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Biomedical subjects

S Mende

Publications and source records attributed to S Mende.

At least 19 recordsLinked to original sources
PubMed2001

[Patient treated with chemotherapy. Alarm signs requiring immediate intervention].

The most common complications in patients receiving chemotherapy are neutropenia with fever, and infections. The risk-adapted application of antibodies, antimycotics and G-CSF is discussed. Nausea and vomiting can usually be avoided by appropriate prophylactic antiemetic treatments. Less common are thrombocytopenia requiring replacement treatment. The frequent anemias associated with tumor treatment have a multifactorial genesis. Red cell concentrates and, where indicated, erythropoietin are available. Typical organ-related side effects of cytostatic agents are rare, but then usually serious. Problems with veins may be resolved with "undertunneled" central venous catheters or completely implanted port systems.

Ambulatory Care↗
PubMed1997

The apolipoprotein E and beta-fibrinogen G/A-455 gene polymorphisms are associated with ischemic stroke involving large-vessel disease.

The relationship between the apolipoprotein E (apoE) and beta-fibrinogen G/A-455 polymorphisms and cerebrovascular disease (CVD) was examined in the present study. We compared 227 patients with the subtypes of CVD (large-vessel disease, lacunar stroke, cardiac embolism, or undetermined pathomechanisms) with 225 control subjects. The occurrence of apoE isoforms (E2, E3, and E4) and the beta-fibrinogen G/A-455 genotype was determined in these individuals. No differences in apoE polymorphisms or allele frequencies between the CVD patients and control subjects were found. However, analysis of apoE genotypes as a function of stroke subtype revealed that the apoE4 allele was significantly more common in those patients with macroangiopathy-associated CVD. The only CVD risk factor that distinguished patients with the E4 allele from those with other apoE genotypes was elevated cholesterol. No association between the beta-fibrinogen G/A-455 polymorphism and CVD was found. However, homozygosity for the A allele was more common in patients with CVD resulting from large-vessel disease. These data demonstrate that the apoE4 allele and the AA genotype of the beta-fibrinogen G/A-455 polymorphism occur significantly more frequently in patients with CVD resulting from stenosis of large, brain-supplying vessels. Such genetic analyses may further our understanding of the etiology of cerebrovascular disease.

Adult↗
PubMed1996

Influence of postnatal overnutrition and pregnancy on non-insulin dependent diabetes induced in Wistar rats by neonatal streptozotocin.

Wistar rats with non-insulin dependent diabetes induced by neonatal streptozotocin (STZ) administration were raised either in large or in small litters. The STZ-treated rats from small litters showed a higher body weight as well as increased blood glucose levels compared with vehicle- and STZ-treated rats reared in large nests at an age of 8 weeks. The higher body weight of these rats was maintained until an age of 15 weeks, whereas the basal blood glucose was normalized. However, both STZ-treated groups exhibited an impaired glucose tolerance. During pregnancy only the glucose tolerance of the STZ-treated animals from large nests was improved although not normalized. The STZ-treated rats from small nests failed to adapt to pregnancy because the blood glucose levels after glucose load were similar to values found in the virgin state. The body weight of pregnant STZ treated rats raised in small litters was significantly lower than in vehicle- or STZ-terated rats from large nests. The number of fetuses per litter was similar in all groups tested. Compared with the vehicle-treated rats from large litters the fetal body weight of STZ-treated rats from small nests was decreased and that of STZ rats raised in large litters was increased. These results suggest that the rats with the more impaired glucose tolerance produce growth-retarded pups and, conversely, rats with rather mild impairment have bigger fetuses than the vehicle-treated ones. In the present study we have examined for the first time the combined effects of postnatal overnutrition and pregnancy on glucose homeostasis of rats treated neonatally with STZ. Our data demonstrate that postnatal overnutrition is an aggravating factor in the development of a diabetic state in these rats, especially at times when the insulin requirement is higher such as puberty and pregnancy.

Animal Nutritional Physiological Phenomena↗
PubMed1992

[The effect of cholesterol on membrane potentials, proliferation and migration of cultivated endothelial cells].

The influence of cholesterol added as cholesterol containing liposomes [sphingomyelin/cholesterol (1: 1; mol/mol)] or as cholesterol suspensions on cultured bovine aortic endothelial cells was investigated. 10(-6) mol/l cholesterol enhanced membrane potential, 10(-5) mol/l caused depolarisation. The proliferation of the cells was dependent on the concentration influenced in opposite directions too. The proliferation was stimulated by 10(-6) mol/l cholesterol and inhibited by 10(-5) mol/l. The migratory rate of the cells was increased by 10(-6) mol/l and 10(-5) mol/l cholesterol. Our results suggest that exogenous cholesterol is integrated in membranes of the endothelial cells and causes in this way changes of membrane potential, proliferation rate and migratory activity.

