Search PubMed⌕ Search

Biomedical subjects

A Heintz

Publications and source records attributed to A Heintz.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Image analysis of DNA cytometry for assessing prognosis after resection of esophageal cancer].

Esophagus cancer is a heterogeneous disease with considerable differences in malignant behaviour. Some relevant factors for prognosis are known. In this study we analyzed DNA-ploidy as a potential prognostic parameter in esophagus carcinoma. Paraffin embedded histological material from 50 patients with an esophagus cancer, obtained by resection, were selected for analysis. Tumor areas within the paraffin material were identified by HE-stained reference sections. One 50 microns section was dewaxed, rehydrated and mechanically and enzymatically treated to a suspension of 10,000 cells/ml. 1 ml of the suspension, containing bare nuclei with small rests of cytoplasma was centrifuged on glass slides. The fixed nuclei were air-dried and stained by Feulgen-SITS technique, which allows quantitative measurement of DNA. The DNA analysis was carried out with a computer-controlled single cell cytophotometry (Leytas 2, Leitz, Wetzlar). In contrast to the flow cytometry with image cytometry only tumors cells were measured. Overlapping nuclei, dirt and other artefacts as well as inflammatory cells were efficiently eliminated. With the DNA image cytometry we could differentiate between diploid and hypotriploid, hypertriploid aneuploid tumors. Best prognosis had diploid and hypotriploid tumors, the worst hypertriploid carcinomas. In the multivariate analysis the DNA-content of the tumor cells in esophagus cancer was the only prognostic parameter. DNA-content of tumor cells may become considerably clinical relevant in esophagus cancer for the decision to perform a resection or palliative treatment. In patients with hypertriploid tumors an adjuvant oncological therapy may increase the prognosis.

Adenocarcinoma↗
PubMed1991

[Local excision of early stages of rectal cancer].

59 patients with rectal cancer were treated by local excision. In 17 of these patients a radical resection was performed afterwards. In one of 21 local excised "low risk" T1-carcinomas a recurrence was observed. Five of 11 local treated patients with "high risk" tumours developed a recurrence. In the group of the radically treated patients two recurrences were seen. Regarding our results the local excision of "low risk" T1-carcinomas seems to be justified, if final histological workup reveals an adequate margin of healthy tissue.

Aged↗
PubMed1991

[Endosonography versus computerized tomography in preoperative staging of esophageal cancers].

The results of endosonography and computed tomography--using an optimized technique of CT--in preoperative staging of esophageal cancer are compared. In 22 of 40 patients with esophageal tumors a complete passage by the ultrasonic endoscope was possible. Endosonography was superior to CT in the assessment of early stages of esophageal tumors (T1/T2). Out of nine tumors confined to the esophageal wall, eight were classified correctly by endosonography, only five by computed tomography. The results in T3- and T4-carcinomas (13 patients) were comparable for endosonography and computed tomography. Endosonography is of importance in the selection of patients with early stages of cancer, in whom a curative resectability is still possible.

Esophageal Neoplasms↗
PubMed1991

[Endosonographic staging of cancers of the esophagus and stomach. Comparison with surgical and histopathologic staging].

64 patients (38 with esophageal and 26 with gastric carcinoma) underwent a preoperative endosonography. In 21 patients with esophageal tumors and in 24 patients with gastric tumors a complete endosonographic examination was performed. In 16 of 21 patients (76%) with esophageal carcinoma the tumor infiltration (T-stage), and in 16 of 18 cases (89%) the lymph node metastases (N-stage) could be assessed accurately. The depth of infiltration of cardia and gastric carcinoma was recognized in 15 of 19 cases (79%), and in 13 of 18 patients (72%) the N-stage was evaluated. Endosonography represents a method which can accurately predict tumor infiltration and regional lymph node metastases.

Endoscopes, Gastrointestinal↗
PubMed1990

[Intrarectal ultrasonography in the preoperative assessment of the depth of infiltration of rectal tumors].

From June 1987 to February 1990, 142 out of 319 patients with rectal tumours were investigated by ultrasound scanning with the object of ascertaining the depth to which the tumour had infiltrated. This examination proved completely feasible in 130 of these patients (84 men, 46 women, mean age 61.7 [42-84] years). Postoperative histological examination revealed an adenoma (n = 59) or a T1 carcinoma (n = 19), while intrarectal ultrasonography disclosed the same findings in 79 patients (true-positive in 75 cases). A T2-tumour was diagnosed by histological examination in 24 patients, and by ultrasonography in 22 (true-positive in 18 cases). The histological diagnosis of a tumour in stage T3 or T4 (n = 27) was in close agreement with the ultrasound findings (n = 24). The positive predictive value of ultrasonography ranged between 0.94 and 0.97 depending on the staging of the tumour, and the sensitivity between 0.75 and 0.96. Preoperative ultrasonographic determination of the depth of invasion of a rectal tumour enables the surgeon to devise a therapeutic plan to suit the individual patient's needs; one option may be local excision.

