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Biomedical subjects

F Kubli

Publications and source records attributed to F Kubli.

At least 145 records · Page 8Linked to original sources
PubMed1976

[Improvement of gynecologic radium therapy through the afterloading method using cesium 137].

For all centers performing gynecological contact irradiation the use of afterloading techniques is urgently required, since they eliminate any radiation exposure to the personnel. The radio-therapist may position and control the empty applicators still free from radiation withoug haste. This procedure diminishes the occurrence of overdosages and underdosages. The care for the patients is possible without radiation exposure, and the morbidity of contact therapy can be reduced by occasional mobilization of the patient, the applicator without sources remaining at its place. The fully automatic apparatus "Curietron" using cesium-137 sources (0.662 MeV gamma emission, half-life period 26.6 years) with an equivalent source activity (factor 2.6) yields the dose distribution demanded in the gynecologic field which in practice is identical to that of Ra-226 (medium gamma emission 1 MeV, half-life period 1620 years). With similar dose distribution, a biological and therapeutical effect alike to Ra-226 may be expected from Cs-137. In comparison with Ra-226, the following advantages of Cs-137 may be mentioned: Lower half-value thickness of 5.5 mm lead (low expenses for radioprotection), less danger with handling (no emanation of radioactive gases), and lower contamination risks in case of breaking. The measured dose distributions at equivalent source activity and similar geometry of the applicators revealed the possibility with regard of all techniques of gynecologic irradiation utilized in our field of arriving at similar relative and absolute dose distributions by means of the Cs-137 afterloading technique. Whilst short-term afterloading irradiation with highly active sources, their radiobiological effectiveness being not yet ascertained, has to be tested at appropriate scientific centers, it is necessary to demand afterloading techniques with dosages and duration of irradiations approved over decades for all centers of gynecological contact therapy because of radiation protection.

Cesium Radioisotopes↗
PubMed1976

[Growth velocity of breast carcinoma and radiographic "early diagnoses"].

Between 1960 and 1975, 53 mammary carcinomas have been observed in a collective of 15000 women a part of whom, comprising finally 80 per cent, was free from troubles (annual prophylactic examination for breast cancer). Of these 53 cases were available two up to eleven preceding mammographic series made within an observation period of 0.2 to eleven years. A "mean growth curve" was obtained empirically, based on 163 mammographic tumor measurements with tumor sizes between 2 mm and 60 mm. In the course of a development period between two and eleven years, 33 per cent of the carcinomas were seen to accelerate their further growth in comparison with the initial value; 66 per cent revealed an increasing slow-down of growth, and all tumors showed considerable changes in their growth rates. Mammary carcinomas altogether continually decelerated their growth as measured by the duplication time of the tumor volume from Tv = 309 days on the average up to an average of Tv = 381 days after two through eleven years. The mean growth curve exhibited an exponential shape which was completed by biomathematical methods and can be described by means of a Power function. It corresponds well to the rate of incidence of the mammary carcinoma which shows an identical rise in relation to increased old age. The medium growth time from a primary cancerous cell with ten micron in size up to the tumor 2 mm in diameter may be estimated biomathematically only and amounts to ten or twenty years with 23 duplication periods. The further average growth rate between the tumor sizes of two and ten millimeter, stages which can be diagnosed roentgenologically, was empirically six years; the most quickly growing tumor needed almost two years. For the purpose of early cancer detection (tumor size below 10 mm, lymph nodes histologically free from metastases), the serial mammography to be performed every 18 months or two years is the only technique which provides utilizable early recognition marks and besides does allow a simple judgement. Solely the symptoms "suspect desification, partly spiculated" in sixty per cent and "typical cancerous microcalcification" in forty per cent have been observed as the earliest signs. The reliability ("certainty") of mammography is frequently overestimated (false negative rate: 7 to 18%) and should be quoted only for collectives where control mammographies have been made over a period of five or ten years. Roentgenological controls of alterations below three millimeter in size and without an indication for biopsy ought to be performed within six months, and still sooner in case of larger alterations. It is not possible earlier than after five or ten years to judge of the radicality of a therapy, as spread cancerous cells, on he average, reveal similar growth rates as does the primary tumor.

Adult↗
PubMed1976

[The pattern of distribution of free amino acids in human amniotic fluid related to the duration of pregnancy. Part I: Changes in concentration in normal pregnancy (author's transl)].

Gas-chromatographic measurement of 18 free amino-acids from about 500 specimens of amniotic fluid between the 10th and 41st week of pregnancy. Statistical methods showed different concentrations of amino-acids in amniotic fluid during pregnancy. Serine, cysteine, methionine and tryptophane show constant concentration. Valine tyrosine and hydroxyproline continuously decrease. The other amino acids tested here show a biphasic course of concentration, falling by about 40-70% between the 10th and the 30th week after which they remain stable. Alanin, threonine, glycine and ornithine show a clear increase of concentration. This diversity of concentration of amino-acids during pregnancy hints at the importance of various factors for the composition of amniotic fluid.

