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Biomedical subjects

J Hoch

Publications and source records attributed to J Hoch.

At least 19 recordsLinked to original sources
PubMed2003

[Local recurrence of breast cancer. Isolated local recurrence located at the skin of the latissimus dorsi donor flap after breast reconstruction].

The reasons for local recurrence of breast cancer are currently unknown. Inadequate resection (not RO), undetected multifocal tumors, or absence of postoperative radiation are discussed. Secondary multifocal tumors as well as ipsilateral secondary tumors have been described as potential origins. Partial local recurrences can be considered a sign for general metastasis with an isolated local "reproduction" of the initial tumor. In our patient the observation of isolated local recurrences of the initial breast cancer, located at the skin of the latissimus dorsi donor flap, may be helpful in clarifying the ongoing controversial discussion. Our case study shows that the local recurrence occurred exactly at the initial location of the primary tumor independent of the local epidermal situation. We assume that activated vertical connections exist between the fascial lymphatic system and the dermal lymphatic plexus that "directed" the way to the body wall.

Adenocarcinoma↗
PubMed2003

Sentinel node biopsy in gastric cancer: preliminary results.

BACKGROUND: Extent of lymphadenectomy in gastric cancer is one of the still unresolved and ongoing questions. Whether extensive procedures lead to better survival remains controversial. The detection of sentinel node could become a helpful method to define the desirable extent of lymph node dissection for each particular patient. MATERIAL AND METHODS: Prospective, single-centre, clinical trial. Sentinel node is identified using vital blue dye. After performance of D2 lymphadenectomy, the pathologist minutely investigates all lymphatic nodes by histological and immunohistochemistry techniques. RESULTS: During a period of 36 months, an attempt to localise the sentinel node for biopsy was made in 22 patients. The successful rate of sentinel node detection with a good relation between metastatic involvement of the sentinel node and other nodes was 56% (13 out of 22 patients). All these patients suffered from small tumours and early stage of the disease. In large tumours and advanced stages, blue dye stained the tissue around the tumour diffusely rendering the identification of true sentinel node impossible. Fresh frozen section of the sentinel node resulted in two patients in a false negative outcome because of micrometastatic involvement. CONCLUSIONS: Sentinel node biopsy in gastric cancer using vital staining is a feasible method. Reliable results were seen in early stage of the disease. Fresh frozen section of sentinel node has probably a low sensitivity for detection of micrometastases.

Feasibility Studies↗
PubMed2003

[Lymphadenectomy in gastric carcinoma--present status, new trends and personal experience].

The only hope for long time survival in gastric cancer is radical surgery with complete tumour removal. Lymphadenectomy as a part of surgical procedure helps to remove tumour completely. The value of lymphadenectomy for staging is clear and surgeons have no doubt about it. Therapeutic effect of lymphadenectomy with improvement of the prognosis remains uncertain. In this work we would like to discuss current trends in lymphadenectomy in gastric cancer, especially evaluating the value and extent of the procedure.

Adult↗
PubMed2002

Detergent extract from chlamydial elementary bodies used as antigen for enzyme-linked immunosorbent assay.

Soluble antigen (SA) from chlamydial elementary bodies (EBs) was extracted with N-lauroylsarcosine. The extracted SA composed of lipopolysaccharide (LPS) and proteins was compared with EBs using an enzyme-linked immunosorbent assay (ELISA). Patient sera from natural chlamydial infections exhibited ELISA mean absorbance (A(492) and A(405/650)) values 2-5 times higher with SA than with EBs, resulting in a better discrimination between positive and negative human sera.

Adult↗
PubMed2002

[Fibronectin-chemotaxis and collagen-gel contraction of the palmar aponeurosis in morbus dupuytren].

Causes for Morbus Dupuytren (MD) on the cellular level are largely unknown. We have studied chemotaxis and collagen-gel contraction of cultivated cells from nodules and cords of Morbus Dupuytren patients and normal palmar aponeurosis. The cells of the seized tissue showed an increased chemotaxis in gradients of the chemo-attractant fibronectin. Furthermore embedded into collagen-gels cells from MD patients especially from the region of cords to the skin had an enhanced ability to contract a three-dimensional collagen network compared to those originating from the center of the nodules and control palmar aponeurosis. One reason for the increase of chemotactic motion and the ability to contract gels could be a surplus of receptors for extracellular matrix proteins (integrins) on the surface of cells from seized tissues. Flow cytometry of cells fluorimetrically stained for beta 1 -, alpha 2 - and alpha 3 -integrins displayed no differences in the quantity of these main cell surface receptors.

