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Biomedical subjects

R S Holdrinet

Publications and source records attributed to R S Holdrinet.

At least 19 recordsLinked to original sources
PubMed1989

[The diagnosis of a possibly malignant neck lymph node].

With reference to the case histories of four patients with a possibly malignant lymph node whose diagnoses and therapies were seriously delayed, a critical discussion is presented of the recent recommendation on this problem issued by a team from the Central Peer Review Advisory Board. It appears that the observed loss of time can be attributed in part to insufficient insight into the role and technique of lymph-node puncture in patients with a presumably malignant cervical lymph node. We propose a changed diagnostic strategy in such patients, which takes into account the patient's age and the localization of the affected lymph node.

Adult↗
PubMed1989

[Deposition of light chains in various organs; light chain deposition disease].

The case is reported of a patient with renal insufficiency, proteinuria and heart failure caused by 'light chain deposition disease' (LCDD). A renal biopsy showed nodular glomerulosclerosis, IF examination revealed linear deposits of monoclonal lambda light chains along the glomerular and tubular basement membranes. Similar deposits could be shown in a skin biopsy. No light chains could be detected in urine and serum. The patient had a good response to treatment with melphalan and prednisone.

Acute Kidney Injury↗
PubMed1987

[Kahler's disease?].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1987

Prognostic factors in adult patients with acute leukemia at first relapse.

The case histories of 252 adolescent and adult patients with acute leukemia diagnosed and treated between 1975 and 1985 are analyzed with special attention to prognostic factors determining the second complete remission (CR) rate. A first CR was achieved in 65% of cases, 60% for acute myelogenous leukemia (AML), and 75% for lymphoblastic leukemia (ALL). In 86 patients a relapse occurred (50 AML, 36 ALL), and 50% of them entered a second CR after reinduction therapy. Median survival after first relapse of these reinduction-responders was significantly prolonged in comparison to the reinduction-nonresponders for both AML (15 versus 2 months) and ALL (11 versus 3 months). Median duration of the first CR of the reinduction-responders was significantly longer than that of the second CR (13 versus 6 months). The major determinant for the probability to obtain a second CR after reinduction therapy was the duration of the first CR. The latter was significantly longer in the reinduction-responders than in the nonresponding group (13 versus 5 months). Furthermore patients younger than 40 years, and those who relapsed after ending the maintenance therapy, tended to have better chances to achieve a second CR. Rapid achievement of the first CR, and sex of the patients seemed not to be of predictive value. The authors conclude that aiming for a second CR is worthwhile in young patients who relapse after a long first CR.

Adolescent↗
PubMed1987

Plasma and cellular adriamycin concentrations in patients with myeloma treated with ninety-six-hour continuous infusion.

Adriamycin (ADM) concentrations in neoplastic plasma cells, nucleated blood cells, bone marrow cells, and plasma were measured in seven patients with advanced multiple myeloma. ADM was administered as a 96-hour infusion of 9 mg/m2/24 hr. Maximum plasma ADM concentrations were 15.8 +/- 4.4 ng/ml. ADM concentrations in nucleated blood cells, bone marrow cells, and plasma cells increased continuously throughout the 96-hour infusion. Maximum cellular levels were up to 200-fold higher than the maximum plasma concentration and were similar to levels observed shortly after administration of the total dose in one rapid injection. The cellular AUC for 96-hour infusion and bolus injection were comparable. Thus continuous infusion is the equivalent of bolus injection in delivering ADM to the target cells in bone marrow, although plasma ADM concentrations remained very low. These results provide support for administering ADM as a continuous infusion with less toxicity and better patient tolerance.

Blood Cells↗
PubMed1986

Ceftazidime does not enhance cyclosporin-A nephrotoxicity in febrile bone marrow transplantation patients.

Ceftazidime was used as monotherapy for 30 febrile episodes in 28 patients, who underwent allogeneic bone marrow transplantation and who were treated concomitantly with the immunosuppressive agent cyclosporin-A. Ceftazidime did not enhance the well established nephrotoxicity of cyclosporin-A as measured by serum creatinine levels or creatinine clearance. Although an increasing number of Gram-positive infections in these patients warrants vigilance, ceftazidime as initial empirical monotherapy proved to be successful in 95% of all febrile post-transplantation patients. All Gram-negative and 69% of the Gram-positive infections were cured with ceftazidime alone. The overall clinical cure rate was 72%, with microbiological clearance in 63%. This compares favourably with aminoglycoside containing schedules and avoids the aminoglycoside associated nephrotoxicity.

Adult↗
PubMed1984

Translocation 1;7 in dyshematopoiesis: possibly induced with a nonrandom geographic distribution.

Eight patients with various hematologic disorders had an identical chromosomal aberration in their bone marrow or unstimulated peripheral blood, a translocation t(1;7) interpreted as t(1;7)(p11;p11). The translocation chromosome replaced one normal chromosome #7; therefore, the karyotype of the abnormal cells was trisomic for 1q and monosomic for 7q. Including four cases from the literature, a total of 12 patients (4 women, 8 men) with this translocation are known at the moment. The translocation does not seem to be associated with a specific disorder, but almost all patients had a preleukemic syndrome during some stage of their disease. It is very remarkable that 11 of the 12 patients lived in the Netherlands, and 7 patients had a history of iatrogenic exposure to alkylating agents or irradiation; one patient was a radiation worker and another one had a history of toxic exposure to chloramphenicol. It is suggested, therefore, that the t(1;7) is a possibly induced chromosomal aberration with a clearly nonrandom geographic distribution.

Adult↗
PubMed1984

Clinical course and survival in 16 patients with localized plasmacytoma.

The clinical course of 16 patients with localized plasmacytoma, 9 with solitary plasmacytoma of bone (SPB), and 7 with extramedullary plasmacytoma (EMP) are presented. Median follow up of SPB was 77 months and of EMP 74 months. The EMPs were localized in the upper respiratory tract (4 cases), the gastro-intestinal tract (2 cases) and the skin (1 case). The SPBs were localized in the ribs (3 cases), the spine (3 cases), the humoral bone (1 case), the skull (1 case) and the mandibular bone (1 case). In 3 patients with EMP and in 5 patients with SPB, the monoclonal protein could be determined at presentation. Local recurrences following surgical removal or irradiation occurred in 2 patients with EMP and in 1 patient with SPB after 12-60 months. Classical multiple myeloma developed in 3 patients with EMP and in 4 patients with SPB, 9-130 months after diagnosis. The monoclonal protein level proved to be a useful disease marker which (re)appeared at local recurrence or at dissemination. The median survival of the 16 patients with solitary plasmacytoma was 138 months, which is considerably longer than the median survival of 42 months in 14 stage-I patients with classical multiple myeloma who were observed during the same follow-up period.

Adult↗