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E Dühmke

Publications and source records attributed to E Dühmke.

89 records · Page 5Linked to original sources
PubMed1981

Germinal center cell lymphomas: prognostic significance of their histopathological differentiation.

Clinical data of 48 patients with centrocytic, 83 patients with centroblastic/centrocytic and 64 patients with centroblastic lymphoma who had entered a prospective multicenter study of the Kiel Lymphoma Study Group since October 1975 were compared. Advanced (stage IV) disease at time of diagnosis, predominantly due to bone marrow infiltration, was most frequent in centrocytic (69% of patients) and in centroblastic/centrocytic (51% of patients) lymphomas as compared to only 28% of patients with centroblastic lymphoma. High survival probability of patients with localized centrocytic and centroblastic/centrocytic lymphomas after radiotherapy, contrasting with a worse prognosis of corresponding patients with centroblastic lymphoma, is compatible with the classification of these lymphoma entities as neoplasias of low-grade malignancy. However, as shown by this prospective and previous retrospective trials overall survival probability of patients with advanced centrocytic lymphoma was inferior to that observed in corresponding patients with centroblastic/centrocytic lymphoma. These findings suggest the possibility that patients with advanced centrocytic lymphoma occupy an intermediate position between typical low-grade and typical high-grade malignant non-Hodgkin lymphomas.

Adult↗
PubMed1981

[Results of radiation therapy in malignant hypopharyngeal tumors--a retrospective evaluation of 50 cases (author's transl)].

Fifty cases with malignant tumors of the hypopharynx having been irradiated with cobalt-60 at the Radiological Clinic of the Kiel University between 1965 and 1979 are reported. The cumulative 10-year survival rate amounted to 16%. Age and sex, the histology and mode of growth as well as the stage (mostly III or IV) and the primary site of the tumor had no prognostic significance, whereas the tumor response to treatment proved decisive to the prognosis: of the cases clinically revealing complete regression of the tumor, 32% could finally be regarded as cured. Using sole radiation therapy it was possible to obtain total regression of the tumor in 72% with doses between 1500 and 1650 ret, and in 84% with doses between 1651 and 1800 ret. All the patients with clinically incomplete tumor regression deceased within a year.

Adult↗
PubMed1981

[Treatment of malignant lymphomas of the oropharynx (author's transl)].

The natural history of malignant lymphomas of the oropharynx and their response to treatment are described by evaluating the course of 41 patients, who after histological verification underwent radiotherapy in the Radiological Clinic of Kiel University between 1965 and 1979. The analysis of the malignant non-Hodgkin lymphomas according to the "Kiel classification" reveals a clear predominance of the germinal center tumors and the high grade malignancies. The long-term results of treatment show a good prognosis for clinical stages I-II1 (two adjacent lymph node or extranodal regions involved above the diaphragm, "Ann Arbor"-classification modified by Musshoff) with a 85% probability of both survival and freedom of disease. For clinical stages II2-IV long-term actuarial survival and disease free survival were lowered to 51% and 23%. Whereas in 93% a complete tumor regression could be achieved by the primary treatment, one third of these patients developed a recurrence of the disease, mainly caused by incomplete therapy, such as missing the "extended field" radiotherapy or a necessary chemotherapy because of old age, myelodepression or simply refusion of further treatment. According to the results of this study chemotherapy seems to be necessary from clinical stage II2 on (two distant lymph node or extranodal regions or three or more regions located anywhere involved above the diaphragm). Finally a refined locoregional irradiation technique for malignant lymphomas of the oropharynx is described: fast electrons and cobalt rays in daily alternation for the posterior cervical lymphnodes. Last not least we present the unusual treatment schemes of the "Kiel Lymphoma Study Group" for malignant non-Hodgkin-Lymphomas of different histologies and stages.

Female↗
PubMed1980

[Medical radiography with fast neutrons (author's transl)].

