PubMed Health⌕ Search

Biomedical subjects

C Wilke

Publications and source records attributed to C Wilke.

26 records · Page 2Linked to original sources
PubMed1988

[Staging in non-Hodgkin's lymphomas].

In the period from 1970 to 1986, 46 patients with non-Hodgkin's lymphoma were laparotomized and splenectomized at the Surgery Division, University of Göttingen. The operation was frequently carried out in advanced or generalized stages with a therapeutic indication and served for purely diagnostic purposes in only a proportion of the cases. The Kiel classification was chosen for the histology. Accordingly, hairy-cell leukemia (14 cases) and chronic lymphatic leukemia (12 cases) were the most frequent diagnoses, followed by LP immunocytoma and centroblastic-centrocytic lymphoma (seven cases each). In four out of the 20 clinical pictures which were not already generalized by definition, i.e. in 20% of the cases, exploratory laparotomy resulted in a change of stage (comprising two improvements and two deteriorations). The spleen was affected in 41 out of the 46 patients; in addition, lymphomatous infiltrations were found in six of the 12 liver biopsies taken and in 15 out of 17 lymph node preparations taken. The average spleen weight in the NHL patients (1,623 g) was markedly higher than in a reference group of Hodgkin patients (317 g). With critical establishment of the indication, exploratory laparotomy with splenectomy in histologically verified NHL and lymphography in the clinical staging are the most precise methods of investigation in graduated diagnosis of non-Hodgkin's lymphomas.

Adult↗
PubMed1987

[Staging in Hodgkin's lymphoma. Exploratory laparotomy with splenectomy].

In the present paper, 66 Studies on exploratory laparotomy with splenectomy in Hodgkin's lymphoma from Western Europe and the USA are presented in tables. This statistical compilation on 7183 laparotomies shows that the spleen was involved in 39.9% (2685 out of 6900 cases investigated), the liver in only 7.7% (446 out of 5789) and the abdominal lymph nodes were involved in 30.3% (1389 out of 4578) of the cases. Altogether, laparotomy with splenectomy led to a change in staging in 33% of the patients (1892 out of 5745). In the period from 1970 to 1986, 123 patients with Hodgkin's lymphoma were laparotomized (and also splenectomied apart from one exception) at the Surgical Division, University of Göttingen. The patients comprised 52 cases in the context of primary staging and 71 cases in the context of secondary staging. In 43 cases (35.2%) the spleen was affected, in seven cases (5.7%) the liver was affected, and there was combination with spleen involvement in each case. Infiltration of abdominal lymph nodes was shown in 38.2% (26/68). Exploratory laparotomy led to a change in stage in 46 cases (37.1%) comprising 28 improvements and 18 deteriorations. Before laparotomy, 15 patients were in stage I, 29 in stage II, 44 in stage III and 21 in stage IV. After pathological staging, 14 were in stage I, 40 were in stage II, 47 were in stage II and 19 were in stage IV. Out of the 14 patients who could not be assigned to any stage before the operation, 11 could be definitively staged afterwards. In addition, lymphography was performed in 103 patients, liver and spleen scintigraphy in 51 patients, sonography in 30 patients and computer tomography in 22 patients. In the re-examination of the lymph node situation in the retroperitoneal space, lymphography attained a specificity of 48% and a sensitivity of 71.4% with a positive prediction precision of 35.7% and a negative prediction precision of 88.8%.

Hodgkin Disease↗
PubMed1987

[Ambulatory care of interstitial lung diseases].

Clinical symptoms, radiological finding and functional results of patients with interstitial lung diseases were followed in a dispensary about 10 years. We compared the progress of 10 patients with pulmonary fibrosis histologically proved and of 19 patients without any previous evidence of fibrosis but suspicious of developing fibrosis at present. In both groups we found a rising proportion of patients suffering from dyspnoe on exertion and from increasing impairment. Functionally a significant decrease of the vital capacity was found especially in patients with fibrosis. The course of oxygen tension during physical exercise on a bicycle ergometer was well correlated to the dyspnoe on exertion. An airflow obstruction already existing at the start of the observation period was found to have an unfavourable influence on the progress of the interstitial lung disease. Eight patients being suspicious of a developing fibrosis were investigated clinically. On 5 patients a pulmonary fibrosis could be confirmed. A treatment using corticoids was started. To find a progression of a known interstitial lung disease in due time, it is necessary to check thoroughly these patients functionally and radiologically in a dispensary at regular intervals.

Ambulatory Care↗
PubMed1987

[Lymphography in Hodgkin's lymphoma. Diagnostic value based on the current status of experience and knowledge].

Lymphography was carried out at least once in 355 patients with Hodgkin's lymphoma (HL). In 229 patients, there was a histological subclassification: 26 LP, 63 NS, 122 NC and 18 LD cases. The lymphographic manifestations could be subdivided empirically into two superordinate groups: 1. lymph nodes closely linked together in chains (LC) with dense structures as well as LC destructions, LC debris and 2. LC of varying size with pathological internal structure. Apart from in the NS type, a correlation between the lymphological appearance and the histological subtype could not be discerned in any other histological subgroup. After lymphography, 61.6% of stages I and II were assigned to stage III. The staging of the lymphography was: stage I 24.5%, stage II 47.3%, stage III 10% and stage IV 9%, and after lymphography: stage I 9.9%, stage II 17.7%, stage III 63.1% and stage IV 9.3%. From a qualitative point of view, lymphography is superior to all other methods in the diagnosis of malignant lymphomas and should hence be carried out obligatorily in suspicion of a malignant lymphoma.

Adolescent↗
PubMed1984

[Lymphogranulomatosis and persistent left superior vena cava. Contribution to the diagnostic problem of the interference of morphologically different images].

Unilateral mediastinal dilatations are suspicious of the presence of a lymphogranulomatosis. It is reported on a case in which the diagnosis of Hodgkin's disease was rendered more difficult by a persistent left superior vena cava. The discussion of the case shows that in the differential-diagnostically problematic mediastinal region - corresponding to the clinical appearance - all methods available must be used for the clarification of the etiology.

Adult↗
PubMedDate not supplied

The influence of guiding equipment and stents on the beta dose distribution in the brachytherapy of in-stent restenosis.

BACKGROUND: Intracoronary devices such as stents or guide wires may disturb the dose distribution of beta sources in cardiovascular brachytherapy. As clinical observations indicate that underdosage increases the risk of restenosis, accurate measurements are mandatory to investigate these effects. METHODS AND RESULTS: Dose perturbation effects of different interventional equipment were systematically determined. Dose distributions of 90Sr-beta line sources were measured by means of a special set-up employing plastic scintillator dosimeters in a water phantom. Shielding effects were found to be 2-5% for single stents and 5-10% for graft stents, stent-in-stent geometries, and guiding catheters. Guide wires close to the source reduced the dose by 25-30%. CONCLUSIONS: Beta dose perturbation effects of typical stent types are almost negligible and can be corrected by an increased source dwell time if necessary. Guide wires produce effects which are clinically much more important and should therefore be retracted from the irradiation area.

Brachytherapy↗