Search PubMed⌕ Search

Biomedical subjects

R Pavelka

Publications and source records attributed to R Pavelka.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Evaluation of real-time sonography in the pretherapeutic staging of malignant tumors of the tongue and mouth floor].

Based on our three years experience with about 200 transcutaneous real-time sonographies of the tongue and the floor of mouth, an assessment of the determination of size and site of 38 pretherapeutically examined malignant tumours (35 squamous cell carcinomas) was made. The patients were examined in reclined position, the head retroflected. Curved array transducers of 5 or 7.5 MHz and a silicon elastomer block as interface turned out to be optimal. All tumours could be detected by sonography as hypoechoic, more or less homogeneous, ill-defined areas. Two thirds of the tumour ulcerations could be seen as hard hyperechoic reflexes within the hypoechoic areas. When comparing the maximal diameter of tumours of the 20 operated patients, we found an agreement (5 mm tolerance) of sonography with the surgical specimen in 14 of 20 tumours (70%), of sonography with the clinically estimated diameter in 10 of 20 tumours (50%), whereas the clinically estimated diameter was in agreement with the surgical specimen in only 8 of 20 tumours (40%). A peritumoral inflammatory infiltration can simulate a larger tumour size in sonography. The extent of tumours within the tongue, to the floor of mouth, the lateral pharyngeal wall and the preepiglottic space was documented correctly in most cases. In three cases a previously unknown spread across the midline was found sonographically. Including the sonographic findings in the TNM classification, 5 T1 tumours would have been staged as T2 and one T3 tumour as T4. Inflammatory diseases of the tongue can show the same sonomorphology as malignant tumours.

Adult↗
PubMed1985

[Immunoglobulin A serum antibodies against the capsid antigen of Epstein-Barr virus in the differential diagnosis and follow-up of nasopharyngeal cancer].

IgA antibodies to Epstein-Barr virus capsid antigen (IgA anti-VCA) can be detected in sera of patients with certain types of nasopharyngeal carcinoma (NPC). IgA anti-VCA titres were determined by the indirect immunofluorescence technique. 17 control patients with benign diseases or carcinomas of the head and neck other than NPC had negative IgA anti-VCA titres less than or equal to 1:16. NPC was diagnosed histologically according to the Cologne modification of the WHO classification. Among 16 cases of untreated or recurrent NPC, a rare disease in Europe, seen over the past three years, those with undifferentiated carcinomas with and without lymphoid stroma and the non-keratinizing carcinomas with lymphoid stroma were IgA anti-VCA positive (1:32 to 1:512), whereas patients with squamous cell carcinomas were negative. In four cases the primary tumour had not been diagnosed by other ENT doctors in spite of known regional or distant metastases consisting of undifferentiated carcinomas with or without lymphoid stroma. IgA anti-VCA antibodies in the sera of these patients indicated the probable site of the primary tumour. NPC was verified by biopsy in all these cases. In 2 serologically negative patients the original diagnosis of undifferentiated NPC with lymphoid stroma had to be revised to malignant Non-Hodgkin lymphoma. In the follow-up of 6 NPC patients the trend of changes in IgA anti-VCA titres correlated with the course of the disease, but the minute tumour-related changes could be detected only when at least two previous sera of the same patient were included in every test.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Viral↗
PubMed1985

Recombinant interferon-alpha-2C in laryngeal papillomatosis: preliminary results of a prospective multicentre trial.

A preparation of interferon-alpha 2C of high purity formed by recombinant DNA technology was used as adjuvant therapy following removal of laryngeal papillomas by cauterization or laser vaporization. Preliminary data on 20 patients are reported and include 11 complete and 7 partial responses. Side-effects included initial temperature elevation, but this subsided and other side-effects were uncommon. No antibodies to the interferon preparation were found in any of the patients.

Clinical Trials as Topic↗
PubMed1985

[Sonographic, clinical and surgical correlations in the diagnosis and control of the course of tongue infiltrations].

With a high-resolution sonographic system, anatomical details in the area of the floor of the mouth and tongue are visualized. The value of sonography in the pretherapeutic assessment of suspicious palpation findings was investigated. 22 patients' tumors were examined during radiation, to document the course of therapy. 55 sonograms were evaluated and confirmed the excellent applicability of this procedure in the precise pretherapeutic determination of the size of the lesions and their relation to the surrounding structures. The tumors are readily detected even during radiotherapy.

Humans↗
PubMed1983

[Medical history of invasive cervical carcinoma. Symptoms and medical care in 87 cases].

The history of 87 patients suffering from invasive cervical cancer was taken using a special pattern of questions at the time of the patient's clinical admittance. After a minimum of two years after therapy the course of the disease was evaluated in each case and compared to the history and the stage of the tumor. The symptoms "postcoital bleeding" and "metrorrhagia" were found in different frequency in a significant dependence of the stage of the tumor. 26 patients (30%) had undergone a gynecologic examination without suspicion of malignancy within two years before clinical admittance, 18 of them in combination with a routine "PAP-smear". 15 patients reported the last unsuspicious examination even within the last year before clinical admittance. In this group of patients the highest rates of pelvic lymph node involvement (33,3%) and of mortality from recurrence (26,7%) were found. This surprising fact can be seen as evidence for a second form of cervical cancer with rapid invasive growth which may apart from false negative cytologic results be responsible for apparent failures of preventive care.

