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Biomedical subjects

G Bastert

Publications and source records attributed to G Bastert.

At least 217 records · Page 12Linked to original sources
PubMed1990

[The extent of radical axillary lymph node excision].

A study on histological findings in 1047 patients who underwent total axillary lymph node dissection (topographical levels I-III), was conducted. A mean of 20.3 lymph nodes (LN) was assessed; LN metastases were detected in 492 cases. Retrospective analysis showed that, by mere dissection of LNs level I, 10 of the 492 nodal positive cases (2.0%) would have been classified false negative. Additionally, according to the number of positive LNs detected in stage I, 85 of the 492 patients (17%) would have been assigned to a group with a better prognosis (prognostic groups 1-3, 4-9, greater than or equal to 10 pos. LNs). By mere dissection of LNs levels I and II, only 1 of 492 (0.2%) patients would have been categorized false negative and only 24 patients (5%) would have been included in a group with a better prognosis, on the basis of the number of positive LNs dissected. Thus dissection of LNs stages I and II provides sufficient prognostic information. Since, however, in 145 nodal positive cases (14% of the entire collective e.g. 29.5% of all patients with positive lymph nodes), metastases were detected in level III, these LNs should be removed as well, in order to prevent axillary recurrences. One could only dispense with dissection of level III, if LN metastases levels I and II could be excluded during the operation.

Axilla↗
PubMed1990

[Therapy of ascites with tumor necrosis factor in ovarian cancer].

The biotechnological production of human recombinant tumour necrosis factor (rHuTNF) makes this drug available for clinical application. This endogenous compound exhibits tumouricidal activity and regulatory functions within the immune system. 20 out of 23 (87%) patients with refractory recurrent malignant ascites from ovarian cancer were successfully treated in a phase-I and II-study. The production of ascites was either completely suppressed or reduced to a minimum for at least 4 weeks after maximally three intraperitoneal (i.p.) applications. Two of the three non-responders were mucinous carcinomas. In the phase-I study the evaluation of a maximal tolerable dose was not possible due to the rapid therapeutic success at low doses of TNF. The effective dosage was 0.08-0.14 mg TNF/m2 given i.p. Side effects which occurred 2 to 24 hours after the application of TNF were flue-like symptoms combined with general malaise. The side effects were not dose related. All concomitant signs and symptoms could be minimized by prophylactic or therapeutic application of indometacine, paracetamol or pethidine. This applied especially for the typical early phase cytokine side effects e.g. chills and febrile temperatures. The side effects were not dose related. The i.p. treatment with rHuTNF appears to be a novel practicable and effective method for palliation in patients with recurrent ascites even in multiple pretreated patients.

Adenocarcinoma, Mucinous↗
PubMed1990

[The prognostic significance of tumor cell detection in bone marrow of patients with breast cancer].

In 95% of patients with primary breast cancer, the extent of metastases cannot be proven by conventional methods. Nevertheless, more than 50% of these patients have a relapse within five years. To improve the predictive value for recurrency, we examined bone marrow aspirates of 128 patients with primary breast cancer. Bone marrow aspirates from 2-6 sites of the skeleton (iliac crest and sternum) were taken as well as biopsies for histological examination. The immunohistochemical studies were carried out on interphase smears and stained with cytoceratin antibodies (PKK 1) and antibodies against tumor-specific antigen TAG 12 (12 H 12). All patients were screened for distant metastases (X-ray, ultrasound, bone scan). Tumor cells and micrometastases in bone marrow were detected in 41 patients (32%). Their presence was correlated to other prognostic factors (tumor size, lymph node status, oestrogen/progesterone receptors). The median duration of follow-up was 39.5 months. 14 patients (45%) in the tumor cell positive group relapsed, compared to only 4 out of 36 patients in the tumor cell negative group. In 29% we found bone metastases. The relapse free interval was shorter for patients with micrometastases (8 vs. 15.8 months). The presence of tumor cells in bone marrow aspirates detected at the time of primary surgery, is a useful prognostic factor and a good predictor of metastases and may help in selecting patients for systemic adjuvant treatment.

Antibodies, Monoclonal↗
PubMed1990

[Sterility therapy of women in the course of time].

In all eras and cultures infertility has been regarded as one of the worst female diseases. Consequently, infertility investigation has always been one of the central diagnostic and therapeutic problems in medicine. We have attempted a summary of the tremendous evolution of infertility investigation and therapy, culminating in the modern concept of investigation and therapy of the infertile couple as a unit.

Female↗
PubMed1990

Laser surgery in gynecological oncology. Part I: Experimental results. Relapse and metastatic behaviour of the Lewis lung carcinoma subsequent to CO2 laser surgery of the primary tumor. An experimental model to compare the effectiveness of various CO2 laser application techniques.

The influence of various CO2 laser surgical techniques on tumor behaviour was examined in an experimental model on C56BL/6 mice (n = 106) with Lewis Lung carcinomas and compared with that of scalpel excised tumors. Comparisons were made between the healing procedure, the local recurrence rate, metastatic behaviour and the survival rate (n = 86) of mice after laser surgical excision of tumors, using the superpulsed and continuous wave techniques, with and without additional vaporisation of the wound, as well as after general vaporisation only.

