Hepatitis C-virus (HCV) antibodies in patients after kidney transplantation.

The hepatitis C-virus (HCV) is the main etiologic agent of posttransfusion hepatitis (PTH). Most patients depending on hemodialysis need transfusion of blood before kidney transplantation. Of 272 patients after kidney transplantation, 27 (10%) were found to be anti-HCV-ELISA-positive (HCV-Antibody-ELISA, Ortho Diagnostics).

[Hepatitis C virus antibodies in patients following blood transfusion and kidney transplantation].

The prevalence of anti-HCV in patients after kidney transplantation was tested by HCV-Antibody-ELISA (Ortho Diagnostics). In addition, reactive samples were tested by HCV-EIA (Abbott Laboratories), neutralization, anti-HBc (Corzyme, Abbott) and by HBs-Ag (Auszyme, Abbott). 27 of 271 patients (10%) were anti-HCV positive.

[Design, goals and preliminary results of the first national breast cancer study--the Federal Ministry of Research and Technology study of "small breast cancer"].

In the multicentre trial sponsored by the Federal Ministry for Research and Technology (= BMFT), mastectomy is compared with breast preservation in patients with pT1 NO MO breast cancer. On the basis of that protocol breast preservation can also be performed by smaller institutions thus implementing the health policy programme of effecting new treatment modalities on a broad basis. We can already recognise a substantial improvement in treatment standards applied by the different disciplines in the hospitals involved in the study.

Low-fat diet and regular, supervised physical exercise in patients with symptomatic coronary artery disease: reduction of stress-induced myocardial ischemia.

The effects of physical exercise and normalization of serum lipoproteins on stress-induced myocardial ischemia were studied in 18 patients with coronary artery disease, stable angina pectoris, and mild hypercholesterolemia (total serum cholesterol 242 +/- 32 mg/dl). These patients underwent a combined regimen of low-fat/low-cholesterol diet and regular, supervised physical exercise at high intensity for 12 months. At 1 year serum lipoproteins has been lowered to ideal levels (serum cholesterol 202 +/- 31 mg/dl, low-density lipoproteins 130 +/- 30 mg/dl, very low-density lipoproteins 22 +/- 15 mg/dl, serum triglycerides 105 [69 to 304] mg/dl) and physical work capacity was improved by 21% (p less than .

Evaluation of psychosocial aspects in a breast preservation trial.

Our preliminary and exploratory data analysis of the current state of QOL assessment in the ongoing BMFT breast preservation trial indicates that our questionnaire meets criteria of validity, differentiability, and practicability in the context of a large multi-center trial. The results of treatment comparisons tend towards accordance with those of comparable studies, in that they do not show the often-postulated global superiority of breast-preserving therapy over mastectomy with respect to QOL. The special study concept of combining patients with and without treatment preference gives rise to a lot of methodological issues but is the only way to find out whether participation in the therapeutic decision-making process is beneficial to the patient or not.

[Thrombolysis in acute myocardial infarct. An improved long-term prognosis following balloon dilatation].

Unlabelled: A systemic and intracoronary thrombolytic treatment was carried out in 217 patients with acute transmural myocardial infarction between March 1980 and March 1985. 141 patients were only treated with thrombolysis, and 76 were additionally treated by balloon dilation in the same session. Indications for additional balloon dilation were unsuccessful thrombolysis as well as a residual stenosis of more than 50% after primarily successful thrombolysis.

Overview of randomized trials of postoperative adjuvant radiotherapy in breast cancer.

An overview of the mortality results of the mature trials in which radiotherapy was a randomized option after simple or radical mastectomy is presented. The principal aim of the overview was to study long-term survival, and recent trials, often including chemotherapy options, have not been included. A total of 7941 patients were entered into these trials and 4148 deaths occurred.

[Determinants of long-term prognosis following prosthetic mitral valve replacement].

Unlabelled: Data of 235 patients with chronic mitral valve disease (NYHA class III or IV) were analyzed retrospectively. Mitral valve replacement was performed in all patients between 1974 and 1983, 46 patients underwent additional tricuspid valve repair during the same operation. Preoperatively, right and left heart catheterization as well as coronary angiography were carried out in all patients.

[What effect does impaired left ventricular function have on prognosis following prosthetic aortic valve replacement?].