Adult↗
PubMed1982

Evaluation of various monitoring techniques in late pregnancy to detect poor intrauterine fetal growth.

102 pregnant women, suspected of placental insufficiency, according to their physical findings, were regularly monitored by various techniques which were related to the birth of a small-for-date infant (less than 10th weight percentile), and assessed by calculations of recognition, occurrence, and exclusion probabilities. High reliability was given by ultrasonic biometry, by human placental lactogen (HPL) and estriol both in serum, and placental perfusion measurements (113mIn) if they were within the normal range. Antepartum non-stressed cardiotocogram revealed probability rates similar to HPL in serum. Combination of monitoring methods augmented the prognostic value, nevertheless a problem of relatively high numbers of false-positive findings remained. For large departments all methods are recommended; for smaller ones particularly antepartum cardiotocogram in combination with ultrasonic biometry is recommended.

Electrocardiography↗
PubMed1982

[Fear of childbirth - definition and description of the term on the basis of empirical data (author's transl)].

Fear of childbirth was described on the basis of an analysis of fear-inducing situations spontaneously written by 40 pregnant women, and on the basis of the analysis of questionaires concerning anxieties before parturition and answered by 80 additional gravidae, at 12 weeks before and some days before the expected date of delivery. The following factors of anxiety before parturition were found: fear of injury of the mother or of the newborn, fear of efforts in labour, and their concomitant traumas and symptoms, fear of complications during delivery, fear of feeling to be helpless, fear to lose control of coping with labour, and fear of the unknown. The focus of the anxieties varied during the course of pregnancy. 12 weeks before term the main contribution to fear was given by the anxiety of injury, whereas some days before delivery anxiety of efforts in labour and their concomitant symptoms dominated. An offer of different courses of preparations for childbirth in our department should help the pregnant women to cope with her anxieties before parturition or fear of childbirth.

Anxiety↗
PubMed1981

[Clinical experience with danazol treatment of endometriosis and mastopathy].

26 women presenting with internal and external endometriosis and 27 women with chronic cystic mastopathy and mastodyny received 400 mg danazol-a 17-ethinyltestosterone derivate-daily for 3 to 6 months. Before, during and after completion of treatment clinical and endocrinological investigation as well haematological examinations and determinations of blood and urinary chemistry were carried out. In cases of mastopathy plate thermography and mammography were performed; in endometriosis the diagnosis was verified by laparoscopy or-tomy. An improvement in, or disappearance of dysmenorrhoea and pelvic pain was observed in the endometriosis group. At laparoscopy or -tomy a decrease in, but not a complete disappearance of endometriotic foci was seen. A most favourable effect of danazol was seen in mastodyny. A change in plate thermographic or mammographic findings was observed on only a few patients. A significant fall in 17 beta-oestradiol after one month and a slight decrease in basal LH levels (statistical trend) were observed. FSH and HPRL levels were not significantly affected. Ovulation was mostly suppressed, but serum progesterone values were found several times to be in the range characteristic of severe luteal insufficiency (100 to 1500 pg/ml). Hence, not only amenorrhoea, but also breakthrough bleeding occurred. The observed side affects can be ascribed to anabolic (weight gain), androgenic (acne, hirsutism) and hypoestronic (atrophic vaginitis, hot flushes, restlessness) symptomatology.

Adult↗
PubMed1981

Hematologic parameters and iron state in the perinatal period.

In 51 unselected mothers, we studied, before and after delivery: serum ferritin, serum iron, serum transferrin, the erythrocyte count, the hemoglobin concentration, the hematocrit, and the derived red cell indices. Eighteen percent of women showed a hemoglobin value below 120 g/l. The mean transferrin saturation (22 +- 7.6% (SD) and the mean serum ferritin (34 +/- 18 micrograms/l (SD) indicated a probable decrease of iron stores at term. Only three patients seemed to show hematological evidence of latent iron deficiency, and none had manifest iron deficiency. A decrease of iron stores is considered to be physiological. There was no apparent relation between iron store values and infant birth weight centiles. After delivery the changes in red blood indices showed a close correlation with the amount of blood lost during delivery. At 5 or 6 days post partum the serum ferritin level increased and values showed a wide scatter. As with other acute phase proteins, ferritin synthesis might be stimulated by the non-specific mechanisms during the perinatal period. Hence, after normal delivery serum ferritin levels do not necessarily indicate normal iron stores.

Birth Weight↗
PubMed1981

Abdominal decompression. An approach towards treating placental insufficiency.

The effects of abdominal decompression applied over a period of several weeks (mean 4 weeks) in late pregnancy on biochemical and haemodynamic parameters as well as fetal growth and cardiotocogram patterns were studied in a group of 64 pregnant women with identified placental insufficiency. A statistically significant improvement was demonstrated in the following findings after treatment: placental perfusion measurements 113mIn and unconjugated oestriol and human placental lactogen, both in serum. A positive influence on antepartum cardiotocogram was observed only immediately after therapy. An acceleration of fetal growth (biparietal diameter) could not be demonstrated. Frequency and severity of EPH gestosis did not change after abdominal decompression. Abdominal decompression seems to be a valuable aid in the still unsatisfactory treatment of placental insufficiency.

