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Biomedical subjects

R Sauer

Publications and source records attributed to R Sauer.

At least 19 recordsLinked to original sources
PubMed1992

Combined radiation and chemotherapy for epidermoid carcinoma of the anal canal.

Between 1985 and 1992, 46 patients with epidermoid carcinoma of the anal canal were treated prospectively by a protocol of combined radiation and chemotherapy with 5-Fluorouracil and Mitomycin C. The survival rate, NED-survival rate and local tumour control rate were 84%, 71% and 83% at 5 years. Anorectal function was retained in 33 of 41 patients (80%). We observed severe acute toxicity including three deaths, but very little late morbidity. The only marginally significant prognostic factor (P = 0.06) for local tumour control was T-stage. NED-survival was significantly affected (P = 0.02) by reduction of chemotherapy during the second course.

Adult↗
PubMed1992

Therapy of small breast cancer: a prospective study on 1036 patients with special emphasis on prognostic factors.

In 1983, The German Breast Cancer Study Group, sponsored by the Federal Ministry of Research and Technology, started a prospective multicenter trial on the treatment of early breast cancer pT1 pN0 M0. Treatment consisted of initial tumorectomy with microscopically free margins and lower axillary dissection. After conformation of a pT1 pN0-stage, additional treatment was either mastectomy or adjuvant radiotherapy (50 Gy in 25 fractions to the entire breast plus 12 Gy electron boost). In medially located tumors, the parasternal and supraclavicular area was also irradiated with 50 Gy. A randomization between both treatment modalities was initially planned but was not feasible and abandoned. Nearly all patients were treated according to their own choice. From November 1983 through December 1989, 1119 patients were recruited. Eighty-three were excluded from the protocol. Out of the remaining 1036 patients, 733 (71%) underwent breast preservation and 303 (29%) mastectomy. A detailed pathohistological examination of all tumorectomy specimens was performed in a pathologic reference center. Oncogen overexpression was evaluated by immunohistological detection of the transmembrane protein p-185 (corresponding to c-erb-B2) in 425 cases. After a median follow-up of 48 months, the frequency of local recurrences (4.7%), regional recurrences (1%), and distant metastases (5.4%) was the same in the breast preservation group and the mastectomy group. The 3-year disease-free survival was 90% after breast preservation and 88% after mastectomy (p = 0.21). In the breast preserving group, 24 patients with microscopically involved margins had a poorer disease-free survival than the study group (75% vs 90% after 3 years). The width of the margins had no impact on prognosis. Other prognostic factors in an univariate and multivariate analysis were tumor size and tumor grade. Age, menopausal status, hormone receptor status, histological tumor type, and treatment (mastectomy vs breast preservation) were not significant. P-185-expression was dependent on tumor grade and was the strongest prognostic factor in an univariate and multivariate analysis (p less than 0.001). The results emphasize the central role of tumor grade for prognosis and suggest the independent prognostic significance of the c-erb-B2 oncogen (corresponding to p-185) in pN0-patients.

Adenocarcinoma↗
PubMed1978

[The question of the possibility to reproduce field positions in high-voltage therapy (author's transl)].

In order to obtain informations about the possibility to reproduce field positions in high-voltage therapy, controls were made by therapy films on several patients during the irradiation with a linear accelerator and a telecobalt unit. An incorrect position of the fields and/or lead satellites was found in 51% of the controls. The authors discuss possible reasons and their consequences for the radiotherapeutic practice. It must be taken into consideration especially when therapy plans are elaborated, that their realization may cause difficulties in the daily practice.

Cobalt Radioisotopes↗
PubMed1978

[Tridimensional irradiation planning with Philips TPS and ultrasound gray-scale tomography in the course of routine work (author's transl)].

Extent and location of the target volume as well as the optimum choice of radiation and field and the use of wedges or compensation filters are critical parameters with respect to the quality of a treatment plan. The latter should always take into account the individual topography, even if standard concepts can be applied in some cases. We feel that treatment planning in each patient would require too much of the staff's time. Therefore equipment that helps to save planning time is welcome, particularly if it increases the reliability of the final results. In this respect ultrasonic tomography is a useful tool for solving many problems. These will be described, discussed and compared with the advantages of computerized tomography, which is just being introduced.

Mathematics↗
PubMed1978

[Pretherapeutical diagnosis of metastases in carcinoma of the breast (author's transl)].

Conscientious pretherapeutic search for metastases is a prerequisite for every curative local therapy of breast carcinoma. This must be preceded by thorough physical checkup, supplemented by the usual blood tests, thoracic x-ray, and contralateral mammography. The axillary lymphatic nodes should be biopsied, since clinical assessment alone, unsupported by other examinations, yields false results in about one-third of the cases. Skeleton scintigraphy is recommended for routine skeleton diagnostics, possibly followed by specific roentgenography or tomography of individual skeleton sections. Bone marrow biopsy as well as individual biochemical examinations (discussed in this article in detail) are hardly useful in the search for hidden skeleton metastases, but they can be of importance in assessing the course of therapy. If there is the slightest clinical suspicion of metastases of the liver, brain or other organs, additional special examinations must be performed. Scintigraphy in combination with laparoscopy or ultrasound tomography is recommended in liver diagnostics. Brain metastases can be reliably detected by means of computer tomography.

