Biomedical subjects
Publications and source records attributed to H Kölbl.
A new chitinase inhibitor, named argifin, was isolated from the cultured broth of a fungal strain FTD-0668. The strain was identified as Gliocladium sp. from morphological characteristics. The IC50 value of argifin against Lucilia cuprina chitinase was 3.7 microM. Argifin arrested the moult of cockroach larvae upon injection into the ventral abdominal part.
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Since angiogenesis is considered essential for tumor growth and the development of metastasis, we assessed the correlation of microvessel density (MVD) with overall survival in patients with epithelial ovarian cancer. Histologic slides were immunostained for CD34-antigen. MVD was determined within each tumor by enumeration under a light microscope at 200x magnification and an examination area of 0.25 mm2. The Cox proportional-hazards model was used for multivariate analysis. In 63 patients with epithelial ovarian cancer the 5-year survival rate (OS-%) was as follows: 55.0% (+/-12.5) in 18 patients whose tumors had an MVD < 10/field, and 23.6% (+/-6.7) in 45 patients whose tumors had an MVD(10/field (log-rank P = 0.038). MVD showed a significant influence on survival in univariate analysis, but failed to attain a significant value after adjustment for established prognostic parameters such as patients' age at diagnosis, stage of disease, and histologic grading. High MVD was significantly associated with advanced patients' age at diagnosis. This and a considerable heterogenity in the vascular architecture of ovarian carcinoma tissue might be the reasons why MVD did not reveal prognostic significance in multivariate analysis. In contrast to a variety of solid neoplasms, MVD does not seem to be a useful predictor of survival in patients with epithelial ovarian cancer.
OBJECTIVE: The benefit of primary or adjuvant irradiation in the treatment of mixed Müllerian tumors is still not clear. METHODS: During 1981-1997 63 patients were referred for primary (n = 13) or postoperative (n = 50) radiotherapy. Analysis of outcome of primarily and postoperatively irradiated patients was performed separately because of different staging systems. Of 50 patients treated after surgery 29 presented in histopathologic stage I, 4 in stage II, 14 in stage III, and 3 in stage IV. Clinical stage distribution for primary treatment was stage I: n = 9, stage II: n = 1, stage III: n = 3. Forty-four patients in the postoperatively treated group and 6 in the primarily treated group received radiotherapy with a curative intent; external beam therapy was given up to 56 Gy to the pelvis combined with intravaginal or intracavitary brachytherapy. RESULTS: Five-year actuarial overall survival, disease-specific survival, local control, and distant control for 50 patients receiving adjuvant irradiation was 52.9, 57. 5, 83.4, and 70.8%, in stage I: 68.4, 76.1, 95.2, and 81.7%, in stage II: 50.0, 50.0, 75.0, and 66.7%, and in stage III: 31.3, 34.1%, 70.4, and 47.6%, respectively. Four of 13 patients treated with primary irradiation achieved long-term local control. CONCLUSION: These data suggest that adjuvant radiotherapy improves local control and disease specific survival in the treatment of mixed Müllerian tumors compared to data in the literature concerning treatment by surgery alone.
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BACKGROUND: Tumor anemia is a common symptom in cancer patients. This study assessed the prognostic relationship of pretreatment serum hemoglobin levels to survival in a retrospective sample of 206 patients with epithelial ovarian carcinoma. METHODS: Survival analysis was evaluated by univariate (Kaplan-Meier product limit method and log rank test) and multivariate (Cox proportional hazards model) analysis. Mean values were compared by the Kruskal-Wallis test. Serum hemoglobin levels were determined in each patient 24-48 hours before surgery. Anemia was defined as a serum hemoglobin value below 12 g/dL. RESULTS: Tumor anemia was present in 32% of the patients before primary surgery. Hemoglobin levels were significantly lower in patients with residual tumor than in those with no detectable residual tumor after initial surgery (P = 0.008). Although statistically not significant, we found a trend toward lower hemoglobin levels with advanced stage of disease. For 5 years, overall survival probability was 38.5% and 52.3% for patients with pretreatment hemoglobin levels P = 0.008). In multivariate analysis, the relative risk of death was significantly associated with decreasing serum hemoglobin levels. No interaction was found between the grade of anemia and chemotherapy or radiation therapy with respect to its influence on overall survival. CONCLUSIONS: After adjustment for established prognostic factors, tumor anemia was found to have an independent relationship to the overall survival of patients with ovarian carcinoma. Because no significant interaction could be found between the grade of anemia and chemotherapy, marked tumor anemia was considered an indicator of the presence of biologically aggressive tumor cell clones.
OBJECTIVE: To test the hypothesis that infection with Helicobacter pylori is associated with hyperemesis gravidarum. METHODS: From January 1995 to November 1996 we enrolled 105 patients with hyperemesis gravidarum in a prospective study. The Helicobacter serum Immunoglobulin (Ig) G concentrations in these patients were compared with those in asymptomatic gravidas matched for week of gestation. RESULTS: Positive serum IgG concentrations were found in 95 of the 105 hyperemesis patients (90.5%) compared with 60 of 129 controls (46.5%). A chi2 test showed statistical significance (P < .001). The mean (+/-standard deviation) index percentages of the IgG titers were 74.2+/-23.6% in the hyperemesis group and 24.3+/-4.4% in the control group (P < .01, Student t test). CONCLUSION: Infection with H pylori may cause hyperemesis gravidarum.
