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Biomedical subjects

K Kremer

Publications and source records attributed to K Kremer.

At least 19 recordsLinked to original sources
PubMed1994

Integrated optical density (IOD), syntactic structure analysis, and survival in operated lung carcinoma patients.

Histological sections of formalin fixed, paraffin-embedded tissue comprising 195 specimens of human lung carcinomas were Feulgen stained. The nuclei of the histomorphological images were segmented using an automated image analyzing system, and the attributed minimum spanning trees (MST) were calculated. Features related to the DNA-content of the nuclei (integrated optical density (IOD), IOD-entropy, S-phase related fraction, percentage > 5C, etc.), and structural parameters (minimum distance between tumor cell nuclei, minimum distance between tumor cells and neighboring lymphocytes, MST-entropy, MST-current of entropy (entropiefluss), distance between neighboring proliferating tumor cells, etc.) were measured. The following results were obtained: the measured IOD and MST features showed significant differences between the primary carcinomas and metastatic carcinomas in the intrapulmonary lymph nodes. The survival of patients was remarkably improved if the carcinomas displayed a low S-phase related fraction, a low percentage of tumor cells > 5C, a low number of stem lines, and a low MST-current of entropy.

Carcinoma, Bronchogenic↗
PubMed1994

[DNA and MST entropy and current of entropy. New parameters of tumor biological characterization].

The clinical significance of the entropy of the integrated optical density E (IOD) and the corresponding entropiefluss EF (IOD) is discussed as well as the structural entropy E (MST) and its entropiefluss EF (MST). The E (IOD) is based upon the formula given by Stenkvist and Strande. It describes the statistical entropy of the DNA distribution of tumor cell nuclei; the E (MST) is based upon differences in IOD and distance between neighboring tumor cell nuclei and describes the deviation of tumor structure from a "biological constant" structure. The entropiefluss measures the current of entropy or irreversibly created heat which has to be removed through the surface of the tumor. It is a universally valid description of a thermodynamically open system and measures the distance of such a system from its equilibrium stage. The clinical significance of these parameters is tested on 241 specimens of human lung carcinomas and intrapulmonary metastases of extrapulmonary malignancies. The surgical specimens were fixed with buffered formalin. Histological sections cut from paraffin-embedded tissue were FEULGEN stained. The nuclei of the histomorphological images were segmented using an automated image analyzing system, and the attributed minimum spanning trees (MST) were calculated. The following results were obtained: The measured E (IOD) and E (MST) showed significant differences in the primary carcinomas compared to those measured in intrapulmonary lymph node metastases or intrapulmonary metastases. The survival of patients was remarkably improved if the carcinomas displayed a low E (MST), EF (IOD), and EF (MST).

Adenocarcinoma↗
PubMed1988

Effect of the application of an anionic detergent combined with FABRY's tincture and its components on human skin resident flora. Part 2: Dermofug solution combined with either salicylic acid tincture or phenol acid tincture.

Using the forehead skin test, we investigated the combined application of 10 v/v% Dermofug solution and 3 w/v% salicylic acid tincture or 1 v/v% phenol acid tincture. The former combination showed better antibacterial efficacy against the coagulase-negative staphylococci and Propionibacterium spp. in the stratum corneum/acroinfundibulum as well as in the infrainfundibulum of the sebaceous glands. No antibacterial efficacy could be determined against Propionibacterium spp. in the infrainfundibulum of the sebaceous glands after the combined application of Dermofug solution and 1 v/v% phenol acid tincture. In contrast, the combined application of Dermofug solution and 3 w/v% salicylic acid tincture led to a long-term reduction of the cfu-counts of Propionibacterium spp. in the infrainfundibulum of the sebaceous glands. The following conclusions can be drawn from our study and applied to external therapy: a detergent like Dermofug should be used instead of an alcohol to enhance the penetration of a drug into the infrainfundibulum of the sebaceous glands, since the former can block the growth of Propionibacterium spp. in the infrainfundibulum. Secondly, it should be kept in mind that the addition of salicylic acid to a topical antibiotic ointment does not only enhance the penetration of the antibiotic into the infrainfundibulum of the sebacous glands, but that the antibacterial effect of the salicylic acid itself may be the reason for the better clinical antibacterial efficacy of such combinations.

Bacteria↗
PubMed1986

[Cold struma nodule--an absolute surgical indication?].

