Biomedical subjects
Publications and source records attributed to R Schrage.
The case of a 37-year old patient with ovarian cancer stage FIGO IV and vaginal metastasis is reported. The vaginal smear showed psammoma bodies, which are rarely found. The value of the diagnosis "psammoma bodies" is discussed, via a review of the literature.
133 patients attending the colposcopy-laser outpatient consultations were examined simultaneously by cytology, colposcopy and punch biopsy. A cone biopsy was taken 25 patients and one patient was hysterectomised later. A comparison between cytology and histology revealed 17.1% false negative smear results. Cytology and histology showed the same result in 84.6%. The highest percentage of high-grade dysplasia was found in colposcopy with signs of punctation and/or mosaicism. A similar diagnosis was achieved in 92.3% of cases comparing punch with cone biopsy. Simultaneous use of cytology, colposcopy and punch biopsy enables reliable diagnosis and follow-up of dysplastic lesions of the cervix. Besides, one can use punch biopsy as basic histology for local destructive manoeuvres such as laser vaporisation.
Curettage specimens of 104 patients with clinically suspected abortion and unknown localization have been examined histologically. 50 patients with defined ectopic pregnancy, 51 patients with proved abortion and 50 patients with legal abortion had been used to compare with. In two cases syncytial cells could be proved histologically and by this an abortion could be verified. We could see decidually transformed endometrium in all cases with uncertain or certain formerly intrauterine localization of pregnancy. Opposite to this in ectopic pregnancy we could observe this only in 54 per cent. Summarizing our results in abortions as well as in ectopic pregnancies similar histologic findings could be seen.
56 patients with CVS were asked with a standardized questionnaire why they decided to undergo that surgical procedure and how they felt about it. 52 patients said, that their main motivation for CVS was the early diagnosis of a healthy baby. The low health risk of an early performed abruption in case of fetal abnormalities played a secondary role. Concerning the severity of that surgical procedure 44 patients thought, that it was harmless or tolerable and no woman had the feeling that CVS is a fearful intervention. 76% said, that CVS was not painful or only a little bit, 2 patients had the feeling of a painful surgical procedure. The most disagreeable moment during CVS was the hooking of the cervix. There were different opinions comparing CVS stress to amniocentesis stress in patients with a preceding amniocentesis.
The author suggests creating a "Reporting Law Model with Peripheral Part Anonymisation" that preserves the advantages of the reporting law model which are internationally recognised in respect of reliability of registration, on the one hand, while on the other hand the general and individual requirements of sufficient protection of sensitive data are also taken care of. This is achieved by separating the personal data from the factual data at the reporting office level. These data are transmitted separately to the registration offices and their confidential files. It is nevertheless possible to detect any double or multiple reporting and to perform fault finding in respect of personal data. It is also possible to add further data to any patient's case history. This cancer registration model can always cope with the required descriptive and analytical epidemiological tasks that are expected of it. It can be arranged to cover a wide area in a continuous manner without loss of time and without considerable expenditure. Documentation work to be performed by the reporting offices is minimised.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In a matched group of 104 chlamydia culture-positive and 104 culture-negative women, the correlation between simultaneous cultures and cytological findings in the Papanicolaou smear was studied. Cellular changes in metaplastic cells that are described in the literature as being specific for Chlamydia trachomatis, were not associated with genital chlamydial infection. In particular the reported high sensitivity of intracytoplasmatic inclusion bodies could not be confirmed. Likewise, even severe inflammatory changes and a high concentration of lymphocytes were also no reliable diagnostic indicator. The authors conclude that the Papanicolaou smear is not useful as a routine screening method for genital chlamydial infection.
Cytologic, colposcopic, histologic and bacteriologic examination was performed in 229 patients because of previous abnormal cervical cytology. Chlamydia trachomatis was found in a significantly greater proportion as well in 70 women with spontaneous recurrence to normal (17.1%) as in 85 women with dysplasia (17.6%). In comparison, chlamydial infection is found in 4.1% of cytologically normal women. In the 2 to 22 months follow-up Chlamydia trachomatis was seen in 19.6% of 92 women with recurrence to normal cytologic pattern, however, in 10.8% of 65 patients with persistence or progression (p less than 0.025, t-test).
Explore the source record for details and available documents.
The value of early cancer detection in women is limited by the screening methods and their minor reliability in "mass-screening". The effect of detection programs is difficult to demonstrate. The interest in cancer detection is low, especially in elderly high risk patients. A more suitable application of screening tests with widespread indication of further methods together with exact demonstration could be the basis for better results in early cancer detection programs in women.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The results of cancer screening in women were evaluated from 1,1 million investigations during the third quarter of 1971 to the second quarter of 1974. Positive cytological results of the uterine cervix were found in 0,39% on first investigation and in 0,38% on repeat investigations. Positive results in the breast amounted only to a quarter (0,1%) of the frequency of positive cytological results despite the fact that breast cancer occurs more frequently than cervical carcinoma. Only 0,03% positive findings were obtained by digital rectal palpation. The low incidence of the diseases sought for and the partly low sensitivity of the screening methods are responsible for the small numbers of positive findings in early detection investigations and are an indication of the effort involved. Participation of the population in investigations for early detection of cancer is unsatisfactory especially in older age groups with an increased risk.
Among 1554 patients with post-memopausal hemorrhage over 7 years one half were due to benign causes, the other in almost equal parts to carcinoma of the fundus or cervix. Ca of the fundus is more likely when post-menopausal bleeding occurs at a relatively old age, a late menopause and a long interval between menopause and post-menopausal bleeding. Nulliparae more often have Ca of the corpus than in the cervix or have benign changes. The trias known for the corpus Ca: adiposity, diabetes and hypertension is confirmed. An enlargement or softening of the uterus and myomatous changes also indicate Ca. Anatomical and clinical criteria permit not only a detailed assessment of post-menopausal bleeding but also a definition of cases at risk before bleeding occurs and give an indication for detailed investigations.
In breech presentations a little more girls are born than boys, among head presentations there is a slight excess of boys. Among the factors favoring pelvic presentation birth weight has, according to present investigations, a decisive influence on the different sex relationship in the two presentations. Boys are little more common than girls in head presentation in the higher weight groups, in breech presentation in the upper and lower weight groups, while girls predominate in the middle weight groups. The absolute size of the middle weight groups in breech presentation causes the small excess of girls. A possible link with the slightly higher mortality of boys during the first year and its higher incidence in very high and very low weight groups are discussed as well as the dependence of the production of breech presentation on weight and mobility of the fetus.
Explore the source record for details and available documents.