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Biomedical subjects

W E Schreiner

Publications and source records attributed to W E Schreiner.

At least 19 recordsLinked to original sources
PubMed1989

[Major gynecologic surgery in the geriatric patient].

A retrospective analysis of 256 important interventions in geriatric gynecologic patients (over 70 years of age) was carried out. There were 77 vaginal, 86 abdominal, 9 combined abdomino-vaginal and 82 breast operations. Minor (131) and major (31) complications are described in detail. Two postoperative deaths accounted for a mortality rate of 0.8% in these patients. It is emphasized, that on the premises of a thorough evaluation of the possible treatments, a modern anesthesiologic technique, a well devised operative strategy and the modern postoperative care we can nowadays justify extensive surgery even in the very old gynecologic patient.

Aged↗
PubMed1989

A prospective randomized trial of low molecular weight heparin-DHE and conventional heparin-DHE (with acenocoumarol) in patients undergoing gynaecological surgery.

The antithromboembolic efficacy of once a day low molecular weight heparin in fixed combination with dihydroergotamine (LMWH-DHE) was compared with conventional heparin-DHE in combination with Acenocoumarol (heparin-DHE/A) in 191 patients undergoing gynaecological surgery. LMWH-DHE proved equally effective in preventing thromboembolic complications, with a similar incidence of postoperative bleeding and side effects. Deep vein thrombosis occurred once in each group and one non-fatal pulmonary embolism occurred in the LMWH-DHE group. The main advantage of LMWH-DHE was significantly better patient acceptance of the single daily subcutaneous injection as compared with the two injections of conventional heparin-DHE (P = 0.02). On the other hand, LMWH-DHE was associated with significantly increased incidence of intraoperative bleeding (P less than 0.02). The bleeding did not, however, cause any clinical problems. Discontinuation of therapy due to bleeding or pain at the site of injection occurred three times in each group. We consider the use of LMWH-DHE to be an attractive, economic and safe method of thromboembolic prophylaxis.

Acenocoumarol↗
PubMed1989

[Results of treatment of 177 stage Ib and IIa cervix cancers at the Zurich University Gynecologic Clinic].

Between 1971 and 1980, 177 patients were treated for a carcinoma of the uterine cervix (145 stage Ib, 32 stage IIa) in the Department of Gynecology and Obstetrics at the University Hospital Zürich, Switzerland. There were 115 patients who underwent radical hysterectomy combined with pelvic lymphadenectomy. Of these, 91 also received radiotherapy. Surgery could not be performed on 62 patients due to internal medical problems and risks presented by anaesthesia. They were treated solely by combined radiotherapy. Of the 177 patients, 79.5% had a squamous-cell carcinoma, 14.8% an adenocarcinoma and the other 5.7% rare types of carcinomas. Of the 115 patients who were operated, metastases of pelvic lymph nodes were found in 13% and an infiltrative carcinoma of the parametrium in 8.7%. The most severe complications we had were uretero- or vesicovaginal fistulas (5.2% of all operated patients). No significant statistical difference was found in the results of the three methods of treatment. The 5-year survival rate in stage Ib was between 61 and 81% (non corrected) and between 75 and 85% (corrected). In stage IIa, there were not enough patients for valid statistical conclusions to be drawn.

Adenocarcinoma↗
PubMed1988

[Pathologic Papanicolaou class IV smear without histologic correlation--what should be done?].

13 of 188 patients with a Papanicolaou smear Type IV of the cervix showed histologically only abnormal epithelium, CIN I or II, a result which does not explain the cytologic result. For several reasons a hysterectomy was performed in 5 cases. In only one of these patients a pathological finding, an endometrial carcinoma stage 0, was detected. In the other 8 cases a routine procedure under regular colposcopic and cytologic control had been performed. According to the results during a median follow-up over 52 months, such routine procedure is justified, if the patient wants children and if respectively a regular colposcopic/cytologic control or a control curettage after 3-6 months is undertaken.

Adult↗
PubMed1986

[Nongynecological occult cancers diagnosed in the course of their ovarian metastases. A clinical and anatomicopathological study of 8 cases].

