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Biomedical subjects

R Burkhardt

Publications and source records attributed to R Burkhardt.

At least 19 recordsLinked to original sources
PubMed1991

The systemic influence of recombinant interleukin 2 on the manifestations of lepromatous leprosy.

14 patients with lepromatous leprosy received twice daily injections of 10 micrograms recombinant interleukin 2 (rIL-2), by the intradermal route, in the skin of the back for 8 d (total dose, 160 micrograms). Lymphokine administration was accomplished without drug toxicity, or the development of acute nerve damage. The majority of patients developed nontender axillary lymphadenopathy during the course of treatment. Local injection sites showed progressively larger zones of induration, peaking at 24 h and persisting for many days. Early 12-h reactions were of a macular, erythematous nature and exhibited an increasingly striking diurnal variation. The morning injection sites were three- to fourfold larger in diameter than those placed in the evening (9 am to 9 pm). Systemic manifestations of intradermal rIL-2 administration were noted. Peripheral blood T cells, including CD4+ and CD8+ phenotypes, increased 2-2.5-fold and NK cells increased sixfold. Elevations in [3H]TdR incorporation into peripheral blood mononuclear cells occurred to a variety of mycobacterial antigens, but not to those of Mycobacterium leprae. Within 2 wk, biopsies at sites far removed from the back showed increased infiltration of mononuclear cells in 12 of 14 patients. Immunocytochemistry revealed the presence of newly emigrated CD4+ T cells, monocytes, and dermal CD1+ Langerhans cells. Endothelial cells of small dermal vessels expressed major histocompatibility complex class II determinants on their surface. Transmission electron microscopy of these specimens revealed markedly enlarged endothelial cells with many surface projections extending into the lumen as well as extravasating lymphoid cells. The numbers of acid-fast M. leprae in the peripheral sites were examined by slit smear and in biopsies of matched leprosy lesions taken before and after IL-2 administration. Within 2 mo, slit smears showed a 0.5 log or greater reduction in 12 of 14 patients, with a mean for all patients tested of 0.5 log units. Biopsy specimens showed a 1 log unit or greater reduction in the bacterial index (B.I.) in 6 of 14 patients. Historical controls in this Nepalese population showed a 0.5 log unit reduction after multidrug therapy over a period of 12 mo. Thus, after 8 d of IL-2 injections, a fivefold reduction in B.I. was observed during the first 2 mo of the study. Antibody levels against M. leprae phenolic glycolipid 1 (PGL-1) and lipoarabinomanan B were markedly elevated after IL-2 injections, while PGL-1 antigen levels were reduced. We conclude that the administration of rIL-2 has had a significant effect in decreasing the total body burden of M. leprae.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1979

[What prospects of success does Iscador therapy offer in advanced ovarian cancer?].

Having established the hypothesis that the carcinostatic effect of Iscador described in the literature and ascertained by own observations should also show in the treatment of carcinoma of the ovary, we compiled all respective cases treated since November 1969 in the Gynecological Ward of the Gemeinnütziges Gemeinschaftskrankenhaus Herdecke. The collective consisted of 25 patients with primary neoplasms of the ovary who received post-operative treatment with Iscador. The average age was 50.96 years. 20 women were in the advanced stages III and IV according to FIGO. Five-year survival rates were 100% in stages I and II, 23% in stage III and 0% in stage IV. After establishing best possible congruence, our group of patients was compared with a collective of 22 women with neoplasms of the ovary who had received post-operative treatment with Cytoval. Inspite of less favorable prognostic indicators for the Iscador patients, the latter reached an average survival rate of 16.2 months as compared to 5.2 months in the group treated with Cytoval (ratio 3.1:1). The survival period of Iscador patients in stage III was 4.2 times longer, in stage IV 1.6 times longer than that of the Cytoval patients. The difference is statistically significant (alpha less than 0.018). A comparison of the results of the two collectives shows that Iscador a special preparation of viscum album, is a useful and effective treatment of carcinoma of the ovary, particularly since it usually does not cause serious and undesired side effects. Thus the original working hypothesis was confirmed.

