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Biomedical subjects

H Denck

Publications and source records attributed to H Denck.

At least 55 records · Page 3Linked to original sources
PubMed1982

[Results of a comparative therapy study for inoperable lung cancer].

In a prospective randomized study 78 selected patients with bronchogenic cancer have been included, and five different treatment modalities have been compared (1. Biologic therapy; 2. Vitamin A + Cytoxan; 3. Vitamin A + Telecobalt irradiation; 4. Telecobalt irradiation; 5. Immunotherapy). No significant differences if survival times between the different groups have been observed. Nevertheless, significant differences of survival times were found between small cell and squamous cell carcinoma patients without respect to the therapy applied. The highest number of remissions was obtained by therapy 3, followed by 4 and 2. Consequences for further studies are discussed.

Adult↗
PubMed1982

Combination of surgery and polychemotherapy for cure in early small-cell bronchial carcinoma.

In 1969 a cooperative randomized two arm study of surgery and adjuvant chemotherapy was started. Within three years after the operation the polychemotherapy was given intermittently using a combination of cyclophosphamid + 5-FU + MTX + vinblastin. From a total of 859 patients operated for cure preliminary evaluations per 1.3.1981 found 53 patients with small cell type carcinomas. An increase of the 3-year survival rate of 13 per cent shows a clear positive therapeutic effect. This also demonstrates the importance of surgery even on small cell bronchogenic carcinoma by decreasing the tumor burden. To evaluate wether or not the number of long-term survivors can be increased furthermore, a new randomized trial was started in 1979 to compare the polychemotherapy used with a new designed intermittent polychemotherapy-schedule using alternating cyclophosphamid + CCNU + MTX, there after cyclophosphamid + adriamycin + vincristin and there after ifosfamid + VP-16; then radiation therapy and there after repeating the whole sequence.

Antineoplastic Agents↗
PubMed1981

[Bronchus cancer - surgery].

Of 9,000 patients with bronchus carcinoma observed during 1958-1980, 3.041 (33%) underwent resection. Although in principle the standard operations are lobectomy for the peripheral and bilobectomy or pneumonectomy for the central carcinoma, parenchyma-saving operations such as clamping or segmental resection or main bronchus resection are justified under certain conditions; however, here all regional lymph nodes have to be removed again. We consider the surgical indication of small-celled carcinoma like any other form of bronchus carcinoma. For stage I, the 5-year survival chance is 40% - 50%, for all stages only 20%. Extended resections including pericardium, large vessels, thoracic wall, trachea, upper thoracic aperture, are justified especially in symptomatic cases, although the 5-year survival rate is less than 10% in these cases.

Carcinoma, Bronchogenic↗
PubMed1981

[Therapy of acute bleeding from esophagus varices (author's transl)].

Acute bleeding from esophagus varices in portal hypertension is still a considerable therapeutic problem, and quite different approached to treatment are being followed. We use the following approach general procedures like treatment of shock, treatment of coagulation disorders etc.; emergency endoscopy; submucosal sclerosing if varices can be identified endoscopically as the source of bleeding. If bleeding cannot be stopped in this way a Sengstaken probe is applied for 4-6 hours, and after that sclerosing of the bleeding area is tried again. If bleeding does not stop at that time yet, the vena coronaria ventriculi or the venae gastricae breves are sclerosed by the transhepatic route. In almost all cases bleeding can be stopped successfully if this sequence of procedures is followed. After bleeding has been stopped, surgery establishing a portacaval shunt may be taken into account.

Dilatation↗
PubMed1980

[Regional cytostatic infusion therapy in patients with inoperable gastrointestinal carcinomas and metastases in the liver (author's transl)].

Report on 50 patients with incurable gastrointestinal carcinoma and 8 patients with metastases in the liver who received a regional transarterial continuous infusion therapy with 1 g 5-Fluorouracil daily for a period of 5 to 6 days. A clinically demonstrable remission for a period of 6 to 15 months occurred in 76% of the patients. The treatment which is administered in intervals of 6 to 8 weeks is well tolerated and the incidence of complications is low. Therefore this method may be recommended for otherwise completely incurable gastrointestinal carcinomas.

Adult↗
PubMed1980

Chronic vascular disease of the upper extremity: radiologic and clinical features.

The major chronic vascular diseases of the upper extremity are (1) subclavian artery occlusions, (2) thoracic outlet syndrome, and (3) angiospastic disease of the hand. Central subclavian artery lesions ease of the hand. Central subclavian artery lesions can have either hemodynamic consequences (subclavian steal syndrome) or, by peripheral embolization, can provoke ischemic symptoms of the hand. Costoclavicular narrowing can cause functional or fixed stenosis of the subclavian artery and can also involve the vein or brachial plexus. Symptoms due to pressure on the brachial plexus are most frequent, but embolization to the peripheral vessels may also occur. Angiospastic disease, the most frequent lesion of upper extremity vessels, comprises three types: Raynaud's disease, in which there are intermittent attacks of coldness and discoloration without evidence of occlusion on the angiogram; asphyxia manus et digitorum in which the attacks are also intermittent but there is morphologic evidence of occlusion; and digitus moriens or mortuus, in which there is a painful, permanent discoloration. All investigations of chronic vascular disease of the upper extremity should begin with arch aortography and then proceed to a selective catheterization of the vessels that are presumed to be involved.