Animals↗
PubMed1989

Human monoclonal antibodies directed against ovarian carcinoma.

In order to obtain human monoclonal antibodies for immunodetection or treatment of ovarian carcinoma, we generated hybridomas by fusing peripheral blood lymphocytes of patients with ovarian carcinoma and the mouse myeloma cell line X63.Ag8.653. The patients were immunized prior to collection of peripheral blood lymphocytes with autologous tumor cells admixed with New Castle Disease Virus. Immunocytologic studies of hybridoma supernatant with tumor cells fixed with methanol and air-dried tumor cells indicated that all 14 antibodies reactive with tumor cells were directed against cytoplasmic or nuclear antigens. One hybridoma designated as 1B3 was very stable and secreted a specific IgM antibody. This cell line expanded in nude mice and the monoclonal antibody 1B3 was effectively purified from ascites or supernatant fluid. In experiments with tissue sections partly derived from the patient whose peripheral blood lymphocytes were used for fusion, biotinylated 1B3 recognized ovarian tumor cells. There was no significant cross-reaction against normal tissue from stomach, small intestine, colon, lung, kidney, endometrium, placenta, or lymph node. Mammary carcinoma preparations were also stained by 1B3 while normal breast tissue was negative.

Animals↗
PubMed1989

[Initial experiences with a monoclonal antibody to the progesterone receptor complex].

Today, the immuncytochemical demonstration of estrogen receptors can be regarded as established. Recently, a monoclonal antibody (mab) against the progesterone receptor-complex became commercially available. The antibody Mi 60-10, developed by Milgrom and co-workers, is murine and principally directed against the progesterone receptor of the rabbit, but it also attacks an "epitop" of the human receptor. The Western-Blot analysis shows the antibody having several specific bands against T-47-D cells in the region of 110,000 dalton. To estimate the practical performance of this antibody, 73 primary breastcarcinomas were incubated with both the ER-ICA-Kit and the new "mab". The PAP method was used for visualisation. In a frozen section the mab Mi 60-10 proved as successful as the ER-ICA-Kit. However, in contrast to the ER-ICA-Kit, the mab Mi 60-10 is also successful in locating the receptor, also in formalin-fixed samples embedded in paraffin. This is also the case with blocks, which were stored for several years. In aspirated cytological samples the immunocytochemical demonstration of progesterone was just as successful as that of estrogen and comparable with results on the histological section. A satisfactory validity can be obtained today through the development of highly specific monoclonal antibodies against the progesterone receptor complex, with the complete receptor diagnosis of mammary carcinoma both immunocytochemically in frozen sections and additionally, of progesterone receptors in paraffin wax sections. The only current problems involve the exact quantification of the immunocytochemical results. It is predictable today, that the DCC-method, when compared to the immunocytochemical receptor analysis, will reduce in significance.

Antibodies, Monoclonal↗
PubMed1989

[Epithelial growth factor receptors (EGF-R) and DNA flow cytometry in addition to lymph node and hormone receptor status as prognostic factors in primary breast cancer].

The presence of receptors for epidermal growth factor (EGF-R), the percentage of cells in S-phase and DNA-ploidy measured by flow-cytometry are new prognostic factors in breast cancer. In order to investigate the relationship between EGF-R, S-Phase/DNA-ploidy and clinical data, we measured these parameters in 68 tumors from patients with operable breast cancer. 11 Patients had positive EGF-R's (specific binding greater than 10 fmol/mg membrane-protein) and 37 patients had a positive S-Phase (more than 5% of cells in S-Phase). 10 of 44 carcinomas of ductal type were EGF-R positive, while only 1 of 18 lobular-type tumor displayed positive EGF-R's. We found significant inverse correlations between EGF-R's and estrogen receptors (p less than 0.00001) and between EGF-R's and age (p less than 0.0001): EGF-R positive tumors were found more often in young patients and in patients with estrogen-receptor-negative tumors. The EGF-R's and flow-cytometric data did not correlate with tumor size and/or nodal status. There was no correlation between EGF-R and S-Phase/DNA-ploidy in the breast cancer specimens suggesting that these two prognostic parameters are independent from each other.

Biopsy↗
PubMed1989

[The nuclear surface area as a malignancy parameter in breast cancer].

For better characterisation of the degree of malignancy of breast cancers, we have attempted to establish a correlation between nuclear size and prognosis in breast cancer. Karyometric investigations were carried out on biopsies from 200 primary breast cancers. On the basis of the nuclear areas determined, we were able to distinguish three groups of carcinomas: group I: carcinomas with small nuclear areas (n = 33), mean value 97.76 microns 2, group II: carcinomas with intermediate nuclear areas (n = 98), mean value of the nuclear areas 146.5 microns 2, group III: carcinomas with large nuclear areas (n = 69), mean value 190.8 microns 2. After five years, 6% of the patients in group I had died, as compared to 35% in group II and 48% in group III. The median survival time was 45 to 48 months in group I, as compared to 37 months in group II and 28 months in group III. There was a direct correlation between axillary lymph node status and nuclear size: the carcinomas with the small nuclear sizes showed the least involvement. A comparison of the prognostic relevance of nodal status and nuclear area size, reveals a good relevance for the nuclear area similar to that of the nodal status. The results of the biopsy cytology are already available to the surgeon before the operation.

