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Biomedical subjects

J L Ziegler

Publications and source records attributed to J L Ziegler.

At least 19 recordsLinked to original sources
PubMed1991

The value of a clinical definition for epidemic KS in predicting HIV seropositivity in Africa.

Kaposi's sarcoma (KS) in African adults can present in endemic (non-HIV-related) and epidemic (HIV-related) forms. We evaluated the usefulness of a clinical case definition for epidemic KS in predicting HIV seropositivity. A total of 235 patients with KS presenting to the Uganda Cancer Institute from January 1, 1988 to March 31, 1990 were evaluated with history and physical examination. Symptomatic patients underwent chest radiography and upper gastrointestinal endoscopy. One hundred seventy-four patients (80%) underwent HIV ELISA testing with Western blot confirmation. The clinical case definition had a 91% sensitivity and a 95% specificity in predicting HIV seropositivity. Oral KS was the most sensitive specific site of involvement in predicting HIV seropositivity. The clinical case definition is useful in assessing patients to determine prognosis and likelihood of responding to aggressive therapy.

Adolescent↗
PubMed1990

Kaposi's sarcoma: introduction and overview.

KS can be considered to be a paradigm for cancer development. It is readily observable in the skin and has a preneoplastic counterpart. Its development is related to geographic, environmental, genetic, and acquired conditions. Despite a reliably consistent histologic appearance, the tumor displays varied clinical manifestations and natural history that may be attributed to tumor and/or host determinants. Thus, this intriguing neoplasm lends itself to intensive epidemiologic, clinical, and biologic study in an attempt to pin down the etiologic covariants and to develop hypothetical models for further testing.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Intralesional recombinant tumor necrosis factor-alpha for AIDS-associated Kaposi's sarcoma: a randomized, double-blind trial.

The effect of recombinant tumor necrosis factor-alpha (rTNF), injected directly into the tumor, was evaluated in a Phase I/II study of 27 patients with AIDS-associated Kaposi's sarcoma (KS). The maximally tolerated intralesional dose was less than 100 micrograms/m2 and the recommended intralesional dose was 25 micrograms/m2. In a double-blind, randomized, placebo-controlled study, rTNF reduced the cross-sectional area of 15 of 16 (94%) of the injected KS lesions and caused complete disappearance of 3 of 16 (19%) lesions. Only injected lesions showed a response. Rigors and fever were common dose-dependent side effects and were attenuated by meperidine. There were no changes in human immunodeficiency virus (HIV) activity as determined by serum p24 antigen levels. While biologically active, the systemic toxicity of rTNF as well as the lack of distant antitumor effects in noninjected lesions limits its clinical usefulness under the conditions employed in this trial.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Primary central nervous system lymphomas in patients with AIDS.

Primary central nervous system non-Hodgkin's lymphomas are observed in approximately 1.9% of all patients with acquired immunodeficiency syndrome (AIDS). The yearly incidence of AIDS-associated tumors has surpassed the yearly incidence from all other causes and could become as frequent as low-grade astrocytomas by 1991. Patients' signs, symptoms, and radiographic studies are not specific for this lesion; brain biopsy usually is necessary to make a definitive diagnosis. Most tumors are high-grade lymphomas and are pathologically similar to the primary central nervous system lymphomas observed before the AIDS epidemic. AIDS-associated tumors respond readily to radiation therapy. However, patient survival remains limited owing to other manifestations of the syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Pathogenesis of AIDS-associated Kaposi's sarcoma.

Kaposi's sarcoma presents the oncologist with a myriad of unanswered questions. What accounts for the genesis, distribution, and natural history of this tumor? How could a tumor with such a singular histologic appearance occur in such diverse clinical circumstances? What accounts for the unusual geographic, ethnic, and demographic features of Kaposi's sarcoma? Clearly, the answers to these questions will involve a multifactorial etiology, and may only be arrived at by methodical, piecemeal dissection of each question.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Hypothesis: AIDS is an autoimmune disease directed at the immune system and triggered by a lymphotropic retrovirus.

By attaching to the CD4 (T4) molecule of the helper-inducer lymphocyte, the human immunodeficiency virus (HIV) envelope imitates the normal ligand for this receptor, namely, an invariant component of the class II major histocompatibility antigen (MHC). Depending on the degree of antigen mimicry, the normal immune response to retrovirus envelope would be expected to recognize and cross-react to self-MHC. By disguising as "self" the virus then provokes an autoimmune attack of class-II-bearing cells and an anti-idiotypic response to the CD4 antigen. As a consequence of this immune response to virus infection, communication between CD4 lymphocytes and antigen-processing cells becomes blocked, resulting in progressive disruption of antigen recognition, immunodysregulation, and dysfunctional responses of catastrophic proportion. If this hypothesis gains support, then there are profound implications for prevention and treatment.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Flow cytometric analysis of lymphocyte phenotypes in AIDS using monoclonal antibodies and simultaneous dual immunofluorescence.

