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Biomedical subjects

H H Riedel

Publications and source records attributed to H H Riedel.

At least 19 recordsLinked to original sources
PubMed2000

[Retrospective study of pelviscopic adhesiolysis for treatment of chronic lower abdominal pain (January 1996-December 1997)].

A report is given about 486 patients, who were operated because of suspicion of adhesion in 74 cases (15.2%), of an adnexal tumor 116 (23.9%), endometriosis 9 (1.9%), infertility 24 (4.9%), irreversible contraception 42 (8.6%) or chronic abdominal pain in the lower abdomen 221 (45.5%). 89.1% of them suffered preoperatively of chronic abdominal pain. 350 (72%) patients had to be laparotomized once or several times. 326 women only had adhesions; adhesions and an adnexal tumor were found in 107 patients; 53 women had adhesions and endometriosis. Among the 326 women with adhesions only were about 45% with adhesions of first and just as many with second graduation, adhesions of third graduation were found in 10% of the patients. Adhesions of first graduation were solved completely in all cases, such of second graduation could be solved in 43% of cases completely and in 54% at least incompletely. Adhesions of third graduation were solved in most of the cases (74%) incompletely. 221 (67.8%) of the patients with adhesions only answered the questionnaires 8-10 months later. Two third of them were free from pain or stated a clear improvement. After complete adhesiolysis 70% of the women stated a positive result of operation, 57% after incomplete adhesiolysis.

Adult↗
PubMed1999

[Multiple phlebothrombosis following cesarean section due to heterozygous factor V Leiden mutation detected post partum].

Activated protein C resistance in factor V Leiden mutation is currently the most frequent hereditary defect accompanied by high risk of thromboembolism. Thromboembolism often develops in the presence of additional risk factors such as pregnancy, birth, taking oral contraceptives, immobilization and surgical operations. A case of multiple phlebothrombosis following caesarean section in heterozygous factor V Leiden mutation evidenced post partum is reported. The patient developed extensive phlebothrombosis in both legs on postoperative day three despite preventive thrombosis treatment with low-molecular heparin. She also suffered from short-term incomplete paresis of her left arm and epileptic seizure with typical grand mal symptoms. MRI showed partial thrombosis of the superior sagittal sinus and the transverse sinus.

Activated Protein C Resistance↗
PubMed1998

Endometriosis diagnosed by laparoscopy in adolescent girls.

105 adolescent girls with mean age of 17.3 (11-19) years had laparoscopy/pelviscopy between 1996 and 1997. In 37 cases, endometriosis was diagnosed (35.2%). The majority of the girls (32.4%) presented with endoscopic endometriosis classification (EEC) stage I. 2.8% of the girls had stage EEC II. The lesions involved one site or pelvic organ (64.8%) with a mean age of 18.7 (14-19) years. In 35.2% of cases, the lesions were at multiple sites with a mean age of 16.9 (11-19) years. Indications for laparoscopy included chronic or acute pelvic pain and right-sided lower abdominal pain. Endometriotic lesions were found in the pouch of Douglas (64.8%), uterosacral ligaments (37.8%), and ovarian fossa (24.3%), 42.8% of directed biopsies were positive. Endocoagulation of the endometriotic lesions was performed in 91.9% of cases.

Adolescent↗
PubMed1998

[Initial experiences with radionuclide mammography at the Cottbus Carl-Thiem Clinic].

In the diagnosis of breast cancer, noninvasive methods are need in order to detect early stages of this disease. These methods have to have a high specificity in order to discriminate malignant and benign lesions. The scintimammography with 99mTc-MIBI might be such a new method. With this examination the early diagnosis of breast cancer might be improved and may reduce the need for diagnostic biopsies. The aim of our examinations was to get first experiences in comparison with the histological results. The histological results were considered to be the reference method. 25 scintigrafical examinations were evaluated, performed from August 1997 to January 1998. The scintigrafical results were recorded qualitative-visually with a score from 1 to 4. The histological results were received within 1 week after realization of the scintigrafical examination. 22 scintigrafical examinations were evaluated correctly. Of 16 benign lesions 14 were evaluated as true negative and 2 as false positive (fibroadenoma, haematoma). Of the 9 breast carcinomas 8 were evaluated as true positive and 1 false negative (lobular carcinoma in situ). In the case of unselected patients, low numbers of examinations and a diameter of the smallest carcinoma from 1.4 cm a sensitivity of 89% and a specificity of 88% has been observed. Our sensitivity and specificity was in the range of the current international scintimammography-studies. Statements about little breast carcinomas (diameter < 1 cm) are not yet available, because such patients were not examined. The scintimammography is not a screening test. It renders no additional information in the case of clear clinical results and/or clear mammography. Therefore useful indications have to be defined in subsequent scintimammography studies. Possible indications are: palpable breast lesions, which appear normal in mammography, uncertain results in mammography without palpable result and in the follow up of operations of breast cancer without mastectomy. It might be interesting to compare in the future new radiological methods and magnet resonance imaging and positron-emission tomography in the diagnosis of breast cancer with the represented conventional method.

