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Biomedical subjects

D Zippel

Publications and source records attributed to D Zippel.

12 recordsLinked to original sources
PubMed2003

Delayed breast cellulitis following breast conserving operation.

A complication of breast conservation, which has been increasingly reported in the literature, is 'delayed cellulitis' in the treated breast. This is to be distinguished from wound infection in the breast following lumpectomy. This study reports 16 cases diagnosed with delayed cellulitis following breast conserving surgery, unresponsive to antibiotic therapy. Diagnostic criteria included: pain, erythema and edema in the operated breast. Symptoms appeared up to 10 months after surgery and time to resolution was seven and a half months. No patients had positive cytology and bacteriology tests were negative. Thirteen patients were observed, and three patients were treated with antibiotics with no apparent immediate effect. The appearance of breast cellulitis after surgery poses a problematic diagnostic and management dilemma. It is important to distinguish between this entity and infection, or inflammatory carcinoma. The picture may be attributed to impairment or occlusion of the lymphatic circulation in the breast. This seems to be a newly defined complication with an incidence of 3-5%.

Adult↗
PubMed1999

Revision hip arthroplasty in patients with a history of previous malignancy.

BACKGROUND AND OBJECTIVES: The potential association between implants and malignancy has been discussed in the literature, but never as a cause of loosening of joint arthroplasty. METHODS: The records of all patients who underwent revision arthroplasty at our institution between 1992 and 1995 were reviewed. RESULTS: Among 93 patients who underwent revision hip arthroplasties, 11 (11.8%) had a history of previous malignancy. At surgery, in 2 of these patients, metastasis was found to be the cause of loosening in the affected hip. CONCLUSIONS: When revision hip arthroplasty is considered, patients with a history of malignancy require attenuated pre-, intra-, and postoperative workup. Management algorithm in such cases is proposed.

Aged↗
PubMed1999

Positive margins of breast biopsy: is reexcision always necessary?

BACKGROUND AND OBJECTIVES: Breast-conserving surgery requires excision of all gross tumor and subsequent radiation therapy. It is generally accepted that the presence of microscopically positive margins requires reexcision. The goal of this study was to identify characteristics that distinguish breast biopsy specimens with positive margins that when reexcised are free from residual tumor. This population of patients may benefit from breast irradiation only, without the need for another surgical procedure. METHODS: One hundred and fifteen of 395 cancer-proven biopsies had positive surgical margins and were treated with reexcision or mastectomy. Sixty-seven of these were negative for residual tumor and 48 were positive for residual tumor. Evaluation for tumor type, tumor size, grade, presence of vascular invasion, volume of the biopsy specimen, true positivity and the number of positive margins, multifocality of the tumor, and type of anesthesia was done by univariate and multivariate analysis. RESULTS: Univariate and multivariate analysis revealed that factors associated with a positive reexcision included margin status, method of detection, histologic appearance, and type of anesthesia used. CONCLUSION: These results suggest that small, clinically detectable unifocal tumors could be treated without the need for a further excision. Eradication of microscopic residual tumor could be done by irradiation only, sparing the patient an additional surgical procedure.

Aged↗
PubMed1998

Sentinel lymph node involvement--a predictor for axillary node status with breast cancer--has the time come?

AIMS: Axillary node dissection for breast cancer is important for staging and its prognostic value. Sentinel nodes are defined as the first nodes into which the primary cancer drains. This study investigates whether identification, removal and pathological examination of these nodes indicates whether the completion of axillary lymphadenectomy is required. METHODS: Using a vital dye injected at the primary tumour site, we were able to identify sentinel nodes in 96 out of 98 women examined. RESULTS: An average number of 2.7 +/- 1.2 nodes per patient were identified as sentinel nodes. In 83% of cases there was a correlation between the involvement of the sentinel nodes and the rest of the axillary nodes. In 14% of patients the sentinel nodes were the only nodes involved with tumour. In three cases the sentinel nodes were negative, but other axillary nodes were tumour-positive. CONCLUSION: The major problem in routine application of this method to the decision to perform axillary lymph node dissection (ALND) is the time needed for pathological identification of lymph node involvement by tumor.

Adult↗
PubMed1995

Aprotinin improves hemostasis after cardiopulmonary bypass better than single-donor platelet concentrate.

