Biomedical subjects
H U Lau
Publications and source records attributed to H U Lau.
[Torsion of the myoma pedicle as a rare cause of ileus in puerperium].
Myoma of the uterus could not only complicate pregnancy and delivery but also puerperium. The paper reports on an unusual, but severe complication due to myoma. A 35-year old woman with myoma of the uterus was admitted with an acute abdomen and ileus on the 16th day after delivery. Pregnancy, delivery and early puerperium were uneventful. During laparotomy a twisting of a pedicle of a myoma and compression of the bowel were found. The myoma was resected and the postoperative course was normal.
[Differential breast tumor diagnosis by comparing blood circulation of the tumor with the contralateral breast using color coded, pulsed Doppler ultrasound].
74 breast tumor patients were preoperatively examined by means of colour and pulsed-wave Doppler sonography using the ultrasonic instrument ALT Ultramark 9 HDI with a broad-band linear scanner, 5-10 MHz. The Doppler flow velocity waveforms, from the vessels of the mammary lesion (affected breast) and the corresponding quadrant of the contralateral breast (non-affected breast), respectively, were compared in respect of the four parameters maximal systolic velocity, minimal diastolic velocity, pulsatility index (PI) and resistance index (RI). In 48 cases we succeeded in representing arterial vessels both inside the affected and the contralateral breast. The aim of the study was to examine whether these parameters show a significantly different degree of deviation in correlation with the tumours being either benign or malign. In cases with benign lesions (n = 24) we did not find any significant differences in all the parameters that we examined. In cases with cancer, however (n = 18), a significantly higher systolic velocity was found in the affected breast compared to the contralateral breast, but there were no differences in the other parameters. Although the quantitative Doppler measurements are angle-dependent parameters, the study showed that the maximal velocity in the affected breast compared to the contralateral breast is the most useful parameter in differential diagnosis of breast tumours.
[Intrauterine device-associated genital actinomycosis. Diagnosis and therapy with reference to five case reports].
Between 1992 and the beginning of 1993, 5 patients attending the gynecological department of the Charité Hospital in Berlin were treated for IUP-associated actinomycosis. The IUP had been used by these women for periods of between five and sixteen years. The primary diagnosis was established on the basis of a histological examination in three cases. In two cases, dysplasias had been diagnosed on the basis of the cytological examination. In one case, the primary diagnosis was suspected by the finding of actinomycetes in the cytological preparation. The treatment of choice is high-dose intravenous penicillin administered over the long term.
[Non-puerperal mastitis in real time and color Doppler ultrasound].
Differential diagnosis distinguishing between nonpuerperal mastitis and inflammatory cancer of the breast is difficult, the conventional method being mammography. In our study, we present the typical findings gained by sonography of 16 patients with nonpuerperal mastitis. They do not differ significantly from those cases with breast cancer. From these 16 patients, 7 were additionally examined using Colour and Pulsed Wave Doppler Sonography. International literature offers little practical knowledge in this field. In the immediate surroundings of the inflammation, we were able to represent up to four arterial vessels per patient. The parameters of the flow velocity wave form of these vessels were compared to those of the vessels in the correspondent quadrant of the contralateral breast. In all cases, the maximum systolic and the minimum end diastolic velocities were higher than in the contralateral breast, giving evidence of an increased vascularity. In 6 cases, the pulsatility and resistance indices in the inflammatory vessels were lower because of a decreased peripheral resistance of the vessel. Under therapy with antibiotics or Bromocriptine, these parameters were equalized in both breasts. The model of nonpuerperal mastitis shows, that Colour and Pulsed Wave Doppler Sonography makes it possible to differentiate tumours of the breast on the basis of an analysis of their vascularity and the comparison with the parameters of the vessels in the contralateral breast. The effects of a pharmacological therapy on the vascularity of breast tumours can also be measured with this method.
[The beginning of gynecologic cytology for cancer diagnosis in Germany].
In 1946 at the Berlin hospital Charité the gynecologist H. Igel founded the first laboratory of gynecological Cytopathology in Germany. The circumstances of the foundation, the reaction of the German medical public and the development to the present state of the laboratory are described.
[Fibromatosis of the breast--a case report and review of the literature].
A case of fibromatosis of the breast mimics a carcinoma by its clinical and mammographic features. The morphological image of this rare disease of the breast is described. The fibromatosis of the breast has to be distinguished histologically from a fibroma and from a low-grade fibrosarcoma. The dignity of the lesion is confirmed by histological and immunohistochemical examination. The possibilities of therapy are discussed and compared with data of the literature.
[Therapy of pronounced pleural and pericardial effusion in metastatic breast cancer with local mitoxantrone and radiation therapy. Presentation of the intrapleural cytologic findings during this therapy].
The method of intrapleural Mitoxantrone therapy in case of metastasizing mammary cancer is presented in form of a case report. The uncomplicated procedure, the high rate of remission and the few side effects are the advantages as compared to other methods of pleurodesis. Mitoxantrone could cause an intrapleural inflammatory reaction. That is supported by the cytologic findings before and after the therapy.
[TNM classification of malignant tumors. Comment].