For physical reasons, radiography by neutrons produces radiographs which are quite different from x-ray images. Biological objects can be transradiated only by fast neutrons. Selective simultaneous recording of neutron images is accomplished best by using cellulose nitrate (CN) foils, used with a track etching method in order to exclude thermal neutrons and gamma quanta. A neutron-radiography set-up in connection with a research reactor is described, as well as optimal conditions for developing the CN foils and the optical display of the resultant image. Image quality of the individual CN foil is characterised by minimal interior unsharpness (35 mu) and a small range of blackening when compared with radiographic film (about 1). Image contrast can be increased by the use of many foils. In addition, this results in a reduction of maximal radiation dose to below 10 rem. Study of isolated spines has shown that fat and necrotic tumours can be demonstrated by neutron radiography without being superimposed by calcium-containing bone, even if these changes cannot be seen on a x-ray radiograph because of the regular bone structure. It appears that neutron radiography can be superior to conventional radiography for the diagnosis of abnormalities with bones, or of areas surrounded by bone. The use of neutron radiography in patients can, at the moment, only be justified for individuals undergoing neutron therapy for the treatment of tumours.

Fast Neutrons↗
PubMed1978

[The jet phenomenon in the bladder (author's transl)].

The jet phenomenon seen during entry of urine into the bladder is illustrated by the urograms of a number of patients. Its diagnostic significance is discussed. Experimental models and theoretical considerations have shown that the jet is determined by the kinetic impulse; for a 1:10 mixture of contrastmedium and water, the jet is visible at all jet diameters and jet speeds at the orifice provided flow at the centre of the jet has fallen to about 0.073 m/s. Transferring these findings to man, and bearing in mind the functional and anatomical peculiarities and pressure differences between the lower ureter and the bladder, it becomes apparent that this phenomen can be produced under physiological conditions.

Humans↗
PubMed1977

[Retrospective analysis of the clinical relevance of the Kiel classification of malignant non-Hodgkin's lymphomas (author's transl)].

405 cases with non-Hodgkin's lymphomas have been diagnosed according to the Kiel classification and analysed retrospectively. 314 patients with non-Hodgkin's lymphomas of low-grade-malignancy (chronic lymphocytic leukemia, lymphoplasmacytoid, centrocytic, centrocytic, centroblastic-centrocytic lymphoma) manifested significantly higher median survival times than the 91 patients with non-Hodgkin's lymphomas of high-grade malignancy (lymphoblastic and immunoblastic lymphoma). Within the group of patients with low-grade malignant lymphomas distinct prognostic differences were found whereas survival times in patients with lymphoblastic or immunoblastic lymphomas were rather similar. The lymphoblastic lymphoma showed a bimodal curve of age distribution whilst all other lymphomas had a maximum of incidence in the seventh decade of life. Increased frequency of B-symptoms did not necessarily represent an unfavorable prognostic factor for the lymphoma entity concerned. Except for chronic lymphocytic leukemia the highest incidence of initial bone marrow involvement was seen in lymphoplasmacytoid, centrocytic and lymphoblastic lymphomas. Centrocytes have been observed in peripheral blood of patients with centrocytic and centroblastic-centrocytic lymphomas, even though lymphocytosis did not exist. Monoclonal hypergammaglobulinemia was found in only 43% of the sera from patients with lymphoplasmocytoid lymphoma. In this disease, it was possible to differentiate between a lymphonodal, a splenomegalic and an extranodal manifestation.

Age Factors↗
PubMed1977

[A retrospective analysis of cases with non-Hodgkin-lymphomas treated in the radiological clinic of the Kiel University between 1969 and 1975].

141 cases with malignant Non-Hodgkin-lymphomas are reported. The stage and results of radiological and/or cytostatic treatment as performed at the radiological clinic of the Kiel University have been related to the histological diagnosis according to the Kiel classification. Therewith, the differentiation by the pathologist between low-grade and high-grade malignancies is evidently clinically relevant.

