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Biomedical subjects

U Schulz

Publications and source records attributed to U Schulz.

At least 127 records · Page 7Linked to original sources
PubMed1977

[Analysis of postoperative deaths in colon and rectal cancer (author's transl)].

Analysis of the clinical and autopsy reports of 200 deaths following surgery for colorectal cancer from 1956 to 1974, at the Dept. of Surgery, University of Heidelberg, revealed that pneumonia (24.5%) was the most common cause of death followed by peritonitis (22%), pulmonary embolism (15.5%), advanced tumor disease (14%), cardiac failure (9.5%), ileus (5.5%), and others (9%). The explanation for the postoperative mortality rate of 12% (cancer of colon) and 13.2% (cancer of rectum) lies in the fact that 82.5% of those who died postoperatively were beyond the age of 60, and 40.5% beyond 70 years at the time of surgery. Moreover, in 50.5% advanced tumors with regional and/or distant metastases were found. In 55.5% severe preoperative complications (ileus: 38%, peritonitis: 11%, abscess formation or hemorrhage: 6.5%) required an emergency operation. Only 38.5% of the procedures were considered for cure. Besides the need for early recognition of the cancer, intensification of pre- and postoper treatment appears to be the predominant task in the effort to decrease postoperative mortality.

Adult↗
PubMed1977

[Reconstructive surgery for supraaortic occlusions--a report of 356 cases].

Internal carotid endarterectomy is an effective and long-lasting means of preventing cerebrovascular accidents. It was entirely successful in 97% of asymtomatic patients. 85% of patients with transient ischemic attacks experienced no further symptoms. In patients with acute stroke, 52% were improved by the operation, but the mortality in this group was 23,9%. We therefore perform emergency carotid endarterectomy only in a conscious patient and within 8 hours of the stroke. The early and late results after reconstruction of the other supra-aortic vessels were good in 90% of cases.

Adult↗
PubMed1977

Leukocyte migration studies in gastric cancer detection: an approach toward improved specificity and sensitivity.

Peripheral blood leukocytes from patients with gastric cancer and various other malignant and nonmalignant diseases and peripheral blood leukocytes from apparently healthy volunteers were tested in the leukocyte migration inhibition test with the use of 4-5 different 3 M KCl extracts of gastric cancer tissue. An operational criterion for defining sensitization of patients' leukocytes was developed; i.e., evidence in an individual sample of leukocytes of either decreased or increased migration areas (migration index less than or equal to 0.79 and larger than or equal to 1.20, respectively) with 3 or more antigen extracts. With this as an indicator of sensitization, it was found that 91% of patients with gastric cancer (39/43), comparto 5% (5/94) and 3% (1/32) of patients with nonmalignant, nongastric diseases and normal controls, respectively, were reactive. Patients with various nongastric cancers were sensitized in 36% (49/135) of cases. Gastritis and gastric, as well as duodenal, ulcer did not influence the reactivity of patients' leukocytes, but considerable sensitization was found in patients with atrophic gastritis or intestinalization. When classified in the usual manner, i.e., by considering the reaction with individual tumor extracts, the specificity and the sensitivity of the test was markedly diminished: More false negative determinations were found in the group of gastric cancer patients, and the percentage of false positives in the group of nonmalignant diseases increased. The results gave evidence of tumor-associated antigens in gastric cancer patients, against which the host elicited a cellular immune response. The high incidence of positive reactivity of leukocytes from patients with gastric cancer, together with the considerable cross-reactivity of leukocytes from patients with nongastric cancer, pointed to the expression of antigens with organ-related and widespread specificities.

Adult↗
PubMed1977

A modified leucocyte migration assay as indicator of malignant and non-malignant gastric mucosal alteration.

When gastric cancer patients' leucocytes were exposed to a panel of tumour extracts, leucocyte migration reactivity was "positive" before operation (90% of cases), it declined after surgery and it reappeared in patients with local recurrence or metastases. In patients with non-malignant gastric diseases, "positive" reactivity against tumour extracts was associated almost exclusively with atrophic gastritis with and without intestinal metaplasia (24/43 cases). "Positive" patients also showed a pathological migration index with an extract of normal gastric mucosa.

Adult↗
PubMed1977

[Improvement of specificity and reactivity of the leukocyte migration test for the diagnosis and follow-up care in stomach cancer].

The leukocyte migration assay proved to be a very sensitive tool in gastric cancer diagnosis. When patients' leukocytes were exposed to a panel of 3m KCl extracts, positive reactivity was found at a rate of 92%. All patients with non-malignant gastric diseases exhibiting "positive" reactivity with gastric tumor extracts also showed a pathological migration index with a 3m KCl extract of normal gastric mucosa, while only in 16% of patients with gastric cancer leukocyte migration was influenced by this extract. Using gastric tumor extracts patients with colorectal cancer showed a cross-reactivity in 67% and patients with carcinoma of the pancreas and oesophagus in 42% of the tests. Three months after curative surgery most patients' leukocyte migration was found to be in the normal range. Positive reactivity reappeared in patients with local recurrence or metastases.

