Search PubMed⌕ Search

Biomedical subjects

C Kuntz

Publications and source records attributed to C Kuntz.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Hydrosonography as an alternative or supplement to endosonography in stomach carcinoma].

Transabdominal ultrasound in the hydrotechnique (hydrosonography) was compared with endosonography for the locoregional staging of gastric cancer. For this purpose 52 consecutive patients were examined by endosonography (7.5 and 12 MHz) and hydrosonography (3.75 MHz). Forty-nine of the 52 tumors could be examined by endosonography and 41 by hydrosonography. The T-staging accuracy rate of endosonography was 74% and 46% for hydrosonography. Carcinoma of the cardia are often classified as uT3 and hT3 preoperatively and pT2 postoperatively due to infiltration of the subserosal fat. The N-staging accuracy rate of endosonography was 86% and 61% for hydrosonography. Based on these results, transabdominal ultrasound in the hydrotechnique (hydrosonography) cannot replace endosonography in gastric cancer staging. However, when performed in conjunction with conventional ultrasound, hydrosonography provides useful information about the local tumor stage, especially in cases of advanced and stenotic tumors.

Adult↗
PubMed1998

Prospective randomized study of stress and immune response after laparoscopic vs conventional colonic resection.

METHODS: In order to evaluate the stress and immunological response to laparoscopic and conventional colon resection we operated on male Wistar rats (350-380 g), performing either laparoscopic (n = 15) or open colon resection (n = 15). A third group (n = 10) underwent anesthesia only. Immediately before and after surgery as well as 1 and 7 days postoperatively a 1 ml sample of blood was taken from the retrobulbar veinous plexus. Stress (corticosterone) and immune parameters (neopterin and interleukin [IL] 1-beta) were measured. Furthermore, the body weight as a parameter of postoperative recovery was monitored. RESULTS: The analysis of variance showed significant differences between the three groups over a period of 1 week (p < 0.0001 for corticosterone, p = 0.0854 for IL 1-beta, p = 0. 0045 for neopterin). Additionally in a t-test significant differences were found between the laparoscopic and conventional group with regard to corticosterone (p = 0.08), to neopterin (p = 0. 045), and to IL 1-beta (p = 0.0043) at the end of the operation. One week after the operation the stress and immune parameters were back to normal levels in each group except IL 1-beta, but the recovery indicated by body weight was different according to the kind of the applied operative procedure: 7 days postoperatively the rats lost 5. 99% of their body weight after open surgery and only 2.4% after laparoscopic surgery. After anesthesia only the body weight increased by about 4.8%. CONCLUSION: Laparoscopic colon resection alters the stress and immune system of healthy rats less than open colon resection. This observation is confirmed by the quicker recovery in laparoscopically operated rats.

Animals↗
PubMed1998

[Mammography use among 35-50-year-old women. Descriptive study of a population seeking services at the centers of health tests].

OBJECTIVE: The aim of the study was to evaluate mammography rates and indications (diagnosis or screening) among women from 35 to 50 of age, and to search the main factors associated to mammographic screening. DESIGN AND SETTING: The data were collected from 6409 women through a specific questionnaire completed by a nurse. RESULTS: Among women from 35 to 50 years of age, 61% have undergone at least one mammography during their life; 25.6% had undergone a screening mammogram within the last three years. Whatever women's age or indications, the gynecologist was the first physician to prescribe mammography. Logistic regression model adjusting for multiple variables was used to examine factors associated with women who underwent a screening mammography within the last three years. Women more likely to be screened were 45 to 50 years of age (vs 35-40 years of age: adjusted OR 8.9, 95% CI: 7.2 to 11.2), had higher educational level (adjusted OR 1.3, 95% CI: 1.1 to 1.5), had family history of breast cancer (adjusted OR 2.7, 95% CI: 2.1 to 3.4), and used routine gynecologic care (adjusted OR 1.9, 95% CI: 1.6 to 2.4). CONCLUSION: Individual screening by mammography very often occurs after 40 years, Such behaviors may lead public health professionals to question current recommendations for breast cancer mass screening in women 50 years of age and older.

Adult↗
PubMed1997

[Endosonographic diagnosis in preoperative radiotherapy of locally advanced rectal carcinoma].

