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Biomedical subjects

C Benz

Publications and source records attributed to C Benz.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Severe complications in diagnostic laparoscopy. 9 years experience in 747 examinations].

BACKGROUND: Despite the introduction of non-invasive imaging procedures, diagnostic laparoscopy is still indicated in suspected liver cirrhoses, cancer staging and ascites or fever of unknown origin. Although the use of laparoscopy decreased over the last decade, some centers still have much experience and their complication rates are of special interest. PATIENTS AND METHODS: The complication rate of 747 patients undergoing a diagnostic laparoscopy in our clinic during the last 9 years is listed retrospectively, and the respective therapy is examined. RESULTS: Severe complications were found in 11 cases (1.5%): 6 bleeding complications, 2 bowel perforations and 3 other complications. Five of these 11 patients had to be operated on (45%). One patient with metastatic gastric cancer died of a multiple organic failure following a lararoscopic tumor biopsy (0.13%). CONCLUSION: The diagnostic laparoscopy is of significant value and has still a low complication-rate in centers with special experience.

Abdominal Neoplasms↗
PubMed1996

Endoscopic biliary stenting for the palliation of pancreatic cancer: results, survival predictive factors, and comparison of 10-French with 11.5-French gauge stents.

OBJECTIVES: To compare the efficacy and complications of different stent lengths and diameters in the palliation of jaundice caused by pancreatic cancer, as well as investigate survival predictive factors and the success of endoscopic therapy. METHODS: This study summarizes our results with 103 pancreas cancer patients treated by endoscopic plastic biliary stenting, of whom 87 were followed up until death or the time of writing. Before therapy, bilirubinemia, tumor primary size, presence of distant metastases, and signs of duodenal involvement were evaluated as prognosis risk factors. In a retrospective, nonrandomized fashion, we compared the efficacy and complications (especially clogging) of 10-French versus 11.5-French gauge stents and of "short" (< or = 8 cm) versus "long" (> or = 9 cm) prostheses. RESULTS: Thirty six men and 51 women (median age 74 yr) with pancreatic cancer were analyzed. Stenting could abolish jaundice or make it imperceptible (bilirubinemia < 3 mg %) in 74 patients (85%). Median bilirubinemia after treatment decreased from 13.9 mg/dl to 1.0 mg/dl. Hospital mortality was 2.7%. The commonest long term complication was clogging, which occurred 66 times in 33 patients. Median stent patency was 3 and 4 months for 10-F gauge and 11.5-F gauge stents, respectively (p > 0.05). When analyzing the patients who were alive 6 months after therapy, the clogging rate was 46% and 55% for 10-F and 11.5-F stents, respectively (p > 0.05). The length also did not influence stent patency. The only risk factor assessed before therapy, which independently predicted survival, was the presence of distant metastases. Median survival for patients with metastatic disease was 2.5 months and 9 months for those without metastases (p = 0.0015). CONCLUSIONS: We conclude that 10-F and 11.5-F stents have the same efficacy in the palliative management of malignant obstructive jaundice due to cancer of the pancreas. Detection of distant metastases is the best outcome predictive factor in these patients and should be regarded as a restriction to the insertion of biliary metal stents.

Adenocarcinoma↗
PubMed1995

[Percutaneous transhepatic cholangioscopy (PTCS)--an important supplement in diagnosis and therapy of biliary tract diseases (indications, technique and results)].

In 39 patients with biliary disease inappropriate for a transpapillary access (21 m, 18 f, mean age 62 y.) 61 percutaneous transhepatic cholangioscopies (PTCS) were performed. In 28 cases (71.8%) diagnostic PTCS was done in order to investigate the etiology of a biliary stenosis. Nine of these patients had histological as well as clinical outcome indicating a benign lesion. Histology was positive for malignancy in 14 (82%) out of 17 patients with clinically assumed malignant stenosis. The etiology of the stenosis remained obscure from a clinical point of view in two cases with negative histology for malignancy. In twelve patients (30.7%) we performed PTCS for endoscopically controlled laser or electrohydraulic lithotripsy of bile duct stones. The procedure was successful in all patients and stone fragments were delivered to the duodenum by saline lavage. Seven of these patients had stones combined with a benign stenosis and were additionally treated by long-term drainage (Yamakawa drain) for three to twelve months. Two of the seven patients had no relaps of the biliary stricture after a follow-up of ten and twelve months respectively. In five cases (12.8%) PTCS controlled insertion of a guide-wire was attempted after failure of the radiologically guided internalization of the percutaneous drainage. The procedure was successful in three of these patients.

