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Biomedical subjects

F Kubli

Publications and source records attributed to F Kubli.

At least 37 records · Page 2Linked to original sources
PubMed1986

Complications of intraperitoneal dextran application for prevention of adhesions.

In 47 patients (dextran group: 32 patients, control group: 15 patients) undergoing laparotomy for microsurgical detachment of adhesions and tuboplasty, the complications of a repeated postoperative intraperitoneal instillation of 6% dextran 60 (5 days) were monitored. In the dextran treated group, abdominal pain and dyspnea occurred significantly more frequently than in the control group. In 6 cases, we observed an edema of the vulva and in two cases an edema of the thigh. During the intraperitoneal irrigation with dextran, a significant increase of body weight and central venous pressure occurred. Bradycardia was observed between the 3rd and 6th postoperative days. Blood pressure remained unchanged. 75% of the patients in the dextran group had pleural effusions containing dextran on the 5th postoperative day. We think that the uncertain desired effects of dextran in the prevention of adhesions do not outweigh the certain and substantial undesired side effects.

Adult↗
PubMed1985

[Problems and limits of mammographic cancer diagnosis. Comparison of preoperative radiologic diagnosis with histologic findings in 335 patients with subcutaneous mastectomy].

Subcutaneous mastectomy was performed in 335 patients between 1974 and 1982. In 265 of these, original mammographies were available which were analysed retrospectively and compared with the final histological finding of the subcutaneous mastectomy preparation. The rate of newly discovered non-invasive carcinomas in this was 11%, whereas the rate of invasive carcinomas was 8%. Radiological criteria: high degree of dysplasia, difficult assessment and mastopathy associated with large cysts, are associated with a significantly increased number of malignant histological findings. The radiological criteria of mastopathy, such as adenosis, fibrosis, indurating oedema of stroma, small-cyst mastopathy, as well as parenchymal patterns according to Wolfe, are not important with regard to our group of patients in respect of further selection of risk patients. Criteria of malignancy which are typical of carcinoma, are on the whole rarely recognised, because their assessment is often difficult. In patients with preceding carcinoma of the other breast, indication for subcutaneous mastectomy in case of "unclear" mammography has proved justified: In 4 out of 18 cases, a non-invasive or invasive carcinoma was found. Indication for primary subcutaneous mastectomy was too liberal in case mammography had been assessed as "benign", for the carcinoma rate was only 1/73. In radiologically "unclear" findings, the number of subsequently discovered non-invasive and invasive carcinomas was distinctly higher (in each case 6 out of 58). In such cases an attempt should be made to confirm preoperative diagnosis by means of additive measures before performing subcutaneous mastectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Complications and side effects of artificial ascites for adhesion prevention].

The side-effects of "artificial ascites" induced with Dextran 60 (Makrodex 6%) as a mean of preventing adhesions were investigated in 47 patients (treatment group: 32 patients; control group: 15 patients) in whom microsurgery had been performed for infertility with adhesiolysis. On the day of surgery and the following four days 300 to 500 ml of Makrodex was instilled via an intraperitoneal catheter (7.5 ml/kg body weight on day of surgery; 5 ml/kg body weight on days 2 to 5). In addition, the patients received, on the day of surgery, single doses of 450 IU of hyaluronidase (Kinetin), 500,000 KIU of aprotinine (Trasylol) and 1 g of hydrocortisone acetate instilled intraperitoneally. In the group treated with Dextran, there was a significantly higher number of patients who felt unwell and had abdominal complaints and dyspnea. In six cases in the Dextran group a vulval edema was seen, and in 2 cases a thigh edema. A significant weight increase and elevation of central venous pressure occurred for the duration of the "artificial ascites" in this group. There were a few cases of bradycardia with frequencies of under 50 beats per minute. On the fifth p.o. day 75% of the patients in the Dextran group had a pleural effusion. Such changes were not observed in the control group. In view of these side-effects and the fact that it is still not proven that Dextran effectively prevents adhesions we no longer carry out this form of adhesion prophylaxis.

Adult↗
PubMed1985

DNA flow cytometry of ovarian tumors with correlation to histopathology.

Tissue samples from 49 women with seven benign and 42 malignant ovarian tumors were examined by means of DNA flow cytometry (FCM). The FCM data (DNA-ploidy and the number of S-phase fractions) were compared with the International Federation of Gynecology and Obstetrics (FIGO) stage, the histologic grade of differentiation and in some cases with the clinical outcome. The benign ovarian tumors were all diploid with a mean of 2.1% (+/- 1.66) S-phase fractions. Adenocarcinomas with the histologic grade 1 were diploid and had a mean of 2.1% (+/- 1.17) S-phase fractions. Grade 2 adenocarcinomas were aneuploid in eight of nine cases and revealed an increased proliferative activity (7.7% +/- 2.67 S-phase fractions). A high number of aneuploid cases (nine of 13) and an increased DNA synthesis were found in grade 3 adenocarcinomas (12.0% +/- 5.72 S-phase fractions). Four of six malignant nonepithelial tumors also had high numbers of S-phase fractions (9.7-14.5%). A significant correlation between the histologic grade and the DNA synthesis, FIGO stage, and DNA-ploidy was found. DNA-FCM may be used as an additional diagnostic tool supplementing routine histopathologic examination of ovarian tumors for better biological characterization, especially for those with uncertain grading, for grade 2 neoplasms, and for malignant nonepithelial tumors.

