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Biomedical subjects

H Wiebelt

Publications and source records attributed to H Wiebelt.

At least 19 recordsLinked to original sources
PubMed1999

Mortality in a cohort of toluene exposed employees (rotogravure printing plant workers).

Since the beginning of the 1960s, toluene has been used as a solvent in all German rotogravure printing plants in a high degree of purity. These particular exposure conditions allow the investigation of the potential carcinogenicity of long-term toluene exposure. A historical cohort study was performed that included 6830 German men from 11 plants who were exposed to toluene from 1960 to 1992 in three work areas with different exposure levels. Overall, 466 deaths were observed, which provided a standardized mortality ratio (SMR) of 91.3 for overall mortality. A significantly decreased SMR for total mortality was seen in one of the three work areas (SMR = 67). Mortality from cancer did not differ substantially from the expected level, but in one of the work areas, mortality from cancers of the bone (Ninth Revision of the International Classification of Disease [ICD]-9 170; SMR = 813) and connective tissue (ICD-9 171; SMR = 631) was significantly elevated. In the entire cohort, mortality from lung cancer was increased by about 35% above total mortality, and by about 95% in one work area with low toluene exposure (not statistically confirmed). The SMR for death from alcohol dependence was statistically significantly increased (ICD-9 303; SMR = 314).

Aged↗
PubMed1995

[Postoperative complications and fatalities in surgical therapy of colon carcinoma. Results of the German multicenter study by the Colorectal Carcinoma Study Group].

In a prospective multicenter study an analysis of postoperative morbidity and mortality of 1224 patients with colon carcinoma treated in 7 departments of surgery was performed. The postoperative morbidity rate was 23.2% in elective surgery and 39.1% in emergency surgery. Postoperative mortality was 3.4% in elective cases and 11.6% in emergency cases. Preoperative associated diseases, which are more frequent in higher age, advanced tumor stage, and postoperative non-surgical complications rise operative mortality. However, surgical complications increase postoperative mortality only in cases of anastomotic leaks. The rates of postoperative complications depended on different surgical departments. Departments performing a delayed tumor resection in emergency surgery had better results. In elective cases the standard of oncological resections should be observed. In emergency cases operative procedure and extension of the resection should be planed in consideration of preoperative risk factors of the individual patient.

Adult↗
PubMed1994

[Long-term results of surgical therapy of colon cancer. Results of the Colorectal Cancer Study Group].

In a prospective multicentre observation study with free choice of treatment 1157 patients with solitary colonic carcinoma were entered free of selection between August 1984 and November 1986. The 5-year-survival rate for all patients was observed 45.7 +/- 3.0%, relative (age-corrected) 60.2 +/- 4.0%. Multivariate analysis using multiple logistic regression analysis identified R-classification, stage, institution and timing of surgery as independent prognostic factors regarding survival. In R0 resected patients occurrence of locoregional recurrence was the strongest prognostic factor. Study data could demonstrate a substantial variability in frequency of locoregional recurrence and survival among the participating institutions. The data support the importance of application of principles of radical surgery and gives evidence for the outstanding importance of surgery for the prognosis of colonic carcinoma.

Adenocarcinoma↗
PubMed1993

The prognosis of patients with stage III melanoma. Prospective long-term study of 286 patients of the Fachklinik Hornheide.

BACKGROUND: Prognostic factors for patients with stage III melanoma are still controversial. METHODS: Two hundred eighty-six patients with solitary cutaneous malignant melanoma of the skin in Stage III (International Union Against Cancer [UICC]) were followed up for as long as 11 years. RESULTS: Patients in risk group pT 4a, pN O (primary tumor thickness of more than 4 mm or invasion of subcutis and absence of regional lymph node metastasis in elective lymph node specimen) have a 5-year survival rate of 72.8%. If regional metastases are excluded clinically (pT 4a, NO), the 5-year survival rate is 62.8%. Patients with regional lymph node metastases have an average 5-year survival rate of 39%, depending mainly on the number of involved lymph nodes and the depth infiltration of the primary tumor. The number of involved lymph nodes reflects the grade of dissemination. It shows a stronger correlation with the prognosis than does the size of metastases. CONCLUSIONS: The authors recommend that revisions of the UICC classification should distinguish Stage IIIA and IIIB based on the presence or absence of regional metastases and that a clearer distinction should be made between regional cutaneous or subcutaneous metastases and regional lymph node metastases.

Adult↗
PubMed1993

Operative mortality in carcinoma of the rectum. Results of the German Multicentre Study.

An analysis of operative mortality for carcinoma of the rectum in the German Study Group Colo-Rectal Carcinoma (SGCRC) comprising 1115 operated patients, found a total operative mortality rate of 4.3% and a 30-day-mortality rate of 2.8%. Advanced age, severe concurrent disease, anastomotic leakage in anterior resections and institution were found to be factors with independent significant influence. In anterior resections, especially low anterior resections, with protective enterostomy, the lower rates of anastomotic leakage and mortality emphasize the advantages of protective enterostomy.

