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Biomedical subjects

R Kuzmits

Publications and source records attributed to R Kuzmits.

At least 19 recordsLinked to original sources
PubMed1990

Serum neuron-specific enolase is a useful tumor marker for small cell lung cancer.

Small cell lung cancer (SCLC) may be potentially curable. A correct diagnosis of cancer cell type is important and serum markers are of great value. Although several markers have been suggested, they have been of limited value because of insufficient specificity. To assess the value of serum neuron-specific enolase (S-NSE) as a possible marker of SCLC, the serum levels of 81 patients with SCLC (59 patients with extensive disease and 22 patients with limited disease) were compared with the serum levels of patients with non-small cell lung cancer (N-SCLC) and 93 patients with nonmalignant lung diseases. The S-NSE level also was measured in 104 patients with extensive disease of various other malignancies, including 71 solid tumors and 33 malignant hematologic disorders. From 105 healthy control subjects, the upper limit of the normal range (x + 2 standard deviations [SD]) was determined as 12.3 ng/ml. The S-NSE level was elevated in 78% of patients with SCLC, including 11 of 22 (50%) with limited disease and 52 of 59 (88%) with extensive disease. In contrast, the S-NSE level was raised only in 18% of patients with advanced N-SCLC (nine of 50) and 6% of patients with nonmalignant lung diseases (six of 93). Twelve patients (17%) with other solid malignant tumors and two patients (6%) with malignant hematologic disorders had raised S-NSE levels. Serial N-NSE levels were obtained in 13 patients with SCLC. S-NSE levels fell in all patients responding to chemotherapy and increased again with progression of disease. Our results indicate that S-NSE seems to be specific for SCLC (85%), whereas sensitivity seems to be dependent on the stage of disease. Further, S-NSE may be a useful marker for monitoring treatment and predicting relapse in patients with SCLC.

Biomarkers, Tumor↗
PubMed1990

Increased growth hormone responses to growth hormone releasing hormone and thyrotropin releasing hormone in patients with metastatic testicular cancer.

In 16 patients with metastatic testicular cancer and 10 age matched male control subjects growth hormone (GH) responses to growth hormone releasing hormone (GHRH; 1 microgram/kg body weight iv.) and thyrotropin releasing hormone (TRH; 200 micrograms iv.) were measured. Basal GH levels and GH levels following stimulation with GHRH or TRH were significantly increased in cancer patients compared to control subjects. 9 patients with testicular cancer were studied both in the stage of metastatic disease and after they had reached a complete remission. In complete remission GH responses to GHRH tended to decrease but the differences did not reach statistical significance. Our data suggest an alteration of hypothalamic and/or pituitary regulation of GH secretion in patients with metastatic testicular cancer.

Adult↗
PubMed1989

Clinical biochemistry of neuron specific enolase.

The soluble brain protein 14-3-2 first described by Moore and McGregor in 1965 is now known to be a cell specific isoenzyme of the glycolytic enzyme enolase (EC 4.2.1.11), designated neuron specific enolase (NSE). It is not only a marker for all types of neurons, but also for all neuroendocrine or paraneuronal cells. The appearance of NSE is a late event in neural differentiation, thus making NSE a useful index of neural maturation. The demonstration that tumors of the nervous system and of neuroendocrine origin contain NSE has promoted the study of NSE as a possible tumor marker. Immunocytochemistry has been used to identify NSE in cytologic preparations from several types of tumors, offering useful indications for differential diagnosis. NSE levels in serum from tumor patients are not useful in the diagnosis of early stage disease. However, serum NSE levels have been shown to be helpful in the identification of advanced small cell lung cancer, neuroblastoma and several other neoplasms. The main use of serum NSE is the monitoring of chemotherapy and the detection of a relapse in these cases.

Biomarkers, Tumor↗
PubMed1989

[Therapy of metastatic carcinoid with the somatostatin analog octreotide and with recombinant interferon alfa 2b].

A 69 year-old male with carcinoid syndrome and undetectable primary tumour, but disseminated liver metastases, was treated with somatostatin analogue octreotide (Sandostatin) and later additionally with recombinant interferon alpha 2 b (r IFN alpha 2 b, Intron A). The carcinoid symptoms (flushing, diarrhoea) were stopped within hours by octreotide. Simultaneously, the urinary 5-hydroxyindolacetic acid (5-HIAA) excretion and serum serotonin levels decreased by more than 50%. In spite of continued treatment with r IFN alpha 2 b a reduction in dosage of octreotide resulted in a rapid recurrence of carcinoid symptoms, suggesting that IFN alpha 2 b had no effect on the carcinoid symptoms in this patient. Since, furthermore, no regression of the tumour mass was observed, treatment with IFN was stopped after 8 months. During 15 months of treatment to date the patient has been kept free of symptoms by octreotide.