Malignant non-gynecological diseases manifested through ovary metastases are rare but not exceptional. In routine histological examinations of the ovary within the last 6 years we have found an unknown non-gynecological disease in 8 patients undergoing surgery in the gynecological clinic in Zurich. One lobular bilateral breast cancer, one pancreatic cancer, three stomach cancers and three lymphomas were diagnosed. The symptoms, treatment, prognosis and anatomo-pathological aspects are discussed.

Adenocarcinoma↗
PubMed1986

[Perioperative prevention of thromboembolism in gynecology].

Operative or postoperative deep vein thrombosis (DVT) occurs in about 10-30% of the patients undergoing gynecologic surgery, depending on the kind of operation and the presence of predisposing risk factors. Fatal pulmonary embolism is the direct and most severe complication of DVT in 8% of all patients in the postoperative period. DVT commonly results in circulatory insufficiency and ulcers of the lower extremities. The goal of effective prevention of DVT is achieved only by the use of drugs like coumarin, dextran, low dose heparin or low dose heparin-DHE. The therapeutic value of these medicaments and their side effects will be presented and new developments shortly discussed.

Coumarins↗
PubMed1986

[Obstructive endometriosis of the efferent urinary tract].

Even though, in every 7th to 8th patient with endometriosis, it occurs in the efferent urinary tract, little attention has been paid this fact, generally speaking. This may be due in part to the atypical symptomatology of ureteral or respectively vesical endometriosis. However, its consequences can be serious in both younger patients as well as postmenopausal women. On the basis of two of the authors' own cases and the literature, the clinical symptoms and treatment of vesical endometriosis and ureteral obstruction associated with pelvic endometriosis are discussed.

Adult↗
PubMed1985

[A case of vaginal adenocarcinoma after uterine exposure to diethylstilbestrol].

From 1946 to 1971, diethylstilbestrol, a nonsteroid synthetic estrogen, came in for widespread use in the USA, and in other countries only occasional use, for the treatment of high-risk pregnancies. In 1971 a retrospective epidemiologic study showed a close association of this therapy with occurrence of vaginal and cervical adenocarcinoma in young women (mean age 19 years). Up to 1981 63% of 429 clear cell carcinomas of the vagina and cervix were related to DES exposure in utero in the USA. Following reports on a few cases in other countries, the present report is the first in a Swiss female, aged 23, with stage III DES-induced adenocarcinoma of the vagina. The risk of DES-related adenocarcinoma is estimated at about 1%, but benign teratogenic lesions are present in over 50% of patients. Vaginal adenosis is the most frequent finding, but other malformations of vagina (septa), cervix, uterus and fallopian tube may be found. Malformations of the genital tract have also been described in DES-exposed male offspring.

Adenocarcinoma↗
PubMed1985

[Purely mesenchymal homologous uterus sarcomas (leiomyosarcomas and endometrial stroma sarcomas) at the Zurich University Gynecologic Hospital].

From 1960 through 1983 sixty-four so-called pure mesenchymal homologous sarcomas of the uterus were observed at the Women's University Hospital Zürich. A review of the histological slides revealed that only 40 cases represented true sarcomas according to the contemporary diagnostic criteria. These were 25 leiomyosarcomas and 15 endometrial stromal sarcomas. Leiomyosarcomas: The leading symptoms in these patients are uncharacteristic abdominal pain (15/25) as well as bleeding disturbances (11/25), the latter being present with equal frequency in the pre- and post-menopause. In 7 of the 11 patients with bleeding abnormalities the diagnosis was already made on examination of curettings, in all the other patients after laparotomy only. Sixteen patients had Stage I, four Stage III and five Stage IV tumors. The treatment consisted in surgery alone (9/25), surgery combined with radiotherapy (11/25) or with chemotherapy (2/25) as well as radiotherapy alone (1/25). In two cases no therapy was undertaken because of advanced cachexia of the patients. Only three patients are still alive without recurrence 4 to 12 years after the diagnosis, all had Stage I tumors. Endometrial stromal sarcomas: In these patients bleeding abnormalities represent the leading symptom (14/15), especially postmenopausal bleeding (13/14). In all cases with vaginal bloody discharge the diagnosis was made on examination of the curettings, in a single case after laparotomy only. Eight patients had Stage I, three Stage II, three Stage III and one Stage IV tumors. The treatment consisted of surgery alone (4/15) or in combination with radiotherapy (4/15), radiotherapy alone (6/15) and chemotherapy alone (1/15).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