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Biomedical subjects

W Behr

Publications and source records attributed to W Behr.

At least 19 recordsLinked to original sources
PubMed2000

Combination of high-dose chemotherapy and monoclonal antibody in breast-cancer patients: a pilot trial to monitor treatment effects on disseminated tumor cells.

BACKGROUND: Tumor relapse occurring in high-risk breast cancer patients after high-dose chemotherapy (HDC) and autologous stem-cell transplantation may arise from cells resistant to chemotherapy, as well as from tumor cells reinfused with autologous stem cell grafts. This pilot study was designed to investigate whether ex vivo immunomagnetic purging of PBSC and subsequent immunotherapy with MAb 17-1A is feasible and can reduce the number of disseminated tumor cells in BM. METHODS: Twelve high-risk breast-cancer patients, seven in Stage II/III and five in Stage IV (UICC breast cancer classification) underwent surgery of the primary tumor and received two cycles of induction chemotherapy, followed by HDC. After each cycle of induction chemotherapy PBSC were collected and incubated with Ab-coated immunomagnetic beads, to remove contaminating tumor cells. Prepared stem-cell grafts were transplanted 24 h after completion of HDC. After recovering from HDC all 12 patients received a total dose of 900 mg MAb 17-1A within 4 months. The effect of in vivo purging with MAb 17-1A after HDC was controlled by examining bone aspirates of the patients with an immunocytochemical assay, allowing the detection of one cytokeratin-positive tumor cell in 10(6) total nucleated cells (TNC). RESULTS: Tumor cells were found in 5/12 BM aspirates prior to chemotherapy and even after HDC. Further monitoring of BM aspirates for cancer cells during Ab therapy showed a consistent reduction of tumor cells in four out of these five patients. After a median clinical follow-up of 41 (32-48) months all four patients are alive. These results are different from those of a historical control group of six patients with breast cancer treated with the same chemotherapy schedule, but without 17/1A consolidation. In comparison with the patients from the study group, all patients of this control group revealed a significantly increased number of tumor cells in BM (p < 0.01) after HDC during follow-up of 5 (3-7) months. These preliminary results indicate that induction chemotherapy, followed by HDC, may reduce disseminated tumor cells in BM. DISCUSSION: Immunotherapy with MAb 17-1A after HDC may further eliminate residual disease without severe toxicity.

Adult↗
PubMed1998

Three-dimensional 31P magnetic resonance spectroscopic imaging of regional high-energy phosphate metabolism in injured rat heart.

The purpose of this study was to measure the spatially varying 31P MR signals in global and regional ischemic injury in the isolated, perfused rat heart. Chronic myocardial infarcts were induced by occluding the left anterior descending coronary artery eight weeks before the MR examination. The effects of acute global low-flow ischemia were observed by reducing the perfusate flow. Chemical shift imaging (CSI) with three spatial dimensions was used to obtain 31P spectra in 54-microl voxels. Multislice 1H imaging with magnetization transfer contrast enhancement provided anatomical information. In normal hearts (n = 8), a homogeneous distribution of high-energy phosphate metabolites (HEP) was found. In chronic myocardial infarction (n = 6), scar tissue contained negligible amounts of HEP, but their distribution in residual myocardium was uniform. The size of the infarcted area could be measured from the metabolic images; the correlation of infarct sizes determined by histology and 31P MR CSI was excellent (P < 0.006). In global low-flow ischemia (n = 8), changes of HEP showed substantial regional heterogeneity. Three-dimensional 31P MR CSI should yield new insights into the regionally distinct metabolic consequences of various forms of myocardial injury.

Adenosine Triphosphate↗
PubMed1997

Double-tuned four-ring birdcage resonators for in vivo 31P-nuclear magnetic resonance spectroscopy at 11.75 T.

A high signal-to-noise ratio (SNR) in 31P-nuclear magnetic resonance (31P-NMR) spectroscopy can be obtained only with good B0-field homogeneity and optimal coil sensitivity. This demands double-tuned coils with a highly sensitive 31P channel and an additional 1H channel for 1H-magnetic resonance imaging, shimming, 1H decoupling, and nuclear Overhauser enhancement (NOE). For studies on an 11.75 T magnet, we built coils derived from the four-ring birdcage design originally described by Murphy-Boesch. A comparison with conventional, single-tuned coils shows that, in spite of double tuning, there is no significant loss in 31P sensitivity while the 1H channel provides the requested performance. The coil design offers the advantage of circular polarization on both channels.