Animals↗
PubMed1991

Cyclic-alternating versus response-oriented chemotherapy in small-cell lung cancer: a German multicenter randomized trial of 321 patients.

To test whether alternating chemotherapy is a favorable treatment modality in small-cell lung cancer (SCLC), 334 patients were randomized to receive either fixed cyclic-alternating treatment with ifosfamide/etoposide (IE), cyclophosphamide, doxorubicin, and vincristine (CAV), or response-oriented treatment with IE therapy up to maximal response and subsequently an immediate switch to CAV. In both arms, six cycles were given in 3-week intervals. After chemotherapy, patients with limited-stage disease received chest irradiation with 45 Gy. Prophylactic cranial irradiation with 30 Gy was applied to all complete responders. No maintenance therapy was given to patients with complete response. Minimum follow-up was 2 years. Of 321 assessable patients, the overall response rate was 70% for cyclic alternating and 77% for response-oriented treatment. Complete remission (CR) rates were 26% versus 26%. The median survival times were 9.7 months for cyclic-alternating versus 10.7 months for response-oriented treatment; the 2-year survival rates were 11% versus 9%. In limited-stage disease (LD) patients, there was a median survival of 12.5 months versus 12.3 months and a 2-year survival rate of 21% versus 18%. In extensive-stage disease (ED) patients, median survival was 8.5 versus 9.1 months, and the 2-year survival rate 3% versus 4%. From these results, we conclude that the cyclic-alternating treatment according to the hypothesis of Goldie et al has no advantage in comparison to a sequential treatment strategy with an immediate switch to a second-line protocol at the time no further response to first-line therapy is seen. Our major aim in the treatment of SCLC is to administer an active regimen at any time during the course of treatment regardless of whether sequential or alternating therapy is used.

Adult↗
PubMed1991

Association of dry eye signs and symptoms with tear lactoferrin concentration.

Diagnoses of dry eye made with the Lactoplate Immunoassay Test (which assesses tear lactoferrin concentration) were compared to diagnoses based on dry eye symptoms, tear break-up times, and rose bengal staining. For a population of 49 subjects with normal and mild to moderate dry eyes, contingency tables showed that the lactoferrin-based diagnoses were not significantly related to the diagnoses made using any of the other factors. Lactoferrin concentrations were statistically correlated with symptom scores, but there was no significant correlation between lactoferrin concentrations and either tear break-up time or rose bengal staining. These results suggest that: 1) the dry eye problems in the subject population may not have been associated with lacrimal gland dysfunction (which the Lactoplate assesses); 2) Lactoplate tests are not sensitive enough to allow accurate diagnoses for the population of mild to moderate dry eye subjects used; 3) signs and symptoms associated with dry eyes occur before lactoferrin changes are manifest so lactoferrin changes had not yet appeared in the subjects; or 4) in mild to moderate dry eye subjects, lactoferrin changes occur only in reflexive tears and not in the basal tears that were tested in this study. In summary, measurement of tear lactoferrin concentration alone has not been shown to be a sufficiently sensitive and specific test for the diagnosis of mild to moderately dry eye as defined by more common clinical techniques.

Adult↗
PubMed1990

High-intensity therapy versus low-intensity therapy in advanced breast cancer patients.

The aim of this study was to evaluate the significance of response to the first two cycles of FEC (5-fluorouracil, 4-epirubicin, cyclophosphamide) in patients with advanced breast cancer. A total of 99 patients entered the study. They showed either high risk criteria and were previously untreated or showed low risk criteria and were pretreated by hormonal therapies. Eighty-two patients were evaluable. In 22 (27%) who had disease progression despite two cycles of FEC, further therapeutic attempts proved ineffective, the median survival being 2.8 months. The remaining patients responded either by stable disease (SD, n = 29; 35%), by partial or by complete remission (PR, CR, n = 31; 38%). These 60 patients were randomized to two regimes of maintenance therapy: FEC every 3 weeks or LMF (leukeran, methotrexate, 5-fluorouracil) every 6 weeks. The subsequent course of the disease was not different in both arms. It was neither influenced by the quality of early response, i.e. SD, PR, CR, nor by the intensity of chemotherapy. The prognostic impact of early response to two cycles of FEC proved to be higher than other prognostic parameters in the patients examined. Thus, early response may serve as a valid guide to adapt maintenance chemotherapy in individual patients with advanced breast cancer.

Adult↗
PubMed1989

Compliance of physicians and patients with a consensus protocol for treatment of advanced breast cancer.