Endorectal ultrasound (EUS) is important for the indication of preoperative radio(chemo)therapy of locally advanced rectal carcinomas. Preoperative radio(chemo)therapy causes an increased echogenity of the ultrasound, which histologically corresponds with increased fibrosis. After preoperative radio(chemo)therapy, the accuracy rate of EUS of tumor infiltration depth (T) and lymph-node status (N) is 75% compared with postoperative histology. With the help of EUS before and after radio(chemo)therapy (n = 28 patients) "downstaging" was noticed endosonographically in 10 patients (3 times in T and 7 times in N staging) and "upstaging" in 3 patients (3 times in T and 1 times in N staging). There was no "understaging" of local tumor infiltration depth after preoperative radio(chemo)therapy.

Adenocarcinoma↗
PubMed1997

Flexible endoscopic ultrasonography of colonic tumors: indications and results.

BACKGROUND AND STUDY AIMS: Based on the positive results of endorectal ultrasound we evaluated flexible colonic endosonography for colonic tumors. At present there are no generally accepted indications for this procedure. Moreover, it is unclear whether the results are valid enough to warrant specific therapeutic interventions. PATIENTS AND METHODS: Over a one-year period we performed flexible colonic endosonography (12 MHz rotating scanner) on 31 patients with colonic tumors. The examination was only performed when therapeutic implications were expected (e.g. endoscopic procedure when there was no sign of malignancy; oncological resection when there were signs of malignancy in ulcerative colitis or familial polyposis). RESULTS: Of 40 tumors examined, 36 were correctly staged by endosonography, compared to postoperative histology as the gold standard (16 of 17 adenomas, 5 of 5 pT1 carcinomas, 8 of 8 pT3 carcinomas). In two cases pT4 carcinomas were wrongly classified endosonographically as uT3 carcinomas, because the infiltration of the visceral peritoneum was technically not recognizable. Overall the accuracy rate of staging was 85%. Lymph node staging was correct in 36 of 40 patients, amounting to an accuracy rate of 90%. CONCLUSION: Because of its high accuracy rate flexible colonic endosonography has a place in the preoperative staging of colonic tumors in selected patients, especially those with ulcerative colitis, familial adenomatous polyposis or macroscopically suspicious adenomas. It helps to clarify the extent (oncological resection, lymphadenectomy) of resection required in conventional surgery and helps to avoid laparoscopic procedures in advanced colonic cancer.

Colonic Neoplasms↗
PubMed1997

Isolation and characterization of dolichol-linked oligosaccharides from Haloferax volcanii.

Biosynthesis of procaryotic glycoproteins has been studied in some detail only in the extreme halophile Halobacterium halobium. To extend these studies for a moderate halophile, dolichol phosphate-linked oligosaccharides were isolated and characterized from Haloferax volcanii. Mannosyl (beta 1-->4)galactosyl phosphodolichol could be characterized as a main component by GC/MS permethylation analysis, mass spectrometry and 1H-NMR-spectroscopy. Furthermore, two additional components, present in lower quantities, were partially characterized and identified as a tetrasaccharyl phosphodolichol containing mannose, galactose, and rhamnose in the ratio of 2:1:1 as well as another dihexosyl phosphodolichol. Both the latter compounds contain an additional charged group. All these oligosaccharides were found to be linked to a dolichol consisting of 11 or 12 isoprene units including a saturated omega-terminal isoprene residue.

Chromatography, DEAE-Cellulose↗
PubMed1997

[Metalloproteinases in the extracellular matrix: structure and activity].

The matrix metalloproteinases (MMP) are a multigenic family involving 14 enzymes which can cleave most, if not all, the components of the extracellular matrix (interstitium and basement membranes). The present work reports on the main structural characteristics, the substrate preference and the site synthesis of these proteinases and their inhibitors (TIMP). Human MMPs are produced by various cell types and are involved in the remodelling of the extracellular matrix in many physiological and pathophysiological circumstances. Elastolytic MMPs produced by monocytes and/or macrophages (matrilysin, gelatinases, macrophage elastase) are likely to be implicated in the development of acquired pulmonary emphysema.