Adult↗
PubMed1998

[Pelviscopy within the scope of differential gynecologic-surgical diagnosis. Endometriosis--chronic appendicitis].

Endometriosis associated with chronic pelvic pain is one of the most indications for gynecological pelviscopy. The differential diagnosis of chronic appendicitis is difficult to the similar symptoms, chronic course of both diseases and the increase of an earlier diagnosis of endometriosis concerning the age of women. The meticulous inspection of the whole abdominal cavity is necessary to exclude not only surgical diseases but for evaluation of endometriotic lesions in the area of genital and extragenital organs. Planning of hormone therapy and second-look pelviscopy should be performed by gynecologists.

Adult↗
PubMed1997

[Possibilities and limits of mammography with special reference to breast carcinoma--a comparison of clinical, mammography and histologic diagnoses].

This paper informs about the diagnostical accuracy of clinical examination and mammography at the women's Hospital of the Städtische Klinikum Zwickau from 1989 to 1992 when pathological changes of breasts are diagnosed. A total of 508 diagnostical biopsies was performed during this study period. The histological examination resulted in 276 benign breast lesions and in 232 breast cancers. In 432 cases there was a lump palpable in the breast that was noticed at first by more than 60% of women themselves. 288 (56.7%) correct and 220 (43.3%) false diagnoses were established following the clinical examination. This resulted in a sensitivity of 100% with a specificity of 20.3% and an overall accuracy of 56.7%. However, with the help of mammography 386 (76.6%) pathological changes of breasts were found to be correct. 118 mammograms proved to be false. Out of these 90 (17.8%) had a false-positive diagnosis and 28 (5.6%) a false-negative one. The overall accuracy of mammography was 76.6% (sensitivity 87.9%, specificity 67%).

Biopsy↗
PubMed1996

[Symptoms of ovarian failure after hysterectomy in premenopausal women. A retrospective study based on postoperative perception of 245 women].

A total of 437 patients who had undergone hysterectomy in the department of Obstetrics and Gynaecology, Heinrich Braun Clinic, Zwickau, between 1982 and 1992 were asked about vegetative and psychological problems after the operation. All were under 42 years old and had at least one ovary left intact. In all, 245 women returned the questionnaires. After hysterectomy 26.1% reported ovarian failure and 36.7% did not observe typical menopausal symptoms. Symptoms were significantly more frequent in patients where ovary had been removed. It made no difference whether a vaginal or an abdominal incision had been made. Psychic problems were reported by 17.6% of the patients. Patients with ovarian failure had more negative symptoms. Postoperatively, 34 women received hormonal therapy, and 10 of them finished the therapy successfully. The rate of ovarian failure and psychic symptoms can be reduced by adequate information before and after hysterectomy. A decision to perform a hysterectomy should be made only if the operations is strictly indicated. Prophylactic oophorectomy should not be performed in patients under 50 years. Effective hormonal substitution is recommended for patients with menopausal symptoms.

Adult↗
PubMed1996

[Incidence distribution of postoperative adhesions after using different coagulation techniques. An animal experiment study].

