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Biomedical subjects

H W Schreiber

Publications and source records attributed to H W Schreiber.

At least 19 recordsLinked to original sources
PubMed1992

Detection of colorectal carcinomas by intraoperative RIS in addition to preoperative RIS: surgical and immunohistochemical findings.

The immunoscintigraphic detection of tumour foci less than 1 cm in diameter fails even with single photon emission tomography (SPET) owing to low contrast against background activity. In an attempt to improve detection of macroscopically invisible tumour spread, intraoperative scintimetry (IOSM) with a hand-held gamma-probe was performed in addition to SPET 24-30 and 41-48 h after injection of the technetium-99m carcinoembryonic antigen (CEA MoA) on 12 patients with colorectal carcinoma and 3 patients with different neoplastic and inflammatory diseases. Tumour specimens were measured in vitro in a gamma well counter. For comparison, the presence and amount of CEA in the tumour cells were evaluated immunohistochemically. After modification, the gamma-probe originally designed for iodine-131 was 20 times more sensitive; activities of 99mTc located close to the collimator hole were measured with absolute sensitivity of 100 cps = 2.5 kBq 99mTc. The unfavourably high background activity affected both the in vitro and in vivo analysis: SPET results had been considered positive in 8 of 15 cases. In vitro tumour/non-tumour (t/nt) ratios greater than 2.0 were found in 4 cases. In vivo IOSM resulted in t/nt ratios greater than 2.0 in only 3 patients. In most cases, there was no coincidence of elevated t/nt ratios from the different methods. A correlation was derived between positive immunoscintimetric in vitro findings and immunohistochemically proven interstitial localization of CEA in tumor cells. In conclusion, the measurement technique of IOSM seems adequate, but clinical success will depend on a more specific enrichment of MoA in tumour tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Conservative surgery--introduction].

To choose a careful operative technique is to choose an advantageous cost/benefit ratio in terms of natural and human science. The results are comparable with those of other techniques, but there is an additional advantage in terms of quality of life.

Diagnosis↗
PubMed1990

Immunochemical characterization and quantitative distribution of pancreatic stone protein in sera and pancreatic secretions in pancreatic disorders.

A fluorometric immunoassay has been established to quantitate pancreatic stone protein providing a sensitivity for concentrations from 0.015 to 0.5 micrograms/mL. When concentrations of pancreatic stone protein were determined from pancreatic secretions obtained either from patients suffering from chronic pancreatitis (n = 31) [including the calcifying forms (n = 10)], pancreatic cancer (n = 22), or nonpancreatic diseases (n = 17), no significant differences were found. In contrast, increased concentrations were found in serum samples from patients with chronic (39/66) and acute pancreatitis (16/20) compared with control patients. The differences between these diagnostic groups and controls were highly significant (P less than 0.0001) and independent of pancreatic enzyme activity. Immunochemical analyses of serum pancreatic stone protein showed an isoelectric point (pH 9) similar to that reported for the pancreatic thread protein. With respect to recent communications, these data do not support the etiopathogenic role postulated for pancreatic stone protein in chronic pancreatitis and chronic calcifying pancreatitis by other investigators.

Adult↗
PubMed1990

[Modern cancer therapy--an interdisciplinary task].

The diagnosis of cancer and the treatment of cancer patients are initially an interdisciplinary entity. Progress has been achieved through oncological multimodal cooperation between various forms of organisations. The ensuing problems confirm the following two main points. (1) The continuing delay in diagnosis of cancer still prevents most patients from benefitting from the implementation of optimal therapeutic possibilities and interdisciplinary cooperation. (2) What the surgeon does not achieve or neglects during the primary operation cannot be compensated for through conservative oncological measures.

Aftercare↗
PubMed1990

[Intraoperative radiotherapy of pancreas and stomach cancer].

IORT can be part of an oncologic treatment plan for patients with pancreatic or advanced stomach cancers that can be potentially cured by surgery. When used palliatively IORT can relieve symptoms. Used curatively IORT allows the administration of irradiation boost which complements percutaneous irradiation of the tumor region and the regional lymph nodes. External radiotherapy may also include irradiation of the liver which is performed simultaneously with chemotherapy. IORT also permits the application of oncolytic doses for adenocarcinomas of the upper gastrointestinal tract.

Brachytherapy↗
PubMed1979

[Computer tomographic findings after resection of the rectum (author's transl)].