Extracellular Matrix↗
PubMed1997

[Endosonography, CT and MRI in the diagnostic concept of rectal carcinoma].

The stage-adapted operative treatment of rectal cancer in the context of adjuvant therapy regimes necessitates accurate and, in times of diminishing financial resources, cost-effective preoperative staging. From January 1988, 424 patients with rectal cancer were examined by endosonography. In the same period 28 additional patients were staged by hydro-CT within a prospective study as the endorectal sonography probe could not be passed through the tumor stenosis. Sensitivity and specificity for T and N staging were equal or superior in the endosonography group. Compiled data in the literature for MRI staging of rectal cancer show results similar to those with endosonography. Therefore we see no indication for preoperative rectal staging methods other than endosonography unless the latter examination is technically impossible.

Cost-Benefit Analysis↗
PubMed1996

[Colorectal hydrosonography in diagnosis of tumorous and inflammatory diseases of the large intestine].

PURPOSE: Evaluation as to whether diagnosis of large bowel disease and TNM staging of colorectal carcinoma are possible by colorectal hydrosonography (HUS). METHOD: 52 patients with suspected neoplastic or inflammatory large bowel disease, underwent HUS. Before performing abdominal ultrasound, the colon was filled with fluid. Morphological alterations of the bowel wall were judged benign or malignant. Colorectal carcinomas were classified according to the TNM system. RESULTS: Laparotomy was performed in 46 of 52 patients. Correlation with surgery and histopathology showed that 77% of morphologic alterations of the colonic wall were detected by HUS. While benign lesions of the colonic wall occasionally mimicked malignant disease, colonic carcinomas were reliably diagnosed by HUS, because destruction and invasion of the bowel wall was visible. Carcinomas of the lower part of the rectum, however, were missed in most cases. Accuracy to determine the infiltration depth of colorectal carcinomas was 89%, but hydrosonographic N-staging was unreliable. Inflammatory disease of the large bowel as well as changes complicating the inflammatory bowel disease were accurately diagnosed by HUS. CONCLUSION: In selected patients, colorectal HUS is suited for diagnosis and staging of colonic tumours. It also helps to evaluate inflammatory bowel disease, because small and large bowel can be reliably distinguished from each other and the degree of stenosis of inflamed colonic segments becomes visible. Furthermore, HUS increases the visibility of fistulas.

Colon↗
PubMed1996

Ulnar nerve entrapment at the elbow: correlation of magnetic resonance imaging, clinical, electrodiagnostic, and intraoperative findings.

The diagnosis of ulnar nerve entrapment at the elbow has relied primarily on clinical and electrodiagnostic findings. Recently, magnetic resonance imaging (MRI) has been used in the evaluation of peripheral nerve entrapment disorders to document signal and configuration changes in nerves. We performed a prospective study on a population of 31 elbows in 27 patients with ulnar nerve entrapment at the elbow. The study correlated MRI findings with clinical, electrodiagnostic, and operative findings. A control population consisting of 10 asymptomatic subjects also was studied by MRI. Electrodiagnostic evaluation confirmed ulnar neuropathy in 24 (77%) elbows of the 31, with localization to the elbow region in 21 (68%). MRI, using a short tau inversion recovery sequence, demonstrated increased signal of the ulnar nerve in 30 (97%) elbows of the 31 and enlargement of the ulnar nerve in 23 (74%). No MRI abnormalities were found in the control population. MRI signal increase of the ulnar nerve occurred an average of 27 mm proximal to the distal humerus and extended distally an average of 4 mm below the distal humerus. The mean total length of increased ulnar nerve signal was 34 mm. Ulnar nerve enlargement occurred an average of 19 mm proximal to the distal humerus and extended distally an average of 8 mm above the distal humerus. The mean total length of ulnar nerve enlargement was 12 mm. The 12 patients who underwent a surgical procedure for ulnar nerve entrapment were found to have ulnar nerve compression, with 9 (75%) having excellent and 3 (25%) having good postoperative results. In this study, MRI was both sensitive and specific in diagnosing ulnar nerve entrapment at the elbow as defined by clinical, electrodiagnostic, and operative findings.

Adult↗
PubMed1996

Magnetic resonance neurography of peripheral nerve lesions in the lower extremity.

