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Biomedical subjects

R Grundmann

Publications and source records attributed to R Grundmann.

At least 19 recordsLinked to original sources
PubMed1990

[Neopterin as a marker of aspecific immunostimulation with Propionibacterium avidum KP-40 in patients with gastrointestinal tumors. A prospective randomized study].

This prospective randomized study demonstrated that a preoperative intravenous infusion of 10 mg of the bacterial preparation Propionibacterium avidum KP-40 to patients with gastrointestinal tumors significantly (P less than 0.001) enhanced the secretion of neopterin, measurable as long-lasting (greater than 16 days) elevated urine excretion. Postoperative re-infusion of P. avidum KP-40 caused (statistically significant (p less than 0.001] re-enhancement of neopterin urine levels.

Adult↗
PubMed1990

Preoperative immunostimulation with propionibacterium avidum KP-40 in patients with gastric carcinoma: a prospective randomized study.

Sixty-eight patients admitted for resection of gastric carcinoma entered a prospectively randomized trial. Patients in the therapy group (n = 34) received a preoperative controlled infusion of 10 mg Propionibacterium avidum KP-40. The therapy and control group did not differ with regard to postoperative complications, tumor recurrence rates (therapy group: 41%, control group: 38%), and patient survival rates (survival rate in the therapy group after 25 months: 53%, in the control group after 25 months: 50%).

Adenocarcinoma↗
PubMed1990

[Immunoglobulin therapy of postoperative sepsis].

35 patients with septic postoperative complications entered a prospectively randomized study. The clinical state of these patients was daily determined using the sepsis score described by Elebute and Stoner. Endotoxin and antithrombin III were measured in the plasma using the limulus-amoebocyte-lysat test for endotoxin determination. The septic patients were treated with an immunoglobulin preparation (Pentaglobin) administered by the intravenous route. This preparation is enriched in IgM and IgA. Due to the immunoglobulin therapy the endotoxin titres decreased; simultaneously a reduction of mortality and shortening of time of hospitalization and of mechanical ventilation were observed.

Antithrombin III↗
PubMed1990

Comparative study on lymphocyte subpopulations in cancer patients after immunostimulation with propionibacteria and in renal transplant patients after combined immunosuppression.

In two groups of patients the influence of unspecific immunostimulation (group 1) and combined immunosuppression (group 2) on lymphocyte subpopulations was studied. Patients constituting group 1 suffered from gastric and colorectal carcinoma, respectively, and were preoperatively treated with 10 mg whole cell preparation of immunostimulating Propionibacterium avidum KP-40 (Köln-Propioni, strain 40). Patients of group 2 were submitted to combined immunosuppressive therapy and treated with antilymphocyte globulin, prednisone, and azathioprine subsequent to renal transplantation. Immunostimulation with P. avidum KP-40 resulted in a significant increase (p less than or equal to 0.01) of the natural killer (NK) cell population, whereas total leukocyte and lymphocyte counts as well as helper and suppressor T lymphocyte subsets did not evidently differ from control values. On the contrary after immunosuppression all subsets of lymphocytes as well as NK cells significantly decreased.

Azathioprine↗
PubMed1990

[Quality assurance in clinical studies: a necessity].

Good Laboratory Practice (GLP), Good Manufacturing Practice (GMP), and Good Clinical Practice (GCP) are the constituents of a new concept for quality assurance in pharmaceutical research. They are to establish standards for preclinical and experimental research in animals (GLP), for the manufacturing of drugs (GMP), and for trials on medical products in human beings (GCP), respectively. Each of the 3 entities is characterized by the same principles of control; these involve written instruction describing the general operations to be performed, the so called Standard Operating Procedures (SOP), and Quality Assurance Units being responsible for surveying the operations in accordance with the SOP, and ensuring that the generated data will satisfy the requirements for quality. As far as clinical trials are concerned, the SOP is represented by the study protocol and a Monitor provides for the surveying of the trial. GCP is further characterized by ethical principles, which aim primarily at protecting personal integrity and welfare of the trial subjects. The Declaration of Helsinki is the accepted basis for clinical trial ethics. Following the Declaration of Helsinki during the planning, conducting, surveying and evaluating of clinical trials provides for a degree of seriousness being the real hallmark of Good Clinical Practice.

Animals↗
PubMed1990

Monitoring of tumor necrosis factor therapy with neopterin.

As neopterin is only secreted by stimulated macrophages, serum neopterin levels are an important marker for cellular immunity. Daily determinations of serum neopterin were performed in five patients with advanced colorectal carcinoma receiving a therapy with tumor necrosis factor (TNF). 24 h after every TNF infusion a significant, but only short-lasting increase of neopterin was observed. This effect was dependent on the applicated TNF dose. These results prove that determinations of serum neopterin levels are a helpful parameter for monitoring an immunomodulating therapy with TNF.

