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Biomedical subjects

J van de Loo

Publications and source records attributed to J van de Loo.

At least 73 records · Page 4Linked to original sources
PubMed1988

[Bronchoscopic diagnosis of lung infiltrates in immunocompromised patients].

Bronchoscopy with bronchoalveolar lavage was undertaken in 21 immunocompromised patients for microbiological and cytological diagnosis. In all of these patients radiologically confirmed pneumonic lesions had developed which, under empirical antibiotic treatment, had progressed or not clearly regressed. In four patients each the causative organisms of the pneumonia were identified as Pneumocystis carinii and Legionella, respectively, and Aspergilla in a further three. Proof of the causative organism in these patients resulted in a change of the antibiotic treatment. The pneumonia was healed in 11 patients. Ten patients died. Early bronchoscopy to identify the causative organism is recommended in immunocompromised patients so that, by administering microorganism-specific treatment, the at present high mortality in this group may be reduced.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Clinical course and risk factors in patients with generalized mycoses].

A retrospective analysis of the clinical course of disseminated fungal infections in 32 patients revealed 25 cases of candidiasis, 5 patients with aspergillosis, and 2 with mixed fungal infections. All patients had undergone cytostatic therapy for malignant hematological diseases as the predisposing risk factor for fungal infection. 30 patients had severe granulocytopenia (less than 500/cmm). In addition, 30 patients had received broad spectrum antibiotics and 16 had been treated with corticosteroids. 17 of 32 patients were treated systemically with antimycotic drugs for proven fungal infection. No antimycotic agents were given to 15 patients because fungal infections were diagnosed only on post mortem examination. 19 patients succumbed to overwhelming disease, including 5 in spite of antimycotic therapy. Patients in whom systemic candidiasis was detected after recovery of granulocytopoeisis had a better prognosis than patients who developed systemic fungal infections during the period of ongoing severe granulocytopenia.

Adult↗
PubMed1988

High-dose cytosine arabinoside and mitoxantrone: preliminary results of a pilot study with sequential application (S-HAM) indicating a high antileukemic activity in refractory acute leukemias.

In an attempt to further improve on the encouraging results achieved by high-dose cytosine arabinoside (HD AraC) and mitoxantrone (HAM) in refractory acute leukemias, a timely modified sequential schedule of both drugs was developed (S-HAM) and applied to 13 patients with far advanced acute leukemias, 8 of whom had been treated with the original HAM protocol before. Based on the cell kinetic and pharmacokinetic rationale outlined by Capizzi et al., HD AraC 3 g/m2 was applied every 12 h on days 1 and 2 followed by mitoxantrone 10 mg/m2/day on days 3 and 4. After 3 days without therapy the identical sequence was repeated on days 8 and 9 (HD AraC) and 10 and 11 (mitoxantrone), respectively. Of the 13 patients 9 (69%) achieved a complete remission, 2 were resistant and 2 were early deaths. Six of the 8 patients with prior HAM treatment obtained a further complete remission with S-HAM. In 2 of these patients a longer remission was induced by S-HAM than by the preceding original HAM treatment. Although these data are preliminary and need confirmation on larger numbers of patients, they strongly suggest a high antileukemic activity of the S-HAM protocol which may even be superior to the previously used HAM regimen.

Adolescent↗
PubMed1988

Human recombinant granulocyte macrophage colony stimulating factor (GM-CSF) treatment of patients with acute leukemias in aplasia and at high risk of early death.

In the first clinical study on GM-CSF in acute leukemias continuous infusion of the growth factor is given to patients in aplasia and at high risk of early death due to age over 65 years and/or intensive chemotherapy for resistance or relapse. Among 6 patients (4 AML, 2 ALL) receiving a total of 7 courses two died too early to contributing adequate data. Three patients and 4 courses showed earlier neutrophil recovery than related control groups and a fourth patient with secondary AML showed a neutrophil recovery time in the normal range, but much shorter than her platelet and reticulocyte recovery. No evidence was obtained so far for leukemic regrowth in these patients including blood and bone marrow cytology, monitoring of DNA aneuploidy by flow cytometry and clonogenic cells by colony assays. Thus, GM-CSF may be useful for rescue after intensive chemotherapy of AML and ALL and may not necessarily increase the risk of leukemia progression.

Aged↗
PubMed1988

Deficiency of intact thrombospondin and membrane glycoprotein Ia in platelets with defective collagen-induced aggregation and spontaneous loss of disorder.

Platelets from a patient with a severe lifelong bleeding tendency, which later spontaneously disappeared, lacked intact thrombospondin and glycoprotein (GP) Ia. Before disappearance of the bleeding disorder, results of coagulation studies and platelet aggregation in response to adenosine diphosphate (ADP), arachidonic acid, thrombin, A23187, epinephrine, and ristocetin were normal. In contrast, aggregation only occurred in the presence of collagen or wheat germ agglutinin at unusually high doses of these agonists. The platelets adhered normally to purified bovine and human type I collagen, and they did not spread in the presence of methylated type I collagen. No collagen-induced clot retraction was observed. Two-dimensional gel electrophoretic analyses of platelet proteins and immunologic studies showed that intact thrombospondin and GP Ia were absent. Aggregation in response to collagen could be restored by adding thrombospondin. Disappearance of the bleeding tendency occurred at the onset of menopause; subsequent analyses revealed that thrombospondin and GP Ia were present in platelets and that collagen-induced platelet aggregation was normal. These results suggest that both thrombospondin and GP Ia are essential in collagen-induced platelet aggregation. The spontaneous disappearance of the bleeding tendency may have been related to hormonal influences.