This study compares the incidence of adhesions after using the Endocoagulator by Semm with the incidence of adhesions after using the Nd-YAG-laser with 30 watts and 100 watts. At a total of 100 female Wistar-rats both, the uterine-horns and 2 correspondent spots at the ventral abdominal-walls were coagulatet. resp. vaporized. After 14 resp. 28 days a relaparotomie was made: 1. With the Nd-YAG-laser (30 and 100 watts) (significant) adhesions were found, at the uterine-horns in 100% of all cases with the Endokoagulator in 50%. At the peritoneal spots with the Nd-YAG-laser (30 and 100 watts) (not significant) adhesions were found in 10% of all cases, with the Endokoagulator 5% were found. 2. In addition to the macroscopic results histologic researches were also made: It was shown, that the treatment with Nd-YAG-laser develops a high grade of carbonisation-waste, which is known to be a main cause for the development of adhesions. 3. The division in 14- and 28-day-groups showed no significant differences in the incidence of adhesions. 4. There were found more significant adhesions at the uterine-horns than at the peritoneal-spots.

Animals↗
PubMed1995

[Development of gynecologic endoscopy in Germany--a statistical overview 1989 to 1993].

The first statistical report on pelvioscopy/laparoscopy of total Germany covers a five years period from 1989, 01.01 to 1993 31.12. It includes a total of 461,568 pelvioscopies/laparoscopies from 374 hospitals and 52,861 pelvioscopies/laparoscopies from 116 medical practitioners. Hospitals' response rate was 43% with 99.2% reporting pelvioscopy/laparoscopy. The response rate of medical practitioners was 41% with 97.4% performing same methods. During the five year period of survey, hospitals reported a total of 2095 serious complications requiring laparotomy or control laparoscopy (complication rate = 4.5/1000). Medical practitioners reported a total of 197 serious complications (complication rate = 3.7/1000). Compared with the data of the fourth statistical survey of laparoscopy (1986 to 1988) there is a remarkable increase in serious complications. Most of them are mechanical lesions of blood vessels in the abdominal wall or in the mesosalpinx, followed by mechanical lesions of the intestine. Also remarkable is the observation that pelvioscopy/laparoscopy as surgical method is continuously increasing. As shown in previous statistics on pelvioscopy for tubal sterilization the bipolar technique is the most popular one for both hospitals and medical practitioners. It is followed by endocoagulation after Semm whereas mechanical techniques are of little importance. The monopolar high frequency current is still used in 9.6% by hospitals and 8.8% by medical practitioners, with and without transsection. Sterilization failure rate remains nearly at the same levels as it was reported previously: 1.6/1000 in hospitals and 3.7/1000 in private practices. The highest failure rate was observed after the use of monopolar HF-techniques. 82.5% of the hospitals and 65% of the medical practitioners reported tendency in performing endoscopy by surgery is continuously increasing.

Cause of Death↗
PubMed1995

[Chronic recurrent abdominal pain--significance and success of laparoscopic/pelviscopic adhesiolysis].

The report is given about 154 patients, who were operated because of chronic abdominal pain in the lower abdomen 27 (17.5%), suspicion of adhesion 43 (27.9%), of an adnexal tumor 56 (33.8%), of endometriosis 5 (3.2%), sterility 11 (10%), or irreversible contraception 16 (7.2%). 112 patients had to be laparotomized once or several times. 105 women had only adhesion; adhesion and an adnexal tumor were found in 27 patients, 22 women had adhesion and endometriosis. Predominant were adhesions of second graduation, 72 women had these adhesions, nine of 105 patients had adhesions of first graduation, adhesions of third graduation had 24 patients. In the last group there was the greatest number of laparotomies. 95 patients answered the questionnaires six months later. 35 (36.8%) were free from pain, 13 (13.8%) stated a clear improvement, 38 (40%) were temporarily free from pain, and 9 (8.2%) stated unchanged pain. One woman complained postoperatively about clear aggravation of pain.

Abdominal Pain↗
PubMed1995

[Tubal sterilization in the new unified Germany--results of a survey].

A total of 4 statistical reviews of pelviscopic surgery had been issued in the Federal Republic of Germany until 1988. The five new federal states started such reviewing first in 1989 by quoting the number of tubal sterilization at 800. Our study, covering the period from May 31, 1991 to June 01, 1992 reveals an increase in pelviscopic surgery up to 20,000 with upward tendency. All 198 hospitals of the five new states were included in the inquiry and 133 of them took part in the survey. Out of 20,915 sterilization reported, 18,873 (90.3%) were performed by endoscopic surgery. Coagulation techniques such as monopolar and bipolar HF-methods, the endocoagulation according to Semm, and Laser techniques were available for endoscopic tubal sterilization. Mechanical methods such as a clip or Yoon's ring were used in less than 10% and were therefore of limited practical importance. Severe complications were reported in 32 cases.