Animals↗
PubMed1997

Tumor cell contamination of peripheral blood stem cell transplants and bone marrow in high-risk breast cancer patients.

Twenty-one high-risk patients with primary stage II/III breast cancer were treated with high-dose chemotherapy comprising etoposide, ifosfamide, carboplatin and epirubicin (VIC-E). Tumor cells of epithelial origin were analyzed using the monoclonal antibodies CK2 (IgG1) and A45-B/B3 (IgG1) against cytokeratin (CK) components in bone marrow (BM) aspirates prior to chemotherapy, and in peripheral blood stem cell transplants (PBSCT). They were separated after the first (21/21 patients) and the second cycle (16/21 patients) of induction chemotherapy with VIP-E (etoposide, ifosfamide, cisplatin, epirubicin). Preliminary results showed CK positive tumor cells in 40% (14/35) of the analyzed transplants. In 7/12 (58.3%) patients, CK positive tumor cells were detectable in BM prior to treatment. Sixteen patients were separated after the 1st and 2nd cycle of VIP-E. PBSCT of 14/16 patients were assessable for presence of CK positive tumor cells. Our preliminary results demonstrate a lower tumor cell contamination of PBSCT separated after the 2nd cycle of induction therapy (14.3%) compared to contamination after the first induction therapy (64.3%). To date, 4/21 patients have experienced a relapse, and three of these patients had tumor cell positive transplants. Due to the small patient number only a trend towards a superior relapse-free survival in the patient group with CK negative transplants can be shown by Kaplan-Meier analysis.

Adult↗
PubMed1994

[The value of the urea/creatinine ratio for differentiation of up and lower gastrointestinal hemorrhage].

The urea/creatinine-ratio has been proposed as an instrument for differentiating upper from lower gastrointestinal haemorrhages. The predictability of this method was investigated in 105 cases with the source of bleeding to be in the upper gastrointestinal tract and in 31 cases in the lower gastrointestinal tract. Determination of the urea/creatinine-ratio predicted the site of bleeding in only 60% of the patients. The use of the ratio in diagnostic decision making would increase the number of unnecessary colonoscopies. Thus, the urea/creatinine-ratio does not appear to be clinically useful in predicting the localization of a gastrointestinal bleeding with adequate certainty.

Adult↗
PubMed1993

[Can administration of trasylol in reduced Hammersmith dosage with simultaneous transfusion of autologous blood meet the requirements of open heart surgery?].

PROBLEM: The general positive effect of the proteinase inhibitor trasylol on blood loss and transfusion demand in cardiac surgery has been demonstrated in several placebo-controlled studies. Given the possibility of cardiac and renal side effects associated with a high dose of trasylol (Hammersmith dosage: 6 x 10(6) kallikrein inactivator units KIU), the question of a dose reduction was raised. METHODS: Being designed as a randomized double-blind comparative group study, the investigation included 120 patients with elective primary cardiac surgery from November 1990 to April 1992. One characteristic aspect of this study was the combined administration of trasylol and autologous blood transfusions. To compare the efficacy and safety of different doses of trasylol, two groups, each with 60 patients, were created: the former with the full Hammersmith dose (high dose group = HD group), the latter with half of the Hammersmith dose (los dose group = LD group). A placebo group had to be excluded for ethical reasons. RESULTS: The trasylol plasma levels showed a good dose correlation for the complete interval. The intra-operative bleeding tendency, as judged by the surgeons in charge, did not show any statistical significant difference between the HD group and the LD group. As to the post-operative blood loss via thoracic drainage, the early collection periods did not show any difference between both study groups. Starting at 6 hours post-operatively, the drainage losses showed a tendency towards lower volumes in the HD group. This difference was statistically significant for the time period "6-12 hours post-operatively". The analysis of the post-operative complications did not show any difference. SUMMARY: In this study with a high percentage of autologous blood transfusions, a lower dose of trasylol seemed to be nearly as effective as a full Hammersmith dose. However, such a reduced dose did not demonstrate any advantage regarding the complication rate in comparison with the conventional high dose.

Aprotinin↗
PubMed1992

[Effect of storage duration and irradiation dose on in vitro aggregation of thrombocytes].

