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Biomedical subjects

H Maass

Publications and source records attributed to H Maass.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Recurrence rate following surgery of incontinence in patients with hypotonic urethra].

In a retrospective study, 94 patients were examined after incontinence operation. We show the anamnestic, clinical and urodynamic results. Standardised questions were used for exploring the patients' history. The loss of urine during provocation, like coughing with a filled bladder up to 300 ml, showed the clinical incontinence. The urodynamic investigations were performed with a modern, computer-guided instrument. The pressure was measured by highly flexible polyurethane catheters with micro-tip pressure transducers. The examinations were made in horizontal position with 100 ml, and upright position with either 100 ml or 300 ml bladder volume. Approx. 50% of the examined patients had postoperative stress incontinence both anamnestically and urodynamically. After vaginal repair and the Marshall-Marchetti-Krantz procedure, regardless of maximal urethral closure pressure (UVDR max), the recurrence rate was doubled in comparison to Burch colposuspension. After dividing all patients into those with hypotonic and those with normotonic urethra, the recurrence rate was doubled when UVDR max was low. The comparison of vaginal repair and abdominal colposuspension in patients with hypotonic urethra showed a significantly higher recurrence rate in the first group. In a preliminary prospective study, 19 patients with hypotonic urethra prior to surgery underwent Burch colposuspension. The examinations 3-6 months later did not show any stress incontinence. The main UVDR max ascended from 28.2 to 38.2 cm H2O. The increase was statistically significant (p less than 0.003). Unsatisfactory results after incontinence operations were obtained on patients with vaginal repair with hypotonic urethra. Preliminary results show, that after Burch colposuspension on patients with low maximal urethra closure pressure, a reduction of recurrence may be achieved.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

The present status of the adjuvant endocrine treatment.

Adjuvant therapy of breast cancer is accepted as a useful method for reducing mortality in patients with histologically axillary involved lymph nodes. Polychemotherapy regimens and hormonal treatment procedures are used to reach this goal. Hormonal treatment seems to be useful especially in selected patients. This article deals with (a) new methods for selecting hormone-responsive tumors and patients, and (b) it will give a brief overview of major publications concerning adjuvant endocrine therapy and (c) will summarize the data from the Gynecological Adjuvant Breast Group (GABG) trials.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

[Endocrine therapy of breast cancer].

A survey is given about the value of endocrine especially adjuvant treatment of breast cancer, the necessary case selection procedure with aid of time- and therapy dependent hormonal receptor status using new introduced monoclonal antibodies and of the practical possibilities. Special attention was directed to the very potent substances with less side effects aminoglutethimide, tamoxifen and high dose medroxyprogesteronacetate.

Aminoglutethimide↗
PubMed1986

Immunohistochemical measurement of estrogen receptors in breast cancer tissue samples.

A new estrogen receptor immunocytochemical assay (ER-ICA) which uses monoclonal antibodies to the estrogen receptor protein was applied to 97 breast cancer tissues. The results were correlated to those obtained by conventional dextran coated charcoal assays. The presence or absence of nuclear staining was significantly associated with positive or negative estrogen receptor status by dextran-coated charcoal (P less than 0.001). Furthermore ER-ICA results showed a high degree of correlation with a light microscopic grading. The relationship between ER-ICA results and response to endocrine therapies in patients with advanced disease was assessed in 20 patients. Six of 11 (55%) ER-ICA positive patients responded, whereas 8 of 9 (89%) ER-ICA negative patients failed.

Antibodies, Monoclonal↗
PubMed1985

[Immunohistochemical determination of estrogen receptors in breast carcinoma tissue using monoclonal antibodies. 1st clinical findings].

The results of preliminary investigations into specific immunohistochemical detection of the estrogen receptor in breast cancer tissue by means of monoclonal antibodies are presented. Thirty-one tumor tissue samples stored in a tumor tissue bank for between 10 and 35 months were immunohistochemically studied. The comparison between the immunohistochemical result and the result of the biochemical estrogen receptor assay show a large measure of agreement (90%). The comparison of the results with regard to response to endocrine therapy in cases of metastatization shows that immunohistochemical detection furnishes at least as much information as the dextran-coated charcoal method.

Antibodies, Monoclonal↗
PubMed1985

[Drug sensitivity testing of gynecologic tumors using Volm's test and stem cell assay].

A variety of test systems have been developed for predicting the efficacy of cytotoxic drugs in the treatment of individual malignant human tumors. The present paper reports on the author's experience with Volm's short-term chemosensitivity test and Hamburger and Salmon's stem-cell assay. In the Volm test the influence of adriamycin on the incorporation of radioactively labelled uridine in an individual tumor cell suspension was investigated. Comparison with a cytostatic-free control permitted conclusions to be drawn with regard to the proliferation-related chemosensitivity. The stem-cell assay is based on the capacity of certain tumor cells, the so-called stem cells, to form colonies in a bilaminar soft agar system. The growth of the colony of pre-incubated cytostatics was evaluated in relation to that of untreated tumor cells. The Volm test was successful in 63 (95%) out of a total of 66 tests conducted. Twelve tumors were chemosensitive in the test and 51 chemoresistant. In the stem-cell assay, growth of a colony which permitted chemosensitivity to be tested was only found in 27 out of 183 tests. The criterion of chemosensitivity with a reduction of at least 50% in the number of cells in the colony by at least one cytostatic was satisfied by 14 (29%) of the 49 stem-cell assays which could be evaluated, there being no differences between breast and ovarian carcinomas. The two test systems indicated the chemosensitivity correctly in less than 50% of 49 retrospectively evaluated courses of disease. In contrast, resistance was predicted correctly in 90%.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Agents↗
PubMed1984

[High-dosage oral gestagen therapy as a failure-regime in metastatic breast cancer].