Computed tomography findings in the pelvis after resection of the rectum, obtained from 48 patients primarily suspected of recurrent carcinoma, are represented. Compared with conventional radiographic methods CT demonstrates directly in most cases the presence of a pelvic mass, its extension and relationship to adjacent soft tissue. In some cases this is advantageous for further diagnostic procedures, but also for treatment and further check-up. False conclusions are discussed. The distinction between recurrent carcinoma and retroperitoneal fibrosis in the pelvis, frequently enhanced by retarded healing of the sacral cavity, remains a problem. Progress in the early diagnosis of recurrence of pelvic mass could be made by regular CT check-up during the first two years after resection of the rectum, to increase the value of palliative radiotherapy treatment indicated in any case. As CT, however, is expensive and not always available, this demand cannot be met and the value of conventional radiographic methods remains at present unquestioned.

Colectomy↗
PubMed1979

[Prognostic indices in acute pancreatitis (author's transl)].

In a retrospective study 55 patients with acute pancreatitis were reviewed in order to establish the prognostic value of 11 indices which can be determined either at admission of 48 hours after the onset of the disease. The results show: 1. the 5 indices determined at admission (age, white blood cell count, blood glucose, SGOT, LDH) do not permit a clear identification of the variable courses of acute pancreatitis, 2. a high risk group can be selected; in this group an early intensive care is recommended, i.e. a vigorous fluid replacement, endotracheal intubation and assisted ventilation with PEEP, and, if necessary, peritoneal dialysis. Furthermore these indices are helpful to decide very early whether a patient has to be transmitted to a medical centre for intensive care and/or surgical treatment.

Acute Disease↗
PubMed1979

[Indications for surgery and operability from the point of view of the surgeon (author's transl)].

The decision as to surgical intervention and operability must also take into account somatic, personal, psychosomatic and social factors. The advances made in medical science have added to rather than detracted from the difficulties of the problem. Although the final decision rests with the surgeon the indications as to surgical intervention and operability present problems which demand interdisciplinary co-operation, first with the general practitioner, then, after admission to hospital, with the various specialists and subsequently again with the general practitioner.

Decision Making↗
PubMed1979

[G. I. diagnostics; its ranking and interdisciplinary organisation (author's transl)].

The complicated and expensive diagnostic apparatus available today has to be applied in an orderly sequence. This order depends on certain prerequisites, e.g. on the disease, urgent complications, patient tolerance, apparatus potential, hospital structure and organisation etc. The more rational the indication is to use certain methods, the more efficient will be the results. The appropriate concepts and suggestions for certain general and specific examples, used by us at present are demonstrated. Complicated and expensive diagnostic procedures have to be decided primarily on an interdisciplinary level. The increased costs of these procedure are balanced by a decrease in hospital stay and fewer operative explorations too. At other places different actions will be taken for equally good reasons.

Gastrointestinal Diseases↗
PubMed1978

[Pancreatic glucagon and the pathogenesis of diabetes mellitus (author's transl)].

Eleven patients who had had total pancreatic resection had hyperglycaemia (16.8 +/- 7.7 mmol/1 corresponding to 3.02 +/- 1.38 g/l) after fasting for 14 or 36 hours. After arginine stimulation there was no evidence for pancreatic glucagon. These findings indicate that (1) in man there are no sites of pancreatic glucagon production outside of the (resected) pancreas; (2) marked hyperglycaemia may occur without glucagon.

Adult↗
PubMed1978

[Principles of radical surgery of gastric carcinoma (author's transl)].

For over a decade, therapeutic results in cases of macrocarcinoma have remained almost constant. The absolute 5-year survival rate is 10-15%. However, in cases of early detection, the 5-year survival rate is over 90%. Systematic screening to detect the cancers early has resulted. The practical results is the systematic observation of high-risk groups. The therapy of choice for macrocarcinoma and cancer that is detected early is subtotal resection. Resection of the cardia should be replaced by gastrectomy, which should also be performed only when defined diagnostic criteria are met.

Gastrectomy↗
PubMed1978

[III. Continued education in surgery. A. Prospective studies, methods for determination of therapy results. Topics on and results of prospective studies in surgery].

Since the first clinical prospective trial of J. Lind in 1753, the controlled study has proved to be an essential instrument in clinical research. Possible topics include: pharmacologic prophylaxis of complications such as stress ulcer, thrombosis, etc., indications for operation, preoperative preparation, choice of surgical procedure, and techniques or postoperative treatment. Examples for each topic are given.

Clinical Trials as Topic↗