Humans↗
PubMedDate not supplied

Clinical and prognostic relevance of the Kiel classification of non-Hodgkin lymphomas results of a prospective multicenter study by the Kiel Lymphoma Study Group.

Clinical and prognostic relevance of the Kiel classification of non-Hodgkin lymphomas (NHL) was investigated in 1127 patients entering a prospective multicenter observation study. Survival of the 782 (69.4 per cent) patients with low-grade malignant NHL (lymphocytic lymphomas, predominantly B-CLL, LP immunocytoma, centrocytic lymphoma, centroblastic-centrocytic lymphoma) exceeded that of the 341 patients (30.2 per cent) with high-grade malignant NHL (centroblastic, immunoblastic, lymphoblastic lymphomas). Prognosis was best in centroblastic-centrocytic lymphoma and in B-CLL and least favorable in immunoblastic and lymphoblastic lymphomas. Survival of LP immunocytoma and centrocytic lymphoma patients was intermediate after 2 to 2.5 years of follow-up. Corresponding to histopathology, pattern of survival curves of low-grade malignant NHL (slow decline, no plateauing) differed from that of high-grade malignant NHL (rapid decline, subsequent plateauing). Prognosis of B-CLL was superior to that of LP immunocytoma. Stages I and II were more frequent in centroblastic-centrocytic lymphoma (21 per cent) than in LP immunocytoma (2.5 per cent) and centrocytic lymphoma (11 per cent). Ability of radiotherapy to induce stable complete remissions in stage III of centroblastic-centrocytic lymphoma indicates prolonged restriction of lymphoma to the lymphatic system. In immunoblastic and centroblastic lymphomas, stages I and II were diagnosed in 34 and 38 per cent of cases, respectively, but only in stage I/IE of centroblastic lymphoma prolonged remissions were achieved by radiotherapy. In advanced high-grade malignant NHL marked improvement of prognosis was solely possible by induction of complete remissions whereas in corresponding low-grade malignant lymphomas also partial remissions were prognostically relevant.

Adult↗
PubMedDate not supplied

Combined chemotherapy, radiotherapy, and immunotherapy for pancreatic carcinoma--a case report.

Therapeutic modalities for incompletely resected pancreatic carcinoma are rare. Effective treatment must not only prolong the period of palliation but also limit the adverse sequelae of the Whipple procedure so as not to compromise the quality of the remaining life span. New treatments include the use of gemcitabine and type I interferons. We treated a patient with incomplete resection of a pancreatic tumor with two cycles of gemcitabine (1000 mg/m2) and cisplatinum (50 mg/m2) followed by radiotherapy (45 Gy/5 weeks) combined with interferon-beta (three times a week/5 x 10(6) IU). Two small liver metastases occurred subsequently. In all, four cycles of gemcitabine/cisplatinum were delivered. The patient lived at least 9 months with stable metastatic liver disease and local control. He had no acute toxic reactions except for a decrease in the leukocyte count, no long-term side effects, and a satisfactory quality of life. A regimen of sequential gemcitabine/cisplatinum and radiotherapy in combination with interferon-beta deserves further consideration as therapy for pancreatic carcinoma.

Adenocarcinoma↗
PubMedDate not supplied

[Osteosclerosis of the vertebrae in radiological diagnosis and its pathomechanism].

Primarily osteosclerosis is detected in secondary hyperparathyroidism, renal osteodystrophia and some renal tubular disorders. As mentioned, the sclerosis of vertebral body is often prominent in the regions adjacent to the endplates the typical "rugger-jersey-spine". In our study osteosclerosis was detected in about 10% of the patients with renal osteodystrophia. A still unknown defect in vitamin D-metabolism and a increased avidity of the skeleton for calcium may also involved. The result of this accumulation of steroid is a net increase of bone tissue, with or not mineralization. Conventional radiography is the method of choice in detecting typical features.

Adult↗
PubMedDate not supplied

Inversion recovery snapshot FLASH MR imaging.

