Biomedical subjects
Publications and source records attributed to E Gitsch.
The radioisotope radical operation may cause an improvement of results in carcinoma of the cervix stage I b, II, and IV. The increased yield of lymph nodes enables a more reliable prognosis in advanced cases. Recurrent tumors at the pelvic wall may be detected earlier by isotope nephrography.
In the period 1972--1975 432 conizations were performed. 76,6% of all patients were dismissed healed after conization without necessity of hysterectomy; the duration of stay in hospital after operation was in uncomplicated cases 7,9 days, in complicated cases 9,9 days. In 13,9% complications were registered, mainly bleedings (10,9%). In more than half of the cases with not totaly removed carcinoma in situ the uterus showed rests of the malignant lesion. That indicates that in such situations a hysterectomy should be done in every case. If there was a suspicion of invasive carcinoma an excochleation was performed instead of cone biopsy. The high rate of false negative results in such cases confirms that the conization at the moment seems to be the method of choice in clarification of positive cytologic or colposcopic findings.
A report is present of 1300 unselected patients investigated for breast cancer by liquid crystal thermography. The value of this method is comparable to the value of mammography, since the number of carcinomas which remained undetected by each diagnostic procedure was equal. The high degree of diagnostic accuracy achieved by the use of liquid crystal thermography indicates that this simple dignostic procedure is recommendable as a screening method for the detection of breast cancer in gynaecological practice.
Determination of the creatinine concentration of the amniotic fluid was undertaken between the 25th and 40th week of gestation in 114 patients. The normal serum creatinine level was simultaneously determined in 43 of these patients. The aim of this study was to examine whether this parameter of fetal renal function allows a conclusion to be drawn with respect to fetal maturity and the length of gestation. With increasing length of gestation a marked increase in the amniotic fluid and the maternal serum creatinine concentration was observed (p less than 0.01). The large scatter of the values made it impossible to relate any particular creatinine concentration to a certain week of gestation. However, if the concentration of creatinine in the amniotic fluid has reached a value of 2 mg% or more, a mature baby can be predicted in most cases. A tendency to raised levels of creatinine was seen in cases of EPH gestosis and latent diabetes mellitus. The determination of creatinine in the amniotic fluid can be recommended with certain reservations as an additional method to assess fetal maturity.
The immunological reactivity of 19 operated cases of breast cancer (14 T1 2, 5T3) was investigated before and at 3-weekly intervals up to 12 weeks after radiotherapy by means of a large panel of techniques. The results were compared with two groups of identically-investigated patients, one consisting of 11 cases of cervical cancer (stage III), treated solely by irradiation and the other of 12 cases of cervical cancer (Stages I a and II b), treated by operation only. Before irradiation and in the non-irradiated group cellular immunity appeared to be more disturbed in cases of breast cancer than in cases of cervical carcinoma, as shown by the lowest number of lymphocytes, the lowest number of spontaneously-rosetting lymphocytes, the lowest percentage of DNCB sensitization in patients and the lowest percentage of Tuberculin-positive skin tests. In both types of carcinoma the humoral immunity appeared to be impaired, as apparent from the lowered immune response to tetanus vaccination. Other parameters of humoral immunity such as the immune globulin concentration, iso- and heteroagglutinine, the titre of measles antibodies or membrane fluorescence of lymphocytes showed no dinstinct trends during the investigation period. After irradiation a) inhibiting and b) stimulating influences were observed: a) The incidence and extent of the immune response to tetanus vaccination was further reduced and a distinct lymphopenic effect was observed. b) The incidence of positive skin tests with varidase, as well as the number of spontaneously-rosetting lymphocytes increased after the commencement of irradiation. Apart from the known sensitization with DNCB and skin tests with tuberculin, determination of the antitoxin titre before and after tetanus vaccination provided the most reliable results in regard to immunological reactivity in the investigated tumour patients.
By performing the radioisotope radical operation (pre-surgical labelling of the lymphatic tissue of the pelvis with colloidal 198Au) with the aid of a gamma camera, it was possible in 78 out of 93 cases to completely extirpate the regional lymphatic tissue of the pelvis. In eight out of 24 cases with positive findings on the lymph nodes we were also able to extirpate with this technique residues of carcinomatous lymphatic tissue during the course of a secondary isotope lymphadenectomy. This fact is likely to further improve the recovery rate--all the more so since even the scanner and eye probe technique already reduced the mortality rate due to recurrence by 16.4% after 5 years.
