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Biomedical subjects

W Heidenreich

Publications and source records attributed to W Heidenreich.

At least 19 recordsLinked to original sources
PubMed1995

[100 years radical abdominal operation of cervix carcinoma: in memory of Wertheim's predecessors].

1895 was a crucial year in the course of the development of abdominal radical surgery for effective treatment of cervical cancer. In March of 1895, Ries presented the rationale of modern radical hysterectomy and was the first to call for systematic removal of pelvic lymph nodes. Independently, Clark in Baltimore, Rumpf in Berlin, and Latzko in Vienna performed the first radical hysterectomies. This article is dedicated to the memory of the contributions by these four pioneers of surgical gynecology presented in 1895.

Europe↗
PubMed1995

[Modified Sarafoff suture for single layer closure of uterotomy in cesarean section. A prospective study].

125 caesarean sections were performed at the Department of Obstetrics and Gynecology, Allgemeines Krankenhaus Celle, during the last 6 months of 1991. The caesarean section rate was 13.4% (930 deliveries in that period).--For closure of the uterotomy a two-layer suture was applied (62 patients) as well as a one-layer suture, the modified Sarafoff suture (63 patients). Both techniques were used alternatively. We compared intraoperative and postoperative courses of the two groups of patients in a prospective study. Between the 8th and 10th day after surgery an ultrasonic examination of the scar was performed. The data in both groups did not show any significant difference, except that the scar in the one-layer group was thinner.--So, our results did not support an advantage of the one-layer suture as compared to the two-layer technique.

Adult↗
PubMed1994

[Giant ovarian cystoma in mature pregnancy].

Ovarian tumours occurring during pregnancy pose considerable problems in respect of diagnosis and treatment. Unexpected difficulties arose in the case of patient suffering from a giant ovarian cystoma which ruptured sub partu and was diagnosed only during an emergency Caesarean section. Ileus occurred on the sixth postoperative day. This had been caused by an operation cloth left in the abdomen following the Caesarean section. The patient was awarded damages of DM 5000,-.

Abdomen, Acute↗
PubMed1994

[Increasing age in surgical interventions].

The percentage of octogenerians and older patients receiving surgical therapy has increased from 1.1% to 4.6% in the last 10 years in the department of gynecology and obstetrics of the AKH Celle. The indications for surgery can be subdivided into two categories in these very old patients: total or subtotal prolapse often accompanied by a large degree of individual suffering and carcinoma or at least suspected carcinoma. The postoperative complication rate amounted to 6.8% which is only insignificantly more than the general complication rate. An improvement of quality of life is the primary factor for the surgical indication.

Aged↗
PubMed1992

[Malaria tropica and pregnancy].

The authors report on a female patient of 26 years of age suffering from malaria tropica infection in her 36th week of pregnancy with fatal outcome. The newborn (after performance of Caesarean section) was infected connatally. Although infections with malaria are rare in Europe today--especially during pregnancy--there is a probability of rising incidence on account of increasing international tourism. Therapeutic problems are expected to multiply due to the resistance of Plasmodia to antiparasitary medication. Additionally pregnancy involves the risk of a more severe course of the disease in the mother. Pregnant women should be discouraged from travelling to countries with malarial risk because of the likelihood of a high rate of abortion, danger of intrauterine retardation, increased incidence of premature deliveries and risk of connatal infection of the newborn. If such warnings cannot be heeded, the persons concerned must be given all relevant information on conventional preventive measures in accordance with WHO recommendations and drug prophylaxis as recommended by a hospital or institution dealing with tropical diseases according to updated standards. The measures to be taken must be adapted to the individual risk of exposure of the patient.

Adult↗
PubMed1991

[Improvement of the mesh-graft method with use of a fibrin glue. Contribution to the surgical correction of vaginal aplasia].

Congenital absence of the vagina can be corrected by covering the walls of the neo-vagina with skin mesh grafts. We performed this operation in 6 patients, of whom 3 had been operated before without success, and used fibrin sealing for hemostasis and fixation of the grafts. The results were very satisfying. In each case the length of the neo-vagina has completely been maintained until now, without any shrinking or shortening.

Adult↗
PubMed1990

Cytologic findings after construction of a neovagina using two surgical procedures.

