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Biomedical subjects

T Otto

Publications and source records attributed to T Otto.

At least 109 records · Page 6Linked to original sources

[Prognostic factors for predicting the success of immunotherapy in metastatic renal cell carcinoma].

Only approximately 20% of the patients with metastatic renal cell carcinoma who undergo systemic immunotherapy will respond to this form of treatment. Appropriate selection of patients could exclude many who will not benefit from immunotherapy from a toxic and expensive treatment. Several factors predicting the outcome of immunotherapy have been reported so far. These predictors can be classified into (1) patient-related factors, (2) tumour-related factors and (3) alterations of the immune system during immunotherapy. Performance status and the interval between tumour nephrectomy and metastasization are the most important patient-related factors. Liver metastases are apparently an unfavourable tumour-related prognostic factor. Various alterations of the immune system during immunotherapy are significantly linked with the outcome of the treatment. In consequence, the prospective investigation of prognostic factors within clinical trials appears to be mandatory.

Carcinoma, Renal Cell↗

[Cytokine therapy of metastatic renal cell carcinoma].

Cytokine therapy of metastatic renal cell carcinoma reveals a remission rate of about 25% regarding to the different patients selection criteria, i.e. age, performance status, site of metastasis, tumour load. Remission is not correlated to patient's survival. Adjuvant or neoadjuvant immunotherapy is not a treatment option. Nephrectomy has no influence on distant metastases and should be limited to symptomatic primary tumours. In conclusion, cytokine therapy is not a standard treatment. Its value has to be evaluated in randomized trials.

Carcinoma, Renal Cell↗

[Principles of tumor invasion and metastasis].

Histopathological and clinical parameters are of limited value in characterization of the individual course of disease in bladder cancer patients. Down-regulation of E-cadherin, an intercellular adhesion molecule, and upregulation of autocrine motility factor receptor (AMFR) expression have been shown to play a part in tumour cell invasion and metastasis. In a retrospective analysis concerning 95 different bladder specimens and a prospective study in 100 bladder cancer patients, reduction in E-cadherin concomitantly with an increase in AMFR expression was associated with a poor prognosis. The dual use of these two antigens may improve early diagnosis of high-risk bladder cancer patients and influence treatment decisions.

Cadherins↗

[Initial experience with a new type of high energy neodymium laser in correcting stenosis of the airway].

The aim of the study was to assess the use of a new Nd:YAG laser--mediLas fibertom--in correcting malignant and benign stenoses of the airways. Eighteen patients were included in the study. In 9 these were caused by malignant tumors, in 3 by nonmalignant tumors, in 6 by post-inflammatory stenoses of the airways. Altogether 99 laser sessions were carried out. In patients with malignant diseases complete recanalization was achieved in 6 patients, in 2 partial. One patients did not benefit form the laser procedure. In patients with benign tumors complete recanalization was achieved in all of the patients. In 5 out of 6 patients the post inflammatory stenosis was corrected. Satisfactory results observed after the second, fourth and one year after the initial laser procedure encourage to use this from of therapy in cases of malignant and nonmalignant narrowing of the airways.

Adolescent↗

[Use of video-thoracoscopy for diagnostic and small surgical procedures in the chest].

The report introduces videothoracoscopy as a new diagnostic and therapeutical method in chest surgery. The main indications for thoracoscopic procedures were described. Also, 37 videothoracoscopic procedures performed on 35 patients were presented. In 5 cases procedure was therapeutical, in the rest of them diagnostic. In all diagnostic cases, thoracoscopic procedures allowed to determine accurate diagnosis. No significant complications were observed.

Biopsy↗

Does [3H]2-methoxy-idazoxan (RX 821002) detect more alpha-2-adrenoceptor agonist high-affinity sites than [3H]rauwolscine? A comparison of nine tissues and cell lines.