Adenoma↗
PubMed1990

[Endosonographic staging of rectal tumors].

Pre-operative staging was performed in 81 patients with rectal tumours by means of endorectal sonography. In 87% of cases (70 out of 81), the endosonographic findings corresponded with the histopathological appearance; the recognition of T0 and 1 tumours, which is important in deciding surgical procedures, was possible in 94% (51 out of 54). Differentiation between T0 and T1 tumours (i.e. between adenomas and carcinomas infiltrating the submucosa) was not possible. Five out of ten of T2 and 14 out of 16 T3 tumours were staged correctly. One T4 tumour was placed in too low a stage. A comparison of the echo structure of adenomas and carcinomas in 76 patients showed that 28 out of 43 adenomas (65%) have homogeneous echoes, while 24 out of 33 carcinomas (73%) showed inhomogeneous low intensity echoes.

Adult↗
PubMed1990

[High-resolution thin-section CT in the preoperative staging of rectal tumors: a comparison with endoluminal sonography and histology].

Rectal carcinomas are amongst the most common malignant tumours. The aim of this work was to determine whether high resolution CT with thin sections (1 mm) can provide satisfactory delineation of perirectal tumour infiltration. Correct determination of local tumour spread was possible in four out of nine patients and distinction between those tumours confined to the rectal wall and those infiltrating the perirectal tissues was possible in four out of eight patients.

Aged↗
PubMed1989

[Surgical treatment of liver metastases from colorectal carcinoma].

Between 1978 and 1985 a total of 49 patients (20 women and 29 men, aged 31-78 years) were operated upon for liver metastases of a colorectal carcinoma. Metastasis recurrences occurred in 42 of 46 patients (91%). Three patients died in connection with the operation (6.1%). The five-year survival rate was 10.7%. Neither number, site and volume of the metastases, level of carcinoembryonic antigen concentration, tumour differentiation, stage or site of primary tumour, nor type of operation (enucleation or hemihepatectomy) had any influence on survival rate. Since most of the recurrences in the liver had occurred after enucleation at the site of the previous resection, it is feasible that the results could be improved by extending the area of resection.

Adult↗
PubMed1989

Endoluminal ultrasonic examination of sessile polyps and early carcinomas of the rectum.

The results of conventional endosonographic techniques in the assessment of early carcinomas and sessile polyps of the rectum have been unsatisfactory. We therefore developed a new technique in which the rectal cavity is filled directly with water. Using this technique, the anatomy of small rectal tumors is preserved and the layers of the rectal wall are easier to differentiate, especially with a 10-MHz scanner. The clinical results in 66 patients demonstrate that this new technique is very accurate in the preoperative staging of adenomas and T1-carcinomas of the rectum.

Carcinoma↗
PubMed1989

[Primary mediastinal seminoma].

Primary mediastinal seminoma is an uncommon lesion and should be included in the differential diagnosis of mediastinal tumors. Symptoms and signs may not be clear and in most cases the diagnosis is made by sternotomy or thoracotomy. Our recommendation is that patients with primary mediastinal seminoma should undergo curative resection or reductive surgery. Curative resection should be followed by radiation therapy. Chemotherapy with cisplatin-containing combinations should be reserved for patients who have metastases at the time of diagnosis.

Adult↗
PubMed1989

Endoluminal sonography in follow-up of rectal carcinoma.

Fourteen patients who had undergone local excision, anterior resection or low anterior resection for rectal carcinoma were examined by endoscopic ultrasonography. In two of three cases of local recurrent carcinomas, endoscopic sonography was superior to computed tomography in determining the depth of tumor infiltration. There were difficulties in differentiating scar tissue from local tumor formation when the mucosa appeared normal upon endoscopic examination. Only repeated follow-up examinations starting in the postoperative period, will allow a differentiation between scar tissue and local tumor recurrence.

Adenocarcinoma↗
PubMed1989

[The extragonadal seminoma: a differential diagnosis for mediastinal growth].

The extragonadal seminoma rarely manifests as a mediastinal tumour. It is histologically similar to the testicular seminoma and is often combined with other malformations. The tumour produces signs and symptoms due to its space-occupying or infiltrating nature. Radiological methods cannot establish the diagnosis, which is performed by surgery; however, in most of the cases staging is required (thoracotomy). Treatment is possible by surgical excision, irradiation or drug therapy, with an average five-year survival rate of 75%.

Adult↗
PubMed1989

[New endosonographic examination technic for improving the assessment of small rectal tumors].

Conventional endosonographic techniques of examination in early carcinoma and sessile rectal adenoma have shown unsatisfactory results. We therefore fill the rectal cavity directly with water. Using this technique the anatomy of the rectal polyp is preserved, and the separate layers are easier to differentiate, especially when the 10-MHz scanner is used. The clinical results in 56 patients show an improvement concerning the preoperative staging especially in those tumors which are not palpable.

Carcinoma↗