Search PubMed⌕ Search

Biomedical subjects

C Wittekind

Publications and source records attributed to C Wittekind.

At least 163 records · Page 9Linked to original sources
PubMed1990

[The modular image analysis computer for assessment of prognosis in testicular tumors].

Since 1981 a total of 107 patients with non-seminomatous germ cell tumors of the testis (NSGCT) in clinical stage I were assigned to a "wait and see" protocol. At a median follow-up of 40 months (4-100) thirty seven pts. (35%) relapsed with 84% of these within the first year. Employing the Hedley-technique out of 50 primary tumor-tissues available nuclear suspensions were obtained, staining according to the DNA-Feulgen-procedure and evaluated by the modular image analysis computer (MIAC, Leitz, FRG). In 67% hyperpentaploidy was found in the cases with progression while only 23% exhibited a greater than 5c-rate in the NED-group. With logistic regression achieving a p-value of 0.0296 hyperpentaploidy has to be considered a significant prognosticator in NSGCT/CS I.

Dysgerminoma↗
PubMed1990

[Mediastinal sequestration with ectopic pancreatic tissue].

We report on a five-year-old patient with a chronic pneumonia of the upper left lobe of the lung, in whom a broncho-enteric sequestration with ectopic pancreas was found in the mediastinum. Reviewing the literature, different theories on the embryogenesis of this extremely rare anomaly are discussed.

Bronchopulmonary Sequestration↗
PubMed1990

Budd-Chiari syndrome: portacaval shunt and subsequent liver transplantation.

The Budd-Chiari syndrome (BCS) is caused by hepatic venous outflow obstruction, which often leads to death as a result of portal hypertension and liver failure. Therapeutic approaches vary widely from conventional medical therapy to liver transplantation. If and when a patient suffering with BCS needs surgery remains a matter of contention. However, it is well accepted that portacaval shunt surgery and orthotopic liver transplantation represent efficient surgical treatments of this condition. We report on a patient with an eventful course after BCS was diagnosed. After portacaval shunt surgery the patient had acute liver failure and had a successful orthotopic liver transplantation.

Adult↗
PubMed1989

[Erythrohepatic protoporphyria with rapidly progressing liver cirrhosis].

A 49-year-old man, known to have had an increased light sensitivity since childhood, was admitted to hospital because of jaundice. Biochemical and morphological examination revealed cirrhosis of the liver with cholestasis. There was a 70-fold increase of protoporphyrin content in the erythrocytes, increased fecal protoporphyrin excretion as well as secondary coproporphyrinuria. Despite symptomatic treatment with ursodeoxycholic acid and cholestyramine hepatic failure ensued for which orthotopic liver transplantation was performed five months after the diagnosis had been made. The patient died two months later of treatment-resistant septicaemia and multiorgan failure. This case demonstrates the need for annual monitoring of liver functions and porphyrin parameters to ensure earliest possible diagnosis of hepatic involvement in erythrohepatic protoporphyria.

Cholestyramine Resin↗
PubMed1989

Unusually rapid development of a HBsAG-positive liver cirrhosis after liver transplantation.

We report the case of a 44-year-old man who was transplanted in 1986 for hepatocellular carcinoma in a HBsAG-positive liver cirrhosis. The patient had no severe complications postoperatively. He received passive immunization for the prevention of hepatitis B reinfection during the first 6 months after liver grafting. Twelve months after the transplantation the new liver was reinfected with hepatitis B virus. Without any clinical or laboratory signs of severe hepatitis, the patient developed a histologically proven complete liver cirrhosis within 8 months after reinfection of the graft. The reasons for this might have been, first, a deleterious course of the infection under immunosuppressive therapy, and, second, the additional influence of a postoperatively acquired CMV infection or the combined toxic influence of cyclosporin A and its metabolites on the acute inflammation in the liver.

Adult↗
PubMed1989

[Carcinoid tumor of the liver].

