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Biomedical subjects

M Link

Publications and source records attributed to M Link.

At least 37 records · Page 2Linked to original sources

[Assessment of positive cytologic and/or colposcopic findings in the uterine cervix in pregnancy].

When cytologic and colposcopic findings are atypical during pregnancy, a differentiated diagnostic approach is necessary for the sake of an undisturbed course of pregnancy. Scraping of the portio with cervical curettage--a procedure with a low complication rate--for provisional diagnosis (to rule out an invasive carcinoma) permits a definitive diagnosis to be established after lying-in. Problems are pointed out.

Adolescent

[Once again: the perioperative antibiotic prophylaxis in cesarean section].

In continuation of our clinical observations on perioperative prophylaxis by application of Halospor and Gentamicin the dosage of Halospor has been reduced to 2 grams once only. According to our experiences in 98 cases of cesarean section we can recommend these advance: fever in 12.2% (21.2% without prophylaxis), secondary wound-healing in 2% (6.7%) and therapeutical antibiotics in 13.3%, Metronidazol as often as not (36.6%).

Cefotaxime

Weekly high-dose methotrexate and doxorubicin for osteosarcoma: the Dana-Farber Cancer Institute/the Children's Hospital--study III.

Weekly high-dose methotrexate with leucovorin rescue and vincristine (HDMTX) and doxorubicin was administered as adjuvant postoperative therapy to 46 patients with a diagnosis of conventional high-grade nonmetastatic osteosarcoma of an extremity between July 1976 and December 1981. The primary lesions were managed by wide or radical amputation (26 patients) or by limb-sparing resection in 20 selected patients. The margins of the resections were retrospectively classified as marginal in three, wide in 16, and radical in one. The 5-year relapse-free survival (RFS) for all patients is 59% (95% confidence interval [CI], 43%, 74%) and overall survival is 78% (95% CI, 65%, 91%). The RFS for patients initially having a limb resection procedure is 55% (95% CI, 32%, 77%) compared with 62% (95% CI, 43%, 81%) for those initially having amputations (P = .52). Using multivariate analysis, the only significant prognostic variables that predicted RFS of greater than or equal to 3 years, were the presence of moderate to marked lymphocytic infiltration of the primary tumor (P less than .002), primary site outside of the proximal humerus (P less than .005), and the absence of a predominance of osteoblastic pattern in the primary tumor (P less than .03).

Actuarial Analysis

[Heart disease and pregnancy--results of consequent interdisciplinary management].

In this paper it has been published about the interdisciplinary cooperation during the treatment of 143 pregnant women having heart diseases. In spite of a partial centralisation this number only 0.46 per cent of all deliveries in a period of 16 years. 32.1 per cent of the cases are congenital heart diseases and 46.2 per cent acquired heart diseases. In the acquired heart diseases mitral failures prevailed. Pacemakers have to be applied preventively only in 6.3 per cent. NYHA-stages did not impair during pregnancy. Vaginal operative delivery is compulsory only in two of seven cases heart diseases indicated a cesarean section. Consequent early get-up in the puerperium is important in NYHA-stages I-III. Maternal mortality was 0. Perinatal mortality was 0.7% (one child died antenatally).

Cesarean Section

Chronic infectious mononucleosis syndrome, pancytopenia, and polyclonal B-lymphoproliferation terminating in acute lymphoblastic leukemia.

A 17-year-old previously healthy girl is reported who developed acute infectious mononucleosis followed by progressive ill health over 20 months, associated with pancytopenia and a polyclonal B-lymphoproliferation, terminating in acute lymphoblastic leukemia (ALL). Epstein-Barr virus (EBV) was recovered from the patient's nasopharyngeal secretions; serologic titers of antibodies to EBV-associated antigens were compatible with a chronic persistent EBV infection. Plasma interferon levels were markedly elevated. EBV-specific cell-mediated immunity, as well as Natural killer (NK) cell activity were markedly deficient. Other studies of cell-mediated immunity revealed notable abnormalities, including abnormalities in T-cell subset ratios, and a serum blocker of autologous mitogen-induced lymphoproliferation. Humoral (plasma)-mediated, but not cell-mediated, suppression of hemopoiesis was demonstrated using in vitro erythroid and myeloid colony culture techniques. Immunophenotyping of the patient's bone marrow cells preterminally was consistent with ALL. Autopsy revealed pathologic changes of ALL in marrow and multiple organs. We conclude that our patient developed an EBV-driven lymphoproliferative disorder, with associated defective cell-mediated immunity and hemopoiesis. Ultimately, the patient's documented polyclonal lymphoproliferative state was superimposed by acute lymphoblastic leukemia.

Adolescent

Mediastinal nonlymphoblastic lymphomas in children: a clinicopathologic study.