Construction of a neovagina using the Grossman and mesh-graft techniques was done upon 20 patients with congenital absence of the vagina. Evaluation of cytologic specimens taken one to 13 years after the operation showed a remarkable resemblance to those from normal epithelium. In 18 of 20 patients, keratinization only pointed to the origin of the graft. No nuclear atypia or history of cytologic dysplasia was found. Thus, regular gynecologic and cytologic examinations, according to the principles applied to healthy women, are sufficient in patients who have undergone construction of a neovagina.

Adult↗
PubMed1989

[Treatment of withdrawal symptoms using clonidine during pregnancy].

In order to prevent symptoms of drug withdrawal during pregnancy, we treated a woman with clonidine, an alpha-2 adrenergic agonist with central and peripheral actions. We saw a good response of the withdrawal symptoms without any period of severe hypotension or bradycardia. Two healthy babies were subsequently delivered by cesarean section.

Adult↗
PubMed1988

[Genital and extragenital abnormalities in Mayer-Rokitansky-Küster syndrome].

Only 28 of 51 patients with the Mayer-Rokitansky-Küster (MRK) syndrome had the typical findings of vaginal aplasia and bipartite solid uterine buds. Among the other 23 patients 15 had additional malformations of the kidneys and urinary tract. Eight patients had more or less marked skeletal malformations, especially of the cervical vertebrae. The term "MRK syndrome" should no longer be used for such cases with extragenital malformations.

Abnormalities, Multiple↗
PubMed1988

[Long-term results of Grossmann vaginoplasty].

17 patients with the Mayer-Rokitansky-Küster-Syndrome who had been operated 1972-1978 using the Grossmann vaginoplasty are reviewed. 14 patients were examined 9-13 years after the operation. The results were rather similar: the vaginal opening seemed to be normal, but the vagina was only 6-7 cm long. 13 patients were completely satisfied and refused the proposal of lengthening the vagina.--Grossmanns vaginoplasty is a safe, rather simple method. Satisfying long-term-results can be obtained by this operation.

Female↗
PubMed1988

[Determination of the growth fraction using monoclonal antibody Ki-67 in breast cancers].

In 329 breast tissues (120 benign lesions and 209 invasive breast carcinomas) the growth fraction was determined using the monoclonal antibody Ki-67. The percentage of Ki-67 positive cells or the Ki-67 growth fraction was determined on histologic and cytologic specimens after immunoperoxidase staining. In benign breast lesions, the Ki-67 growth fraction never exceeded 11%, whereas in breast cancer 14.4 +/- 9.9% of cells were Ki-67 positive ranging from 1 to 48%. Breast carcinomas were classified according to the histologic grading system of Bloom and Richardson (G1-G3). Poorly differentiated carcinomas. (G3) had significantly higher Ki-67 growth fractions than well differentiated tumors (G1). Ki-67 was also correlated with axillary lymph node status. Growth fractions of N+ carcinomas were significantly higher than those of N0 tumors (16.4 +/- 10.4% versus 12.4 +/- 9.4%; p = 0.006). Thus, this new method yields similar results to those obtained by other researchers through the use of flow cytometry and thymidine labelling. As determination of Ki-67 growth fractions is an easy and rapid technique, it is ideal for routine clinical use. Ki-67 may be useful in prognosis and in the selection of patients for various treatment modalities such as adjuvant therapy. A wide-spread use of Ki-67 would be helpful to gain further experience.

Antibodies, Monoclonal↗
PubMed1987

[T-cell classification of the peripheral venous blood of patients with breast cancer].

Using monoclonal antibodies the total number of T-lymphocytes, as well as of helper and suppressor T-cells, was measured in peripheral venous blood of 78 women with carcinoma of the breast and 68 women without malignant disease (control group). There was no significant difference between the two groups as regards pre-operative values. The same was true with regard to different carcinoma stages. Serial tests on 15 patients who had received adjuvant chemotherapy revealed a reduction in the absolute number of all lymphoid cells except monocytes. Helper T-cells were more strongly affected than suppressor T-cells. By determining lymphocyte subpopulations in women with leukopenia caused by cytostatics one will probably be able to identify those patients particularly susceptible to infection. Determining T-cells may also make it possible to deduce a special recurrence risk.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

The correlation of growth fractions with histologic grading and lymph node status in human mammary carcinoma.

