Biomedical subjects

M E Koster

Publications and source records attributed to M E Koster.

5 recordsLinked to original sources

PubMed2001

[Consequences of diethylstilbestrol during pregnancy; 50 years later still a significant problem].

Since the 1940s, diethylstilbestrol (DES) has been administered to about three million pregnant women in the United States and in the Netherlands, between 1947 and 1975, to about 220,000. The most important consequences described are: for DES mothers an increased risk of mammary carcinomas and for DES daughters a 1 in 1000 chance of clear cell adenocarcinoma (CCAC) as well as an increased risk of (pre)malignant abnormalities of the stratified epithelium in the vagina and cervix. In addition to this, DES daughters frequently have developmental disorders of the cervix and corpus uteri. In connection with this fertilisation disorders have been described as well as unfavourable outcomes of pregnancy: more ectopic pregnancies, abortion and premature birth. DES sons exhibit an increased frequency of several benign abnormalities of the genitalia. The DES problem continues to be an important issue. The entire cohort of DES mothers is in the age group with a high risk of mammary carcinoma. The youngest DES daughters will be of childbearing age for at least another 15 years; the risk of ectopic pregnancies and pre-term labour is increased. The oldest DES daughters are now reaching postmenopausal age. The incidence of CCAC of the vagina and cervix in the population is bimodal, with a second peak at older age. It is still unknown if at this age DES daughters will have an increased incidence of these malignancies. From animal experiments it becomes clear that DES administration to pregnant mice results in an increased incidence of genital tumours not only in the second generation but also in the third. This has yet to be investigated in humans and deserves special attention. The legally imposed destruction of patient files after a period of ten years is a serious threat to patient care and scientific investigation, notably in obstetrics and child medicine.

Adenocarcinoma, Clear Cell↗

PubMed1995

Tracheal obstruction after placement of a metal wire expandable stent (Wallstent).

Metal wire expandable stents are increasingly being used to alleviate tracheal obstruction due to malignancies. Patients usually tolerate these stents well and experience good to excellent palliation of their symptoms [1]. We report a case in which severe tracheal obstruction occurred 5 days after placement of a Wallstent, caused by formation of fibrinoid plaques at the proximal end of the stent.

Adult↗

PubMed1990

Problems and coping behaviour of facial cancer patients.

On the basis of an arrangement scheme by Cohen and Lazarus, an investigation has been made into the literature on problems patients experience after having undergone tumour surgery resulting in facial mutilation. Furthermore, the ways in which these patients cope with their problems have been looked at. The greatest problems arise at the interpersonal level, and in particular with intimate (sexual) relationships and with superficial, anonymous contacts. The face is found to be of essential importance in interpersonal relationships. During the first phase of the disease, when all attention is focused on the fact of having cancer, patients especially react with intrapsychic coping mechanisms. Later, after surgery, the problems are mainly concentrated on the inescapable necessity to live with a clearly visible mutilation. At this stage, in order to be able to talk about his experiences, to find recognition; and to adapt his self-image, the patient particularly turns to other people for support. It turned out that the ordering of Cohen and Lazarus' arrangement scheme gives a good outline of the difficulties patients encounter. In addition to this, several psychological theories and concepts offer good explanations for the facts as found.

Adaptation, Psychological↗

PubMed1990

Continuous adventitious lung sounds.

Recent research has increased the still limited understanding about the generation of continuous adventitious lung sounds. These sounds all have a definite pitch, such as in stridor and wheezing. With the use of waveform analysis, one can examine more closely the relationship between what is heard and the pathophysiology causing the sound. Clinical examples are given to show the utility and limitations of current lung sounds analysis techniques.

Acoustics↗

PubMed1990

[Psychosocial aspects of the face and the dentition: an overview].

On the basis of literature a description is given of the way people looked at body and face during history. Psychological and psychosocial consequences of physical (un-)attractiveness in general and of mouth and teeth in particular come up for discussion. Physical (un-)attractiveness seems to be of influence on the intellectual and emotional development and on the social relations of the individual. The findings lead to a theoretical model that can be used for further investigations on psychosocial effects of dental treatment within the departments of Special Dental Care.

Beauty↗