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Biomedical subjects

J Kunz

Publications and source records attributed to J Kunz.

At least 145 records · Page 8Linked to original sources
PubMed1987

[Radiation proctocolitis following gynecologic radiotherapy: an endoscopic study].

The prevalence of radiation injuries was assessed in 155 of 206 surviving patients who had had radiation therapy for carcinoma of the uterus or vagina. The patients were examined according to a standardized protocol. 51 (32.9%) exhibited endoscopic proctitis, and in 10 of them sigmoid colon was also affected. The prevalence of colitis was 31 of 66 (47%) in patients treated for carcinoma of cervix and 19 of 86 (47%) in those treated for carcinoma of corpus. 41 (80.4%) had clinical symptoms (bleeding and diarrhea in 53% each). The mean time lag between radiation therapy and beginning of symptoms was 9 months. Histology was positive in only 24 (47.1%) of 51 endoscopically documented cases of proctocolitis. There was no increase in the prevalence of radiation injury after previous surgery of any kind. Nor was higher risk found in patients with hypertension, diabetes, or congestive heart failure. However, patients with low body mass were at increased risk (p less than 0.01). There was a dose-response relationship between total dose and endoscopic proctitis (p less than 0.001). The incidence was 0% below 40 Gy, 20% at 60 Gy and 50% at 90 Gy.

Adult↗
PubMed1986

Pancreatic endocrine tumours: histological, immuncytochemical and electronmicroscopical investigations.

Fifteen endocrine pancreatic tumours (8 insulinomas, 3 gastrinomas, 1 vipoma, 3 tumours without hormonal activity) and two cases with dysplasia of the endocrine pancreas are reported. Immunohistochemical and electronmicroscopical investigations produced evidence of multihormonality in adenomas that clinically appeared to be monohormonal. The S-phase fraction of such tumours is below 1% which indicates their low proliferative potential. The malignancy of endocrine pancreatic tumours cannot be seen from cytochemical or histological symptoms; it can be established with certainty only from the presence of metastases. Multiple endocrine adenomas should suggest the possibility of hereditary endocrine polyadenomatosis. Hyperplasia and distribution disorder of the endocrine tissue as well as pathologically increased nesidioblastic activity represent the morphologic substrate of dysplasia of the endocrine pancreas as a potential cause of hyperinsulinaemic hypoglycaemia in infancy.

Adenoma, Islet Cell↗
PubMed1986

[The role of disturbed DNA synthesis in the genesis of cervical carcinomas. Results of histoautoradiographic studies].

Histoautoradiographic and histopathologic studies are presented for normal and atypical cervical squamous epithelium from biopsies in 129 women. Labelling indices were obtained using in vitro labelling of biopsy specimens with H3-thymidine. In 38 cases with normal squamous epithelium, different indices were observed depending on the indication for operation. The index for normal epithelium with nearby preneoplastic changes was 5.3 +/- 1.8; for normal epithelium of patients with other diseases (uterus myomatosus, descensus uteri) it was 2.8 +/- 1.3. The index for virus-induced koilocytic dysplasias (6.3 +/- 2.9) lay between those of mild (5.3 +/- 1.4) and moderate dysplasias (7.2 +/- 1.8) without histopathological signs of virus infection. Carcinoma-in-situ (11.7 +/- 4.0) and microcarcinomas (12.6 +/- 4.2) showed higher values. There were no significant differences between the labelling indices of the microcarcinomas and preneoplastic lesions. Early stages of tumor development may histoautoradiographically offer hints of proliferative activity. In later stages the proliferative heterogeneity of the tumors limits the interpretability of the indices. The results are discussed in light of the possible role played by papilloma virus in the genesis of cervical cancer.

Autoradiography↗
PubMed1986

[Cell proliferation and glial fibrillary acidic protein in brain tumors].

The results of histoautoradiographic and immunohistochemical studies of biopsy specimens of 15 brain tumours are reported. The specimens were labeled with 3H-thymidine using an in vitro technique. Meningiomas, oligodendrogliomas and well differentiated astrocytomas showed a median S-phase fraction of about 1%. In contrast, the labeling indices of 4 from 7 anaplastic astrocytomas were higher (2.1, 3.0, 3.5, 11.4). With increasing degree of malignancy the proliferative heterogeneity of the tumours increases. In every glioma varying amounts of glial fibrillary acidic protein (GFAP) were detected immunohistochemically (PAP technique). In 3 high-grade gliomas (2 glioblastomas, 1 anaplastic astrocytoma) an inverse relation of the investigated parameters (high S-phase fraction, low GFAP expression) was found. An exact prediction on biological behaviour of an individual tumour by GFAP detection immunohistochemically is not possible, because a high GFAP content can be detected also in some malignant tumours. However, the 3H-thymidine labeling indices of viable parts of the tumours, probably reflecting the growth fraction seem to be clinically important parameters, especially in respect to the prognosis.

Adolescent↗
PubMed1986

[S phase fraction and immunohistologic demonstration of the epithelial marker MAM-6 in orofacial tumors].