Adult↗
PubMed1995

[Bleeding peptic ulcers--concept for acute therapy].

Acute ulcer bleeding still is a life-threatening event. The therapeutic goal is to establish intensity, activity and location of the bleeding and to assess primary hemostasis by consequent endoscopic therapy, also preventing recurrence significantly. With the injection method, primary hemostasis accounts for over 90% success. Also recurrent bleeding can be stopped to the same extent. Endoscopic doppler allows a qualitative and quantitative registration of potentially dangerous vessels on the ulcer base. Drug therapy does serve for the acute treatment to a lesser extent; it is more valid for the initiation of the conservative ulcer therapy. Surgical interventions therefore confined to risk patients in whom a primary hemostasis failed or the ulcer is located in a dangerous site, for instance in the back wall of the duodenal bulb.

Acute Disease↗
PubMed1994

[Acute segmental hemorrhagic penicillin-associated colitis in a 32-year-old patient].

We report on a 32-year old patient who developed acute abdominal cramps and bloody diarrhea two days after taking phenoxymethyl penicillin. After excluding other causes, we diagnosed an acute segmental hemorrhagic penicillin associated colitis. In this case report we discuss the literature on this diagnosis and present the etiology, course, prognosis, and differential diagnosis of this entity.

Adult↗
PubMed1994

The association of p53 immunopositivity with tumor proliferation and other prognostic indicators in breast cancer.

Abnormal accumulation of the p53 tumor suppressor gene product was analyzed in 198 primary invasive human breast carcinomas. In 47 of these cases, single-strand conformational polymorphism was used to detect mutations in the highly conserved exons 5-9 of the gene. Mutations as determined by single-strand conformational polymorphism were found in 15 of 15 strongly immunopositive cases (100%) and 3 of 23 immunonegative cases (13%). There were also nine cases with < 1% immunopositive cells (borderline immunopositivity); p53 mutations were detected in seven of these cases. The results suggest that p53 immunopositivity is a highly specific, albeit somewhat insensitive surrogate for p53 mutations. p53 accumulation, detected by immunohistochemical methods using antibody PAb 1801, was noted in 29.8% of the cases and was associated with estrogen receptor (ER) negativity (P = 0.0003), progesterone receptor (PR) negativity (P = 0.008), and high histological grade (P = 0.037) by univariate analysis. Incorporation of bromodeoxyuridine was used to determine the percentage of cells synthesizing DNA (proliferative fraction). When bromodeoxyuridine was administered either in vivo (n = 93) or in vitro (n = 79), p53 accumulation was only marginally related to proliferative fraction (P = 0.067 by chi 2; P = 0.055 by Mann-Whitney). When tumors were segregated by ER status, the aforementioned associations of p53 immunopositivity with PR negativity, high histological grade, and increased proliferation rate lost their significance. p53 accumulation did not correlate with tumor size, clinical stage, axillary node metastases, or age at diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Axial hiatal hernia--correlation of motility disorders and pathological reflux in the esophagus in patients with and without reflux esophagitis].

Hiatal hernia is a very common finding in esophagogastroduodenoscopy (EGD). Only some patients with hiatal hernia suffer from gastroesophageal reflux disease (GERD), defined by pathological 24-h-pH-metry, while almost all patients with GERD do have hiatal hernia. To work out the differences in possible motility disorders and in a pathologic acid reflux we examined 92 patients with hiatal hernia by means of manometry and 24-h-pH-metry of the esophagus. A motility disorder of the tubular esophagus in the patients with GERD (with or without reflux esophagitis) was significantly more common than in patients without GERD (p = 0.006). In most cases it was an esophageal hypomotility. There is no significant difference in the basal pressure of the lower esophageal sphincter (LES) between the two groups. We conclude that besides other factors which impair esophageal clearance function a motility disorder of the tubular esophagus is the main cause for the development of GERD in the patients with hiatal hernia. A lowered pressure of the LES seems not to play a major role in the etiology of reflux esophagitis.