Cell Migration Inhibition↗
PubMed1977

[The afterloading system of Essen for the intracavitary radiotherapy (author's transl)].

An afterloading system for the intracavitary radiotherapy is described which works with a unique radiation source of 10 Ci 192Ir moving in steps of 1 cm. The times during which the source stops can be determined at a control panel. By using an intermediate piece of 10 cm, a total course of the source of 20 cm can be obtained. The course of the source can be calculated individually by a computer program. This program even takes into consideration an additional deep therapy if the position of the deep therapy field in the target volume is known. This method allows to adapt the total isodoses very precisely to the course of the tolerance doses.

Female↗
PubMed1977

[Radiotherapy of lymphogranulomatosis--relations between radiomyelitis and oncogenic alteration of the spinal marrow (author's transl)].

The authors compare the results of two methods of the upper and lower system irradiation in case of Hodgkin's disease with respect to the spinal marrow. The frequency of radiomyelitis is opposed to the frequency of Hodgkin-specific alterations of the spinal marrow. 74 patients were submitted to telecobalt irradiations the dosage of which was below the tolerances known for the spinal marrow. Two of them presented a radiomyelitis and two a paraplegia of Hodgkin in the irradiated region. One paraplegia caused by the formation of a tumor developed in a region next to the irradiation field; certainly this region would have been affected by a higher dosed large-field irradiation of the spinal marrow. The application of the large-field methods in 61 patients did not cause any radiomyelitis in spite of doses which were higher than the tolerance doses for the spinal marrow of Franke. Hodgkin- specific infiltrations of the spinal canal were also not observed. The large-field method can also be recommended because it seems to offer a larger therapeutic field between the risks of spinal Hodgkin manifestations and radiomyelitis.

Adult↗
PubMed1976

[Endarterectomy versus vein bypass grafts in femoropopliteal occlusions (author's transl)].

On the basis of our experience with 1827 femoropopliteal arterial reconstructions performed from 1959 through 1974 we have worked up a system of strict guidelines for the choice of procedure. The vein bypass is the method of choice in all cases at stages III/IV (i.e. resting pain or gangrene), in lengthy occlusions of the femoral arteries continuing into the distal popliteal arteries or in stenotic lesions or occlusions of the tibial arteries, in all recurrent occlusions, and in cases with calcification or dilatation of the arterial wall. The indication for endarterectomy is restricted to stage II (i.e. intermittent claudication) and to segmental occlusions of the femoral or popliteal arteries as well as transitional or lengthy occlusions of the femoral artery continuing to the proximal popliteal artery. Under these guidelines a total group of 645 patients underwent 721 femoropopliteal reconstructions-307 endarterectomies and 414 vein grafts-from 1971 through 1974. The average age of the patients was 60 years. In 50% of all cases operations were carried out for advanced ischemia treatening the extremity. For all the series the patency rate of vein bypass was 79% and of endarterectomy 71%. Accumulative patency rates by the life table method according to the preoperative degree of arterial insufficiency and the postoperative follow up period of 4 years do not show statistically significant differences between both procedures under the given guidelines.

Adult↗
PubMed1975

[Postoperative mortality and its etiology (author's transl)].

Over a ten year period of time from 1.3. 1962 to 31.12. 1972 at the Dept. of Surgery, University of Heidelberg 104927 patients were admitted to the hospital, 77950 operative procedures were carried out and 4217 patients died post operatively. The etiology of death as related to age distribution, disease and time of postop. death are discussed. The lethality causes are demonstrated by the classification of Petren. Autopsy examination reveals cardiac and/or circulatory failure to be the main cause of death (26,4%), followed by malignant tumors (12,7%), pneumonia (12,6%), cerebral causes (10,2%) and peritonitis (9,5%). Possible consequences of the distribution are being discussed.

Death↗
PubMed1975

[Experimental demonstration of hemogenous growth of various collateral nets in chronic iliac av-fistulas].

A 2 cm long iliac av-fistula is established in 13 dogs. Flow and pressure measurements are performed in the distal fistula artery and the adjacent arteries before and immediately (stage I) as well as 3 months (stage II) and 6 to 12 months (stage III) post shunt. The development of extensive collaterals adjacent to the chronic iliac av-fistula is demonstrated angiographically and by post-mortem vascular casts. After occlusion of the proximal fistula artery a retrograde flow is directed towards the fistula even in the acute stage. This "free" retrograde flow increases from 70 ml/min to 1230 ml/min in stage II and 1755 ml/min in stage III. Collaterals of the tail artery contribute approximately 44%, of the contralateral iliac artery 20% and side branches of the abdominal aorta most of the remaining 36% of the retrograde arterial fistula flow. Successive occlusion of the tail artery and the contralateral iliac artery in stages II and III results in a nearly identical per cent decrease in "free" retrograde flow and in pressure. Even in the pre-fistula stage clamping of the iliac artery induces the same relative pressure-drop in the distal iliac artery. These findings indicate, that the three main collateral networks adjacent to the iliac artery all expand proportionally to their prefistula status in the 6 - 12 months following construction of the iliac av-fistula.

Animals↗