AIR Research

 

Eur Respir J 2002 May;19(5):981-2; author reply 982-3

Evaluation of bronchodilator responses in patients with "irreversible"
emphysema.

Kummer F.

Publication Types:
Letter

---

Wien Klin Wochenschr 1999 Dec 23;111(24):1044-7

[Austrian Society for Lung Diseases and Tuberculosis: Consensus on diagnosis and
therapy of bronchial asthma in adults. Revised draft 1999]

[Article in German]

Aigner K, Block LH, Kneussl M, Kummer F, Neumann M, Zach M, Zwick H.

Allgemein offentliches Krankenhaus der Elisabethinen, Linz, Osterreich.

Publication Types:
Consensus Development Conference
Review

---

Wien Klin Wochenschr 2000 Jan 14;112(1):41-5

[Austrian Society of Lung Diseases and Tuberculosis: Consensus on Management of
Chronic Obstructive Lung Diseases (COPD). 1999 Revision]

[Article in German]

Aigner K, Block LH, Kneussl M, Kummer F, Neumann M, Zach M, Zwick H.

Allgemein offentliches Krankenhaus der Elisabethinen, Linz.

Publication Types:
Consensus Development Conference
Review

---

Wien Med Wochenschr 1999;149(2-4):76-7

[Clinical aspects and diagnosis of pulmonary thromboembolism]

[Article in German]

Kummer F.

II. Medizinischen Abteilung/Lungenabteilung, Wilhelminenspitals der Stadt Wien.
friedrich.kummer@2me.wil.magwien.gv.at

The symptomatology of PTE is good for the suspicion of PTE only. Symptoms are
mainly based on dyspnoea (respiratory rate) and pain in the chest. Clinical
diagnostic procedures, on the other hand, are backed up by evaluation of
specific risk factors (previous thrombosis, post-operative state,
immobilisation) and search for deep venous thrombosis (DVT). Blood gas analysis
is very sensitive to unravel (latent) respiratory failure, along with
established routine measures (blood pressure, ECG, chest-film) and additional
echocardiography. Most important in our experience is a perfusion scan at the
earliest opportunity. Spiral-CT angiography is indicated in special cases only.
We looked at 115 consecutive patients with suspected PTE and found close
correlations between risk profiles of thrombosis, pathological BGA and high
probability perfusion scans. DVT was detected in 50% only. Positive predictive
values for high risk and pathological BGA were 86 and 92%, respectively. An
algorithm for diagnostical/therapeutical strategies is presented. The early
application of an heparin-bolus is stressed.

---

Eur J Cancer 1998 Nov;34(12):1977-80

Vinorelbine/gemcitabine in advanced non-small cell lung cancer (NSCLC): a phase
I trial.

Krajnik G, Wein W, Greil R, Marhold F, Mohn-Staudner A, Kummer F, Malayeri R,
Zochbauer-Muller S, Huber H, Pirker R.

Austrian Association for the Study of Lung Cancer (AASLC), Department for
Internal Medicine I, University of Vienna Medical School, Austria.

Vinorelbine and gemcitabine are both active as single agents in advanced
non-small cell lung cancer (NSCLC). Because of their different mechanisms of
action, good tolerability and possible administration on an out-patient basis,
vinorelbine/gemcitabine should be an interesting combination for palliative
chemotherapy. Thus, we initiated a phase I dose-escalation trial in order to
determine the maximum tolerated doses of vinorelbine/gemcitabine that can be
administered without haematopoietic growth factors, the dose-limiting toxicities
and the most frequent side-effects of this novel combination. 40
chemotherapy-naive patients with advanced NSCLC were treated with different
doses of vinorelbine/gemcitabine on days 1, 8 and 15, and this treatment cycle
was repeated on day 29. Vinorelbine and gemcitabine were escalated from 10 to 30
mg/m2 and 600 to 1200 mg/m2, respectively. A total of 63 treatment cycles were
administered and 27 patients received at least two treatment cycles.
Dose-limiting toxicities were leucopenia plus thrombocytopenia (2 patients) and
mucositis (1 patient). The maximum tolerated dose was established at 25 mg/m2
vinorelbine combined with 1200 mg/m2 gemcitabine. Frequent side-effects were
leucopenia, anaemia, nausea/vomiting, flu-like symptoms, skin rashes and
elevation of liver enzymes. The recommended phase II doses are 20-25 mg/m2
vinorelbine combined with 1000-1200 mg/m2 gemcitabine on days 1, 8 and 15, but
myelosuppression will have to be carefully monitored.

