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Biomedical subjects

M Matter

Publications and source records attributed to M Matter.

At least 19 recordsLinked to original sources
PubMed2006

CPT-11 and concomitant hyperfractionated accelerated radiotherapy induce efficient local control in rectal cancer patients: results from a phase II.

Patients with rectal cancer are at high risk of disease recurrence despite neoadjuvant radiochemotherapy with 5-Fluorouracil (5FU), a regimen that is now widely applied. In order to develop a regimen with increased antitumour activity, we previously established the recommended dose of neoadjuvant CPT-11 (three times weekly 90 mg m(-2)) concomitant to hyperfractionated accelerated radiotherapy (HART) followed by surgery within 1 week. Thirty-three patients (20 men) with a locally advanced adenocarcinoma of the rectum were enrolled in this prospective phase II trial (1 cT2, 29 cT3, 3 cT4 and 21 cN+). Median age was 60 years (range 43-75 years). All patients received all three injections of CPT-11 and all but two patients completed radiotherapy as planned. Surgery with total mesorectal excision (TME) was performed within 1 week (range 2-15 days). The preoperative chemoradiotherapy was overall well tolerated, 24% of the patients experienced grade 3 diarrhoea that was easily manageable. At a median follow-up of 2 years no local recurrence occurred, however, nine patients developed distant metastases. The 2-year disease-free survival was 66% (95% confidence interval 0.48-0.83). Neoadjuvant CPT-11 and HART allow for excellent local control; however, distant relapse remains a concern in this patient population.

Adenocarcinoma↗
PubMed2006

[Visceral surgery].

Visceral surgery has benefited from several significant therapeutical improvements in 2005. They involve more specifically endocrine surgery, obesity, ovarian cancer, rectocele and cystic pancreatic neoplasia. Minimal invasive surgery is increasingly used, for example in endocrine conditions and obesity treatment. New techniques also emerge, such as electrical gastric stimulation for obesity or Stapled Trans Anal Rectal Resection (STARR) for anterior rectocele. Accurate diagnosis criteria allow better management of cystic pancreatic neoplasia, especially to choose the best treatment of this condition.

Bariatric Surgery↗
PubMed2004

Can fixation instability improve text perception during eccentric fixation in patients with central scotomas?

BACKGROUND: Oculomotor behaviour was investigated in 14 patients with central scotomas from age related macular degeneration (AMD) or Stargardt's disease. A scanning laser ophthalmoscope (SLO) was used to project letters and words onto the retina and to assess fixation behaviour. Five patients reported while deciphering letters that they needed to "move their eye" to prevent the image from vanishing. The observation of the SLO fundus images revealed that the gradual disappearance of the stimulus did not result from a transient projection of the word in the lesion. This prompted the authors to investigate, in an experimental setting, whether purposeful changes in fixation position could improve the perception of an eccentrically fixated text stimulus. METHODS: Twenty normal subjects were asked to alternate fixation, every three to four seconds, between two vertically aligned dots, spaced 10 degrees apart, and to report any changes in the perception of a laterally located letter, 1.5 degrees in height, 7 degrees apart and equidistant between the two fixation spots. RESULTS: Nineteen subjects reported a transient refreshment of the letter image immediately after the realisation of a saccade. Improved perception lasted approximately a second. With persistent fixation, they noted a rapid fading effect that reduced letter recognition. CONCLUSION: These observations suggest that ocular instability during eccentric viewing can have a functional advantage, probably related to counteracting Troxler's phenomenon. In addition to alternating between PRLs, it appears that saccades related to fixation instability might be valuable and improve text perception in individuals with a central scotoma and eccentric fixation. This possibility should be taken into consideration when conducting visual rehabilitation procedures.

Adult↗
PubMed2003

Dual transplant of marginal kidneys. Case report and review of the literature.

