Saving unused insulin for countries in need.
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Developing Countries↗
Biomedical subjects
R Raab
Publications and source records attributed to R Raab.
[Virostatic treatment of herpes simplex infections of variable severity].
Aciclovir (ACV) is the most effective drug for the virostatic management of herpes simplex virus (HSV) infections, and the rate of side-effects is low. ACV resistance is rare, occurring only in highly immunocompromised patients (so far about 30 cases have been reported). Dosages and modes of application of ACV in different HSV infections are indicated and discussed.
Acyclovir↗
[Liver resection in 157 patients with colorectal metastases].
The mean life expectancy for patients with hepatic metastases from colorectal carcinoma is poor. Removal of those tumors leads to an improvement of this situation. In 157 patients with colorectal metastases liver resection was performed. The overall 5-year survival rate was 23% with a median of 34.9 months. Significant prognostic factors for survival were size, and distribution of metastases, percent hepatic replacement by tumor, and radicality of operation. These results emphasize again that in selected patients with colorectal liver metastases resectional therapy is in principle indicated. Especially in the light of lacking therapeutical alternatives this offers presently the only chance for longterm cure or at least significant palliation.
Adult↗
[Extensive angiodysplasia of the colon and rectum as a cause of recurrent lower intestinal hemorrhage].
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Arteriovenous Malformations↗
[The procedure in recurrent tumors of the liver].
From 1981 to 1988, 13 patients with liver metastasis and 7 patients with primary hepatic tumors underwent a second hepatic resection for tumor recurrence. A second resection was feasible even after an extensive first resection. Several patients experienced tumor recurrence shortly after the first resection, but lived a long time after the second resection. The actuarial survival after a second resection for colorectal metastasis was similar to that after the first resection. Therefore a second resection for tumor recurrence is reasonable and may prove especially important in individual situations.
Adenoma, Bile Duct↗
Dominance in lambda S mutations and evidence for translational control.
Phenotypic analysis of a collection of point mutations in the lysis gene S of bacteriophage lambda indicates that many of the S alleles exhibit at least partially dominant character, suggesting that the S gene product (gpS) must oligomerize to achieve its lethal membrane effect. Moreover, mutations found 5' to the coding sequence also show a dominant character and appear to define a site, designated sdi (structure directed initiation) where mRNA secondary structure controls the choice of initiation codons. We propose that formation of the sdi structure occludes the consensus Shine-Dalgarno sequence and results in initiation at the Met3 codon, generating a lethal 105 residue polypeptide. The model predicts that, in the absence of the sdi stem-and-loop, initiation occurs at the Met1 codon, generating a 107 residue polypeptide, which is a non-lethal inhibitor of lysis. In support of the model, alteration of the first codon was achieved using site-directed mutagenesis, resulting in an S allele that is more lethal and induces lysis significantly sooner than the wild-type.
Amino Acid Sequence↗
[Multiple colorectal cancers: properties and long-term prognosis].
In our own patient population with primary colorectal cancer (n = 1352, 1971-1984) we analyzed the frequency, characteristics and prognosis of multiple carcinomas. The overall incidence was 7.3% (4.5% synchronous and 2.8% metachronous carcinomas). Compared to single cancer synchronous tumors had a worse and metachronous tumors had a better 5 year-prognosis (58%, 43% and 86% respectively). This suggests that synchronous and metachronous colorectal carcinomas may be two biologically separate entities. Conclusions from our observations are discussed in regard to diagnosis, therapy and follow-up.
Colonic Neoplasms↗
Anti-idiotype immunization of cancer patients: modulation of the immune response.
Thirty patients with advanced colorectal carcinoma (CRC) were treated with alum-precipitated polyclonal goat anti-idiotypic antibodies (Ab2) to monoclonal anti-CRC antibody CO17-1A (Ab1) in doses between 0.5 and 4 mg per injection. All patients developed anti-anti-idiotypic antibodies (Ab3) with binding specificities on the surfaces of cultured tumor cells similar to the specificity of Ab1. Furthermore, the Ab3 competed with Ab1 for binding to CRC cells. Fractions of Ab3-containing sera obtained after elution of the serum immunoglobulins from CRC cells bound to purified tumor antigen and inhibited binding of Ab2 to Ab1. The Ab3, therefore, may share idiotopes with Ab1. Six patients showed partial clinical remission and seven patients showed arrest of metastases following immunotherapy. Four of the thirteen patients with measurable clinical responses had received Ab2 alone, whereas 9 patients had also received chemotherapy.
