Biomedical subjects
Publications and source records attributed to H Sommer.
A simple procedure: 'Percutaneous endoscopic gastrostomy' was useful to provide seriously ill patients with a long-term enteral nutritional support. The catheter remained in place for 26 days in median, up to 1 year. No complications were related to the puncture of stomach. One leakage after changing the catheter through a narrowed channel had to be treated surgically.
In this paper therapeutic results are reported obtained from 444 patients with endometrial cancer which were operated on. In 260 patients the primary operation was completed by a different radiation therapy. The 5-years-survival rates are 75,9% Surgical and radiological therapeutic measures are demonstrated with regard to their development and to side effects.
A 17-year old patient who was continuously dialyzed due to Fanconi-anemia and bilateral renal insufficiency developed an acute and severe bleeding from a ruptured Graafian follicle (corpus luteum). The bleeding was life-threatening, most likely due to the continuous treatment with heparin necessary for hemodialysis procedure. Differential-diagnostic considerations and interdisciplinary therapeutic measurements are reported.
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The DNA sequence of the termini and the flanking regions of the 17-kb transposable element Tam1 was determined. Tam1 is integrated in the chalcone synthase gene of the niv-53 mutant of Antirrhinum majus. The element has a 13-bp perfect inverted repeat at its termini and appears to induce a 3-bp duplication of the target site upon integration. The DNA sequence of a niv revertant was analyzed and found to differ from the wild-type sequence by an additional 2 bp that seem to derive from the target site duplication. Stretches of homologous sequences have been found between the ends of Tam1, within each terminus of the element, and between the termini and target site sequences. Structural similarities between the ends of Tam1 and the Spm-18 element of Zea mays reflect a possible horizontal spread of a common progenitor.
Gestation- and lactation-dependent variations of magnesium concentrations were measured in the maternal and fetal body fluids and tissues of rabbits. Samples of serum, milk, and mammary gland were investigated. A decrease in magnesium in the maternal serum during the early gestation period from 0.80 mmol/l in the first week to 0.73 mmol/l in the third week was observed. In the last week of gestation a rapid increase of magnesium concentrations both in maternal (0.83 mmol/l) and fetal (2.84 mmol/l) serum was determined. An assumed active diaplacental transfer of magnesium from the doe to the fetus was indirectly established. An active transport mechanism for magnesium from the maternal serum into the mammary glands was enhanced by strong concentration gradients of approximately 1:33 between serum and milk.
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A multicenter double-blind study of the effectiveness of sulfasalazine and 6-methylprednisolone, alone and in combination, was conducted on 452 patients with Crohn's disease. One hundred sixty patients were previously untreated; 292 patients were previously treated. The Crohn's disease activity index (CDAI) was used to determine whether a patient had active (CDAI greater than or equal to 150, n = 215) or quiescent disease (CDAI less than 150, n = 237). Treatment of active disease consisted of high-dose 6-methylprednisolone, 6-methylprednisolone combined with 3 g of sulfasalazine, 3 g of sulfasalazine alone, or placebo, and lasted 6 wk. Patients in remission received maintenance doses of one of these drug regimens for periods of up to 2 yr. One hundred ninety-two patients completed the 2-yr study period. Results were evaluated using life-table analysis and outcome ranking. These methods showed 6-methylprednisolone to be the most effective drug in overall comparison of all patients (p less than 0.001); in previously treated patients (p less than 0.001); and in subgroups: active disease (p less than 0.001), only small bowel disease (p less than 0.05), and both small bowel and colon disease (p less than 0.05). Combination of 6-methylprednisolone and sulfasalazine was the most effective regimen in previously untreated patients (p less than 0.05) and when disease was localized in the colon (p less than 0.001). Sulfasalazine alone was least effective in overall comparison of all patients (p less than 0.05) and in all strata. Drug treatment was of no significant benefit to patients with quiescent disease. Continuous administration of low doses of 6-methylprednisolone, or the combination regimen, was beneficial in patients who responded initially to treatment of active disease. The addition of sulfasalazine, however, offered no advantage.