Cell Movement↗
PubMed2002

[Emergency ERCP].

Although the effectivity of an urgent ERCP was confirmed, some aspects relating to this method are still discussed. Timing of this procedure has not been established yet. Whereas there is no doubt about indication with decompression of the common bile duct in acute cholangitis, views on the effectiveness of examination incl. papillotomy in case of acute pancreatitis are not uniform. The authors demonstrate a group of 538 patients who had urgent ERCP within the last three years with a successful cannulation rate of 93%. The experience of large centres is confirmed as the great efficiency and effectivity of this procedure when the standard conditions and processes are respected.

Acute Disease↗
PubMed2001

Synthesis and biological evaluation of novel macrocyclic paclitaxel analogues.

[reaction: see text] This work describes the synthesis of two novel macrocyclic taxoid constructs by ring-closing olefin metathesis (RCM) and their biological evaluation. Computational studies examine conformational profiles of 1 and 2 for their fit to the beta-tubulin binding site determined by electron crystallography. The results support the hypothesis that paclitaxel binds to microtubules in a "T" conformation.

Antineoplastic Agents, Phytogenic↗
PubMed2001

Two bioactive saponins from Albizia subdimidiata from the Suriname rainforest.

Bioassay-guided fractionation of a methanol extract of Albizia subdimidiata using the engineered yeast strains 1138, 1140, 1353, and Sc7 of Saccharomyces cerevisiae as the bioassay tool resulted in the isolation of the two active saponins 1 and 2; one of these, albiziatrioside A (1), is described for the first time. The structures of 1 and 2 were established on the basis of HRMS, 1D and 2D NMR spectral data, and GC--MS analysis of the sugar units. Both isolated compounds showed significant cytotoxicity against the A2780 cell line.

Carbohydrate Conformation↗
PubMed2001

[Perioperative hypothermia and its sequelae].

UNLABELLED: Perioperative hypothermia is associated with the development of haemocoagulation, cardiovascular and metabolic disorders leading to an increased morbidity and mortality. The objective of the investigation was to assess the extent of hypothermia and its clinical and laboratory consequences. A group of 30 patients subjected to elective radical laparotomy on account of colorectal carcinoma was divided into to equivalent groups. To the first group heated infusions were administered, to the second group not heated ones. In all patients the central and peripheral temperature, rate of postoperative normalization of the temperature, postoperative thermal comfort, consumption of analgesics and biochemical and haematological parameters were monitored. RESULTS: In patients with non-heated infusions more marked and longer perioperative hypothermia was recorded with a significant alteration of the number of leucocytes and thrombocytes. In the other investigated indicators there was no significant difference between the two groups. Hypothermia did not cause serious complications in any of the patients. CONCLUSION: Although no serious clinical complications induced by hypothermia were recorded, the authors recommend an active approach and provisions for the perioperative maintenance of body temperature as a standard of contemporary perioperative care.

Adult↗
PubMed2001

[Intestinal duplication. A rare disease in the differential diagnosis of cystic abdominal tumors].

Intestinal duplications are described as uncommon congenital anomalies rarely diagnosed in adults. A case of young woman with obscure abdominal symptomatology is demonstrated. After investigation the cause of it was disclosed surgically. During operation a cystic ileal duplication was exposed and resected. Despite of difficulties calling for another operation, the case was successfully solved. Based on the author's experience some aspects of these diseases--etiopatogenesis, symptoms, possibilities of examination and complications are discussed and surgery as the main treatment is emphasized.

Abdominal Neoplasms↗
PubMed2001

[Serious surgical complications associated with chronic anticoagulant therapy].

Chronic anticoagulant treatment is administered mostly for cardiological reasons. Cumarin derivatires are used in the majority of cases (Warfarin, Pelentan). It is necessary to monitor this treatment regularly and to control the dose according to the INR value. Different complications can occur; the haemorrhage represents a serious one. The authors discuss several aspects of anticoagulant therapy and possible prevention of the complications. The importance of the problems is demonstrated on the authors' clinical experience--two cases of haemorrhage after Warfarin administration simulating an acute surgical event.

Abdomen, Acute↗
PubMed2001

[Monitoring parameters of energy metabolism in patients with acute abdomen--possible prognostic factors?].

