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Biomedical subjects

H Pickel

Publications and source records attributed to H Pickel.

At least 91 records · Page 5Linked to original sources
PubMed1989

Arteriovenous malformations of the uterus.

Six cases of the rare condition of arteriovenous malformation of the uterus are reported. Uterine bleeding was the most common presentation, with the site of the lesion and the caliber of the vessels determining its degree. A preoperative diagnosis was made by angiography in two patients, and was aided by ultrasonography in one.

Adult↗
PubMed1989

Early stromal invasion of the vulva.

151 vulvectomy operation specimens and 154 biopsies from the vulva were examined. They represented either dysplasias, carcinomata in situ or invasive squamous cell carcinomas. 17.4% of the cases showed early stromal invasion as well in dysplasias and carcinomata in situ as in the margins of the invasive carcinomas. On the other hand the early stromal invasion of the vulva does not show such striking alterations as does that of the cervix uteri.

Biopsy↗
PubMed1988

Magnetic resonance imaging in clinical cervical cancer: pretherapeutic tumour volumetry.

MRI can define the spread, size, and volume of clinical cervical cancers. Appropriate pulse sequences and slice thicknesses are necessary. Twenty-five patients underwent MRI tumour volumetry before radical hysterectomy. The volume obtained by MRI was compared with that obtained from the histological giant sections; the volumes agreed at a statistically significant correlation coefficient of 0.983. The volumes obtained by MRI of 13 unfixed surgical specimens correlated with their histological volumes with a statistically significant coefficient of 0.894. Tumour volumes were compared with the respective clinical stages. Clinical stage did not correlate with tumour volume. Three very large tumours were in clinical Stage Ib. Tumour size is a major prognostic factor, can be measured easily, and, as the basis for classification, is superior to FIGO staging. MRI can measure tumour volume before treatment.

Female↗
PubMed1988

Prognostic factors in cervical cancer on the basis of morphometric evaluation.

As for all tumours, the most important prognostic factors in cervical cancer are growth pattern and the extent of its spread. The systematic study of serial giant sections of specimens obtained at radical hysterectomy has made these morphological factors assessable by biometry. Statistical analysis produced the following ranking of prognostic factors in cervical cancer: the size of the primary tumour, lymph node involvement, infiltration of the connective tissue layer between cervix and parametrium, exophytic growth, parametrial invasion, and mitotic rate. These factors can be used in a biomathematical model to exclude or predict tumour recurrence or death from disease.

Female↗
PubMed1988

Objective results of the operative treatment of cervical cancer.

Surgical staging of cervical cancer samples the retroperitoneal lymph nodes and, at some centres, the parametria. While better than subjective clinical staging, its value is limited because the results of a sampling procedure differ widely from those of a systematic lymphadenectomy. Additionally, considering the pathology of parametrial involvement, it seems unlikely that biopsy can find the majority of parametrial cancer deposits. The most precise data on the spread of cervical cancer are produced by radical hysterectomy and systematic lymhadenectomy. The tumour size has proven to be the most important prognostic criterion and therefore the best suited for patient classification. Tumour size can be measured by a number of methods. Between 1971 and 1987, 583 of 867 patients with Stage Ib to IIb cervical cancer underwent surgical treatment. Lymphadenectomy was systematic and hysterectomy included the resection of the entire parametria at the pelvic wall. In a total of 359 serial giant sections were of sufficient quality for evaluation; most were Stage IIb cases. The frequency of positive pelvic lymph nodes was 30.3% among 132 Stage Ib cases and 44.7% among Stage IIb cases. Most tumours occupied over 40% of the cervical volume. Five-year survival by clinical stage failed to show a statistically significant difference between Stages Ib and IIb. Objective classification by tumour size showed the patients with the smallest tumours to have a five-year survival rate of 92.1%. The patients with the largest still-operable tumours occupying 80% to 100% or more of the cervix still had a five-year survival rate of 65%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Adjuvant chemotherapy after radical hysterectomy for cervical cancer.

Invasive cervical cancer can be treated by surgery, radiotherapy, and cytostatic chemotherapy. For decades, surgery alone or in combination with radiotherapy was the treatment of choice. At our hospital, primary radiotherapy was reserved for patients with advanced disease. Antineoplastic agents, especially combinations which included cisplatin, achieved good results in patients with advanced disease--or after other therapeutic modalities had been exhausted. This led us to use postoperative chemotherapy for high-risk patients with positive pelvic or parametrial nodes or vascular invasion. Radiotherapy had not improved the survival of such patients. A combination of bleomycin, vincristine, mitomycin C and cisplatin was used. The results were compared with those of patients who had received radical abdominal surgery only (n = 166) or surgery and postoperative radiotherapy (n = 170). The 29 patients who underwent surgery and chemotherapy had a statistically higher incidence of all risk factors. Nonetheless, after a three-year follow-up they had fewer recurrences and fewer deaths than did the other patients. We believe that systemic antineoplastic treatment can reduce recurrences and death in patients with invasive systemic cervical cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Adjuvant gestagen therapy in stage I endometrial cancer].

