Biomedical subjects
Publications and source records attributed to H Becker.
The author refers to two examples taken from the work of Balint groups in arguing that the social environment of the several participants is an integral component of what the group must reflect on. The notion of a group process dealing with "pure" cases is ideology. The author relates his argument to Parin's comments about "social critique in the interpretive process".
Sixty patients with metastatic renal cell carcinoma were entered into an ongoing randomized phase II study with lonidamine, 350 mg/m2 orally daily (arm A) and high dose tamoxifen, 150 mg/m2 orally daily for 6 months, afterwards 50 mg/m2 (arm B), until tumor progression. All patients had measurable disease and documented tumor progression prior to treatment. There were 1 complete and 1 partial remission among 19 evaluable patients in arm A (10.5%) and 2 complete and 1 partial remission among 25 evaluable patients (12%) in arm B. Objective responses were observed in pulmonary, nodal, and cutaneous metastases. In addition, in 63% and 64% tumor progression could be stopped in arm A and B, respectively. Median response duration was 100 days (range, 20-361) in arm A and 150 days (range, 28-355) in arm B. One year survival rate was 37.5% with lonidamine and 35% with tamoxifen. In arm A patients with tumor progression within 12 weeks after diagnosis of metastatic disease survived significantly shorter than patients with a longer interval (P less than 0.05). Nephrectomy or number and localization of metastatic sites failed to significantly influence probability of remission or survival. Toxicity was mostly mild to moderate. Four patients in the lonidamine arm had to discontinue treatment because of intolerable myalgias, which were immediately reversible. These data suggest that lonidamine and high-dose tamoxifen are moderately effective in widespread renal cell carcinoma where treatment intention is palliative.
A method that has proved to be the most sensitive approach for the early diagnosis of infection of the oral mucosa around dental implants has been used to monitor the exit-sites of percutaneous devices. For three months the state of the skin-catheter interface of 13 CAPD-patients was examined every four weeks. This examination included the measurement of pocket depth with the aid of a periodontal probe, the measurement of SFFR (sulcus-fluid-flow-rate) using standardized filter paper strips and a bacteriological swab of the exit-site. The results obtained demonstrated that SFFR can be measured around percutaneous implants. The measurement of SFFR appeared to be more useful in the monitoring of exit-sites of percutaneous devices than the measurement of pocket depth or the use of bacteriological swabs. Further studies for prolonged periods are necessary to determine whether measurement of SFFR can reliably predict onset of exit-site infection before clinical signs become evident.
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We studied the relationship between CD5+ B cells and the activity of the disease process in patients with autoimmune diseases. In rheumatoid arthritis (RA), levels of CD5+ B cells were associated with autoantibody production as determined by serum rheumatoid factor and antinuclear antibodies. In addition, CD5+ B cells were significantly correlated with C-reactive protein, and data from longitudinal studies showed a marked influence of corticosteroid treatment on numbers of CD5+ B cells. Patients with systemic lupus erythematosus (SLE) had slightly elevated levels of CD5+ B cells as compared with normals, but a close association with measures of an active disease was not observed. In a group of patients with type I diabetes mellitus, CD5+ B cells were detected in patients with anti-islet cell antibodies. Our results suggest that CD5+ B cells are related to the activity of the autoimmune process and can be modulated by therapy in patients with RA. Although CD5+ B cells do not seem to have a major role in SLE, polyclonal activation might affect this B cell subset as well in this disease. Further studies are needed to define the precise role of CD5+ B cells in organ-specific autoimmunity.
In vitro cultures of the liverwort, Fossombronia pusilla, have been ititiated from spores. They grew well on Gamborg B5 medium supplemented with 2% saccharose and 12.5 micrograms/l vitamin B12. Undifferentiated cultures were obtained on Knop mineral solution with 4% glucose. The cultures produced the same constituents as collected material. Perrottetianal A and B, known substances from liverworts were isolated and characterized by spectroscopic methods as well as alpha-(-)-santonin. A hitherto unknown diterpene dialdehyde-8-hydroxy-9-hydroperrottetianal A--could also be characterized. Furthermore, 7 terpenes were identified by GC/MS. A petrol ether extract and the isolated terpenes exerted antibacterial activity.
Five new sesquiterpenoids, three monocyclofarnesane, and two cuparane derivatives, isolated from the liverwort Ricciocarpos natans (L.) Corda have been tested against Biomphalaria glabrata, one of the snail vectors of schistosomiasis (bilharzia). Molluscicidal activity is exhibited by four of the sesquiterpenoids with an LC100 of 11 ppm of the most toxic compound. Lunularic acid, a common growth inhibitor of liverworts, and five of its synthetic derivatives have also been tested, and two derivatives were found to be highly active.
