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Biomedical subjects

G Kindermann

Publications and source records attributed to G Kindermann.

At least 19 recordsLinked to original sources
PubMed1979

[Hepatitis-B-surface antigen and panarteritis (author's transl)].

A case of an acutely beginning histologically proved panarteritis is described which was initiated by hepatitis B caused by blood transfusions. After one year of steroid therapy the arteritis was no longer seen histologically, Australia-antigen became negative. Terminally the patient developed an apoplexy, renewed gastric bleeding, septicemia with obstructive jaundice, nose bleeding, increasing renal insufficiency, and cardiac failure. The Australia-antigen reappeared in the serum. It could be assumed that the panarteritis had progressed. Immune complexes of Australia-antigen and corresponding antibodies which are deposited in the vascular wall and cause an inflammatory reaction, are being held responsible for the panateritis. They were proved serologically and by immunofluorescence in the vascular wall. In cases of panarteritis of unknown origin Australia-antigen can be found in a high percentage, as was demonstrated by a second case.

Adult↗
PubMed1979

Early detection of ductal breast cancer: the diagnostic procedure for grouped microcalcifications.

Mammography and xeroradiography for grouped microcalcifications are considered the most effective diagnostic methods to detect occult breast carcinoma. Radiography must direct the surgeon to excise the nonpalpable area. The removal of the tissue with grouped microcalcifications must be confirmed by intraoperative radiological control. The histologic preparation must be guided by radiographic controls. Tissue with calcific deposits is examined by step sections. The diagnostic success depends upon the cooperation between the radiologist, the surgeon, and the pathologist. Our results from 1964 to 1977 have shown a frequency of 14.4% of occult carcinoma. Ductal or lobular carcinomata in situ have been diagnosed in 8.9%. In 9.9% of the patients, cystic disease with severe and atypical proliferations has been encountered.

Biopsy↗
PubMed1979

Early detection of ductal breast cancer: the diagnostic procedure for pathological discharge from the nipple.

Pathologic discharge from the nipple may be the only symptom of an early stage of carcinoma. Galactography is then the diagnostic method of choice to locate intraductal, nonpalpable lesions. The technique of galactography, the adequate surgical approach of pathologic galactographs (milk-duct segment resection), and the appropriate histological work-up of the surgical specimen are demonstrated. We report on 1918 galactographies in 1363 women with pathological discharge. In only 427 cases was a milk duct segment resection necessary (31.4%). In 8.5%, we found invasive intraductal cancer and in 2.9% ductal carcinomata in situ. Only 1 patient with breast cancer had axillary metastases. Extensive intraductal solid, papillary or adenomatous proliferations were found in 11.9% of the patients with excision. In 46.7% of the patients, papillomas were excised, a definitive treatment for this process. The supposition for success in the early diagnosis of cancer is close teamwork among the radiology, surgery and pathology services: the diagnostic result depends upon this. We attribute our yield of exact diagnosis to a very sophisticated histological work-up. We believe that this is necessary to avoid diagnostic failures.

Biopsy↗
PubMed1979

[The ramining cervical stump (author's transl)].

The subtotal hysterectomy is no longer indicated for the treatment of female genital disease with rare exceptions. It has been known for a long time that the remaining cervical stump has very few advantages but many potential risks. Among our patients who had cervical stumps removed 32 of 69 cases had malignant changes in the cervical stump. Decensus and prolapse was the next common abnormality. If adnexal tumors or cervical cancers do not indicate an abdominal approach for the removal, the vaginal approach for the removal of the cervical stump ist preferred since this is easier and less risky.

Adult↗
PubMed1979

[Early diagnosis of cancer in operative gynaecology. II. On the general effects of preventive cancer examinations on operative gynaecology (author's transl].

Beyond early diagnosis of cancer and treatment of cancer the increase of gynaecological operation is primarily due to a liberalization of the indications. That more women have gynaecologic disease in the framework of the classical indications than before cannot be substantiated. The causes of the changes in indications are outlined. Demands of patients as consumers on a new expansive medical care system are among the changes. Self interests of the Obstetricians and Gynaecologists who constitute a larger percentage of medical specialists at present are part of the reason. The principle of preventive examinations has a psychological impact and the practice of the preventive examinations has an administrative impact on the increasing number of gynaecological operations. This trend is discussed with the example of hysterectomy. The experience of other countries is mentioned in which the advantages and disadvantages of an increasing number of gynaecological operations is analyzed and in which a regulation is attempted to prevented escalating costs. It can be assumed that a similar analysis and regulation will become necessary in Germany.

Female↗
PubMed1978

[The value of an exploration of the mesogastric and epigastric regions in laparotomies (author's transl)].

The records of 4765 laparotmies including 1422 Caesarean sections were reviewed regarding additional surgical or medical findings. In 13.79% of the cases additional pathological findings were present which required additional general surgery or urologic surgery, or intra-operative or post-operative diagnostic steps. The exploration of the general abdominal cavity by inspection and/or palpation during the gynaecological or obstetric laparotomies was therefore very valuable. This simple preventive step requires very little time and maybe of considerable importance for the patient.

Abdomen↗
PubMed1977

[Benign cutaneous lymphadenosis (Bäfverstedt's disease) of the nipple (author's transl)].

