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Biomedical subjects

E Merkle

Publications and source records attributed to E Merkle.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Experiences with an alternative distension medium in oral contrast imaging of the small intestine].

PURPOSE: The image quality of oral small bowel imaging is often poor on account of the small bowel enema. A new contrast medium should increase the image quality due to better compliance of patient because of the better taste of substance. The loading of patient with radiation or time should not increase. METHODS AND PATIENTS: We investigated prospectively 40 patients, randomized in two groups of 20 patients each. Two different substances were used as contrast medium: barium-methylcellulose and Barium-Mucofalk, respectively. The quality of the double contrast, profile of the mucosa, duration of radiation, duration of examination, dose-area product, and taste of the substance were judged for significance. RESULTS: The taste of the new contrast medium was judged to be better: twice as often as "good" and five times less often as "bad", the difference was not significant due to the small number of patients. There is no significant difference in the other criterias. CONCLUSION: Mucofalk is an alternative contrast medium for oral small bowel radiology in cases of difficult placement of the tube for enema. The quality of double contrast and visualization of the profile of mucosa are the same while the taste is better.

Administration, Oral↗
PubMed1995

[Radiation exposure during digital hysterosalpingography: how much is due to fluoroscopy?].

PURPOSE: To determine the proportion of radiation exposure from fluoroscopy during the performance of hysterosalpingography, using a digital image intensifier. MATERIAL AND METHOD: 20 women with primary or secondary sterility were examined. The total radiation dose was measured and the proportion due to fluoroscopy was determined. The use of a computer programme permitted accurate differentiation of the dose obtained by fluoroscopy and radiography. Total mean radiation dose was 256 cGy x cm2; fluoroscopy contributed 187 cGy x cm2. On average, fluoroscopy contributed 69% of total radiation dose. CONCLUSION: During hysterosalpingography with a digital image intensifier, fluoroscopy should be as brief as possible since it contributes most of the radiation dose.

Adult↗
PubMed1995

[Results of catheter embolization of renal cell carcinoma].

PURPOSE: We pointed out the value of catheter embolisation of kidney tumours. METHODS AND PATIENTS: We treated 42 patients with kidney tumours. For peripheral embolisation we placed Histoacryl or Ethibloc into the kidney artery via a transfemoral catheter. 33 patients had haematuria. 8 patients were lost for follow up. 26 patients were treated by embolisation alone and 8 patients were treated before nephrectomy. RESULTS: Haematuria was stopped in 98% and never reoccurred. The intraoperative blood-loss was 600 ml on average. 55% of patients treated by embolisation alone died within the first year. 51% of patients suffered from a slight postinfarction syndrome. One patient died of sepsis and one had pulmonary insufficiency due to AV shunt and pulmonary embolism. CONCLUSIONS: Peripheral embolisation of kidney tumours can be used successfully and is minimal invasive, in case of haematuria and pain. The perioperative risk is reduced due to limited blood loss.

Adult↗
PubMed1995

[Alveolar echinococcosis of the liver--computerized tomography findings].

In order to ascertain the typical computed tomographic findings of hepatic alveolar echinococcosis, 24 computed tomograms of 19 patients were evaluated. The liver was involved in all cases whereas the diaphragma was infiltrated in 32%, and the retroperitoneal area in 42%. The right liver lobe was affected in 65%. Both before and after intravenous bolus contrast medium administration, the lesions were mainly inhomogeneous and of low density; a masking of the lesions due to the contrast medium administration was not observed; the enhancement pattern was irregular. Calcifications were detected in 96% of the cases, cystic structures in 50%, and cholestasis in 54%. On the basis of the crucial finding of calcifications in combination with the other typical observations, CT seems to be very suitable for the evaluation of hepatic alveolar echinococcosis.

Adult↗
PubMed1994

[Immunocytochemical detection of tumor cells in bone marrow as a prognostic factor in breast carcinoma].

In a prospective study at the University of Erlangen, Dept. Gynaecol, and Obstet., 228 patients with breast cancer during their primary surgery and 20 patients during their metastatic surgery, underwent bone marrow punctions at six punction sides, which were twice at the sternum and twice at both iliac crest. The control group was 20 patients without an invasive carcinoma. Aim of the study was to detect or exclude tumour cells in the bone marrow via examination of the biopsies with monoclonal antibodies EMA and cytokeratin and consequently to find out the meaning of the results as prognostic criteria by statistical measurements. Tumour cells in the bone marrow were detected in 46.5% (106/228) of the patients, who underwent a bone marrow biopsy during primary surgery. 21% (23/106) of the patients who were bone marrow positive, but only 5.75% (7/122) of the patients, who were bone marrow negative, developed metastases during a median follow-up of 20 months. This difference is statistically significant. 17 of the 30 patients with recurrences developed bone metastases; 16 of them were EMA-positive. The median recurrence-free interval was 5 months in the bone marrow positive group and therefore noticeably shorter, than in the bone marrow negative patient group with 11 months. Of the nodal negative patients, 2 bone marrow positive patients developed distant metastases. With the knowledge of the nodal status and bone marrow biopsy result, it was possible to predict 28 of the 30 patients correctly in respect of their risk to metastasize. The result of the bone marrow puncture was proved in a multivariate analysis to be an independent prognostic factor.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomarkers, Tumor↗
PubMed1993

[Carotid angiography by magnetic resonance].

