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G Schwesinger

Publications and source records attributed to G Schwesinger.

At least 19 recordsLinked to original sources
PubMed2005

Non-diagnosed pheochromocytoma as a cause of sudden death in a 49-year-old man: a case report with medico-legal implications.

Pheochromocytomas are known to be rare causes of sudden death. A 49-year-old man with a medical history of arterial hypertension and diabetes mellitus complained about nausea and malaise in the morning. During the day his condition deteriorated. He went to the emergency department, where he was given intravenous drugs against nausea and was sent home. On the way back, his condition deteriorated dramatically so that his wife drove back to the emergency room, where he collapsed and sustained cardiac arrest; resuscitation efforts were unsuccessful. Autopsy revealed a large tumour of the left adrenal gland. The strong suspicion of pheochromocytoma was confirmed by histology, immunohistochemistry and biochemical investigations. An acute hypertensive crisis, caused by the hitherto unknown pheochromocytoma was ascertained as the cause of death. The morphological findings are presented, the difficulty to diagnose pheochromocytoma and the medico-legal implications are discussed.

Adrenal Gland Neoplasms↗
PubMed2005

Juvenile papillomatosis (JP) of the female breast (Swiss Cheese Disease) -- role of breast ultrasonography.

This report summarises the imaging findings of juvenile papillomatosis (JP) in a 16-year-old woman. Sonographically, the lesion was oval, well defined, heterogeneous with multiple small, cystic spaces. Ultrasonography can be helpful in differentiating between JP and similar cystic lesions, fibroadenomas, phyllodes tumours, intracystic papillomas and carcinomas. A core needle biopsy is still needed to confirm the diagnosis. An open biopsy with excision of the lesion is mandatory, mere observation is inadequate because of insufficient knowledge about the direct relationship between JP and subsequent cancer.

Adolescent↗
PubMed2005

Papillary intracystic carcinoma of the female breast--role of ultrasonography.

We report on a 76-year-old patient with papillary intracystic breast carcinoma. Papillary intracystic carcinomas represent a rare entity. Among all malignant breast tumors, this lesion has an incidence of 0.5-2%. Palpation is not sufficient to distinguish benign from malignant findings. The same applies to mammography, unless the tumor infiltrates the cyst wall. The method of pneumocystography has become obsolete. Sonography is the preferred diagnostic modality to distinguish cystic from solid lesions and to differentiate simple cysts from cysts with intracystic growth. In this respect, Doppler and power Doppler sonography can be instrumental. It is feasible to obtain preoperative ultrasound guided FNAC or core biopsies of the cystic and solid components for cytological or histological verification. Complete excision of the cyst which should include the intracystic growth is considered the treatment of choice.

Aged↗
PubMed2005

Candidosis and aspergillosis as autopsy findings from 1994 to 2003.

We analysed the autopsy records of the Greifswald University Institute of Pathology (located in Eastern Germany) in respect of findings of candidosis and aspergillosis from 1994 to 2003. We also present eight immature aborted fetuses and premature infants with a mycosis. In a total of 2027 autopsies we found 164 cases of invasive candidosis and aspergillosis (8.1%) including a combination of both on four occasions. Other authors cited between 0.7 and 7.3%. In these 10 years in our material mycoses and in particular candidosis increased in spite of slightly decreased numbers of autopsies. The differences comparing the 5-years periods (1994-98 and 1999-2003) are highly significant for both mycoses and candidosis. They are not significant for aspergillosis. A similar relationship was observed in the distribution of mycotic organs and causative origin for candidosis alone. In the last 5 years the gastrointestinal and respiratory tracts, including the peritoneum, were more frequently infected by Candida. Non-haematological neoplasia and pneumonia as basic diseases more often appeared in cases of candidosis. All eight immature aborted fetuses and premature infants suffered from candidosis. The survey confirms the importance of autopsy as a tool for education and quality control in medical diagnostic and therapeutic activity in the field of mycoses, too.

Aborted Fetus↗
PubMed2004

Two cases of severe sepsis due to Vibrio vulnificus wound infection acquired in the Baltic Sea.