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A total of 131 cycles of 71 sterility patients, who suffered from anovulatory cycles at least previous 6 months, were monitored daily by a rapid radioimmunoassay for LH and by gynecological examinations before we attempted to induce ovulations with Clomiphene. The width of the cervix, spinnbarkeit, transparency of the cervical mucus and karyopycnotic and acidophilic index of the vagina were recorded daily. 18 subjects exhibited hypoplasia of the uterus and 32 husbands of the 71 patients suffered from severe to medium oligospermia. Homologous inseminations were performed in 15 patients. Different patterns of LH serum levels were observed during and after Clomiphene treatment. The response of LH to Clomiphene and preovulatory LH rise was recorded in 73 cycles. No Clomiphene response with preovulatory LH peak was observed in 31 cycles. 11 patients out of 71 subjects failed to ovulate. 12 patients (30.7%) out of 39 subjects with normospermatic husbands became pregnant. 6 patients (18.7%) of 32 subjects whose husbands suffered from oligospermia became pregnant. A total pregnancy rate of 30% calculated, when the 11 patients with negative responses are excluded. The conclusion is reached that sterility patients benefit most, when both gynecological as well as rapid LH estimations by radioimmunoassay are used to time imminent ovulations in Clomiphene treated subjects.
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Eleven patients with stage-III cancer of the cervix were investigated before, during and after radio-therapy in regard to their state of humoral immunity on the basis of determinations of the serum IgG, IgM and IgA concentration, of hetero- and isoagglutinins, of tetanus antitoxin before and after vaccination with toxoid, of measles antibodies and of the percentage of lymphocyte membrane fluorescence. The cellular immunity of the same patients was investigated by determination of the percentage of spontaneously-rosetting lymphocytes, of skin-test reactivity with DNCB before and after sensitization, of skin-test reactivity with candida, trichophyton, varidase, OT and staphylo antigen. The function of polymorpho-nuclear leucocytes was investigated by means of the NVT test and St. aureus, E. coli and latex particles. All investigations were performed both before, and 3, 6, 9 and 12 weeks after the commencement of radiotherapy and the results were compared with those of an operated, non-irradiated group (stages I b and II a). Two types of noteworthy results were observed: 1. A decrease in immunological reactivity, probably in connection with cancer, since this reaction was observed both in irradiated and in non-irradiated cases, characterized by lowered or absent immune answer to tetanus toxoid, lymphopenia, decrease in sensitization to DNCB and less positive skin tests to old tuberculin and varidase. 2. An additional inhibition (although in one investigation stimulation of the immune answer was also seen), probably in connection with radiotherapy, characterized by an additional decrease in immune answer to tetanus toxoid, in skin sensitivity to DNCB sensitization and in tests with old tuberculin, and an augmented lymphopenia, as well as an increase in positive skin tests with varidase. No significant changes were observed with any other method.
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A report is presented of 6 surgically-treated cases of recurrent cervical carcinoma. Two of the patients have survived and remained free from gynaecological or urological symptoms or signs for more than four years.
12 patients were investigated in regard to their state of humoral immunity by means of the following determinations: IgG, IgM, and IgA concentrations in the serum, hetero- and isoagglutinins, tetanus antitoxin before and after immunization with toxoid measles antibodies and the percentage of lymphocytes with membrane fluorescence. The cellular immunity was investigated in some patients with determination of the percentage of spontaneously-rosetting lymphocytes, of the DNCB skin-test reactivity before and after sensitization with DNCB and of skin-test reactivity to candida, trichophyton, varidase, OT and staphylo antigen. The functional efficiency of polymorphonuclear leucocytes was investigated by means of the NBT test and Staph. aureus, E. coli and Latex particles. All investigations were performed before, and 3, 6, 9 and 12 weeks after surgery. 4 methods only amongst the entire spectrum employed in the investigation proved to give sufficient evidence of signs of decreased efficiency of the immune response in the investigated patients: determination of tetanus antitoxin before and after immunization, a distinct increase in titre being observed only in 5 cases, determination of the sensitization to DNCB, which was positive only in 4 cases and determination of skin-test reactivity to varidase and OT, which was found to be less frequently positive than in controls. However, all these reactions showed no evidence of any correlation to surgical management and appeared merely to reflect characteristic responses of these cancer patients. Moreover, with the exception of the decrease in lymphocytes, no changes were detected in the data obtained by the other methods used in this study which might show some reflection of an alteration in response following surgery.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.