OBJECTIVE: We describe the clinical application and utility of high-resolution magnetic resonance neurography (MRN) techniques to image the normal fascicular structure of peripheral nerves and its distortion by mass lesions or trauma in the lower extremity. METHODS: MRN images were obtained using a standard 1.5 Tesla magnet and custom built phased-array coils. Patients were imaged using T1-weighted spin echo without and with gadolinium, T2-weighted fast spin echo with fat peripheral nerve tumors (three neurofibromas and one schwannoma), two with intraneural cysts, and three with traumatic peripheral nerve lesions. Six patients with peripheral nerve mass lesions underwent surgery, thereby allowing MRN images to be correlated with intraoperative and pathological findings. RESULTS: Preoperative MRN accurately imaged the normal fascicular anatomy of peripheral nerves and precisely depicted its relation to tumor and cystic lesions. Increased signal on T2-weighted fast spin-echo and short tau inversion recovery fast spin-echo pulse sequences was seen in the peripheral nerve fascicles of patients with clinical and electrodiagnostic evidence of nerve injury. CONCLUSION: MRN proved useful in the preoperative evaluation and planning of surgery in patients with peripheral nerve lesions.

Adult↗
PubMed1996

[General stress response in laparoscopic and conventional cholecystectomy].

To objectify perioperative stress response to laparoscopic (LCE) and conventional cholecystectomy (CCE) a prospective, controlled trial was planned and biochemical stress parameters were measured in the blood of patients, who underwent elective surgery because of symptomatic cholecystolithiasis. Patients with acute cholecystitis, pancreatitis, choledocholithiasis or malignant disease were excluded from the study. Values from 40 patients after LCE and from 18 patients after CCE were compared. Both groups had statistically similar patient characteristics and perioperative care. The LCE group showed a significantly lower stress response with respect to interleukin 1 beta, interleukin 6, epinephrine, norepinephrine and glucose.

Adult↗
PubMed1996

[Diastolic dysfunction in chronic renal failure patients under hemodialysis].

Myocardial hypertrophy due to volume and pressure overload is common in hemodialysis patients because renal failure is usually responsible for arterial hypertension. The left ventricular filling pattern often exhibits abnormalities denoting a relaxation disorder. These abnormalities increase after hemodialysis sessions, which are sometimes followed by severe hypotension. This sequence of left ventricular hypertrophy, altered relaxation, and severe postdialysis hypotension sometimes associated with severe ventricular rhythm disorders deserves to be studied in detail. The data gathered would help to determine the prognosis in this situation, which often depends on cardiac function.

Diastole↗
PubMed1995

[Hepatic echinococcosis with gallstones of the echinococcal cavity].

HISTORY AND CLINICAL FINDINGS: A 65-year-old woman was hospitalized with suspected cholelithiasis. The only contributory item in the history was jaundice of uncertain cause 15 years previously. Physical examination elicited pain in the right upper abdomen on deep palpation. INVESTIGATIONS: Alkaline phosphatase and gamma-GT activities were raised (324 and 407 U/ml, respectively). Ultrasound revealed cholecystolithiasis; the bile duct was 5 mm in diameter. Intravenous contrast-medium cholangiography showed choledocholithiasis and circular flat calcification in the bifurcation of the hepatic duct. Computed tomography revealed this structure to be a space-occupying mass (10 x 6 x 5 cm), with a calcified border (density of 27 Hounsfield units), raising the suspicion of a blood-containing hydatid cyst. Additionally there were two calculi in the left hepatic duct. But the echinococcus test (by indirect haemagglutination and enzyme-linked immunosorbent assay) was negative. TREATMENT AND COURSE: Endoscopic retrograde cholangiography (ERC) with papillotomy was performed and two choledochal concrements removed. Concrements within the mass were also visualized. Obstructive jaundice developed 3 days after the ERC and a laparotomy was performed. Excision of the hydatid was not possible because the stone-filled hydatid cavity could not be punctured. Choledochal exploration discovered membranes which histologically were chitin-like structures and corresponded to scolices. Under chemical litholysis the hydatid became smaller. In addition, albendazole was given in two four-week cycles (400 mg twice daily). The patient quickly recovered and 5 months later was symptom-free.

Aged↗