Acrylates↗
PubMed1978

[Rational use of bone marrow biopsy. longitudinal hemisection of samples, for simultaneous adaption of various histological preparations without loss of material (author's transl)].

Unfortunately, the combination of the superior histologic embedding technique for semi-thin sectioning of undecalcified bone in methacrylate with special methods in enzyme or immune histochemistry did not prove to be very successful up to now. These shortcomings are attributed to the influence of the embedding medium itself. They can be overcome by processing one part of a biopsy specimen after embedding in methacrylate, the other one after freezing. Optimal and comparable results have been obtained by a simple instrument for longitudinal hemi-sectioning of a cylindrical biopsy specimen of cancellous bone of adequate size, and by developing a suitable technique for the cutting of frozen sections of undecalcified bone. These methods are presented. Examples are given of the benefits of the simultaneous evaluation of one and the same biopsy-specimen with light-microscopic, ultramicroscopic, enzyme- and immun-histochemic technique.

Biopsy↗
PubMed1977

[Bone marrow diagnostic in hairy cell leukaemia (author's transl)].

Evaluation of the histologic changes of the bone marrow and clinical data of twelve male and two female patients with hairy cell leukamia before treatment. Mean age of the patients was 46 years, time from the onset of symptoms 5.5 months. 13 of the patients were anaemic, showing splenomegaly, 12 suffered from thrombopenia, 9 from granulocytopenia, and 8 from hepatomegaly. In all of the cases, the relative numbers of lymphocytes in the blood had been increased together with various amounts of characteristic hairy cells. All of the cases had a typical histologic picture of lymphocytic bone marrow infiltration, mostly of the diffuse type. In 50% of the cases not only the well known rod-like intracellular inclusions could be seen, but also ring-shaped figures whose significance is discussed. Decrease of the granulopoiesis, disintergration of the marrow sinusoids, and osteoporosis are the most important additional signs. The progression of the disease is marked by increasing bone marrow infiltration, by splenohepatomegaly, anaemia, thrombopenia, and increasing numbers of typical lymphocytes in the blood. The bone marrow being considered to be the origin of the disease for good reasons, the histobiopsy of this organ ranks among the diagnostic and prognostic measures to be taken at first sight.

Adult↗
PubMed1977

[Bone marrow biopsy investigation: an important prognostic factor in aplastic anaemia (author's transl)].

In thirty-five patients with aplastic anaemia initial bone marrow biopsy investigations were performed. 25 patients showed partial bone marrow aplasia whereas in ten patients complete myeloid aplasia could be demonstrated. Probability of survival was approximately ten times higher in patients with partial than in patients with complete bone marrow aplasia. The results of bone marrow biopsy investigations had a greater predictive value than the degree of diminution of single cellular blood components. Initial bone marrow biopsy investigation facilitates the selection of poor risk patients who should be treated by bone marrow transplantation rather than by conventional therapy.

Adolescent↗
PubMed1977

[Megakaryocytic myelosis--cause of "idiopathic" thrombocythemia].

Primary thrombocythaemia is to be distinguished from the secondary type by higher counts of megakaryocytes especially of atypic and gigantic forms of these cells, showing up in adequate histological preparations of bone marrow biopsies. From the analysis of those preparations the autonomous proliferation of the megakaryocytopoiesis clearly is to be understood as the reason of the socalled primary thrombocythaemia, occurring in the forms of isolated or mixtcellular megakaryocytic myelosis of the well differentiated type. Both of these forms can convert into thrombocytopenia when atypical and immature megakaryocytes start to overcrowd the picture or when myelofibrosis develops. The latter is to be considered in causal connections with the ineffective dislocated thrombopoiesis, a common finding among megakary-ocytic myelosis complicated with myelofibrosis. Megakaryocytic myelosis therefore is the clue of three different clinical syndromes, which are alternatively marked by the haemostaseologic or the histologic consequences of the overproduction of platelets, or by the proliferation of the megakaryocytes themselves.

Bone Marrow Examination↗