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51.
L. Bergmann E. Weidmann H. M. Enzinger K. Fenchel D. Jonas P. S. Mitrou 《World journal of urology》1991,9(4):215-218
Summary Interferon-alpha (IFN-) and interleukin-2 (Il-2) are effective as single agents in metastatic renal cell cancer (RCC) with response rates of 15–30%. Additionally, IFN- is assumed to act synergistically with Il-2 in the induction of lymphokine-activated killer cells. (LAK cells) in vitro. With the aims of increasing the response rate by combining both cytokines and of reducing side effects, we started a clinical trial with a daily alternating schedule of 10×106 units/m2 s.c. rIFN-2b (Essex, Munich, FRG) and 3×106 Cetus units/m2 rIL-2 (EuroCetus, Frankfurt, FRG) in the form of 1 h infusions over a period of 14 days. Patients found to have progressive disease after two cycles of therapy were withdrawn from the study; patients with stable disease or better received two further cycles.Of the 27 patients included in the study, 22 (16 male, 6 female) are evaluable for response. In 1 patient with multiple pulmonary metastases complete remission was achieved, in 5 patients partial remission, and in 2 a minor response. The schedule was practicable; the main side effects were influenza-like symptoms, fatigue and hypotension. Some patients suffered from arthralgias and erythemas up to 3 weeks after finishing the therapy cycle. On the whole, the side effects seem to be less severe than those arising from schedules using continuous Il-2 infusions.This work was supported by Grant No. 01GA8802 of the Bundesministerium für Forschung und Technologie (BMFT) 相似文献
52.
Jonas JL 《Journal of music therapy》1991,28(3):149-160
The purpose of this study was to investigate seniors' comparative music preference for four generic styles including art music, country music, popular music of today, and traditional jazz. The study also attempted to identify certain variables that have an effect on preference. Sixty-three subjects with a mean age of 82.5 from four nursing homes in the South Central Michigan area participated in the study. An interview and musical preference test were administered to the subjects individually. The listening test consisted of 16 music selections, four from each style. The seniors judged how much they liked the selections on a scale from 1 to 5, with 5 indicating greatest preference. Results indicated that country music style was preferred the most, followed by traditional jazz, art music, and lastly popular music. Variables that were found to affect preference were education level, community size in which the seniors grew up, and music training outside the school setting. 相似文献
53.
Ohrvall U Eriksson B Juhlin C Karacagil S Rastad J Hellman P Akerström G 《World journal of surgery》2000,24(11):1402-1408
With adequate medical management the midgut carcinoid tumor generally is an indolent malignancy associated with substantial
life expectancy and appreciable life quality, even in the presence of liver metastases and significant tumor burden. Abdominal
complications may occur in this entity of carcinoids owing to entrapment of intestines and encasement of mesenteric vessels
by mesenteric metastases and associated marked mesenteric fibrosis. This may be the cause of abdominal pain, disabling diarrhea,
weight loss to the extent of malnutrition, and eventually the risk of death with acute or chronic intestinal obstruction or
intestinal gangrene. Operative removal of the mesentericointestinal lesion is often indicated to prevent or treat these complications
but may be technically difficult when mesenteric metastases extend in the vicinity of major vessels in the mesenteric root.
At laparotomy 56 patients with advanced midgut carcinoids underwent removal of the mesenteric tumor with a method for preserving
the mesenteric vessels. This was feasible by mobilizing and releasing the right colon and mesenteric root from posterior adhesions,
identifying the mesenteric artery below the pancreas, and free-dissecting this artery on the tumor capsule in the mobilized
mesentery. Dissection was successful even with tumors initially judged inoperable unless tumor growth completely surrounded
the mesenteric vessels or extended retroperitoneally. One patient was subjected to distal intestinal artery bypass. Symptom
relief was been substantial and often of long duration after mesenteric tumor removal in patients who prior to surgery often
had threatening intestinal ischemia. Patients with advanced midgut carcinoids may benefit markedly from dissectional removal
of mesenteric tumors, which (conceivably better than conventional wedge resection) preserves the length of the remaining intestine. 相似文献
54.
