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Biomedical subjects

U Kunze

Publications and source records attributed to U Kunze.

50 records · Page 3Linked to original sources
PubMed1980

[Gerontopsychiatry in the psychiatric land hospital (author's transl)].

Care of geriatric patients is a significant, comprehensive and at the same time difficult task facing the psychiatric hospitals run by the Land government. In this field of psychiatry too, new approaches and concepts are beginning to materialise, which, however, are rendered even more difficult by many obstacles which have to be overcome. The present article reports from the practice of a Land hospital, and describes the new accents which have to be placed on diagnostic and therapeutic aspects as a result of the opening of a new ward for gerontopsychiatric patients, and explains how these new aspects influence prognosis. The article is based on the data of 200 patients whose treatment has been completed after this study was taken up. The purpose of this article is to provide a first critical reflection on the work done by the hospital and its staff, including the stimulation of discussions with other institutes and the outpatients field of activities.

Admitting Department, Hospital↗
PubMed1977

Correlation between the clinical picture, the EEG and cerebral blood flow after partial occlusion of the middle cerebral artery in man.

Quantitative measurements of global and regional cerebral blood flow were performed in 18 patients 1 to 3 days after the onset of symptoms of acute cerebral ischemia due to partial occlusion of the middle cerebral artery and were repeated 21 days thereafter. The first rCBF measurement revealed either an extensive ischemic focus or an ischemic focus with simultaneous reduction of the global blood flow within the corresponding hemisphere in all patients. The later measurements indicated no change in blood flow in the ischemic focus in any case, but there was a slight increase of global cerebral blood flow in 1/3 of the cases. The measurements of cerebral blood flow were correlated with the neurological, psychopathological and EEG findings and in spite of an unaltered cerebral blood circulation, all patients showed a distinct clinical imrovement. Various hypotheses for the return of neurological functions in patients with persistent cerebral ischemia are discussed.

Adult↗
PubMed1977

Lapse of consciousness and automatisms in temporal lobe epilepsy: a videotape analysis.

Videotape analysis of 76 attacks in 14 epileptics showed two electro-clinical types of psychomotor attacks. The first and most common type had three clinical phases, consisting of an initial motionless stare, stereotyped movements, and reactive automatisms during impaired consciousness. The second and less common type started with stereotyped and reactive automatisms. In the first type, focal temporal or lateralizing features were common. In the second type, there were only diffuse changes in the electroencephalogram. The value of recording attacks with nasopharyngeal electrodes was emphasized by a high yield for focal-lateralizing electroencephalographic features.

Adult↗
PubMed1977

Critical remarks on external cephalic version under tocolysis. Report on a case of antepartum fetal death.

SALING and MULLER-HOLVE recently proposed an improved method of external cephalic version brought about a renewed interest in this obstetric procedure. In spite of the undisputed advantages in individual cases we posed the following questions: 1. The extent of the decreased cesaerean section rate 2. The fetal risk We estimate a decrease of cesarean sections by about 1.5% under the assumption that a breech presentation in primiparae is an indication of cesarean section and that 70% of the version attempts would be successful. The estimate includes some cases of multi-parae breech presentations which would have been operated without external version. The resulting decrease of the cesarean section rate is generally not very important and has a greater impact only in individual cases. We have some misgivings about the fetal risk. We report here on a case of intrauterine fetal death after failed external version. A 28 year-old primiparae without known pregnancy complications was admitted with a breech presentation in the 37th week of gestation. The biparietal diameter of the fetal head was appropriate and the placenta was posterior. Cardiotocogram before and after the unsuccessful version were in part misinterpreted. Seven hours after the version the fetal death was confirmed. Histological examination of the placenta showed a severe dissociated maturation disturbance in addition to a 10 X 8 cm large abruptio which had not been noted clinically. A prediabetes was suspected. The fetus itself showed no anomalies. This was interpreted as a severely placentogenically prestressed infant and prediabetes. The extent of the placental disturbance was unknown and had not been appreciated from the ultrasound examination. The placenta had acute infarcts and a circumscript abruption. The CTG was misinterpreted in part. In another case of version the postoperative cardiotocogram showed pathologic patterns. The birth occurred three weeks later without problems with a well child and an umbilical artery pH of 7.31...

Abruptio Placentae↗
PubMedDate not supplied

[Relation of breast cancer tumour stage and the degree of registration in a population-based cancer registry].

UNLABELLED: Population-based cancer registries provide a large database of cancer cases which can be used for evaluation of cancer epidemiological and care-related questions. In particular, the latest projects in breast cancer screening and quality assured breast cancer diagnostics represent appropriate databases in the use of cancer registry data for further evaluation. For breast cancer the tumour stage distribution is a well suited, early available indicator for evaluating such interventions. The problem in using data from cancer registries occurs with the rather long time period until registration can be completed (up to 3 years). Thus, early usage of cancer registry data remains rather questionable. AIM OF THE STUDY: This analysis aims to show whether the distribution of breast cancer tumour stage depends on the completeness of registration and whether a valid estimate of the tumour stage distribution is possible at an early stage, on the basis of a not fully completed registration. METHODS: The cancer registry records all new cancer cases of the Federal State of Schleswig-Holstein. For the period from 1998 to the beginning of 2003 all breast cancer cases and their tumour stage distribution were extracted at three-month' intervals. Completeness of registration for each date was estimated on the basis of cancer data from the Federal State of Saarland. The expected number of breast cancer cases for Schleswig-Holstein was set to 100%. RESULTS: In total, 7,418 patients with new breast cancer were analysed. Already at a degree of 50% of registration a stable distribution of tumour stage could be observed. For example, the variability of the T1-category (tumour size < or = 2 cm) showed a maximum of three per cent in the range from 50% up to 100% completeness. Also for lymph nodes and distant metastases just a small degree of variability from one to three per cent points could be shown. A 75% completeness of breast cancer registration was established about six months after the end of the year of diagnosis. Complete registration could only be reached significantly later, approximately after two years. CONCLUSION: For the cancer registry of Schleswig-Holstein a significant relation of the tumour stage distribution in the degree of registration could not be detected. A stable distribution could be shown with a completeness of 50-75%. Hence, it appears to be methodically justified to analyse the tumour stage of breast cancer data with sufficient validity with a completeness of 75 %. The tumour stage distribution can be used as an early indicator (about six months after the end of the year of diagnosis) for evaluation of projects like mammography screening, quality management or research on medical care.

Breast↗
PubMedDate not supplied

Subcortical arteriosclerotic encephalopathy (Binswanger's disease). A vascular etiology of dementia.

A 51-yearold man with moderate intermittent hypertension had a rapidly progressive, profound dementia in the absence of significant localizing neurological signs. Postmortem examination disclosed the vascular alterations and diffuse white matter degeneration which characterize subcortical arteriosclerotic encephalopathy (SAE) or Binswanger's disease. The case underscores the need to consider vascular disease as an etiology of dementia -- even in the absence of focal neurological deficit.

Dementia↗