Aged↗
PubMed1993

Effectiveness of colorectal cancer screening: results from a population-based case-control evaluation in Saarland, Germany.

In order to evaluate the effectiveness of colorectal cancer screening by the faecal occult blood test (FOBT) in Germany a population-based case-control study was conducted in Saarland, a southwestern state of Germany. As cases, we identified 522 persons (244 males, 278 females) who died of colorectal cancer between 1983 and 1986 between the ages of 55 and 75 years. For 163 male cases complete screening histories were retrieved together with up to five age-matched controls who had not died of colorectal cancer identified from the files of the case's referring general practitioner (GP). For 209 female cases screening histories were retrieved from their GPs and gynaecologists as well as for age-matched controls. Individual screening histories were established with emphasis on identifying whether FOBTs were carried out asymptomatically or symptomatically. In the time period 6-36 months prior to diagnosis 13% of the male cases and 14% of the male controls had at least one asymptomatic FOBT with a corresponding matched odds ratio of 0.92 (95% CI: 0.61, 1.75). For the same prediagnostic period 16% of the female cases and 29% of the female controls had at least one asymptomatic FOBT leading to an odds ratio of 0.43 (95% CI: 0.27, 0.68). Thus, for males where participation rates are generally low, no protective effect could be seen but for females where participation rates are higher a clear protective effect is seen. Possibilities for bias need to be taken into consideration when interpreting these results. Organizational measures ensuring a high penetrance of a mass screening programme are seen as a way to elevate efficacy.

Aged↗
PubMed1991

[Do cancer patients survive longer today than before? Survival analysis of cancer patients in the Saar region from 1972 to 1986].

In the Saarland there is a population-based cancer registry, which has collected information about cancer cases over a long period. An important task of population-based cancer registries is the analysis of its data in respect to incidence, mortality and survival of cancer patients. Not all patients who have been diagnosed with cancer die of that disease. In order to evaluate the survival of cancer patients in respect of their particular disease, survival rates are calculated after the determination of the influence of other causes of death. The so-called relative survival rates (calculated for the first five years after diagnosis) are also used in order to evaluate simultaneously the prognostic importance of variables such as sex, age and year of diagnosis. This analysis with data from the cancer registry of the Saarland deals with 9 tumor localizations: stomach, colon, rectum; breast, cervix uteri and corpus uteri; prostate, lung, malignant skin melanoma. In general the 5-year relative survival rates slightly increased when the time period 1972-1976 was compared with 1982-1986. Cancer of the corpus uteri was one exception, in that the relative survival rate was constant over time, and cancer of the cervix uteri was another, in that a decrease of relative survival rate was found, which together with the decreasing incidence might be ascribed to a successful early detection program. There was no significant improvement in the relative survival time for lung or breast cancer patients.

Adult↗
PubMed1990

[Progress in the early detection of cervix cancer from the viewpoint of the Saarland cancer register].

The efficacy of the nationwide screening programme for cervical cancer in the Federal Republic of Germany, which has been in effect since 1971, has never been checked by means of controlled epidemiological studies. Therefore routinely collected mortality and morbidity data are up to now the only indicators of potential progress in early detection. Mortality statistics of cervical cancer are of restricted value due to lack of specificity regarding the cause of death on death certificates. Data of the population based cancer registry of Saarland are used to investigate trends in terms of age, stage and birth cohort-specific detection rates of cervical cancer and its preinvasive precursors. There was a substantial decrease in incidence rates of invasive cervical cancer, which was most pronounced for advanced tumour stages and young and middle-age groups and which is consistent with comparable results in other countries following the introduction of screening programmes. However, a selection effect of the screening programme suggested by a decrease in survival rates of women with invasive cervical cancer in the 1980ies, must also be taken into account.

Adult↗
PubMed1990

[Incidence and prognosis of breast cancer in young women in relation to changes in the risk factor profile].

Trends in breast cancer incidence in women aged 25-44 years are assessed in detail based on data from the population-based cancer registry of Saarland-Germany. Compared to 1968-72, from 1978-82 and 1983-87, a highly significant increase in age-standardised incidence by more than 30% was observed. The increase in incidence was most pronounced among women of 25-29 years of age (relative incidence rate 1978-87, compared to 1968-77: 2.03, 95% confidence interval: 1.11-3.71). The role of changes in prevalence of known and suspected risk factors, mainly the age at the onset of menarche, the age at first birth, parity and early and long-term use of oral contraceptives in adolescence, which may partly explain the observed trends, are discussed. The results have important public health implications, such as the need for extended cancer surveillance and epidemiologic research in the Federal Republic of Germany, and offer a quantitative basis for the development and implementation of future early detection programmes as well as the need for medical care facilities.

Adult↗
PubMed1989

Change of epidemiological characteristics of malignant melanoma during the years 1962-1972 and 1983-1986 in the Federal Republic of Germany.