J Atzpodien H Kirchner U Jonas L Bergmann H Schott H Heynemann P Fornara S A Loening J Roigas S C Müller H Bodenstein S Pomer B Metzner U Rebmann R Oberneder M Siebels T Wandert T Puchberger M Reitz 《Journal of clinical oncology》2004,22(7):1188-1194
PURPOSE: We conducted a prospectively randomized clinical trial to compare the efficacy of three outpatient therapy regimens in 341 patients with progressive metastatic renal cell carcinoma. PATIENTS AND METHODS: Patients were stratified according to known clinical predictors and were subsequently randomly assigned. Treatment arms were: arm A (n = 132), subcutaneous interferon alfa-2a (sc-IFN-alpha-2a), subcutaneous interleukin-2 (sc-IL-2), and intravenous (IV) fluorouracil; arm B (n = 146): arm A treatment combined with per oral 13-cis-retinoic acid; and arm C (n = 63), sc-IFN-alpha-2a and IV vinblastine. RESULTS: Treatment (according to the standard 8-week Hannover Atzpodien regimen) arms A, B, and C yielded objective response rates of 31%, 26%, and 20%, respectively. Arm B, but not arm A, showed a significantly improved progression-free survival (PFS) compared with arm C (P =.0248). Both arm A (median overall survival, 25 months; P =.0440) and arm B (median overall survival, 27 months; P =.0227) led to significantly improved overall survival (OS) compared with arm C (median OS, 16 months). All three sc-IFN-alpha-2a-based therapies were moderately or well tolerated. CONCLUSION: Our results established the safety and improved long-term therapeutic efficacy of sc-IL-2 plus sc-INF-alpha-2a-based outpatient immunochemotherapies, compared with sc-INF-alpha-2a/IV vinblastine. 相似文献
55.
The discovery of endocrine therapy of diseases of the prostate can be regarded as one of the most important events in the
history of medicine and in urology in particular. This article delivers an overview about scientists and clinicians involved
in this work during the last 200 years. A close historical relation between the endocrine therapy of benign prostatic hyperplasia
and prostate cancer can be recognized. The historical framework between the work of John Hunter in the late eighteenth century,
that of Charles Brenton Huggins in the late 1930s, and that of Andrew Schally in the 1970s has been assembled herein. With
respect to all the other men who contributed greatly to this medical achievement, e.g., Edward L. Keyes and Russell S. Ferguson,
with their first report on radioorchiectomy for the treatment of metastatic prostate cancer in 1936, this historical vignette
is intended to make them part of the historical record. 相似文献
56.
A 15 year old boy with autoimmune polyendocrinopathy-candidosis-ectodermal dystrophy syndrome suffered recurrent episodes of severe intractable diarrhoea, steatorrhoea, and hypocalcaemia. The only treatment modality, which controlled the malabsorption syndrome, was immunosuppression with intravenous high dose methylprednisolone and oral methotrexate maintenance therapy. 相似文献
57.
58.
