[Subcutaneous mastectomy].
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Biomedical subjects
Publications and source records attributed to F Kubli.
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In 147 cases of mammary carcinoma, 388 serial mammographies were performed before final treatment. The average retrospective observation time was 27 months with a range of two months to 11 years. The number of serial mammographies per case ranged between two and 11. The tumor volume doubling times (TV); obtained by measuring the growth of the tumor nucleus shadow in the mammographies, ranged from 44 to 1869 days with an average of 212 days. No correlation between volume doubling time and histologic differentiation could be found. One hundred of these cancer patients were found in a screening population of 22,000 women receiving serial mammographies in a time period ranging from two to 16 years. An additional 40 cancer patients surfaced in this group without roentgenologic but with foregoing clinical or thermographic abnormalities before final diagnosis. An additional 21 cancer patients surfaced without any foregoing abnormalities. The follow-up tumor ranged between three months and two years with a mean time of one year and nine months. Not considering tumor size, pathologic-thermographic signs appeared with greater frequency the faster the tumor grew. Theoretically, an average of more than 16 years should elapse before an initial tumor cell develops into a 10-mm primary mammary carcinoma (30 doubling times). Therefore the length of time necessary for a 2-mm tumor to grow to a size of 10-mm is, on the average, four years.
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From 1974-1978, 101 women in the fifth decade of life were delivered. The course of the pregnancy was more often complicated by pre-eclampsia. Premature and dysmature deliveries were not more common than in younger women. The sex ratio was more in favor of females than usual. Despite shorter duration of labor and delivery the Apgar ratings at 1 and 5 minutes were less favorable in the new borns of older pregnant women. The infants required more often intubation and transfer to the pediatric hospital. The perinatal mortality was 4.2%. Down syndrome occured in 4.2% of the infants and abnormalities occured in 4.9%. Routine genetic amniocentesis and intensive pregnantal care should lower the fetal morbidity and mortality in these cases. Urinary total estrogen determinations are proposed as a parameter for the monitoring of the these risk cases besided ultra-sound and fetal monitoring.
The results of 1,000 transabdominal amniocenteses between 15 and 20 weeks gestation are reported. The method is described. The bio-chemical and cytogenetic results are reported. - Amniocentesis in the first trimester is not a routine investigation since fetal and maternal risks are associated with this procedure. The risk of abortion following amniocentesis was lowered from 6/1000 to 2/500 by improvement of the technique under ultra-sound control. The worst maternal complication observed was a septic abortion one day after amniocentesis. 96% of all cyto-genetic examinations showed normal karotypes. The largest group at risk were mothers over 35 years of age. In this group chromosome anomalies were found in 17 cases. All neural tube defects were found by determination of the alpha-fetoprotein in the amniotic fluid. 26 terminations of pregnancy for fetal indications were carried out. Two patients refused therapeutic abortions despite trisomy 21 for ethical reasons. One patient continues her pregnancy with a 47 XYZ pregnancy.
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