Adenocarcinoma↗
PubMed1985

[5MHz realtime sonography of the breast. 2. Examination technic and diagnostic value].

The diagnostic value of mamma-sonography using realtime technique was evaluated in a prospective study based on the experience of 452 pathomorphologically confirmed sonographic results. Large cysts (greater than 1 cm) were correctly classified as 97%, while small cysts (less than or equal to 1 cm) were recognized in 84%. Eighty-six percent of the fibroadenomas were visualized; 50% of these lesions were classified as "benign" and 34% as "equivocal--probably benign". In 70% of the patients with mastopathic alterations, no abnormalities were detected sonographically, except when cystic lesions (greater than 3 mm) were present. Fifty-percent of the in-situ-carcinomas and small carcinomas (less than or equal to 1 cm) were recognized, while 97% of the larger carcinomas (greater than 1 cm) were demonstrated. The frequency of the different echographic criteria was analyzed with regard to the pathohistological results.

Adenofibroma↗
PubMed1984

[Treatment of intestinal atony following gynecologic operations. Study on the effectiveness and tolerance of ceruletide].

The efficacy and tolerability of Ceruletide and Neostigmin were compared in patients with postoperative intestinal atonia after extensive gynecological surgical operations. Patients treated with Ceruletide (n = 30, dosage of Ceruletide 2 ng/kg/min. i.v.) showed earlier defecation than the Neostigmin-group (n = 30, dosage of neostigmin 3 x 0,5 mg/die). The frequency of side effects was comparable in both groups, patients treated with Ceruletide suffered mainly from gastrointestinal symptoms (nausea) whereas patients treated with Neostigmin complained of disorders of circulation. Ceruletide is faster effective than Neostigmin, the tolerability of both drugs is equivalent.

Blood Pressure↗
PubMed1984

[DNA measurement of malignant tumors by impulse cytophotometry. The principles and importance for assessing growth behavior and the degree of abnormality].

Monometric DNA impulse cytophotometry of ploidism state (diploid or aneuploid tumors with stemmline shift, polyploidism ) and proportion of DNA-synthesized cells (S-phase proportion) were determined on over 500, mostly malignant, tumors of different sites. The results were compared with histopathological findings (TNM stage and degree of differentiation). Large diploid carcinomas of the oral cavity have lower S-phase activity than aneuploid tumors. Carcinomas of the breast, stomach and ovary are frequently diploid. Aneuploid carcinomas of these regions generally have high synthesizing activity. Mucoid signet-ring carcinomas of the stomach have lower S-phase activity than non-mucoid carcinomas. In the colorectal region aneuploid carcinoma predominates, in the colon more than in the rectum. Tumor metastases from colon and rectum into the liver predominantly are from aneuploid primary tumors. For tumors of the breast, corpus uteri and ovary with high and moderate differentiation there is a direct correlation between histological grade of differentiation and the S-phase proportions. Aneuploid tumors vary from low to high synthesizing activity. Diploid meningioma and glioma have a low S-phase proportion, aneuploidism correlates with an increase in growth. Supplementation of histopathological diagnosis by determining ploidism and S-phase activity makes an important contribution in the assessment of the degree of malignancy, as well as for therapeutic purposes.

Aneuploidy↗
PubMed1984

[Plate thermography in the assessment of changes in the female breast. 1. The value of malignancy criteria using Tricoire's technic].

In a retrospective study on 19,641 patients of which 2702 were clarified by morphology criteria of malignancy by Tricoire were examined. Nearly all criteria were relevant. Only the "mild circumscript heatness " and "one atypical vessel" have failed as criteria of malignancy. The vascular pattern D + E ( Bourjat ) is shown as an additive sign of malignancy. The correct classification in typical and atypical vascular patterns depends from a decisive dynamic test.

Breast↗
PubMed1984

[Subcutaneous mastectomy: the importance of the histopathological assessment technic].

Subcutaneous mastectomy was performed in 300 patients between 1974 and 1981 for various indications. Precancerosis or non-invasive carcinomas were established by previous biopsy in 106 patients. The comparison of pathologic anatomy data of conventional and serial assessment of specimens showed an increase of clinically occult non-invasive carcinomas from 5.4 to 18.3% and of preoperatively undiagnosed invasive carcinomas from 2.3 to 7.7% in serial assessment and unchanged indication. Whereas the therapeutic value of subcutaneous mastectomy cannot be judged with certainty due to the relatively short observation period, the diagnostic value seems, according to these findings, to be ascertained. However, a much more complex histologic assessment technique beyond the usual is required.