In the FRG data on more than 2,000 patients with malignant melanoma (MM) have been documented so far by the malignant melanoma cooperative group (MMCG 1962-1972) and by the central malignant melanoma registry of the German Dermatological Society (CMMR 1983-1988). In this study we compared the basic characteristics between these two multicenter data collections (CMMR until 1986) in order to detect any changes in clinical epidemiology of MM diagnosed within the past 20 years. The age distribution of the patients with MM at the time of first diagnosis did not reveal any change: a similar portion of patients was under 50 years of age (1962-72: males 44%, females 45%; 1983-86: males 44%, females 47%). The percentage of males with MM, however, increased in the CMMR group (35-41%) and the portion of tumors localized on the trunk was found markedly increased in both sexes (males: 39-56%, females: 15-25%). Comparison of the tumor thickness indicated some significant advance in the early recognition of MM: the percentage of thick tumors (greater than 1.5 mm) decreased between both time periods (males: 72-41%; females: 60-37%) with a corresponding elevation of thinner tumors. Nevertheless, during both time periods the first diagnosis was metastasizing melanoma in about 10% of all patients. Also, the proportion of prognostically unfavorable, nodular malignant melanomas remained nearly constant (about 30% of all patients in both groups).

Adult↗
PubMed1989

[Antiphlogistic effect of bromelaine following third molar removal].

A placebo-controlled double-blind study of 100 patients with impacted and/or dislocated lower wisdom teeth was conducted to examine the tolerance and antiphlogistic efficacy of bromelaine--a mixture of proteolytic enzymes from ananas comosus. Treatment was started 1 day prior to third molar surgery with a daily dose of 3 x 80 mg and was continued for a total of 6 days. On the 1st day following surgery, linear measurement (distance: tragus-pogonion) showed swelling to be 7.5% lower under drug treatment than in the placebo group. Two-dimensional image evaluation increased this difference to 15.9%, which however still failed to attain the significance level of 20%. Between the 3rd and the 7th postoperative day no differences were found between the two groups regarding the extent of soft tissue swelling or the speed of edema resolution.

Adolescent↗
PubMed1986

[Preventive lymphadenectomy in cutaneous malignant melanomas. A matched pair study].

Data on 70 patients with melanomas classified as clinical stage I, who had been treated surgically with wide excision (n = 49) or wide excision plus prophylactic lymph node dissection (n = 21) at the University Dermatology Clinic, Freiburg i. Br. between 1975 and 1977, were reviewed in a retrospective study. The effectiveness of elective lymph node dissection was examined by creating 21 pairs of patients, matched according to sex as well as to the level, location and thickness of the tumors (to within +/- 5%). One patient in each pair underwent wide local excision and prophylactic lymph node dissection (WE + PLND) to others did not (WE only). Depending on tumor thickness there was a better chance of survival for the PLND patient group. However, these differences were not statistically significant.

Female↗
PubMed1984

Autoinhibition of noradrenaline release from the rat heart as a function of the biophase concentration. Effects of exogenous alpha-adrenoceptor agonists, cocaine, and perfusion rate.

Rat isolated perfused hearts with the right sympathetic nerves intact were loaded with 3H-(-)-noradrenaline. The nerves were stimulated with trains of 180 pulses at 3 Hz and at 10 min intervals. The overflow of 3H-noradrenaline and 3H-metabolites was determined by liquid scintillation spectrometry. Clonidine (IC50 17 nM), oxymetazoline (IC50 63 nM), and alpha-methylnoradrenaline (apparent IC50 35 nM, determined in the presence of cocaine and propranolol) decreased the stimulation-evoked overflow of 3H-noradrenaline by 26, 49, and 78%, respectively, but not methoxamine up to 100 microM (propranolol present). Oxymetazoline and alpha-methyl-noradrenaline did not cause desensitization of the presynaptic adrenoceptors when present at their IC80 for 33 min. At a perfusion rate of 7 ml/min, yohimbine 1 microM enhanced the stimulation-evoked 3H-noradrenaline overflow by 26% in the absence, and by 58% in the presence of cocaine. Phentolamine 1 microM increased it by 69% when the neuronal reuptake was blocked. The increase by the antagonists faded with successive period of nerve stimulations, and was positively correlated with the biophase concentration of noradrenaline as reflected by the amount of 3H-noradrenaline released into the perfusate per nerve stimulation. At a perfusion rate of 1.8 ml/min (neuronal reuptake blocked), yohimbine 1 microM increased the overflow by 127%. The results indicate that the alpha 2-adrenoceptor-mediated autoinhibition in the rat perfused heart depends on the clearance of transmitter from the biophase via neuronal reuptake and diffusion into the vascular space. Reduction of either elimination pathway enhances the biophase concentration of noradrenaline, thus increasing the autoinhibition of release.

Adrenergic alpha-Agonists↗