From 1969 to 1984 3,972 operations of the thyroid gland were performed. 3,540 scintigraphic findings were evaluated retrospectively. In 2,013 (57%) cases one or more so-called cold thyroid nodules were found. The malignancy rate in these nodules was 5.6%. The fine needle biopsy and cytology gave in 17.9% false-negative results. Based on a malignancy rate of 5.6%, rather high false-negative results of fine needle biopsy and acceptable postoperative complication rate we estimate strict operative indication.

Biopsy, Needle↗
PubMed1986

[Dynamic pexis (teresplasty) in the treatment of reflux esophagitis].

For teresplasty, the lig. teres has to be prepared together with a palmarsize patch of peritoneal layer to the effect that by suturing the edges of that peritoneal layer a solid cord is produced which is firmly connected to the liver via the lig. falciforme and lig. teres. The loose end of that cordlike structure is fixed by suturing between the distal part of the oesophagus and the gastric floor. The left lobe of the liver comes to lie on top of the ligament, and a permanent longitudinal tension is applied to the oesophagus via the liver. Necessary restressing is thus produced, as recommended by Stelzner for restoration of the lower oesophageal sphincter function. The effect is dilatory angiomuscular closure of the distal oesophagus. Evidence to the effectiveness of teresplasty has so far been produced from 48 patients with therapy-resistant oesophagitis and severe complaints. The approach proved to be superior to other surgical techniques to cope with reflux, in that, different from plication, no detrimental sequels were recordable (gas bloat syndrome, telescopic phenomenon).

Esophagitis, Peptic↗
PubMed1985

[Transdiaphragmatic esophagus resection--a procedure for the curative and palliative treatment of esophageal cancer].

From 12/80 to 1/85 133 patients with a carcinoma of the esophagus were admitted to the hospitals in Düsseldorf and Würzburg. 105 (7 total, 98 subtotal) of them were resected (79%). 14 were treated with a substernal bypass (average age: 60 years). 76% of all tumors were found in stage III and IV. The esophagus was replaced with stomach (98) and colon (7). For bypass the stomach (12) and jejunum (2) were used. The hospital mortality was 17.6% (all operations), 16.2% (resection) and 28.2% (bypass). The 2-year-survival-rate was only 15% (due to 76% of stage II and IV).

Adenocarcinoma↗
PubMed1985

[Esophagus resection without thoracotomy in cancer. Report of experiences with 100 cases].

Between 1980 and 1984 126 patients were admitted to the surgical department of the University of Düsseldorf for cancer of the esophagus. 100 (= 79%) patients were operated upon. In the majority of cases we dealt with advanced tumors (76% stage III and IV UICC). In 87 patients the esophagus was removed by transhiatal blunt dissection. In 13 patients the tumor bearing esophagus was bypassed by the substernally transferred stomach. Overall mortality was 20%. Varying with tumor stage the median time of survival was 5,5 months, again with wide variation depending of tumor stage. Only in stage I and II tumors there is a chance of significant prolongation of life or even cure. The majority of our patients and their relatives considered the outcome of the operation as a success, even if the time of survival was only short.

Adult↗
PubMed1984

[Gas gangrene--still a diagnostic and therapeutic problem].

From 1970 to 1980 132 patients were admitted to our Dept. under the diagnosis of gas gangrene. In 54 cases there was no bacteriological evidence of clostridium perfringens. In all patients surgery was performed immediately, followed by hyperbaric oxygen therapy. The overall mortality rate among 78 patients with proven gas gangrene came up to 38%, the amputation after limb injuries to 55%. In our experience we can not state a clear cut advantage of hyperbaric oxygenation as far as the death rate is concerned.

Adult↗
PubMed1983

[Postgastrectomy syndromes with special reference to reflux esophagitis].

60 patients without suspicion of recurrence of stomach cancer have had a follow-up by mean of 65 months after the procedure of a total gastrectomy. In 16 cases an additional esophagomanometric and endoscopic-bioptic examination was performed. Up to 1975 the operative procedure of stomach replacement was a jejunal interposition, afterwards the technique of a jejunoplicationn. Clinical signs of an esophageal reflux were found in one half of the patients with a jejunoplicatio and in a third of the cases with a jejunal interposition. Endoscopic-bioptic evidence of a reflux-esophagitis has been found in 13 of 16 patients. A functioning sphincter mechanism of the lower esophagus could be demonstrated in 5 of 16 cases. There was no proof of a correlation between the results of endoscopic-bioptic and manometric examinations. A prevention or reduction of esophageal reflux is as well possible by the technique of jejunal interposition as by jejunoplication.

Esophagitis, Peptic↗