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Biomedical subjects

H Frommhold

Publications and source records attributed to H Frommhold.

At least 73 records · Page 4Linked to original sources

[Value of sonography following pancreas transplantation].

The authors report on 15 patients with pancreas transplants hospitalised at their clinic and treated appropriately between 1979 and 1984. Nine of these patients were subjected to control sonography directly after the operation and subsequently once weekly. The sonographic findings were compared with laboratory data and the clinical course of the patients' condition. One woman patient was subjected to control via CT. The clinical findings agreed with the laboratory values and the sonographic results. Hence, sonography after pancreas transplantation is an important "must". However, it is imperative to combine this with suitable laboratory tests and with a close watch on the clinical course in order to arrive at a relevant conclusion.

Adult↗

[Standardized low-dose-rate afterloading therapy of cervical cancer using a ring applicator].

At our hospital, the Munich method has already proved its value in gynecologic brachytherapy. In order to use this method for the afterloading technique (LDR), too, we developed a computer program for a standardized therapy with the circular applicator. A certain arrangement of sources is indicated for all applicator sizes. So the dose prescribed (point A) as well as the treatment times and the maximum rectum doses can be given in tabular form. Furthermore, another reduction of the exposure of the rectum could be achieved by means of a certain symmetric arrangement of the sources. To our opinion, this standardized treatment scheme allows in most cases a sufficiently exact definition of the dose distribution in the pelvis minor. If necessary, a more individualized irradiation planning can be established later using CT scans.

Brachytherapy↗

Combined radiation and chemotherapy for locally advanced transitional cell carcinoma of the urinary bladder.

A prospective study was performed on 22 patients with locally advanced transitional cell carcinoma of the urinary bladder to evaluate the toxicity and efficacy of an integrated treatment with cis-diamminedichloroplatinum (1.6 mg/kg body weight every 3 weeks for four cycles) and 60 G cobalt 60 or 18 MEV photons. Local and systemic toxicity caused by this treatment schedule was minor. Late sequelae consisted of contracted bladder in three patients. The rate of tumor-free bladders after a mean follow-up of 14 months was 17 of 22. Distant metastases occurred in three patients. Local recurrence of superficial tumor elsewhere in the bladder was observed in two patients. Six patients died 4 to 10 months after initiation of the integrated therapy, three of these without evidence of disease.

Aged↗

[Echographic differential diagnosis of scrotal contents. A contribution to evaluation of the method].

Ten patients were selected from a clinical material comprising 336 sonograms of the scrotal contents in order to discuss the differential diagnosis of testicular and extra-testicular conditions. The decision whether a tumour is testicular or extra-testicular does not usually pose a problem, but may be impossible for small peripheral tumours. The shape of the epididymis and vas deferens and the structure of the testes is of significance in the differentiation between torsion and epididymitis. Rare diseases--myxoliposarcoma, infiltrating urothelial carcinomas from the bladder growing along the vas, lymphangiomas--are considered in the differential diagnosis of space-occupying lesions. Lymphangiomas produce a typical appearance on ultrasound. The criteria for the diagnosis testicular trauma, rupture, parenchymal tears and haematocoeles are defined. Differentiating liquid from solid is rarely a problem. A testicular abscess in the presence of chronic orchitis can simulate a solid tumour.

Abscess↗

[Combined radio-/chemotherapy of invasive bladder cancer].

In a prospective study, 19 patients with advanced transitional carcinoma of the bladder (stages T.3 and T.4) were treated by combined radiotherapy and chemotherapy. A total of 450 mg cis-platinum or 1.6 mg/kg body weight were given in four treatment periods with three-week intervals. At the same time, the total dose of 60 Gy was given to the tumour over two periods (telecobalt or high-energy photons). There were few systemic or toxic side effects. Recurrence-free survival during the next 36 months was 76%, which compares with a control group treated by irradiation only, who had a survival of 48%.

Aged↗

Multiple intracranial metastases from a prolactin secreting pituitary tumour.

A 28 year old man presented with partial hypopituitarism and signs of a pituitary tumour. A chromophobe adenoma was partially removed by right frontal craniotomy. Seven years later complete hypopituitarism and hyperprolactinaemia were documented, at which time there was no evidence of tumour recurrence of CT scan. The patient was treated with bromocriptine but the pituitary tumour redeveloped a year later. Nine years after the original operation the first metastasis was demonstrated together with very high prolactin levels. The intracranial metastasis, and the pituitary tumour were removed at a second craniotomy following which the prolactin concentration fell. Further metastases developed subsequently and the patient died 12 years after the initial diagnosis. At autopsy multiple metastases were found in the brain, tumour cells were present in the subarachnoid space and in cerebral veins. The pituitary tumour and secondaries were shown by immunocytochemistry to contain prolactin but not ACTH or growth hormone. This appears to be the third well documented case of a metastasizing, prolactin secreting pituitary tumour.