Antibodies, Anti-Idiotypic↗
Mutational analysis of bacteriophage lambda lysis gene S.
A plasmid carrying the bacteriophage lambda lysis genes under lac control was subjected to hydroxylamine mutagenesis, and mutations eliminating the host lethality of the S gene were selected. DNA sequence analysis revealed 48 single-base mutations which resulted in alterations within the coding sequence of the S gene. Thirty-three different missense alleles were generated. Most of the missense changes clustered in the first two-thirds of the molecule from the N terminus. A simple model for the disposition of the S protein within the inner membrane can be derived from inspection of the primary sequence. In the first 60 residues, there are two distinct stretches of predominantly hydrophobic amino acids, each region having a net neutral charge and extending for at least 20 residues. These regions resemble canonical membrane-spanning domains. In the model, the two domains span the bilayer as a pair of net neutral charge helices, and the N-terminal 10 to 12 residues extend into the periplasm. The mutational pattern is largely consistent with the model. Charge changes within the putative imbedded regions render the protein nonfunctional. Loss of glycine residues at crucial reverse-turn domains which would be required to reorient the molecule to reenter the membrane also inactivate the molecule. Finally, a number of neutral and rather subtle mutations such as Ala to Val and Met to Ile are found, mostly within the putative spanning regions. Although no obvious explanation exists for this subtle and heterogeneous class of mutations, it is noted that all of the changes result in a loss of alpha-helical character as predicted by Chou-Fasman theoretical analysis. Alternative explanations for some of these changes are also possible, including a reduction in net translation rate due to substitution of a rare codon for a common one. The model and the pattern of mutations have implications for the probable oligomerization of the S protein at the time of endolysin release at the end of the vegetative growth period.
Alleles↗
Rejection and nephrotoxicity. Diagnostic problems with cyclosporine in renal transplantation.
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Cyclosporins↗
[Kidney transplantation from the surgical viewpoint].
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Humans↗
Enhancement of choline dehydrogenase activity in rat liver mitochondria by clofibrate feeding.
Male rats were fed a diet containing 0.75% clofibrate. After three weeks, the specific activity of choline dehydrogenase of a liver mitochondrial fraction was more then doubled. However, the activity of two other NAD-independent flavoenzymes of the inner mitochondrial membrane namely proline and succinate dehydrogenases were not altered significantly. Thus changes of the inner mitochondrial membrane induced by clofibrate seem to be restricted to some particular enzymes.
Alcohol Oxidoreductases↗
The application of monoclonal antibodies to the characterization and diagnosis of lymphoid neoplasms: a review of recent studies.
Twenty-three T-cell neoplasms were divided, according to their reactivity with the OKT monoclonal antibodies as follows: Fourteen neoplasms of diverse histopathology expressed the OKT3+ OKT4+ phenotype, commonly associated with the helper T-cell subset; seven histologically similar lymphoblastic neoplasms expressed diverse phenotypes consistent with various stages of intrathymic differentiation and two neoplasms expressed the uncommon OKT3+ OKT10+ phenotype. Thus, T-cell neoplasms are divisible into phenotypes that correspond to normal stages of T-cell differentiation and functionally distinct T-cell subsets. Benign and malignant lymphoid cells were investigated in cell suspension and in cryostat tissue sections for their reactivity with OKB1, OKB2, OKB4, and OKB7, monoclonal antibodies known to detect distinctive B lymphocyte antigens. Fetal liver pre-B cells, cases of pre-B acute lymphoblastic leukemia, and common-type acute lymphoblastic leukemia were OKB2+ but unreactive with the other OKB antibodies. All mature lymphoid tissue B cells and 47/47 surface immunoglobulin (SIg)-positive B-cell neoplasms were OKB2+. Interfollicular, follicular center, and many, but not all, mantle zone B cells were OKB1+ OKB7+. Follicular center B cells were OKB4+ but mantle zone and interfollicular B cells were OKB4-. 45/47 SIg+ B-cell neoplasms were OKB1+ OKB4+. 45/46 SIg+ B-cell neoplasms were OKB7+. Benign and myeloma plasma cells were OKB-. T-cell neoplasms were OKB2- OKB4- but were occassionally OKB1+ and OKB7+. The OKB antibodies appear to detect distinctive antigens that may be expressed at different stages of B-cell differentiation.
