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Biomedical subjects

G Kindermann

Publications and source records attributed to G Kindermann.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Serous papillary adenocarcinoma of the endometrium].

7 cases of serous-papillary adenocarcinoma of the endometrium (UPSC) were found in a retrospective study of 80 patients which were treated at the Department of Gynaecology of the University of Munich from August 1987 to December 1989 because of endometrial adenocarcinoma. Characteristic histologic findings and prognostic factors of the UPSC were examined by means of large scale sections of the completely worked-up uteri and compared with the usual adenocarcinoma of the endometrioid type (UEC). Despite only minimal myometrial infiltration in some cases, lymphangiosis carcinomatosa was almost always present (6/7) and more than 50% of patients showed evidence of blood vessel involvement. In all patients with pelvic lymph node dissection metastases were found. According to our results in line with the literature, UPSC is a highly malignant and morphologically distinct variant of endometrial adenocarcinoma without promising treatment to date.

Cystadenocarcinoma↗
PubMed1991

[Differentiated operative therapy of endometrial carcinomas].

The traditional surgical procedure to treat operable endometrial cancer is the removal of the uterus and both adnexa. In the trend of modern gynecological oncology this standardized operation should be changed in favour to a more individual procedure adapted to preoperative and intraoperative stage of the disease. A carefully fractioned curettage (of the cervix and the corpus uteri) is necessary to differ stage I (T1) and stage II (T2). Further important prognostic factors as myometrial invasion, nodal status, lymph vessel and blood vessel involvement and the intraabdominal findings (T3) are details of the post-surgical evaluation. A differentiated surgical treatment of the endometrial cancer includes for a stage I disease hysterectomy, bilateral adnectomy and pelvine lymphonodectomy. We recommend this additional procedure in all stages of the disease: The nodal status is for almost all genital cancers and breast cancer the most important prognostic factor. Postoperative adjuvent therapy (radiotherapy, hormonal therapy, chemotherapy) may be indicated by that. The surgical procedure for stage II (corpus and cervix involved) disease is a radical hysterectomy (Wertheim), bilateral adnectomy and pelvine lymphonodectomy. A paraaortal lymphonodectomy may be recommended, but most of the patients are 70 years and more and have a multimorbidity. Therefore, we indicated this additional procedure only in 7.5% of the operated patients. The surgical strategy in the (rare) stage III individual cancer is similar to the procedure in progressive ovarian cancer: Cytoreduction and debulking (e.g. omentum majus, peritoneum, involved bowel) has to be performed subsequent to hysterectomy, bilateral adnectomy and lymphonodectomy to improve the poor prognosis.

Endometrial Neoplasms↗
PubMed1990

Ile-Ser-bradykinin is an aberrant permeability factor in various human malignant effusions.

In this study we provide evidence for the presence of the aberrant peptide, Ile-Ser-bradykinin, in various human malignant exudates. The peptide was detected by deproteinisation of the effusion, application to reversed-phase HPLC, collection of the fractions containing Ile-Ser-bradykinin (retention time 6.90 min), degradation with carboxypeptidase B, and rechromatography of the resulting des-Arg-Ile-Ser-bradykinin (des-Arg-ISB) (retention time 13.5 min). In addition, all positive samples were confirmed by amino acid analysis and most of them (7/8) by amino-acid sequencing. In malignant effusions from 8 patients out of a group of 113 patients, Ile-Ser-bradykinin was found in concentrations between 12 and 520 mumol. In 44 malignant effusions, Ile-Ser-bradykinin was suspected, but could not be confirmed by the required additional methods (amino-acid analysis, sequencing) because of its low concentration. Sixty eight benign effusions were negative for Ile-Ser-bradykinin.

Amino Acid Sequence↗
PubMed1988

Postoperative urological complications after radical surgery for cervical cancer.

Functional disorders of the lower urinary tract must be considered inevitable after Wertheim hysterectomy. These disorders include disturbances of the collecting phase as well as of the voiding phase of the bladder, and the development of urinary stress-incontinence. Urodynamic studies are necessary to find out more about the pathophysiology of these disorders. The results of our follow-up studies confirm that during the early postoperative phase patients do not feel the urge to void, and, after micturition, have no idea whether or not the bladder is empty. Micturition itself becomes difficult. At a later stage, sensitivity in respect of the bladder contents is regained. Some months later the incidence of urinary stress-incontinence rises markedly. The dysfunction is due partly to direct trauma of the bladder and urethra. As a reason for the long-lasting fall in urethral closure pressure, combined with urinary stress-incontinence, some damage to the pelvic nerves must be assumed. Disorders of micturition have been poorly investigated. It is only during the postoperative phase that functional infravesical obstruction must be assumed. At a later stage micturition mostly becomes normal. In contrast to the results of others (Schüssler, 1988) the results of our studies confirm that these disorders are due not only to nerve lesions. Disorders of the collecting phase as well as of the voiding phase of the bladder are mostly transient. As a consequence we suggest that the direct operative trauma, with oedema, haematoma and scar formation, is responsible for bladder dysfunctions during the early postoperative stage at least.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1986

[Breast saving cancer surgery. Results of a long-term study (Berlin study, 1963-1982)].

Between 1963 and 1982, 1,139 patients underwent surgery for unilateral mammary malignoma at the Charlottenburg Gynaecological Clinic of the Free University Berlin. Primary therapy consisted of simple mastectomy in 948 cases and tumourectomy/quadrantectomy with subsequent radiotherapy (40 Gy) in 191 cases. We performed a retrospective analysis of "matched samples" of tumourectomy/quadrantectomy and mastectomy. The observation period of both groups spans a minimum of one year to a maximum of 20 years after primary operation. In pT1- and pT2-tumours the overall survival after tumourectomy/quadrantectomy at 5, 10 and 15 years was no worse than after total breast removal. The results of our long-term follow-up study lead us to conclude that tumourectomy/quadrantectomy and breast irradiation are suitable for primary treatment of mammary cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

A comparison between the results of simple mastectomy and tumorectomy for breast cancer: the problem of local recurrence.

Between 1963 and 1981, 1139 patients had surgery for unilateral breast cancer at the Charlottenburg Gynaecological Clinic of the Free University Berlin. A total of 948 patients had a simple mastectomy and 191 patients had an extended tumorectomy (or lumpectomy) with subsequent radiotherapy (40 Gy). Retrospective analysis of "matched cases" treated by tumorectomy or mastectomy showed the rate of local recurrence after tumorectomy to be nearly double that after simple mastectomy (8.7% after tumorectomy, 4.7% after mastectomy). Life expectancy with a local recurrence after conservative surgery, was however, better than that after simple mastectomy.

Berlin↗
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↗