UNLABELLED: The prognosis of patients treated on account of serious surgical abdominal attacks is influenced apart from the severity of the condition also by failure of the energy metabolism. Some disorders of the milieu intérieur are the result of a deficient energy situation, energy failure participates in the development of organ disorders, failure and death. The cellular energy metabolism can be expressed as the so-called "redox-state" which can be assessed directly by estimating the ratio of ketone substances in arterial blood--AKBR--Arterial Ketone Body Ratio. The objective of the study was to test whether assessment of the AKBR index is possible, what is its importance in clinical practice and to compare its validity in particular with the commonly used scorin system APACHE II and MPI. The authors evaluated 24 patients operated on account of obstruction of the large intestine and 8 patients operated on account of peritonitis of intestinal origin. While evaluation by means of the MPI score helped to assess the prognosis, evaluation by the APACHE II score did not contribute to prediction of the development of the disease. Assessment of AKBR was of prognostic value only in patients who died during treatment. CONCLUSION: For practical use it is necessary to improve and simplify biochemical examination and scoring systems and learn how to utilize them better.

APACHE↗
PubMed2001

[Colostomy and ileostomy and their complications].

Establishment of an artificial intestinal outlet is even nowadays associated with a more than 50% postoperative morbidity. More frequent surgical complications are described in colostomies, patients with ileostomies are threatened more by a metabolic breakdown due to fluid loss via the stoma. This complication threatens patients with ileostomy not only in the early postoperative period but may represent also a long-term problem in particular in risk patients. The authors evaluated complications associated with establishment of an artificial outlet of the gut in 88 patients operated in 1999-2000. Complications were more frequently recorded in patients with colostomy, i.e. in 9.7%. In 80.8% patients with ileostomies fluid losses via the stoma exceeding 1000 ml/24 hours were observed. Early and systematic replacement of water and minerals prevented the development of serious metabolic and circulatory disorders. The authors consider a priority solution in particular in temporary derivation of the intestinal passage establishment of an ileostomy despite the risk of metabolic complications.

Adult↗
PubMed2001

[Recurrent adhesive ileus after surgical treatment of ovarian teratoma, malposition of an intrauterine device and dolichosigmoid--case report] ].

A 30-year-old woman was operated for ovarian teratoma and repeatedly for adhesive ileus during 1995-1999. A partial left ovarectomy, extirpation of an intrauterine device (IUD) in malposition (greater omentum) and appendectomy were performed during the first operation. Early adhesive ileus developed on the fourth postoperative day. Adhesectomy was performed in the region of the terminal jejunum. A new adhesive ileus developed after twenty seven months when patient underwent laparoscopy for gynaecological problems with conversion to laparotomy because of greater adhesions intraperitoneally another adhesectomy was performed. During the next eleven months new adhesive obstructions of the bowel developed and a third operation had to be performed incl. resection of the dolichosigmoideum on account of chronic problems during defaecation. A special tube as a intraluminal splint was inserted as prophylaxis of mechanical ileus in the postoperative period. But during next thirteen months subileous conditions and mechanical ileus developed again (up to now). The picture of intraperitoneal conditions was disastrous: almost total fibrotic changes allowed only partial adhesectomy. The passage through bowel is limited and is restricted to dietetic and medicamentous preparations. This case-report demonstrates postoperative adhesions a very old and very serious problem at the beginning of the third millennium.

Adult↗
PubMed2000

[Plastination histologic investigations on the inserting pars terminalis aponeurosis dorsalis of three-sectioned fingers].

With the help of thick transparent cross-sections of fingers, manufactured by plastination histology, it has been shown that fibres of the extensor aponeurosis insert not only the way described in current textbook on the basis phalangis distalis and on the capsule of the distal interphalangeal joint. Our studies prove that parts of the dorsal extension plate insert dorsally to the nail matrix and others run over the edge of the basis phalangis to the proximal part of the diaphysis where they intermingle with the periost of the phalanx.

Dissection↗
PubMed2000

[Radical treatment of a primitive neuroectodermal tumor of the thoracic wall].

Primitive neuroectodermal tumours are one of the histological types of soft tissue sarcomas. Although the maximum incidence of these tumours is at a relatively young age, they may be encountered also after the fifth decade. As apparent from the submitted case-record, their clinical and histological diagnosis can be relatively difficult. Treatment is extremely pretentious and the only hope for the patient is radical surgery. After an extensive resection of the thoracic wall the authors decided to replace it by an allograft. The excellent functional and cosmetic results and the relatively long period without signs of a relapse are evidence that the selected procedure was justified.

Female↗