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J Schultze

Publications and source records attributed to J Schultze.

At least 19 recordsLinked to original sources
PubMed2005

Fast T1- and T2-weighted pulmonary MR-imaging in patients with bronchial carcinoma.

PURPOSE: A prospective study to evaluate the diagnostic potential and limitations of three fast MRI sequences in patients with bronchial carcinoma based on the comparison with spiral CT. MATERIAL AND METHODS: Three fast chest MRI sequences from 20 patients with central or peripheral bronchial carcinoma were evaluated by two observers for relation of tumour to adjacent structures, lymph node enlargement, additional pulmonary lesions and artefacts. The information from MR-imaging was compared with the results from spiral CT. MRI comprised a T1-3D-GRE breath-hold examination ("VIBE", TR/TE 4.5/1.9 ms, flip-angle 12 degrees , matrix 502 x 512, 2.5 mm coronal slices), a breath-hold, T2-HASTE sequence (TR/TE 2000/43 ms, matrix 192 x 256, 10 mm coronal slices) and a respiration-triggered T2-TSE sequence (TR/TE 3000-6000/120 ms, matrix 270 x 512, 6 mm transverse slices). The FOV was adapted individually (380-480 mm). RESULTS: The presence of the primary bronchial carcinoma and infiltration of thoracic structures by tumour tissue could be demonstrated by all sequences. VIBE sequence was more suitable for detecting small pulmonary nodules than the other MRI examinations, but compared to CT still 20% of these lesions were missed. Contrary to VIBE and T2-weighted TSE scans, HASTE sequence was limited in imaging mediastinal lymph nodes due to missing relevant findings in 2/20 patients. HASTE images significantly provided the lowest rate of artefacts in imaging lung parenchyma (P < 0.001 in peripheral parenchyma), but spatial resolution was limited in this sequence. Concerning the differentiation between tumour and adjacent atelectasis (n = 8), T2-weighted TSE imaging was superior to CT and VIBE in all cases and to HASTE sequence in 4/8 patients. CONCLUSION: The combination of VIBE and HASTE sequence allows for an adaequate imaging of thoracic processes in patients with bronchial carcinoma, limited only in visualizing small pulmonary nodules. To obtain more detail resolution and to differentiate tumour tissue from adjacent atelectasis, T2-TSE examination may be added in selected cases.

Aged↗
PubMed2004

Isolated bacterial meningitis as the key syndrome of infective endocarditis.

BACKGROUND: Bacterial meningitis is an unusual first manifestation but a major complication of infective endocarditis. PATIENTS AND METHODS: We present three well documented cases of isolated bacterial meningitis in endocarditis. Against this background we review the literature. RESULTS: All patients presented with bacterial meningitis. Staphylococcus aureus was isolated in blood cultures of all patients, but was found only in the cerebrospinal fluid (CSF) of one patient. The underlying endocarditis was confirmed histologically in all three cases. Two patients recovered completely and one died. CONCLUSION: An extensive search for endocarditis is recommended in every case of an unusual isolate in bacterial meningitis whether it is isolated from blood or CSF.

Aged↗
PubMed2004

CD40 activation: potential for specific immunotherapy in B-CLL.

Despite encouraging scientific and therapeutic advances, chronic lymphocytic leukemia (CLL) principally remains an incurable disease. Allogeneic transplantation represents the only curative approach, but is marked by high mortality. Novel and less toxic treatment modalities are needed. Immunotherapeutic approaches have clearly demonstrated potential effectiveness in CLL and other B-cell malignancies. To successfully direct immunity against CLL, highly immunogenic tumor cells or tumor-antigen-loaded antigen-presenting cells are necessary. The CD40-CD40L interaction has been shown to significantly increase antigen presentation in normal and malignant B-cells. Here we discuss biology and potential therapeutic applications of the CD40-system in CLL.

Antigen Presentation↗
PubMed2001

Primary gastrointestinal non-Hodgkin's lymphoma: I. Anatomic and histologic distribution, clinical features, and survival data of 371 patients registered in the German Multicenter Study GIT NHL 01/92.

