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Biomedical subjects

M Wunderlich

Publications and source records attributed to M Wunderlich.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Extended organ resection of colorectal cancer].

Between 1965 and 1984 in 215 patients with colorectal cancer an extended resection was performed due to invasion of adjacent organs. 158 patients were operated on primary and 57 patients on recurrent tumors. Most of the tumors were localized in the sigma and the rectum and therefore about 77% of the resected organs derived from the urogenital tract. 55% of the resected organs proved to be infiltrated histologically by the tumor. In 71% of the patients at least one organ was histologically infiltrated. Postoperative complications were observed in 26%. The mortality was 12%. In the period between 1978 and 1984 the mortality rate was decreased to 7.6%. The prognosis was independent of the localization of the primary tumor and of the number of resected organs. Infiltration of adjacent organs by the tumor was of significant prognostic value. The low perioperative mortality and the reasonable 5 year-overall survival (35%) are encouraging and tumor penetration should not be the reason for inoperability.

Adult↗
PubMed1987

[Value of CT following surgery for rectal cancer (a prospective study)].

The results of computed tomography of 48 patients after operation on rectal carcinoma who underwent close-meshed computer tomographic examinations are given in a prospective study. (First examination 6 weeks after operation, further examinations at intervals of 3 months, mean observation time: 12 months). The results of follow-up by means of computer tomographic examination are compared with clinical examinations and control of CEA levels. The use of computer tomographic examination resulted in 43 confirmed negative, 3 confirmed positive and 2 false negative findings (including cases with CT-aided fine needle biopsy). These results give an accuracy of 96% and thus exceed clinical examination and controls of CEA-level. How far early diagnosis of local recurrence of rectal cancer influences survival time, can be answered after completion of this study in the next few years.

Adenocarcinoma↗
PubMed1987

Results of surgery for local recurrence of colorectal cancer.

A prospective study was undertaken on the incidence, symptoms, diagnostic measures and therapy of local recurrence of colorectal carcinoma following radical surgical management. 156 (22%) out of 715 patients developed recurrence of the tumour, which was local in 90 patients. In addition, 36 patients with LR from other hospitals were treated. Half of the patients were symptom free at the time of diagnosis. 109 out of the 126 patients were treated by surgery, a radical operation being feasible in 53 cases. 30% of these have survived 36 months. The operative mortality was low (4.6%), although extensive surgery was necessary in most of the cases. The preliminary results of this study support the hypothesis that a postoperative follow-up programme for patients with colorectal cancer leads to early detection of local recurrence and improves the chance of cure by surgical treatment.

Colonic Neoplasms↗
PubMed1987

[Congenital total AV block in the direct fetal electrocardiogram].

The congenital total av-block in the fetal electrocardiogram is a rare condition with a frequency of 1:20 000. The reason are heart failure and umbilical cord complications, but probably immunological reactions may be the source of a part of these blocks. In the sera of mothers, which have born children with a congenital total av-block, antibodies of IgG-class would be found, for instance anti-Ro (SS-A) and anti-La (SS-B). These mothers had or developed a connective-tissue disease (Sjögren's syndrome or Lupus erythematosus). This means a new behavior for the obstetrician detecting pre- or intranatally a total av-block. A own case will be demonstrated together with a differential diagnostical example of interference dissoziation.

Adult↗
PubMed1986

[Consequences of after-care in colorectal cancer].

Results of a computer supported follow-up-program on patients with colorectal cancer are presented. Between 1978 and 1985 1024 patients underwent these program, the drop-out-rate was 18%. 231 recurrences in 137 patients were discovered (40% local recurrence, 30% liver metastases and 30% others). 54% of patients with local recurrence and 43% with liver metastases were free of symptoms. Radical surgery was performed in 47% of local recurrences and in 24% of liver metastases. The three year survival rate after radical surgery for recurrence amounted to 28% for local recurrences and to 31% for liver metastases.

Colonic Neoplasms↗
PubMed1986

Local recurrence of colorectal cancer: effect of early detection and aggressive surgery.

A prospective study was undertaken of the incidence, symptoms, diagnostic measures and therapy of local recurrences of colorectal carcinoma following radical surgical management. Out of 715 patients, 156 (22 per cent) developed recurrence of the tumour, which was local in 90 patients. In addition, 36 patients with local recurrence from other hospitals were treated. Half of the patients were symptom-free at the time of diagnosis. Out of the 126 patients, 109 were treated by surgery, a radical operation being feasible in 53 cases. Fifty per cent of these have survived for at least 17 months. The operative mortality was very low (4.6 per cent), although extensive surgery was necessary in most of the cases. The preliminary results of this study support the hypothesis that a postoperative follow-up programme for patients with colorectal cancer leads to early detection of local recurrence and improves the chance of cure by surgical treatment.

Aged↗
PubMed1986

[Sphincter function following colo-anal anastomosis].

The effect of colo-anal anastomosis (CAA) on the function of the anal sphincters was assessed in 27 cases by interview, sphincter manometry and a retention test. During an observation period of 3-12 months after closure of colostomy, the percentage of patients with perfect continence increased from 50 to 80%, of those with solid stool consistency from 30 to 90% and of those with solid stool consistency from 30 to 90% and of those with less than 5 b.o./day from 30 to 80%. The operation resulted in a significant reduction of the length of the anal canal from 4.0 +/- 0.3 to 1.7 +/- 0.2 cm (p less than 0.001) and a significant reduction of the resting tone from 85.5 +/- 7.9 to 30.3 +/- 6.1 cm H2O (p less than 0.001). The contraction pressure was hardly influenced, the recto-anal inhibition reflex was temporarily lost. Minute preoperative assessment of a normal sphincter function with anal manometry is an essential prerequisite for the evaluation of the indication for a CAA.

