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Biomedical subjects

M Kummer

Publications and source records attributed to M Kummer.

33 records · Page 2Linked to original sources
PubMed1982

Malnutrition in the hospitalized geriatric patient.

The nutritional status of 59 consecutive geriatric male patients admitted to the medical service of a Veterans Administration Hospital was evaluated and compared with that of 93 younger patients admitted during the period. Protein-calorie malnutrition was diagnosed in 61 per cent of patients aged 65 or older compared with 28 per cent of patients younger than 65. The death rate and the incidence of infection were higher in the malnourished geriatric patients, however, there was no increase in the incidences of these abnormal findings compared with well-nourished patients udder the age of 65. The presence of malnutrition on admission, regardless of age, predicted a significant increase in the risk of infection or death during the hospital course.

Age Factors↗
PubMed1978

[The prognostic value of lymphocyte transformation by phytohemagglutinin in children with acute lymphatic leukemia].

The response to phytohemagglutinin (PHA) of lymphocytes from 62 children with acute lymphoblastic leukemia (ALL) was tested before and during cytostatic therapy. Nineteen patients were tested as well for reactivity in autologous mixed lymphocyte-blast cell cultures. The prognostic value of the results obtained has been assessed. Children remained longer in their first complete remission 1) if the response to PHA before therapy was normal or only slightly diminished, or 2) if it returned to normal as soon as complete remission was attained, and 3) if periodic intensification therapy was followed by a rebound in spontaneous lymphocyte proliferation. The stimulatory response to PHA during maintenance therapy and the reactivity in mixed lymphocyte- blast cell cultures were not helpful prognostic criteria. In conclusion, determination of the PHA responsiveness at specific times, i.e. before therapy, after remission induction and after periodic intensification therapy, could help identify poor risk patients in ALL.

Antineoplastic Agents↗
PubMed1976

Immunological follow-up of acute lymphoblastic leukaemia.

In different treatment groups of children with acute lymphatic leukaemia and undifferentiated leukaemia, the lymphocyte count and a number of immunologic parameters were examined during the various stages of treatment. These parameters were related to the type of chemotherapy as well as the stages of treatment. This paper deals with the values of lymphocyte counts, of gamma globulin, IgG, IgM and IgA and the results of the DNCB skin tests, as a parameter for cellular immunity. IgG determined by acetate sheet electrophoresis showed no significnat change, while its significant reduction was shown during the periods of prophylactic reinduction with vincristine in the Pinkel VII scheme, The IgM level was significantly raised in the initial stage before treatment and in all periods of treatment both in the Pinkel VII group and in an earlier therapeutic group treated with methotrexate every two weeks and vincristine pulses every six weeks. IgA was raised in both groups before treatment but significantly reduced during the phases of maintenance and reinduction. About 50% of the P VII cases had negative DNCB skin tests during maintenance therapy, while all long-term survivors in the earlier methotrexate group had a positive skin test.

Antibody Formation↗
PubMed1976

[Responsiveness of lymphocytes to stimulation by pha and autologous blasts in acute lymphatic leukemias during remission (author's transl)].

The paper deals with the question how far the lymphocytes of acute lymphatic leukemia patients in remission can be stimulated by PHA and autologous blasts in the MLC-Test. The lymphocyte stimulation by PHA showed considerable variation dependent on the phase of therapy. A significant reduction of the responsiveness to PHA stimulation was found during the prophylactic reinduction treatment with Vincristin and Prednisolon compared with the results during maintenance therapy. The examination of lymphocyte stimulation by conserved autologous blasts in the mixed lymphocyte culture-test yielded positive results in one of three children at the beginning of remission and in 2 of 3 children during the consolidated remission period.

Child↗
PubMed1975

Prevention of meningeal leukaemia and relapses by cranial irradiation and intrathecal MTX in acute lymphatic leukaemia.

