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Biomedical subjects

E Schilling

Publications and source records attributed to E Schilling.

At least 19 recordsLinked to original sources
PubMed1999

Aerosolized amphotericin B inhalations as prophylaxis of invasive aspergillus infections during prolonged neutropenia: results of a prospective randomized multicenter trial.

We performed a prospective, randomized, multicenter trial to evaluate the effectiveness of prophylactic inhalations with aerosolized amphotericin B (aeroAmB) to reduce the incidence of invasive aspergillus (IA) infections in patients after chemotherapy or autologous bone marrow transplantation and an expected duration of neutropenia of at least 10 days. From March 1993 until April 1996, 382 patients with leukemias, relapsed high-grade non-Hodgkin lymphomas, or solid tumors were randomized with a 13:10 ratio to receive either prophylactic aeroAmB inhalations at a dose of 10 mg twice daily or no inhalation prophylaxis in an unblinded fashion. The incidence of proven, probable, or possible IA infections was 10 of 227 (4%) in patients who received prophylactic aeroAmB. This did not differ significantly from the 11 of 155 (7%) incidence in patients who received no inhalation prophylaxis (P =.37). Moreover, no differences in the overall mortality (13% v 10%; P =.37) or in the infection-related mortality (8% v 7%; P =.79) were found. In contrast to other nonrandomized trials, we observed no benefit from prophylactic aeroAmB inhalations, but the overall incidence of IA infections was low.

Administration, Inhalation↗
PubMed1999

[Amyloidosis of the tongue as a possible diagnostic manifestation of plasmacytoma].

Plasmocytic non-Hodgkin's lymphoma is the most common tumor of bone and bone marrow, typically diagnosed by symptoms such as monoclonal paraproteinemia, proteinuria, anemia and hypercalcemia. In its progress, deposits of amyloids in almost all organs can be observed. However, plasmacytomas which are diagnosed by macroglossia of primarily unknown etiology are rare. This case report presents a 61-year-old woman who suffered from a persistent swelling of the tongue with painful ulcerations. A biopsy led to the diagnosis of primary systemic amyloidosis of the light-chain type, which subsequently proved to be a plasmacytoma with lambda light-chains stage II after Durie and Salmon. In the course of the disease the patient developed further deposits of amyloids in the whole gastro-enteric system. Macroglossia as a primary manifestation of plasmacytoma is rarely described in medical literature. However, reports on deposits of amyloid in the tongue in advanced stages of disease are well known.

Amyloidosis↗
PubMed1998

Increased risk of malignancy in patients with systemic lupus erythematosus.

BACKGROUND: Systemic lupus erythematosus is a chronic, multisystem, autoimmune disorder that primarily affects women. Morbidity and mortality have improved for lupus patients during the last 15 years. An increased risk of malignancy in patients with lupus has been shown in some, but not all studies. The purpose of this study was to ascertain cancer risk in lupus patients by linking two disease registries. METHODS: Participants in the Chicago Lupus Cohort included 616 women with lupus who were residents of Cook County, Illinois. They were seen during 1985-1995 at 4 University, inner city, and suburban inpatient and outpatient clinics in Chicago. Malignancies occurring in these subjects during the study interval, 1985-1995, were identified from the Illinois State Cancer Registry by matching name, birthdate, and social security number. Standardized incidence ratios (SIRs) were estimated for all malignancies in this cohort of lupus patients using age, gender, and all race or race-stratified specific cancer incidence data from Cook County, Illinois. RESULTS: The registry linkage study with the Illinois State Cancer Registry documented that 30 women with lupus had a malignancy. The expected number of malignancies for women in the lupus cohort was 15.0. There were 8 cases of breast cancer and 4 each of lung and cervical cancer. In the remaining 14 women, 12 different types of cancers were noted. The SIR and 95% confidence interval (CI) for malignancy for all women with lupus in the study were 2.0 (1.4, 2.9) and lung cancer was the only individual cancer increased in all women--SIR and 95% CI were 3.1 (1.3, 7.9). In the analysis stratified by race, the risk of malignancy (SIR and 95% CI) was increased in Caucasian women, 2.3 (1.4, 3.9). Breast cancer was the only individual cancer increased in Caucasian women with lupus with an SIR and 95% CI of 2.9 (1.4, 6.4). CONCLUSIONS: Lupus patients have an increased risk of malignancy. Breast, lung, and gynecological malignancies were the most common malignancies observed in the cohort and breast cancer was significantly increased in Caucasian women.

Adult↗
PubMed1997

Immunosuppressive drug use during pregnancy.

