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Biomedical subjects

G Schwesinger

Publications and source records attributed to G Schwesinger.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1997

Correlations between endotoxin, interferon-gamma, biopterin and serum phospholipase A2-activities during lethal gram negative sepsis in rats.

OBJECTIVE: To establish a standardised reproducible animal model of intraperitoneal sepsis, and to investigate early immunoserological responses to find a mediator-based system for evaluation and grading of diffuse peritonitis in patients DESIGN: Prospective experimental study SETTING: 4 Teaching hospitals, Germany and Austria MATERIAL: 42 LEW. 1W rats, 12 of which acted as controls INTERVENTIONS: Gram negative sepsis was induced by intraperitoneal injection of 6 ml of a mixture of Escherichia coli (K1:H+) 10(10) organisms/ml, autogenous haemoglobin 2.9 ml (haemoglobin concentration 3%), 0.9% sodium chloride 3 ml, and suspension 0.1 ml. Control rats were given physiological saline 6 ml alone. MAIN OUTCOME MEASURES: Concentrations of endotoxin, interferon gamma (IFN-gamma), and biopterin, and serum phospholipase A2 (PLA2) activity. RESULTS: There were significant differences between the septic and control rats in concentrations of endotoxin (EU/ml) (median (interquartile range) 21.85 (2.02-159.5) compared with 0, p < 0.0001; IFN-gamma (pg/ml) 1263.0 (271.0-7575.0) compared with 101.0 (89.0-141.0), p < 0.0001; biopterin (nmol/L) 111.0 (66.4-156.3) compared with 53.7 (38.3-67.6), p < 0.001; and PLA2 (U/L) 163.0 (125.8-209.0) compared with 112.5 (88.5-126.5) p < 0.01. CONCLUSIONS: Measurements of concentrations of endotoxin, IFN-gamma, pteridines, and PLA2 activity may well be adequate markers for early recognition of sepsis, and perhaps for grading it during the first 6 hours after induction. The allow a clear distinction to be made between septic and non-septic disorders in 87% of cases.

Animals↗
PubMed1997

[Initial experiences and outcome of gasless laparoscopic pelvic lymph node excision combined with Schauta vaginal radical hysterectomy in stage IB cervix carcinoma].

In 11 patients with a cervical cancer stage IB a gasless laparoscopic pelvic lymph node dissection in combination with a vaginal radical Schauta-Amreich-hysterectomy was performed. The technique of the gasless lymph node dissection with the Laparolift (ORIGIN Medsystems, Menlo Park) is described. Because of the advantages of this technique (ability to use conventional and endoscopic instruments, perform irrigation and suction, dot with sponge sticks, change instruments quickly, prepare and remove lymph nodes without influence on visibility) it was possible to obtain a radicality (45 lymph nodes-median value) according to oncological standards for an abdominal radical Wertheim hysterectomy. If the radicality is equivalent to a Wertheim hysterectomy the combination of the radical vaginal Schauta-Amreich-hysterectomy and the gasless laparoscopic pelvic lymph node dissection offers a real alternative to the abdominal Wertheim hysterectomy because of low postoperative morbidity and quick mobilisation.

Adenocarcinoma↗
PubMed1996

[Hormonal premedication in endometrium ablation--results of a prospective comparative study].

In a prospective study in 40 patients the pretreatment for endometrial ablation with a gestagen (Orgametril 10 mg/die), danazol (600 mg/die) and an injection of a GnRH-analogon (Decapeptyl-Depot) was compared with a control group without pretreatment. The subjective estimation of the surgeon (endometrial thickness and depth of coagulation) showed a sufficient pretreatment in 90 % of all cases following danazol- and GnRH-analogon-pretreatment. In 90 % of the danazol- and GnRH-analogon pretreated group the histological findings showed also an atrophic or little proliferative endometrium. In a follow up of 6 months after endometrial ablation the highest amenorrhoea-rates were reached following danazol- and GnRH-analogon pretreatment. These two regimes should be used for the pretreatment for endometrial ablation.

Adult↗
PubMed1996

[Large cervix myoma after supra-cervical hysterectomy].

By means of laparoscopic supracervical and pelviscopic intrafascial hysterectomy (CISH) new minimally invasive hysterectomy methods for benign indications have been developed where the cervix or a portion of the cervix remain intact. The carcinoma risk is extremely small. Using the example of a large cervical myoma 25 years after a supracervical hysterectomy, the possibility of recurrent myomas is emphasized.

Cervix Uteri↗
PubMed1994

[One hundred years of cryptococcosis. Medical mycology in the 19th century in Greifswald].