Adolescent↗
PubMed1980

[Aneurysmal dilatation of the bulb of the azygos vein. Radiological and clinical value].

An aneurysm of the vena azygos should be taken into consideration when establishing the differential diagnosis of a tumor in the area of the right tracheobronchial angle or of an enlargement of the right upper mediastinum. Bilateral pelvic phlebography with demonstration of the retroperitoneal venous system and the azygos venous system is the only purposeful examination. Tentative diagnosis is made on the basis of the X-ray (radioscopy and general X-ray of the chest) and is supplemented by X-rays of the patient in a recumbent position (Valsalva- and Müller-test) and appropriate tomography. The most frequent cause of the azygos aneurysm in our patients was aplasia of the inferior vena cava. One patient presented an infrahepatic interruption of the inferior vena cava with azygos continuation. Phlebography of the inferior vena cava should always be performed in cases of azygos aneurysm. An abnormality of the inferior vena cava may be missing; in such cases the existence of a cardiac defect, abnormal emptying of pulmonary veins or hepatic cirrhosis should be taken into consideration. The enlargement of the azygotic arch may also occur during pregnancy. Thus an azygos aneurysm is frequently but not necessarily associated with enlargement of the azygotic arch. We saw one patient among our cases who presented aplasia of the inferior vena cava without any dilatation of the azygotic arch.

Adolescent↗
PubMed1980

Aneurysmal bulb dilation of the azygos vein: radiological and clinical significance.

An aneurysm of the azygos vein is usually detected in the course of routine chest X-rays. It presents as a sharply circumscribed tumor shadow in the area of the right tracheobonchial angle or as an enlargement of the upper right mediastinum. A tentative diagnosis is supplemented both by further X-rays in a supine position in combination with the Valsalva and Müller tests and by tomography. The most frequent cause of an azygos aneurysm found in our material is aplasia of the inferior vena cava. Infrahepatic interruption of the inferior vena cava with azygos continuation can also be an associated malformation. Therefore, bilateral pelvic phlebography with visualization of the retroperitoneal venous and azygos systems is mandatory for establishing the correct, complete diagnosis. We have found no concomitant hemodynamic derangements. It is important to note that under these circumstances no therapy is indicated.

Adolescent↗
PubMed1979

[Surgery of bronchus carcinoma (author's transl)].

The results of surgery for bronchial carcinoma can be improved by further stressing of early diagnosis, by operative methods adapted to oncological needs and assessment of techniques which increase operability as well as by adequate and general additional therapy. Based on our material of 8,423 patients of which 2,773 (i.e. 23%) have been operated the results of the operation in relation to type of operation, histology, Feinstein's classification, TNM stages and other are demonstrated.

Austria↗
PubMed1979

[The surgical treatment of lliofemoral venous thrombosis (author's transl)].

The surgical treatment of acute iliofemoral thrombosis has shown such favorable results that it holds a firm place in the treatment plan. Improvements may possibly be achieved by combining surgical thrombectomy with streptokinase treatment. In certain cases of incomplete thrombectomy or chronic iliofemoral venous thromboses a temporary arteriovenous shunt is indicated which as far as possible should be performed at the level of the adductor canal (Brunner). As a standard method of surgical emboloprophylaxis, the umbrella filter devised by Mobin-Uddin has extensively gained ground today, since with a low rate of complications it offers great safety against recurrent embolism. Among 269 patients treated for acute iliofemoral venous thrombosis, thrombectomy has in addition to shortest hospitalization shown the lowest rate of postthrombotic syndromes and other complications in 172 patients.

Femoral Vein↗
PubMed1979

[Hematological observations in patients following immunostimulation through intrapleural application of Corynebacterium parvum].

The Ludwig Lung Cancer Study Group aims to investigate the role of immunotherapy as adjuvant treatment modality in operable non-small cell bronchial carcinoma. The participants are 12 european clinics and institutes. With a proven accrual of 350 patients per year the group offers a sharp tool in clinical oncology with regards to bronchial carcinoma. The accrual phase of the first trial was closed on February 2, 1979 with 475 patients, starting a new protocol on February 5, 1979. The ongoing randomized clinical trial aims to determine if intrapleural administration of corynebacterium parvum (c. p.) can increase the tumor recurrence-free interval or increase survival. Furthermore the study aims to identify high and low risk patient subgroups after biological and immunological investigations. The possibility of giving c. p. intrapleurally in humans was investigated in a phase-I-toxicity study. A dose of 7 mg has been adopted for the clinical trial since this dose combines a measureable systemic effect (increase of leucocyte and monocyte counts) with acceptable toxicity. The main morbidity was fever, flu-like symptoms and chest pain.

Antibody Formation↗
PubMed1979

[Results of surgical treatment of gastrointestinal malignancies].

The present results of surgery in gastrointestinal carcinoma, including all stages of the disease, show a 20% 5-year-survival-rate in stomach carcinoma, 45% in colon carcinoma and 41% in rectum carcinoma. It can already be demonstrated that improved early diagnosis may improve the results of surgical treatment of stomach carcinoma. Effective local and general follow-up treatment must be demanded.

Colonic Neoplasms↗