PubMed Health⌕ Search

Biomedical subjects

J Fass

Publications and source records attributed to J Fass.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Extra-gastric non-Hodgkin's lymphomas of the abdomen--the role of surgical treatment].

A multimodality approach offers the best chance for treatment of Non-Hodgkin lymphoma. Surgery, radiation therapy, and/or chemotherapy when used in combination offer better response and longterm survival rates. Surgical therapy offers good results in stage I and II according to the Ann Arbor classification. Aim is the excision of the tumor with the removal of lymph nodes. The best treatment in stage III and IV is chemotherapy and radiation followed by surgical tumor reduction. Complications like perforation or bleeding occurred while the patients received either chemotherapy or radiotherapy. Resection of the Non-Hodgkin lymphoma prevented the complications of hemorrhage and perforation associated with chemotherapy and radiation.

Adolescent↗
PubMed1991

[Results of Parks postanal repair in idiopathic anal insufficiency].

To assess the functional results of postanal repair of faecal incontinence we carried out clinical, physiological and radiological studies in 31 patients. Continence was improved in 26 (84%) patients, 19 (62%) of whom regained normal continence at a minimum of 12 months follow-up. A successful clinical outcome after postanal repair does appear to be related more to an improvement in sphincter pressures than to any reduction of the anorectal angle.

Anal Canal↗
PubMed1991

[Surgical therapy of chronic constipation].

Results of the surgical treatment for conservative intractable constipation in 70 adult patients are reviewed. 49 patients with severe symptoms have been treated by partial colectomy as sigmoid colectomy (n = 23) or left hemicolectomy (n = 26). 33 patients underwent colectomy with cecorectal anastomosis (n = 25) or ileorectal anastomosis (n = 8). Out of these patients with colectomy seven had undergone previous segmental colonic resection or internal sphincterotomy. Of those patients with cecorectal anastomosis who were dissatisfied, three underwent ileorectal anastomosis. Overall, a mortality rate of 3.3% and morbidity rate of 22.5 resp. 54.5% for partial and total colectomy were observed. The most frequent occurring complication after colectomy was small bowel obstruction in 30% requiring laparotomy in 40%. Of 45 patients who underwent partial colectomy, 34 (75%) had normal bowel function or were markedly improved. In 28 of 32 patients (87.5%) treated by colectomy a successful result has been achieved. The operation of sigmoid colectomy or left hemicolectomy may be recommended as a treatment for constipation only in patients with less severe symptoms or patients with recurrent sigmoid volvulus. For those patients with severe constipation, at present, colectomy with ileorectal anastomosis seems to be the surgical procedure that offers the greatest probability of improvement. However, the significant morbidity claimed the need for a careful patient selection.

Adolescent↗
PubMed1990

[Postcholecystectomy syndrome--still a current argument today?].

The "postcholecystectomy syndrome" was originally defined by Pribram as a pure functional disturbance after cholecystectomy. Today it has become a melting pot of various postoperative syndromes of mostly obscure origin. It's incidence is said to be 26-40%, but surgically treatable lesions of the biliary system amount only 1.5%. Functional consequences for biliary excretion are rare because the loss of the gallbladder reservoir is substituted in part by the biliary tree.

Bile↗
PubMed1989

Radioimmunoscintigraphy with 111In labelled monoclonal antibody fragments (F(ab')2 BW 431/31) against CEA: radiolabelling, antibody kinetics and distribution, findings in tumour and non-tumour patients.

Forty seven patients with suspected malignant disease (mainly colorectal cancer) were studied with 111In labelled F(ab')2 fragments of an anti-CEA monoclonal antibody (BW 431/31). The kinetic data revealed a long whole body retention of the label (62% after 4 days) and a rapid blood clearance (77% within 24 h, 89% within 48 h) leading to an early positive tumour contrast 24 h p.i. and optimal scintigrams 48 h p.i. Diagnostic results were promising in local recurrences of colorectal cancer (8/10 positive = 80%) though false positive findings in patients with inflammatory bowel disease occurred probably due to cross-reaction with a human granulocyte antigen. Liver metastases and tumours neighbouring liver and spleen were often missed (10/27 = 37%) because of high nonspecific uptake in these organs. Thus BW 431/31 proved to be a suitable compound for radioimmunodetection, however, further improvements to optimize tumour affinity and specificity of the antibody are mandatory.

Aged↗
PubMed1989

[Clinical significance of immunoscintigraphy for the diagnosis and treatment of gastrointestinal malignant tumors].

Eighty-one immunoscintigraphy (IS) studies in 80 patients with gastrointestinal malignancies were re-evaluated retrospectively to analyze accuracy and clinical impact of the IS findings. Selection of patients was based upon complete diagnostic records and a clinical follow-up of at least 6 months. The 3 antibody preparations used (99m-Tc labelled complete anti-CEA antibodies (BW 431/26), 111-In labelled F(ab')2-fragments against CEA (BW 431/31), and a mixture of 131-I labelled F(ab')2-fragments against CEA and CA 19-9 (IMACIS-1] yielded equal diagnostic sensitivities (65%, range 60-78%) except for liver metastases. These were preferably detected by the 131-I labelled compound. Best results were gained in local recurrencies of gastrointestinal cancer (12/15 true positive = 80%). Among these were 3 out of the 4 lesions which had been exclusively recognized by IS. Thus IS should be applied in patients with suggested local recurrencies and inconclusive outcome of routine diagnostic workup. A widespread and frequent use of IS (e.g. screening of metastases) cannot be advocated since diagnostic results were not convincing and the immunologic risks of IS (development of human anti-mouse antibodies) are still under discussion.