The authors compared [3H]2-methoxy-idazoxan (RX 821002) and [3H]rauwolscine binding in rat cerebral cortex, spleen and kidney; guinea pig kidney; porcine kidney; human kidney and platelets and HEL and NG 108-15 cells. [3H]RX 821002 had less nonspecific binding and higher affinity than [3H]rauwolscine in most models. Although both ligands detected similar alpha-2 adrenoceptor numbers in rat, porcine and human kidney and in NG 108-15 cells in saturation experiments, [3H]RX 821002 detected more alpha-2 adrenoceptors than [3H]rauwolscine in rat cerebral cortex and spleen, guinea pig kidney, human platelets and HEL cells. These differences were seen in Tris and in glycylglycine buffer regardless of whether EDTA, MgCl2, MgCl2 plus GTP or GTP plus NaCl was added to the former and were not explained by additional labeling of serotonin or dopamine receptors or nonadrenergic sites; in contrast, [3H]rauwolscine also labeled nonadrenergic sites in porcine kidney. In prazosin competition experiments, both ligands differentially recognized alpha-2-adrenoceptor subtypes but this could not account for the observed differences in detected receptor numbers. In epinephrine competition experiments, both ligands labeled similar numbers of agonist low affinity sites in all models; [3H]RX 821002, however, labeled more agonist high-affinity sites than [3H]rauwolscine did in models in which it detected a greater total number of receptors. It was concluded that [3H]RX 821002 is a more suitable ligand for the detection of alpha-2 adrenoceptor than [3H]rauwolscine because of less nonspecific binding, higher affinity and greater specificity for alpha-2 adrenoceptors; moreover, [3H]rauwolscine appears not to detect all agonist high-affinity sites of alpha-2 adrenoceptors.

Adrenergic alpha-Agonists↗

Keyhole-limpet hemocyanin immunotherapy in the bilharzial bladder: a new treatment modality? Phase II trial: superficial bladder cancer.

The efficacy of immunotherapy with keyhole-limpet hemocyanin or bacillus Calmette-Guerin for superficial bladder cancer is well known. A strong similarity has been noted between keyhole-limpet hemocyanin antigen and schistosomal antigen. In regard to this finding, we investigated the mechanisms of specific immunotherapy with keyhole-limpet hemocyanin in schistosomal associated transitional cell carcinoma. Keyhole-limpet hemocyanin was used for its ability to prevent tumor recurrence and because of its similarity to schistosomal antigen for intravesical specific immunotherapy in 13 patients with superficial transitional cell bladder tumors (Ta, Tis, T1) associated with urinary schistosomiasis. Keyhole-limpet hemocyanin immunotherapy reduced the recurrence rate of superficial bladder tumors to 15.4% compared to 76.9% before therapy.

Adjuvants, Immunologic↗

[Pneumonia in patients after extracorporeal circulation].

Hospital infections are still an important problem of to-days medicine. The most common and dangerous one is pneumonia. The purpose of this study was to determine the cause of pneumonia in patients operated on under extracorporeal circulation. It was proved that micro-organisms responsible for pneumonia in our patients were Pseudomonas sp. and Staphylococcus aureus. No correlation between the bacterial flora cultured from the air in operating theatre and post-op. ward and bacterial flora responsible for pneumonia was found. It can be infer that pulmonary infections were rather caused by hospital cross-infections or endogenic infections in colonized patients.

Adult↗

Inverse relation of E-cadherin and autocrine motility factor receptor expression as a prognostic factor in patients with bladder carcinomas.

Down-regulation of E-cadherin, an intercellular adhesion molecule, and up-regulation of autocrine motility factor receptor (gp78) expressions have been shown to play a role in tumor cell invasion and metastasis. Monoclonal antibodies against E-cadherin and gp78 were used to stain serial snap-frozen sections of 12 normal bladder and 83 bladder carcinoma specimens (27 noninvasive, 53 invasive, and 3 metastases). In normal urothelium, E-cadherin is expressed while gp78 is not. Positive expression of E-cadherin and negative expression of gp78 were found to be associated with a low risk of clinical progression in the superficial bladder carcinoma patient group. While reduction in E-cadherin concomitantly with an increase in gp78 expression was associated with poor prognosis, 71% of the patients (n = 30) underwent rapid cancer progression, and 32% of the patients died of cancer-related disease at a median of 2 years after initial diagnosis. Thus, it is suggested that reduction of E-cadherin expression associated with an increase in the level of gp78 in bladder cancers may define a high risk group of patients. The dual use of these two antigens may improve early diagnosis of high risk bladder cancer patients and influence treatment decisions.