Simultaneous dual immunofluorescence and flow cytometry was used to study sixteen lymphocyte phenotypes in 209 men including: healthy homosexuals, lymphadenopathy patients (LAN), and AIDS patients. Significant differences between the distribution of lymphocytes in healthy homosexuals and healthy heterosexuals were decreased percentages of helper/inducer T cells (Leu 3), increased cytotoxic/suppressor T cells (Leu 2), and consequently a decreased Leu 3/Leu 2 ratio. The increased Leu 2 cells were identified as functionally cytotoxic subset Leu 2+ 15- phenotype rather than suppressor cells which are Leu 15+. Leu 2 and Leu 3 bearing cells exhibited an excess of membrane-bound immunoglobulins which were easily elutable at 37 degrees C. An increased percentage of an HLA-DR framework determinant bearing T cells were also detected. Within the NK cell family, Leu 7 cells were moderately increased and the functionally unidentified Leu 2+ 7+ population was strikingly elevated. LAN or AIDS patients were compared to healthy homosexual controls. Lower percentages of Leu 3 cells and higher percentages of Leu 2 cells were evident in LAN patients. These subsets were similar in LAN and AIDS patients. The increase in Leu 2+ cells was due to the Leu 2+ 15- cytotoxic subset. Fewer T cells had immunoglobulin in LAN and AIDS. A definite increase in Leu 2+ DR+ cells but not Leu 3+ DR+ cells occurred in AIDS compared to LAN or healthy controls. NK cell changes already present in healthy homosexuals persisted in LAN and AIDS patients. No differences in the distribution of B cells was detected in any intergroup comparisons. Changes in monocytes or pan-T cells were relatively insensitive measures of immunologic alterations among any of the groups. These results indicate many of the changes in lymphocyte subsets seen in AIDS and LAN subjects are already present in a carefully screened population of healthy homosexuals in San Francisco. Many of the changes in Leu 2 and NK family of cells suggest a possible adaptive response to viral or neoplastic challenge. Whether these interesting phenotypic alterations relate to functional changes in response to such challenge of the identified subsets waits further investigation.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Early studies of Burkitt's tumor in Africa.

While still a trainee in oncology, John Ziegler had the unexpected opportunity to direct a Burkitt's tumor research project in Africa. He was given a leading role in conducting early studies on the treatment of this tumor. Dr. Ziegler's youthful zeal, administrative talent, and scientific ingenuity enabled him, in a relatively short time, to carry out fundamental studies on treatment of Burkitt's tumor as well to establish an outstanding center for cancer research in tropical Africa. The lessons learned from these studies have become principles for treatment of many other human cancers.

Burkitt Lymphoma↗
PubMed1985

AIDS and oncogenesis.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1979

Cure of Burkitt's lymphoma. Ten-year follow-up of 157 Ugandan patients.

192 Ugandan patients with Burkitt's lymphoma were treated with various regimens containing high-dose cyclophosphamide. 21 patients died during induction therapy, and 14 died after partial responses. Of 157 patients who responded completely to treatment, 16 were lost to follow-up (10 in 69 died and 72 (51%) are alive and disease-free. 31 of the long-term survivors have relapsed at least once and have been successfully retreated. Overall, 34 surviving patients had central-nervous-system involvement, also successfully treated. It is concluded that Burkitt's lymphoma is curable in at least 50% of patients, and that relapse and central-nervous-system involvement are not incompatible with long survival.

BCG Vaccine↗
PubMed1979

Radiographic manifestations of Burkitt's lymphoma in American patients.

Radiographic manifestations of Burkitt's lymphoma in 40 American patients are presented. Pleural effusions were the most common intrathoracic abnormality and were correlated with abdominal ascites more often than with intrathoracic tumor. Tumor involved bone in four patients had intrinsic bowel involvement; nine instances were in the ileum. Intrinsic renal tumor was seen in only two patients. Both ultrasound and computed tomography were useful.

Adolescent↗
PubMed1979

The present state of development of cancer chemotherapy.

Cancer chemotherapy has evolved through 3 decades of remarkable progress. At the present time over 40 drugs and biologicals are employed in the treatment of cancer, and hundreds of promising compounds and analogs await their turn in the clinic. The medical management of cancer patients with chemotherapy has developed into a recognized subspecialty--medical oncology, a discipline that now works closely and effectively with surgery and radiotherapy in planning treatment strategies. Major areas of progress to date include the concept of combination chemotherapy, the development of hematologic and microbiologic supportive care, and the demonstration of effective adjuvant chemotherapy. Further progress is anticipated in a number of areas: rational selection of anticancer compounds based on metabolic or kinetic vulnerability; increased attention to biologic substances that modify neoplastic cell behavior; continued refinement of doses and schedules of active compounds to optimize therapeutic benefit and minimize toxicity; awareness of novel methods of drug delivery; and development of physical or chemical modifications to enhance drug effects.

Antineoplastic Agents↗
PubMed1978

[Long-term, complete remission in non-Hodgkin's lymphoma following high-dosage combination therapy with or without autologous bone marrow transplantation].

22 patients with malignant non-Hodgkin lymphoma resistant to conventional chemotherapy were treated with high-dose combination chemotherapy followed in the first 12 patients by infusion of their cryopreserved autologous bone marrow. The next 10 patients received chemotherapy alone. Four patients died shortly after chemotherapy. Four patients remain in unmaintained remission 40, 30, 20 and 8 months after treatment. Patients receiving cryopreserved marrow recovered leukocyte, granulocyte and platelet function significantly faster and had significantly fewer febrile days than did controls. These findings demonstrate that high dose combination chemotherapy may benefit some patients unresponsive to conventional chemotherapy, and that cryopreserved bone marrow can speed hematopoetic recovery and be of clinical benefit to the patient.

Antineoplastic Agents↗