Using magnetic resonance imaging, arteriosclerotic lesions of the supra-aortic vessels may be well demonstrated. The comparison between 3 magnetic resonance angiography (MRA) techniques (Spin Echo, Gradient Echo 2D FLASH, Gradient Echo 3D FISP) and Digital Subtraction Angiography (DSA) as reference in 50 patients suspicious of stenotic lesions proved the high reliability of these methods. Specially in determining the degree of stenosis, a good correlation between DSA and SE in 87%, between DSA and 2D FLASH in 78% and between DSA and 3D FISP in 83% could be assessed. Since 3D technique may exaggerate the degree of stenosis, we didn't observe any false negative result in severe stenosis. Therefore we think that the 3D technique is a safe technique which enables a good overview of the supra-aortic vessels and could therefore be suitable for screening.

Aged↗
PubMed1992

[Life threatening menorrhagia in thrombasthenia. (Glanzmann-Naegeli) thrombasthenia].

Glanzmann's Thrombasthenia is a rare inherited disorder of platelet aggregation with normal platelet count and humoral coagulation. It is caused by the deficiency or functional disorder of platelet membrane glycoproteins IIb und IIIa. This complex is considered to be a receptor for fibrinogen. Menorrhagia often occurs as a clinical manifestation of affected females. We report a case of severe menorrhagia in a 13-year-old girl during her third menstrual cycle. She needed several red blood cell transfusions. The bleeding could only be stopped by administration of Lynestrenol.

Adolescent↗
PubMed1991

[Thermolabile characteristics of steroid hormone receptors in breast cancer].

The thermolability of steroid hormone receptors was examined in a prospective study at the Gynaecology and Obstetrics Division, University of Erlangen, to clarify the cause of false negative hormone receptor findings. The loss of steroid hormone receptor content was measured in relation to the duration of operation, the time and duration of preservation. The investigations show a high thermolability of the steroid receptors. This is of considerable significance in conventional operations. Compared to the determination of hormone receptors at the time of biopsy for histological verification of the putative diagnosis of breast cancer, analysis at the end of the modified radical mastectomy and segment resection or excision of recurrences only detected 43% of the content of oestrogen receptors and 50% of the content of progesterone receptors. After storage of the surgical preparation for one hour at room temperature, the yield of oestrogen receptors fell to 35% and that of progesterone receptors fell to 31% of the original receptor content. A fresh determination of hormone receptors after cryopreservation for one to two weeks at -40 degrees C postoperatively showed only a minor loss of receptors amounting to 5.3% of the oestrogen receptors and 6.6% of progesterone receptors. On the other hand, cryopreservation at the same low minus temperature for five to six months, reduces the yield of oestrogen receptors by 34.6% and that of progesterone receptors by 33.9% compared to the intraoperative analysis.

Breast↗
PubMed1990

[Adjuvant chemotherapy of breast cancer with the CMFV protocol].

Adjuvant CMFV therapy was administered from 1975 to 1984 at the Department of Gynaecology and Obstetrics of the University of Erlangen in 331 patients from a patient population, who underwent an operation with the intention of curing invasive breast cancer. Six cycles of this therapy were administered to 224 women. Only these patients were considered in the evaluation. 538 patients without axillary lymph node metastases and without adjuvant therapy served as reference population. The significance of adjuvant CMFV therapy in relation to the lymph node and menopausal status was investigated in a retrospective analysis. It was shown, that the five-year actual survivals in the group of premenopausal patients with one to three affected lymph nodes and CMFV therapy (n = 60), did not differ significantly from the group of women with premenopausally negative lymph nodes without adjuvant therapy (n = 198) (87.7% versus 88.2%). On the other hand, in the postmenopausal patients, the five-year actual survivals for the corresponding groups were 65.9% and 83.2%, respectively. The difference was significant. The results indicate, that adjuvant CMFV therapy improves the prognosis in premenopausal women, above all in cases with one to three affected lymph nodes. In the postmenopausal patients, a comparable effect could not be demonstrated in this group of patients.

Adult↗
PubMed1990

[Long-term study of the significance of hormone receptors as prognostic factors in breast cancer].

To check the question as to the prognostic significance of oestrogen and progesterone receptors in invasive breast cancer, the course of the disease was registered in 660 patients in the context of a retrospective study. These patients had been operated on with the objective of curing breast cancer between 1976 and 1984. A receptor analysis of these patients is available with regard to both receptor types. Positive progesterone receptors could be detected in 38%, positive oestrogen receptors in 70%. Values over 15 fmol/mg tissue protein were rated as positive. The proportion of oestrogen-receptor-positive tumours increased with the age of the patients. On the other hand, the progesterone receptor did not show this dependence. During analysis of the median receptor concentrations as well as of the progesterone combinations, a correlation between the axillary lymph node status and the hormone receptor status of the primary tumour could not be observed for the two receptor types. The survival time in relation to the oestrogen receptor status did not indicate any significant effect on survival time. On the other hand, the improvement of survival time depending on the positive progesterone receptor status was highly significant in statistical terms (p less than 0.001) especially in nodal-positive patients. Both patients with axillary lymph node metastases and positive progesterone status, compared with patients without lymph node invasion and a negative progesterone status, had the same survival rate.

Adult↗