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Biomedical subjects

E Kovats

Publications and source records attributed to E Kovats.

28 records · Page 2Linked to original sources
PubMed1985

Effect of adjuvant chemo- or immunotherapy on the prognosis of colorectal cancer operated for cure.

After radical surgery for colorectal cancer, 178 patients with a Dukes' B or C tumour were randomly assigned to one of three groups: A, controls (n = 62); B, chemotherapy (n = 59); C, immunotherapy (n = 57). Randomization criteria (age, sex, Dukes' stage, localization of tumour, operative procedure) were evenly distributed throughout the groups. After a median observation time of 30 months, statistical analyses were performed: survival and probability to be free of recurrence was described by Kaplan-Meier estimates of the survival function; for comparison of these survival functions, Breslow's test was used. Overall analyses show no benefit in the treatment group compared to controls. Separate analyses by Dukes' stages showed that in patients with Dukes' C tumours the probability of survival 40 months after surgery was 72 per cent in group C, 51 per cent in group B, and 33 per cent in group A. The differences between groups C and A, and B and A were statistically significant (P less than 0.02 and P less than 0.03 respectively). For a Dukes' C tumour the probability to be free of distant metastases at 30 months after surgery was 80 per cent in group B, 68 per cent in group C and 52 per cent in group A. Also for a Dukes' C tumour the probability to be free of liver metastases at 21 months after surgery was 83 per cent in group B, 81 per cent in group C, and 54 per cent in group A (significant differences: B-A and C-A P less than 0.04 for both). There was no influence on the estimated incidence of local recurrences for stage Dukes' C. Patients with a Dukes' B tumour did not benefit from either of the adjuvant therapy schemes.

Adjuvants, Immunologic↗
PubMed1985

Biological activities of lipopolysaccharide fractionated by preparative acrylamide gel electrophoresis.

Lipopolysaccharide from a smooth strain of Salmonella minnesota was fractionated into two major fractions and one intermediate fraction by using sodium dodecylsulfate-polyacrylamide gel electrophoresis. On the basis of the study by Hitchcock and Brown, it was deduced that the top fraction was mainly long O-side chain LPS and the bottom fraction was O-side chain-less LPS. The middle fraction was a mixture of both short O-side chain LPS and O-side chain-less LPS. The antigenic properties and biological activities were not altered in this fractionation procedure. Comparison of the biological activities of the top fraction with those of the bottom fraction revealed that the bottom fraction had higher activity in polyclonal B-cell activation and spleen-swelling effect and that there was no significant difference in adjuvant activity, ability to render macrophages cytotoxic, induction of colony-stimulating factor and the ability to induce the Schwartzmann reaction. It was suggested that O-side chain makes no contribution to the latter biological activities including adjuvant activity of S. minnesota LPS.

Adjuvants, Immunologic↗
PubMed1985

Biological effects of White-type polysaccharides of gram-negative bacteria.

The White-type polysaccharide (WPS), often called Freeman polysaccharide, was obtained by hydrolyzing gram-negative bacteria in 0.2 N acetic acid at 100 degrees C for 2 h. The crude product contained partially degraded O-antigens as well as other components that were active as immune adjuvants, enhancers of macrophage cytotoxicity of tumor target cells, and inducers of osteoclastic bone resorption. The same WPS preparation augmented the tumor cytotoxicity of normal mouse spleen cells and slightly retarded the take of L1210 leukemia in mice. The WPS preparations generated colony-stimulating factor in mice but were not active in lymphoproliferative (mitogenicity) tests. Chemical analyses of the WPS preparations did not detect the presence of components characteristic of the lipid moiety of endotoxins. The WPS samples were also negative in biological assays of endotoxicity such as local Shwartzman and toxicity tests. These findings indicate that gram-negative bacteria contain nonendotoxin components that are potent modifiers of some biological responses.

Actinobacillus↗
PubMed1984

Lateral distant view for improved accuracy in locating rectal tumors.

The lateral distant view of the rectum is proposed for more precise identification of sites of rectal tumors for preoperative planning and to increase the number of sphincter-saving operations. In a prospective study of 39 patients with rectal tumors, radiologic and rectoscopic measurements of tumor levels were compared with each other and with the actual tumor site. Radiologic measurement on the lateral distant view showed that tumors usually are located much higher (2-11 cm) than is suggested by rectoscopic evaluation. Unlike rectoscopy, the lateral distant view also can be used for measuring the length of the anal canal. This measurement is important for evaluating the distance between the tumor and the inner end of the anal canal and reflects the width of a possibly tumor-free margin. Sphincter-saving operations could be predicted much better by the lateral distant view than by rectoscopy.