Publication Types:
Clinical Trial
Clinical Trial, Phase I

---

Respiration 1998;65(3):171-2

Comment on:
Respiration. 1998 ;65(3):173-7

Patients with chronic obstructive pulmonary disease (COPD): their veins and
pulmonary embolization.

Kummer F.

Publication Types:
Comment
Editorial

---

Respiration 1998;65(1):16-7

Comment on:
Respiration. 1998 ;65(1):63-70

Old versus new: nitroglycerin versus NO?

Kummer F.

Publication Types:
Comment
Editorial

---

Wien Klin Wochenschr 1997 Sep 19;109(17):688-91

Phase II trial of gemcitabine in advanced non-small-cell lung cancer.

Malayeri R, Ulsperger E, Baumgartner G, Forstner B, Aigner K, Hubner M, Kummer
F, Krajnik G, Zochbauer S, Krejcy K, Huber H, Pirker R.

Klinische Abteilung fur Onkologie, Universitatsklinik fur Innere Medizin I,
Vienna, Austria.

Gemcitabine has shown activity in different solid tumors. In the present study
we have evaluated its efficacy in 32 patients with advanced non-small-cell lung
cancer in a phase II trial. Gemcitabine (1250 mg/m2) was given intravenously as
a 30-minute infusion on days 1, 8 and 15. Cycles were repeated every 4 weeks.
Twenty-nine patients were evaluable for response and all patients for toxicity.
Partial remissions and stable disease were seen in 4 (14%) and 13 (45%)
patients, respectively. Improvement of symptoms occurred in 54% of the patients.
Side effects were mild and included predominantly leukopenia and
thrombocytopenia. In conclusion, gemcitabine is active and well tolerated in
patients with advanced non-small-cell lung cancer.

Publication Types:
Clinical Trial
Clinical Trial, Phase II
Multicenter Study

---

Pneumologie 1997 Mar;51(3):279-85

[Pulmonary vasculitis: systematic aspects, pathogenesis and therapy]

[Article in German]

Kummer F, Meisl FT, Pohl WR.

Medizinische Abteilung/Lungenabteilung, Wilhelminenspital der Stadt Wien.

Publication Types:
Review
Review, Tutorial

---

Eur Respir J 1997 Feb;10(2):392-6

Erratum in:
Eur Respir J 1997 Apr;10(4):963

Adjunctive interferon-alpha-2c in stage IIIB/IV small-cell lung cancer: a phase
III trial.

Prior C, Oroszy S, Oberaigner W, Schenk E, Kummer F, Aigner K, Hausmaninger H,
Peschel C, Huber H.

Dept of Medicine, University of Innsbruck, Austria.

Preliminary studies have shown bioactivity of interferons (IFNs) in the
treatment of small-cell lung cancer (SCLC). The aim of the present study was to
determine whether, in patients with advanced SCLC, a combination of recombinant
IFN-alpha-2c and standard induction chemotherapy would improve response rates
and survival at acceptable toxicity. Of the 85 patients recruited by 11 centres
in Austria, 77 were evaluable for response after induction therapy; of these, 43
were randomized to receive the combined treatment (three cycles each of
cyclophosphamide/vincristine/doxorubicin and cisplatin/etoposide plus
subcutaneous IFN-alpha-2c), and 34 received chemotherapy alone. After the
induction phase, patients in the IFN arm had higher rates of complete (30 vs
15%) and partial remission (42 vs 29%) than those who received chemotherapy
alone. Accordingly, there was a lower rate of progressive disease in the
interferon arm (21 vs 44%; p < 0.05). Whilst there were no significant
differences in time to progression (7.6 vs 5.4 months) patients in the IFN arm
survived longer than those in the chemotherapy arm (p < 0.02). Six of the
patients treated with IFN (14%) survived for more than 2 yrs, whereas none in
the chemotherapy arm did. We conclude that the addition of interferon-alpha-2c
to induction chemotherapy may improve response rates and survival in advanced
small-cell lung cancer.

