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Biomedical subjects

E Dreher

Publications and source records attributed to E Dreher.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Pearl index of the new Sof-T spiral in relation to ultrasound follow-up].

463 patients (109 nulliparae, 354 uni- and multiparae) were fitted with a new intrauterine device (IUD), Sof-T, and observed during 6,624 cycles. Two independent centres participated in the study. The T of Sof-T is made of flexible polyethylene, the two occlusion bodies, of medically approved silastic. If the Sof-T is correctly placed, they lie in the uterine horns. A copper wire of a total surface of 360 mm2 is winded around the vertical branch. The echogenicity of the occlusion bodies facilitates their visualization by ultrasound, thus improving the safety of the new Sof-T. The softness and the adaptability of these occlusion bodies to the cavity of the uterus decreased trauma, and thus hemorrhage and pain, compared to 16 other studies on IUDs. The small number of salpingitis recorded in our study of the Sof-T may be attributed to the fact that the pathogens transported and transmitted by sperm could probably not penetrate into the uterine tubes because they were stopped by the occlusion bodies.

Adolescent↗
PubMed1991

[Vulvar cancer. Bern university gynecologic clinic patients treated 1978 to 1987].

Between 1978 and 1987, 44 women with primary invasive carcinoma of the vulva were treated. The mean age of the patients was 69 years (24-91). The predominant histologic type was squamous cell carcinoma. Thirteen radical vulvectomies were performed. Various other vulvar operative procedures were performed on 27 cases and were followed up with or without radiation therapy. The 5-year survival rate was 80% in stage T1 patients, 58% in T2 and 40% in T3. Patients with negative lymph nodes had a survival rate of 79% after 5 years and those with positive nodes a survival rate of 40%. A modified radical vulvectomy was performed: to the Pary-Jones incision we use an additional groin incision. The advantage is better wound healing as compared to Way's technique.

Adult↗
PubMed1990

[Discrepancy in histopathological findings of curettage material and hysterectomy specimens in malignant tumors of the uterine body].

The clinical staging of the malignoma of the uterine corpus according to the FIGO classification corresponds in only 85.7% in stage I and 35.7% in stage II to the histopathologic staging after operation. Tumor grading and histology from D and C differ in 31.8% and 9.4% respectively from the hysterectomy specimen. We propose therefore to prefer surgical and histopathological staging to the pure clinical FIGO-staging in order to plan adjuvant therapy and for comparing therapeutic results of different patient groups as well.

Adenocarcinoma↗
PubMed1990

[Terodiline in the treatment of stress incontinence in women].

Terodiline combines simultaneously a parasympatholytic and a calcium antagonistic effect and can be used positively for the treatment of urge-incontinence of women. 44 female patients with an urge-incontinence have been examined urodynamically before and after a six-week treatment with terodiline. After therapy the urodynamic parameters ameliorated significantly. A subjective amelioration or even a healing of the urge symptomatic occurred in 86.4% of the patients. The side effects were minor.

Adult↗
PubMed1989

[The mirror as a possibility of participation in routine gynecologic examination: effects on the psychological status of the female].

The effect of active participation by means of a hand-mirror during gynecological examination was investigated in that three groups were formed: one that wanted and got the mirror, one that wanted the mirror but was not given it and thirdly refusers. The mirror leads to significantly greater satisfaction, which however does not override preexisting attitudes concerning one's body and sexuality as well as the image of the doctor. In that respect acceptance or refusal of the mirror reflects in some ways the open-mindedness or conservatism of the patients.

Body Image↗
PubMed1988

Treatment of advanced ovarian cancer with surgery, chemotherapy, and consolidation of response by whole-abdominal radiotherapy.

Between April 1981 and June 1985, 195 patients with ovarian cancer, International Federation of Gynecology and Obstetrics (FIGO) Stages IIB, IIC, III, and IV, entered a trial that consisted of surgery and chemotherapy with cisplatin (P) and melphalan (PAM) with or without hexamethylmelamine (HexaPAMP or PAMP regimens) every 4 weeks for 6 cycles. Because the intent was to study the outcome by treatment after evaluation of first-line chemotherapy, patients were evaluable only if the response was assessed by a second-look operation or if measurable disease progression was documented. One hundred fifty-eight patients (81%) were evaluable for response. Forty-five (28%) achieved pathologically confirmed complete remissions (pCR), and 24 of these patients received whole-abdominal radiation (WAR) for consolidation of response. Five patients with complete remission after WAR relapsed, as did nine of the 21 with complete remission who had not undergone WAR. The 3-year time to progression percentage (TTP +/- SE) from second-look operation was 70% +/- 7% for all patients who achieved pCR, 83% +/- 8% for those who received WAR, and 49% +/- 15% for those who did not receive WAR (this was not a randomized comparison). The 3-year TTP percentage for the 49 partial responders was 21% +/- 6%, identical for the 19 who had WAR and the 30 who had no radiation therapy. Additional or alternative methods for consolidation of pCR are needed since patients continue to relapse despite optimal initial response to therapy.