Adult↗
PubMed1984

Postoperative assessment of below-knee bypass grafts.

Our results seem to demonstrate that, even when healthy or arteriosclerotic arteries tolerate knee flexion without any impairment of blood flow, all bypass materials, to a certain extent, have a tendency toward morphologic changes, such as kinking, looping, stenosis and decrease of peripheral blood flow. Reocclusion in below-knee reconstruction, which cannot be explained by poor outflow situation or technical faults, might be related to the graft material used as well as hemodynamic changes caused by flexion of the knee joint. With the use of ASV grafts, these changes are minimal and of little or no clinical importance; when HUV is used, these changes are more distinctive and might, in some instances, be the cause of reocclusion. This could explain the difference in the late results with the use of ASV or HUV. The results of reinforced PTFE still await evaluation. However, it should be kept in mind that the results in addition to the already mentioned influences are also caused by neointima proliferation and progression of the disease.

Aged↗
PubMed1983

[Sphincter preservation in rectal cancer: possibilities and limits of anterior resection].

The feasibility of sphincter preservation was studied in surgery of tumours in the upper, middle and lower third of the rectum. All patients operated on for rectal cancer between January 1977 and May 1980 were included in the investigation. Preoperative localization of the tumours was performed with the rigid sigmoidoscope. Every patient was scheduled for post-operative follow up. Altogether 211 patients were operated on for rectal cancer. 111 were treated by anterior resection, 90 by abdominoperineal excision, and 10 by other sphincter-saving methods. All of the 59 tumours located in the upper third of the rectum (12 to 16 cm from the anus) were treated by anterior resection. 62 tumours were located in the middle third (8 to 12 cm). In these cases anterior resection was carried out in 60% of the men and in 82% of the women, whereas the other patients underwent abdominoperineal excision. 80 tumours were located in the lower third (4 to 8 cm). Anterior resection was possible in only 4.4% of the men and in 14% of the women. Irrespective of their localization on sigmoidoscopy, 37% of the tumours which were within reach of the finger on rectal palpation could be removed by anterior resection. Local recurrence after anterior resection occurred in 18.3%, the median follow-up time being 50 months. The cumulative probable survival for all stages was more than 5 years for 60% of the patients.

Aged↗
PubMed1983

[Value of computer tomography of the small pelvis for the early diagnosis of local recurrence after surgery of rectal cancer].

The value of pelvic computed tomography (CT) in the detection of local recurrence following radical operation for rectal cancer was assessed in a prospective study on 15 patients. A positive CT finding was checked in every instance by a second-look operation (11 cases). Tumour tissue in the pelvis was found in 9 patients, whereas in 2 patients the positive CT finding was proven to be false. 5 out of 9 cases with recurrent tumour underwent radical surgery. In the 4 cases with a negative CT finding no recurrence has developed after a median observation time of 34 months. Pelvic CT is a useful and reliable method of detecting pelvic recurrence before it becomes clinically obvious. However, the method does not allow certain prediction of whether or not the recurrence will be radically operable.

Adenocarcinoma↗
PubMed1983

[Therapy of local recurrence after colorectal cancer].

A prospective study was undertaken of the incidence, symptoms, diagnostic measures and therapy of local recurrence of colorectal carcinoma following radical surgical management. 69 (16%) out of 434 patients developed recurrence of the tumour, which was local in 51 patients (12%). Half of the latter group was symptom free at the time of diagnosis. 45 out of the 51 patients were treated by surgery, a radical operation being feasible in 25 cases. 60% of these have survived for at least 30 months. The operative mortality was very low, with only one death, although extensive surgery was necessary in most of the cases. The preliminary results of this study support the hypothesis that a postoperative follow-up programme for patients with colorectal cancer leads to early detection of local recurrence and improves the chance of cure by surgical treatment.

Colonic Neoplasms↗
PubMed1982

[Sphincter-preserving operations in cases of ulcerative colitis (author's transl)].

Eighteen cases of operated ulcerative colitis are described. In 15 cases ileorectal anastomosis was performed. In one case, the rectum had to be excised because of a massive rectal haemorrhage; in another case, the anastomosis had to be separated Hartmann's operation) because of a dehiscence of the anastomosis. A re-examination of 13 patients shows full continence in 12 cases; one patient was incontinent with regard to flatus. The Karnofsky Index shows 100 in 10 patients, and 90 in 3 patients. The sigmoidoscopy reveals normal rectal mucosa in 6 patients, a moderate colitis in 5 patients and a severe colitis in 2 patients. There are only two indications for rectal excision in our opinion: uncontrollable rectal haemorrhage and carcinoma (dysplasia).

Adult↗