Search PubMed⌕ Search

Biomedical subjects

T Junginger

Publications and source records attributed to T Junginger.

At least 199 records · Page 11Linked to original sources
PubMed1994

Factors influencing survival after resection of pancreatic cancer. A DNA analysis and a histomorphologic study.

BACKGROUND: The influence of DNA content on prognosis in stomach cancer has been investigated rarely, and the results are controversial. METHOD: The prognostic relevance of the DNA content and histomorphologic parameters was evaluated in 41 patients after resection of pancreatic cancer. RESULTS: In the univariate analysis, the DNA content, tumor size, lymph node status, tumor stage, nuclear grade, and type of resection had a statistically significant influence on the prognosis. No association was found between the DNA content and the histomorphologic features. Apart from the operative procedure, the DNA content was the strongest indicator of prognosis in the multivariate analysis. CONCLUSIONS: Further investigations are necessary to find out if DNA analysis can be performed preoperatively on material obtained by fine-needle aspiration.

Cell Nucleus↗
PubMed1994

[Aortoduodenal fistula. Incidence--diagnosis--therapy].

Six patients were operated on for an aortoduodenal fistula at the Department of General and Abdominal Surgery, Johannes-Gutenberg-University Mainz. All patients had received an aortic graft implant between 1 and 10 years ago. The etiology, symptoms, and diagnostic and surgical treatment of these six cases are presented, and the results are discussed in comparison with the results of other studies. The main symptom of all of our patients was gastrointestinal bleeding. In our patients arteriography and computed tomography were the best diagnostic procedures. At surgery, five patients underwent graft excision and axillobifemoral bypass (only four patients, as one died before implantation). In the other patient a local repair, with closure of the graft defect and bowel defect, followed by interposition of an omental pedicle, was performed. Two patients died within 6 days of operation due to multiple organ failure.

Aged↗
PubMed1994

[Long-term animal experiment analysis of the use of resorbable staple sutures in partial gastrectomy].

In animal experiments with a 12-month follow-up, the safety and compatibility of absorbable staple lines following gastrointestinal surgery were analysed. In two groups of pigs, partial gastrectomies with gastroduodenostomy (Billroth I, n = 10) or gastrojejunostomy (Roux-en-Y, n = 12) were performed, and Lactomer-a copolymer of glycolic acid and lactic acid-staple lines were used for closure of the lesser curvature of the stomach and the duodenal stump. Application of the staple lines caused no problems and was safe. In 1 of the 22 pigs, which died of an ileus 9 days postoperatively a suture dehiscence (4.5%) at the lesser curvature of the stomach was observed. Macroscopic examination showed no major inflammation around the staples. Microscopically complete absorption of the Lactomer staples without extensive scarification in the gastrointestinal wall could be demonstrated 12 months postoperatively. Our results yielded no contraindications for the clinical use of absorbable staple lines in gastrointestinal surgery. The manufacturer has given advance notice of smaller staples, which it is considered will be an advantage.

Absorption↗
PubMed1994

[Endoscopic, extraperitoneal adrenalectomy].

Between March and June 1994 three adrenalectomies were performed via an endoscopic extraperitoneal approach. After creating a carbon dioxide retropneumoperitoneum three 10 mm trocars were introduced in the area of conventional lumbar incision. Via these ports adrenalectomy was performed. Time of operation amount to 215, 290 and 330 min. No postoperative complications were observed. Time of postoperative hospitalisation amount to 3, 4 and 7 days. The advantage of the extraperitoneal approach is that it decreases postoperative pain and allows more rapid recovery.

Adenoma↗
PubMed1994

[The value of quantitative DNA analysis in evaluating the prognosis of differentiated thyroid cancer].

In this study we analyzed DNA ploidy as a potential prognostic parameter in differentiated thyroid carcinoma. In the case of papillary cancer the depth of tumor infiltration, a micro- or macroinvasive tumor growth, an invasion of vessels and the ploidy had an influence on prognosis. In the case of follicular cancer depth of tumor infiltration, the presence of distant metastasis, grading, uni- or multifocal tumor growth and the ploidie had an influence on prognosis. In the case of papillary cancer the multivariate analysis for the ploidy shows a strong and independent influence on the prognosis. Even when comparing with tumor stage, EORTC score and AGES score the ploidy allows an additional prognostic differentiation. In follicular carcinomas a multivariate analysis was not possible due to the strong associations of the prognostic parameters.

Adenocarcinoma, Follicular↗
PubMed1994

Epidemiology of hepatocellular carcinoma. Evaluation of viral and other risk factors in a low-endemic area for hepatitis B and C.