Bone Neoplasms↗
PubMed1978

[Cervical-lymph node metastasis of unknown primary tumour (author's transl)].

The therapeutical results of 39 patients with cervical lymph node metastasis of unknown primary tumour are presented. 34 patients received radiotherapy, 2 chemotherapy, and in 2 cases the metastasis was only excised. In 22 patients the radiotherapy consisted of homogenic irradiation of the neck, in 12 patients the area of tumour manifestation was irradiated with a dosis ranging from 4000 to 6000 rad. The cumulative survival rate of all the patients was 64% after one year and 30% after 4 years. Ninety one per cent of the patients who were without symptoms after the therapy, survived this time interval. All patients without therapeutical success died. The median survival time of all patients was 20 months. In 21 patients the primary tumour was found later. In 13 cases (62%) the tumour was located in the head and neck region. In 7 patients the histology of the tumour had to be changed.

Adenocarcinoma↗
PubMed1978

[Preoperative radiotherapy and curative radiotherapy without mastectomy in carcinoma of the breast (author's transl)].

The aim of preoperative radiotherapy of mastocarcinoma is to reduce the size of the tumor to enable radical surgery in the third stage. This method is preferable to postoperative radiotherapy for anatomical and radiobiological reasons. It has not yet been possible to prove beyond doubt that preoperative radiotherapy also has a favourable effect on symptom-free survival. Curative radiotherapy without mastectomy is recommended for tumors of 2 - 3 cm size which are mobile, in small and medium-sized breasts, if the axilla is free or has only 1 - 2 mobile lymphatic nodes. Tumorectomy must be followed by surgical revision of the axillary region. High-voltage equipment is mandotory for radiotherapy. Results obtained to date are in no way inferior to those of mastectomy. Local control rate is 90-100%. The cosmetic result is usually excellent.

Breast Neoplasms↗
PubMed1977

[Dosis-performace-effects on the pluripotent hematopoietic stem cell. Results of partial body irradiation using 8MeV-x rays].

It was the aim of this study of document the influence of various dose rates on the CFU'S compartment. The information obtained should serve as a guideline to the design of radiotherapeutic programs with less hemopoietic toxicity in clinical radiation therapy. CBA mice were subjected to partial body X-ray irradiation from a linear accelerator (8MeV). The effect of dose rates of 6,70, 520 and 2800 R/min on CFU'S were studied in the irradiated and shielded marrow immediately after irradiation and 5,24 resp. 48 hours, 1 week and 3 weeks later. The following conclusions can be made: The reduction of CFU'S is significantly greater for low dose rates. After a dose of 150 R CFU'S reach normal values at 2 weeks, after 300 R at 3 weeks. With 450 R they are still subnormal at 3 weeks. A rebound phenomenon with increased CFU'S is seen at 3 weeks with 150 R and 300 R. An increase of CFU'S in shielded marrow is seen immediately after irradation. This increase is not dependent on the dose rate. The clinical implications of these findings are discussed.

Animals↗
PubMed1977

Synthesis, purification, and chemical characterization of the amino-terminal 1-34 fragment of bovine parathyroid hormone synthesized by the solid-phase procedure.

Peptides prepared by solid-phase synthesis during a systematic study of structure-activity relations in parathyroid hormone have been subjected, after sequential purifications, to rigorous analysis of purity by a variety of analytical techniques including sequence analysis by the Edman procedure. The present paper undertakes a critical appraisal of the utility of different tests of peptide purity and the use of the procedures in guiding and monitoring optimal synthesis strategies. Sequence analysis of a peptide representing the amino-terminal 34 residues of bovine parathyroid hormone (bPTH-(1-34)) revealed the presence of at least 30% of contaminating error peptides which were undetected by other analytical procedures. The major contaminant was identified as a peptid in which glutamine at position 29 was deleted. A repeat synthesis using fluorescamine rather than ninhydrin to monitor the coupling reaction resulted in a preparation that lacked the contaminant resulting from deletion. These findings demonstrate the particular value of sequence analysis in the evaluation of purity of peptides synthesized by the solid-phase technique.

Adenylyl Cyclases↗
PubMed1977

[Diagnostic laparotomy in Hodgkin's disease: indication, management, results (author's transl)].

Till December 31st 1976, diagnostic laparotomy was carried out in 58 patients with Hodgkin's disease. Of these, 23 cases (40%) revealed abdominal involvement. The tumor stage found by conventional diagnostics before surgical treatment had to be altered in 16 patients (27%). It had to be increased in ten and lowered in six cases. Of 13 splenic Hodgkin infiltrations twelve had not been supposed preoperatively; four out of 43 sound organs had been suspected preoperatively because of splenomegaly. Subdiaphragmatic histological findings involving a rather unfavorable prognosis were seen in nine patients (16%). In Hodgkin's disease, risk groups cannot be selected with confidence, as no definite correlation between the frequency of subdiaphragmatic affection and the primary manifestations, histology or general symptoms was observed. Since operation risk of diagnostic laparotomy is low, operable stage I-III cases with Hodgkin's disease should undergo diagnostic laparotomy prior to treatment planning.

Adolescent↗