Antibodies, Monoclonal↗
PubMed1989

Principles of radical surgery in gastric carcinoma.

The principles of radical surgery for gastric carcinoma are discussed on the basis of 102 patients treated between 1985 and 1988. Early gastric carcinomas accounted for 11.8% of the cases. Tumor stage, localization and histopathological Lauren grading were the most important parameters influencing the decision on the extent of the excision. Thirteen (22.4%) of the 58 operations done with curative intent were subtotal gastrectomies for small antral tumors. The remaining 45 patients required total gastrectomy with splenectomy. A lymphadenectomy of compartment II was obligatory in all radical procedures. Despite high co-morbidity of the patients the postoperative mortality was 3.1% for total gastrectomy, 4.8% for subtotal gastrectomy and 6.3% for palliative bypass procedures.

Carcinoma↗
PubMed1988

[Diagnostic strategies of the stomach].

Gastric surgery is still a major part of routine surgical practice. Diagnostic strategies should be oriented to the surgical consequences and their value for our understanding of pathophysiological connections. Endoscopy, perhaps with biphasic radiography, is mandatory for diagnosis of tumor malignity and localisation. Analysis of secretion is indicated in cases of ulcer recurrence. Postoperative syndromes can be detected and classified by scintigraphic methods. The new procedure of endoscopic ultrasonography seems to offer special benefits for diagnostic problems such as gastric lymphoma and other intramural tumors.

Diagnosis, Differential↗
PubMed1987

[Special aspects of right colon cancer].

752 patients with colon carcinoma of the years 1966-1985 were studied retrospectively. 189 tumors were located in the right and 563 in the left colon. There was no difference in the 5-year survival rate, Dukes classification and operative mortality in both groups. Considering the higher median of tumor diameter, the three months longer diagnostic delay and the twice higher rate of undifferentiated carcinomas the prognosis of the right sided tumors is relatively better. In our opinion the cause of this more efficient local tumor defence is the better blood and lymph supply of the right colon and mucosal mechanisms. Expression of this better tumor defence is the distinct tumor colitis in the right colon. Improvement of the right colon carcinoma prognosis is to be expected of earlier tumor diagnosis. Routine endoscopic evaluation of hemoccult positive subjects is most helpful.

Adult↗
PubMed1987

[Radioimmunoscintigraphy using SPECT: methodology, problems and clinical experiences].

Radioimmunoscintigraphy (RIS) with 111In-and 131I-labelled monoclonal antibodies (MAbs) against CEA and/or CA 19-9 was performed in 83 patients with various gastrointestinal carcinomas. A total of 276 body regions could be examined. The results of planar scintigraphy and SPECT were compared intraindividually. Using 111In-labelled MAbs the sensitivity of RIS was significantly improved by SPECT (88.9 vs. 52.4% with planar scintigraphy, p less than 0.01). For 131I-labelled MAbs the effect was smaller (83.9 vs. 65.6% with planar scintigraphy, n.s.). This finding can be explained by different kinetics and biodistribution of the used MAb preparations. 111In-labelled MAbs with long whole-body retention and rapid blood clearance reveal ideal qualities for SPECT; on the other hand, the short whole-body retention of 131I-labelled MAbs leads to small count rates and therefore long counting times that make delayed SPECT unsuitable in clinical practice.

Antibodies, Monoclonal↗
PubMed1985

[Wound healing disorder in surgery of colorectal cancer--a multifactorial computer analysis].

From 1966 through 1984 1,451 resections of colorectal carcinoma have been performed in the Department of General Surgery at the RWTH Aachen. 229 (15.8%) of the patients developed an infection of the abdominal incision. As predisposing factors we observed failures correlated with progression of tumor as anemia and hypoproteinemia, a bad general condition and late stages of carcinoma. Accompanying illnesses only had an influence on the infection rate if they could not be recompensated by intensive care medicine. No influence could be determined by the age itself. The improved preoperative preparation with orthograde lavage and enteral and systemic antibiotic prophylaxis caused a decrease of the infection rate from 25% to less than 10%. Nevertheless attending to all these parameters a quick and atraumatic operation procedure is indispensable to avoide a failure of wound healing.

Bacteroides Infections↗
PubMed1985

[Follow-up and late results following treatment of childhood femoral shaft fractures].

On reexamining 82 femoral shaft fractures in children (50 conservatively and 32 operatively treated) 75% of the patients did not have any complaints. 25% showed a mild limping which in the majority was caused by a longitudinal overgrowth of more than 5 mm. This overgrowth was mostly to be found in patients with unstable osteosynthesis. Muscular atrophy was seen mainly in the operative group. Cutaneous necrosis after plaster extension was the most common complication. Only one rotational deformity was observed. In conclusion we think that the conservative treatment of the uncomplicated femoral shaft fracture in children is the proceeding of choice. Open fractures, especially in polytraumatic cases, should be treated by osteosynthesis, which has to be motion stable. The worst therapy of femoral shaft fractures is, as our results show, an unstable osteosynthesis.

Adolescent↗