Adult↗
PubMed1994

Growth factors and their receptors.

Breast cancer represents a type of malignancy that is amenable to therapy targeting growth factors and receptors. There is considerable evidence that signaling mechanisms involving growth factors and their receptors are important in the normal development of breast epithelium. Dysregulation of these pathways may contribute to the proliferative, invasive, and metastatic phenotypes of breast cancer cells in humans. Approaches being tested in the preclinical setting include antibodies or peptides that disrupt receptor-ligand interactions as well as other compounds that can interfere with downstream signalling.

Animals↗
PubMed1992

The HER2 (c-erbB-2) oncogene is frequently amplified in in situ carcinomas of the breast.

Amplification and overexpression of the HER2 (c-erbB-2) oncogene was assessed in paraffin-embedded specimens from 27 in situ carcinomas of the breast and from 122 stage II breast cancers. Gene amplification detected in these archival tissues by differential polymerase chain reaction (PCR) was found in 48% of in situ carcinomas and in 21% of stage II lesions (chi 2 = 7.62, p less than or equal to 0.01). In addition, the level of gene amplification correlated with the level of HER2 oncoprotein expression as measured by immunohistochemistry for both in situ cancers (p less than or equal to 0.025) and stage II cancers (p less than or equal to 0.0005). This high incidence of HER2 gene amplification with accompanying overexpression in non-invasive breast tumors suggests that perturbations of the HER2 oncogene are among the earliest and most common genetic lesions in human breast cancer.

Breast Neoplasms↗
PubMed1992

[Stomach wall abscess--endoscopic diagnosis and therapeutic possibilities].

This is a case report of a rare gastric wall abscess of a 70 year-old woman who came to hospital with non-characteristic pain in the upper abdomen. The diagnosis was made by endoscopy. After endosonography the patient was treated by endoscopic drainage, antibiotics and abstinence of food. Two weeks later the abscess had healed. Subsequently recurrent arterial emboli occurred in the left leg leading to several operations. Two months after hospitalisation the woman died as a result of circulation failure induced by septicaemia. Surprisingly, post mortem examination showed endocarditis of the mitral valve with septical metastases in multiple organs. A review of the literature is given and etiology and pathogenesis of the gastric wall abscess are reviewed. The surgical treatment is compared with endoscopic therapy.

Abscess↗
PubMed1991

[Lye corrosion of the esophagus. Course under long-term bougienage].

In an alcoholic state a 61-year-old woman swallowed by mistake about 125 ml of a lye-containing glass-washing liquid (pH 12). About 30 min later she repeatedly brought up blood-containing vomitus and was admitted to hospital. Extensive corrosive damage in the oesophagus and entire stomach developed within a few days. Two weeks later a circular narrowing of the oesophageal lumen, which could not be passed endoscopically, was seen. Afterwards she repeatedly underwent endoscopic bougie dilatation. At the third dilatation the oesophagus was perforated, mediastinitis occurred but responded without further problems to conservative medical treatment. Two months after the initial injury a Billroth II gastric resection was performed because of complete stenosis of the gastric exit. Bougie dilatation was continued at widening intervals for 18 months after the ingestion. Subsequently the patient has remained without symptoms, although a secondary Barrett oesophagus has developed at the oesophago-gastric junction which, because of the potential danger of malignant degeneration, will require regular follow-up.

Accidents, Home↗
PubMed1991

[Esophageal motility disorders with thoracic pain of unknown origin].

35 patients with angina-like chest pain underwent esophageal manometry after a coronary artery disease had been ruled out by angiography. Furthermore, patients after gastric or esophageal surgery, with pathologic upper gastrointestinal endoscopy or with pathologic gastroesophageal reflux as seen on 24-hour-pH-metry were excluded from this study. 29 out of 35 patients (83%) had a normal manometric study, six patients (17%) had a motility disorder; five of these showed an unspecific dismotility pattern and were asymptomatic while the study was done; only one patient presented with esophageal spasm. Since only this latter patient was symptomatic while the study was done, a correlation between symptoms and this motility disorder seems likely. --If pathologic gastroesophageal reflux has been ruled out, esophageal manometry can establish a diagnosis in only 3% of patients with angina-like chest pain without esophageal symptoms (dysphagia, odynophagia, heartburn or regurgitation). We conclude that this complicated examination should not be done in these patients.