The statistical significance of ophthalmological and pediatric findings in the development of retinopathy of prematurity (ROP) was evaluated in a retrospective study of 338 premature infants. Short gestation time, frequent hypoxia, and low birthweight were strongly correlated with advanced stages of ROP. The influence of Vitamin E treatment, duration of oxygen therapy, and need for transfusions was less significant. Neither multiple births nor the infant's sex had any influence on the development of ROP. Cryotherapy appears to reduce ROP, but the number of cases in the present study was too small to permit statistical analysis.
In 16 patients with possible disturbed CSF circulation longterm recording of intracranial pressure (ICP) was performed. In 9 of the 16 patients the disorder became evident after the application of an exogenous volume-pressure testing procedure. This procedure enabled a classification into a group I--disturbed CSF circulation (8 patients)--and another group II--normal CSF circulation (8 patients). During a routine Xenon-CT-CBF study all patients of both groups were given to 1 g acetazolamide (DIAMOX) intravenously. Before, during and after the administration of DIAMOX the epidural ICP was continuously measured. An increase in ICP was monitored in all patients. In group I the average initial ICP was 13.6 +/- 7.6 mmHg. The maximum ICP was reached within a time interval of 13.1 +/- 4.5 min after DIAMOX administration. At this time the mean ICP was 36.4 +/- 19.2 mmHg (p less than 0.01). The average initial ICP in group II was 6.3 +/- 4.2 mmHg. The maximum ICP was reached within a time interval of 13.6 +/- 1.1 min. At this time the mean ICP was 11.9 +/- 4.8 mmHg (p less than 0.01). In respect to the maximum ICP both groups were significantly different (p less than 0.01). Despite a considerably rising ICP up to values of about 50 to 70 mmHg in several patients of group I only 1 patient complained of being sick. Presumingly, an ICP elevation caused by vasodilatation would be better tolerated than ICP elevations due to other causes.
A new suction cannula is described that is able to dissect and aspirate breast tissue. The cannula has proven effective in treating gynecomastia without surgical resection of breast tissue.
The major disadvantage of breast ptosis correction using the standard mastopexy procedure is the visible scarring. The use of an implant alone is often inadequate, especially in the more ptotic breast. A technique employing a submuscular expandable mammary prosthesis together with release of the breast tissue from the underlying muscle is described. This method enables correction of greater degrees of ptosis than is possible with implant placement alone.
A new cannula has been designed that facilitates liposuction procedures by increasing the amount of fat tissue breakdown before aspiration. The cannula allows for greater application and opens up new horizons in aspirative surgery.
Although Montgomery's tubercles are often prominent structures on the areola, little attention has been paid to their reconstruction. Present techniques for nipple-areola reconstruction result in a flat-appearing surface that is usually not characteristic of a normal areola with its projecting Montgomery's tubercles. We describe a technique for creating Montgomery's tubercles that has resulted in a more normal-appearing nipple-areola complex and a higher degree of patient satisfaction.
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Porcine liver was perfused by heated blood for 45 min. Vascular isolation was not needed as blood was collected from the aorta, heated and infused in the portal vein by a roller pump. Blood temperature was 43 degrees C, 43.2 degrees C, 43.6 degrees C and 44 degrees C. During perfusion, the liver was thermally insulated by a double layer polyethylene sheet. One pig died during perfusion because of a cardiac arrest, another pig after perfusion of 44 degrees C because of an acute liver failure. Serological examinations after perfusion showed a transient increase of liver enzymes. Morphological changes were obvious but seemed to be reversible. These examinations proved that by this method porcine liver can be heated precisely and homogeneously at temperatures required for extreme hyperthermia.
Several European studies have been conducted to confirm the efficacy, tolerability, and safety of a new oral contraceptive (OC) combining 250 micrograms norgestimate with 35 micrograms ethinyl estradiol (Ortho-Cyclen or Cilest). In a 12-month multicenter German study of 147 women, treatment with this formulation resulted in no pregnancies, a low incidence of side effects, and excellent cycle control. The drug had no effect on estrogen-mediated fibrin formation nor on the activity of coagulation inhibiting or promoting factors. Similarly, the documented low androgenicity of the highly selective progestational agent norgestimate results in a more positive metabolic profile. Glucose, insulin, and hemoglobin A1c concentrations measured before and after glucose loading were not adversely affected by treatment with the norgestimate-containing OC, and all changes were reversible on its discontinuation. In addition, lipid metabolism was positively influenced by the drug. Low-density lipoprotein cholesterol, a known risk factor for cardiovascular disease, was reduced while the cardioprotective lipid fraction, high-density lipoprotein cholesterol, was increased. Clinical trials to determine the OC's effects on coagulation, endocrine function, and carbohydrate and lipid metabolism are reviewed. Also discussed are several studies demonstrating the formulation's unique endometrial effects, which may possibly be related to its low androgenic activity and consequent low incidence of breakthrough bleeding and amenorrhea.
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