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Biomedical subjects

W Jonat

Publications and source records attributed to W Jonat.

122 records · Page 7Linked to original sources
PubMed1978

Some comments on the necessity of receptor determination in human breast cancer.

Estrogen receptors (ER's) were determined by agar gel electrophoresis in 105 human mammary tumor biopsies. Fifty-three tumor specimens revealed measurable amounts of receptor, and 64% of these patients showed an objective remission after endocrine treatment. If we also include cases with partial remission, previous response, and arrested growth but no actual remission, the benefit rate increases to 87%. The corresponding percentage in the ER-negative groups is 13%. In a retrospective study of 42 patients with human breast cancer, a correlation between ER finding and remission rate after chemotherapy was found. Of the ER-negative patients, 71% showed an objective remission after polychemotherapy, whereas only 43% of the ER-positive cases revealed such remission. The presented data are discussed with special regard to their clinical relevance.

Antineoplastic Agents↗
PubMed1978

[Bilateral carcinoma of the breast after radiotherapy and chemotherapy for Hodgkin's disease (author's transl)].

A 34-year-old patient had radiotherapy and chemotherapy for Hodgkin's disease of the nodular sclerosing type 2 A thirteen years prior to the treatment of a right cancer of the breast in the stage M0 N1 T3. Seven months later the patient had a left cancer of the breast in the stage M0 N0 T4. The literature is reviewed and the possibility of occurrance of secondary carcinoma following treatment of Hodgkin's disease is discussed.

Adult↗
PubMed1976

Progesterone in the uterus. VI. On the question of the in vitro progesterone metabolism in human endometrium and myometrium.

Human endometrial and myometrial tissue pieces were incubated with radioactively labeled progesterone in nutrient medium for 20 min., 1 hr and 2 hrs. The only compound extracted from the tissue pieces and the nutrient fluids was identified to be progesterone by TLC, chemical reactions and crystallization experiments. Radiometabolites could not be detected in the tissue pieces and in the nutrient fluids under the experimental conditions applied (10(-7) M 1,2-3H-progesterone in the incubation medium). This result is comparable with recent findings on the in vitro progesterone metabolism by rat uterine tissue.

Chromatography, Thin Layer↗
PubMed1975

Progesterone in the uterus. IV. Dependence of the in vitro progesterone metabolism in the rat uterus on the progesterone concentration.

After incubation of uterine segments of normal rats with various 3H-progesterone concentrations in nutrient medium, different patterns of radioactive steroids were obtained in uterine tissue. Using hormone concentrations of less than 5 X 10(-7)M progesterone metabolites could not be detected in the tissue. A series of metabolites appeared with progesterone concentrations of 10(-6)M and higher. Six radiometabolites were identified and two were characterized.

Animals↗
PubMedDate not supplied

Short rib-polydactyly syndrome type III: comparison of ultrasound, radiology, and pathology findings.

Short rib-polydactyly syndrome (SRPS; types I-IV) is an autosomal recessive, lethal skeletal dysplasia characterized by short-limb dysplasia, narrow thorax, and polydactyly. This syndrome is invariable and can be detected by 2-trimester ultrasound. The underlying gene has not been discovered yet. We report a case of SRPS subtype III Verma-Naumoff-Le Marec that was sonographically detected at 20 weeks' gestation and compare prenatal ultrasound with postmortem findings from pathology and radiology. Since the risk of recurrence is 25%, early ultrasound for consecutive pregnancies was advised and performed at 11+6 weeks' gestation in the following pregnancy without any findings. Ultrasound diagnosis in this rare case of SRPS is a valuable tool for identification and early management, since there are no specific biochemical or histopathological markers for this syndrome. Radiological and pathological findings confirmed SRPS type III and assisted in the differential diagnosis of the subtype.

Adult↗
PubMedDate not supplied

A case of fetal parvovirus B19 myocarditis, terminal cardiac heart failure, and perinatal heart transplantation.

We report a case of fetal cardiomegaly secondary to myocarditis as a result of intrauterine parvovirus B19 infection. The fetus was delivered through caesarean section because of increasing deterioration of cardiac function at 33 + 3 weeks with reverse flow in the ductus venosus. Four weeks later, a cardiac transplantation was carried out because of therapy-resistant dilative cardiomyopathy. This case shows that fetal parvovirus B19 infection may occur without anemia and myocarditis and does not always result in spontaneous reformation of a dilated heart and normal recovery. It may become the determining prognostic factor for the child.

Adult↗
PubMedDate not supplied

Intraoperative evaluation of laparoscopic insufflation technique for quality control in the OR.

