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Biomedical subjects

J Witt

Publications and source records attributed to J Witt.

At least 19 recordsLinked to original sources
PubMed2003

Single center experience of a new intensive induction therapy for ewing's family of tumors: feasibility, toxicity, and stem cell mobilization properties.

PURPOSE: To examine the feasibility, tolerability, and toxicity of an intensified induction regimen (vincristine, ifosfamide, doxorubicin, and etoposide [VIDE]) in patients with newly diagnosed Ewing's family of tumors (EFT); to assess ability to maintain dose-intensity, and predictability of peripheral-blood stem cell mobilization. PATIENTS AND METHODS: Thirty patients were treated with vincristine 1.4 mg/m2 (maximum 2 mg) on day 1, doxorubicin 20 mg/m2, ifosfamide 3 g/m2 plus mesna and etoposide 150 mg/m2 on days 1 to 3. Cycles were given every 21 days for up to six cycles. RESULTS: One-hundred and seventy cycles of VIDE were given. The median treatment interval was 21 days (21 to 42) and nadir count: hemoglobin 8.3 (6.3 to 11.9), neutrophils 0.045 (0.0 to 2.1), and platelets 45 (3 to 343). There were 96 episodes of infection requiring hospitalization (56%). Growth factor support reduced infectious complications by 34%. Etoposide dose was reduced, or omitted, in 24% of cycles. Four patients did not complete six cycles due to unacceptable toxicity and one patient progressed on treatment. Twenty patients underwent peripheral-blood stem cell harvesting, 15 after cycle 3, and five after cycle 4. Median CD34+ yield was 4.6 x 106/kg per patient (1.8 to 14.5). Overall response to treatment, measured in 24 patients, was 88%. Seven of 11 patients undergoing surgery achieved greater than 90% necrosis of tumor (64%). CONCLUSION: VIDE is an effective induction regimen with substantial but acceptable toxicity that allows predictable mobilization of stem cells. Maintenance of dose-intensity is feasible in the majority of patients. Growth factors play a role in maintaining dose-intensity and reduce infectious complications.

Adolescent↗
PubMed1996

The pelvic C-clamp for the emergency treatment of unstable pelvic ring injuries. A report on clinical experience of 30 cases.

An unstable pelvic ring injury was stabilized with the AO C-clamp in thirty multiply injured patients. The average ISS was 29 (19-57). Transfusions totalled 24 units of blood/fresh frozen plasma/platelets (0-117) on average. In 12 cases, the application was for an unstable fracture alone, in 18 patients there was an unstable haemodynamic situation in addition. The application was haemodynamically effective in 10 cases. In 66% of cases, the initial reduction was good and the anatomy of the pelvic ring was adequately restored. Ten patients (33%) died; five during the first hours after admission due to haemorrhagic shock; the remaining five from multiple organ failure, fat embolism and head injury. Definitive stabilization was accomplished after 4.5 days on average (0-15). Complications relating directly to the clamp did not occur. The application of the C-clamp has a clear place in the management of polytraumatized patients with linear unstable pelvic ring injuries.

Adolescent↗
PubMed1995

Biochemical characterization of basilase, a fibrinolytic enzyme from Crotalus basiliscus basiliscus.

Snake venoms, especially from the Crotalidae family, contain a variety of enzymes that prevent blood coagulation by virtue of their fibrinolytic enzymes. Nineteen snake venoms were screened for fibrinolytic activity and the highest activity was found in the venom of Crotalus basiliscus basiliscus venom. The active principle, basilase, was isolated, purified, and found to have fibrinolytic and fibrinogenolytic activity. It had a molecular weight of 22,000 and 1 mol of zinc per mole of protein associated with it. The proteolytic activity of the enzyme against dimethyl casein was inhibited by ethylenediaminetetraacetic acid and alpha 2-macroglobulin. It did not inactivate alpha 2-macroglobulin. Basilase did not have any of the following activities: thrombin-like, factor X-like, protein C activating, or urokinase-like. It caused neither hemorrhage nor platelet aggregation. In spite of its proteolytic activity, basilase did not hydrolyze the membranes of platelets. Basilase had 24% alpha-helix, 31% beta-sheet, 25% turns, and 20% unordered structure, as determined by Fourier Transform Infrared spectroscopy. Basilase is an enzyme that hydrolyzes fibrin directly without activation of plasminogen.

Amino Acid Sequence↗
PubMed1995

[Colloid carcinoma of the urachus. Cytologic diagnosis and differential diagnostic classification].

