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M Gerhard

Publications and source records attributed to M Gerhard.

24 records · Page 2Linked to original sources
PubMed1995

Peripheral arterial-vascular disease in women: prevalence, prognosis, and treatment.

Lower extremity atherosclerosis results in significant morbidity in women, particularly in women following the menopause. Up to 25% of women aged 55 to 74 years are affected by this disease. When noninvasive testing is used to determine the prevalence of lower extremity atherosclerosis, and men in this age group are equally represented. Cigarette smoking, diabetes mellitus, and menopause are risk factors for atherosclerosis of particular interest in women. The prevalence of cigarette smoking is rising rapidly among women, and diabetes appears to be a greater risk factor for atherosclerosis in women than in men. Risk factor reduction, in addition to an exercise program, are important parts of the treatment program for stable claudication. In both men and women with more severe symptoms, an ankle/branchial index (ABI) of less than 0.3 is associated with more severe symptoms, an ankle/brachial index (ABI) of less than 0.3 is associated with a poor prognosis. Men and women fare equally well following revascularization for severe peripheral atherosclerosis. However, there are some data to suggest that women may be offered peripheral revascularization at a lower rate.

Age Factors↗
PubMed1994

Specific detection of carcinoembryonic antigen-expressing tumor cells in bone marrow aspirates by polymerase chain reaction.

PURPOSE: To establish a sensitive assay for the specific detection of carcinoembryonic antigen (CEA)-expressing tumor cells in the bone marrow of patients with colorectal cancer and other CEA-positive carcinomas. PATIENTS AND METHODS: A CEA-specific nested reverse transcriptase (RT) polymerase chain reaction (PCR) assay was developed and optimized using limiting dilutions of a CEA-positive cancer cell line mixed with normal bone marrow cell specimens. The optimized test was then used to examine bone marrow samples obtained from 15 patients with abdominal carcinomas (colorectal, n = 10; pancreatic, n = 3; gastric, n = 2) and six patients with breast cancer. Specificity was assessed by examination of 56 negative controls (malignant hematologic disease, n = 28; nonmalignant disease conditions, n = 5; healthy bone marrow donors, n = 8; normal peripheral-blood samples, n = 15). For 11 patients with abdominal carcinomas, immunostaining evaluations were performed using an anti-CEA and an anticytokeratin antibody, and the results compared with the nested PCR assay. RESULTS: In the sensitivity calibration system, single CEA-expressing tumor cells were detected in 2 to 5 x 10(7) normal bone marrow cells. All 56 control samples failed to amplify. This demonstrates that mRNAs coding for highly homologous CEA-related antigens expressed by various lineages of blood cells do not interfere. Bone marrow samples from 10 of 15 patients with abdominal cancers and four of six breast cancer patients scored positive, indicating micrometastatic bone disease. Four of 11 samples from the gastrointestinal cancer patients were found to be positive by the PCR method, but were negative with the immunocytology method. CONCLUSION: Since approximately 30% of the colorectal carcinoma patients that score negative in immunocytology staining of bone marrow samples have been reported to relapse, earlier diagnosis of the presence of malignant cells is needed. Our result that samples scoring positive in the described CEA-specific PCR test remained negative by two immunostaining methods suggests a higher sensitivity. We conclude that PCR amplification of CEA mRNA may lead to an earlier diagnosis of micrometastatic bone disease in patients with CEA-expressing carcinomas.

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PubMedDate not supplied

The combined treatment of congenital vascular defects.

UNLABELLED: Eighty-one patients with a vascular malformation on the extremities were evaluated. In 32 patients the abnormality was localised in the upper and in 49 in the lower extremity. Signs, symptoms, treatment modalities and long-term results were tabulated. In the upper extremity pain was the most frequent presenting symptom. Three types of malformation were distinguished: purely venous, venous with microshunts and malformations with macroshunts. The treatment of the first group consisted of excision of varices and superficial naevi, in the second group the combined treatment of embolisation and excision was the treatment of choice, in the last group the selective embolisation without resection was most frequently done. The treatment was most successful in those cases, where there was a malformation with macrofistulas in the shoulder-region or only a localised lesion, that could be excised. The first sign and symptom of the lower extremity was swelling or a naevus vasculosus. After inventarisation 4 groups of vascular malformations have been distinguished, the cavernous (venous), the cavernous (venous) with microshunts, the arteriovenous with macrofistulas and a purely venous (truncular) group, which we did not have in our patients with an upper extremity abnormality. Conservative treatment in purely venous malformations prevented progression, the combined treatment was successful in patients with an AV-malformation of the pelvis, or around the knee or in patients with a small excisable lesion. IN CONCLUSION: the purely venous abnormality can be successfully treated with conservative measures, the arteriovenous malformation with macroshunts in pelvis and shoulder region should be embolised, and circumscript lesions excised with or without embolisation, depending on the character of the lesion.

Adult↗