Benign circumscribed cutaneous lymphadenosis of the areola of the nipple (Bäfverstedt's disease) occurs in children and adults. We observed 11 cases: 3 men, 3 children and 6 women. The areola undergoes rapid swelling and becomes red. At times the nipple itself is included. Unilateral enlargment and distortion of the nipple area becomes apparent. Sometimes this is associated with a tumor-like infiltration of the retro-mammillary tissue. In Contradistinction to Pagets disease of the nipple and to a mammillary adenoma there is no eczema and no ulceration. The clinical features and the typical pruritic course establish the diagnosis. Healing is spontaneous, but protracted. The aetiology is probably of an inflammatory nature. Treatment with short courses of antibiotics and anti-inflammatory agents resulted in a faster reduction of the cutaneous signs and corroborated the clinical diagnosis. We consider surgical treatment as unnecessary because circumscript benign lymphadenosis of the nipple area has a harmless course.

Adolescent↗
PubMed1977

[Extreme oedema of the ovaries: a contribution to conservative surgery for ovarian "tumours" (author's transl)].

A laparotomy for a suspected cystic ovarian tumour which was thought to extent as far as the costal arch, was carried out on a 24-year-old patient with a long history of oligomenorrhea and sterility. Due to excessive oedema, both ovaries were tremendously enlarged. The right ovary was twisted 360 degrees. No haemorrhagic infarct, however, was present. Both ovaries, which were about 40% of the normal size due to pressure from the oedema, were incized. The ovaries were than sutured and left in situ. Laparoscopy 9 weeks later confirmed that the ovaries had returned to a normal size. The patient's menstrual cycle became regular. Even though the process may be unusually extensive, conservative methods should be given preference when the patient is so young.

Adult↗
PubMed1976

[Microcalcifications on the mammaogram, surgical clarification and histologic findings. Concerning the problem of the diagnosis of occult carcinoma of the breast (author's transl)].

Microcalcifications on the mammogram could be an important indication for an occult carcinoma. Up until 31 December 1976, we intentionally removed such grouped microcalcifications 218 times in a group of 17,523 examined females (32,245 mammographs). The selection was confirmed radiologically. The acquired material was then examined histologically via an complicated technique. We found 35 carcinomas and 89 proliferating mastopathies of which 34 required at least strict supervision and sometimes additional treatment. - With strict indications, one-third of the previously clarified cases revealed disorders requiring treatment. In over one-half of the cases, the films indicated nothing of a serious nature. It must, however, be noted that an existing cancer is not always discovered in spite of the intentional excision of microcalcifications. This only serves as an indirect indication.

Biopsy↗
PubMed1976

[Pathologic discharge from the breast. Galactography and histologic clarification (author's transl)].

Up until 31 December 1975, 1646 galactograms were made in 1150 female patients. The intentional segment resection and then the histologic preparation via complicated technique adapted to the excision was conducted 371 times. - In 99 out of 100 cases, an anatomic substrate could be found for the discharge. We were unable to discover any pathological finding to explain the discharge in only 3 cases (0.8%). Included in the benign processes were 170 cases of duct papillomas (45.8%). In these cases segment resection is also adequate therapy. - Approximately 8% of the excisions revealed cancer. In additional 12%, serious proliferative processes in the breast were found which should, at least, be kept under careful clinical supervision. - Galactography used in combination with an adapted surgical and histologic technique to diagnose not only a carcinoma which has evaded other methods of detection but also possible preliminary stages is a valuable procedure.

Breast↗
PubMed1976

[Does oral contraception cause cancer? (author's transl)].

A complete answer to the question of the relationship between malignant tumors in man and the administration of contraceptive steroids is at present not possible. Difficulties of the investigation are caused by the multiplicity of compounds used for contraception, the generally slow development of malignant tumors and the difficulty of the epidemiologic and statistical investigations on the multi-factorial etiology of cancer. Nevertheless, it can be stated with a high degree of certainty that "cancer due to the pill" does not exist in man and that a direct hormonal induction of malignant tumors in man cannot be proved. The question whether oral contraceptives may favor the development of cancer indirectly is explored in this paper regarding cancer of the female genital tract and the breast. No correlation between oral contraception and squamous cell carcinomas of the vulva and vagina and tumors of the ovary is known. As yet no statistics are available on the incidence of carcinoma of the endometrium in women who took oral contraceptives during their reproductive life span. Because of the direct hormonal suppression of the endometrial growth by oral contraception, a protective effect against endometrial hyperplasia and endometrial cancer must be expected. For cancer of the female breast no protective and no enhancing cancer risk due to progestational agents can be postulated. The known fragmentary data suggest a more protective value. Regarding dysplasia and carcinoma in situ of the uterine cervix large investigations in high numbers of patients are available. An increase of the risk to develop cancer of the cervix by using oral contraception cannot be shown with sufficient accuracy at our present state of knowledge by statistical means. Some observations suggest that oral contraception increases the relevant exogenous factors for carcinogenesis of the uterine cervix such as sexual behavior and hygiene.

Breast Neoplasms↗
PubMed1975

Laparoscopic ovarian biopsy in seventy-one amenorrhoeic patients.

During laparoscopy we performed 132 ovarian punch biopsies in seventy one amenorrhoeic patients. With increasing experience, laparoscopic ovarian biopsy is a valuable element in the examination of amenorrhoeic patients. Biopsy specimens with an edge length of 4-5 mm for surface and depth can be obtained during laparoscopy under general anaesthesia without any great risk or difficulty. When performed bilaterally, it provides a representative picture of the cellular structure and function of the ovaries and thus makes a contribution to the prognosis of a disturbance in the endocrine regulating-circuit of ovarian function. In addition, the ovarian biopsy provides information about the basic gonadotrophic situation of the patient as a longitudinal section. It should be included in the synopsis of all endocrine and genetic parameters of a patient, particularly in clinic in which the morphological substrate of disturbed functions and apparent diseases is still examined.

Adult↗