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Biomedical subjects

R Adam

Publications and source records attributed to R Adam.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Long-term studies of patients with borderline tumors of the ovaries].

This retrospective investigation comprises a follow-up observation of 51 patients with borderline tumours of the ovaries, who had been treated at the Department of Gynaecology of the University of Erlangen between January 1st 1966 and December 31st 1986. The average age was approx. ten years younger that of patients with invasive carcinomas and 65% of the patients were in stage I. For women in stage Ia desiring children, unilateral adnexectomy is sufficient in the context of meticulous staging laparotomy. The remaining ovary should be further exposed by wedge excision. Once the family is complete, hysterectomy and adnexectomy should then be carried out retrospectively in view of the high risk of bilaterality. In ovarian tumours of borderline malignancy stages II and III, the surgical therapy should correspond to the procedure for invasive carcinomas, with the objective of postoperative freedom from tumour. Lymphonodectomy is not obligatory in view of the very rare involvement of lymph nodes. The question as to the necessity of adjuvant therapy is still open. Our observations indicate, that combination chemotherapy, containing cisplatinum is effective as adjuvant therapy in advanced stages as well as in recurrences, which cannot be completely resected surgically. 18% of our patients with borderline tumours suffered a recurrence or tumour progression, in consequence of which five died (10%). The recurrences were manifested clinically after 33 months at the earliest, and after 164 months at the latest, so that the follow-up in these patients should extend over a period of more than ten years.

Adenocarcinoma, Mucinous↗
PubMed1989

[Experiences with drill biopsy in the diagnosis of breast tumors].

We report on our experiences of 598 drill biopsies in 581 female patients. The method is suitable for clarification of dubious palpatory findings in the breast, for verification of relapse, and for receptor analysis in individual cases. It is simple to carry out, almost free of complications and provides sufficient tissue for rapid-section diagnostics. It has a high precision (90% to 92%): no false positive results were noted. The advantage, compared to excision biopsy, consists of the shortening of the duration of operation and anesthesia and better diagnostic clarification. The problem of the excision cavity is avoided. In case of a mastectomy or quadrantectomy, the primary tumor and remains connected with the tissue surrounding the tumor is available in toto for histological examination. The risk of tumor cell dissemination from drillbiopsy did not appear to be increased. The limitations of the method apply to small (less than 1 cm) not definitely palpable tumors near to the thorax wall in large, voluminous breasts. The diagnosis of specific histological types requires a high degree of experience in ultrastructural appraisal of breast tissue. A negative drill biopsy should be followed by an excision biopsy, where a carcinoma is suspected.

Biopsy↗
PubMed1989

[Comparison concentrations of serum CA-72.4 with CA-125 during a clinical course in patients with ovarian cancer].

The course of CA-72.4 serum concentrations was compared with the course of CA-125 in 17 patients with ovarian cancer. The serum levels of CA-72.4 were usually just above the detection range of the assay (3 units/ml). The comparison of the courses of the serum levels of both markers exhibited parallelism. However, no additional information could be obtained by determination of CA-72.4 in those patients who did not demonstrate elevated CA-125 levels at primary diagnosis or during recurrent disease.

Antibodies, Monoclonal↗
PubMed1989

Hematobilia resulting from heterotopic stomach in the gallbladder neck.

Hemorrhage has never been described as a complication of gastric heterotopia of the gallbladder. A case of a heterotopic stomach perforated into the Calot's area and causing hematobilia by arteriobiliary fistula in a young man is described. The clinical presentation, radiologic features, operative and histologic findings are presented, as well as the mechanism of hematobilia and the probable embryologic cause. Extensive review of the literature indicates that this case is unique both in its presentation of hematobilia and by the pathologic configuration of the heterotopic gastric tissue.

Adult↗
PubMed1988

Serum CA-125 as a guideline for the timing of a second-look operation and second-line treatment in ovarian cancer.