To assess whether hepatocellular carcinoma (HCC) in patients with cirrhosis of the liver is associated with particular risk factors, a retrospective, case-control study was performed. Eighty-six patients with HCC (90% had underlying cirrhosis of the liver) were compared with 86 controls who had cirrhosis but not hepatocellular carcinoma. Hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc), and to hepatitis C virus (anti-HCV) were evaluated; and alcohol and nicotine abuse were assessed by history. The prevalence of HBsAg and anti-HBc was similar in both, case and control patients. Antibodies to hepatitis C virus were detected more frequently among patients with HCC and cirrhosis (37%) compared to cirrhosis alone (22%). Alcohol abuse was found more frequently in patients with cirrhosis alone. Smoking habits were comparable between the two groups. None of the tested variables were related to an increased risk for HCC. Using an ordinary logistic regression approach, none of the variables could be identified as an independent risk factor for HCC. However, the combination of hepatitis B virus infection and hepatitis C virus infection was more prevalent in the patients with hepatocellular carcinoma and cirrhosis (48%) when compared to patients with cirrhosis alone (13%) (odds ratio 6.364; CI 1.149-35.229). In conclusion, we failed to identify independent risk factors for the development of HCC in Germany. However, the combination of hepatitis B and C virus infection increases the risk for liver cancer. Molecular analyses have to be performed to elucidate viral hepatocarcinogenesis.

Aged↗
PubMed1993

Prognostic value of DNA analysis in colorectal carcinoma.

BACKGROUND: Reported experiences regarding the prognostic significance of DNA content in colorectal carcinoma have been a matter of controversy. METHODS: DNA analysis with image cytometry was performed in 137 patients with colorectal cancer. Only patients who had resection without tumor residual and who did not die postoperatively as a consequence of the operation were entered in the study. At the time of DNA analysis, neither the histomorphologic data nor the relapse-free survival time of the patients were known. RESULTS: In this investigation the DNA content of tumor cells had no univariate or multivariate influence on the relapse-free survival time. The prognosis was dependent on the tumor localization, depth of tumor infiltration, lymph node metastasis, and grade. CONCLUSIONS: DNA content provides no additional prognostic information in colorectal carcinoma.

Adult↗
PubMed1993

Perioperative nonspecific histamine release: a new classification by aetiological mechanisms and evaluation of their clinical relevance.

As a consequence of the performance of a randomized controlled clinical trial on perioperative histamine release and cardiovascular and respiratory disturbances, several types of increases in plasma histamine had to be distinguished instead of only two which existed at the beginning of the study: drug-induced allergic and pseudoallergic reactions. First of all, the new classification by aetiology (clinical epidemiology) was derived from a meta-analysis (secondary analysis) of the most recent literature. According to that histamine release in the perioperative period has several, different causes and is involved in several, different disease manifestations. A clear distinction (classification), however, is necessary if histamine release as an unwanted (adverse) effect has to be recognized, value judged according to its clinical relevance and therefore also prevented by histamine antagonists. Histamine release by neuro-endocrine and neuro-inflammatory mechanisms, cytotoxic histamine release and local, cytokine induced histamine release have been distinguished from pseudoallergic histamine release, but its functions are not yet clear. It has been analysed in prospective trials which used special clinical situations as models: patients on a normal ward or before and during upper GI endoscopy without premedication, but also in specific phases of laparoscopic cholecystectomy (trocar phase and dissection phase). Their existence in the clinical reality is now very likely, but new trials must investigate the pathophysiological effects such as in metabolism, coagulation, pulmonary haemodynamics (shunt volume) and gastric acid secretion. Histamine release by pseudoallergic mechanisms, however, was identified in the very vulnerable post-induction phase of anaesthesia up to skin incision. Its incidence was much higher than ever expected and its clinical relevance was demonstrated by the severity of reactions and the intervention strategies of the anaesthetists who were blinded concerning the type of the plasma substitute given and the prophylaxis with antihistamines. Pseudoallergic histamine release was clearly unwanted (adverse). Its occurrence in the other phases of anaesthesia has to be further evaluated in the tedious procedure of data analysis of the Mainz-Marburg-trial. The overall incidence of histamine release in the trial was so incredible high (72% of all patients, some of them with up to 4 episodes of histamine release) that a distinction between pseudoallergic (unwanted) and other types of histamine release (possibly less unwanted or even beneficial) is urgently needed. In the phase of steady state (maintenance) of anaesthesia the H1-(+)H2-prophylaxis was highly effective. Further analysis must show whether this is also the case during the phases of induction of anesthesia.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1993

Endoscopic ultrasonography in the diagnosis of regional lymph nodes in esophageal and gastric cancer--results of studies in vitro.

A total of 90 regional lymph nodes (43 benign/47 metastatic) from 16 surgical resection specimens of patients with esophageal and gastric carcinoma were examined in vitro by endosonography. The validity of endosonographic criteria of lymph node dignity (size, echogenicity, internal echo pattern and margin structure) was assessed using computer-supported B-mode analysis and compared to histopathological results. Of 26 lymph nodes with a diameter of more than 10 mm, 19 were metastatic (72%). The subjective assessment of the internal echo pattern (homogeneity) and the node margins by an experienced observer allowed the diagnosis of metastatic lymph nodes, but there was a high proportion of false positives (52%). Lymph node echogenicity, assessed either subjectively or by computer analysis, did not permit the differentiation between benign and metastatic lymph nodes.