We report a rare case of colloid carcinoma apparently of urachal derivation. In a patient presenting with nycturia cytological analysis of urine led to a tentative diagnosis of colloid carcinoma of urachal origin. Endoscopic and radiological investigations confirmed this provisional diagnosis. For this reason, the surgical procedure could be properly planned and restricted to the removal of the apex of the bladder and urachus.

Adenocarcinoma, Mucinous↗
PubMed1995

Treatment with acarbose, an alpha-glucosidase inhibitor, reduces increased albumin excretion in streptozotocin-diabetic rats.

1. We examined the effect of the alpha-glucosidase inhibitor acarbose on urinary albumin excretion (UAE) in streptozotocin diabetic rats. 2. Treatment with acarbose for 8 weeks after induction of diabetes prevented the significant increase in UAE observed in untreated diabetic rats relative to nondiabetic controls. 3. Acarbose significantly reduced integrated glycemia, which correlated with albumin excretion rates, and exerts a salutary effect on diabetic renal dysfunction.

Acarbose↗
PubMed1995

Injuries in windsurfing due to foot fixation.

Two cases are reported: a 27-year-old man fractured the lower leg and an 18 year-old man sustained a rupture of the anterior cruciate ligament and medial collateral ligament during windsurfing. Both injuries may be ascribed to the fact that the patients' feet were fixed in footstraps and that their legs were twisted during the fall. Footstraps evidently represent a hazard, and action should be taken towards solving this problem. We suggest that either the footstraps be fitted with a release mechanism or surfers avoid using them.

Adult↗
PubMed1995

Consumer product branding strategy and the marketing of physicians' services.

Hospitals have traditionally maintained physician referral programs as a means of attracting physicians to their network of affiliated providers. The advent of managed care and impending healthcare reform has altered the relationship of hospitals and physicians. An exploratory study of marketing approaches used by twelve healthcare organizations representing twenty-five hospitals in a large city was conducted. Strategies encountered in the study ranged from practice acquisition to practice promotion. This study suggests that healthcare providers might adopt consumer product branding strategies to secure market-share, build brand equity, and improve profitability.

Attitude of Health Personnel↗
PubMed1995

The stability of children's physical activity as measured by accelerometry and self-report.

The Computer Science Application (CSA) accelerometer uses integrated circuitry and memory to provide a continuous recording of minute-by-minute movement counts. It has been previously validated as an objective monitor of children's physical activity in field and laboratory settings. Our purpose was to derive accelerometry summary variables reflective of different physical activity intensity levels, evaluate the stability of these summary variables, and define the number of days needed to adequately measure usual physical activity. A secondary study purpose was to compare three self-report questionnaires to accelerometry. Thirty children (7-15 yr) wore accelerometers for 12 h.d-1 for 6 d. Daily summary variables of average movement count (total physical activity) and daily frequency of sedentary through vigorous activity were constructed. Intraclass correlation coefficients (R) and 95% confidence intervals (CI) were used to analyze the data. Accelerometry stability using 1 monitored day to represent usual physical activity was R = 0.42-0.47. When 6 d were used, stability increased to R = 0.81-0.84. Acceptable intraclass correlations and CI were achieved with 4 d of monitoring (R = 0.75-0.78, CI = 0.60-0.88). The self-report questionnaires were poorly to moderately correlated to accelerometry variables (r = -0.03-0.51). Data indicate that in field settings: 1) accelerometry can be used to assess the intensity of children's activity and 2) 4 or more days of activity monitoring are needed to achieve satisfactory reliability.

Adolescent↗
PubMed1994

[Fournier gangrene].

Since first described in 1883 by Fournier only 420 cases of Fournier's gangrene have been published worldwide during the last 100 years. The anatomic association between the fascies of penis, scrotum, perineum, groin and gluteal favors the fast spread of tissue necrosis. We report two cases in which the penis, scrotum and a great part of the trunk and extremities were affected. Extensive débridement, including removal of the scrotum, and antibiotic treatment permitted us to get rid of the symptoms. Reconstruction of the skin defects was done in a second step by applying mesh grafts. The histological findings correspond to those found in cases of necrotizing fasciitis. The basic difference between these two illnesses is their localization. While Fournier's gangrene, as a special form, is localized primarily in the anogenital area, fasciitis may arise in all locations. For successful treatment of Fournier's gangrene speedy radical débridement and local application of antibiotics to cover the entire area are required.

Adult↗
PubMed1993

Childhood predictors for high adult blood pressure. The Muscatine Study.