Aged↗
PubMed1989

[The cholesterol risk factor--initial results of a screening study in industries].

After the distribution of suitably informative leaflets all the employees of 2 companies were invited to participate in a screening programme with the aim of detecting elevated cholesterol levels. 238 out of 510 employees participated in the screening. Related to the age-adjusted Austrian recommendations for the upper limit of normal values, cholesterol was elevated in 73 people (30.7%). The percentage of smokers was slightly below the Austrian rate with 26% in company M and 30% in company H. All the participants were informed of their laboratory results within one week. Participants with a moderately or extremely increased risk were invited to a personal talk. Furthermore, a number of other previously undetected abnormalities were detected in 41 cases (17.2%), leading to subsequent clinical diagnosis and treatment. In addition, 3 plasma factor defects were discovered. These investigations served as a foundation for a more intensive planned programme. A continuation of this screening procedure is planned involving about 10,000 people per year.

Adult↗
PubMed1989

[Cholesterol screening in a bank for the detection of a risk population].

In October 1987 voluntary screening for cholesterol war performed in a bank. After preceding information had been issued to the participants 25 ml blood were drawn on 4 days from 667 employees (48.9% males, 51.1% females) for determination of the blood lipids and other parameters. The mean age (range 19 to 60) was 39 +/- 9 years; 29.2% were smokers. The mean cholesterol level amounted to 212 mg/dl. According to age- and sex-related normal values 42% exhibited an increased risk, whereby the percentage was particularly high (55%) in the age group under 30 years.

Adult↗
PubMed1989

Early-onset thrombocytopenia during combination chemotherapy in testicular cancer is induced by vinblastine.

Platelet kinetics were studied in 70 patients with testicular cancer to elicit the agent responsible for chemotherapy-induced transient early-onset thrombocytopenia; 204 treatment courses were analyzed using three different therapy protocols, which contained vinblastine and bleomycin either alone or in combination with cisplatin. Platelet count decreased significantly from the start of vinblastine administration reaching its nadir on the third day of therapy in each of the three treatment groups. Between day 4 and day 10 of the treatment cycle, platelet counts steadily increased even in patients still receiving continuous bleomycin infusions. The conclusion that the observed early-onset thrombocytopenia was caused by vinblastine was substantiated by the outcome of two additional examinations. Platelet half-life was significantly shortened 24 hours after vinblastine administration and electron microscopy revealed a dissolution of cytoplasmatic microtubules with loss of the typical discoid shape of platelets within 15 minutes after the start of therapy. Both findings occurred irrespective of the specific treatment protocol, i.e., even after nothing but vinblastine had been given. These results strongly suggest that vinblastine is the main cytostatic agent responsible for the transient early-onset thrombocytopenia observed during chemotherapy of testicular cancer.

Adolescent↗
PubMed1989

HLA-antigen distribution in seminoma, HCG-positive seminoma and non-seminomatous tumours of the testis.

Histocompatibility antigens play a certain role in the development of testicular tumours. 151 patients with testicular cancer (86 non-seminomatous germ cell tumours--NSGCT--and 65 pure seminoma) were typed for the HLA-antigens of the A, B, C and DR locus. 24 patients of the pure seminoma group and 50 patients of the NSGCT group had an elevated serum HCG level preoperatively. The antigen DR-5 was elevated in the seminoma group whereas the incidence of B-13 was increased in the NSGCT group. In terms of antigen distribution HCG-positive seminoma resembles seminomatous tumours rather than NSGCT.

Chorionic Gonadotropin↗
PubMed1988

Microsomal aromatase in testicular tumour tissue: increased activity in choriocarcinoma compared to embryonal carcinoma.

Microsomal aromatase activity was assayed in testicular tumour tissue from one patient with choriocarcinoma and two patients with embryonal carcinoma. In the microsomal fractions of tumour tissue conversion of 3H-testosterone and 3H-androstenedione to 3H-17 beta-estradiol and 3H-estrone was measured. Aromatase activity was markedly increased (8-fold) in choriocarcinoma compared to embryonal carcinoma. In the choriocarcinoma patient, high HCG-levels measured in serum and the increased aromatase activity in the tumour with resulting elevated estrogen levels in serum seem to be responsible for the decreased production of androgen in this type of tumour.

