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Biomedical subjects

E Holzer

Publications and source records attributed to E Holzer.

At least 37 records · Page 2Linked to original sources
PubMed1980

Treatment of carcinoma in situ: evaluation of 1609 cases.

In 1609 cases of carcinoma in situ, various methods of treatment were adopted: primary irradiation (22 cases), radical hysterectomy (11), simple hysterectomy (418), cervical amputation (83), ring biopsy with cervical curettage (63), and conization alone (1012). The outcome was related far less to the method of treatment than to the reliability of the primary diagnosis. If the latter was based only on colposcopically directed punch biopsies or cervical curettage, even with ring biopsy, 2.1% of patients died of cancer. In patients treated by hysterectomy, the vaginal approach resulted in 4 times fewer recurrences than did the abdominal approach, because of visualization of the extent of the lesions. Best results were obtained after conization with serial step-sectioning of specimens. Among 634 cases treated by conization with total removal of the lesion, there were no recurrences.

Biopsy↗
PubMed1979

[Legionnaires' disease in Germany (author's transl)].

In February 1979 a 51 year old man fell will in Munich, displaying symptoms of an influenza-like illness which developed into pneumonia. The patient died eight days later of circulatory collapse which failed to respond to treatment, accompanied by high temperature, leucopenia and agranulocytosis. Typical rods detected in the lung tissue and histological sections by immunofluorescence indicated the possibility of a Legionella pneumophila infection. The pathogen isolated from the lung tissue on CYE agar was identified as L. pneumophila, serogroup I. The diagnosis was confirmed by the CDC, Atlanta. This is the first time this organism has been isolated in Central Europe from a case with a fatal outcome.

Germany, West↗
PubMed1976

[Ectopic pregnancy carried to full term with a living infant].

A section delivery was performed for transverse lie on a fourth para of 38 years at the beginning of labour on term. Thereby a full term extrauterine gravidity was found. According to the placental insertion in the ampullar part of the tube, on the ovary and upon the visceral peritoneum it can be classified as tubo-abdominal pregnancy which probably had developed after rupture of a tubal pregnancy which initially was established in the ampullar part. Blood supply was accomplished mainly by the hypertrophied ovarian vessels of the right side. After removal of the amniotic sac and partial resection of the great omentum the uterus had to be amputated supracervically for excessive loss. The postoperative course was uneventful, mother and child were discharged healthy.

Breech Presentation↗
PubMed1976

[Results of the conservative management of carcinoma in situ of the uterine cervix by conization (author's transl)].

From 1958 to 1969 conizations for carcinoma in situ of the uterine cervix were carried out in 683 women. In 523 cases no further therapy was instituted immediately. Step serial sections of the conization specimens showed that carcinoma in situ was completely removed in 346 (66.2%) of the cases. In 177 (33.8%) of the cases, the excision of the atypical epithelium was incomplete or not with certainty complete, by the conization. Of these patients 43 women were older than 45 years. Follow-up examinations after conization with complete removal of all atypical epithelium showed that only one case showed again a pathological epithelium. In this case, hysterectomy for an adnexal tumor four years after conization showed a mild dysplasia of the endocervix. Follow-up examination of the cases with incomplete or possibly incomplete conization showed no further pathological finding in 90% of the cases. In 19 (10.7%) of the women, atypical epithelium reappeared after varying lengths of follow-up. In 4 women, invasive carcinoma had developed and in 2 women, microinvasive carcinoma had developed. Following operative treatment, further follow-up examinations in these patients were negative. Conization of the uterine cervix with complete removal of all atypical epithelium is shown to be adequate treatment for carcinoma in situ. In cases with incomplete or not with certainty complete removal of atypical tissue by conization, individual follow-up is necessary. If further pregnancies are desired the small risk of observation is justifiable. Diagnosed persistence of atypical epithelium is an indication for a hysterectomy. Hysterectomies are also necessary if the patient does not comply adequately with the follow-up protocol.

Adult↗
PubMed1975

[Long term results after Latzko operation for vesico-vaginal fistula].

The Latzko operation for the closure of a vesico-vaginal fistula is still not well enough known. Urologists have voiced doubts about the functional quality of the late results after this operation. Pouches in the bladder wall which could lead to infection and stone formation are said to occur frequently. Follow-up studies regarding this question are not known. Therefore the patients treated at the University Hospitals Erlangen-Nuernberg and Graz between 1962 and 1972 were subjected to a standardized follow-up protocol. Of 37 women who had the Latzko operation, 24 women returned for a follow-up examination. 19 women had no intermittent urinary tract disease and the follow-up results were normal. In many instances a scar corresponding to the previous fistula could not be detected on cystoscopy. Immediately after the operation, one patient had a recurrent fistula and has not been re-operated. Four women had significant urinary tract findings or had intermittent urinary tract disease. These complications were possibly due to the operation in one case and likely due to the operation in a second case. Our findings suggests that the Latzko operation is the method of choice for the treatment of the typical post-hysterectomy vesico-vaginal fistula.

Cystitis↗
PubMed1975

[The extent of the atypical squamous epithelium of the cervix uteri (author's transl)].

210 cone biopsies were examined. In 27 cases a dysplasia of low degree and in 30 cases a dysplasia of higher degree was found to be the maximal epithelial lesion; a carcinoma in situ was found in 87 cases and an early stromal invasion in 66 cases. The examinations were performed in sagittal sections of the central areas of cone specimens. In each section the lengths of all atypical epithelial extensions were measured. In cases with different atypical epithelial in the same section, e.g. different dysplasias or carcinomata in situ, the extent of the atypical epithelium was defined as the total sum of all respective epithelial lengths. Moreove,the sum of these lengths is considered as a parameter of the surface area of an atypial field and is expressed as a percentage of the total epithelial cone surface. It was observed that in any given lesion, the higher the maximal epithelial atypia, the more frequent the coincidence of different types of atypia. The coincidence was most frequent in early stromal invasion. These results are in conflict with the present theory that carcinoma in situ orginates from dysplasia: under that assumption the dysplasias would have to become less frequent with the occurence of a carcinoma in situ. The average surface area of an atypical epithelium is greatest in cases of early stromal invasion; it is significantly greater in cases of carcinomata in situ than in dysplasias. The extent of the atypical epithelial fields can be attributed to two factors: On the one hand, the coincidence of different types of atypical epithelium is directly proportional of the degree at atypia; on the other hand, areas of carcinomata in situ were in themselves more extensive than areas of dysplasias. Expansion variations were also shown in different types of dysplasias. However, no differences in expansion could be observed in carcinomata in situ with and without stromal invasion. In early stromal invasion the significant increase in surface-area was almost exclusively due to the coincidence of carcinomata in situ with dysplasias. It is evident that a positive correlation exists between the tendency toward invasive growth and the extent of the atypical epithelium. Finally, the degree of the epithelial atypia appears to be a function of the extent of the atypical epithelium on the surface of the cervix.

Carcinoma in Situ↗