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Biomedical subjects

E Burghardt

Publications and source records attributed to E Burghardt.

At least 37 records · Page 2Linked to original sources
PubMed1988

Objective results of the operative treatment of cervical cancer.

Surgical staging of cervical cancer samples the retroperitoneal lymph nodes and, at some centres, the parametria. While better than subjective clinical staging, its value is limited because the results of a sampling procedure differ widely from those of a systematic lymphadenectomy. Additionally, considering the pathology of parametrial involvement, it seems unlikely that biopsy can find the majority of parametrial cancer deposits. The most precise data on the spread of cervical cancer are produced by radical hysterectomy and systematic lymhadenectomy. The tumour size has proven to be the most important prognostic criterion and therefore the best suited for patient classification. Tumour size can be measured by a number of methods. Between 1971 and 1987, 583 of 867 patients with Stage Ib to IIb cervical cancer underwent surgical treatment. Lymphadenectomy was systematic and hysterectomy included the resection of the entire parametria at the pelvic wall. In a total of 359 serial giant sections were of sufficient quality for evaluation; most were Stage IIb cases. The frequency of positive pelvic lymph nodes was 30.3% among 132 Stage Ib cases and 44.7% among Stage IIb cases. Most tumours occupied over 40% of the cervical volume. Five-year survival by clinical stage failed to show a statistically significant difference between Stages Ib and IIb. Objective classification by tumour size showed the patients with the smallest tumours to have a five-year survival rate of 92.1%. The patients with the largest still-operable tumours occupying 80% to 100% or more of the cervix still had a five-year survival rate of 65%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Prognostic factors and operative treatment of stages IB to IIB cervical cancer.

Between 1971 and 1985, a total of 325 cases of cervical cancer, Stages IB to IIB, in which operation was performed were evaluated with a view toward prognostic factors and survival rates. In radical abdominal operations, a complete resection of parametrial tissue was the goal. Extensive lymphadenectomy of the pelvis was performed. Operative specimens were processed by giant sections comprising cervix, lateral parametria, and vaginal cuff. Lymph nodes were cut by step-serial sections. Exact measurements of tumor sizes were done along with investigations of parametrium and lymph nodes. Tumors were classified according to a ratio of tumor size to size of cervix. Incidence of lymph node involvement increased with tumor size, reaching a maximum of 68.3% in the group with a ratio from 70% to 80%. Direct spread into the parametrium was rarely found, even in larger tumors occupying the entire cervix. parametrial lymph nodes were most often involved; these were scattered over the entire ligament. Five-year survival rates reached 88.1% in patients with no nodal involvement and 60.9% with nodal involvement. In the latter, the results depended on the number of nodal groups involved and the diameter of metastases. Parametrial involvement alone had no influence on healing rates, but when pelvic nodes were simultaneously involved, the results were less satisfactory. Survival rates based on tumor size differed only between the group with a ratio up to 20% and the large-tumor groups, with rates ranging from 97.5% to 70.9%. There was no statistical difference between Stages IB (31.1% positive nodes) and IIB (44.1% positive nodes) with regard to survival rates (82.2% and 76.9%, respectively).

Aged↗
PubMed1987

Application of polyurethane foam for sampling volatile mutagens from ambient air.

This paper reports the use of polyurethane foam (PUF) in the sampling of airborne mutagens too volatile to be retained by glass fibre filters. Air was sampled simultaneously with a glass fibre filter and PUF plugs, and the two extracts of the samples were tested for mutagenicity and analysed for polycyclic aromatic hydrocarbons (PAH). As PUF itself was found to contain mutagens, it was thoroughly rinsed, and a blank extract of the same PUF used for sampling was tested as a control. The resulting blank extracts were not mutagenic. In the first series of experiments, in which methanol was used as the extraction solvent, sampling induced clear-cut mutagenic effects in the PUF extracts. As the mutagenicity of the PUF itself appeared only with the use of methanol or other alcohols as extraction solvents, a second series of experiments was carried out in which acetone was used as the extraction solvent. In these experiments sampling induced no mutagenicity in the extracts. The discrepancy between the two series of experiments may be due to the absence of volatile mutagens in the second series, but another explanation may be an artefact induced by the solvent in the first series. Additional experiments suggest that sampling induces the formation, from PUF, of compounds mutagenic upon extraction with methanol. The study leads to the provisional conclusion that no volatile mutagens could be demonstrated in ambient air sampled by the use of PUF as an absorbent, notwithstanding the clear-cut effects of the filter extracts and the presence of volatile PAH in the PUF extracts.

Air Pollutants, Occupational↗
PubMed1986

Pelvic lymphadenectomy in operative treatment of ovarian cancer.