Animals↗
Renal allograft survival in patients transfused perioperatively only.
We investigated in a prospective study the effects of perioperative blood transfusions on the outcome of renal transplantation. All patients (n = 105) receiving their first cadaveric renal allograft were transfused perioperatively (i.e. 0-6 hours before transplantation) with two units of non-washed, unfiltered packed red cells. Forty-eight were transfused perioperatively only; 57 patients had received blood earlier and thus were transfused pre- and perioperatively. Graft survival one and two years post-transplant was 79 per cent at both time intervals in the group transfused perioperatively only, and 85 per cent and 74 per cent in the pre- and peroperatively transfused group. No adverse effects were observed concerning perioperative transfusions. In patients transfused perioperatively only, acceptable graft survival rates are obtainable. In these patients the risk or presensitisation is avoided, and thus their chance of successful transplantation increased.
Adolescent↗
Resection of synchronous liver metastases from colorectal cancer.
Whereas resection for metachronous liver metastases from colorectal cancer is considered to be a potentially curative approach, little is known about the prognosis after resection of synchronous liver metastases. In the past, these patients usually underwent only palliative therapy. Therefore, we have analyzed the data of 36 patients who underwent curative hepatic resection of synchronous liver metastases from colorectal carcinomas from 1977 to 1987 at the Department of Surgery, Hannover Medical School. In 19 patients, liver resection was combined with colonic resection; in the other 17 patients, hepatic resection was performed after a median interval of 2 months following resection of the primary tumor. No operative mortality was observed in either of the approaches. The median survival time was 28 months for all patients with a median recurrence-free interval of 13.5 months. Overall 5-year survival probability for all patients was 20%. There were no significant differences observed between immediate or delayed liver resection (median survival 18 months versus 31 months). Survival rates were not different after resection of solitary versus multiple liver metastases (26 versus 28 months). Twenty-one of the 36 patients had a recurrence of their liver metastases. In 7 of them, curative liver resection could be performed again. These 7 patients had a significantly improved survival (p less than 0.05) compared to the residual 14 patients. It is concluded that patients with synchronous liver metastases from colorectal cancer may profit from resection of the primary tumor and liver metastases. Timing of liver resection--immediate versus delayed--obviously has no impact on survival rates.
Adult↗
Is liver transplantation superior to resection in early stage hepatocellular carcinoma?
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Carcinoma, Hepatocellular↗
Liver metastases of breast cancer: results of liver resection.
BACKGROUND: In case of distant metastases breast cancer is generally regarded as incurable. Therefore liver surgery is withheld from those patients, even in cases of isolated liver metastases. MATERIALS AND METHODS: Over 11 years we performed 35 liver resections in 34 patients with liver metastases of breast cancer. The median age was 47 years. The median interval between the primary operation and the liver resection was 27.3 months. 59% of the patients had a solitary metastasis. RESULTS: Curative (R0) resection was possible in 86%. Operative mortality was 3% (n = 1). Overall 5-year survival was 18.4% (median 27 months). Prognosis was significantly (p < 0.001) better following R0-resection (22%, median 41.5 months) than after R1/2-resection (maximum 20 months, median 5 months). Beside the radicality an unfavorable influence on the prognosis could be demonstrated only for a prior local recurrence of the primary tumor (p < 0.05). Other factors like stage of the primary tumor and number and size of the metastases were without prognostic significance. CONCLUSIONS: Patients with isolated liver metastases of breast cancer may have a long lasting benefit from liver resection. In individual cases cure may be possible.
Adult↗