221 patients with endometrial cancer stage Ia and Ib have been operated on between 1980 and 1986. 99 patients have been irradiated postoperatively. 122 patients got 300 mg medroxyprogesterone acetate per day over one year provided that the carcinoma was limited to the uterine corpus, the invasion into the myometrium was at a maximum of 2/3 of the uterine wall, there was no invasion of the lymphatic vessels and the tumour was histologic uniform. The 5-year-survival rate of the patients operated on without irradiation but with gestagens was 98.1 per cent calculated with actuarial method in contrast to a matched group from the years 1970 to 1979 with operation and irradiation but without gestagens of 93.2 per cent. These results demonstrate that an individualized therapy in stage I is possible in patients with a low risk of recurrence.

Adenocarcinoma↗
PubMed1988

[Histology and cytology of a rare dysplastic adenosis of the cervix uteri with formation of a highly differentiated adenocarcinoma ("adenoma malignum")].

Extremely well-differentiated adenocarcinomas of the cervix are rare neoplasms and are often termed "adenoma malignum". Histology and cytology of the tumor are described in a 37 year old woman. Such adenocarcinomas are of four histological types: endometrioid, mucinous, clear cell and mixed. The cytological evaluation should be useful in some cases, a substantial number of cases show a normal smear or moderate dysplasia. When this disease is identified at an early stage and treated appropriately, the prognosis is not as unfavourable as earlier reports suggest.

Adenocarcinoma↗
PubMed1988

[Treatment of invasive vulvar cancer (results of therapy 1970-1981)].

Between 1970 and 1981 we saw 108 patients with vulvar carcinoma stages I-IV at the university clinic of Graz. 93 of them we could follow up at a minimum of 5 years. 15 patients died intercurrently. A radical vulvectomy with inguino-femoral lymphonodectomy could be done in 49 patients (45.4 per cent), a local excision or a simple vulvectomy in 27 patients (25 per cent). 7 patients have been irradiated primarily, 14 patients had no treatment. The best 5-year survival rate had the patients stage I operated on and/or irradiated postoperatively. Survival rate of stage II was 60.7 per cent, in stage III 18.5 per cent. Only 17 of 27 patients in this stage could be operated on.

Adult↗
PubMed1987

The predictive value of a combination of tumor markers in monitoring patients with ovarian cancer.

To evaluate the predictive value of the serial determination of various tumor markers, we measured carcinoembryonic antigen, ferritin, cancer antigen 125, and tissue polypeptide antigen in 109 patients with ovarian cancer before surgery, during postoperative chemotherapy, and follow-up. From these patients two groups were randomly selected. Group 1 (30 patients) had a favorable course, and Group 2 (30 patients) had an unfavorable course. Using the discriminant analysis we calculated a linear discriminant function and a cut-off score. The two groups were thereby separated according to their scores (characteristic values) from their marker values. The scores accurately reflected the clinical course in 55 of the 60 patients (91.7%). This discriminant function was then used to make a prognosis in 49 patients. In 21 patients an elevated characteristic value (greater than or equal to cut-off score) indicated disease progression 5 months before clinical confirmation was possible. The remaining 28 patients scored below the cut-off point. From six to 65 months (mean, 26.2) after surgery all are free of recurrence. It is concluded that invasive procedures, second-look laparotomy, for instance, may not be necessary in following up ovarian cancer patients with normal tumor marker profiles.

Adult↗
PubMed1987

Chemotherapy for advanced and/or recurrent cervical cancer.

A combination of bleomycin, vincristine, mitomycin-C, and cisplatin was used to treat 39 patients with advanced and/or recurrent cervical cancer. Twenty patients showed an objective response (complete or partial) with a mean duration of 14.8 months. The overall response rate was 58.8%. Twelve patients are still alive and in remission 7-36 months after the start of chemotherapy. Toxicity was acceptable.

Adult↗
PubMed1987

Prognostic factors and operative treatment of stages IB to IIB cervical cancer.

Between 1971 and 1985, a total of 325 cases of cervical cancer, Stages IB to IIB, in which operation was performed were evaluated with a view toward prognostic factors and survival rates. In radical abdominal operations, a complete resection of parametrial tissue was the goal. Extensive lymphadenectomy of the pelvis was performed. Operative specimens were processed by giant sections comprising cervix, lateral parametria, and vaginal cuff. Lymph nodes were cut by step-serial sections. Exact measurements of tumor sizes were done along with investigations of parametrium and lymph nodes. Tumors were classified according to a ratio of tumor size to size of cervix. Incidence of lymph node involvement increased with tumor size, reaching a maximum of 68.3% in the group with a ratio from 70% to 80%. Direct spread into the parametrium was rarely found, even in larger tumors occupying the entire cervix. parametrial lymph nodes were most often involved; these were scattered over the entire ligament. Five-year survival rates reached 88.1% in patients with no nodal involvement and 60.9% with nodal involvement. In the latter, the results depended on the number of nodal groups involved and the diameter of metastases. Parametrial involvement alone had no influence on healing rates, but when pelvic nodes were simultaneously involved, the results were less satisfactory. Survival rates based on tumor size differed only between the group with a ratio up to 20% and the large-tumor groups, with rates ranging from 97.5% to 70.9%. There was no statistical difference between Stages IB (31.1% positive nodes) and IIB (44.1% positive nodes) with regard to survival rates (82.2% and 76.9%, respectively).

Aged↗