Tissue samples of 9 leukoplakias, 19 oral squamous cell carcinomas, 9 basaliomas and 6 specimens of normal oral mucosa were labeled with 3H-thymidine using an in vitro technique; the size of the S-phase fraction was determined histoautoradiographically. Whereas leukoplakias (with or without dysplasia) showed an homogeneous growth pattern, carcinomas and basaliomas demonstrated significantly higher proliferative activity in the tumor periphery. In the basaliomas the pallisade cells showed significantly higher indices than the polygonal cells. The proliferative potential of the oral squamous cell carcinomas is high compared to other neoplasias and depends on the grade and type of growth. The epithelial marker MAM-6 detected immunohistologically on the same tissue, showed a stronger expression in oral carcinomas than in leukoplakias. A direct relationship between the intensity of antigen expression and the proliferative behaviour (size of the S-phase fraction) was not detectable.

Adult↗
PubMed1985

[Purely mesenchymal homologous uterus sarcomas (leiomyosarcomas and endometrial stroma sarcomas) at the Zurich University Gynecologic Hospital].

From 1960 through 1983 sixty-four so-called pure mesenchymal homologous sarcomas of the uterus were observed at the Women's University Hospital Zürich. A review of the histological slides revealed that only 40 cases represented true sarcomas according to the contemporary diagnostic criteria. These were 25 leiomyosarcomas and 15 endometrial stromal sarcomas. Leiomyosarcomas: The leading symptoms in these patients are uncharacteristic abdominal pain (15/25) as well as bleeding disturbances (11/25), the latter being present with equal frequency in the pre- and post-menopause. In 7 of the 11 patients with bleeding abnormalities the diagnosis was already made on examination of curettings, in all the other patients after laparotomy only. Sixteen patients had Stage I, four Stage III and five Stage IV tumors. The treatment consisted in surgery alone (9/25), surgery combined with radiotherapy (11/25) or with chemotherapy (2/25) as well as radiotherapy alone (1/25). In two cases no therapy was undertaken because of advanced cachexia of the patients. Only three patients are still alive without recurrence 4 to 12 years after the diagnosis, all had Stage I tumors. Endometrial stromal sarcomas: In these patients bleeding abnormalities represent the leading symptom (14/15), especially postmenopausal bleeding (13/14). In all cases with vaginal bloody discharge the diagnosis was made on examination of the curettings, in a single case after laparotomy only. Eight patients had Stage I, three Stage II, three Stage III and one Stage IV tumors. The treatment consisted of surgery alone (4/15) or in combination with radiotherapy (4/15), radiotherapy alone (6/15) and chemotherapy alone (1/15).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Value of histopathologic findings following liver transplantation based on biopsy course studies].

A total of forty-four biopsies from nine liver transplantation patients, who had developed complications postoperatively, were studied histologically and, in part, electron-microscopically. Morphologic signs of acute rejection were seen in three patients, while there were indications of chronic rejection in one patient. In combined lesions, such as drug-induced hepatosis, cholangitis, hepatitis, and rejections, the interpretation of biopsy findings may be difficult, and special entities cannot in every case be separated unequivocally. Changes of serum bilirubin and of serum enzyme activity do not run entirely parallel to the microscopically detectable structural lesions. For diagnosis of complications after liver transplantation both the morphologic and the clinical findings must be considered.

Adult↗
PubMed1984

[Milk-duct papillomas of the breast: diagnosis, clinical course, morphology and associated pathology].

From 1978 through 1982, 52 cases of benign intraductal papilloma were observed in the Histopathology Laboratory of the University Women's Hospital, Zürich. The neoplasms were solitary in 20 cases and multiple in 32. Symptomatology, diagnosis and therapy of these tumors are presented and discussed. The indication for biopsy or further histological examination was a pathological palpatory finding (54%), discharge from the nipple (36.5%), or an incidental mammographic finding (9.5%). Five (15.5%) of the 32 patients with multiple intraductal papilloma, but none of those with solitary papilloma, had an associated carcinoma in the same breast.

Adolescent↗
PubMed1984

[Recommendations for the systemic perioperative prevention of infections in gynecology and obstetrics].

Antibiotic prophylaxis for gynecologic and obstetric surgery is reviewed. Numerous clinical studies conducted under controlled conditions have established and confirmed the beneficial effects of short term (preferentially single-dose) perioperative antibiotic prophylaxis for various procedures. Cephalosporins, particularly of the first generation, have been used extensively despite the fact that their antimicrobial spectrum does not include all pathogens recovered from postsurgical infections in gynecology. Perioperative antibiotic prophylaxis is effective in reducing the incidence of infection-related morbidity and mortality of vaginal hysterectomy, especially in premenopausal women. This protective effect is less pronounced for abdominal hysterectomy. The incidence of postoperative infections at a particular hospital should be used as guideline as to whether antibiotic prophylaxis will be beneficial or not for these patients. The same applies to C-sections, for which antibiotic prophylaxis should be administered to high risk patients only, such as secondary C-section or patients with severe underlying diseases. The optimal timing appears to be after cord clamping, which prevents transfer of the antibiotic to the newborn.