Adult↗
PubMed1984

Maternal perception, tocodynamometric findings and real-time ultrasound assessment of total fetal activity.

"Total" fetal motor activity was determined in 111 healthy patients between 25 weeks of pregnancy and term using two real-time ultrasound devices simultaneously. Furthermore tocographic findings and also maternal perception of fetal movements of the same patients were stored synchronously on magnetic tape. A comparison was drawn between these three methods, i.e. real-time ultrasonography, maternal perception and tocographic tracings ("spikes" indicating fetal movements). Of all fetal movements, as assessed by real-time ultrasonography, the mothers perceived a total of 38% whereas "spikes" in tocographic tracings corresponded with fetal motor activity (excluding "breathing") in only 25% of the cases (P less than 0.001). Also major statistically significant differences could be found between maternal perception of fetal body movements with or without fetal limb movements in 56% and routine- tocography in 37% (P less than 0.001). Also isolated limb movements were most often detected by mothers (23%) than were revealed by tocographic findings (14%; P less than 0.001). Maternal signals were truly positive in 74% compared to tocography in only 56% of the cases (P less than 0.001). It is concluded that maternal perception of fetal movements is a more reliable method of monitoring fetal motor activity than analysis of tocographic tracings.

Adolescent↗
PubMed1984

[Adjuvant chemotherapy in breast cancer: present status].

Adjuvant chemotherapy should be conducted at present only under controlled conditions ("studies") with the consent of the patient after supplying her with adequate information ("informed consent"). The most important prognostic factor in primary carcinoma of the breast is the axillary lymph node status. The decisive role with regard to determining the further course of action and mapping out the treatment strategy will be played by the operating surgeon and the pathologists. Adjuvant chemotherapy can prolong the relapse-free survival time for all prognostic sub-groups known so far (the differences, however, are not significant in every case). It is very probable that the total survival rate will be improved for certain sub-groups. The effectivity of adjuvant chemotherapy decreases with increasing involvement of the lymph nodes. Pre-menopausal patients with one to three affected lymph nodes presently derive the biggest benefit from adjuvant chemotherapy. Short-term chemotherapy (up to 6 months) will suffice. The optimal treatment period is not yet known. The aggressivity of the adjuvant chemotherapy chosen for a particular case is of absolutely paramount importance. Provided the dosage is the same for both groups, there is no evidence of any clear difference between pre-menopausal and post-menopausal patients. It seems, however, that the quantitative reduction of the relapse rate is greater with pre-menopausal patients. Onset of chemotherapy should be as early as possible after surgery (14th postoperative day). A dosage schema should be followed according to calculated full dosage, if possible via the intravenous route of administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

[Preventive treatment of respiratory distress syndrome in newborn infants with antepartal glucocorticoid administration (betamethasone). Clinical results and changes in the lecithin/sphingomyelin ratio of the amniotic fluid].

Betamethason was administered to 105 patients with threatened premature labour at risk for respiratory distress syndrome (RDS) of the newborn. The most important indications were premature rupture of the membranes (30%) and premature labour (40%). The betamethason treatment was given between the 27. and 35. week of gestation. 79% of the patients delivered prior to 36 weeks of gestation, over 50% prior to 34 weeks gestation. The total incidence of RDS was 25%. Severe types of RDS (stage III and IV) were rare (7%). The mortality of RDS after betamethason treatment was 5.4%. After 32 weeks gestation the mortality from RDS was 0%. Severe types of RDS appear to occur more often in male than in female infants. The incidence of RDS was not lowered further by premature of the membranes. The lecithin/sphingomyelin(L/S)-ratio in the amniotic fluid following treatment with betamethason increased to over 2 in only 2/3 of the cases. The predictive value of the L/S ratio that respiratory distress syndrome of the newborn only occurs rarely with values over 2 was maintained after treatment with betamethason. Our rate in cases with an L/S ratio over 2 was 7.9%.

Amniotic Fluid↗
PubMed1984

Maternal perception of fetal movements and real-time ultrasound findings.

Two real-time ultrasound instruments were used simultaneously for comprehensive recording of "total" fetal motor activity in 50 patients in the second half of pregnancy. Synchronously, cardiotocographic findings and maternal perception of fetal movements were stored on magnetic tape. In most cases fetal "gross" movements were perceived by the mothers (mean: 63%). Isolated movements of fetal extremities were reported by the mother in only about 15% of all cases. Mothers registered a total of all movements in 37%. We found a statistically significant difference in the percentage of perceived fetal movements with regard to parity (p less than 0.001) and with regard to gestational age (p less than 0.01). With multiparity or an increasing gestational age the body movements of the fetuses were felt more accurately by the mothers. In 30% of all cases the mothers perceived movements without sonographic confirmation. The findings of this study suggest that maternal perception of major fetal body movements is accurate in the majority of cases. However, the relatively high rate of false positive maternal perception should be taken into consideration if the maternal record of daily fetal movements is to be used for fetal monitoring.

Female↗