Biomedical subjects
Publications and source records attributed to H L Koch.
Twelve nephrectomized patients were examined by computed tomography in prone and supine position. The distances necessary for irradiation planning were measured in order to estimate which position is more favorable for irradiation. The advantages of prone position in comparison to supine position seem uncertain and do not outweigh its disadvantages.
Three patients showing typical radiological appearances of dyschondrosteosis of Léri-Weill are described. The characteristic features of this syndrome are Madelung's deformity and growth retardation. Autosomal dominant inheritance is assumed, but sporadic cases also occur. In two of our patients--mother and daughter--we were able to confirm the mode of inheritance of this type of mesomelic growth retardation.
Explore the source record for details and available documents.
The authors present the therapy results and side effects of 422 patients who had been submitted to a radical or partially radical operation or to ablatio mammae. The post-operative irradiation was effected under high voltage conditions with doses between 40 and 50 Gy corresponding to the stage. The survival times were not influenced either by the surgery method or by the post-operative irradiation dose. As compared to radical surgery, however, edemas of the arm were significantly less frequent and serious after a less radical operation. No significant increase of recurrences was observed after partially radical operations.
Explore the source record for details and available documents.
Between 1970 and 1973, 411 operated patients with mastocarcinomas were post-irradiated according to the stage under high voltage conditions at the Institute of Medical Radiology of the University of Tübingen. At regular intervals, the patients were examined clinically and by means of mammography and other methods of nuclear medicine and radiology in our follow-up department. During a five-year period of observation, 21 patients showed a tumor manifestation in the contralateral breast. These patients have a remarkably unfavourable prognosis. Up to now, only one patient survived five years without symptoms after the therapy of the contralateral mastocarcinoma.
Explore the source record for details and available documents.
Perforation in the course of diverticulitis of the right side of the large bowel is a rare disease, which is mostly misinterpreted as appendicitis and generally disregarded in the differential diagnosis of pathological processes of the lower right abdomen. The results of radiological investigations (plane film, barium enema, CT) are demonstrated in two cases and diagnostic findings are discussed. Plane film of the abdomen allows only unspecific diagnosis of an inflammatory process in the right lower quadrant, barium enema reveals changes in the wall of the colon due to abscess formation. CT is also suitable to show those peridiverticular inflammatory changes, which lead to the right diagnosis.
Explore the source record for details and available documents.
Between 1970 and 1973, 411 patients suffering of carcinoma mastitoides of all stages were post-irradiated under high-voltage conditions in the Institute of Radiology in Tübingen. These cases were evaluated in order to study the importance of the appearance of a local or regional recurrence. 65 of the patients (= 15,8%) presented recurrences; in 28 of these cases a remote formation of metastases could be diagnosed already before the appearance of the recurrence or at the same time. In 37 cases (=9%) the recurrence was the first and, in the beginning, the only symptom showing a progression of the primary disease. Only a short time later, 30 of these 37 patients were affected with new tumor manifestations. In most of these cases, a close correlation in time can be demonstrated between the appearance of the recurrence and other manifestations of the tumor.
Serial CEA measurements performed in 102 lung cancer patients during and after radiotherapy and chemotherapy correlated well with the course of disease. CEA levels above 10 ng CEA/ml prior to radiotherapy signaled metastatic spread even when this was not evident from clinical staging of the patient (TNM). This finding contributed to the early adoption of radiotherapy in favor of palliative treatment. Alterations of the CEA concentration during therapy could be used for monitoring the efficiency of treatment. Increasing CEA levels always signaled disease progression, decreasing CEA levels were found to be associated with improvement. In the posttreatment follow-up, increasing CEA levels were always reliable predictors of recurrent disease. Slope analysis of the posttreatment CEA time courses discriminated bone and/or liver metastases with a slope greater than 0.5 ng/ml/10 days from local recurrences, lymph node, lung and brain metastases with slope values less than 0.5 ng/ml/10 days.
Serial CEA determination have been performed in 335 patients with operable breast cancer who received radiotherapy and then were the subjects of a long-term follow-up study. Tumor extension was staged by the surgeon according to the TNM classification. Elevated pretreatment CEA levels (greater than 10 ng/ml) indicated metastatic spread even when this was not evident from the original TNM classification. Elevated CEA levels of greater than 4 ng/ml also led to a reevaluation of patients and in 20% metastatic spread was found. Therapy was adapted when patients had demonstrable distant spread. Response to treatment could be correlated with decreasing CEA levels while increasing CEA levels were generally found when disease progression was observed. During long-term CEA follow-up, 80% of recurrent cancers were signaled by increasing CEA levels. A mean lead time of 4.8 months was calculated for the initial CEA increase before clinical confirmation. Slope analysis of the posttreatment CEA time course represented a numerical parameter which was characteristic for osseous and/or liver metastases when values of greater than 0.5 ng/ml/10 days were recorded. Soft tissue, lymph node, lung and brain metastases showed generally a slope value of less than 0.5 ng/ml/10 days.
Explore the source record for details and available documents.