken into consideration in multimodal treatment plans. In cases of emergency surgical interventions during chemotherapy or because of tumor based complications there is of course minimal influence to be exerted on the complication rate except through very diligent anastomosis sutures and wound closure.

Antineoplastic Agents↗
PubMed1986

Variation and adaptation of Pseudomonas aeruginosa toxicity to HeLa cells and fibroblasts.

The toxic components of supernatants from Pseudomonas aeruginosa cultures directed against HeLa cells and Staphylococcus aureus were evaluated with the aim of discovering interactions. Supernatants of eight different strains of P. aeruginosa were assayed for cytotoxic activity. All were active against HeLa cells; seven were toxic for S. aureus. On repeated suspension of P. aeruginosa in 0.9% sodium chloride solution, a shift from HeLa cell toxicity to staphylococcal lytic activity occurred along with a change of toxic activity from a high (50,000 +/- 5,000) to a low (8,000 +/- 400) molecular weight (MW) range on gel filtration. Addition of protein to the minimal medium of cultures producing material toxic only for S. aureus reactivated the generation of HeLa cell-toxic material. Cultivation of P. aeruginosa in the presence of HeLa cells and a chloramphenicol supplement produced suppression of the generation of material toxic for S. aureus but facilitated that of HeLa-toxic material of high MW. Adaptation of toxicity against fibroblasts developed only on cocultivation of P. aeruginosa together with S. aureus and in the presence of fibroblasts. Under these conditions a strong lytic activity for S. aureus appeared, even in the presence of chloramphenicol. Chloramphenicol caused the material toxic for fibroblasts to elute at a low MW well separated from that toxic for HeLa cells. In contrast to the high-MW toxic substances, the low-MW material did not induce antibodies after injection into rabbits. This may explain failures of vaccination against P. aeruginosa infection and of serum therapy of homologous sepsis in humans.

Bacterial Toxins↗
PubMedDate not supplied

Intraoperative and postoperative PTH secretion mode in patients with hyperparathyroidism.

The development of a sensitive 2-site immunoradiometric assay which detects only intact human PTH (1-84) enabled us to study kinetics of PTH secretion intraoperatively. In a prospective study, we assessed the PTH (1-84) secretion mode intraoperatively in 54 patients with adenomas, in 14 patients with tertiary hyperparathyroidism (HPT), and in 2 patients with persistent HPT. After the removal of adenomatous or hyperplastic tissue, a significant drop of PTH (1-84) concentration was seen. A 50% decrease in the basal PTH concentration was reached significantly earlier for adenomas than for hyperplasias. In the 2 cases with unrevealing neck exploration, the PTH (1-84) concentrations showed hardly any change. The recovery of PTH secretion was studied in 23 patients, 20 of whom had a single adenoma; in 2 cases, a hyperplasia was present and 1 patient showed the clinical signs of a toxic HPT. We found an initial drop of PTH concentration 4 hours postoperatively below the limit of detection and a rapid recovery within 24 hours postoperatively. The PTH concentration values were well within the normal range after 48-72 hours.

Adenoma↗
PubMedDate not supplied

Clinical management and current research in isolated limb perfusion for sarcoma and melanoma.

Currently, isolated limb perfusion (ILP) attracts major interest in the treatment of soft tissue sarcoma and melanoma confined to the limb. The procedure combines innovative approaches such as hyperthermia, the use of cytokines, as well as the administration of high-dose chemotherapy. Although used since more than 40 years, the basic knowledge on the mode of action of ILP is still limited. Besides regional toxicity, systemic effects following the application of rhTNF in the perfusion circuit have to be taken into account. Furthermore, WHO criteria of tumor response are rarely met after perfusion of sarcomas. To overcome this, new modalities based on tumor metabolism are currently under investigation. Also the clinical decision on how to proceed after a successful ILP is discussed.

Antineoplastic Agents↗