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Biomedical subjects

J C Rageth

Publications and source records attributed to J C Rageth.

36 records · Page 2Linked to original sources
PubMed1990

Adenocarcinoma of the uterine cervix. An analysis of 84 cases between 1970 and 1988.

Of 1284 cases with cervical carcinoma of Stages 0-IV treated at the Gynaecological University Hospital CH-Zurich between 1970 and 1988, 84 (6.5%) were adenocarcinomas; whereas a previous study performed at our clinic between 1950 and 1970 had only revealed an incidence of 3.2%. Compared with the 1200 cases of squamous cell carcinoma during the period from 1970 to 1988 it is of interest that patients with adenocarcinomas are slightly older (median value: 48 years, squamous cell carcinoma: 44 years) and that there is a temporary postmenopausal decrease in incidence: whereas there were 29 cases in the 45- to 54-year age group and 12 in the 65- to 74-age group, only 3 cases occurred in the 55- to 64-age group. Of the 38 women undergoing radical hysterectomy, 9 (24%) showed metastases in the pelvic lymph nodes. Of 115 squamous cell carcinomas operated in the same way, 15 (13%) were metastatic, which corresponds to a value of 3.65 (p = 0.057) in the chi-square test and is just below significance different. No metastases could be evidenced in any of the 28 adnexa removed bilaterally. The general appearance of the adenocarcinoma largely corresponds to that of its squamous cell counterpart of the cervix, although there are certain indications, confirmed by some references, as to poorer prognosis, earlier formation of lymph node metastases and slightly reduced radio-sensitivity.

Adenocarcinoma↗
PubMed1990

A comparison between pregnancy-associated alpha 2-glycoprotein (alpha 2-PAG), carcino-embryonic antigen (CEA), CA-125, and CA-15-3 as tumor markers in breast cancer.

Pregnancy-associated alpha 2-glycoprotein (alpha 2-PAG) has been advocated as a good marker for various malignant diseases, in particular carcinoma of the breast. Re-evaluation of previously published results was required and in this study the correlation between alpha 2PAG and CEA, CA-125, and CA-15-3 was investigated and the monitoring efficiency determined in comparison to these above mentioned markers. Overall monitoring efficiency of alpha 2-PAG was in the same range as the corresponding parameters of CEA and CA-125; specificity was very high at the expense of sensitivity, resulting in a high positive predictive value. Monitoring of such patients by alpha 2-PAG as sole marker is not recommended.

Adult↗
PubMed1989

[Major gynecologic surgery in the geriatric patient].

A retrospective analysis of 256 important interventions in geriatric gynecologic patients (over 70 years of age) was carried out. There were 77 vaginal, 86 abdominal, 9 combined abdomino-vaginal and 82 breast operations. Minor (131) and major (31) complications are described in detail. Two postoperative deaths accounted for a mortality rate of 0.8% in these patients. It is emphasized, that on the premises of a thorough evaluation of the possible treatments, a modern anesthesiologic technique, a well devised operative strategy and the modern postoperative care we can nowadays justify extensive surgery even in the very old gynecologic patient.

Aged↗
PubMed1989

[Risk factors: assessment at the initial examination].

Risk factors can be characterized as anamnestic or prospective (important regarding the outcome). The relative risk rises with the number of ovulatory menstrual cycles. Contraceptive pills and combined estrogen-gestagen therapy do not rise the relative risk. Irradiation of the breast leads to a higher risk depending on the applicated dose and the age of the irradiated subject. It is though important to state that the irradiation in mammographic examination of the breast is so minimal that it can be neglected and that no increased risk for the contralateral breast after irradiation for breast cancer could be documented.

Breast Neoplasms↗
PubMed1986

[Pregnancy, labor and the puerperium in paraplegic patients].

Due to better care and better knowledge pregnancies in paraplegic patients nowadays have a good prognosis. We report on 16 deliveries in 13 paraplegic or tetraplegic patients. To minimise the danger of possible further damage it is important to know about the special problems associated with pregnancies in paraplegic mothers. It is particularly important to know about the elevated risk of premature labour and the risk of autonomic hyperreflexia in lesions above D7. To prevent urogenital infections, patients should try to keep the genital region clean and try to empty the bladder as completely as possible. Intermittent catheterisation might be necessary. One should try to prevent decubital ulcers, and therefore an eventual anaemia (below 80%) should be corrected by transfusions. The patients should be instructed how uterine contractions can be palpated manually because sometimes perception of contractions in other ways is not possible. Repeated examinations of the cervix also help to prevent premature birth. Hospitalisation of the mother two to three weeks before the expected date of birth is suggested. If the lesion is higher than D7, symptoms of autonomic hyperreflexia (bradycardia and rise of blood pressure with the risk of cerebral haemorrhagia) are almost always present when labour starts. To prevent this possibly life-threatening complication, early application of epidural anaesthesia is suggested. There is no contraindication to spontaneous delivery. Vacuum extraction or forceps are necessary more frequently. In the post-partal period, prophylaxis of decubital ulcers is important. Breast feeding is not influenced.

Adult↗
PubMed1983

[Vasectomy for contraception].

In order to obtain more information about possible sequelae of vasectomy, a follow-up examination was conducted in 247 men who had been vasectomized between one and ten years previously. A high degree of satisfaction with this method of family planning was found, and negative reactions were few. The relatively wide indication adopted at the University Hospital in Basel for vasectomy as a method of preventing pregnancy is therefore confirmed. Lack of objective information about possible physical or psychosexual reactions appears to be the most important reason why this method of contraception has not yet received due recognition.