Male Sprague-Dawley rats (50--70g) were fed a standard laboratory diet containing 6% dietary fiber substances (diet I), the same diet supplemented with 5% guar (diet II), 10% wheat bran (diet III), or 5% pectin of high (76%) methylic esterification (diet IV), or a fiber-free diet (diet V). After a 6-week feeding period, the body weight of the animals had increased to 300--350g. The common bile duct was then canulated and the exocrine pancreatic function tested under urethane anesthesia (1.5 g/kg body weight). The tested fiber substances had no effect on the basal pancreatic secretion of volume, bicarbonate, lipase, amylase or protein, or on the wet weight and histological appearance of the organ. However, the fiber substances influenced the pancreatic response to maximal exogenous stimulation with secretin (3.0 CU/100 g X hour) and cholecystokinin (0.6 IDU/100 g X hour) and the enzyme content of the gland significantly. Compared with diet V, diet I increased the DNA content of the pancreas and its secretion of bicarbonate and protein, and decreased the protein concentration in the gland. Diet II reduced the pancreatic content of trypsinogen and protein. Diet III decreased the protein content, but increased the bicarbonate secretion, which was also increased by diet IV. -- We conclude that fiber substances influence stimulated secretion and the enzyme content of the pancrease to a varying degree.
A prospective study was done in 101 patients and clinical usefulness of a fine needle-catheter-jejunostomy was investigated; this procedure was modified according to the procedure devised by Delany (2). The instruments used were two split canules and a polyurethane catheter (inner diameter 2.1 mm); these instruments are simple, safe and can be applied quickly. Formation of fistulae, peritonitis, ileus or deaths caused by the procedure could not be observed. The catheter needs to have certain mechanical qualities as e.g. sufficient rigidity. Percutaneous endoscopic gastrostomy is an alternative to corresponding surgery procedure. The stomach is punctured under sight and a Foley catheter is applied immediately. We performed this procedure without major complications in seven cases, and found it to be very useful. The techniques described here are essentially important if the advantages of the enteral as compared to the parenteral nutrition are to be made use of. As soon as the problems of diarrhea and belching are solved, tube feeding will offer in the near future a real alternative to parenteral nutrition, especially in patients who need long time artificial nutrition.
In this paper, therapeutic results of 1,453 cervical cancer patients stage T1-T4 who have been treated at the Gynaecological Hospital and the Radiological Hospital of Jena University are reported. The overall Five-Year Survival Rate amounted to 68.4 per cent. Surgical and radiological therapeutic measures are demonstrated with regard to their development and to side effects between 1965 and 1983. As a consequence of the results obtained the necessity for treating cervical cancer patients in a cancer center has to be stressed.
Results and secondary effects of postoperative radiation therapy by telecobalt and conventional x-rays at 589 female patients with malignoma of the cervix are discussed. Advantages and disadvantages of both methods are analysed critically. The 5-years-survival rates are 78,6% respectively 87,0%.
414 patients with cervical carcinoma were treated by radiation only because of local or general inoperability. The 5-years-survival of these patients was 50.7%. The importance of primary irradiation in treatment of carcinoma of cervix is pointed out. Kind and frequency of side effects of the several different methods of radiation are investigated. Alterations of the rectum were the most common complication and especially frequent, if both x-ray radiation and local radiological therapy (radium, cobalt60 , caesium137 ) were performed. The therapy with percutane telecobalt in combination with local radioactive sources was followed by a small rate of complications.
The early stages of the cervical carcinoma require a different treatment after special diagnostic measures to prevent therapeutic lesions or overtreatment. In this paper therapeutic results are reported obtained from 269 patients with cervical carcinoma category T1 which were operated on without any other therapeutic measures from 1965 to 1976. - Five-year survival rates were 97 per cent. The results show that the new trend for malignant diseases: as conservative as possible and as radical as necessary, didn't increase the risk of recurrence. The change from vaginal radical hysterectomy to hysterectomy in stage Ia or abdominal radical hysterectomy in stage Ib improved the results of treatment.
Based on a material of 1502 patients with carcinoma of cervix uteri, treated between 1965 and 1976 in gynaecological-radiological teamwork in the Department of Medicine at the University of Jena, we report on 304 cases of primary operation and following radiation therapy with telecobalt. The 5-year-survival rate of all cases in this group is 78,6%, the rate of recurrences 14,1%.
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