From the end of 1979 to September, 1985, radical pelvic lymphadenectomy was performed at the Graz Clinic in 123 cases of Stages IA to IV ovarian cancer following maximum debulking procedure. In 97 patients lymphadenectomy was done primarily. In 26 it was performed during a follow-up operation to chemotherapy. The frequency of pelvic node involvement was 61.8% in the total material and 78.0% in 82 cases of Stage III disease only; 75.0% positive nodes were found in Stage III after chemotherapy. Aortic nodes were positive in 41.4%, but only when pelvic nodes were also positive. The 5-year actuarial survival rate for Stage III disease was 53.0% after pelvic lymphadenectomy compared with 13.0% without. In cases with negative nodes the survival rate was 74.7%; with positive nodes the survival rate was 45.9%.

Adult↗
PubMed1984

Management of advanced ovarian cancer.

Since the end of 1979 extensive pelvic lymphadenectomy has been performed at the Graz University Clinic of Obstetrics and Gynecology in the operative treatment of ovarian cancer in stages Ib to IV. In 27 of 48 patients (56.3%) positive nodes were found. The frequency of involved nodes in stage III only was 61.1% (N = 22). The incidence of positive paraaortic nodes in 16 evaluated cases was 31.2%, but these were only found when pelvic nodes were involved too. In 12 cases lymphadenectomy was done in second-look laparotomy. It became apparent that after operative and cytotoxic treatment with Adriamycin, Cis-Platinum and Cyclophosphamide (following the regimen of Ehrlich et al.) pelvic lymphnodes were still found positive in 8 of 12 cases (66.7%). The distribution of the nodes involved showed that the caudal lymphnodes were more often affected that than cranial ones. The results so far suggest that extensive pelvic lymphadenectomy may improve survival rates of patients with advanced ovarian cancer.

Actuarial Analysis↗
PubMed1983

Site and origin of squamous cervical cancer: a histomorphologic study.

Based on extensive histomorphologic study, a concept of cervical carcinogenesis is formulated. Intraepithelial neoplasia arises in well defined and predestined fields that are well demarcated from each other. Different forms of intraepithelial neoplasia coexist and have different topographic distribution. Extension and enlargement of atypical epithelial fields are not brought about by active spread, but by apposition of new fields. Two different pathways exist for the genesis of intraepithelial neoplasia affecting cell types involved in regeneration or transformation. In the majority of cases the precursor lesion is atypical squamous metaplasia in the transformation zone. Less commonly, malignant change occurs in original squamous epithelium, probably via atypical basal hyperplasia. The role of the "last gland" is seen as the anatomic landmark dividing these two areas. So-called minor forms of intraepithelial neoplasia cannot progress and change into carcinoma in situ, as they are differently located.

Carcinoma, Squamous Cell↗
PubMed1981

[The problem of so-called conservative treatment of the atypical cervical epithelium (author's transl)].

There is an increasing tendency of a so-called conservative treatment of intraepithelial atypia. The new term of cervical intraepithelial neoplasia (CIN) supposedly called for a new concept of treatment. However, the term CIN replaces only the ambiguous terms of Carcinoma in situ and Dysplasia. The term CIN expresses the latter two being principally identical changes that are distinguishable only by differentiation. Persistent dysplasia is nothing but a highly differentiated Carcinoma in situ and must be treated as such. - For final diagnosis of CIN not only the histological pattern must be known but above all the relationship to the stroma and the extent of changes. NEither cytology nor colposcopy and directed biopsy or a combination of these can define the lesions with such accuracy as is necessary as a basis for a really adequate treatment. It could be proved that treatment results of Carcinoma in situ depended on the quality of primary diagnosis. Out of 390 cases that were treated after limited biopsy, eight died of cancer. After treatment of 1012 cases with conization alone there was not one fatal case. The danger of so-called conservative treatment lies not only in unrecognized invasive lesions but above all in preinvasive lesions remaining in deeply situated glands. Their discovery may fail in spite of regular follow-ups. They will reappear possibly only after a long latency period as invasive cancer.

Biopsy↗
PubMed1980

Treatment of carcinoma in situ: evaluation of 1609 cases.

In 1609 cases of carcinoma in situ, various methods of treatment were adopted: primary irradiation (22 cases), radical hysterectomy (11), simple hysterectomy (418), cervical amputation (83), ring biopsy with cervical curettage (63), and conization alone (1012). The outcome was related far less to the method of treatment than to the reliability of the primary diagnosis. If the latter was based only on colposcopically directed punch biopsies or cervical curettage, even with ring biopsy, 2.1% of patients died of cancer. In patients treated by hysterectomy, the vaginal approach resulted in 4 times fewer recurrences than did the abdominal approach, because of visualization of the extent of the lesions. Best results were obtained after conization with serial step-sectioning of specimens. Among 634 cases treated by conization with total removal of the lesion, there were no recurrences.

Biopsy↗