Cross-Sectional Studies↗
PubMed1994

[Dr. Wang's tube--study of a new technique for eliminating pathogens in sperm preparation for reproductive medicine].

A total of 30 ejaculates has been tested for ejaculate volume, spermatozoal concentration, motility, agglomeration, agglutination and contamination by microorganisms. After that the ejaculate has been washed twice and transferred in the Dr. Wangs Tube which was filled with medium before. After an incubation time of 90 minutes very quickly moving spermatozoan could be observed through the microscope in the upper part (C-D) of the Tube. After the Tube was cut by means of a special glasscutter the motility of the containing spermatozoans of part C-D has been determined again, followed by a second bacteriological examination of the so prepared ejaculate. The results of sperm preparation with the Dr. Wangs Tube regarding the sperm motility has been very good (85.7% of the sperm samples showed a motility rate of 90% or even more after treatment). The bacteriological examination has been satisfactory: in 77.7% of the cases all existing sperm bacterias has been eliminated by preparation in the Dr. Wangs Tube. Among other microorganisms Escherichia coli, Proteus mirabilis and Staphylococcus aureus which are considered to be pathologic could be isolated from five of the ejaculates and have been removed after treatment with the Dr. Wangs Tube. The handling of the Tube was rather demanding and Technically problematic. There has been caused glass-splinters by cutting the Tube which got visible while observing the ejaculate-medium-liquid through the microscope. Their sizes were nearly equivalent to the size of a sperms head or even bigger. If the so prepared ejaculate would be used for insemination and in-vitro fertilisation the very small splinters may destroy the success of the treatment and should be avoided or removed. The Dr. Wangs Tube offers a new modified swim-up technique for sperm preparation and is able to produce a high quality, nearly sterile sperm sample. Because of the technical deficiency of the system, the high purchase and running costs and the very small output (sperm sample volume, number of spermatozoans) the Dr. Wangs Tube is not be recommended for the reproductive medicine in its present shape.

Adult↗
PubMed1993

[The development of pelviscopic (laparoscopic) surgical procedures in former East Germany--statistics from 1986-1988 inclusive].

The fourth German pelviscopy/laparoscopy statistical report includes survey data on a total of 219,314 laparoscopies from 354 clinics and 40,892 laparoscopies from 161 private practices. Clinics' response rate was 44.7%, 98.9% of them reported performing laparoscopies; and the number of serious complications requiring laparotomy or control laparoscopy was 492 (2.2/1,000). For private practices, the comparable figures were 66%, 90.8% and 123 (3/1,000), respectively. Compared with data from the third laparoscopy statistical survey, the data show a slight increase in serious complications, most of which were mechanical lesions of blood vessels in the abdominal wall or in the mesosalpinx, followed by mechanical lesions of the intestine. As shown by the previous survey, 16.5% of the complications were burns. For tubal sterilization, bipolar techniques were still predominant; approximately equal numbers of departments used this method, with or without subsequent transsection of the tubes. Endocoagulation by the method of Semm was the second most popular procedure; the use of clips and rings was of little significance. Monopolar high-frequency (HF) current was still used with transsection by 4.1% of clinics (4.7% of private practices) and without transsection by 2.5% (5.3%). Sterilization failure rates remained the same as those previously reported (2.5/1,000 in clinics, 2.8/1,000 in private practices), the highest rates were observed after the use of monopolar HF techniques. Sixty-six percent of the clinics and 41% of the private practices reported their intention to increase the use of endoscopic operational methods.

Female↗
PubMed1992

Pelviscopy/laparoscopy and its complications in Germany, 1949-1988.