Adult↗
PubMed1991

Stress response protein (srp-27) determination in primary human breast carcinomas: clinical, histologic, and prognostic correlations.

Expression of an estrogen-regulated protein known as the 27,000-d heat-shock or stress-response protein (srp-27) was evaluated in human breast carcinomas and established breast cancer cell lines. Results obtained by Northern and Western blot analyses and immunohistochemical methods were concordant. Immunohistochemical assessment of srp-27 expression in 300 breast carcinomas (with median patient follow-up of 8 years) was performed. Twenty-six percent of lymph node-negative and 45% of lymph node-positive tumors were overexpressors. Univariate analysis demonstrated significant correlations between srp-27 overexpression and estrogen receptor (ER) content, pS2 protein expression, nodal metastases, advanced T stage, lymphatic/vascular invasion, and a shorter disease-free survival period (but not a shorter overall survival) for the study population as a whole. Regression tree analysis showed that srp-27 expression was an independent prognostic indicator for disease-free survival only in patients with one to three positive lymph nodes. The Cox proportional hazards model confirmed the independent prognostic significance of nodal involvement, T stage, and ER content but failed to recognize srp-27 overexpression as a significant independent parameter predictive of patient outcome in the patient population as a whole. The observed associations between srp-27 overexpression and more aggressive tumors suggest a biologic role for srp-27 in human breast carcinomas.

Blotting, Western↗
PubMed1991

In vivo measurement of breast cancer growth rate.

S-phase cells of 66 primary breast cancers were labeled in vivo by preoperative infusion of the thymidine analogue bromodeoxyuridine. A monoclonal antibody specific for DNA-incorporated bromodeoxyuridine was used to identify positive cells and compute a labeling index on histologic sections. The labeling index (the percentage of cells in S-phase) ranged from 0.1% to 23.9%; it correlated positively with poorly differentiated cancer, higher mitotic counts on routine histologic examination, and tumor size; and it correlated inversely with estrogen and progesterone receptors. The labeling index did not correlate with nodal involvement or ploidy. Of the 15 patients with a labeling index greater than 12%, three died and one had systemic disease after a median follow-up of 19 months. No other patients had recurrences. There were no clinical complications of bromodeoxyuridine infusion.

Breast Neoplasms↗
PubMed1991

Early and late events in the development of human breast cancer.

We hypothesize that early events in the development of at least some human breast cancers involve faulty epithelial-mesenchymal interactions and that the stromal cells themselves play an active role in this abnormal process. In contrast, later events accelerating breast tumor progression may occur in association with genetic changes involving only the malignant epithelial cells. These conclusions arise from a review of the literature, our comparative studies of HA metabolism in fibroblasts cultured from either normal or malignant breast tissues, and from molecular-genetic studies performed on sequential specimens from a single patient and on a wide variety of human breast tumor samples. HA is a proteoglycan component of the ECM which is known to stimulate epithelial cell detachment and motility and is most abundant in fetal and rapidly growing tissues. We find that many breast cancer-derived fibroblasts are stimulated to produce HA in response to TGF-beta under conditions where HA accumulation by normal tissue fibroblasts is almost uniformly inhibited. In a single patient, we had the opportunity to examine three malignant effusions that occurred sequentially to identify genetic changes associated with the later stages of breast cancer progression. Although, common cytogenetic abnormalities were found in all the effusion samples, only the last effusion exhibited a loss of heterozygosity at the c-Ha-ras locus. In this case, the allelic loss correlated with improved growth in vitro of the primary cells and with ability to become a permanently established cell line.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast Neoplasms↗
PubMed1991

Evaluation of the new RadioVisioGraphy system image quality.

A comparison of the physical properties of a new charge-coupled device-based direct digital intraoral radiographic system, its predecessor, and high-speed silver halide intraoral radiographic films is reported. The new system proved to have a higher dose dynamic than the former device. The resolving power of the new system is 11 line pairs/mm compared with a maximum of 14 line pairs/mm for intraoral film.

Evaluation Studies as Topic↗