Abdomen↗
PubMed1981

[Serum ferritin in pregnancy at term and in newborn (author's transl)].

Serum ferritin, -iron, and -transferrin, and red cell blood count in 53 non-selected pregnant women at term, and from the respective cord blood samples were determined. In addition, serum ferritin was measured in 20 infants longitudinally on the first and sixth day of life. The mean cord blood concentrations of fetal serum ferritin were 135 micrograms/l, (maternal: 30,5 micrograms/l), and of fetal serum iron 27,7 mumol/l (maternal: 17,3 mumol/l), and of fetal transferrin 1,6 g/l (maternal: 4,43 g/l). A correlation between maternal and fetal serum ferritin levels could not be demonstrated. There was also no relationship between maternal serum ferritin concentrations and fetal serum iron, transferrin, and red blood count. Within the first week of life serum ferritin levels of the newborn showed a tendency to increase. From these results and from experimental data in the literature, we conclude that the feto-placental unit covers its demand on iron at the mother's expense, and independent from maternal iron stores. It is probably only an additional insufficient nutritional supply of iron, combined with depleted iron stores which might have unfavourable effects to the fetal and neonatal iron metabolism.

Erythrocyte Count↗
PubMed1980

[Changes in obstetric management over the past decade (author's transl)].

Over a observation period of 10 years (1969-1979) developments in perinatal control techniques, mostly started in the 1st Department of Obstetrics and Gynaecology, University of Vienna, at the beginning of that period, and their effect on the obstetric management are presented. In contrast to a trend of decreasing birth rate for the whole of Austria the annual numbers of deliveries in this hospital remained -after a temporary increase-unchanged. Subpartial cardiotocographic monitoring is presently applied in about 95% of all cases. The frequency of Caesarean sections has risen from below 4% to approximately 8% over the past years. Simultaneously, a shift was observed from vital to preventive fetal indications in Caesarean sections, with a parallel tendency to relatively fewer vaginal-operative deliveries. The uncorrected perinatal mortality rate has been lowered to 1.35%. This decrease is partly due to our efforts to select high-risk pregnancies in order to control them intensively. Thus, ultrasound examinations have been liberally put into practice, e.g. leading to an early diagnosis of multiple pregnancy. Use of tocolytic drugs, as well as surgical closure of the cervix together with intensive prenatal care of pregnant women with a high risk of prematurity have proved their worth as compared with control groups. Due to early and special interest in research and in monitoring of placental insufficiency, hormone determinations and measurements of placental perfusion by isotopes took a fixed place in monitoring of high-risk pregnancies early on during the observation period. Evaluation of fetal lung maturity by amniocentesis now enables us to make well-grounded decisions to stop tocolytic measures or to induce labour. In the latter field the local application of prostaglandins to the cervix by an adaptor has recently opened up new aspects. Attention has also been paid to the emotional aspect by new techniques of psychprophylactic preparation for childbirth and by a policy of rooming-in of mother and child.

Cesarean Section↗
PubMed1980

[Influence of duration of sterility on the course of pregnancy (author's transl)].

106 sterile patients who had become pregnant were divided into three groups depending on the duration of their sterility (3-5 years, 5-8 years, more than 8 years). Mostly within one year after treatment of sterility the women became pregnant independent on the duration of their sterility. Pregnant, former sterile patients showed a higher percentage of early and late abortions and of neonates with "low birth weight" (less than 2500 g) than a normal population, but there was not observed a relationship to the duration of sterility.

Abortion, Spontaneous↗
PubMed1979

[Hormonal and functional parameters in hyperprolactinaemia (author's transl)].

58 women with raised serum prolactin levels and normal hypophyseal-X-ray parameters were subdivided into three groups according to the serum prolactin level (16 to 40, 41 to 80, greater than 80 ng/ml). In addition to the determination of LH, FSH, oestradiol, progesterone and testosterone in the serum and thyroid diagnostic procedures the following hormonal tests were performed: 1. response to gestagen; 2. response to clomiphene; 3. Gn-RH-test for hypophyseal function; 4. ovarian response to administered gonadotropins (only in cases with prolactin levels greater than 80 ng/ml). The grade of menstrual cycle disorders depends on the severity of the observed hyperprolactinaemia. Slight disorders like luteal phase insufficiency, anovulatory cycle and oligomenorrhoea are associated with low- or medium-grade hyperprolactinaemia. Mainly secondary, but also primary amenorrhoea is found in cases with higher serum prolactin levels (greater than 80 ng/ml). In these cases the hypophyseal response to Gn-RH is frequently found (61%) to be negative and, moreover, the ovarian response to administered gonadotropins seems to be diminished. Increasing HPRL levels often appear to be associated with a negative response to the other above-mentioned tests.

Clomiphene↗