Repair of the truncal valve and associated interrupted arch in neonates with truncus arteriosus 总被引:6,自引:0,他引:6
Jahangiri M Zurakowski D Mayer JE del Nido PJ Jonas RA 《The Journal of thoracic and cardiovascular surgery》2000,119(3):508-514
OBJECTIVE: Truncal valve regurgitation and interrupted aortic arch have frequently been identified as risk factors in the repair of truncus arteriosus. We wished to examine these factors in the current era including the impact of truncal valve repair. METHODS: Between January 1992 and August 1998, 50 patients underwent surgical repair of truncus arteriosus. Their ages ranged from 2 days to 6 months (median, 2 weeks). Nine patients had associated interrupted aortic arch. Of the 14 patients (28%) in whom truncal valve regurgitation was diagnosed preoperatively, 5 had mild regurgitation, 5 had moderate regurgitation, and 4 had severe regurgitation. Five underwent truncal valve repair and 1 underwent homograft replacement of the truncal valve with coronary reimplantation. RESULTS: The actuarial survival was 96% at 30 days, 1 year, and 3 years. There were no deaths in patients with associated interrupted aortic arch. The 2 deaths in the series occurred in patients with truncal valve regurgitation, neither of whom underwent repair. Postoperative transthoracic echocardiography in patients who underwent valve repair showed minimal residual valvular regurgitation. None of the patients has required reoperation because of truncal valve problems or aortic arch stenosis at a median follow-up of 23 months (range, 1-60 months). Conduit replacement has been done in 17 patients (34%) after a mean duration of 2 years. The freedom from reoperation for those who had an aortic homograft was 4 years and for those who had a pulmonary homograft was 3 years. CONCLUSION: Despite the magnitude of the operation, excellent results can be achieved in complex forms of truncus arteriosus. In the current era interrupted aortic arch is no longer a risk factor for repair of truncus. Aggressive application of truncal valvuloplasty methods should neutralize the traditional risk factor of truncal valve regurgitation. 相似文献
59.
60.
Becker AJ Uckert S Stief CG Truss MC Machtens S Scheller F Knapp WH Hartmann U Jonas U 《The Journal of urology》2000,164(2):573-577
PURPOSE: Knowledge of the functional anatomy, hemodynamics, neurophysiology and pharmacology of penile erection has improved tremendously during the last 2 decades. However, only few in vivo studies on human peripheral neurotransmission have been carried out up until now. Therefore, we conducted a study to examine plasma levels of catecholamines norepinephrine (NE) and epinephrine (E) in the peripheral and cavernous blood of healthy men during penile flaccidity and in different phases of erection. MATERIALS AND METHODS: Blood samples were drawn simultaneously from the corpus cavernosum (CC) and the cubital vein (P) in 53 healthy volunteers with normal erectile function, in four different functional states of the cavernous erectile tissue (flaccidity = 1, tumescence = 2, rigidity = 3, detumescence = 4). Penile erections were induced by audiovisual and tactile stimulation and the plasma concentrations of NE and E were determined by means of a radioimmunoassay (RIA). RESULTS: A significant (p <0.001) reduction of NE in CC plasma was found from flaccidity (362 + or - 173 pg./ml.) to rigidity (248 + or - 122 pg./ml.), followed by an increase in the detumescence phase (336 + or - 199 pg./ml.), (p <0.001). In contrast, changes in NE levels in the peripheral plasma were less pronounced from 1P (202 + or - 102 pg./ml.) to 3P (229 + or - 118 pg./ml.), (p = 0.006) and from 3P to 4P (222 + or - 127 pg./ml.), respectively (p = 0.370). The most pronounced increase in cavernous E levels were observed from flaccidity (47 + or - 41 pg. /ml.) to tumescence (130 + or - 106 pg./ml.) (p <0.001). Cavernous E levels dropped significantly from 113 + or - 67 pg./ml. during rigidity to 76 + or - 57 pg./ml. + or - during detumescence (p <0.001). The course of peripheral plasma levels of E was similar to that in the cavernous blood. Mean peripheral E level was 69 + or - 55 pg./ml. in the state of penile flaccidity, reaching 98 + or - 78 pg./ml. in tumescence and 82 + or - 64 pg./ml. in rigidity (p <0.001), respectively, and finally decreasing to 62 + or - 46 pg./ml. in detumescence. CONCLUSION: Penile erection, based on the relaxation of cavernous and arterial smooth muscle, is accompanied by a significant reduction of NE in cavernous blood, while E levels rose in peripheral and cavernous blood during developing erection. 相似文献