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Biomedical subjects

S L Roth

Publications and source records attributed to S L Roth.

36 records · Page 2Linked to original sources
PubMed1989

Carcinoma of the nasopharynx--comparison of the UICC and Ho clinical staging systems.

From 1974 to 1985 definitive radiation therapy was performed in 76 patients with nasopharyngeal carcinoma (NPC). Of the 76 patients 59 presented UICC stage IV and 13 UICC stage III. The distribution of the stages was more homogeneous for the Ho system: Ho I, n = 4; II, n = 21; III, n = 16; IV, n = 32; V, n = 3. Radiotherapy followed the guidelines of the M.D. Anderson Hospital in Houston. A median dose of 68 Gy was given to the primary and of 66 Gy to the neck nodes, independent of the histologic subtype. The 5-year actuarial survival rate was 41% and the disease specific relapse-free survival (r.f.s.) 45%. Analysis according to the UICC classification and Ho's classification showed obvious deficiencies in both staging systems, but did not result in major prognostic differences. The freedom from local relapses correlated (P less than 0.05) with the T categories of the UICC at presentation (75% in T1 vs 45% in T4) and the freedom from distant metastases was significantly influenced by the cervical status (fixed cervical lymph nodes (UICC N3) vs, e.g., UICC N2: 51% vs 90%; P less than 0.05). In case of supraclavicular lymph nodes (Ho IV; Kyoto C) the freedom of distant metastases was lower than in case of upper cervical lymph nodes (58% and 79%, respectively; P = 0.3).

Adolescent↗
PubMed1989

Prognostic factors in limited rectal cancer treated with intracavitary irradiation.

At the Centre Georges-François Leclerc of Dijon, 91 limited rectal tumors received a complete intracavitary 50 kV contact radiotherapy alone or associated with interstitial brachytherapy according to the guidelines of J. Papillon. Nineteen had a villous adenoma and 72 a well or moderately differentiated rectal adenocarcinoma. The majority of patients had contra-indications for major surgical procedures. The median age was 70 years. Seventy-six percent (69/91) of the rectal tumors remained free from local recurrence. After salvage therapy, the local control was 91% (83/91). Sphincter preservation was obtained in 85% (77/91). "De novo" adenocarcinomas developed on pre-existing benign pathology and villous adenomas were not significantly different with regard to local control (76% resp. 75% versus 59.5%; p = 0.22). According to the Dijon clinical staging system, the local relapse-free survival at 5 years was 97% for CS T1A, 77% for CS T1B, 65% for CS T2A, and 60% for CS T2B. Tumors of the anterior rectal wall had a better local control rate than lateral and posterior primaries (100% versus 63% versus 67%). For the middle rectum, the local relapse-free survival was 94% compared to 54% of the upper and 77% of the lower rectum. Four additional patients had a preoperative intracavitary therapy and salvage surgery for incomplete tumor regression; the complete remission rate is 96% (91/95). Intracavitary radiotherapy alone is an effective treatment for limited rectal cancers. Contact X ray therapy can be used alone in CS T1A whereas a combination of contact X ray therapy and interstitial brachytherapy is often the optimal approach in CS T1B and CS T2A. In CS T2B, our data do not support the use of intracavitary techniques alone. In these cases, the sequence external irradiation followed by an interstitial implant seems of interest and deserves further evaluation with more patients and follow-up.

Adenocarcinoma↗
PubMed1989

[Radiotherapy technics and results in nasopharyngeal carcinoma at the Cologne University Clinics from 1974 to 1985].

At the university clinics of Cologne 76 patients were treated for nasopharyngeal carcinoma with curative intent from 1974 to 1985. The radiotherapy followed the guidelines of the M.D. Anderson Hospital, Houston and the Royal Marsden Hospital, London using a multiple field technique. A median dose of 68 Gy megavoltage radiotherapy was given to the primary and of 66 Gy to the neck nodes independent of the histologic subtype. The determinate relapse-free survival was 45% after five years and the local relapse-free survival 61%. The multiple field technique allowed to reduce the dose to the parotid. Only 25% of the patients suffered from a dry mouth after one year and only 10% after four years.

Adolescent↗
PubMed1988

Results of endocavitary irradiation of early rectal tumors.

At the C. G. F. Leclerc, Dijon, 91 early rectal tumors were treated with intracavitary contact radiotherapy alone or in combination with interstitial brachytherapy. The median age of the patients was 70 years. Most of them were referred because of poor surgical risk. Preservation of the sphincter was obtained in 85% (77/91). The actuarial local relapse-free survival rate at 5 years was 74% (67/91). No significant difference was seen between the 72 adenocarcinomas and 19 villous adenomas (p = 0.12). For the middle rectum the rate was 94% compared to 54% for the upper and 77% for the lower rectum. Anterior primaries fared better than posterior and lateral tumors (100%, 63%, and 67% respectively). After salvage therapy the local control rate raised to 91% (83/91). The clinical and endoscopic staging system of Dijon was of prognostic significance: T1A adenocarcinomas (purely exophytic tumors of less than 3 cm) had a better 5-year local relapse-free survival rate (97%) than T2A, T1B or T2B (p less than 0.01).