We studied the influence of storage (1-5 days) and gamma irradiation (0, 25, 50, 100 Gy) on the in vitro aggregability of stored platelets. Platelet aggregation was measured using the method of Born and Breddin and the aggregating agents ADP, collagen, ristocetin and arachidonic acid. With increasing time of storage the ADP-, collagen- and ristocetin-induced platelet aggregation was significantly diminished. On the other hand, the irradiation even with 100 Gy had no additional effect.

Blood Component Transfusion↗
PubMed1991

[Bedside determination of clinical-chemical quantities using dry chemistry in an emergency admission].

We evaluated the clinical relevance and reliability of a solid phase chemistry apparatus (Seralyzer) installed for near-patient testing of CK, GOT, glucose and potassium in the emergency admission of our hospital. Calibrations and quality controls were done by technologists of the central laboratory, the analyses were performed by the nursing staff after appropriate training. The rapid availability of the laboratory tests shortened the diagnostic process in only 8% of the patients. Clinical chemistry test results, therefore, appear to be of minor importance in making the diagnosis in an emergency room. The coefficients of variation of the inter-operator imprecision varied between 2.1 and 8.8% (means = 5.06%), when the measurements were performed by persons with no professional laboratory training, and between 2.7 and 8.5% (means = 3.98%) for skilled laboratory personal. In order to test the accuracy we correlated the dry chemistry values measured by the nurses in the daily routine with the results of a wet chemistry system. The Spearman rank correlation coefficients ranged between 0.916 and 0.950. Thus after appropriate training non-laboratory personal is able to perform dry chemistry testing with adequate precision and accuracy provided a competent supervision is guaranteed.

Aspartate Aminotransferases↗
PubMed1990

[Is preservation of erythrocyte concentrates with added solutions an alternative to deep freezing in heart surgery autologous blood donation?].

In patients undergoing cardiovascular operations the deep freezing of autologous red blood cells (RBC) was compared with the liquid storage in PAGGS-Sorbitol. On an average 3.9 units of blood were predeposited in the group with deep freezing and 3.4 in the group with liquid storage. The number of complications was the same in both groups despite the shorter intervals between the donations in the group with liquid storage. 58 out of 74 patients (= 78%) with deep frozen autologous RBC and 42 out of 65 patients (= 65%) with liquid stored RBC need no homologous blood. 12% of the liquid stored RBC were discared due to unforseen delaying of the operation.

Adenine↗
PubMed1988

[Diagnostic problems in neurosyphilis].

In two patients admitted to hospital-one with signs of cerebral infarction, the other with headaches, vertigo and paraesthesias-the TPHA test was "reactive", while the 19S(IgM)-FTA-ABS test was not. There was no cerebrospinal fluid (CSF) pleocytosis. Further CSF analyses and serological tests for syphilis (including CSF protein profile, demonstration of oligoclonal IgG, quantitative determination of Treponema-specific antibodies in serum and CSF) confirmed the diagnosis of neurosyphilis requiring treatment. In both patients the biologically false-negative 19S(IgM)-FTA-ABS test at first became transiently reactive after treatment. This unusual finding was probably due to antigen, liberated by treatment, again stimulating previously blocked IgM antibody synthesis. The listed additional tests should be performed in all patients with a reactive TPHA test and neurological or psychiatric signs and symptoms.

Antibodies, Bacterial↗
PubMed1988

[Production of leukocyte-poor erythrocyte concentrates with bedside filtration. Effectiveness and practicability of a new filter system in comparison with 2 other systems].

The effectiveness and practicability of a new filter (Leucostop LT) for the production of leukocyte- and platelet-poor red cells at the bedside was evaluated and compared with two other leukocyte removal filter systems for bedside use (Erypur b and Sepacell R-500 A). As for the residual leukocytes and platelets, we found no essential differences between the tested filter systems: The mean value of the leukocyte contamination was between 11.2 (Leucostop) and 14.3 X 10(6) (Erypur b), the mean value of the platelets between 1.0 (Sepacell) and 3.0 X 10(9) (Erypur) per unit by filtering one red cell concentrate (RCC) through the filter. The red cell recovery after priming the system with 200 ml of saline was between 94.4% (Erypur) and 99.6% (Leucostop). The Leucostop LT system showed the highest flow rate; even 16-day-old RCC could be filtered within 60 min at the bedside, whereas with the Sepacell R-500 A system only 2- or 3-day-old RCC could be filtered in this time.

