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Biomedical subjects

K Rothe

Publications and source records attributed to K Rothe.

At least 19 recordsLinked to original sources
PubMed2006

Feminizing reconstructive surgery for ambiguous genitalia: the Leipzig experience.

PURPOSE: We report the results of feminizing reconstructive surgery for ambiguous genitalia with regard to the degree of virilization according to Prader and the long-term outcome with special emphasis on sexual intercourse. MATERIALS AND METHODS: Patients 16 to 46 years old with CAH (41) and MPH (17) were followed continuously by an interdisciplinary team that provided standardized hormone substitution and reconstructive surgery. More virilized genitalia were treated using a 2-stage procedure. RESULTS: Of patients with CAH no surgery and clitoris reduction were done in 4 and 2 (Prader I and II), no surgery, a 1-stage and a 2-stage procedure were done in 2, 3 and 4 (Prader III), a 2-stage procedure, a 1-stage procedure and surgery for fistula were done in 16, 4 and 2, respectively, while 1 refused surgery (Prader IV), and a 2-stage procedure was done in 5, including pull-through vaginoplasty in 2 (Prader V). Of patients with MPH no surgery was done in 6 (Prader I and II), a 1-stage procedure and a 2-stage procedure were done in 3 and 1 (Prader III), respectively, and a 2-stage procedure was done in 6, while 1 refused surgery (Prader IV). Revision vaginoplasties were necessary in 7 patients (12.1%) because of scar stenosis in those who underwent 1-stage as well as 2-stage procedures. None of our patients required reconstructive surgery to create a neovagina. Of the 58 patients 32 achieved sexual intercourse and in 17 the postoperative result would allow sexual intercourse, while in 3 the possibility of sexual intercourse is uncertain. For 3 patients sexual intercourse would not be possible since feminizing reconstructive surgery was refused. One patient could not be followed. CONCLUSIONS: Two-stage surgery leads to a favorable outcome in patients with CAH and MPH, and virilized genitalia (Prader IV and V).

Adolescent↗
PubMed2001

Fracture treatment in children--data analysis and follow-up results of a prospective study.

The versatile Orthofix modular system can be used to treat long-bone fractures in children from the 2nd year of life. It allows definitive fracture management over a short period of time without traumatizing the soft tissues. The possible early mobilization and full weight-bearing mean that the children are able to return early to school or kindergarten. The method enables the stabilization of open fractures with or without excessive soft tissue injury as well as secondary callus distraction. There is no need for a second surgical intervention and no prolonged period of physiotherapy. This fracture treatment suits children's needs and maintains their quality of life.

Adolescent↗
PubMed1996

[Hepatic veno-occlusive disease--simulating acute abdomen in chemotherapy of Wilms' tumors].

Two of fifteen patients treated in the last 5 years in our hospital for malignant renal tumors developed a venoocclusive disease (VOD). Both had stage II Wilms' tumors with favorable histology. The VOD occurred in the pre- and postoperative period, respectively, some days after application of vincristine and dactinomycin. The boys were aged 2 years and 3 months and 2 years and 9 months, respectively, with body weights of 13 kg and 19 kg, respectively. The treatment of VOD required intensive care procedures. The tumours were removed by nephrectomy and the patients have now remained in remission for 3 years and 1 year and 4 months, respectively. Jaundice, enlargement of the liver, ascites and fever were the symptoms in both patients. Initially, the VOD presented like appendicitis.

Abdomen, Acute↗
PubMed1993

Integrating capital budgeting techniques.

A.J. Hogan, in "Capital Expenditure Planning: The Value of Information to Hospitals," published in 1987 in Hospital and Health Services Administration, illustrated the value of information to the expenditure process. He noted that knowing what your competitors are up to, as well as where your facility stands in the market, can enable all concerned to make better judgments. One of the likely outcomes of good judgments is the efficient use of all resources. Unfortunately, Hogan's model draws on a non-existent computerized regional planning agency with the authority to approve or deny proposals. Integrated strategic financial planning also illustrates the value of information. In this case, information is readily available. The sources are the administrators: finance, accounting, marketing, and planning experts, doctors, nurses, statisticians, and epidemiologists. Each can make a unique contribution to the process, and together they can effectively guide the organization's capital budgeting programs. We have illustrated that there does exist a planning model that can work with the plurality of viewpoints in today's hospitals to produce the "most informed" decisions with known sensitivity to the decision criteria used.

Budgets↗
PubMed1993

[Osteochondrodysplasias. Prenatal diagnosis and pathological-anatomic findings].