Platelet transfusion and aprotinin administration improve platelet function and clinical hemostasis after extracorporeal circulation. To compare two methods of improving postoperative hemostasis, we preoperatively randomized 40 patients undergoing various open heart procedures into two groups. Group A included 20 patients who, immediately after bypass, received single-donor plateletpheresis concentrates collected from ABO-compatible donors (Baxter Autopheresis-C System). They were compared with 20 patients who received high-dose aprotinin (6 x 10(6) KIU) before and during cardiopulmonary bypass (group B). Group A patients showed significantly higher platelet count after single-donor plateletpheresis concentrate transfusion (157 +/- 36 x 10(9)/L compared with 118 +/- 42 x 10(9)/L (p < 0.05). However, platelet aggregation on extracellular matrix was better in group B (3.4 +/- 0.7 versus 2.8 +/- 0.9; p < 0.05). Total 24-hour blood loss and exposure to homologous blood products were significantly less in group B (396 +/- 125 mL and 1.1 +/- 1.6 units compared with 617 +/- 233 mL and 5.4 +/- 3.4 units; p < 0.01). Despite higher platelet count in patients after single-donor plateletpheresis concentrates transfusion, hemostasis in patients receiving aprotinin is better due to improved platelet function.

Aprotinin↗
PubMed1991

Age-dependent experimental tumor dissemination of murine melanoma B16.

Female C57BL/6 Jena mice, 3-, 12-, and 18-month-old, were inoculated intravenously (i.v.) with syngeneic melanoma B16 cells. The number of experimental lung metastases, counted 21 days after tumor inoculation, was significantly higher in older hosts. Pretreatment of young adult mice with immunosuppressive dose of cyclophosphamide considerably increased the number of lung nodules. The number of lung metastases was reduced when young and old animals were pretreated or treated with Poly (I:C). Similar treatment of mice with two other immunomodulators (thymalin and diacetyl-splenopentin 5) was practically without effect on metastasis formation. It is suggested that the higher number of experimental metastases of melanoma B16 in aged mice is mediated by immuno-senescence.

Adjuvants, Immunologic↗
PubMed1989

Abnormal macrophages and NK cell cytotoxicity in human systemic lupus erythematosus and the role of interferon and serum factors.

Macrophage (MO) and natural killer (NK) cell mediated cytotoxicity to K562 target cells were strikingly decreased in patients with systemic lupus erythematosus (SLE). SLE NK cells failed to release soluble factor(s) for lysing the targets. IFN-induced enhancement of both types of cytotoxicity was impaired. NK cells from healthy subjects kept their activity in culture with or without IFN for more than six days whereas SLE NK cell activity declined to zero at day 3. So, the increased IFN level of many SLE patients and a possible prior IFN priming effect seemed unrelated to the insensitivity to exogenous IFN in vitro. Inhibition factor(s) of SLE serum suppressed NK cytotoxicity in the presence of IFN whereas IFN sensitivity of MO remained unaffected indicating the complex regulation by serum components of immune reactions.

Chromium Radioisotopes↗
PubMed1985

Studies on the mechanism of macrophage cytotoxicity.

The interactions with tumor target cells of resident and BCG-activated murine peritoneal macrophages (M phi) as well as of BCG-activated M phi additionally stimulated by a lymphokine-like factor were investigated in order to get some insight into the cytolytic process mediated by activated M phi. The lymphokine-like factor enhancing the cytotoxicity of BCG-activated M phi (MCF) was isolated and partially purified from cell-free fluid of rat Zajdela ascites hepatoma. M phi cytotoxicity was determined by a modified 51Cr release assay. Scanning and transmission electron microscopic findings suggested a two-step mechanism of target cell lysis: a first step of specific attachment of processes of M phi on the target cell surface and a second step with transport of lysosome-like vesicles to the target cells obviously with liberation of these vesicles in the immediate vicinity of target cells resulting in a local accumulation of cytolytic substances. This interpretation was supported by findings after treatment of interacting effector and target cells with amphotericin B and bestatin which substances were modifying M phi cytotoxicity. MCF caused only an augmentation of M phi cytotoxicity without qualitative differences to the cytolytic action of merely BCG-activated M phi.

Adjuvants, Immunologic↗
PubMed1980

[Determination of the chemotaxis of peritoneal macrophages from mice by means of different test systems (author's transl)].

The chemotactical response of mouse peritoneal macrophages was examined by means of three different methods: 1. A modified migration chamber technique 2. An agarose assay 3. A 51chromium labelling assay. Casein and the synthetical peptide N-formylmethionin leucine were applied as chemoattractants. The results show that the migration chamber technique is more sensitive and therefore more suitable to determine the chemotactical response of mouse peritoneal macrophages than the assay under agarose. An additional labeling of macrophages with 51chromium in the migration chamber technique is inefficient.

Animals↗