Blood Transfusion↗
PubMed1986

Thrombotic thrombocytopenic purpura without anemia.

A patient is described who presented with fever, fluctuating neurological abnormalities, renal dysfunction, and thrombocytopenia. The necropsy revealed the classic histological findings of thrombotic thrombocytopenic purpura (TTP). Hemolytic anemia and fragmented red cells, hallmarks of TTP, were absent in our patient; this does not fit into the classic description of this syndrome.

Anemia, Hemolytic↗
PubMed1986

Adult celiac disease and primary biliary cirrhosis.

The association of primary biliary cirrhosis and adult celiac disease was observed in a female patient. Because of their clinical overlap the diagnosis of both conditions may be difficult especially in the early stage of their coexistence. The hypotheses regarding a common etiological link between celiac disease and primary biliary cirrhosis are discussed.

Celiac Disease↗
PubMed1986

Quantification of bone alkaline phosphatase in serum by precipitation with wheat-germ lectin: a simplified method and its clinical plausibility.

We report an easy, rapid method for quantifying bone isoenzyme of alkaline phosphatase (EC 3.1.3.1., ALP) in serum. The original method described by Rosalki and Ying Foo (Clin Chem 1984;30:1182-6) was somewhat simplified. In contrast to their results, we found that bone ALP is precipitated quantitatively by wheat-germ lectin. To check the clinical plausibility of the method, we used samples from several comparison groups (blood donors, children, pregnant women, patients with neoplasms but without skeletal involvement) and a large number of patients suffering from bone diseases and diseases of the liver and biliary tree. Measured activities of bone ALP nearly always correlated with the clinical diagnosis. Only patients with hepatitis often had pathological bone activities not in accord with the other findings. Possible reasons for this observation are discussed.

Alkaline Phosphatase↗
PubMed1985

Rhinocerebral mucormycosis in a diabetic ketoacidotic patient.

A 51-year-old, ketoacidotic diabetic with the rare neurological complications of rhinocerebral mucormycosis is reported. The clinical presentation was characterized by initial severe frontal headache, rapid visual loss with complete external ophthalmoplegia and intracranial spread by invasive fungal growth. Its course and fungostatic therapy with amphotericin B and ketoconazole are described and the literature reviewed.

Acidosis↗
PubMed1985

Determination of reference intervals for 10 serum proteins measured by rate nephelometry, taking into consideration different sample groups and different distribution functions.

Reference intervals were established for 10 serum proteins (IgA, IgG, IgM, transferrin, haptoglobin, complement C3, complement C4, alpha 1-acid-glycoprotein, alpha 1-antitrypsin, alpha 2-macroglobulin) measured by rate nephelometry. The reference individuals - 200 blood donors - were divided into 5 subgroups: men aged 19-39 and 40-60 years, women aged 19-39 and 40-60 years and women aged 19-48 years using oral contraceptives. Where possible, two or more subgroups were combined to give reference sample groups. Criteria for this procedure are given. The reference limits of the sample groups were estimated by parametric methods. Assuming that for a specified serum protein the type of distribution is the same in each subgroup, the data were standardized with estimated group specific parameter values and combined into one big sample. This permitted an improved determination of the underlying type of distribution. As a possible form of distribution we also considered the normal distribution truncated on the left side at c greater than or equal to 0. In some cases, after determination of an optimal c, this unusual distribution fitted the data significantly better than the generally used normal or log-normal distribution.

Adult↗
PubMed1985

[Atypical course of infections with enteritis salmonellas].

During the six-year period from 1978-1983 968 so-called "enteritis Salmonellae" were isolated in our laboratory. 50 of them (= 5,2%) were primary isolations from extraintestinal specimens, first of all from blood, abscess smear and urine. The greater part of the patients with an atypical course of enteritis salmonellosis showed clinical signs of septicemia (44%) or local suppuration (24%). In atypical salmonellosis advanced age and sex distinctly prevailed compared to the distribution of age and sex of patients suffering from typical Salmonellae enteritis. 80% of the patients with atypical salmonellosis had mostly resistance lowering basic diseases, first of all diabetes mellitus, or were treated with immunosuppressive therapy. The spectrum of "enteritis Salmonellae" isolated only from feces during the same period differed significantly (p = 0,01) from the spectrum of Salmonellae types found in extraintestinal specimens. An atypical course was relatively often caused by S. enteritidis, S. panama and S. virchow.

Adolescent↗