The monoclonal antibody Ki-67 reacts with a human nuclear associated with cell proliferation that is expressed only in the G1, S, G2, and M phases of continuously cycling cells. This offers a simple opportunity to determine the growth fraction of tumors by immunostaining of fresh tissue. One hundred fifty-four invasive carcinomas of the breast were used in this study. The average number of Ki-67 positive cells was 15.3 +/- 10.1% (range, 1%-48%), whereas in 41 benign lesions of the breast only 4.4 +/- 2.6% (range, 1%-10%) of cells were positive. A correlation was found between growth fractions and histologic grading. On average, N+ tumors with less than four positive lymph nodes had a significantly higher growth fraction (20.4 +/- 14.2%) than N0 tumors (13.0 +/- 9.2%), whereas N+ tumors with more than three lymph node metastases had only 17.3 +/- 3.6% Ki-67 positive cells. This method yielded similar results to those obtained by other researchers through the use of flow cytometry and thymidine labeling. Determination of growth fractions by Ki-67 is suitable for routine use and may be useful in prognosis and in the selection of patients for various treatment modalities.

Antibodies, Monoclonal↗
PubMed1987

Determination of growth fractions in benign breast disease (BBD) with monoclonal antibody Ki-67.

Certain types of benign breast disease (BBD) carry an increased risk of malignancy. Several morphological criteria such as an atypia score are used to define this group, and the use of a kinetic parameter may provide additional information. Therefore, the growth fractions of 120 benign breast lesions were determined using the monoclonal antibody Ki-67. The values obtained range from 0.3% to 10.8% (average 3.1% +/- 2.2%) compared to breast carcinomas with an average of 15.3% +/- 10.1%, range 0.8% to 47.8%. All specimens were classified using the terminology of Azzopardi. The prevailing histological entities were cystic disease, fibroadenoma, and blunt duct adenosis. Between these groups no differences in growth fractions were observed. Postmenopausal patients had slightly lower values than premenopausal women. Further prospective studies are needed to evaluate whether those cases of BBD with a high number of Ki-67 positive cells have an increased risk of breast cancer, independently from conventional histological classifications.

Adenoma↗
PubMed1986

[Therapy and results of the treatment of breast cancer. A report on 1,003 cases 1970 to 1978].

1003 women with invasive breast carcinoma were treated in the Department of Obstetrics and Gynecology, Medical School Hannover, between 1970 and 1978. In 787 patients modified radical mastectomy was combined with postoperative radiation therapy. In 797 patients, who were observed for at least 5 years, the 5 year survival rate was 63.0%, depending on tumor stage. In spite of intensive loco-regional treatment, local recurrence occurred in 18.0%. For us, that was one among other reasons to discontinue routine postoperative radiation therapy.

Adolescent↗
PubMed1986

[Therapy and results of the treatment of vulvar cancer. A review of 234 cases 1951-1976].

From 1951 to 1976 234 patients with invasive carcinoma of the vulva were treated at the Department of Obstetrics and Gynaecology, Medical School Hannover. 53.3% of these patients underwent simple vulvectomy. Radical vulvectomy and lymphadenectomy was performed in 17.9%. 45.7% received postoperative radiotherapy. -213 patients were followed up 5 years or more. After surgery alone the 5-year-survival rate was 56.9%, after operation and radiotherapy 43.4%, after exclusive radiation 14.2%. The 5-year-survival rate of all patients was 42.7%.

Adenocarcinoma↗
PubMed1986

[Spontaneous splenic rupture as a cause of postoperative hemorrhage].

Following a vaginal hysterectomy without complications, intraperitoneal after bleeding from an adnexal stump occurred, making a laparotomy necessary. On the following day a second laparotomy had to be performed because of a recurrence of hemorrhage in the abdominal cavity. The source of the bleeding could not be found. A third laparotomy the next day revealed a splenic rupture, which had evidently occurred spontaneously. Spontaneous ruptures of a normal spleen are considered rare. In cases of intraperitoneal hemorrhage where the source of bleeding cannot be found, the possibility of splenic rupture should be considered, even if there is no history of trauma.

Adult↗