OBJECTIVE: With increasing technology and computerized systems in the OR, the physician's responsibility is growing. For intraoperative evaluation of insufflation techniques, a data acquisition model for quality control study of potential insufflation problems is necessary. METHODS: A computer-based, online data acquisition model was designed with a Pentium notebook, PCMCIA data acquisition board PCI-460-P1 and a Visual Designer 3.0 measurement program (both Intelligent Instrumentation, Inc., Tucson, AZ), temperature meters Therm 2280-1 and 2283-2 (Ahlborn, Holzkirchen, Germany) and temperature probes 401 AC and 402 AC (YSI, Inc., Yellow Springs, OH) and T-430-2R (Ahlborn, Holzkirchen, Germany). Gas flow was measured with laminar flow element LFE 1 and flow meters Digima premo 720 (both Special Instruments, Noerdlingen, Germany). During 73 standard laparoscopic procedures, gas flow (L/min) in the insufflation hose, pressure (mm Hg) in the hose and abdomen as well as temperature (degrees C) in the hose, abdomen and rectum were measured continuously at 3 Hz rate. RESULTS: Actual values measured show a wide range often not identical with insufflator presetting. Pressure in the abdomen is usually less than hose pressure. Intra-abdominal pressure peaks (< or = 50 mm Hg) occurred during insufficient anesthesia, while leaning on the abdomen, during trocar insertion and other manipulation. Blood-irrigation fluids found in the hose (n=3/73) can lead to bacterial contamination. Negative pressure (-50 mm Hg) was measured due to Endobag removal. Negative flow (< or = 15 L/min) was caused by pressure on the abdomen, insufflator regulation and an empty CO2 gas tank. Gas temperature in the hose equals room temperature but can decrease in the abdomen to 27.7 degrees C due to high gas flow, large amounts of gas used and prolonged insufflation. Further insufflation-related problems were documented. CONCLUSIONS: This computer-based measurement model proved to be useful for quality control study in the OR. Results demonstrate the need for intraoperative evaluation of insufflation techniques for laparoscopy. Although no obvious complication related to insufflation problems occurred, some findings potentially question patient security.

Computer Graphics↗
PubMedDate not supplied

Sexual activity as cause for non-surgical pneumoperitoneum.

BACKGROUND: Pneumoperitoneum is usually seen after bowel perforations and surgical procedures. An increasing number of cases of non-surgical pneumoperitoneum related to sexual activity has been reported worldwide over the last years. CASE EXAMPLE: A typically young, otherwise healthy woman comes into the emergency department of Stanford University, California, complaining of recurrent chest pain. Free air under the diaphragm disclosed in the X-ray usually leads to intensive, costly and invasive diagnostics sometimes resulting in emergency laparotomy without any results. Finally, after thorough discussion of the sexual history of the patient is taken, vaginal insufflation during sexual activity is revealed as the cause of non-surgical pneumoperitoneum. DISCUSSION: Patients are often unaware of the open access between the vagina and abdomen. Insufflation pressure during vaginal insufflation with >100 mm Hg--used as a diagnostic tool in CO2-pertubation--can dilate genital organs and push remarkable amounts of air into the abdomen. Gas resorption can take up to several days, and the patient often does not connect the pain to its cause. Embarrassment and modesty often prevent the patient from talking about sexual activity. CONCLUSION: Sexual pneumoperitoneum is not a bizarre sex accident but a rare and serious patho-mechanism. In cases of atypical non-surgical pneumoperitoneum in sexually active women, a careful inquiry into the medical-sexual history can reveal the cause of pathophysiology without comprehensive, painful and unnecessary diagnostics. Sexual history as a diagnostic tool should always be considered in unclear cases.

Adult↗
PubMedDate not supplied

Clinical experience with an optical access trocar in gynecological laparoscopy-pelviscopy.

BACKGROUND AND OBJECTIVES: Development in surgical technology must demand not only improved efficacy and risk reduction but also a reduction in costs and efficient use of human resources. For 25 years we have discussed the development of optical access trocars and their probable benefits. They are now available in the form of the OPTIVIEW by Ethicon and the SURGIVIEW by US Surgical. METHODS: Between December 1996 and March 1997, we utilized the optic obturator trocar, OPTIVIEW, in 104 cases of gynecological operative laparoscopy. The instrument was equipped with an axial grip to facilitate ergonomic handling. RESULTS: The optical trocar was used with a Z-incision techniques in 16 cases; a vertical incision was used in 58 cases. In all of the gynecological procedures, the optical trocar was more advantageous than classic trocars placed without direct vision. Our estimation was that separation of tissue layers was very good in 71 cases, good in 26 cases and problematic in 5 cases. No complications occurred with the use of this trocar. The Z-incision was preferable to the vertical incision although it required a longer time of insertion of up to 5 seconds. Altogether, the OPTIVIEW presented an easy way of avoiding intestinal and vascular injury during initial trocar entry. CONCLUSIONS: The application of this new tool is practical, safe and handy. However, it requires training in its appropriate use. Vertical incisions should be sutured after removal of the instrument. Additional trocars need not be optical trocars as they can be placed under direct vision and laparoscopic control. It is our opinion that a combination of sophisticated new technologies such as the OPTIVIEW trocar, robotic arm, harmonic scalpel and 3-D vision would provide safe and efficient means to accomplish gynecologic laparoscopic surgical procedures.

Adult↗