INTRODUCTION: Double transplantation is one possible answer to the shortage of donor organs. While each donor kidney would be unsuitable when considered as a single allograft, use of both kidneys should provide sufficient nephron mass for effective glomerular filtration. CASE REPORT: This is the first Swiss report of a dual adult transplant of marginal kidneys in a 46-year-old man, who was transplanted for the fourth time. Follow-up at 6 months is excellent without acute rejection. CONCLUSION: Recent analysis of dual marginal versus single ideal transplant outcomes, found a comparable 1-yr graft survival in both of the procedures. Long term results are still lacking and guidelines to decide between single, double or no transplantation are emerging.

Age Factors↗
PubMed2001

[Surgical site infection surveillance: an effective preventive measure].

Surgical site infection (SSI) is a feared complication of any surgical procedure. Despite clear progresses during the last decades, recent studies (some from Switzerland) show that many patients still suffer from SSIs and that SSIs have a huge impact for patients and public health. Thus, the prevention of SSIs must constitute a priority of nosocomial infections control in hospitals. In addition to classical approaches focusing on skin preparation, antibiotic prophylaxis, asepsis, and operative environment, surveillance has proved effective in decreasing the incidence of SSIs. The present paper reviews the principles and the main components of an SSI surveillance program.

Cross Infection↗
PubMed2000

Mechanisms of postprandial hyperglycemia in liver transplant recipients: comparison of liver transplant patients with kidney transplant patients and healthy controls.

Impaired glucose tolerance or diabetes mellitus are frequent complications after organ transplantation, and are usually attributed to glucocorticoid and immunosuppressive treatments. Liver transplantation results in total hepatic denervation which may also affect glucoregulation. We therefore evaluated postprandial glucose metabolism in a group of patients with liver cirrhosis before and after orthotopic liver transplantation. Seven patients with liver cirrhosis of various etiologies, 6 patients having received a kidney transplant, and 6 healthy subjects were studied. Their glucose metabolism was evaluated in the basal state and over 4 hours after ingestion of a glucose load with 6.6 (2) H glucose dilution analysis. The patients with liver cirrhosis were studied before, and again 4 weeks (range 2-6) and 38 weeks (range 20-76, n=6) after orthotopic liver transplantation. Basal glucose metabolism was similar in liver and kidney transplant recipients. Impaired glucose tolerance was present in both groups, but postprandial hyperglycemia was exaggerated and lasted longer in liver transplant patients. Postprandial insulinemia was lower in liver transplant recipients, while C-peptide concentrations were comparable to those of kidney transplant recipients, indicating increased insulin clearance. Glucose turnover was not altered in both groups of patients during the initial 3 hours after glucose ingestion, but was higher in liver transplant early after transplantation during the fourth hour. Postprandial hyperglycemia remained unchanged in liver transplant recipients 38 weeks after liver transplantation, despite substantial reduction of immunosuppressive and glucocorticoid doses. We conclude that liver transplant recipients have severe postprandial hyperglycemia which can be attributed to insulinopenia (secondary, at least in part, to increased insulin clearance) and a late increased glucose turnover. These changes may be secondary to hepatic denervation.

Adult↗
PubMed2000

[The place of surgery in the treatment of advanced localized, recurrent and metastatic breast cancer].

In the multidisciplinary treatment of locally advanced and metastatic breast cancer, aggressive surgical options can be chosen in selected cases. They may allow: survival to be prolonged by the resection of metastases (liver, ovary, lung), symptomatic treatment (bone pain, local recurrence, infiltration of the chest wall), prevention of potentially disabling complications (pathologic fractures, medullary compression), exclusion of another tumoural or non tumoural diseases. The decision to perform surgery has to be discussed between the surgeon and the oncologist so as to optimise its timing. Surgical treatment can follow induction therapy or can precede chemo- or hormonotherapy.

Abdominal Neoplasms↗
PubMed1987

The effect of iron and folate therapy on maximal exercise performance in female marathon runners with iron and folate deficiency.