Snapshot fast low angle shot (FLASH) magnetic resonance (MR) imaging techniques have been developed to enable real time imaging of MR parameters. The method is based on a 64 x 128 FLASH tomogram acquired within less than 200 ms. This work describes snapshot FLASH MR using a single 180 degrees pulse prior to the acquisition of a series of FLASH images. The experiment creates continuous dynamic inversion recovery (IR) T1 contrast in successive images. The total acquisition time of 16 images displaying the IR behavior is less than 4 s. Representative snapshot FLASH IR MR images of the abdomen of healthy rats and of an implanted hepatic tumor are illustrated.

Animals↗
PubMedDate not supplied

Long-term results of radiotherapy alone for carcinoma of the vulva.

From 1953 to 1978, definitive radiotherapy for carcinoma of the vulva without surgery was used as a standard therapy at a university hospital in Germany. We retrospectively reviewed the records of 170 patients treated mainly with electron-beam radiation to the vulva and Co-60 to the inguinal lymph nodes. Total doses to the vulva ranged from 6 to 90 Gy. A 30-year retrospective follow-up was accomplished. Tumor and node classification, tumor location, and parity were significant independent factors affecting survival. Actuarial survival was 52% for women with T1 disease, 25% for T2 disease, 10% for T3 tumors, and 0% for T4 tumors; survival with N0 tumors was 39% versus 13% with N2 lesions. Tumors of the labia minora were associated with a better survival rate (40.8% at 5 years) than were tumors at other locations (15%-21% at 5 years). Patients with zero to three children had significantly better results (32% at 5 years) than patients with four to seven children (11%). A dose of 60 Gy did not produce better long-term survival rates compared with lower doses, perhaps because low electron energy missed microscopic disease in deep vulvar tissues. On the basis of this review, patients with vulvar carcinoma should have at least a complete tumor resection. The therapeutic window between tumor control probability and the normal tissue complication rate in nonresected patients is too narrow: local recurrences are quite frequent with lower dose schedules, and survival rates are very poor, whereas complication rates are high with radical dose schedules that nevertheless provide acceptable cure rates.

Adult↗
PubMedDate not supplied

Results of postoperative radiotherapy of cervix carcinoma after radical versus non radical hysterectomy.

UNLABELLED: We studied the outcome of our 68 cervix carcinoma patients treated either with: 1) radical surgery and postoperative 192Ir high-dose rate afterloading brachytherapy or postoperative radiotherapy to the whole pelvis or with 2) standard hysterectomy and postoperative radiotherapy to the whole pelvis. Forty-eight women were treated by radical hysterectomy from 1988 to 1992 and--due to risk factors--by postoperative radiotherapy (Group 1), 20 other patients (Group 2) pretreated with standard hysterectomy were admitted to the university hospital for postoperative radiotherapy of the whole pelvis. Postoperative radiotherapy consisted of 39.6 Gy total dose using the box technique, plus two afterloading applications with a single dose of 7.5 Gy and 6 Gy external beam therapy to the pelvic lymph nodes sparing the midline. Comparing the Kaplan-Meier plots of both groups, the tumor related survival curve, the locoregional control and the rates of metastatic disease were nearly identical. But in the analysis of special subgroups, patients with positive lymph nodes after standard hysterectomy and postoperative radiotherapy had a worse prognosis (75% three years' survival rate) than patients after radical surgery (86% three years' survival rate). Lymphangiosis was a negative prognostic factor for the patients pretreated with standard hysterectomy (60% versus 80% three years' survival rate), but not for patients after radical surgery (80% three years' survival rate), despite the same radiotherapy in both groups. CONCLUSION: Standard hysterectomy fails to be an adequate treatment for early cervix carcinoma because moderately dosed postoperative radiotherapy cannot achieve complete locoregional control in all cases of positive lymph nodes or invasion of lymph vessels. However, based on the empirical results of many authors and our own results, postoperative radiotherapy is further indicated in high risk cases of cervix carcinoma after radical surgery.

Female↗