Two severe cases of Vibrio vulnificus wound infection with secondary septicemia occurred during 1 week in August 2003 on the German island of Usedom in the southwestern Baltic Sea. In both cases, pre-existing wounds were inoculated by wading in contaminated sea water. One of the patients died from septic multiorgan failure. To the best of our knowledge, this is the first fatality due to a V. vulnificus infection to have occurred in Germany. Microbiological analysis revealed high concentrations of V. vulnificus in sea water along the coastline, following a period when water temperature exceeded 20 degrees C for more than 2 weeks.

Female↗
PubMed2004

[Primary intracystic squamous cell cancer of female breast].

We report on a 45-year-old patient who presented with a 7 cm palpable right breast mass which had been classified as a cyst by ultrasonography. Multiple aspiration cytologies revealed no evidence of malignancy. Repeat sonography in our institution showed a lesion at 1 o'clock, 1 cm deep, and 3-8 cm from the nipple. The lesion contained a solitary cystic component measuring 3.9 x 4.1 x 4.4 cm. A 3.1 x 2.6 x 2.5 cm solid, inhomogeneous mass with irregular margins was found at the lateral border of the cyst. This mass raised suspicion of an intracystic carcinoma. Histopathologic analysis of 5 high-speed biopsy tissue cores demonstrated an invasive large-cell ductal carcinoma (G2-3). Final histopathologic assessment subsequent to breast-preserving resection and axillary node dissection confirmed the initial diagnosis: keratinizing intracystic squamous cell carcinoma (G2-3, pT2, pN0 (0/15)). The search for a remote primary squamous cell carcinoma included a chest X-ray, cystoscopy, colposcopy and PAP smear, esophago-gastroscopy, ENT consultation (laryngoscopy), and did not reveal any extramammary cancer. The postoperative management consisted of a total of 6 cycles of chemotherapy (Cisplatinum 75 mg/m (2) BSA and Paclitaxel 175 mg/m (2) BSA every 21 days) and subsequent percutaneous radiotherapy. In accordance with published reports, the diagnostic and therapeutic management was analogous to that of adenocarcinoma of the breast. However, some authors recommend the same chemotherapy as used for squamous cell carcinomas of other organs. It remains difficult to make any statements regarding the adjuvant therapy and prognosis, since this type of tumor is so infrequent, especially as an intracystic lesion.

Biopsy, Needle↗
PubMed2003

[Early description of a pulmonary aspergillosis 1847 from Greifswald].

In 1847 the student of medicine Theodor Sluyter (1817-1895) from Greifswald published his thesis in Berlin including the first well-documented case of human pulmonary aspergillosis. In 1856 Rudolf Virchow (1821-1902) classified the depicted fungi as an Aspergillus species. Possibly Carl Ferdinand Eichstedt (1816-1892) carried out the autopsy. He is known by the first description of a fungus as the cause of pityriasis versicolor in 1846. Further involved scientists from Greifswald were Wilhelm Baum (1799-1883), Theodor Litzmann (1815-1890) and the botanist Johann Konrad Schauer (1813-1848). Their curricula vitae are given in further details as well the curriculum of T. Sluyter.

Aspergillosis↗
PubMed2002

Treatment of severe Candida infections in high-risk patients in Germany: consensus formed by a panel of interdisciplinary investigators.

Now that modern medicine can provide increasing chances of cure to patients with formerly incurable disorders, therapy-related complications play the key role in outcome. Thus, among opportunistic infections, severe candidiasis remains a challenge. A multidisciplinary panel of 20 investigators was formed to find a consensus on antifungal strategies for various underlying conditions in neutropenic and non-neutropenic patients. To record their preferences, the investigators used an anonymous voting system. Among antifungal agents, fluconazole emerged as the major alternative to the classic amphotericin B, being therapeutically at least equivalent but clearly less toxic. Factors that restrict the use of fluconazole include pretreatment with azoles, involvement of resistant species like Candida krusei, and an inability to exclude aspergillosis. Flucytosine can be reasonably combined with both amphotericin B and fluconazole. Within the limited antifungal armamentarium, amphotericin B lipid formulations and itraconazole also appear useful and require further investigation. The general consensus of the group is that antifungal agents should be administered at sufficient dosages, rather early, and often empirically.

Antifungal Agents↗
PubMed2002

[Immunohistochemical research on breast cancer cell proliferation and hormonal receptor status with special emphasis on HER-2/neu expression].