Women with rheumatic diseases frequently need treatment throughout pregnancy and lactation. Physicians must confront the dual challenge of monitoring the possible effects of the underlying maternal disease and the medications on both mother and child. It is essential that the maternal disease be well controlled before, during, and after pregnancy to ensure the best possible outcome for the mother and child. Corticosteroids have been used extensively and safely in pregnant patients with systemic lupus erythematosus and rheumatoid arthritis; there have been no reports of congenital malformations in the exposed infants. There is considerable experience using azathioprine during pregnancy if the maternal condition requires use of a cytotoxic drug; there has been no increased risk of congenital malformations in the exposed infants. There is limited information on the safety of other medications, including 6-mercaptopurine, cyclophosphamide, and cyclosporine. Methotrexate is contraindicated during pregnancy, and chlorambucil should be avoided because there are other effective immunosuppressive agents available for use. Corticosteroids (prednisone and methylprednisolone) can be used safely during lactation. All other immunosuppressive medications, azathioprine and 6-mercaptopurine, chlorambucil, cyclophosphamide, cyclosporine, and methotrexate, are contraindicated during lactation.

Adrenal Cortex Hormones↗
PubMed1995

Aerosol amphotericin B inhalations for prevention of invasive pulmonary aspergillosis in neutropenic cancer patients.

To determine the value of aerosol amphotericin B inhalations for prevention of invasive pulmonary aspergillosis (IPA), we initiated a prospective randomized multicenter trial. The scheduled intent-to-treat interim analysis included 115 patients (30%) with prolonged neutropenia after chemotherapy for acute myeloid leukemia, acute lymphoblastic leukemia/high-grade non-Hodgkin's lymphoma, or solid tumors undergoing autologous stem cell transplantation. Sixty-five patients had been randomized to receive prophylactic aerosol amphotericin B inhalations at a dose of 10 mg twice daily (group A); for the remaining 50 patients no aerosol amphotericin B prophylaxis was used (group B). No serious side effects from amphotericin B inhalations occurred, but coughing (54%), bad taste (51%), and nausea (37%) caused early cessation of aerosol amphotericin B prophylaxis in 23% (15/65) of courses. In group A, the incidence of proven, probably, or possible IPA was 5% (3/65) as compared with 12% (6/50) in group B (p > 0.05). Microbiologically documented bacterial pneumonias were observed in 5/65 (8%) patients in group A and in 1/50 (2%) patients in group B (p > 0.05). Thus, no reduction in incidence of IPA from use of prophylactic aerosol amphotericin B inhalations was found in this interim analysis. As there were no serious side effects from aerosol amphotericin B prophylaxis, accrual in the study will continue for a total of 380 patients.

Administration, Inhalation↗
PubMed1990

[Comparison of several variables of metabolic, immunologic and endocrine function with personality factors in perioperative stress].

To look for relations between stress and personality a comparison of neuroendocrine, metabolical, immunological variables with personality factors according to Eysenck was performed. There are unsharp relations between physiological variation and personality scores, which give reference to interconnections between stress, perioperative course and complications; not in the simple minded understanding that stress causes trouble, but the dependence of perioperative difficulties on that, how an individual percepts its inner and outer surface and reacts on events on them. The anticipation of aversive signals alone is not sufficient for triggering the stress reaction, it needs additionally the corporeal perception, which signals the brain, that the threatening event really occurred. In perioperative time the stress reaction solves round about the 5th day postoperatively.

Adolescent↗
PubMed1988

Elevated levels of head activator in human brain tumors and in serum of patients with brain and other neurally derived tumors.

In normal human tissue high concentrations of the neuropeptide head activator are found in the hypothalamus, in the retina, and in the gastro-intestinal tract. Up to 100-fold elevated levels of head activator over neighbouring tissue were found in tumors of the brain, especially in tumors of neural origin like astrocytoma and glioblastoma, but also in meningioma. Coincident with elevated tissue levels, an increased secretion into the general circulation was observed. Elevated levels of head activator in the blood were also observed in patients with tumors in peripheral locations, especially in tumors of gastrointestinal tract and/or of neuroendocrine origin. After tumor removal, the head activator levels in the blood dropped to normal values suggesting a possible role of head activator in neuroendocrine tumorigenesis.

Animals↗
PubMed1986

The neuropeptide head activator loses its biological acitivity by dimerization.

On molecular sieve columns the neuropeptide head activator elutes at two distinct positions corresponding to apparent mol. wts of 700 and 1400 daltons. The low mol. wt component is stable only under high ionic conditions and represents the monomeric state of the head activator. Only this form is biologically active. The higher mol. wt component, which is reapidly formed under physiological conditions, is the dimeric head activator and is biologically inactive. We suggest that this dimerization is of biological relevance as a mechanism for inactivation of neuropeptides.

Amino Acid Sequence↗
PubMed1986

Postnatal development of the connexion between tubulus seminiferous and tubulus rectus in the bovine testis.