In a multicenter study we used a consensus protocol including more than five subsequent therapeutic steps for treatment of patients with advanced breast cancer. A total of 335 evaluable patients from 27 participating hospitals were allocated to a low- or high-risk group, receiving different therapies during the initial phase of treatment. About half of these patients were treated without protocol violations (compliers). The protocol non-compliers were divided into three groups: those receiving more intensive therapy than recommended, those with similarly intensive, and those with less intensive therapy. The reasons for protocol violations were analysed. The intensity of the therapy given actually was correlated with the survival of subgroups. Median survival times were significantly longer in 208 low-risk than in 127 high-risk patients (P less than 0.0001), marginally longer in 165 compliers than in 170 non-compliers (P less than 0.04), significantly longer in low-risk compliers than in low-risk non-compliers (P = 0.002), and significantly shorter in high-risk compliers than in high-risk non-compliers (P = 0.007). Survival of all subgroups of low-risk non-compliers was the same regardless of the actual therapies given. The survival of high-risk patients who received less intensive therapy was significantly longer than that of high-risk compliers (P = 0.015). After six cycles of successful chemotherapy there was no difference, either in time to progression or in survival, between patients who had received either maintenance therapy or no therapy. We postulate that the groups of low-risk and high-risk patients comprised patients with different prognoses. Among low-risk patients, survival of the subgroup with poor prognosis (low-risk non-compliers) was not influenced by therapy. Among high-risk patients, a subgroup with poor prognosis may have been overtreated by using standard chemotherapies as recommended in our consensus protocol.

Breast Neoplasms↗
PubMed1989

[The effect of alkyl-lysophospholipids and membrane potentials, proliferation and migration of isolated calf aorta endothelial cells].

Cancerostatical active synthetic alkyl-lysophospholipids were examined with regard to their effects on membrane potential, proliferation and migration of isolated endothelial cells. In sublytic concentrations all alkyl-lysophospholipids tested caused a hyperpolarization of the membrane of endothelial cells. The effect of alkyl-lysophospholipids on proliferation of endothelial cells was dependent on the serum supplement. The migration of endothelial cells was strongly inhibited by 1-O-octadecyl-2-O-methyl-glycero-phosphocholine. Possible mechanisms of action are discussed.

Animals↗
PubMed1988

Glutathione content and gamma-glutamyltranspeptidase activity in squamous cell head and neck cancer xenografts.

Drug resistance is a major problem in chemotherapy of squamous cell head and neck cancers (SCHNC). Since glutathione (GSH) plays a crucial role in mediating tumor cell resistance against various toxic insults, GSH metabolism in SCHNC xenografts was investigated. Xenografts from lymph node metastases contained markedly higher GSH concentrations compared with those derived from the corresponding primary lesions. After subcurative chemotherapy with cisplatin (DDP), a significant increase of both GSH levels and gamma-glutamyltranspeptidase activity (gamma-GT) was gained in tumor HT1M. Tumor HT3M showed high concentrations of GSH and gamma-GT, although these latter concentrations did not increase following chemotherapy with DDP. These findings suggest a possible impact of GSH metabolism on both the formation of metastases and the phenomenon of drug resistance in SCHNC.

Animals↗
PubMed1987

[Concept of treatment of metastatic breast cancer outside university clinics: description of the method and evaluation of efficacy].

It has been recognized during the past decade that it may be advantageous to develop complex strategies for treatment of metastatic breast cancer (MBC). In these strategies the type and efficacy of preceding therapies and the compliance of the patients have to be considered. Since about 80% of all patients with MBC are treated outside university hospitals it should be tested if a complex strategy for treatment of MBC can be realized in these institutions. The method was based on three principles: There was an exchange of data between participating institutions and study center after each visit of a patient. Second, there was one data sheet for admission of a patient to the study and fifteen sheets for follow-up documentation each with a different bottom line; in the bottom line of these sheets two therapies according to the strategy were proposed, one in case of 'no progression' and another in case of 'progression' of the disease. Third, a copy of completed sheets had to be returned to the study center; the study center provided the next sheet with the appropriate treatment recommendation. 335 evaluable patients were prospectively recruited from 27 participating institutions between January 1983 and December 1985. Based on the estimated incidence of MBC in the region, it was calculated that 45% of all MBC patients of the region had been admitted to the study. Only 27% of these patients were treated at the university hospital indicating that 85% of all MBC patients of the region were treated outside university hospitals.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Cisplatin/etoposide versus ifosfamide/etoposide combination chemotherapy in small-cell lung cancer: a multicenter German randomized trial.

