Biomedical subjects
Publications and source records attributed to M Wiesel.
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Tumor cells of three urological longterm cell lines have been labelled with 35[S]-Methionin and added to red cell concentrates. Red cell concentrates rich in tumor cells were passed through a cell saver and two special membranfilters under standard conditions. The 35[S]-Methionin labelled tumor cells were detected by liquid scintillation counting. On an average, only 0.027% of the radioactivity was left after passing through the cell saver and the membran filters in the 12 experiments. If investigations in clinical use of cell-saver and membran filter confirm these results, there will be significant consequences in urological tumor surgery by the possibility of transfusing the salvaged autologous blood.
A case is reported of a 26-year-old woman who developed contact dermatitis due to a peripheral venous catheter. This catheter had a metal connector, made of nickel-brass. The patient had been admitted for uterine contractions and was to receive an infusion of salbutamol. Twelve hours after the catheter had been set up, she developed at the puncture site an acute inflammatory reaction, with oedema and bullae. She later admitted to having had a few "spots" when wearing a cheap metal bracelet. Skin tests with nickel (5% solution of nickel sulphate) confirmed the diagnosis. This case underlines the importance of looking for an allergic history in patients.
Definite suspensions of malignant cells from three human tumor cells lines (bladder, prostate and renal cell carcinom) were passed through a cell saver (Althin Mediplast) and a leucozyte removal filter (PALL RC 100) under standard conditions. The examination of the solutions did not detect any malignant cells at all. If investigations with malignant cells in the blood will confirm these results, the use of intraoperative autotransfusion in urological tumor surgery would be possible.
Authors present a simple small bowel surgical wash-out technique that can be used in the treatment of severe chloroquine poisoning. This toxicokinetic treatment can improve the prognosis of this poisoning in under-developed countries, without substitution with modern toxico-dynamic treatment. Toxico-dynamic treatment needs intensive medical care, which is unavailable in these countries. Surgical wash-out of the small bowel could also be a complement to medical treatment in very massive chloroquine poisoning.
A retrospective study reports 65 patients with metastatic disease from nonseminomatous germ cell testicular tumors who underwent a salvage lymphadenectomy either to remove a residual mass or to confirm a complete clinical response after polychemotherapy. Scarring was found in 23 patients (35%), differentiated teratoma in 25 patients (39%) and residual cancer in 17 patients (26%). Of the 12 patients staged as complete responders 2 were found to have cancer, 4 teratoma and 6 fibrosis. Neither tumor markers nor CT scan could accurately predict which patients with residual masses would have cancer, mature teratoma or necrosis. Thus needle biopsy or limited resection is inadequate in its ability to detect persistent vital tumor. After a follow-up of 10-106 months 49 patients (75%) are living with no evidence of disease. 12 patients (19%) died of tumor progress. The most critical prognostic determinant was the nature of the tissue resected. 21 (91%) of 23 patients with only fibrous or necrotic elements are living with no evidence of disease. However, of 17 patients with persistent cancer in the resected tissue only 8 patients (47%) fared well. Our experience confirms the original concept which called for postchemotherapeutic tumor surgery in all patients who demonstrated either a partial or complete clinical response.
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The use of different immunosuppressive protocols (high-dose/low-dose CsA) has little effect on first cadaveric transplants in nonsensitized patients. However, low-dose CsA induction treatment reduces early nephrotoxic crises. There is a clear benefit of quadruple drug induction treatment for retransplants and sensitized transplant candidates. Steroid-free immunosuppressive therapy can be applied to a majority of long-term patients.
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