PURPOSE: The study was initiated to obtain epidemiologic data and information on anatomic and histologic distribution, clinical features, and treatment results in patients with primary gastrointestinal non-Hodgkin's lymphomas (PGI NHL). PATIENTS AND METHODS: Between October 1992 and November 1996, 371 PGI NHL patients were eligible to evaluate clinical features. Radiotherapy and chemotherapy were stratified according to histologic grading, stage, and whether surgery had been carried out or not. RESULTS: A total of 74.8% patients had gastric NHL (PGL). Within the intestine, the small bowel and the ileocecal region were involved in 8.6% and 7.0% of the cases, respectively. Multiple GI involvement (MGI) was 6.5%. Approximately 90% of the GI NHL were in stages IE/IIE. Aggressive NHL accounted for the majority, with a distinguishable pattern in several sites. Forty percent of PGL were of low-grade mucosa-associated lymphatic tissue type. One third of large-cell lymphomas had low-grade components. Most intestinal NHL were germinal-center lymphomas. The site of origin was prognostic. In gastric and ileocecal lymphoma, event-free (EFS) and overall survival (OS) were significantly higher as compared with the small intestine or MGI (median time of observation, 51 months). In PGL, localized disease was prognostic for EFS and OS. Histologic grade influenced only EFS significantly. Numbers in intestinal lymphomas were too small for subanalyses. CONCLUSION: PGI NHL are heterogeneous diseases. The number of localized PGL allowed for detailed analyses. Larger studies are needed for stages III and IV and for intestinal NHL. A uniform reporting system for PGI NHL, in terms of definitions and histologic and staging classifications, is needed to facilitate comparison of treatment results.

Adolescent↗
PubMed2001

Primary gastrointestinal non-Hodgkin's lymphoma: II. Combined surgical and conservative or conservative management only in localized gastric lymphoma--results of the prospective German Multicenter Study GIT NHL 01/92.

PURPOSE: The aim of the study was to obtain data on anatomic and histologic distribution, clinical features, and treatment results of patients with primary gastrointestinal non-Hodgkin's lymphomas, particularly combined surgical and conservative treatment (CSCT) versus conservative treatment (CT) alone for primary gastric lymphoma (PGL) in localized stages. PATIENTS AND METHODS: Whether the treatment included surgery was left to the discretion of each participating center. Radiotherapy (Rx) and chemotherapy were stratified according to histologic grading, stage, and the inclusion or omission of surgery as follows: patients with low-grade PGL were treated with extended-field (EF) Rx (30 Gy). In case of residual tumor after surgery or in case of CT only (in stage IIE after six cycles of cyclophosphamide, vincristine, and prednisone), an additional boost of 10 Gy was given. All patients with high-grade PGL were treated with four (stage IE) or six (stage IIE) cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone followed by EF Rx (stage IE) or involved-field (IF) Rx (stage IIE). Rx dosage corresponded to low-grade NHL. RESULTS: Between October 1992 and November 1996, 106 patients had CT only. The survival rate (SR) after 5 years was 84.4% and was influenced neither by patients' characteristics nor by stage or histologic grade. Seventy-nine patients had CSCT. Their SR was 82.0%. Complete resection of the tumor (R0) was prognostic for the overall survival (P =.0165) as compared with incomplete resection. CONCLUSION: Although the study was not randomized, a stomach-conserving approach may be favored.

Aged↗
PubMed2001

MCP-1 modulates chemotaxis by follicular lymphoma cells.

The localization and establishment of follicular lymphoma (FL) cells in distinct anatomic sites probably involves chemokine and adhesion receptors on the neoplastic cells and appropriate chemokines and adhesion receptor ligands in the microenvironment. Several chemokines play an important role in normal B-cell trafficking and differentiation. Monocyte chemoattractant protein-1 (MCP-1) is a C-C chemokine that induces chemotaxis of a variety of lymphoid cells through its receptor CCR2. CCR2 is also expressed on B cells, and MCP-1 induces chemotaxis of normal B cells. In this report, we investigated expression and function of CCR2 on FL cells. We found FL cells as well as the t(14; 18)+ B-cell lymphoma line H2 expressed CCR2. MCP-1 potentiated SDF-1-induced chemotaxis of FL cells and H2 cells, but MCP-1 alone did not induce chemotaxis. The specificity of the effects of MCP-1 and SDF-1 was demonstrated by antibody blocking studies. Because FL cells are generally associated with follicular dendritic cells (FDCs), FDCs may be an important source of chemokines. We found that cultured FDCs produced MCP-1, and this production was enhanced by tumour necrosis factor. These data implicate MCP-1 in the migration and localization of FL cells.

Antibodies, Monoclonal↗
PubMed2000

[The age-specific results of the adjuvant radiotherapy of breast carcinoma].