In adult populations, elevated blood pressure is related to the development of stroke, renal disease, and occlusive atherosclerosis. The significance of blood pressure levels in childhood, unless extremely elevated, has not been related to disease outcomes. In a study carried out in Muscatine, Iowa, the risk of high blood pressure in young adult life was evaluated based on the observations of blood pressure and other factors made during the school-aged years. Subjects, 2445 in number, were first observed at ages 7 through 18 years and again between 20 and 30 years. During childhood, measurements of blood pressure, height, and weight were made on alternate years. At adult ages, the same measurements were again made and a health questionnaire was administered. Adult blood pressure was correlated with childhood blood pressure, body size, and change in ponderosity from childhood to adult life. Adult ponderosity was related to childhood ponderosity, and those who were most obese as adults showed the greatest increase in weight from their childhood years. These observations suggest that strategies to prevent the acquisition of excess ponderosity during childhood may be useful in preventing adult hypertension.

Adolescent↗
PubMed1993

Purified haemoglobin preparations in the evaluation of HbA1c determination by ion exchange chromatography.

The use of ion exchange resins for the estimation of HbA1c in clinical samples rests on the assumption that HbA1c is effectively and efficiently separated from other N-terminally modified haemoglobins and from HbA0. To test this assumption, we applied highly purified preparations of HbA(1a+1b, HbA1c and HbA0 to ion exchange minicolumns, using conditions of application simulating actual blood samples and the first and second elution buffers provided by the manufacturer. The authenticity and purity of the applied haemoglobin preparations were documented by high performance liquid chromatography, gel electrophoresis and carbohydrate content. About 40% of the applied HbA(1a+1b) eluted in the first fraction; 45% eluted in the second fraction, and 10% to 15% required 1 mol/L NaCl to elute from the column. Of the applied HbA1c, 65-80% eluted where expected in the second fraction, about 20% required 1 mol/L NaCl to elute from the column, and the remainder eluted with HbA(1a+1b). Some 3-6% of pure HbA0 applied to minicolumns emerged in the second fraction, with the remainder eluting as expected after making the buffer 1 mol/L in NaCl. The results indicate that the fraction eluting from ion exchange minicolumn chromatography that is designated 'HbA1c' contains HbA(1a+1b), and that a substantial portion of the HbA1c in an applied sample does not elute in this fraction.

Chromatography, High Pressure Liquid↗
PubMed1991

Treatment of de Quervain tenosynovitis. A prospective study of the results of injection of steroids and immobilization in a splint.

In a prospective study of non-operative treatment of de Quervain tenosynovitis, ninety-nine wrists of ninety-five consecutively seen patients who had this diagnosis had an injection of one milliliter of a 1 per cent lidocaine solution and one milliliter of a suspension containing forty milligrams of methylprednisolone acetate. Twelve patients (twelve wrists) were lost to follow-up. Of the remaining eighty-seven wrists, fifty-four (62 per cent) had a satisfactory outcome at a mean of eighteen months (minimum follow-up, twelve months). The duration of symptoms before treatment did not affect the outcome. The result in thirty-three wrists (38 per cent) was considered unsatisfactory. Thirty of these wrists were subsequently treated with operative release of the first dorsal compartment, and twenty-two (73 per cent) of the thirty were found to have a separate compartment for the extensor pollicis brevis. The prevalence of a separate compartment is significantly higher than that in the general population, as shown in anatomical studies of cadavera.

Adolescent↗
PubMed1990

[The value of magnetic resonance tomography in the diagnosis of renal space-occupying lesions].

41 patients (45 renal tumours) were examined by magnetic resonance imaging to assess the value of the method and its use to specify renal tumours. Histological findings were available in 38 cases. The results of MRI were compared with the CT and ultrasound diagnosis and the histological findings. In 92.1% (35/38) the CT-diagnosis agree with the histological findings, the ultrasound in 76.3% (29/38) and the MRI in 84.2% (32/38). To specify renal tumours the diagnosis by CT-scan and ultrasound is sufficient.

Adult↗
PubMed1990

[Diagnosis and differential diagnosis of hepatic artery aneurysms].

Four cases of intra- and extrahepatic aneurysms of the hepatic artery are discussed concerning the etiology, symptoms, therapy and complication rate. The diagnostic approach and problems in differential diagnosis are specified. Localization of the aneurysm and especially the relationship of the collateral circulation of the hepatic bed are essential to plan the therapy and are based on angiography. Interventional therapeutic techniques are favored for intrahepatic localization. Reconstructive or ablative surgery is indicated to treat the extrahepatic aneurysm.

Aneurysm↗