Breast cancer is the most frequent gynecological tumor. The HER-2/neu oncogene may play a role in the prognosis and management of patients with breast cancer. In a retrospective study on 100 patients, we correlated the expression of this oncogene with the classic clinical and pathological factors. 32 % of patients exhibited overexpression of HER-2/neu. There was no significant correlation with classic parameters. This finding could indicate that HER-2/neu expression is a new independent prognostic factor. Prospective studies correlating HER-2/neu overexpression with prognosis might provide additional data.

Breast Neoplasms↗
PubMed1999

[Disseminated candidiasis in premature twins. Case report].

A case of disseminated candidosis in a premature newborn twin I (26th weeks of pregnancy) is reported. A severe mycotic infection of the organs, especially the kidneys was present. Even Candida in the pancreatic islets of Langerhans cells could be demonstrated. Twin II also suffered a Candida infection but in contrast to twin I she survived after therapy. Candida infection of twins is rarely reported in the literature.

Candidiasis↗
PubMed1999

[In Process Citation]

Endometriosis is a proliferative disease, which is often diagnosed with delay. Laparoscopy and histology are necessary for diagnosis. Different factors influence the success of therapy. Proliferative markers are very important for the differential diagnosis of active and inactive endometriosis. In a study it could be shown that endometriosis with high proliferative activity (high expression of Ki67) has a high response rate to GnRH-analogues treatment. Active endometriosis has to b distinguished to select an optimal treatment. A high proliferative activity of endometriosis should be treated with a hormonal-surgical combination.

Journal Article↗
PubMed1998

Cancer associated serum antigen (CASA) levels in patients with breast carcinoma and in 3 control groups without breast cancer.

We have examined the predictive value of measurements of CASA (Cancer Associated Serum Antigen) levels in patients with breast carcinoma. The measurement uses monoclonal antibodies that bind to an epitope on the polymorphic epithelial mucin. CASA levels were of less value compared with the levels of other tumor markers (CA 15-3, CA 549 and CEA) in the management of patients with early breast cancer.

Adult↗
PubMed1997

Hormonal inhibition of endometrium for transcervical endometrial ablation--a prospective study with a 2-year follow-up.

OBJECTIVE: To determine the best pretreatment of the endometrium prior to roller ball endometrial ablation. STUDY DESIGN: Forty patients with recurrent hypermenorrhea underwent diagnostic hysteroscopy and dilation and curettage. They were then assigned to receive either no pretreatment or pretreatment with danazol, a GnRH-analogue, or a gestagen prior to roller ball endometrial ablation. Endometrial suppression was estimated by the surgeon at the time of the procedure, and endometrial biopsies were obtained. Patients were followed for 24 months. RESULTS: The subjective estimation of the surgeon showed a sufficient pretreatment after danazol or a GnRH-analogue in 90% of the cases. Histological findings correlated with these findings. The highest level of amenorrhoea at 2 years of follow-up was also reached after danazol or GnRH-analogue pretreatment. CONCLUSIONS: Danazol- or GnRH-analogue should be used for pretreatment prior to endometrial ablation using the roller ball technique.

Cohort Studies↗
PubMed1997

[Hysteroscopic diagnosis and follow-up of adenomatous hyperplasia and therapeutic consequences].

63 cases of adenomatous endometrial hyperplasia (1st-3rd degree) were diagnosed by hysteroscopy and D&C at the Department of Obstetrics and Gynaecology of the University of Greifswald from January 1991 to December 1994. In 40 patients with adenomatous hyperplasia (2nd-3rd degree) a hysterectomy was performed. 23 patients presenting with 1st degree hyperplasia were treated continuously with gestagenes for a period of 6 months. In those cases we performed a repeated diagnostic hysteroscopy and D&C to check the success of hormonal treatment. In 92.5% of tall cases the histological diagnoses of a lower degree adenomatous hyperplasia, cystic glandular hyperplasia or of a normal endometrium were made after hysterectomy. Only in one patient (2.5%) an endometrial carcinoma developed from an adenomatous hyperplasia (3rd degree). There was no progression to observe of adenomatous hyperplasia after hormonal therapy with gestagenes. We conclude that in those cases a hysterectomy has not necessarily to be carried out. However, in adenomatous hyperplasia of 3rd degree hysterectomy has to be the treatment of choice, because there is an increased risk of invasion.

Adenocarcinoma↗