Publication Types:
Clinical Trial
Randomized Controlled Trial

---

Shock 1996 Mar;5(3):184-9

Alveolar macrophages of patients with adult respiratory distress syndrome
express high levels of heat shock protein 72 mRNA.

Kindas-Mugge I, Pohl WR, Zavadova E, Kohn HD, Fitzal S, Kummer F, Micksche M.

Institute of Tumor Biology/Cancer Research, Vienna University, Austria.

Adult respiratory distress syndrome (ARDS), a multifactorial disease with poor
prognosis, is characterized by an accumulation of inflammatory cells within the
airspaces of the lungs. There is evidence that alveolar macrophages (AM) are
involved in the pathogenesis of this pulmonary disease. It has been demonstrated
that AM synthesize heat shock proteins (HSPs) after exposure to certain stress
factors. Increasing evidence suggests that HSPs could confer protection against
oxidative injury, noxious molecules, and bacterial toxins. In stressed cells HSP
72 appears to be essential for survival during and after exposure to cellular
injury. The aim of this study was to evaluate the magnitude of HSP 72 expression
by human AM of patients with ARDS and correlate that with respiratory burst
activity. Bronchoalveolar lavage was performed in six ARDS patients, 10 patients
with high risk for developing ARDS, and two patients who underwent bronchoscopy
for other reasons. Spontaneous ex vivo expression of HSP 72 in AM could be
demonstrated by immunocytochemistry. Total RNA as well as poly(A)-rich mRNA were
extracted from recovered AM and analyzed by Northern blot and slot blot using a
human HSP 72-specific probe. Signals of slot blot were analyzed by densitometry
and expressed as relative levels of HSP 72 mRNA of stressed (42 degrees C) HT
1080 control cells. Significantly (p < .001) higher levels of HSP 72 mRNA were
measured in patients with ARDS (96.2 +/- 9.5 relative levels) in comparison to
those not developing this syndrome (46.0 +/- 4.2). With regard to respiratory
burst activity of AM in patients with ARDS, there was a negative correlation
between HSP 72 expression and reactive oxygen species production. The AM of
patients with ARDS with high relative levels of HSP 72 expression showed low
respiratory burst activity. A predictive value for disease severity of high
level of HSP 72 mRNA in AM in patients at risk for ARDS has to be evaluated by
future studies. This demonstration of HSP 72 expression ex vivo suggests a
protective role of HSP response against endo/exogenously generated stress
factors in AM.

---

Acta Med Austriaca 1996;23(3):105-8

[Practicability, effectiveness and tolerance of a standardized prepared
theophylline infusion]

[Article in German]

Pohl WR, Kummer F, Lorber H, Wurtz J, Aigner K, Pfeiffer KP.

II. Medizinischen Abteilung und Pulmologie, Wilhelminenspitals der Stadt Wien.

The practicality, efficacy, and tolerance of a standardized, ready-to-use
theophylline solution (Eloasthmin, Leopold Pharma, Graz) was studied on 33
patients with bronchial asthma and/or chronic obstructive bronchitis (COPD) (19
males, 14 females) aged 19 to 79 (median 50) years. Eloasthmin a ready-to-use
pure theophylline solution containing no auxilliary substances, contains one
gram theophyllin per liter in a hypotonic (2/3) NaCl solution. The infusion
therapy was carried out in patients in an acute stage of their chronic
obstructive ventilation dysfunction. The therapy was carried out for 2 to 4 days
at a dose of 400 to 1000 mg theophylline per day, so that theophylline blood
levels remained within the therapeutic range of 8 to 20 mg/ml. A highly
significant improvement (p < 0.001) of lung function parameters was seen during
treatment: VC before therapy = 2.46 l, after therapy = 3.36 l; FEV 1 before
therapy = 1.34 l, after therapy = 2.04 l; and PEF before therapy = 3.48 l/s
after therapy = 5.13 l/s. Since most patients also received concomittant
medication (beta 2-sympathomimetica and/or glucocorticoids), it was difficult to
differentiate the specific efficacy of the theophylline.

Publication Types:
Multicenter Study