Of the 85 female marathon runners examined in this study, 14 (16%) had serum ferritin levels below 40 ng/ml but only two (2%) had iron deficiency anaemia (haemoglobin below 12 g/dl); 28 (33%) had serum folate levels below 4.8 ng/ml and of these two (2%) had haemoglobin levels below 12 g/dl and 13 (15%) had mean corpuscular volumes greater than 95 fl. One week after treatment with oral folate (5 mg/day) or iron (50 mg of elemental iron/day), serum ferritin and folate levels were normal but maximum oxygen uptake, maximum treadmill running time, peak blood lactate levels and the running speed at the blood 'lactate turnpoint' were not changed from values measured during an identical test performed 1 week earlier. These parameters were also unchanged in a third exercise test performed after a further 10 weeks of treatment. Serum folate or serum ferritin levels in a control (placebo-treated) group with initially high serum ferritin or folate levels fell with placebo treatment but maximum treadmill running time, maximum oxygen uptake values, peak blood lactate levels and the running speed at the blood 'lactate turnpoint' were unchanged. We conclude that biochemical evidence of iron and folate deficiency is relatively common in female distance runners; that 1 week of treatment corrects the biochemical evidence of folate and iron deficiency but that such treatment does not influence maximal exercise performance nor does it alter blood lactate levels during exercise. In the absence of iron deficiency anaemia, iron therapy for reduced serum ferritin levels, or folate therapy for low serum folate levels, may not improve maximal treadmill performance even in trained runners.(ABSTRACT TRUNCATED AT 250 WORDS)

Anemia, Hypochromic↗
PubMed1987

Blunt spatula debridement and trifluorothymidine in epithelial herpetic keratitis.

31 consecutive patients with laboratory proven epithelial herpetic keratitis were included in a prospective, controlled study evaluating combined blunt spatula debridement and trifluridine therapy versus trifluridine alone. A group of 20 patients treated by the combined method was compared in sequence with a group of 11 patients treated by trifluridine alone. Epithelial healing time was significantly shorter in the combined treatment group and treatment failures were less frequent. Blunt spatula debridement was well tolerated. Our findings tend to support the concept that combined treatment of herpetic epithelial keratitis by debridement and antiviral therapy is beneficial by shortening the course of epithelial lesions.

Clinical Trials as Topic↗
PubMed1986

[Comparative prognostic study of the in vitro and in vivo development of colorectal tumors. Preliminary communication].

In vitro clonal growth of tumour cells may reflect biological properties of cancer and thus have prognostic value. This study seeks to establish correlations between the clinical outcome in patients after surgery for colorectal cancer and clonal growth of their tumours. History, status and follow-up data are collected. Tumour samples taken at operation under sterile conditions are plated immediately in our methylcellulose clonal assay system. Out of 65 consecutive samples, 3 did not yield sufficient cells for culture. Thirty-four (55%) grew more than 0.3 colonies/10(5) cells seeded; cloning efficiency was greater than 10 colonies/10(5) cells in 19. The 28 (45%) failures included 3 benign polyps cultured; 7 samples had visible bacterial or fungal contamination. The other 18 negative cultures may be due to cytotoxicity of the antibiotics or heterogeneity of tumour cells. These preliminary results show that colorectal cancers grow well in vitro in the absence of restricting factors, but they do not confirm the hypothesis that proliferative potential and differentiation are opposing processes. Location of the tumour may play a role, since best growth was seen in tumours of the caecum and terminal colon.

Cell Division↗
PubMed1986

Topical retinoic acid treatment of drug-induced pseudopemphigoid.

A case of drug-induced ocular cicatricial pemphigoid with pronounced keratinizing squamous epithelium metaplasia was treated for 5 months with all-trans retinoic acid ointment. Keratinization reversed completely and the cicatricial process was stabilized in one eye and slowed down in the other eye. The treatment was well tolerated.

Aged↗
PubMed1985

Rapid diagnosis of herpetic infections by immunoperoxidase method.

The PAP-(peroxidase-antiperoxidase)-immunohistochemical method was tested for rapid diagnosis on corneal specimens in clinically suspected herpetic disease. The method proved accurate, easy and useful in rapid diagnosis of corneal specimens from epithelial keratitis. Corneal buttons after keratoplasties for herpetic lesions were similarly tested for the presence of herpetic antigen. In a total of five corneal buttons, antigen was found in two corneas with necrotizing keratitis, whereas it was not noted in the three corneas opacified by disciform edema.

Antigens, Viral↗