Adenoma, Chromophobe↗

Human chorionic gonadotropin-positive seminoma: is this a special type of seminoma with a poor prognosis?

Prognosis and treatment of HCG-positive seminomas with syncytiotrophoblastic giant cells are still a matter of discussion. Between 1977 and 1982 the serum HCG and alpha-feto protein levels were determined in a prospective study of a total of 51 patients presenting with histologically proven pure seminomas. A total of 13 of the 51 patients with pure seminoma had elevated serum HCG levels, but all of them were negative for alpha-feto protein. On clinical examination six patients had tumor Stage I, six had had tuor Stage II A-B and one patient had a tumor Stage III. The clinical stage was not found to correlate with HCG levels. In six patients presenting with tumors of clinical Stage II who underwent orchiectomy and subsequently radiation therapy there was a decrease in HCG levels following therapy. Five patients were followed for five years after therapy had been discontinued. There is no indication of a relapse in four patients, and the patients are negative or HCG. One patient suffering from a tumor, Stage IIB died three years later as a result of cirhosis of the liver. Autopsy did not reveal any signs of a residual tumor; the serum HCG levels were negative. For the time being HCG-positive seminomas should be classified and treated as a special morphologic form of seminoma.

Adult↗

[Comparative histopathologic and sonomorphological prostate studies].

Ten cadaver prostates were divided into 50 sections and corresponding sections were compared, using ultrasound, with respect to their echogenic structure and histomorphology. The results of normal prostatic tissues, benign prostatic hyperplasia and prostatic carcinomas are described and discussed. It was shown that malignant prostatic lesions showed echo-poor sonograms in vitro. This observation is supported by our clinical experience. Possible explanations are discussed.

Adenocarcinoma↗

[Therapy of malignant lymphomas].

Prognostic factors in patients with Hodgkin's disease and the non-Hodgkin lymphomas are reviewed and discussed since they form the basis of the therapeutic approach to these conditions. Hodgkin's disease is treated according to stage, histology and other prognostic criteria and the appropriate management is presented in tabular form. In the non-Hodgkin lymphomas, prospective studies using the Kiel classification indicated that these lymphomas could be subdivided into types of low-, intermediate- and high-grade malignancy, each requiring different treatment modalities. An expectative approach is often, but not always, recommended in lymphomas of low malignancy. The natural history of lymphomas of high-grade malignancy is unfavourable and, usually, prolonged survival is observed only in those cases in which a complete remission is achieved. Our therapeutic approach to the various forms of these lymphomas is based on the stage of the disease and the respective schedules are summarized for lymphomas of low- and high-grade malignancy. Finally, the chances of cure in Hodgkin's disease and in the non-Hodgkin lymphomas are discussed and recent developments are mentioned.

Adolescent↗

Combined cis-platinum and radiation therapy in patients with stages pT3 and pT4 bladder cancer: a pilot study.

A prospective study was done on 8 patients with advanced transitional cell carcinoma of the bladder to evaluate toxicity of an integrated treatment with cis-diamminedichloroplatinum (1.6 mg. per kg. body weight 3 times weekly) and 60 gray 60cobalt or 18 mev. photons. Local and systemic toxicity caused by this treatment schedule was minor. Late sequelae consisted of a contracted bladder in 1 patient. The rate of bladders free of tumor after a mean followup of 7.7 months was surprisingly high (6 of 8).

Aged↗

[Sonography of the lower urinary tract].

According to literature and to our experiences sonography should be the first investigation of the lower urinary tract in children, if there is suspicion of obstruction or malformation. In many cases the localisation of obstruction or the diagnosis of malformation can be found. Furthermore by sonographic follow-up studies of ureter obstructions by tumors, by concrements or after surgery, the normal radiographic investigations like urography or retrograde pyelography can be reduced. Sonography is a valuable enrichment for investigations of functional and morphological changes of the urinary bladder, especially for the classification of bladder tumors: whereas the diagnosis of urethral diseases still is found by clinical investigations and conventional radiological procedures.

Adult↗

[Therapeutic strategies in the treatment of breast cancer (author's transl)].

Breast cancer is the most common cause of cancer death in women. The probability of being cured of this disease is below 50%. However, for certain stages of disease prognosis can be improved by the application of modern therapeutic strategies. The present paper deals firstly with the relationship between prognosis, staging, and tumour cell characteristics (receptor status and cell kinetic findings). Thereafter, selection and efficacy of cytotoxic chemotherapy and endocrine treatment is discussed and related to the prognostic different entities. The current therapeutic regimen of our group is outlined.

Adult↗