Adolescent↗
PubMed1983

[Sonographic determination of residual urine].

A method to determine residual urine volume by ultrasonotomography has been developed. In 206 patients the greatest horizontal and the greatest sagittal area of the urinary bladder were measured using a B-Mode real time scanner and the volume of the bladder was calculated from these two parameters. Then the bladder was emptied with a catheter and the determined volume was compared with the calculated volume. Applying the statistical method of multiple regression analysis a nomogram was computed for direct reading of the calculated residual urine volume. Using this ultrasonic method the bladder volume determination is highly reliable and due to its advantages (e.g. no risk of infection and urethral injury, quick, simple and inexpensive) it has replaced the catheter method for assessing residual urine volume at our institution.

Humans↗
PubMed1982

Ultrasonic assessment of residual urine volume.

A new method to assess residual urine volume using ultrasound has been developed. By measuring the areas of the bladder in both longitudinal and transverse directions the amount of residual urine volume can be estimated with a degree of accuracy comparable to the catheterisation method. A nomogram containing relevant urine volume determinations has been computed by applying the statistical method of multiple regression analysis in more than 200 cases studied. We find this nomogram to be easy to work with, and due to the advantages of ultrasonic assessment (e.g., there is no risk of infection, it is atraumatic, and it is quick), this approach may be recommended as a suitable method for routine practice in lieu of the catheterisation method.

Humans↗
PubMed1982

[The contribution of ultrasound in urologic diagnosis].

Urological diagnosis is considerably improved by the application of sonography. The best results are undoubtedly obtained if the investigations are carried out by an appropriately trained urologist familiar with clinical differential diagnosis. Various sonographic techniques which have proved helpful in this field are discussed, and a novel method for assessing the residual urinary volume is described.

Curriculum↗
PubMed1982

[Diagnostic and therapeutic problems in angiolipoleiomyoma].

6 cases of angiolipoleiomyoma of the kidney operated in the last 10 years are discussed. New diagnostic possibilities and also, the problems of providing an accurate preoperative diagnosis are mentioned. Usually therapeutic steps depend on whether the tumor ist presenting in combination with tuberous sclerosis or wether it is isolated. Radical surgery is more frequent and justifiable when the tumor is isolated, than in patients with tuberous sclerosis, where the therapy should be more conservative.

Adult↗
PubMedDate not supplied

[Late complications of episiotomy].

By means of a questionnaire and partly by phone calls 467 women who delivered at the Universitäts-Frauenklinik Tübingen 1-5 years ago were interviewed regarding perineal discomfort, wound healing and anal incontinence. 106 women have had a mediolateral episiotomy, 250 a median episiotomy (including 115 complete perineotomies) and 111 women have had no episiotomy. Dyspareunia was reported in 47% of the primiparous woman and by 22% of multiparous women with episiotomy; by contrast without episiotomy, this problem occurred only in 7% and 8% of primiparous and multiparous patients respectively (p less than 0.01). Perineal pain while sitting on a chair was reported by 30% of women with mediolateral episiotomy as compared to 19% of those with median episiotomy or complete perineotomy and 4.5% without episiotomy (median episiotomy vs. mediolateral episiotomy: p less than 0.05, episiotomy vs. no episiotomy: p less than 0.001). Occasional involuntary passage of flatus occurred in 18%, 22% and 14% respectively (differences not significant); involuntary passage of faeces in 7%, 9% and 1% respectively (episiotomy vs. no episiotomy: p less than 0.01). The occasional involuntary passage of faeces persisted for more than 6 months in 2 of 106 women with mediolateral episiotomy and in 3 of 250 women with median episiotomy. Because of the good healing of adequately reconstructed perineal tears and the better outcome of median episiotomy as compared to mediolateral episiotomy the authors advocate to use episiotomy restrictively and, if enlargement of the vaginal outlet is indicated, to use median rather than mediolateral episiotomy. If necessary, median episiotomy may be extended to complete perineotomy.

Adult↗
PubMedDate not supplied

[Experiences with introduction of the UNICEF program "10 steps for successful breast feeding"].

UNICEF's program "The Baby-Friendly Hospital Initiative" launched in 1990 has met with some criticism in various places of Central Europe, since breast-feeding has already reached a high level in these areas. Despite that fact the Hospital Limmattal decided to introduce the program. Although the frequency of breast-feeding had attained over 90% at discharge from our clinic before the program was introduced, it could be further improved after four months. Prior to the introduction of the 10-step initiative, 56% (103) of the mothers had still been fully breast-feeding their babies after four months (82 women had completely or partially weaned their babies, 54 women did not respond). After the introduction the number of fully breast-feeding mothers rose to 61% (129) (83 women had partially or completely weaned their babies, 27 did not respond). Chi-square test: p = 0.01. At present the frequency of breast-feeding at clinical discharge is 97% (92% full breast-feeding); in 83% tea is also fed during childbed (50% thereof with less than the total of 50 ml), 66% of the babies can do without pacifiers, and in 82% the use of the bottle is superfluous. The combination of individual care with the introduction of the 10-step initiative has certainly rendered work in the maternity ward more demanding, but also more satisfactory owing to the staff's improved competence.

Breast Feeding↗