Alanine↗
PubMed1975

[Organic changes and pain after laparoscopic tubal sterilization].

In 100 women who underwent laparoscopic sterilization approximately one year before a follow-up check including gynecological examination, a structurized interview and a "Maudsley Personality Inventory" (MPI) test were performed. 6% complained about algopareunia before the operation which did not disappear afterwards. In 8 patients algopareunia started after the operation, only 2 of them presenting pelvic adhesions at control, whereas 6 patients suffered from psychogenic algopareunia. Neurotic tendency was evidently elevated in all those patients complaining about pelvic pain before and after operation. 6 patients had pelvipathia nervosa, 14 showed organic alterations, but these were not necessarily the reason for the complaints. Laparoscopy revealed pathologic processes e.g. adhesions, pelvic varicosis or adnexitis in 27%, but not more than 11% of these patients with obvious pathology had subjective complaints. These findings underline the fact that pathologic alterations will not necessarily explain pelvic pains and that in most cases psychosomatic factors must be taken into consideration.

Dyspareunia↗
PubMed1975

Significance of amniotic fluid phospholipid determination for the prediction of neonatal respiratory distress syndrome.

198 amniotic fluid samples, obtained from 14-42 weeks of 158 patients were assessed for amniotic fluid phospholipids (total phospholipids, lecithin, sphingomyelin, lecithin/sphingomyelin ratio). The TPLP and Lec-concentrations show significant rises in concentration after 34th week whereas the sphingomyelin concentration remains virtually constant during pregnancy. L/S ratio remains relatively constant smaller than or equal to 2 prior to 32 weeks and smaller than or equal to 3 between 32 and 34 weeks but shows then a steep rise. The amount of Lec (expressed as percentage of total phospholipid concentration) rises from 30-40% at 30 weeks to 70-80% at term whereas the amount of Sph declines from 30-40% to less than 10%. In 12 cases neonatal RDS occurred. With L/S ratio treshold values of 3 correct prediction of RDS was made in 83% of cases, whereas probability of RDS occurrence was 63%. With L/S ratio values greater 3 RDS can be excluded in 95% of cases. The corresponding figures for Lec and TPLP concentration are described too. The range of different results in the literature is discussed.

Amniocentesis↗
PubMed1975

[The amniotic infection syndrome and premature rupture of the amnion. Manifest and threatening unspecific intra-uterine infections of the last third of pregnancy (author's transl)].

In the last third of pregnancy the unspecific bacterial diseases of placenta, umbilical cord and membranes differ from those in earlier months [154; 155; 85]. There is a parallel change in the localization of fetal organs affected. Pathologic anatomical clarification of this led to the conceptual definition of the rare extra-amnial placental-fetal path of infection on the one hand and of primary intra-amnial infection with secondary chorion-amnionitis on the other hand and to identification of the amniotic infection syndrome as a typical entity at the end of pregnancy [19]. While the amnionic sac is closed, unspecific fetal inflammation is rare. Generally this happens only after rupture of the membranes. Since the amniotic infection syndrome often produces only minor clinical symptoms and since fetal infection probably starts early, one searched for means of assessing the risk of infection independently from symptoms. In comparative series of investigations of pregnancies with and without premature rupture of the membranes, cases of neonatal death from infection were preceded by signs of inflammation in placenta, umbilical cord and membranes. Together with the fetal and maternal infections they depended on the length of time between rupture and the onset of labor. pns. The data now available give a clear picture of the development of the inflammatory processes in mature and premature children and suffice for the assessment of fetal and maternal risks.

Abortion, Septic↗
PubMed1975

[Frequency and distribution of breech presentation during pregnancy and labor (authors transl)].

On 975 pregnant women treated and delivered during 1973 at the Heidelberg University department of obstetrics 3780 ultrasound examinations were carried out. The frequency of breech presentation related to the duration of pregnancy and the likelyhood of breech presentation at term were calculated. Breech presentation can be seen as physiologic in 70% of early pregnancies. After the 33rd week it is below 10%, after the 38th week 4%. The probability of breech presentation at term at nay given stage before the 30th week is below 10%. After de 31st week this rises steeply up to a maximum of 66% after the 37th week. These influences of parity on these 2 data are described. The relationship between a low placenta and breech presentation is mentioned. These results are discussed.

Breech Presentation↗
PubMed1975

[Differences in concentration of free amino-acids in fetal and maternal compartments at the end of normal and pathologic pregnancies (author's transl)].

Free amino-acids in the fetal and maternal compartments towards the end of normal and pathologic pregnancies were examined with gas chromatography. Blood was obtained from the cubital and uterine veins and the femoral artery of the mother, from the umbilical artery and vein and the amniotic fluid during Caesarean section. There were only minor differences of concentration of free amino-acid between normal and pathologic pregnancies. Since it is possible in principle that there is mutual balance between maternal and fetal compartments, assessment of changes in amino-acid concentration during dia- and paraplacentar exchanges is usable only with reservations.

Amino Acids↗