BACKGROUND: Aim of our work was to evaluate the standards of treatment in elder women with breast cancer and their results of radiation therapy. PATIENTS AND METHODS: In our hospital 218 breast cancer patients were treated in the years 1990 and 1991. Forty-three women were younger than 50 years of age (group I), 92 between 50 and 64 years (group II), 83 elder than 64 years (group III). One hundred and forty-nine patients underwent mastectomy, 65 patients had conservative treatment (Table 5). Four patients were not operable. All of the patients were irradiated uniformly loco-regionally with 50 Gy Co-60-photons, followed by a boost to the tumor bed with 10 Gy with 6- to 12-MeV electrons. Forty-four patients had an additional chemotherapy. RESULTS: The 5-year survival rate was 79.8% (n = 174), the disease free survival was 59.1% (n = 129) (Table 6). The mean rate of local recurrence was 3.6% (n = 8), 4% after mastectomy (n = 6) and 3% (n = 2) with breast conservation. Age group specific 5-year survival rates were 72% (I), 85.6% (II) and 77.1% (III), respectively, disease free survival rates were 48.8% (I), 65.2% (II) and 57.8% (III), respectively. The rates of local recurrence were 9.3% (I), 3.2% (II) and 1.2% (III), respectively. Significant age group specific differences in surgical and radiotherapeutical treatment could not be found. CONCLUSION: The curative chance of treatment has to be used in every age. A treatment of elder patients below the actual valid standards of treatment is not justified.

Adult↗
PubMed2000

[Tumors of the anterior skull base. Effects of perioperative imaging on adjuvant radiotherapy planning].

OBJECTIVES: Treatment of anterior skull base tumours is still considered being a major challenge for all involved disciplines. Surgical management, complications, as well as the role of imaging for multimodality treatment options should be evaluated critically. PATIENTS AND METHODS: 57 patients underwent interdisciplinary one step trans-basal approaches for resection of benign and malignant anterior fossa tumours. Beside assessment of surgical results and perioperative morbidity, in 13 patients with malignant tumours perioperative imaging was evaluated with regard to further possible radio-oncological treatment options. RESULTS: Applying trans-basal approaches radical tumour resection could be achieved in all cases independent of tumor-size (diameter 12-114 mm). Permanent postoperative complications (until 6 months postoperatively) were found in 4 cases (7%), transient complications in 7 cases (12.3%). Evaluation of perioperative imaging showed a heterogen use of different imaging modalities and revealed lack of standardization, hampering further planning of radiation therapy. CONCLUSION: Treatment of anterior skull base tumours requires a maximum level of standardization of perioperative imaging, to grant a successful surgical and radio-oncological interdisciplinary patient management.

Adenocarcinoma↗
PubMed2000

[Results of radiotherapy in brain metastasis].

PURPOSE: To evaluate the effect of radiation therapy in the treatment of brain metastases. PATIENTS AND METHODS: Fifty-eight patients with brain metastases were irradiated. In 52 patients the post-therapeutic survival time could be evaluated. Most frequent basic tumor entity was lung cancer, followed by breast cancer. Eighteen patients underwent neurosurgery prior to radiation therapy, 23 patients underwent only radiotherapy and in 13 patients an additional chemotherapy was performed. Four patients were treated by all these means. Radiation therapy was done as a whole brain irradiation with a total dose of 40 Gy at single doses of two Gy or 30 Gy at single doses of 3 Gy respectively. RESULTS: There were no radiogenic complications. 42 of 58 patients (72%) showed an improved neurological status. In ten patients radiation therapy had to be abandoned due to deterioration of the patients condition, five patients died in the hospital. Mean survival time for all the patients were 213 days, by subtracting the preterminally treated patients the time improved up to 269 days. The prognosis was dependant of several factors. Main importance had the basic tumor entity itself leading to a mean survival time in breast cancer patients of 347 days in contrary to those with lung cancer and 152 days mean survival time. Good general status, young age and solitary metastasis were positive predictive factors. CONCLUSIONS: Radiation therapy is capable to improve quality of life and to prolong survival after an only short treatment period. Treatment should be initiated quickly and consequently after diagnosis.

Adult↗
PubMed1999

[Outcome of primary combined radio-chemotherapy in head and neck tumors with simultaneous salivary gland protection by amifostine].

AIM: Demonstration and critical evaluation of the use of cytoprotective agents in radiation therapy. PATIENTS AND METHODS: In 1996 9 patients with head and neck tumors were irradiated with a mean dose of 66 Gy and simultaneous application of amifostine. Primaries were in the oropharynx (3), tongue (2), tonsils (2) as well as nasopharynx and soft palate. Parallel carboplatin was administered 6 times with a dose of 100 mg/week and amifostine twice a week with 500 mg over 6 weeks. The evaluation was performed clinically and by sialoscintigraphy (Figure 1). RESULTS: There were no lasting side effects, but episodes of hypotension in 7 of 9 patients and nausea. Radiogenic acute toxicity was nearly uneffected, complaints from xerostomia, however, were diminished. All patients showed increased dermal pigmentation and dermatitis. Sialoscintiraphies 6 months after therapy proved better salivary gland function with correlated better patient condition. CONCLUSION: Amifostine might gain a role in the prevention of lasting radiogenic xerostomia. The required dose is not yet clear. A broader use of amifostine would be favored by lower costs of the substance.