Aged↗

Surgical management of Wilms tumor with intracardiac neoplastic extension.

In the management of Wilms tumor (nephroblastoma) with intracardiac extension (ICE) an interdisciplinary approach is mandatory. The three cases reported here reflect the impressive improvements of both diagnostic facilities and surgical strategies over the last 16 years as evidenced in the literature. Nowadays, prerequisite for a well-planned, safe, and successful operation is the exact delineation of the intravasal tumor extension and the use of the combined techniques of cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA). In the first child (1976) only tumor nephrectomy was performed. Under chemotherapy fatal massive pulmonary embolism occurred. In the second child (1980) ICE was removed after tumor nephrectomy on an emergency basis using CPB. The third child (1987) was operated on electively using the concepts of CPB+DHCA. Now, both children are doing well without evidence of disease 13 years (case 2: stage III) and 6 years (case 3: stage IV) after an aggressive adjuvant-therapy regimen of multiagent chemotherapy and radiation. In conclusion, in children with nephroblastoma and ICE an aggressive surgical approach and subsequent multiagent chemotherapy are advocated.

Chemotherapy, Adjuvant↗

Wilms tumor with intracardiac neoplastic extension.

A rare case of a Wilms tumor with intracardiac neoplastic extension is presented. The good prognosis of even extensive nephroblastoma is the reason for attempting a radical surgical approach to patients with intracardiac tumor thrombus. The exact preoperative delineation of the intracasal tumor extension is essential for a safe and successful operation. Ultrasonography in combination with echocardiography is the preferred modality for detecting intracardiac extension.

Child, Preschool↗

[Cytokine therapy of superficial bladder carcinoma. Mechanisms of action and results of therapy].

The object of immunotherapy is the elimination of tumor cells mediated by modulation of the immune system. This can be achieved by different mechanisms, i.e. cell-mediated and humorally mediated immune reactions. Immunotherapy can be classified as passive, adoptive, active and non-conventional. Most clinical experience has been gathered with unspecific active immunotherapy. Superficial bladder carcinomas can be treated by intravesical application of Bacillus Calmette-Guérin (BCG) or of different cytokines, i.e., interferons or interleukin-2. Since there has not so far been any standard immunotherapy for superficial bladder carcinoma, the efficacy of therapy with cytokines should be evaluated in clinical studies (phase II/III) only.

Carcinoma, Transitional Cell↗

[Unconventional therapeutic methods in superficial bladder cancer].

Several unconventional agents or methods are used for recurrence prophylaxis of superficial bladder cancer. In animal experiments KLH (keyhole limpet hemocyanin) has shown an effect comparable to that of BCG on bladder carcinoma, resulting in an increase of natural killer cell activity. The few clinical data dealing with KLH are contradictory. A prospective randomized study with a large number of patients uniform high dosage and early start of instillation has not yet been performed for definitive evaluation of the clinical role of KLH. Whether mistletoe extracts or intravesical antineoplastic iontophoresis can prevent recurrence is not yet known. Vitamin A and megadose multivitamins in combination with intravesical BCG significantly decrease the recurrence rate. The most effective vitamin or the most important combination has not yet been identified, and the precise mechanism of action is also unknown.

Adjuvants, Immunologic↗

E-cadherin: a marker for differentiation and invasiveness in prostatic carcinoma.

Considerable controversy exists concerning the value of histomorphological data in the assessment of the malignant potential of prostatic carcinomas. We investigated the expression pattern of E-cadherin in human prostate at the translational level. E-cadherin is a specific epithelial cell-cell adhesion molecule which has previously been found to be expressed in well-differentiated non-invasive carcinoma cell lines but is lost in many poorly differentiated invasive cell lines. The E-cadherin expression pattern in the prostate samples was correlated with histopathological findings in the same specimens. We found strong E-cadherin expression in normal prostate and benign prostatic hyperplasia. A decrease in or loss of E-cadherin was seen in 13 of 14 locally advanced and in 8 of 9 poorly differentiated prostatic carcinomas. We conclude that downregulation of E-cadherin expression plays a role in prostate carcinogenesis and invasiveness.

Adult↗