Abdomen↗
PubMed1988

Intrauterine occlusion body (IUB). Preliminary report.

The IUB or SOF-T is a further development of the IUD with additional functions and properties. In 368 IUB insertions over a period of 48 months, there was no intrauterine pregnancy. There was a low removal rate due to bleeding, pain, infection or partial expulsion in 277 insertions performed at two university centers over an average period of 8-1/2 cycles. In 80 cases tubal occlusion was directly or indirectly proven by different methods. The improved ultrasound localisation of the IUB is possibly responsible for its effectiveness and the soft ends are probably the main reason for its improved tolerance compared to other IUDs.

Adult↗
PubMed1988

[Unconscious insecurity before and after breast examination in senology patients without pathologic findings].

The study reported here surveyed unconscious insecurity among healthy women, who consulted a senological outpatient service because of suspected breast cancer. It was investigated whether and in what way the reduction in unconscious insecurity, after being informed that the diagnosis was favorable (no carcinoma), is dependent on certain psychological conditions. The patients were divided into various subgroups according to history and psychological criteria, and these subgroups were then compared with regard to the reduction in their feeling of insecurity after being advised that there were no pathological findings. The individual tendency to tenseness (Brauchli 1983, 1987 a, b) was used as an indicator of unconscious insecurity. Coming to terms consciously with the cancer risk and possible consequences of cancer, proved to be a prerequisite for an adequate reduction in unconscious insecurity after being informed that findings were negative.

Adaptation, Psychological↗
PubMed1988

[Vaginal closure with resorbable clip in total abdominal hysterectomy].

The latest type of clip stapler with resorbable clips for closure of the vaginal stump in abdominal hysterectomies was used by nineteen different surgeons on 80 patients at two university clinics, employing the same surgical procedure. Perioperative handling and the complication-free postoperative course were considered satisfactory. There was no dyspareunia, previously described in association with metal clips. Granular tissue requiring therapy and serosanguinous discharge were clearly reduced. On the basis of measurements of vaginal cuffs removed at the same time it can be said that there is no shortening of the vagina. The question of costs is discussed.

Female↗
PubMed1986

Combination of chemotherapy with methotrexate, bleomycin, and cis-platinum, and radiation therapy for locally advanced carcinoma of the cervix.

Sixteen non-pretreated patients with locally advanced cervical cancer (FIGO Stage IIIb) were treated with two 3-week cycles of platinum, bleomycin, and methotrexate (PBM), which were followed by radiation therapy. Response to both modalities was seen in 11 patients (69%), and three patients (19%) had a progression-free survival of more than 2 years. Radiation therapy was proven to be feasible after two cycles of PBM combination chemotherapy.

Adult↗
PubMed1985

[Preoperative cervix dilatation in 1st trimester pregnancy interruption using 9-deoxy-16, 16-dimethyl-9-methylene prostaglandin E2. A randomized double-blind study].

In the double-blind study reported here the authors were able to confirm the time- and dose-related effect of dilatation of the cervix by means of the new prostaglandin-E2 derivative (9-deoxo-16, 16-dimethyl-9-methylene-PG-E2-potassium salt) as compared to placebo. In spite of the short preoperative duration of action of three hours it was observed that half of the patients treated with the prostaglandin derivative vomited once or several times. The authors therefore consider that administration of the prostaglandin vaginal suppository is only justified in cases with a high risk of cervical injury, and in primiparae undergoing termination under local anesthesia. In 38 patients termination was performed by means of direct cervicomyometrial analgesia. With one exception they approved of chemical dilatation of the cervix in spite of the side-effects, assuming that it would result in less intraoperative pain.

16,16-Dimethylprostaglandin E2↗
PubMed1985

[Total abdominal irradiation following combination chemotherapy and second-look laparotomy in the treatment of advanced ovarian cancer].

From 1980 to 1984 fifty-four patients with advanced ovarian carcinoma after operation and concluding chemotherapy with alkeran (n = 7) or cis-platin/alkeran +/- hexamethylmelamine (n = 47) as well as second-look laparotomy received follow-up radiotherapy either with the moving-strip technique (n = 35) or later the open-field technique (n = 19). 32 patients in CR received radiation therapy. 15 patients in CR are without relapse after undergoing open-field radiation therapy and a mean observation period of 25 months. At this point of time 5 of 17 patients had relapses under the moving-strip radiation treatment. The frequency of the relapses is apparently due to the very long periods of radiation and numerous interruptions in treatment. If residual tumors were present at the begin of ray therapy, a CR could only be achieved in cases where the previous monotherapy was with alkeran.