Multiple primary hepatic carcinoid tumours of the liver was a chance finding at autopsy of an 81-year-old woman. There had been no signs of this or any other paraneoplastic syndrome in life. The tumour had a characteristic solid-alveolar structure (type A of Soga) with only a few atypical cells. Neuron-specific enolase and chromogranin were demonstrated immunohistologically in almost all tumour cells, but S-100 protein, human choriogonadotropin and serotonin in only a few. Peptides and alpha-fetoprotein, however, could not be demonstrated in the tumours. Electronmicroscopy revealed secretory granules of variable size and density in the cytoplasm of the tumour cells.

Aged↗
PubMed1989

The role of liver transplantation in hepatobiliary malignancy. A retrospective analysis of 95 patients with particular regard to tumor stage and recurrence.

The role of hepatic transplantation in patients with nonresectable liver or bile duct cancer remains a controversial issue. An analysis of 95 consecutive cases was undertaken to evaluate retrospectively the pathological tumor stage--in accordance with the TNM system--and outcome after transplantation. Included were patients with the following diagnoses: hepatocellular carcinoma (n = 52), cholangiocellular carcinoma (n = 10), hepatoblastoma (n = 2), hemangiosarcoma (n = 2), bile duct carcinoma (n = 20), and liver metastases from different primary tumors (n = 9). The overall actuarial survival rate at 5 years was 20.4%. Median survival improved significantly within the last 4 years as compared to the preceding era (18.06 vs. 4.0 months). Currently 27 patients are alive, with the longest follow-up more than 12 years. The incidences of residual or recurrent tumor were 27 and 28, respectively. Particularly in patients who underwent transplantation for hepatocellular or bile duct carcinoma without extra-hepatic tumor spread, the results were significantly better; median survival time achieved for these two groups were 120 (p less than 0.01) and 35 months (p less than 0.05). Prolonged survival without tumor recurrence was not seen in patients with cholangiocellular carcinoma or liver metastases. These results demonstrate clearly that liver transplantation for hepatobiliary malignancy is still justified on the premises of careful patient selection by adequate tumor staging.

Actuarial Analysis↗
PubMed1989

[In situ hybridization in detecting virus infections in biopsies following orthotopic liver transplantation].

Using the in-situ DNA hybridization we studied 62 liver biopsies from 34 patients for the presence of CMV-, EBV-, HBV-, and HSV-Genome. In the first biopsies positivity-rates were as follows: CMV 62%, EBV 71%, HBV 15%, HSV 15%. In 6 cases a conversion from a negative intranuclear CMV-status to a positive status was seen correlating with an increase in serological titers and with clinical signs of viral infection.

Adolescent↗
PubMed1989

[Pathologic fractures in dialysis-associated amyloidosis].

A correlation could be demonstrated between four pathological femoral neck fractures in patients who regularly underwent hemodialysis; cystic bone deposits of beta-2-microglobulin amyloid were also found. The characteristic symptom complex includes painful arthralgia of the shoulder, carpal tunnel syndrome, pain in the hip and recurrent knee effusions. The first step in the diagnostic procedure is to demonstrate cystic defects in skeletal radiographs. Then a biopsy of the cystic bone lesion is needed for histological verification of beta-2-microglobulin. The surgical treatment is total joint replacement or augmented composite osteosynthesis due to poor regeneration capacity in the amyloid bone lesion.

Aged↗
PubMed1988

[Severe chronic Epstein-Barr virus infection with natural killer cell defect].

Chronic Epstein-Barr virus infection was confirmed serologically in a 27-year-old man with pneumonia, splenomegaly, pancytopenia, arthritis, neuropathy and psychological changes. Immunological tests revealed a defect in the cytotoxic activity of the natural killer cells. Treatment with high doses of acyclovir intravenously and of antimycotic drugs dramatically and lastingly improved the patient's condition.

Acyclovir↗