The records of 25 pediatric patients with mediastinal nonlymphoblastic lymphoma (NLBL) were reviewed. These patients comprise approximately 5% of all patients with non-Hodgkin's lymphoma (NHL) in the pediatric age group. There were 15 females and ten males. The median age was 13.5 years (range, 2 to 19). Most patients presented with symptoms attributable to a large mediastinal mass, and superior vena cava syndrome was a common feature. Disease was localized to the supradiaphragmatic area in 17 patients (71%) at diagnosis. Pathologic review revealed 22 of these lymphomas to be diffuse histiocytic type in the Rappaport classification, and 20 were large-cell immunoblastic type in the Working Formulation. Treatment regimens were not uniform, but included multiagent chemotherapy in 23 patients and radiation to the mediastinum in 20 patients. Twenty-three patients (92%) attained a complete remission (CR). Of these, 17 (74%) remain disease-free 13 to 65 months from diagnosis (median, 43 months). No CNS relapses have been observed. Mediastinal NLBL in the pediatric age group has distinctive clinicopathologic features that warrant special consideration in the design of treatment protocols.

Adolescent

[Initial results of perioperative antibiotic premedication with halospor and gentamycin in cesarean section].

The perioperative application of antibiotics in prophylaxis of infections is disputed. In a preliminary prospective study the infections morbidity of 44 patients after caesarean section was determined to investigate the effect of short term prophylaxis with halospor and gentamycine. A control group of 104 patients remained without any antibiotic prophylaxis. The patients of the prophylaxis group showed a statistically significant reduction of postoperative infectious morbidity. The costs are equalized by reduction in therapeutic applications of antibiotics.

Cefotaxime

[Uterine ruptures--diagnostic problems following previous cesarean sections].

There are 16 ruptures of the uterus in a total of 28,391 deliveries, adequate a frequency of 0.59% or one rupture in 1774 cases. Whereas the fetal mortality is 43.7%, the maternal one amounts to 0%. Previous cesarean sections could be observed in 56.2%. The problems of ruptures of cicatrical uterus without symptoms and the complications will be referred to.

Adult

Immunologic selection of hemopoietic precursor cells utilizing antibody-mediated plate binding ("panning").

We utilized the property of antibody adherence to plastic to separate and obtain enriched fractions of human myeloid (CFU-GM), erythroid (BFU-E) and pluripotent (CFU-GEMM) hemopoietic precursor cells. Nonadherent buoyant human marrow cells coated with mouse anti-human HLA-DR monoclonal antibody (Mc ab), an anti-pan T lymphocyte Mc ab (Leu 1/17F12) or a granulocyte--monocyte-specific Mc ab (MCS2) were incubated on polystyrene Petri plates coated with affinity purified goat anti-mouse immunoglobulin G (IgG). Cells bound to the coated plates and nonbound cells were separately recovered ("panned") by differential elution. Analysis of the nonadherent buoyant marrow cells demonstrated 12% to possess HLA-DR, 6% T, 40% MCS2 antigens on their surface by indirect immunofluorescence (IMF). After panning, 15% +/- 8%, 14% +/- 4% and 8% +/- 6% cells were plate-bound by their respective antibodies, demonstrating differing binding efficiencies. A substantial degree of purity of the recovered cell fractions was shown for bound 74% +/- 6% and 75% +/- 5% IMF positive cells) and nonbound cells (3% +/- 1% and 0.1% +/- 0.8% positive cells) coated with anti-HLA-DR or anti-T Mc ab respectively, with lesser purity for MCS2 panned cells. Seventy-three percent to 126% CFU recovery was noted, with a sevenfold enrichment of the HLA-DR bound cells for CFU-GM and CFU-GEMM, and 3.5-fold enrichment for BFU-E. Sequential panning, obtaining T nonbound-DR bound-surface immunoglobulin nonbound fractions, resulted in tenfold CFU-GM enrichment (107/10(4) cells, approximately equal to 1/100). Anti-MCS2 antibody was ineffective for panning, but use of this antibody in fluorescence-activated cell sorting (FACS) indicated the absence of the MCS2 antigen on the vast majority of CFU-GM. This study describes a relatively rapid and inexpensive method for obtaining enriched antigenically defined hemopoietic precursors in high yield. These techniques should prove useful for more clearly evaluating cellular and humoral interactions with hemopoietic precursor cells.

Animals

[Results of testicular biopsy in azoospermia].

The causes of male infertility generally fall into three categories: pretesticular, testicular and posttesticular causes. The pretesticular causes are extragonadal endocrine disorders, such as those originating in the pituitary or the adrenals, which have an adverse effect on spermatogenesis. The testicular causes of infertility are conditions in which the primary defects reside in the testes. The posttesticular causes of infertility consist mainly of obstructions of the ducts leading away from the testes. Testicular biopsy is an important method in the diagnosis and management of male infertility.

Biopsy

[Breech presentations in 1957-1961 and 1967-1975 at the Landesfrauenklinik Magdeburg].

Breech presentation is classed as an abnormality because of the high associated perinatal mortality and morbidity rates and the slightly increased maternal morbidity. A review of 14 years' experience with breech delivery was undertaken to ascertain patterns of care. During this period there were 33 183 births and there were 1271 cases of breech presentation. The method of delivery in the 1271 cases included 91,5 per cent vaginal deliveries and 8,5 per cent cesarean sections. There was an increase to 15,3 per cent during the last 2 years of the review. This review indicates a decline in perinatal mortality rate from 20,3 to 5,4 per cent (unselected). Breech presentation is often associated with premature labor. Premature labor represents the significant clinical problem by contributing to perinatal morbidity and death.

Breech Presentation