Endoscopy↗
PubMed1993

[Image analysis DNA cytometry in medullary thyroid gland cancer. Comparison with histomorphologic parameters and prognostic effect].

In 24 patients with a medullary thyroid cancer a histopathological reexamination was performed. In 16 patients the DNA content was measured. Patients with a diploid or hypotriploid tumor had a 5-year survival rate of 100% in contrast to 48% of patients with a triploid or hypertriploid aneuploid tumor. Aneuploid tumors were more often found in patients with a high pre- or postoperative calcitonin level and lymph node metastasis. No correlation was found between the DNA content and the patients age, sex, preoperative CEA value, tumor size, pT4 stage, invasion of vessels calcitonin immunoreactivity, silver or amyloid staining, and distant metastasis.

Adolescent↗
PubMed1993

[Thoracoscopic operation of a tumor of the esophageal wall].

Improvements in video endoscopic technique opens a wide spreaded field of indications of thoracoscopic surgery especially in benign tumors of the esophagus. A 58-years old patient presented with dysphagia. Preoperatively a benign, intramural tumor of the esophagus wall was diagnosed. Enucleation of the tumor was performed by right videothoracoscopy. The use of thoracoscopic operative technique implies rapid disappearance of complaints and a reduced time of hospitalisation.

Deglutition Disorders↗
PubMed1993

[Value of image analysis DNA cytometry in cancer of Vater's ampulla].

In 27 patients who underwent partial duodenopancreatectomy due to cancer of the ampulla of Vater, in addition to the TNM classification and usual morphologic criteria, the paraffin-embedded material underwent deparaffinization, was rehydrated, and was mechanically and enzymatically processed into a single-cell solution. For evaluating the DNA histogram this was analyzed with the help of automatic single cell cytophotometric study. At the time of DNA analysis the histomorphological data and the survival time of the patients were not known. In the univariate analysis the 5-year survival rate of patients with diploid or hypotriploid tumors (n = 12) was 69% of patients with diclonal (diploid-triploid n = 7, triploid-tetraploid n = 1) tumors was 62.5% and no patient with a triploid or hypertriploid tumor (n = 7) survived 5 years. No association could be found between the known prognostic criteria and the DNA content. The multivariate analysis shows that beside the lymph node status, the DNA content of tumor cells had a strong and independent influence on the prognosis in cancer of the ampulla of Vater.

Adenocarcinoma↗
PubMed1993

[Cushing syndrome in ACTH-producing neuroendocrine tumor of the hepatic duct].

We present a patient with an ACTH producing neuroendocrine tumor of the hepatic bile duct which was detected by chance during abdominal surgery for Cushing's syndrome. Diagnostic strategy and surgical therapy in patients with neuroendocrine tumors are discussed. The diagnostic problems caused by combination with an endocrine function disorder like Cushing's syndrome are pointed out.

ACTH Syndrome, Ectopic↗
PubMed1993

[Risk factors of perioperative morbidity and mortality in colorectal cancer with special reference to tumor stage, site and age].

The perioperative risk was prospectively analyzed in 511 patients with colorectal cancer, out of which 5% had an emergency procedure. The morbidity rate was 23.6% without an association with tumour stage or localization. The incidence of nonsurgical complications rose with increasing age because of a rising number of concomitant illnesses (< 50: 5.7%, > 80: 28.1%). The morbidity was associated with an increasing blood loss during the operation (< 500 ml: 10.6%, > 2000 ml: 30.4%), but not with the type of treatment. The overall operative mortality rate was 2.3% with the same rate of surgical complications and complications of preexisting conditions. Morbidity and mortality following emergency procedure were 56%, respectively 20%, expressing mainly septical complications of colorectal cancer.

Adult↗
PubMed1992

DNA image cytometry in stomach carcinoma. Its relation to histomorphologic parameters and its influence on prognosis.

BACKGROUND: The influence of DNA content on the prognosis in stomach cancer is controversial. METHOD: After curative resection of stomach carcinomas (adenocarcinomas [n = 58]; signet ring cell carcinomas [n = 24]; undifferentiated carcinomas [n = 21]), the influence of the DNA content and histomorphologic parameters on the prognosis was examined. RESULTS: In the multivariate regression analysis, the prognosis depended on the lymph node status (P = 0.0009), pT stage (P = 0.02), tumor localization (P = 0.03), and histologic type (P = 0.05). The prognosis was independent of the DNA content. Furthermore, the degree of differentiation, operative procedure, safety distance, size of the tumor, and sex and age of the patient also did not influence the prognosis. CONCLUSIONS: The DNA content of the tumor cells in stomach carcinoma does not influence prognosis.

Adenocarcinoma↗