In the present report, a case of high-risk choriocarcinoma (Figo stage IV, WHO score 12) with persisting vaginal and urethral bleedings is described. In addition to a course of multiagent chemotherapy, arterial embolization of both iliac vessels using Gianturco coils was carried out. This caused a dramatic improvement of the patient's general condition. A subsequently performed laparatomy with extirpation of the uterus and both adnexa finally led to remission.
We investigated the expression of CD44 isoforms containing variant exons v5, v6 and v7-8 in 115 human breast cancer specimens by means of immunohistochemistry. CD44 isoforms CD44v5, CD44v6 and CD44v7-8 were detected in 56% (n = 64), 24% (n = 28) and 15% (n = 17), respectively. In 36 specimens of axillary lymph node metastasis, expression of CD44v5, CD44v6 and CD44v7-8 was found in 94% (n = 34), 92% (n = 33) and 89% (n = 32), respectively. Five year survival rates with or without CD44v5 and CD44v6 expression were 71% versus 86% (log-rank test, P = 0.02) and 62% versus 81% (log-rank test, P = 0.001), respectively. For disease-free survival, expression of CD44v5, CD44v6 and CD44v7-8 showed a prognostic impact (log-rank test, P = 0.004, P = 0.0001 and P = 0.0001, respectively). However, multivariate analysis revealed that all investigated CD44 isoforms failed to be independent predictors of the patient's outcome.
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Twenty-five cases of squamous cell carcinoma of the vulva were examined for p53 protein overexpression using immunohistochemistry. p 53 protein overexpression was associated with poorer overall survival.
BACKGROUND: Overexpression of the p53 protein has been reported to correlate with poor prognosis in several types of tumors. To the authors' knowledge, there are no studies concerning the prognostic value of p53 protein overexpression in squamous cell vulvar carcinoma. METHODS: Twenty-five cases of squamous cell carcinoma of the vulva with International Federation of Gynecology and Obstetrics (FIGO) Stage I-II were examined for p53 protein overexpression using immunohistochemistry. The correlation of p53 protein overexpression with clinical stage, histologic grade, and overall survival was investigated. Follow-up ranged from 36 to 120 months. RESULTS: Clinical stage and histologic grade did not correlate with p53 protein overexpression. p53 protein overexpression was associated with poorer overall survival (log rank: P < 0.05). CONCLUSION: Immunohistochemically detected p53 protein overexpression is significantly correlated with a reduced overall survival rate for patients with vulvar carcinoma.
OBJECTIVE: Aberrant expression of specific isoforms of the cell adhesion molecule CD44 has been detected in various malignant human tumors. We wanted to verify whether the expression of these splice variants was associated with a higher incidence of metastasis and poor prognosis. METHODS: We studied the expression of CD44 splice variants v5, v6 and v7-8 by immunohistochemistry in human cervical cancer. 105 surgically treated patients with cervical cancer of stages IB-IIB were included in the study. RESULTS: Tumors expressing exon v6 had significantly more often metastasized to the pelvic nodes (p = 0.04), and patients suffering from tumors expressing CD44v6 showed poorer overall survival. Even in cases with negative pelvic lymph nodes, we found a significantly poorer prognosis when tumors expressed CD44v6. CONCLUSIONS: Among the investigated CD44 splice variants, expression of exons v6 and v7-8 is the most promising prognostic marker in cervical cancer. They can possibly identify patients with an increased risk earlier than morphologic prognostic parameters.
During the last years, clinical applications and studies of gynecologic endoscopy have gained increasing importance. With regard to vaginal surgery, questions arise about single and combined use of endoscopy and vaginal techniques. Beside sufficient pretherapeutic assessment and patient information, evaluation of these indications requires prospective randomized and comparative trials. Thus, the clinical impact of combined endoscopic and vaginal techniques can be assessed on the basis of objective data. The alternative to this kind of evaluation of new surgical techniques is uncontrolled human experimentation which is neither scientific nor ethical.
OBJECTIVE: To assess the influence of spinal anesthesia on bladder neck position and a clinical stress test in continent women. METHODS: In a prospective investigation, 14 women underwent urodynamic, sonographic and clinical assessment during spinal anesthesia. Results were compared to those obtained immediately preoperatively in the same patient. RESULTS: During spinal anesthesia, the bladder neck was found to be located significantly lower and more posterior, and in 4/7 parous patients (0/7 nullipara) the clinical stress test was positive. CONCLUSION: These data provide additional evidence for the importance of neuromuscular function in the etiology of pelvic floor dysfunction and genuine stress incontinence.
The present multicentre Austrian investigation of the prophylactic intravenous administration of granisetron, a serotonin antagonist, routinely for control of cytostatic-induced nausea and emesis was carried out in 102 patients with cancer of various types undergoing different emetogenic cytostatic regimens (232 cycles of chemotherapy). A major therapeutic response, i.e. maximally one vomit over the first 24 hours, was achieved in 78-90% of patients undergoing a single or multiple day regimen of chemotherapy. Delayed emesis, experienced between day 1 and day 4 after chemotherapy, was observed in < 5% of the patients. However, particularly in single day regimens 25% of the patients showed only a moderate response to granisetron in suppressing delayed emesis. Tachyphylaxis to granisetron therapy was not observed in the first 3 consecutive cycles of chemotherapy. The individual global efficacy of emesis control by granisetron (day of chemotherapy over all cycles plus the following 7 days) was very good. An excellent therapeutic response was seen in 53-55% of all cases. The study also demonstrated the economic advantages of granisetron therapy. In the majority of patients (88/102) only a single dose of granisetron (3 mg) was required. The tolerability was also very good. The main adverse events reported were headache (7.8%) and constipation (4.9%).
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