Biomedical subjects

J Zahner

Publications and source records attributed to J Zahner.

23 records · Page 2Linked to original sources

PubMed1994

Results of conventional-dose cytosine arabinoside and idarubicin in elderly patients with acute myeloid leukemia.

Conventional-dose Ara-C (200 mg/m2 d 1-5) combined with idarubicin (12 mg/m2 d 1-3) was employed as remission induction and consolidation therapy in 23 elderly AML patients with a median age of 66 years (range, 60-75) with AML according to the FAB criteria (M1 n = 3, M2 n = 10, M4 n = 6, M5 n = 2, M6 n = 2), eligible for the study. In seven patients earlier MDS had been documented by previous bone marrow aspirates. The CR rate after one induction course was 65% (15/23). Toxicity was acceptable, with four patients dying during the chemotherapy-induced hypoplasia (4/23). Although 80% of the CR patients received two additional cycles of Ara-C and idarubicin as consolidation therapy, only two patients are still in continuous complete remission more than 12 months after achieving CR. The median disease-free survival of the CR patients was 11.5 months and the median survival of the entire group was 10 months. We conclude that conventional dose Ara-C/idarubicin is an effective protocol for inducing complete remission in elderly patients with AML, but that consolidation therapy consisting of two courses of the same regimen does not produce a relevant rate of long-term disease-free survival.

Acute Disease↗

PubMed1994

Munchausen syndrome in hematology: case reports of three variants and review of the literature.

We describe five patients with hematologic Munchausen syndrome who were discovered within 5 years. The patients presented for hematologic evaluation of coagulopathy, iron-deficiency anemia, or macrohematuria with severe anemia. The final diagnoses were phenprocoumon intake (2x), self-inflicted phlebotomy (2x), and urogenital manipulation (1x). All five patients were female ranging in age between 23 and 45 years; two were nurses. In four cases we were able to unmask the patient. We think that hematologic Munchausen syndrome has a rather uniform pattern and may be divided into three subtypes: (a) anticoagulation type, (b) anemia type, and (c) pretended hematologic form. Hematologic Munchausen syndrome should especially be considered if there is an unexplained coagulation disorder or therapy-resistant iron-deficiency anemia, and if the patient is a young female nurse who has had many hospitalizations.

Adult↗

PubMed1993

[CA-125--a tumor marker of lymphangioleiomyomatosis of diagnostic and prognostic importance?].

Lymphangioleiomyomatosis is a rare tumour of the lymphatic system, affecting mostly women of childbearing age. Due to its rare occurrence, diagnosis is mostly made after thorough examination therefore time for an early treatment is lost. Diagnostically important are, on the one hand, the histological findings with smooth muscle cells invading the lymphatic system, and on the other hand thin-walled cysts in CT scanning of the lung. CA-125 seems to be a suitable screening parameter for LAM, which may be additionally of prognostic value. Sensitivity and specificity of CA-125 require further observation.

Adolescent↗

PubMed1989

The rate of mitosis in cystosarcoma phyllodes (phyllodes tumor, WHO) of the breast. An analysis of 47 cases.

The rate of mitosis was determined in 47 cases of cystosarcoma phyllodes which had already been classified by morphological criteria (tumor margin and cellular atypia) as benign (17 cases), malignant (23 cases) and borderline (7 cases). Tumors which had been classified histopathologically as benign or of borderline had mitotic rates of 3 mitosis/10 HPF or less, whereas malignant cystosarcomas showed rates of 2-36 mitoses/10 HPF. Only high rates of mitosis (10/10 HPF) correlated well with a histopathologic diagnosis of malignancy.

Breast Neoplasms↗

PubMed1989

[Recurrences and metastases of cystosarcoma phylloides (phylloid tumor, WHO). On the 150th birthday of a controversial diagnostic concept].

134 Cystosarcoma phyllodes were been observed in the course of 12 years among the diagnostic and consultative (n = 121) material. 133 tumors occurred in the female, one in the male breast. In 21 cases local recurrences and in 4 cases metastases developed. 6 recurrences following local excision were observed more than once: in one case 10 subsequent recurrent tumors, the last of these in the chest wall after mastectomy. Histopathologically, the recurrences were identified as benign (1 case), as borderline tumors (2 cases) and as malignant cystosarcoma (8 cases). In 10 further cases (48% of the recurrences) a stromal sarcoma was predominant. In accordance with the literature, we found in most cases a more aggressive growth and an enhanced malignancy. It is emphasized, that angioinvasive growth in the recurrent tumors can indicate distant metastases. The frequency of the recurrent cystosarcoma in our series was 16%, multiple subsequent tumors occurred in 29% of them. Recurrences are caused by proliferative remnants of the primary tumor following local excision, or they are tumors-de-novo induced by a extratumoral stromal hypercellularity of the surroundings like a new benign cystosarcoma. Therefore an initial wide excision is recommended for the benign and a mastectomy for the malignant cystosarcoma. The site of distant metastases of the 4 cases were the lung and the skeleton (rib and femur). In one case an axillary lymph node was involved by a recurrent giant cell stromal sarcoma. The interval between primary and metastases was 7 months to 5 years, between recurrent tumor and metastases 6 to 24 months or both tumors were observed simultaneously. Following the recent literature, distant metastases occur at an average rate of 19% of the malignant cystosarcomas. In single cases it is impossible to make a sure prognosis of cystosarcoma phyllodes, because recurrences and metastases are observed in all subtypes, but predominantly in the malignant cystosarcomas.

Breast↗