Biopsy↗
PubMed1989

[Marshall-Marchetti-Krantz operation with fibrin gluing. Results after 2 years].

Since broad experience concerning the stability of fibrin sealing is needed, it has become part of the routine program in orthopaedics and in traumatology. Because of these experiences, we decided to modify the standard Marshall-Marchetti-Krantz-Operation replacing all sutures on both sides of the urethra and the bladder neck by fibrin sealing. So far, 76 patients have been operated using to this new method. All patients had a urinary stress incontinence grade II-III, urodynamically verified and a pronounced urethro-cystocele. To judge the results of the operation the following check-ups were instituted: 1. Urodynamic control, 2. lateral cyst-urethrogram, 3. gynecological examination (anatomical control), 4. subjective, individual evaluation of the patient concerning the involuntary loss of urine. Our study shows that we achieved good surgical and functional results as can be demonstrated both clinically and by urodynamic check-up. The advantage of this method of operation using fibrin sealing is to be seen in the broad lifting up of the anterior vaginal wall without unphysiological fixation and at the same time avoiding all risks of sutures.

Aprotinin↗
PubMed1989

[Evaluating the cervix in pregnancy using vaginal sonography. Studies of cervix insufficiency].

Transvaginal ultrasound provides important detailed information, which cannot be obtained by routine manual vaginal examination. By measuring the outside-inside distance (from os externum to os internum), we can determine the actual length of the cervix. By depicting the cervical canal, we can identify early dilatation. Visualizing the os internum with a possible opening, forming a conus, helps reveal an incompetent cervix. A total of 485 measurements of the cervix was carried out. Fifty patients with normal clinical findings between 28 and 32 weeks of pregnancy were compared to the same number of patients in the 28th to 32nd week of pregnancy, with the clinical diagnosis of an incompetent cervix. A cervical length of 46.3-39.3 mm was found in normal pregnancies, and a length of 34.0-21.4, when a clinically incompetent cervix had been diagnosed, a difference of 12.3-17.9 mm.

Cervix Uteri↗
PubMed1989

[Application of the neodymium-Yag laser in treating adhesions].

The authors conducted an experimental study on the possibilities of application of the "in touch" technique for microsurgical adhesion resection with a Neodymium-Yag laser. It enables good hemostasis and is an alternative to the CO2 laser, the risk of causing vital organ lesions being reduced.

Animals↗
PubMed1989

Detrusor and compliance changes of the bladder after radical hysterectomy.

Disturbances of bladder function after radical hysterectomy are caused by the damage done to the pelvic nerves. Reduced radicality in cases of carcinoma cannot be discussed. In a prospective urodynamic study we checked bladder changes in patients with radical hysterectomy and compared them to those with incontinence operations. Shortly after operation compliance and detrusor function are severely reduced. After 6 months compliance is normalized, detrusor is still reduced, yet residual urine normal. The patient has learned to use abdominal pressure, thus providing a functional normality.

Female↗
PubMed1988

Identification of the human papillomavirus type 18 E6 and E6 proteins in nuclear protein fractions from human cervical carcinoma cells grown in the nude mouse or in vitro.

We recently reported the transcription patterns of human papillomavirus (HPV) type 18 sequences in human cervical carcinoma cell lines. The open reading frames (ORFs) E6* and E6 represent the 5'-terminal cistrons in HPV18 mRNAs. ORF E6* was assumed to be specific for HPV types associated with genital carcinomas. To identify the predicted gene product, ORF E6* from a HeLa cDNA clone was expressed as an MS2 fusion protein in Escherichia coli. The C-terminal 23 amino acid residues were chemically synthesized. A panel of monoclonal antibodies was generated, recognizing E6* and E6* plus E6, respectively. In human cervical carcinoma cell lines grown in vitro these monoclonal antibodies specifically immunoprecipitate the putative Mr 17,000 and 18,000 HPV18 E6 proteins in nuclear protein fractions. In a HPV18 DNA containing human cervical carcinoma established in nude mice, these monoclonal antibodies specifically immunoprecipitate a polypeptide with a molecular weight of 6500 as predicted for the HPV18 ORF E6* gene product in a nuclear protein fraction.

Animals↗
PubMed1988

[Tetralogy of Fallot following coumarin administration in early pregnancy--an embryopathy?].

A case report of a 35-year old woman is presented who continued a coumarin therapy unconscious of an early pregnancy up to day 61. At term she delivered a baby with tetralogy of Fallot, up to now not mentioned in the symptom complex of malformations due to a coumarin therapy. In the case presented the typical symptoms of a warfarin embryopathy including a chondrodysplasia punctata and other morphological changes were lacking. Although some cases of cardiac malformations have been reported in literature following coumarin therapy in early pregnancy, a causal connection could not be confirmed.

4-Hydroxycoumarins↗