Not later than 1842 medico-mycological investigations began at Greifswald in Germany following the appointment of Wilhelm Baum (1799-1883) to the chair of surgery at the university. This is indicated by some theses as well as by the discovery of the contagious characteristics of pityriasis versicolor by Carl Ferdinand Eichstedt (1816-1892) who found a fungus as the cause (1846), which was named Microsporon furfur later (C. Robin 1853). In 1868 the physician (Karl) Friedrich Mosler (1831-1911) published clinical-mycological studies and investigations on animal feeding with yeasts. Some time later (1870) Friedrich Grohé (1830-1886) and his assistants Alwin R. A. Block (1843-?) and M. R. Roth of the Pathological Institute described results of transmission-studies with "Aspergillus glaucus, Penicillium glaucum and yeast". The successor to the chair, Paul Grawitz (1850-1932), also published results of his own mycological investigations. Finally, on 7 July, 1894, during the evening lecture of the Greifswald Medical Society Abraham Buschke (1868-1943) from the Hospital of Surgery gave a talk "on a peculiar disease caused by coccidia" followed by the talk of pathologist Otto Busse (1867-1922) on a "demonstration of a pathogenic coccidia species". Busse's subsequent publications are the first proper descriptions of cryptococcosis (1894 f). Nevertheless, Cryptococcus neoformans has been named in connection with F. Sanfelice, whose results were published later (1895).

Cryptococcosis↗
PubMed1991

[Alcoholic encephalopathies in autopsy material].

A report is given on incidence, complications, causes of death, and morphological diagnosis of chronic alcoholism in autopsy material. Chronic alcoholism was registered in 8.4% of all autopsies. The average age at death of alcoholics, particularly female, was significantly lower than that of all autopsy material. Pneumonia was the most frequent direct cause of death (21.1%). Acute ethanol intoxication was in second position (15.8%). Wernicke's encephalopathy was observed in 0.6% of all autopsies (18% of alcoholics), cerebellar atrophy occurred in 0.4% (12%), and central pontine myelinolysis was found in 0.2% (7%). The mean brain weight of alcoholics was 1310 g as compared with 1400 g of controls. Problems of clinical and postmortal diagnosis as well as medical and social consequences are discussed.

Adult↗
PubMed1990

[Benign fibrous histiocytoma of bone].

In this paper we report one case of a poor rarely benign lesion of bone. We describe the clinical, radiological and histological diagnosis and differential-diagnostic procedures. Good results of operative treatment were reported after excochleation and transplantation of allogen or autogen bone-chips.

Bone Transplantation↗
PubMed1990

[The nosological situation of hereditary motor and sensory neuropathies (HMSN, Charcot-Marie-Tooth disease, neural muscular atrophy)].

Hereditary motor and sensory neuropathies (HMSN) comprise a heterogeneous group of disorders. Since phenotypic manifestations are similar in most families, classification is based on differences in the mode of inheritance, onset and progression of the disease, nerve conduction velocity and nerve biopsy findings. Autosomal dominant, autosomal recessive, X-dominant and X-recessive forms, substantial intrafamilial differences, intermediate forms and the combination of neuropathies with spinocerebellar degeneration within one and the same sibship have been described. On the basis of selected own cases it is demonstrated that there is a broad spectrum of functional and structural abnormalities depending on the progression of the disease and on the site of nerve studied (proximal or distal part). Both the neuronal and hypertrophic variants begin with axonal degeneration of the dying back type followed by segmental demyelination and variable degrees of hypertrophic Schwann cell proliferation. Constantly, posterior columns of the spinal cord reveal fiber loss. Since the molecular basis of the different forms remains to be clarified it seems to be of greater interest to underline common features than to separate seemingly different nosological entities. It is suggested that the latter are partly the result of a selection of cases with a variable severity. Evidently, the syndrome of myatrophic ataxia comprises apart from "pure" HMSN with unsignificant degenerations of posterior columns and "pure" Friedreich's ataxia with mild peripheral nerve fiber loss intermediate forms.

Adult↗
PubMed1989

[Lyme borreliosis with erythema chronicum migrans and Garin-Bujadoux-Bannwarth meningopolyneuritis].

A case report is given on a Borrelia burgdorferi infection regarded to be typical because of its clinical course and the diagnosis lately made. The meningopolyneuritis was treated by use of corticosteroids before the serologic detection of Lyme disease. 21 months after infection our patient died of a colon carcinoma. Histological preparation of the brain showed a slight encephalitis we consider as third-stage Lyme borreliosis. We conclude that antibacterial therapy is necessary in the management of Lyme disease, especially after the administration of corticosteroids.

Antibodies, Bacterial↗
PubMed1989

[Achalasia and mycosis].

Report on a massive candidosis of the oesophagus in a 73-year-old woman with achalasia. Discussion of the possible causes and the differential diagnosis of the achalasia. Reference to the mycotic oesophagitis as one complication, apart from many others, of the lesion of the oesophagus.

Aged↗
PubMed1989

[Farmer's lung].

Report on a pneumokoniosis caused by organic dust in a 66-year-old man. The case in question was a farmer's lung. Discussion of the possible causes, clinical and cellular findings as well as of the diagnosis and differential diagnosis.

Aged↗
PubMed1988

[Rare complications of pulmonary artery aneurysm].

Report on an 80-year-old male with a sacculated, hazelnutsized, intrapulmonary arrosion aneurysm of the right pulmonary artery in the environment of an anthracotically indurated lymphatic node. Communication of the sacculation with the right bronchus of the lower lobe as well as with the oesophagus in final rupture of the aneurysm and fatal haemorrhage. Discussion of etiology and pathogenesis, differential diagnosis, diagnostics and therapy of aneurysms of the pulmonary artery.

Aged↗