Adenocarcinoma↗
PubMed1986

[Germinative testicular tumors. On the current status of diagnosis, therapy and prognosis].

On the basis of results obtained in a multicentric study on testicular tumors (Bonn 1982) including our own group of patients, we give an outline of the present state of modern diagnosis, therapy, and prognosis concerning germinative tumors of the testes: Etiologically essential is an unknown dysontogenetic disturbance of both gonads. The only clinical predilection factor is cryptorchism. Among the new diagnostic methods, specific tumor markers and high-resolution ultra-sonography have been proved especially useful. In non-seminomas, orchidectomy and lymphadenectomy is followed by chemotherapy instead of radiation therapy, today. Polychemotherapy has greatly improved the prognosis. Andrologically most interesting questions concerning sperm conservation, limited retroperitoneal lymphadenectomy, as well as late sequelae of chemotherapy cannot be definitely answered. Our findings rise new questions, which are fully discussed in concluding remarks.

Combined Modality Therapy↗
PubMed1985

[Presentation of a therapy scheme and irradiation technic for short-term contact irradiation of cervical cancer].

Since April 1983 patients with gynecologic tumors have been irradiated with the HDR afterloading method at the University Hospital of Cologne. The therapy scheme for the carcinoma of the cervix consists of a combination of intracavitary contact irradiation and external radiotherapy. Brachytherapy is preponderant in an early stage of tumor extension, whereas teletherapy contributes more to the total dose in advanced stages. At first, the pelvis is totally exposed to a homogenous irradiation, so the shrunken tumor can more easily be arrived by curietherapy. The therapy scheme is described for the different tumor stages with its dosages, fractionations, and treatment pauses. Besides the use of special multiple-way applicators, the risk organs are protected by collimating with a block the middle part of the external irradiation field as soon as the maximum permissible dose is reached. A special block shape minimizes the dose irregularities at the field borders. The total physical dose at point A is about 60 Gy. The high dose rate of HDR afterloading has to be considered when calculating the biologic efficient dose. Here the dose rate factor furnishes a rough relation to the established radium dosage.

Brachytherapy↗
PubMed1984

Affective disorders and ABO blood groups: new data and a reanalysis of the literature using the logistic transformation of proportions.

No statistically significant associations were found between ABO blood group distributions and RDC subtype diagnoses in 79 subjects with unipolar (single episode and recurrent) and bipolar major depressive disorder using data from our sample. We discuss methodological issues related to the control samples and choice of statistical methods in the reported studies which have looked for associations between ABO blood types and patients diagnosed as having an affective disorder. After presenting our rationale for employing the logarithm of the cross product ratio (lambda) in place of the more traditionally utilized chi-squared, we used lambda to reanalyze the original data from nine studies in the literature. The individual studies are equivocal on the basic issue of an association between type O blood and bipolar I illness, either compared to controls or to recurrent unipolar patients. The combined (weighted average) measure of association indicates a small but definite association, but statistical analysis of the dispersion of the individual estimates around this combined estimate reveals that the studies have a higher degree of heterogeneity in results than expected by chance. The consequences of this finding are discussed, and possible explanations are offered.

ABO Blood-Group System↗
PubMed1980

[Prenatal diagnosis of alpha-1-antitrypsin phenotype. Case record and prognosis in severe alpha-antitrypsin deficiency Pi ZZ (author's transl)].

A mother had a child with cirrhosis of the liver and alpha-1-antitrypsin deficiency. In a subsequent pregnancy the fetal phenotype Pi MZ was detected by isoelectrofocusing in the amniotic fluid. Quantitative assay of alpha-1-antitrypsin gave results in the normal range. Umbilical vein blood analysis confirmed the antenatal findings. In this case it has been possible to rule out the disease before birth. In this context the clinical importance of alpha-1-antitrypsin deficiency is stressed, its frequency in the European and North-American population and the prognosis with phenotype Pi Z.

Female↗
PubMed1980

[Diagnostic value of clinical methods in the staging of abdominal Hodgkin's disease (author's transl)].

Explorative laparotomies were carried out on 68 patients with Hodgkin's disease in the University Hospital of Marburg from 1969 through 1978. These laparotomies were preceded by clinical examination, abdominal sonography in 27 cases, lymphography in 55 cases, scintigraphy of liver and spleen in 58 cases, and radiographic examinations of the intestinal tract in 18 cases. Sonography revealed a greater accuracy (90%) for splenic involvement than scintigraphy (74%); the results of sonography and scintigraphy of the liver were comparable. For the detection of para-aortal lymphomas ultrasound and lymphography can be regarded as complementary methods. Our results are compared with findings in the literature on abdominal sonography (n = 50), scintigraphy of liver and spleen (n = 185), and lymphography (n = 465) carried out before explorative laparotomy for lymphogranulomatosis. There was a better correlation for the systemic symptoms of the 68 patients with the clinical stage than with the pathologic stage. The importance of diagnosing different groups, e.g. in stage III, is stressed.

Abdominal Neoplasms↗
PubMed1980

[Pyroderma fistulans sinifica associated with congenital alpha-1-antitrypsin deficiency].