Experience with CNS prophylaxis in 35 children with acute lymphatic leukaemia is reported. Before prophylactic irradiation of the skull was given the average survival time in 36 children was 2,8 (2,7) years. Menigeal leukaemia preceeded bone marrow relapse in 9 cases and followed relapse in a further 5 cases (39%). Between 1971 and 1973 Pinkel's treatment scheme VII was given to 35 children. This included prophylactic skull irradiation and intraspinal MTX injections. 29 children are still in their first remissions which range from 10 - 35 months in length. Meningeal leukaemia has not so far been observed, in this latter group.

Child↗
PubMed1975

[Immunologic parameters in acute lymphatic leukemias in the course of different types of chemotherapy (author's transl)].

In 2 groups of patients under treatment with acute lymphatic leukemia and undifferentiated leukemia, apart from the lymphocyte count, a number of immunologic parameters were examined during the various stages of treatment. These parameters were related to the type of chemotherapy as well as the stages of treatment. This paper deals with the values of lymphocyte counts, of gammaglobulin, IgG, IgM and IgA and the results of the DNCB skin-tests, as a parameter for cellular immunity. The determination of gammaglobulin using the acetate sheet electrophoreses, showed no significant change. However a significant reduction of the IgG was shown during the periods of prophylactic reinduction with Vincristin in the Pinkel VII scheme. IgM quantities were significantly raised in the initial stage before treatment and in all periodes of treatment both in the Pinkel VII group and in an earlier therapeutic group with methotrexate two weekly and Vincristin pulses every 6 weeks. IgA was raised in both groups before treatment but significantly reduced during maintenance and reinduction phases. About 50% of the P VII cases had negative DNCB skintests during maintenance therapy, while all long term survivors in the earlier methotrexate treatment group had positive skintests. The 2 following papers deal with the results of PHA stimulation and the B and T cell determinations.

Child↗
PubMedDate not supplied

[Autologous peripheral stem cell transplantation in children].

19 children between 3 and 23 years underwent 79 leukapheres for collection of blood stem cells. In children suffering from acute lymphoblastic leukemia (ALL), Non Hodgkin's Lymphoma (NHL) and Ewing's Sarcoma (ES) we collected 6.87 x 10(4) CFU-GM/kg (range 2,65-21.7), if collections were started with the first platelet rise. In children with peripheral primitive neuroectodermal tumors (PNET) and neuroblastoma (NBL) we gained only 1.20 x 10(4) CFU-GM/kg (range 0.09-2.24). 17 children received high dose chemoradiotherapy and peripheral stem cell +/- bone marrow rescue. 9 suffered from solid tumors, 8 from hematopoietic malignancies. 9 were transfused with peripheral stem cells only, 8 received bone marrow in addition. Time to reach 0.5 x 10(9)/l granulocytes was very short-median 31 days (12-65), in 4 children receiving more than 5 x 10(4) CFU-GM/kg 12 to 13 days, only. On January 31st, 1989 6/17 children are alive in complete remission after a median observation time of 14.5 months (3-26) after autologous stem cell transfusion, one child is alive in "no remission", 7 died with relapse, 3 died because of infections (2 x aspergillosis, 1 x pseudomonas septicemia). The collection of blood derived stem cells by leukaphereses was well tolerated even in very small children and easily repeatable. With optimal timing high stem cell numbers were obtainable, resulting in a very short duration of posttransplant granulocytopenia.

Adolescent↗
PubMedDate not supplied

Malnutrition and hospital prognosis in the alcoholic patient.

The nutritional status of 65 alcoholic patients admitted to the Medical Service of a Veterans Administration Hospital was evaluated and compared to that 87 nonalcoholic patients admitted during the same period of time. There was no statistical difference in the prevalence of malnutrition in the alcoholic population (36.9%) when compared to the nonalcoholic population (43.7%). The death rate and incidence of infection were similar in both populations as was the prevalence of anemia, depressed total lymphocyte count, and skin test anergy. Malnutrition, however, correlated with an increased death rate and incidence of infection, regardless of whether the patient was an alcoholic or not.

Alcoholism↗