Bleeding Time↗
PubMed1987

Selective staining of platelet glycoproteins using two-dimensional O'Farrell gel electrophoresis and avidin-biotin-conjugated lectins.

A time-saving and sensitive high resolution method for the analysis and identification of platelet glycoproteins using nonradioactive compounds has been developed. Platelet proteins (50 micrograms) of normal subjects were separated by isoelectric focusing and SDS-PAGE. Proteins were either stained with silver or electroblotted onto nitrocellulose. Nitrocellulose blots were treated with the following biotinylated lectins: Abrus precatorius lectin, concanavalin A, Lens culinaris lectin, or wheat germ agglutinin. Staining was achieved by avidin-biotin-coupled peroxidase using 4-chloro-1-naphthol as the substrate. A rapid overview of platelet glycoproteins may be obtained by applying all the lectins to a single blot.

Avidin↗
PubMed1987

Neuraminidase-treated allogeneic blasts for maintenance in acute myelogenous leukemia: results of a prospective randomized trial.

Between July 1, 1981, and July 1, 1985, 167 patients with acute myelogeneous leukemia (AML) were treated with one or, if necessary, two courses of a modified TAD regimen (TAD9) for induction. 96 patients (58%) achieved a complete remission (CR); 62 achieved CR after one and 34 patients after two courses of TAD9. 29 patients (17%) were considered early deaths, and 42 patients (25%) nonresponders. For CR maintenance 64 patients were eligible according to protocol criteria; 33 patients were randomized to chemotherapy, only, (CT) by monthly courses of cytosine arabinoside (ARA-C) alternatingly combined with daunorubicin or thioguanine or cyclophosphamide, while 31 patients were randomized to receive immunotherapy in addition to chemotherapy (CIT) by intradermal injections of 10(10) neuraminidase-treated viable allogeneic blasts per immunization interspersed between the CT courses. Maintenance therapy was given for up to 3 years. The median survival in CT patients is 23 months, while in CIT patients the median has not been reached after 54 months; corresponding median relapse-free survival is 15 months for the CT patients as opposed to 40 months for the CIT group. The differences are not significant. Comparing CT with CIT, the survival data show a persistent trend in favor of CIT; under the conditions of the study, however, a substantial benefit of immunotherapy may be restricted to a certain subset of patients with low risk for early relapse.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

[Internal medicine diagnosis of splenic diseases].

In an adult man the spleen serves two physiologic functions. It is an organ of the immune system, the second function is the sequestration and removal of normal and abnormal blood cells. Most diseases of spleen are associated with enlargement of the organ. Causes of splenomegaly are liver diseases with portal hypertension, infections, malignant leukemias or lymphomas often combined with lymph node enlargement, collagen vascular diseases or Felty's syndrome, chronic hemolytic syndromes and infiltrative diseases such as Gaucher's disease. Some diseases associated with splenic enlargement respond to splenectomy.

Diagnosis, Differential↗
PubMed1986

Lysostaphin-based assay of human granulocyte functions: a reevaluation.

Lysostaphin, a staphylococcus-derived staphylocidal substance, has widely been used in assays of granulocyte phagocytic and bactericidal capability. It rapidly kills extracellular bacteria. Thus, a separate determination of intracellular surviving bacteria can be performed. One prerequisite for this approach is the safe inactivation of lysostaphin (usually brought about by trypsin) before the intracellular bacteria are externalized for plating. This inactivation has been found by others to be incomplete. Data are presented demonstrating a safe inactivation of lysostaphin by trypsin, if the pH value is maintained within the alkaline range. A low variation of results is obtained by plotting the total number of bacteria killed per incubate vs the logarithm of initial bacterial inoculum or of the intracellular surviving bacteria, leading to linear regression lines. The variation of the results increases greatly for initial bacteria/granulocyte proportions of greater than 5/1. The results obtained for two different St. aureus strains are significantly different. Dexamethasone pretreatment (12 mg p.o. within 8 h) had no detectable influence, when fresh blood was assayed, while blood storage at room temperature for 12 h (without dexamethasone pretreatment) led to a significant functional impairment, mainly of bactericidal capability when analyzed in a pairwise fashion. A major limitation of this kind of assays is that killed bacteria cannot be determined directly.

Bacteriological Techniques↗
PubMed1986

Factors of the hemostatic system in diabetic patients. A survey of controlled studies.

Diabetes mellitus is associated with a variety of vascular complications like diabetic retinopathy, myocardial infarction, stroke and peripheral vessel disease. These complications are of utmost importance because they lead to disability and premature death of the patients. The pathogenesis of these lesions has been thought to depend at least partly on defects in the hemostatic system. Many alterations of the coagulation and the fibrinolytic system as well as of the reaction of platelets have been found in diabetics. In general these tend to suggest a state of slightly activated coagulation, of increased platelet reactivity and of decreased fibrinolysis. However, no conclusive picture of the role of hemostasis in the development of vascular lesions in diabetics has emerged yet, as contradictive results have been found by many investigators. The aim of this review article is to sum up the knowledge that has accumulated in the last years in controlled clinical trials concerning the state of the diabetic hemostatic system.

Blood Coagulation Factors↗