A patient is reported who suffered from pyodermia fistulans sinifica (acne conglobata sinifica, acne tetrade) and who presented a severe congenital alpha-1-antitrypsin deficiency (phenotype ZZ). The possible significance of the protease inhibitor deficiency for the development of this disease is discussed. Alpha-1-antitrypsin deficiency has been observed in several dermatoses (panniculitis, cutaneous vasculitis, Ehlers-Danlos syndrome, acquired angioneurotic edema and cold urticaria). The insufficient neutralization of liberated leukocyte proteases has been considered to play an important role in these disorders. Besides the ultrastructural finding in the liver cell which is typical for alpha-1-antitrypsin deficiency crystals were found as are seen in the cholesterol ester storage disease. This was probably caused by an increased influx of fatty acids.

Female↗
PubMed1979

Change of isozyme pattern during activation of a transforming gene product: its relation to other biochemical markers of cellular transformation and differentiation.

Isozyme patterns of leucine aminotransferase were studied in connection with glucose transport and DNA synthesis during the activation and deactivation of the transforming gene product in rat kidney cells transformed by one Rous sarcoma virus mutant (which has a temperature-sensitive lesion in its transforming gene. On temperature shift-down of confluent transformed cells grown at 40 degrees C in the presence of fresh serum, isozyme III of leucine aminotransferase appeared in 12--20 h, with increasing amounts from 24 to 48 h. Upon temperature shift-up, isozyme I became the predominant form in these cells within 4 days, the major change occurring within the first 24 h. The rate of protein turnover was similar to the rate of loss of isozymes I and III during temperature shift-down and shift-up, respectively. A stimulation of incorporation of [3H]thymidine into DNA was observed within 8--12 h after temperature shift-down of the transformed cells. For the maintenance of stimulated DNA synthesis for at least 16 h, continued exposure to the permissive temperature is not necessary. Stimulation of glucose transport occurred prior to the stimulation of [3H]thymidine incorporation. The isozymes of leucine aminotransferase also changed during the in vitro differentiation of Yaffee L6A cells in such a way that isozyme I represented the major part of this enzyme in the fused myotube, and isozyme III was more predominant in the less differentiated state (mononucleated cells).

Animals↗
PubMed1979

[A new contrast medium emulsion for lymphography (author's transl)].

A new contrast medium for lymphography has been developed. It is suitable for direct, such as bi-pedal, lymphangiography, and has certain advantages compared with the commercially available contrast medium Ethiodol, such as absence of a lipogranulomatous reaction and less extensive oil emboli in the lungs. It is also possible to use the substance for indirect, retrosternal lymphography. The substance is indirect, retrosternal lymphography. The substance is an emulsion of triglycerides of iodinated poppy seed oil. The method of preparation of the emulsion is described.

Animals↗
PubMed1977

Changes in leucine aminotransferase isozymes by viral transformation and its correlation with the isozyme changes occurring during differentiation.

The isozyme pattern of leucine aminotransferase (EC 2.6.1.6) in various cell lines and their viral-transformed derivatives were examined. The Wistar 3C rat liver cell line was found to contain only isozyme I, while its simian virus 40-transformed counterpart had isozyme III in addition to isozyme I. A spontaneously transformed late passage clone of these liver cells was also found to have acquired isozyme III. Polyoma virus-transformed baby hamster kidney cells were also found to contain a greater predominance of isozyme III than their normal untransformed counterpart. Examination of the isozymes in a cloned normal rat kidney cell line transformed by a mutant of Rous sarcoma virus which is temeprature-sensitive for transformation indicated that, in fact, such an isozyme change does correlate with transformation. When grown at 36 degrees these cells contained predominantly isozyme III; however, upon reacquiring normal morphology and lowered glucose transport activity when grown at 40 degrees, their isozyme pattern was now found to be changed and consisted predominantly of isozyme I, as is found in normal adult rat kidney tissue. Isozyme III was found to be present in neonatal kidney tissue of the rat and hamster, and its predominance in the virus-transformed normal rat and baby hamster kidney cells was interpreted as indicative of the dedifferentiation of these cells upon viral transformation. A similar change of the isozyme pattern of leucine aminotransferase in chicken embryos during their development was observed, such that in 5-day-old embryos Form III was predominant, while in the more mature differentiated chicken embryo of Day 17, Form I was predominant.

Animals↗
PubMedDate not supplied

Echocardiographically guided electrophysiologic testing in pregnancy.

Electrophysiologic testing is usually performed with fluoroscopy to guide catheter positioning. This method of visualizing catheter placement may not be ideal for patients who are pregnant. We report four cases of echocardiographically guided placement of catheters for electrophysiologic testing because of the consideration of pregnancy. Adequate visualization of catheters was possible, allowing for proper catheter positioning and complete electrophysiologic testing, including the recording of atrial, His-bundle, and ventricular potentials, as well as cardiac stimulation and induction of tachycardia. This method holds promise for patients in whom fluoroscopy may be relatively contraindicated, such as pregnant patients, as well as patients in whom it is desirable to avoid x-ray exposure such as women of childbearing age and young children.

Adult↗