Data of 286 patients with advanced chronic aortic valve disease (NYHA class III or IV) who underwent aortic valve replacement between 1975 and 1982 were retrospectively analyzed using a multivariate Cox regression analysis. Preoperatively, left ventricular volumes and ejection fraction were determined angiographically in all patients. In patients with aortic stenosis and impaired left ventricular ejection fraction survival rate up to 7 years was identical as compared to those with aortic stenosis and normal ejection fraction.

[Surgical indications in mitral valve stenosis, combined mitral valve defect or mitral valve insufficiency. Long-term prognosis of operated or drug-treated patients].

Data obtained from 683 patients with mitral valve disease, NYHA-class III or IV, were retrospectively studied by means of a multivariate Cox regression analysis. Based on symptoms and hemodynamic findings, surgical intervention had been recommended for all patients: closed mitral commissurotomy (n = 361), prosthetic mitral valve replacement (n = 241) and prosthetic mitral valve replacement together with a corrective procedure for the tricuspid valve (n = 81). While the majority of patients underwent surgery during the observation period (n = 528), a substantial number of patients continued on medical treatment (n = 155).

[Long-term prognosis of drug and surgery treated patients with acquired aortic valve diseases: survival statistics and multivariate Cox regression analysis].

Data of 417 patients with advanced chronic aortic valve disease were retrospectively analyzed using a life table and Cox regression analysis. Aortic valve replacement was recommended to all patients based on clinical and hemodynamic findings. While most patients underwent prosthetic aortic valve replacement (n = 349), a minority of patients was treated medically (n = 68).

[Long-term prognosis of acute transmural myocardial infarct after intracoronary thrombolysis treatment].

Reperfusion of the infarct vessel by a combination of intravenous and intracoronary infusion of streptokinase succeeded in 66 of 120 patients with acute transmural infarction in whom the infusion had been started less than six hours after onset of symptoms. The recanalization attempt failed in 26, and 28 were treated conventionally. Size of the infarct was determined by 201Thallium scanning before and 48 hours after the acute treatment phase.

Determinants of survival in patients with congestive cardiomyopathy: quantitative morphologic findings and left ventricular hemodynamics.

We analyzed data from 68 consecutive patients with congestive cardiomyopathy to evaluate the prognostic significance of quantitative morphologic findings in left ventricular myocardium as compared with the prognostic significance of left ventricular hemodynamics. Left ventricular endomyocardial biopsy specimens were obtained from all patients during diagnostic heart catheterization. Myocardial fiber diameter, volume fraction of interstitial fibrosis, and intracellular volume fraction of myofibrils were determined by light-microscopic morphometry.

[Methodology of controlled clinical studies on the primary treatment of operable breast cancer].

We discuss in this paper the thesis that the underlying questions in breast cancer clinical trials are complex in nature and that multivariate procedures are required for statistical analysis. The variety of statistics resulting from multiple significance testing may be insufficient and misleading. Analysis using multivariate methods centres around interactions between treatments and prognostic factors, time dependence of treatment effects, multi-state models of the disease process, and problems of quality of life.

[The value of radiotherapy after modified radical mastectomy. 10-year results of the Heidelberg study].

Modified radical mastectomy was performed in 142 female patients with operable carcinoma of the breast. One of the two prospectively randomised groups received postoperative radiotherapy with 6000 rad. Survival rates were equal for both groups.

On the use of hazard functions in breast cancer studies.

Hazard functions are nowadays used extensively by mathematicians as a tool in the analysis of survival data. They have been implicitly employed in medicine for many years to investigate 'curability'. The hazard function will be shown to be a natural concept which can help the clinician to express in a precise way his ideas concerning the disease process and the biology of treatment effect.

[A controlled clinical study of early mobilisation of patients with myocardial infarction (author's transl)].

This is the report about 265 patients with recent transmural myocardial infarction. In the first week of hospital treatment 63 died. From the remaining 201 patients 101 fulfilled the conditions for early mobilisation of the WHO.

[Are neuroleptic drugs anticarcinogenic? (author's transl)].

Statistical methods seem to confirm the impression that a connection exists between the administration of neuroleptic drugs and a lowered cancer mortality rate. However, further analysis shows that the neuroleptic group and the controls represent two distinct populations which cannot be compared with each other.