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Biomedical subjects

H J Kümper

Publications and source records attributed to H J Kümper.

At least 19 recordsLinked to original sources

[Medical expert assessment in civil and criminal law from the legal liability viewpoint].

In view of the wide range of liability claims, expert medical reports constitute part of the basis of the work of liability insurers. However, the very different qualifications of experts often present the so-called "corporate physician" with great problems, since some expert reports are hardly acceptable, as the author discovered during many years of study of a large number of liability files. In addition, the most striking and frequently occurring criteria are discussed.

Expert Testimony↗

Use of human chorionic gonadotropin and alpha-fetoprotein radioimmunoassays: specificity and apparent half-life determination after delivery and in patients with germ cell tumors.

The specificity of commercially available hCG and hCG-beta antibodies (anti-hCG-beta from N.I.A.M.D.D. (SB6), Serono (S), Biosigma (B), Union Carbide (UC) (I.R.E.) and anti-hCG from Union Carbide) were compared. Using 125I-hCG (CR 115), the crossreactivity with LH (LER 960) was 5.5% for SB6, 0.25% for S and 0.3% for B. In the homologous hCG system UC, crossreactivity was 0.06% with hCG-beta and 1.2% with LH, in the hCG-beta system UC, it was 2.2% with hCG and 0.01% with LH. Parallel standard curves for hCG, the 2nd I.R.P. hCG and hCG-beta were found exclusively with the 125I-hCG, anti-hCG-beta system S. Consequently accurate estimates of the total hCG or hCG-beta content in serum and standardization with the 2nd I.R.P. is possible. This system is the most useful for clinical purposes. The serum half-life of hCG was calculated in 10 pregnant women after delivery and was found to be 10 to 34 h. AFP half-life time, determined by the double antibody radioimmunoassay was 4.0 +/- 1.8 (+/- SD) days in pregnant women after delivery (n = 60) and 3.8 +/- 0.9 days in neonates during the first 16 days of life (n = 26). Altogether, apparent half-life determinations were carried out in 29 patients with nonseminomatous germ cell tumors. The results indicate that half-life determinations of hCG and AFP may have a predictive value with respect to the monitoring of therapy.

Antibody Specificity↗

[Representation of gynaecological fistulas by wick urethrocystocolporectography (author's transl)].

In connection with gynaecological diseases and/or their therapy, genital fistulas constitute a grave complication. Accurate representation of these fistulas in conjunction with the adjacent hollow organs is of curcial importance for their successful removal. A modified kind of wick urethrocystocolporectography, which is a method that has proved efficient in cases of a dislocation in the female genital tract and also in cases of insufficiency of locking of the urinary bladder, provides these preconditions for an efficient therapy. That is, through the difference in the course of motion during holding and pressing in comparison with rest there are detected not only any valve mechanisms present but also dislocations, if any. Moreover, the method, easy to apply as it is and involving only little strain, provides an advantage which cannot be overlooked.

Colon, Sigmoid↗

[Functional risks in the surgical therapy of urinary incontinence and prolapse (author's transl)].

In addition to the known surgical risks in the treatment of incontinence or prolapse there exists a functional risk inherent in the surgical methods, which can even cause a deterioration in the functional condition if the surgical aim is not achieved. The vaginal bladderneck sutures are only worth as much as the tissues they hold together. The surgical treatment of certain cases of prolapse can eliminate the stopcock mechanism of the urethra and lead to the manifestation of a preoperatively-existent incontinence. With the sling operations success depends, among other factors, on the degree of restraint and the correct placement of the sling. The outcome of hysterectomy is endangered by failure to recognize a coexistent prolapse or enterocoele. With Ward's manipulation, high peritonization and adequate treatment of the overextened posterior vaginal vault, the involved functional risks can be minimized. Typical examples are mentioned in the text. Particular emphasis is placed on the necessity of exact knowledge of the circumstances threatending the functional success and their recognition by means of wick-urethrocystocolporectography. For the maintenance of a good doctor-patient relationship, the patient may receive prior to surgery an understandable explanation of the limitations of the methods used in achieving a functional cure.

Aged↗

[The late bladder reaction following radiotherapy of a cervix carcinoma].

This study presents the cystotonometric checks of trends in 102 patients with irradiated carcinoma of the cervix up to the time of the so-called five year survival recovery. As compared with a standard control group concerning the function of the urinary bladder a distinct tendency to hypertonia is realized and attributed as inevitable to radiotherapy. The moderate load being present before the onset of irradiation is mentioned, resulting from diagnostic operations and from the primary disease. Based on these observations, functional findings which allow objectivation appear to be indicated, the aim being to recognize, as early as possible, the increase of vesical reactions with regard to gynecologic radiotherapy and later follow-up care.

Cystoscopy↗