Anal Canal↗
PubMed1986

Results of coloanal anastomosis. A prospective study.

Anterior resection with colo-anal anastomosis was carried out in 40 patients. The main indications were rectal neoplasia (30 cases) and irradiation proctitis (8 cases). Early complications occurred in 12 patients and three died of cardiopulmonary complications. Fistula formation and stenosis were the most frequent late complications. In 23 patients with adenocarcinoma operated for cure there was one recurrence. The functional results were good, although it often took up to 1 year until satisfactory continence, stool consistency and frequency were obtained. Manometry showed a significant decrease in anal canal length and resting tone postoperatively. The method is a practicable alternative to total rectal excision.

Aged↗
PubMed1986

[Results of colo-anal anastomosis in deep-seated tumors of the rectum].

Colo-anal anastomosis as surgical procedure for low rectal tumors was analysed in regard of complication rate, functional and oncological results. The sensibility of the method particularly in tumors near the anal sphincters, was assessed by means of a new radiological procedure (lateral distant view). From 1982 to 1985 colo-anal anastomosis was performed in 30 patients with rectal carcinoma. All tumors were within reach of the palpating finger. Tumor distance from the anal verge was measured endoscopically (6.4 +/- 1.5 cm) and radiologically (9.3 +/- 1.7 cm) (x +/- SD). The complication rate was comparable to that after anterior resection with conventional anastomosis. Inspite of problems with high frequency in the first months after surgery, all patients were satisfied with the functional result of the operation. Frequency decreased within a year to 4 stools/day. At present a reliable evaluation of the oncological results cannot yet be established.

Anal Canal↗
PubMed1986

[Determination of systolic time intervals of the fetal heart as an additional diagnosis sub partu].

The aim was to prove the usefulness of the determination of systolic time intervals PEP (pre-ejection period) and LVET (left ventricular ejection time) in the fetal cardiac cycle.--Based on the fetal electrocardiogram a second signal is necessary to get the corresponding times. In the own material we used the fetal phonocardiogram. Therefore we measured the times of Q-S1 and Q-S2. As a particularly important factor seems to be the quotient of PEP/LVET. The normal result of this quotient was 0.39 +/- 0.04 (0.35-0.43). In pathological cases the quotient was only 0.27 +/- 0.02 (0.25-0.29). These results are compared with the literature. Here are problems, because various investigators use various methods for getting the second signal (phonocardiogram, doppler ultrasonic cardiogram or fetal capillary pulse). Nevertheless determination of the fetal systolic time intervals is necessary, because many parameters are required to have an overview about the fetal condition.

Electrocardiography↗
PubMed1985

Effect of adjuvant chemo- or immunotherapy on the prognosis of colorectal cancer operated for cure.

After radical surgery for colorectal cancer, 178 patients with a Dukes' B or C tumour were randomly assigned to one of three groups: A, controls (n = 62); B, chemotherapy (n = 59); C, immunotherapy (n = 57). Randomization criteria (age, sex, Dukes' stage, localization of tumour, operative procedure) were evenly distributed throughout the groups. After a median observation time of 30 months, statistical analyses were performed: survival and probability to be free of recurrence was described by Kaplan-Meier estimates of the survival function; for comparison of these survival functions, Breslow's test was used. Overall analyses show no benefit in the treatment group compared to controls. Separate analyses by Dukes' stages showed that in patients with Dukes' C tumours the probability of survival 40 months after surgery was 72 per cent in group C, 51 per cent in group B, and 33 per cent in group A. The differences between groups C and A, and B and A were statistically significant (P less than 0.02 and P less than 0.03 respectively). For a Dukes' C tumour the probability to be free of distant metastases at 30 months after surgery was 80 per cent in group B, 68 per cent in group C and 52 per cent in group A. Also for a Dukes' C tumour the probability to be free of liver metastases at 21 months after surgery was 83 per cent in group B, 81 per cent in group C, and 54 per cent in group A (significant differences: B-A and C-A P less than 0.04 for both). There was no influence on the estimated incidence of local recurrences for stage Dukes' C. Patients with a Dukes' B tumour did not benefit from either of the adjuvant therapy schemes.

Adjuvants, Immunologic↗
PubMed1985

[Endoscopy of the spinal canal].

The feasibility of inspecting the spinal canal with a needle-arthroscope of 2.7 mm diameter was tested in the spine of fresh autopsy specimens. It was possible to identify all the structures within the spinal canal, which was also photographically documentated. The clinical application of spinaloscopy for diagnostic purposes and for providing prognostic signs respectively in paraplegic spinal injuries is discussed.

Adolescent↗
PubMed1985

[Galactography in the diagnosis of breast cancer].

Caused by a pathological nipple discharge with a suspect cytological result we made 1818 galactographies. The X-ray results have been classified according to the following points of view: milk duct ectasies, milk duct cysts, ectasies and cysts, intracanalicular proliferations and the so called "normal" duct system. Milk duct carcinomas and carcinomata in situ are found frequently in cases of milk duct abruption and changes in the milk duct borderlines.

Adult↗
PubMed1985

[PQ interval and pre-excitation syndrome in direct fetal electrocardiogram--fetal Lown-Ganong-Levine (LGL) syndrome].

Preexcitation syndromes are rare disturbances of the atrioventricular excitation transmission in direct fetal electrocardiograms. As example we report on a fetal Lown-Ganong-Levine (LGL)-syndrome. This is to differentiate from the Wolff-Parkinson-White (WPW)-syndrome, which is possible by typical changes in the QRS-complex. Possibly the short PQ-interval in the fetal electrocardiogram is functional, but needs postnatal control.

Arrhythmias, Cardiac↗