Treatment of small cell lung cancer by different chemotherapy regimes.
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Biomedical subjects
Publications and source records attributed to W Bischoff.
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We report a case of a mucous papillary tumor in the bladder. Initial treatment was transurethral resection but open partial bladder resection became necessary. Operation revealed an appendix tumor penetrating the bladder. Histologically, it was primary adenocarcinoma of the appendix.
In 43 patients with histologically proved hypernephroid kidney cancer evaluation of the electrophoretic results, serum alkaline phosphatase, thromboplastin time (Quick's time) and bromthalein retention (n = 10) was carried out. As a control group the serum values of 10 patients with clinical tentative diagnosis of hypernephroid kidney cancer were checked; in this group operation and histological examination showed no kidney tumor. Only in one patient we found the typical constellation with elevated alkaline phosphatase, diminished albumin, elevated alpha-2 globuline fraction, and decreased thromboplastin time. 10 patients with histologically proved hypernephroid kidney cancer (nephrectomy) did not show any hepatic dysfunctions. Concerning the laboratory findings there was no difference between the two groups. In case of hepatic dysfunctions of unknown etiology a liver punction should be carried out for histologically examination. The cause of hepatic dysfunction (Stauffer syndrome) in cases of hypernephroid kidney cancer are discussed.
Angiomas of the kidney are benign vascular dysplasias, which usually can be identified angiographically. If there are no clinical symptoms treatment is not necessary. In cases of hematuria and/or hypertension either intra-arterial superselective embolization seems to cause less functional loss of the renal parenchyma, whereas excision often leads to heminephrectomy or even total nephrectomy. Even if the angioma is initially not completely embolized followup study to 2 years has shown complete occlusion of the angioma, either owing to inflammatory reactions or redistribution of blood flow and diminished blood pressure. Two cases of renal angiomas are presented. Treatment consisted of intra-arterial superselective embolization in 1 case and surgical clipping of the supplying arterial branch in the other.
Successful embolisation of an arteriovenous angioma of the kidney with gel foam suspension is described, with a two year follow-up. Embolisation cured hypertension, which had otherwise resisted treatment, and stopped haematuria. The need for careful follow-up is stressed with long-term observations using both angiography and scintigraphy of the affected kidney. The intra-arterial embolisation with gel foam resulted in a redistribution of blood-flow which led to complete success of treatment even thought the vascular malformation had not been totally obliterated.
The value of the catheter occlusion therapy is analyzed in 92 cases retrospectively, and the indication, and complication risk of these procedures are considered. In the following vessel areas occlusion with different methods have been performed with decreasing frequency; kidneys, pelvis, legs, gastrointestinal tract, external carotid and internal carotid artery. Serious complications have been observed in therapeutic investigations at the head, especially in occlusions of the external carotid artery. In this group embolisation therapy should be performed with strict indication only.
In 7 dogs renal arterial embolization was performed using the Seldinger technique and an inflatable Swan Ganz balloon catheter. Methyl methacrylate and butyl-2-cyanoacrylate were injected. 6 months later, the tissue concentration of Cefazolin was measured in the embolized and contralateral kidneys and in serum 2 h after a short infusion of 1 h Cefazolin. The concentrations in serum and homogenized kidney tissue were determined by means of the agar gel diffusion method. Angiography showed no vessels in the embolized kidneys. Histologically there was total atrophy of the tissue, especially of the tubular system. The mean tissue level of Cefazolin in the embolized kidney was 70% of serum. The tissue concentration was always above 10 micrograms/g. This concentration is high enough to inhibit nearly all strains of E. coli, Klebsiella, Salmonella, Shigella and a large part of Proteus mirabilis, whereas nearly all gram-positive bacteria are inhibited at a lower concentration. The value and necessity of antibiotic therapy in embolized kidney cancer is discussed.
A new instrument for (semi-)open renal biopsies is presented. The advantages of this instrument are proved in animal experiments. Histopathological studies in animal and human renal tissues have shown the efficiency of the biopsies.
First experiences concerning reconstructive vascular surgery in malignant tumor surgery are presented. In order to improve total tumor excision, the resection of great veins or nutritive arteries may become necessary. In some cases the reconstruction of vascular defects together with tumor resection may be indicated. Only in the case of younger patients vascular reconstruction of essential vessels seems to be indicated.
Presentation of an eleven year follow-up of a case of angioblastoma of the cerebellar hemisphere and multiple bilateral renal hamartomas in a female patients. Malignant degeneration of these hamartomas was detected early due to regular and careful follow-up examinations.
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In 7 dogs renal arterial embolization was performed using Seldinger technique and inflatable Swan Ganz balloon catheter by injection of methyl methacrylate/butyl 2 cyano acrylat. Six months later tissue concentration of cefazolin was measured in the embolized and kontralateral kidneys and in serum two hours after a short infusion of 1 g of Cefazolin. The concentrations in serum and homogenized kidney tissue were determined by means of the agar well diffusion method. Angiography studies showed no vessels in the embolized kidneys. Histologically there was total atrophy of the tissue especially the tubular system. The mean tissue level of Cefazolin in the embolized kidney was 70% of serum. The tissue concentration was always above 10 microgram/g. This concentration is high enough to inhibit nearly all strains of E. coli, Klebsiella, Salmonella, Shigella and a large part of Proteus mirabilis, whereas nearly all gram-positive bacteria are inhibit at a lower concentration. Value and necessity of antibiotic therapy in embolized kidney cancer is discussed.
In the treatment of bladder hemorrhage intravesical formalin and arterial embolization with their techniques and complications are described and supplemented by our own experiences. Critical reflexions are added about therapeutic use and limitation of both methods.
By artificial embolization before extensive septic amputation arrosion bleedings that are otherwise noncontrollable can be prevented. Resorbable gelatine (Gelforam) is suitable for embolization. For safety one can leave a balloon catheter above the embolized vessel segment for several days.
Case report on a leiomyoma of the prostate, becoming a leiomyosarcoma within 15 months. The patient was cured by radical surgery. The difficulties of histological diagnosis and proper surgical treatment are discussed.
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