A total of 144 patients with small-cell lung cancer (SCLC) were randomized to receive cisplatin/etoposide (PE) or ifosfamide/etoposide (IE) combination chemotherapy. PE consisted of cisplatin, 80 mg/m2, intravenously (IV) on day 1, and etoposide, 150 mg/m2, IV on days 3 through 5. IE consisted of ifosfamide, 1,500 mg/m2, IV on days 1 through 5, and etoposide, 120 mg/m2, IV on days 3 through 5. Six cycles were administered in 3-week intervals. Nonresponders were switched immediately to CAV, consisting of cyclophosphamide, 600 mg/m2, IV on days 1 and 2, Adriamycin (Adria Laboratories, Columbus, OH), 50 mg/m2, IV on day 1, and vincristine, 2 mg, IV on day 1. Patients obtaining complete remission (CR) received prophylactic cranial irradiation with 30 Gy. After completion of chemotherapy, patients with limited disease received chest irradiation with 45 Gy. No maintenance therapy was given to patients in CR. Minimum follow-up was 2 years. Of the 141 patients evaluable, the overall response rate was 65% in PE therapy and 68% in IE therapy. The CR rate was 32% v 20% for all patients, 50% v 24% for limited disease, and 22% v 18% for extensive disease, all in favor of PE therapy. Median survival for all patients was 11.6 months v 9.4 months, for limited disease 14.8 months v 11.0 months, and for extensive disease 8.9 months v 7.5 months, all preferring PE therapy. The 2-year survival rate was higher in PE therapy than in IE therapy for all patients (12% v 9%) and for limited disease (23% v 10%), but not for extensive disease (5% v 9%). Median progression-free survival was 7.5 months v 6.0 months for all patients, 12.2 months v 8.8 months for limited disease, and 5.9 months v 4.4 months for extensive disease, all in favor of PE. Relapse in the area of the primary tumor was found less often after PE than after IE therapy (25% v 38%). Response to second-line CAV was seen in 30% of patients with prior PE and 43% with prior IE therapy, but was usually short lasting, and only one patient achieved CR. Toxicity included three lethal complications. Nausea, vomiting, diarrhea, and skin lesions occurred more often after PE than after IE therapy. These results suggest that PE is superior to IE chemotherapy in limited-stage, but not in extensive-stage SCLC, and that CAV is cross-resistant to PE, as well as to IE in the majority of patients.

Adult↗
PubMed1984

cis-Platinum (DDP) and VP 16-213 (etoposide) combination chemotherapy for advanced non-small cell lung cancer. A phase II clinical trial.

Forty-six patients with non-small cell lung cancer were treated with a combination of cis-platinum, 90 mg/m2 i.v. on day 1 and VP 16-213, 100 mg/m2 i.v. on days 1, 3 and 5. The overall remission rate was 22%, with a median duration of 7 months. Squamous cell and large cell undifferentiated carcinomas responded in 27 and 22% of patients, and seven patients with adenocarcinoma did not respond to chemotherapy. Survival was 7 months for all patients, 11.5 months for responders (7-27+), 8.5 months for patients with stable disease (3-27+) and 5 months for progressive tumours (1-9). Prognosis was adversely influenced by a performance status of less than 80%, a weight loss of more than 10 kg during the last 3 months before start of treatment and a radiologically demonstrable 'major' atelectasis (collapse of at least one superior or inferior lobe of the lung). Only one out of 31 patients with one or more poor prognostic factors came into remission. In contrast, nine out of 15 patients without poor prognostic factors showed objective tumour regression (60% remission rate). Stage and age did not affect the results. Haemotologic and renal toxicity were mild, but poor subjective tolerance (nausea, vomiting, loss of appetite) was prominent.

Adenocarcinoma↗
PubMed1983

[Successful treatment of brain metastases in breast cancer with blood-brain barrier-impervious cytostatics and hormones].

11 patients (age 36-60 years) with breast cancer and CT-scan documented brain metastases (BM) were treated with hormonochemotherapy: 5-fluorouracil 500 mg/m2 i.v. day 1 + 8, adriamycin 50 mg/m2 i.v. day 1, cyclophosphamide 500 mg/m2 i.v. day 1-q4 weeks (FAC) and tamoxifen (TXF) 20 mg/day per os. Ovarectomy was carried out in 3 praemenopausal patients. In 3 cases single BM were surgically resected (2 subtotal, 1 total). One patient was shunted due to a hydrocephalus occlusus. Complete response (CR), i.e. normalization of CT-scan and disappearance of CNS related symptoms, was achieved in 9 out of 11 patients. One patient with partial remission (PR) and another with progressive disease died 6 and 5 months after diagnosis of BM. The median duration of remissions of all patients was 12 (5-43) months. The median survival time from diagnosis of BM was 15 (5-44) months and from mastectomy 46 (26-142) months. The cumulative probability of surviving was 63% one year after diagnosis of BM. One relapsing patient achieved a second CR, another a PR by whole brain irradiation. 4 patients survived more than 18 months from the diagnosis of BM. It appears that chemo-hormonotherapy provides a rational approach to palliation in breast cancer patients with BM in prolonging the survival.

Adult↗