Androstenedione↗
PubMed1988

Acute vascular toxicity after combination chemotherapy with cisplatin, vinblastine, and bleomycin for testicular cancer.

Twenty-one consecutive patients with testicular cancer treated with bleomycin, vinblastine, and cisplatin (PVB) were evaluated for acute vascular ischaemic events during chemotherapy. Angina pectoris occurred in 8/21 (38%) patients, a median 5.6 weeks after initiation of chemotherapy and persisted for 2-7 days. Raynaud's phenomenon was detected in seven (33%) subjects, transient ischaemia of the toes was found in six (29%) patients, one patient complained of migraine, but none had major cerebrovascular accidents. Patients with and without angina pectoris and/or Raynaud's phenomenon did not differ in respect of age, histology of tumor or medication. Ischaemia occurred at any time during the course of chemotherapy. No correlation was found between dosage of drugs and time of onset of ischaemic reactions. However, arterial occlusive event is a frequent and common toxicity and a result of treatment with PVB.

Adult↗
PubMed1988

[Interferon therapy in multiple myeloma].

Natural leukocyte interferon and recombinant interferon alpha-2 have effected remission rates between 10 and 20% in the treatment of multiple myeloma. Response rates have been higher in untreated patients than in relapsing or primarily refractory cases. Patients with slowly proliferating tumors, early tumor stage or IgA-monoclonal protein seem to show increased sensibility to interferon as compared to patients without those characteristics. First trials using combined interferon chemotherapy regimens suggest that the toxicity associated with this treatment modality remains acceptable. At present, however, one cannot definitely decide whether and to which degree the combination therapy will improve the response rates.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Pulmonary veno-occlusive disease in a patient with unilateral absence of right pulmonary artery.

A 25-year-old patient had unilateral absence of the right pulmonary artery (UARPA) and severe left pulmonary artery hypertension. After death from congestive right heart failure, autopsy revealed histologic signs of pulmonary veno-occlusive disease (PVOD) and pulmonary hypertension (PH). An accessory arterial vessel that was thrombotically occluded was found connecting the ascending aorta and the right pulmonary hilum. There was also histologic evidence of arterial thrombi within the right lung arterial vascular bed. The PH in UARPA usually occurs very early during the course of disease. From histologic findings and medical history, it is likely that in this case, late-onset elevation of pulmonary pressures was triggered by the occurrence of PVOD. This is the first case of UARPA and PVOD--a congenital unilateral arterial malformation in the presence of bilateral involvement in a possibly acquired venous obliterative disease.

Adult↗
PubMed1987

Serum neuron-specific enolase. A marker for responses to therapy in seminoma.

Neuron-specific enolase (NSE) was evaluated as a serum marker in 105 patients with testicular cancer and compared with the established tumor markers alphafetoprotein (AFP) and human chorionic gonadotropin (HCG). Increased serum NSE activity was measured in eight of 11 (73%) patients with metastatic seminoma. Serum NSE concentrations fell to within the normal range following chemotherapy. Localization of NSE in seminoma cells was demonstrated immunohistochemically. Only six of 40 (15%) patients with metastatic nonseminomatous germ cell tumors showed elevated serum NSE levels. AFP and HCG were both positive in 70% of patients in this group, and NSE determination gave no additional information. Serum NSE concentrations were normal in 53 of 54 testicular cancer patients after orchiectomy and there was no evidence of metastatic disease; only one had borderline NSE levels, indicating the specificity of serum NSE determination. NSE is a new marker of seminoma and its measurement may be of clinical value in monitoring chemotherapy in patients with metastatic seminoma.

Adolescent↗
PubMed1987

Prognostic value of tumor marker determinations in testicular cancer patients.

This report is based on the observation of 109 patients with testicular cancer over a period of 6 years. At the time of orchiectomy metastases were present in 54 patients. In 13 patients with an initially nonmetastatic disease, secondaries occurred later. The aim of this study was to evaluate the role of serum levels of human chorionic gonadotropin (beta-HCG) and alpha-fetoprotein (AFP) in the prognosis for achieving a complete remission. The importance of serial serum AFP and beta-HCG determinations for the early detection of tumor metastases was also evaluated. Remission rates were lowered significantly in patients with serum AFP levels above 500 micrograms/liter (8%, P less than 0.0005) and serum beta-HCG concentrations exceeding 5,000 U/liter (27%, P less than 0.05). For an early detection of metastases the best results (efficiency 0.92) were achieved with the combination of beta-HCG with AFP and X-ray examination of the chest.

Chorionic Gonadotropin↗