Histology and ultrastructure of the connexion of seminiferous and straight testicular tubules were studied in 58 bovine testes of 29 animals ranging from 4 to 52 weeks of postnatal development. In the 4th and 8th week seminiferous tubules are solid. Their non-germinal supporting cells possess spherical nuclei in a basal location and a great amount of granular endoplasmic reticulum. The straight tubules have a narrow lumen and a stratified epithelium rich in intercellular canaliculi. Between 20 and 25 weeks the seminiferous tubules acquire a lumen and develop a terminal segment, the tip of which (terminal plug) protrudes into the cup-shaped modification of the adjacent straight tubule. At 30 weeks the structural differentiation between seminiferous tubule proper and its terminal segment has proceeded: in the former spermatocytes and spermatids make their first appearance, and the supporting cells have transformed to Sertoli cells. In the latter the morphology of the supporting cell preserves a more primitive state. Starting from the 16th week and proceeding through the 30th week and further, the epithelium of the tubulus rectus close to the connexion with the seminiferous tubule becomes monolayered by rearrangement of its cells and advances along the basal lamina into the area of the seminiferous tubule. Those cells of the seminiferous tubule that are cut off from the basal lamina by invading rectus cells degenerate. Between 40 and 52 weeks the adult situation is principally achieved. The terminal segment of the seminiferous tubule is tripartite consisting of transitional region, intermediate portion, and terminal plug. The terminal segment is surrounded by a vascular plexus. The straight testicular tubule adjacent to the terminal segment is modified into a cup region encompassing the terminal plug, followed by a narrow stalk region, which is lined by simple columnar epithelium. Mononuclear free cells are a constant feature of the tubulus rectus epithelium in all stages of postnatal development.

Age Factors↗
PubMed1986

[Equivalence of oral and intramuscular premedication. III. Effect of premedication on anesthesia and postoperative pain].

600 patients were given 6 different premedications in randomised design to study their effect on the course of anaesthesia and on postoperative pain. Premedication acts indirectly on anaesthesia, depending on the influence of the drug on anxiety and on the somatic correlates of anxiety. The greater the sedative-anxiolytic effect of the premedication, the easier it is to induce anaesthesia, and the more superficial the anaesthesia, resulting in earlier and stronger onset of postoperative pain. On the other hand, the more anxious the patient is, the more he consumes anaesthetic drugs, whereas anaesthesia remains superficial with the same consequences in respect of postoperative pain. In view of postoperative pain, fast and early awakening from anaesthesia must not be aimed at, particularly after operations which definitely result in postoperative pain (long-term operations in those regions of the body that cannot be immobilised).

Administration, Oral↗
PubMed1986

[Equivalence of oral and intramuscular premedication. I. Oral versus intramuscular premedication].

In a randomised study, 6 different premedications (oral flunitrazepam, oral pentobarbital, oral NaCl solution; intramuscular pethidine, intramuscular droperidol/fentanyl, and intramuscular NaCl solution) were administered to 600 patients, to determine the equal efficacy of oral and intramuscular application. The results show a significantly better mode of action of oral premedication.

Administration, Oral↗
PubMed1986

[Equivalence of oral and intramuscular premedication. II. Effect of various conventional premedication drugs].

In a randomised study, 6 different premedications (oral flunitrazepam, oral pentobarbital, oral physiological NaCl solution, intramuscular pethidine, intramuscular droperidol/fentanyl, intramuscular physiological NaCl solution) were administered to 600 patients to determine the equal efficacy of the premedicative drugs in oral or parenteral administration. Patients gave the best rating to the oral application of flunitrazepam. The differences in the assessment of application and effect of the drugs are contrasted by the statement that most patients do not feel any direct influence on their preoperative anxiety by premedication. However, it is easier for them to cope with anxiety because premedication pacifies the patients, whereas each of the dependent variables, such as apprehension, is influenced differently. Oral premedication again proves superior to parenteral premedication.

Administration, Oral↗
PubMed1985

Serum enzymes in toxicity of trichloroethylene after subchronic ethanol pretreatment.

In order to establish evidence of serum enzyme activities in toxicological long-term experiments alterations of alanine aminotransferase (ALAT) and aspartate aminotransferase (ASAT) in the serum of rats were investigated after subchronic ethanol pretreatment and following trichloroethylene exposure. Somewhat lower enzyme activities were found in ethanol treated animals than in those who only got water in nearly all cases. Significant ALAT and ASAT decreases occurred after giving higher ethanol concentrations (5% and 10%, v/v) for 30 weeks. It is possible that this fact among other things could be responsible for the only slight enzyme elevations after trichloroethylene in long-term ethanol pretreated rats.

Alanine Transaminase↗
PubMed1984

Enzyme-linked immunosorbent assay for the neuropeptide 'head activator'.

By exposing different sites of the 'head activator', different sets of antibodies were designed and produced which recognised either the amino or the carboxy terminus of the free 'head activator', which reacted with 'head activator' in a tissue-fixed conformation, or which bound to the 'head-activator' sequence, if it was part of a larger precursor-like molecule. An enzyme-linked immunosorbent assay (ELISA) was developed to characterise the antibodies and also to assay minute amounts of 'head activator' or 'head-activator'-like immunoreactivities in animal or tissue extracts. A competitive ELISA is described which uses biotin-avidin for enhancement. The assay is sensitive with an antibody specific for the amino terminus in the range of 0.5-50 fmol, with an antibody specific for the carboxy terminus in the range of 20-400 fmol. The ELISA specific for the amino terminus is 10-times more sensitive than a radio-immunoassay with tritiated 'head activator' [H. Bodenmüller and B. Zachmann (1983) FEBS Lett. 159,237-240]. Previously no radioimmunoassay existed with specificity for the carboxy terminus.

Antibody Specificity↗