Adenocarcinoma↗
PubMed1985

The treatment of ovarian cancer by a multimodality approach: remission induction with chemotherapy--hexa PAMP and PAMP regimens--followed by whole-abdominal radiation.

Seventy-six evaluable patients with ovarian carcinoma stages FIGO IIb, IIc, III, and IV, either received cis-platin (P) (80 mg/m2 iv. day 1), melphalan (PAM) (12 mg/m2 i.v. day 2) and hexamethylmelamine (HEXAPAMP) (135 mg/m2 orally days 8 to 21) or the same dose of cis-platin and melphalan but no hexamethylmelamine (PAMP) every four weeks. In 24 patients (32%) a surgically ascertained CR was achieved. 16 of these received follow-up radiation treatment to the whole abdomen. At present 19 patients are without relapse (average time 24 months). The trial has not been concluded. Particularly no predictions can be made on the value of follow-up radiation therapy in obtaining long-term remission rates.

Adult↗
PubMed1984

[Laser therapy in gynecology].

Laser therapy is being implemented with increasing frequency in medicine. Carbon dioxide laser is the system most commonly used in gynaecology and the main indications are disease of the uterine cervix, vagina, vulva or perineum. When used in conjunction with the microscope or laparoscope during reconstructive operations on the adnexa, laser speeds up the surgical procedure and brings out the inherent advantages of this technique, namely, precise separation or destruction of tissue, absence of postoperative oedema, uncomplicated wound healing, minimal mechanical trauma, decreased postoperative pain and good haemostasis. With good maintenance and practice laser systems all work well. The only disadvantage is their high cost.

Condylomata Acuminata↗
PubMed1984

Whole-abdomen radiation in patients with advanced ovarian carcinoma after surgery, chemotherapy, and second-look laparotomy.

Forty-three patients with ovarian carcinoma were treated with whole-abdomen radiation (moving strip +/- pelvic radiation), 15 patients had not received prior chemotherapy, and 28 patients were irradiated following chemotherapy and second-look laparotomy. Ten of these had been treated with a variety of chemotherapy regimens (L-PAM, CHAD, Hexa-CAF). Eighteen patients were treated in an ongoing prospective trial with combination chemotherapy consisting of melphalan, cis-platinum, and hexamethylmelamine++ (HexaPAMP). Thrombocytopenia was the limiting toxicity. A temporary pause in the radiation schedule allowing platelets to recover made it possible to complete treatment in 80% of the patients. The acute toxic effects, which included the expected side effects of radiation therapy on intestine, liver and lung, were not more frequent or more severe in the patients who had received prior chemotherapy than in those who had radiation therapy alone. Thirty-four of 43 patients (stage I, seven patients; stage II, seven patients; stage III, 27 patients; stage IV, two patients) are alive and without evidence of disease 26 + months (range 7 to 64 months) after entering the postsurgical treatment program.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Pathologic data of prognostic significance for remission induction in advanced ovarian carcinoma.

Sixty-eight patients with "advanced ovarian carcinoma" were entered into an ongoing phase-II trial for remission induction with cis-platinum (DDP) 80 mg/m2 i.v. on day 1 followed by forced saline diuresis, melphalan (L-PAM) 12 mg/m2 i.v. on day 2 and hexamethylmelamine (HMM) 130 mg/m2 p.o. X 14 days from days 8-21 in six monthly cycles following operative resection and/or staging. Fifty-one patients were evaluable for response, ten had not completed six courses and could not be assessed, two patients died early (one probably of toxicity), and five patients refused treatment and follow-up. Thirty-Two patients had serous, endometrioid or undifferentiated carcinomas of the ovary. Of these, 11 (35%) achieved a pathologically proven complete remission (CR), five (16%) were NED after second-look (residual disease in ovary or removed omentum with all other biopsies and cytology washings negative), eight (32%) achieved a partial remission (PR), and three (12%) had progressive disease. None of the seven patients with clear-cell carcinoma and none of the three patients with Mullerian tumor of the ovary responded. Six of nine patients with tumors of uncertain origin or proven metastasis to ovary did not respond to treatment. These preliminary results indicate that advanced ovarian carcinomas form a heterogeneous group of recognizable neoplastic diseases with striking variation in response to treatment.

Adenocarcinoma↗