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[Assessment of risk before major gynecologic operations using a personal risk check list].
Anaesthesia and operation risk is determined by many factors. State of physical health and main disease of the patient are predominant ones. In many countries attempts have been carried out to systematize the preoperative findings by a classification and to estimate the preoperative risk by objective parameters. The anaesthesia-checklist of Lutz, introduced in 1972, more and more finds a consent in different modifications and is widely used. After approval of specialists, of internal medicine, anaesthesiology and gynaecology an own checklist has been elaborated taking the pattern of principles from Lutz. The scheme considered patient selection, diagnostic possibilities and spectrum of operations in the women's hospital of Humboldt-University of Berlin/GDR. After having tested our checklist in a retrospective (n = 2290 patients) and a prospective study (n = 100 patients) its application in clinical practice can be recommended.
[Indications for the use of the CO2 laser in gynecology].
In accordance with international results and own experiences twenty-two indications for use of carbon dioxide laser in gynecology are reported. It is referred concisely to intervention, diagnosis, special measures of laser surgery, and specific advantage of laser application. The comprehensive advantage is based on CO2 laser operating technique. The results of CO2 laser use are determined by locality and mode of application. The series of indications is not finished.
[Indications for vaginal hysterectomy].
The surgical technique recommended for vaginal extirpation of the uterus from patients with corpus carcinoma differs from methods suggested for any other indications, including inadequately controllable metrorrhagia, uterus myomatosus, in situ carcinoma, Stage Ia carcinoma of the cervix, and positional abnormality. Reported are 1,052 cases of hysterectomy for which these indications had been valid. More than 25 per cent of the patients concerned had been above 60 years of age. There had been complications of two types, intra-operative and postoperative. Infections of the urinary tract ranked on top of the list and accounted for 5.6 per cent of all complications. They were followed by intra-operative bleeding in 2.6 per cent of the cases and postoperative bleeding in 1.6 per cent. There were also two cases of ileus, one of them fatal. Another death occurred due to cardiac insufficiency.
[Accuracy of lymphography in carcinoma of the cervix (author's transl)].
A review has been made of lymphographic diagnoses recorded from patients with cervical carcinoma over more than five years. The diagnosis by lymphography of nodes metastases had to be altered in some 25 per cent, and correction proved necessary also in cases in which lymphography had failed to yield conclusive information. - In the group with lymphographically secured cancer lymph nodes coincided with histological results in 70 per cent of all primary and 90 per cent of secondary checks. Comparable gaps were recorded also from the group with lymphographically inconclusive information on lymph node cancer. - The following conclusions are drawn from the study described: (a) The accuracy of lymphographic diagnosis depends on the experiences of the examiner and changes within time and this must be considered in the evaluation of therapeutic success or failure. - (b) Conclusive findings in the context of lymph node problems are obtainable from selective use of lymphography.
[Experiences on the effectivity of prostaglandin F2alpha during labor after insufficient effect of oxytocin].
A report is given about the efficacy of prostaglandin F2alpha for induction of labour after inefficient application of oxytocininfusion. In all cases induction of labour was indicated or labour should be supported. 80 of the 104 women with weak labour finally delivered on vaginal way. Only 9 of 24 caesarean sections were performed by reason of weak labour in spite of application of prostaglandin F2alpha. There was no influence on the state of the newborns, this was the result of postnatal judgment by Apgar-score.
[Induced abortion with intramuscular administration of 15(S)-15methyl-prostaglandin F 2 alpha].
15(S)-15-methyl-prostaglandin F2alpha was administered by the intramuscular route in 10 patients between 12. and 18. weeks gestation. All these patients aborted within 20 hours, with mean induction-abortion intervall of 14,1 hours. 250 microgram 15(S)-15-methyl-prostaglandin F2alpha was administered 3 hourly. 8 patients had side effects, mainly nausea, vomiting and diarrhea.
[An epidemiological study of cancer of the ovary (author's transl)].
A study of 149 patients with ovarian cancer compared to 149 age-matched women out of the population is analyzed. There were no statistically significant differences in nearly all extragenital and all gynaecological diseases. No differences were found in menstrual history, history of hormonotherapy, age of menarche and menopause, number od nulliparous women, number of deliveries and abortions, radiation exposure, double primaries, blood groups, family history and consumption of nicotine. The findings in this study showed a difference in two variables: There were more women with hypertension and more never married women among the patients with ovarian cancer. It is not possible to define a group of high risk with these findings. It is suggested that endocrine factors influence the onset of ovarian cancer. Therefore these factors more should be taken into consideration in further epidemiological studies.
[Paralysis of the femoral nerve after abdominal and vaginal surgery].
Damages of the femoral nerve during gynaecological operations are more frequent than generally supposed. They are observed after abdominal and vaginal operations caused by pressure on the nerve. During abdominal procedures an unsuitable self-retaining retractor is due to the paralysis. If the legs of the patients are deposited on the shoulder-back-parties of the assistants during vaginal procedures there is the danger of pressing the femoral nerve against the inguinal ligament by strong bending and abduction of the thighs. We report about 3 cases of paralysis of this nerve; recommendations for avoidance are given.