The fourth German pelviscopy/laparoscopy statistical report includes survey data on a total of 219,314 laparoscopies from 354 clinics and 40,892 laparoscopies from 161 private practices. Clinics' response rate was 44.7%; 98.9% of them reported performing laparoscopies; and the number of serious complications requiring laparotomy or control laparoscopy was 492 (2.2/1,000). For private practices, the comparable figures were 66%, 90.8% and 123 (3/1,000), respectively. Compared with data from the third laparoscopy statistical survey, the data show a slight increase in serious complications, most of which were mechanical lesions of blood vessels in the abdominal wall or in the mesosalpinx, followed by mechanical lesions of the intestine. As shown by the previous survey, 16.5% of the complications were burns. For tubal sterilization, bipolar techniques were still predominant; approximately equal numbers of departments used this method, with or without subsequent transsection of the tubes. Endocoagulation by the method of Semm was the second most popular procedure; the use of clips and rings was of little significance. Monopolar high-frequency (HF) current was still used with transsection by 4.1% of clinics (4.7% of private practices) and without transsection by 2.5% (5.3%). Sterilization failure rates remained the same as those previously reported (4.6/1,000 in clinics, 5.3/1,000 in private practices); the highest rates were observed after the use of monopolar HF techniques. Sixty-six percent of the clinics and 41% of the private practices reported their intention to increase the use of endoscopic operational methods.

Female↗
PubMed1990

Sequelae of appendectomy, with special reference to intra-abdominal adhesions, chronic abdominal pain, and infertility.

We analyzed the case histories and operation protocols of 2,465 female patients who had undergone pelviscopy for various reasons at the University Clinic of Obstetrics and Gynecology, Kiel, in the years 1978-1982. 1,743 patients (71%) had reported a previous appendectomy, of whom 965 had had no other intra-abdominal operation. 657 of the latter (68.1%) presented adhesions; these were located in the right middle abdomen in 36.4% of the cases. In comparison to a collective of 308 patients without adhesions after appendectomy, the existence of chronic lower abdominal pain was independent of the presence of adhesions (30-31% in both groups). In 55% of the patients with adhesions who were infertile after appendectomy, periovarian and peritubal adhesions were registered. In order to avoid unnecessary appendectomy or other laparotomies with later formation of adhesions, the use of laparoscopy is recommended in all questionable cases.

Abdominal Pain↗
PubMed1990

[Chlorinated hydrocarbons in seminal plasma and male fertility].

To determine the concentration of polychlorinated biphenyls (PCB), hexachlorobenzene (HCB) and gamma hexachlorocyclohexane (gamma HCH) in human seminal plasma, 176 ejaculates taken from 156 patients consulting the Dept. of Gynecology and Obstetrics of the RWTH Aachen for sterility were analysed gas-chromatographically. 77% of the examined samples exhibited different pathological sperm findings (OAT, AT, OA, A, O, T, P, K). Contrary to all our expectations the concentration of PCB, HCB and gamma HCH in the samples with normozoospermia were higher than in the samples with pathological sperm findings. The wives of 42.5% of the patients with normozoospermia exhibited no organically or endocrinologically reasons for sterility (idiopathic sterility). In this group (normal/idiopathic) the concentrations of the toxic agents were significant higher than in that group of patients with pathological sperm findings. In the group of couples with male normozoospermia and female organic/endocrinologic reasons for sterility (normal/organic) nearly the same concentrations of PCB, HCB and gamma HCH could be shown as in samples with pathological sperm findings. The concentrations of the toxic agents in the samples with the different pathological sperm findings were similar--independent of the kind of diagnosis. A correlation between the spermiogram parameters motility, morphology and density and the concentration of PCB, HCB and gamma HCH in the seminal plasma could not be shown.

Hexachlorobenzene↗
PubMed1990

[Demonstration of chlorinated hydrocarbons in follicular secretions].

To determine the concentration of HCB, HCH and PCB in human follicular fluid, 315 preovulatory follicular taken from 45 patients and aspirated by transvaginal follicular puncture were analysed with the aid of gas chromatography. We distinguished follicular fluid without oocytes and follicular fluid with oocytes. Again the latter is subdivided into follicular fluid containing secondarily fertilized oocytes and non-fertilized oocytes. There are great differences in HCB (0.08 - 1.87 ng/ml), HCH (0.05 - 1.0 ng/ml) and PCB (0.28 - 2.11 ng/ml) concentrations, varying even in the follicles of the same patient. Contrary to all our expectations we did not find any significant difference in the HCB, HCH and PCB concentration of the different follicular fluids. A direct influence of these substances on the fertilization of oocytes in IVF-ET-procedure could not be established.

Biphenyl Compounds↗