Biopterins↗
PubMed1989

[Quality of life after rectal resection or extirpation. A comparison using different measurement parameters].

Two groups of 41 patients each who had undergone rectal resection or excision were questioned about the quality of their life an average of 4.3 or 3.8 years, respectively, after the operation. Three different measurements were obtained (Karnofsky, Grogono and Spitzer indexes). In addition, the patients provided a subjective estimate of the quality of their life. The quality of life was significantly better after resection than after excision, most clearly so according to the Grogono index, and this was also reflected in the patients' personal assessment. In males rectal excision frequently resulted in inferiority feelings, depression and disorders of sexual activity. Females found it easier to cope: they showed only minor differences in quality of life between resection and excision. Irrigation proved to be the best means of stoma care as far as quality of life was concerned.

Adult↗
PubMed1989

[Effect of time of operation and clinic organization on postoperative complications].

During a 1-year period 1082 general surgical interventions were prospectively documented and their complication rates evaluated by a score system. Factors responsible for the complication rates and possibly depending on hospital organization should be analysed. The complication rates were influenced by the selection of the weekday, the length of operation time and the extent of discrepancy between planned and required operation time. Furthermore, the complication rates paralleled the extent of utilization of the operation theatre during a workday. The complication rates were not affected by the beginning of operation and the operation month as well as the monthly utilization of the operation theatres. Whether the weather did influence the complication rates could not be decided: higher complication rates were found in the summer as compared to the winter period, but the complication score was independent of the level of the outside temperature and humidity.

Germany, West↗
PubMed1989

[A simple point score for definition of the risk of postoperative complications].

During a 5-year-period we recorded prospectively 5,823 patients who had undergone general surgery and documented the postoperative complications as wound infection, pneumonia, reoperations and death. A score including all these complications was developed to evaluate the risk of an operation more exactly than using the wound infection rate alone. This method seems to provide a continuous monitoring and the comparison of the complication risks of certain operations within a quality assurance program. For gastric and colon surgery we found a correlation between postoperative antibiotic use and score, but not between score and postoperative hospitalization time.

Anti-Bacterial Agents↗
PubMed1989

[The value of tumor markers in colorectal cancer].

In 137 patients with colorectal carcinoma carcinoembryonic antigen (CEA) was preoperatively measured in serum. Sensitivity of CEA was dependant on the tumor stage. Patients in early tumor stages (TNM stages I + II) demonstrated only in 10% grossly elevated CEA levels compared with 43% of patients with progressive tumor stages (TNM III + IV). The main importance of tumor markers lies still in postoperative follow-up. In patients with a local recurrence of colorectal carcinoma we measured in 57% CEA levels greater than 10ng/ml, in patients with distant metastases even in 75%. CA 19-9 achieved a lower sensitivity in postoperative follow-up of colorectal carcinoma than CEA. Only 22% of patients with a recurrence of colorectal carcinoma had CA 19-9 levels beyond the normal range (37 U/ml) compared with 67% elevated CEA levels in the same group of patients. CEA is still the most important tumor marker in colorectal carcinoma. Measurement of CA 19-9 in postoperative follow-up is no substitute for CEA, it can only be a supplement.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1988

[Follow-up of infected patients in an intensive care unit using the "infection score," endotoxin and AT III determination].

74 patients treated in the intensive care unit for postoperative sepsis were prospectively documented. The severity of sepsis was monitored by a scoring system. Additionally, daily measurements of antithrombin III (AT-III) levels, thrombocytes and endotoxin plasma concentrations were performed. The sepsis score only discriminated between surviving and non-surviving patients. The sensitivity in predicting death due to sepsis was 94%, the specificity 80% in case that a sepsis score of 19 was achieved. In contrast, thrombocytes, endotoxin plasma concentrations and AT-III levels were not able to predict the final outcome, but could be correlated to the severity of sepsis. Since high score levels can also be caused by multiple organ failure due to other reasons, the septic condition of the patients should be defined in the future by the combination of this scoring system with the endotoxin or AT-III measurement.

Adolescent↗
PubMed1988

[DSA in the postoperative diagnosis of patients with kidney transplants].

Image quality and diagnostic significance of intravenous and intraarterial DSA following renal transplantation were assessed in 40 angiographic studies. In 27 of 40 DSA (67.5%) there were pathologic findings such as a renal artery stenosis, aneurysms or rejection within this selected group of patients. There were significant differences in image quality between intravenous and intraarterial DSA. The value of intravenous DSA is limited, particularly in patients with complex anastomosis, implanted polar arteries and kinking stenosis.

Adult↗