Anti-Bacterial Agents↗
PubMed1984

[Prognostic significance of pelvic lymph node metastases in surgically treated cervical cancer].

The prognostic significance of pelvic lymph node metastases in cases of invasive cervical carcinoma treated by radical hysterectomy (meigs- Okabayashi -Held) was analysed in a series of 142 patients who underwent such a procedure during the past ten years at the Gynecological University Hospital in Zurich. Discrepancies between clinical and anatomical staging were noted in 24.6% of the cases. Anatomically, 6 neoplasms were stage Ia lesions, 96 stage Ib, 9 stage IIa and 7 stage IIb. Pelvic lymph node metastases were found in 24 further cases (16.9%) which had, therefore, to be classified as anatomic stage III. The tumour recurred postoperatively in only 9 of the 118 patients (7.6%) with anatomic stage Ia-IIb lesions, but in 10 of the 24 patients with stage III carcinomas (41.7%). In this series, none of the relapsing tumours could be cured, whatever the treatment was. This means that the 6 times higher recurrence rate observed in cases with pelvic lymph node metastases also implicates a 6 times higher mortality.

Adenocarcinoma↗
PubMed1984

[Proliferation kinetics of tumor cells. Histoautoradiographic studies of squamous cell carcinomas of the cervix uteri in the human].

Tissue samples of 42 untreated squamous cell carcinoma of the uterine cervix were labeled in vitro with 3H-thymidine and studied histoautoradiographically. The greatly differing labeling indices (1.1-35.5%) showed no dependence on the age of the patients. Using multiple biopsies in 14 patients with cervical carcinoma we found, that the labeling indices were decreasing in the course of irradiation therapy. In spite of the proliferative heterogenity, the variable duration of their DNA synthetic phase and the differing growth fraction of malignant tumors the autoradiographic registration of the S-phase fraction is a valuable method to characterization of their proliferative activity.

Adult↗
PubMed1984

Urological complications in gynecological surgery and radiotherapy.

Urological complications in connection with gynaecologically or obstetrically indicated operations are rare and usually only of clinical importance when they are not recognized and treated during the operation or in the immediate postoperative period. In such cases, for example, a ureteral lesion can result in loss of the function of the ipsilateral kidney, which is particularly serious when the primary operation was carried out for a benign primary disease. The aim of the present study was therefore to demonstrate to the gynaecologist above all the preventive and diagnostic measures serving to prevent lesions to the efferent urinary pathways or to aid their immediate diagnosis. Amongst the preventive measures is included first a discussion of the pelvic anatomy which, in consideration of the special problems involved in the preparation of the caudal ureter in extended abdominal hysterectomy, is supplemented by experimental and clinical studies on vascularization of the ureters. This section also includes a detailed description of the topographic and sometimes functional divergences of the urinary tract from the norm under physiological and pathological conditions, such as are typically encountered in gynaecologico-obstetric patients, since these deviations predispose patients towards urological complications during surgical interventions. The diagnostic measures include above all the dye tests which can be performed without special technical equipment, and radiological examinations. The radiological tests are illustrated by examples selected from some 300 urograms taken over the past 20 years. The data reported in the literature on the lesions to the efferent urinary pathways are supplemented by data from about 4,000 case histories of patients treated at the Zürich University Gynaecological Clinic by surgery or radiotherapy between 1960 and 1980. The possibilities of a synoptic evaluation of the complication rates of such cases reported in the literature, or a comparison with personal experience, are very limited, since not only is the patient material under consideration very heterogeneous, but in many cases there are sometimes very considerable differences in the preventive measures implemented, in the surgical techniques, in the surgical radicality, and--in the case of combined surgery and radiotherapy--in the treatment plans and types of irradiation. The guidelines relating to the treatment of lesions to the efferent urinary pathways caused by surgery or radiotherapy are presented in detail insofar as they are of importance for the gynaecologist as immediate measures.(ABSTRACT TRUNCATED AT 400 WORDS)

Female↗
PubMed1983

[The endocrine pancreas in pluriglandular neoplasia type I. A report of two cases and review of the literature].

The changes of the endocrine pancreas in two cases of pluriglandular neoplasia type I were studied. A 15 year-old girl showed an amyloid containing ductuloinsular B cell adenoma, microadenomas and nesidioblastic processes. The simultaneous presence of hyperprolactinemia and nephrolithiasis indicates the existence of the endocrine polyadenomatosis. A 33 year-old woman had four amyloid containing B cell adenomas with ductular proliferation, a main cell adenoma of the parathyroid and a prolactinoma of the adenohypophysis. Solitary or multiple ductuloinsular adenomas, amyloid of the endocrine type and nesidioblastic activity are not specific features of the endocrine pancreas in pluriglandular adenomatosis. Similar structures can be found in isolated islet cell tumors or in nesidioblastosis. Ductuloinsular proliferations can also be observed in chronic pancreatitis.

Adolescent↗