High-dosage medroxyprogesterone (Farlutal, 1 g/d orally) was administered to 42 female patients with progressive disseminated carcinomas of the breast after conventional cytostatic and hormonal treatment had failed. Besides evaluation of success of treatment the pharmacokinetics of medroxyprogesterone were investigated. A remission rate of 37% (total and partial remissions) indicated that high-dosage oral treatment with gestagens can be used as "failure-regime" in patients at the end of conventional treatment. The plasma level of the gestagen approached values corresponding to high-dosage intramuscular application.

Administration, Oral↗
PubMed1984

Estrogen receptor status and adjuvant polychemotherapy or antiestrogen therapy in patients with high-risk breast cancer.

This pilot study includes 115 consecutive patients admitted in the period from 1978 to 1981. Patients eligible for this study were at high risk according to the TNM classification with stages pT1-pT3 and pN+, MO. Primary therapy included modified radical mastectomy and axillary-node clearance, one or more ipsilateral nodes being involved in routine histology. All tumors were assayed for estrogen and progesterone receptors. According to the result of the estrogen receptor assay, estrogen-receptor-positive patients were treated with Tamoxifen 30 mg/day for a period of 2 years. Estrogen-receptor-negative patients were treated with cytoxan, methotrexate, and 5-fluorouracil or adriblastin, cytoxan. After a median observation time of 36 months, overall there have been 31 recurrences: 9 = 17.3% in the estrogen-receptor-positive group and 22 = 34.9% in the estrogen-receptor-negative group. The analysis of different subgroups showed no significant differences, either in relation to axillary lymph-node status or in relation to menopausal status in the endocrine-treated compared with the polychemotherapy group. This result suggests, especially in the subgroup of patients with involvement of one to three axillary nodes, that estrogen-receptor-positive and estrogen-receptor-negative patients should be considered as separate groups when adjuvant therapy is indicated. Possibly hormone-receptor-positive patients may benefit from endocrine therapy and do not need polychemotherapy.

Adult↗
PubMed1984

[Adjuvant chemotherapy in breast cancer: present status].

Adjuvant chemotherapy should be conducted at present only under controlled conditions ("studies") with the consent of the patient after supplying her with adequate information ("informed consent"). The most important prognostic factor in primary carcinoma of the breast is the axillary lymph node status. The decisive role with regard to determining the further course of action and mapping out the treatment strategy will be played by the operating surgeon and the pathologists. Adjuvant chemotherapy can prolong the relapse-free survival time for all prognostic sub-groups known so far (the differences, however, are not significant in every case). It is very probable that the total survival rate will be improved for certain sub-groups. The effectivity of adjuvant chemotherapy decreases with increasing involvement of the lymph nodes. Pre-menopausal patients with one to three affected lymph nodes presently derive the biggest benefit from adjuvant chemotherapy. Short-term chemotherapy (up to 6 months) will suffice. The optimal treatment period is not yet known. The aggressivity of the adjuvant chemotherapy chosen for a particular case is of absolutely paramount importance. Provided the dosage is the same for both groups, there is no evidence of any clear difference between pre-menopausal and post-menopausal patients. It seems, however, that the quantitative reduction of the relapse rate is greater with pre-menopausal patients. Onset of chemotherapy should be as early as possible after surgery (14th postoperative day). A dosage schema should be followed according to calculated full dosage, if possible via the intravenous route of administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

[Risk of hepatitis from conventional pooled PPSB preparations].

The risk of hepatitis from prothrombin complex (pooled human clotting preparation) was retrospectively analysed. Of 39 patients who had undergone cardiac surgery, 22 (56%) developed hepatitis, while in those had not received pooled preparations the rate was only 5%. Although the proportion of multiple transfusions was significantly higher among the recipients of clotting preparations, it was found that the decisive hepatitis-inducing factor was the pooled preparation, not the transfusion blood. Contrary to earlier results, all cases were of the non-A, non-B type. The frequency of carriers of the causative virus is apparently not different from that with B virus. Thus both virus types must have occurred at similar frequency in earlier pooled clotting preparations. Since, furthermore, there seems to be no difference in their infectivity and their penetration in the population at large is likely to be similarly low, unrecognised double-infections in recipients of pooled clotting preparations were probably frequent before the introduction of recent methods of demonstrating hepatitis B.

Alanine Transaminase↗