Amifostine↗
PubMed1998

[Late results of radiotherapy of soft tissue sarcoma].

PURPOSE: To evaluate the effect of radiation therapy in the treatment of soft-tissue sarcomas. MATERIALS AND METHODS: Between March 1970 and January 1990, 58 patients with soft-tissue sarcoma were referred for radiation therapy. The most frequent histologic diagnoses included fibrosarcoma (n = 15), neurofibrosarcoma (n = 5) and rhabdomyosarcoma (n = 5). Central tumor sites in the trunk (n = 31) were much more frequent than in the head and neck region (n = 14) or the extremities (n = 13). Thirty-nine of 58 primary tumors were bigger than 5 centimeters. Forty-five patients were irradiated after surgery, 5 patients prior to surgery; in 8 cases only radiation therapy was used. Radiation therapy was performed with Co-60 photons and an average total dose of 58 Gy, fractionated in single doses of 2 Gy. The treatment results were obtained by actual follow-up examinations. RESULTS: Twenty-three of 58 patients survived at least 5 years (39.9%). Of 15 patients with R0 resection 11 were alive after 5 years (73.3%). Local tumor control was achieved in 34 of 58 patients (58.6%). Low 5-year-survival rates were associated with dedifferentiation of the primary tumor (three survivors in 10 patients with G3 tumor), tumor diameters over 5 cm (13 survivors of 39), R2 resection (3 survivors of 16) and tumor sites in the body trunk (11 survivors of 31). CONCLUSIONS: (1) The best results of radiation therapy were achieved after R0 resection of the primary tumor. (2) Tumors in the trunk are prognostically worse because of bigger tumor diameters due to later diagnosis.

Female↗
PubMed1998

[Occult fracture of the femoral neck fractures of the proximal femur].

Bone scintigraphy is a highly sensitive method for the detection of fractures. In case a trauma and clear clinical signs are evident, but the radiography is inconspicuous, bone scintigraphy may lead to the final diagnosis. In the present case of an occult fracture in the proximal femur only scintigraphy indicated the fracture, which then was proved topographically by magnetic resonance imaging.

Aged↗
PubMed1997

Rapid Ca2+-dependent NO-production from central nervous system cells in culture measured by NO-nitrite/ozone chemoluminescence.

We have established simple and reliable measurement of constitutive nitric oxide (NO) synthase-dependent nitrite formation in supernatants from primary central nervous system (CNS) cells in culture using NO-ozone chemoluminescence. We found that: (1) astrocytes, endothelial cells and cerebellar granule cells produce NO upon stimulation with the calcium ionophore A23187 (1 microM); (2) application of 100 microM glutamate for 2 min results in NO-production in cerebellar granule cells and cortical neurons. NO-formation upon application of 50 mM KCl was found in cortical neurons; (3) in cultivated cerebral endothelial cells, an inducible form of NO-synthase (iNOS) is found under standard culture conditions. This induction was blocked by dexamethasone applied for at least 48 h and stimulation of constitutive NOS was detectable while iNOS was inhibited. The activity of iNOS was selectively inhibited by application of aminoguanidine for 48 h. Our results suggest that all major CNS cells implied in cerebral blood flow regulation and neurovascular coupling are capable of rapidly producing the vasodilator NO upon intracellular increases of the universal second messenger calcium.

Animals↗
PubMed1997

Induction of anti-mistletoe lectin antibodies in relation to different mistletoe-extracts.

Mistletoe extracts are frequently applied in adjuvant cancer treatment. The mistletoe lectins are especially suggested to mediate an antitumorous effect. During treatment with mistletoe lectin-rich extracts, anti-mistletoe lectin antibodies preferentially of the immunoglobulin G type are produced against mistletoe lectin (ML)-1. Interestingly, after application of mistletoe extracts containing natural micelles, anti-mistletoe lectin antibodies of the immunoglobulin G as well as one of the immunoglobulin E type were induced in parallel, suggesting that the nature and preparation of the antigens within the extract modifies immune responses. Anti-mistletoe lectin antibodies were shown to neutralize the cytotoxic effect of mistletoe lectin on peripheral blood mononuclear cells in vitro. Thus, the mode of application of these extracts seems to be of importance with respect to the therapeutic effect.

Antibodies↗