In the assessment of response to treatment of ovarian cancer patients, clinical examination is unreliable in detecting small tumor masses. The second-look laparotomy is therefore an accepted procedure. The optimal timing of second-look laparotomy, however, is uncertain. We therefore examined the usefulness of serial serum CA-125 estimations in the timing of second-look laparotomies in 33 patients suffering from ovarian cancer. Increasing CA-125 concentrations were always followed by relapses or progressive disease, whereas decreasing serum concentrations indicated response to treatment. In future we propose to perform second-look laparotomies when CA-125 levels have declined to a steady plateau and to start a secondary treatment when CA-125 levels start to rise again.

Antigens, Neoplasm↗
PubMed1988

[Local recurrence in breast cancer. Course of the disease with reference to morphologic parameters].

In 124 patients suffering from a local recurrence after primary treatment of a breast cancer the course of disease was checked in a retrospective manner. This particular study points out the dependence of the clinical outcome on morphological indicators. The results show that local recurrence is mostly accompanied by a generalisation of the disease and on the whole by a poor prognosis. After five years only 29% of the patients with local recurrence are still alive. Of the morphological indicators the lymphatic carcinomatosis is the most important factor related with poor prognosis. Infiltration of the pectoralis muscle has no influence on the further course. Only in few cases breast tissue that has been left after the first surgical therapy can be regarded as the starting point of a local recurrence. To avoid a further local recurrence the excision with clear tumour margins is necessary. If an incomplete removal has been carried out or in cases of narrow resection margins one has to reckon with new local recurrencies in half of all cases despite adjunctive radiotherapy. The results suggest that in cases of local recurrence beside the local treatment systemic therapy with hormones or chemotherapy might be important.

Breast↗
PubMed1988

[The role of mammography in the diagnosis of simultaneous second cancers in the contralateral breast].

In 1048 breast cancer patients, operated in the period 1969-1985 at the University of Erlangen Clinic of Obstetrics and Gynecology, estimations were made to determine the relative contribution of mammography and meticulous histology to the diagnosis of simultaneous contralateral cancer. The incidence of a bilateral simultaneous disease was 17% (6.1% invasive forms, 10.6% in situ). Complete histological examination of the extirpated tissue as well as the occurrence of discrete radiological signs could account for the detection of 41% of all invasive and 39% of all in situ forms respectively. Those contralateral breast cancer cases detected just by means of mammography, but without any presence of clinical signs, recorded an average diameter of 9 mm and in 20% had metastacised to the axillary lymph nodes. Comparatively, clinically and radiologically diagnosed cases were 17 mm on average and the occurrence of axillary lymph node involvement was 41%. The conclusion is drawn, that a meticulous diagnostic effort is necessary in view of the high incidence of occurrence of simultaneous cancer on the other breast and the prognostic importance of an early diagnosis for many patients. Every minute radiologically detected sign in the other breast of patients with mammary carcinoma requires careful diagnostic clarification. However, it should be considered that the data presented were gathered in a situation in which the radiologist performed the X-ray examination, knowing that an excision would have been carried out in 85 percent of all cases even without his specific localisation. The presence of additional risk factors (lobular cancer, multicentricity and family history of breast cancer) make such an effort justified and obligatory as well.

Biopsy↗
PubMed1988

Binaural summation and lateralization of transients: a combined analysis.

Subjects judged the loudness and the lateral position of dichotic transient signals, which were presented at equal and unequal levels, synchronously and asynchronously, to the two ears. Binaural loudness summation of clicks does not obey a law of linear addition: It is partial at low level and superadditive at high level. Supersummation is greater for interaurally delayed clicks than for coincidental ones. The relation between click loudness and sound pressure (over moderate SLs) can be described as a power function with a greater exponent for the binaural function. Lateral positions spread over a greater range for interaural level differences than for interaural time differences. The time-intensity trading ratio was greater than is typically reported for tones. When sound lateralization was induced by interaural time difference, but not by intensity difference, a virtually perfect negative correlation between loudness and extent of off-center displacement existed.

Attention↗