Prenatal sonographic investigations were applied for malformations to 7,194 foetuses, between October 1985 and April 1992, with 28 cases of osteochondrodysplasia (OCD) and one case of dysostosis being dissected. Included were 20 cases of lethal osteochondrodysplasia, among them two cases of lethal hypophosphatasia, five cases of thanatophoric dysplasia, one case each of Type II shortrib (polydactyly) syndrome (VERMA-NAUMOFF) and metatropic dysplasia, three cases of campomelic dysplasia and eight cases of Type II A imperfect osteogenesis. Also observed were eight cases of nonlethal OCD, among them three cases of diastrophic dysplasia and five of achondroplasia. Dysostosis was recorded from one case and was diagnosed as Type V acrocephalosyndactyly (Pfeiffer). Identification of a specific OCD proved to be difficult in the second or third trimenon. Hence, the form of OCD was prenatally diagnosed only in ten of all cases investigated. Tentative diagnosis was first established from the postmortem radiograph. Additional malformations and other abnormalities then were detected by complementary pathologico-anatomic processing of findings. The final diagnosis was derived from radiological, pathologico-anatomic and histological findings. Diagnosis of this constitutional osteopathy is quite difficult and calls for interdisciplinary cooperation between gynaecologists, neonatologists, paediatric surgeons, radiologists, geneticists and pathologists. More effective counselling of affected families is the major purpose of all the efforts involved.

Adult↗
PubMed1990

[Steroid receptors in the gestagen treatment of endometriosis].

In 35 patients with laparoscopically proved endometriosis we determined the cytosolic estrogen and progesterone receptor content in endometrial samples before and after a 3-month course of progestagen treatment (DCC method). Dienogest was given in 20 cases, norethisterone in an other group of 15 patients. Compared with a normal group the receptor content was clearly higher in endometriosis patients. It correlated closely to the histological findings dated according to Noyes. In more than 60% of the pretherapeutic cycles there were some signs of disturbed differentiation. After 3 month of therapy the binding capacity of steroid receptors significantly decreased, particularly in norethisterone patients. Both clinical results and receptor conditions correspond to previous investigations concerning the competition behaviour, having confirmed different binding affinity to the receptor for the two gestagens here tested.

Adult↗
PubMed1990

[Bronchopulmonary foregut malformations with communication to the esophagus].

Congenital abnormal communications between separated pulmonary tissue and the oesophagus are rarities. Only about 50 cases have been reported in the literature. For all different forms the term of bronchopulmonary foregut malformation (BPFM) was first applied by Gerle and his coworkers in 1968. Major symptoms of this condition involved respiratory distress, cough, dyspnea, vomiting and repeated pneumonia. This paper presents reports of two own patients. In both cases was confirmed a bronchopulmonary foregut malformation in the lower right thorax with ectopic main bronchus communicating into the distal oesophagus. According to the literature we describe our own experience and discuss embryologic pathogenesis and surgical consequences for children.

Bronchial Fistula↗
PubMed1988

[Menstrual cycle stimulation in the in vitro fertilization program--effects on estrogen and progesterone receptors of the endometrium].

Clomiphene in combination with human menopausal gonadotropin (HMG) or HMG alone was used for ovarian stimulation in the IVF program. In 41 cases without embryo transfer (ova could not be obtained or fertilised) 7-8 days after laparoscopy on endometrial biopsy was performed. Serum steroid hormone levels were estimated at the same day and in the time before follicular puncture. Histological classification of the received endometrium and the determination of the kinetic parameters of cytosolic estrogen and progesterone receptors were carried out. A strong correlation exists between histological results and receptor properties. Luteal phase defects are not only connected with a significant decrease of receptor binding capacity but also an increase of the dissociation constants occurs. Clomiphene HMG treatment results in general reduction of binding affinity of the cytosolic estrogen receptor. No correlation was found between the serum hormone levels at day of biopsy and the endometrial histology or receptor parameters on the other hand.

Clomiphene↗
PubMed1987

[Determination of estradiol receptors in the endometrium--a contribution to the diagnosis of functional sterility].

In 86 cases of female infertility an endometrial biopsy was performed. The received tissues were examined by histological methods and the binding of estradiol on the specific cytoplasmic receptor was studied. Serum levels of estradiol and progesterone were estimated at the same day.--The estradiol receptor levels from ovulatory cycles are directly dependent on the histological dated phase of the menstrual cycle. The level was highest in late proliferative phase and declines during the secretory phase.--Luteal phase deficiency and other luteal phase defects are connected with a decrease of estrogen receptor concentrations in secretory endometrium.

Adult↗
PubMed1985

[Treatment of ovarian cancer with combined operative, radiologic and cytostatic therapy].

It is reported about significant superior results of two years of the combined ovarian cancer treatment in contrast to operation and chemotherapy. Our therapy is the combination of operation, great field radiation technique, chemotherapy and second-look-operation. The remission of two years: Stage I: 64%, stage II: 50%, stage III: 45% and stage IV: -Only in stage IV no improvement can be achieved by addition of the radiation therapy.

Adult↗