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R Kokoschka

Publications and source records attributed to R Kokoschka.

17 recordsLinked to original sources
PubMed1985

Natural killer cell activity in tumor-draining lymph nodes: investigations in patients with malignant melanoma and head and neck cancer.

Mononuclear cells isolated from peripheral blood (PB) of patients with malignant melanoma and head and neck cancer were tested for natural killer (NK) cell activity against K562 targets. Significantly lower levels of NK activity were observed in patients with malignant melanoma with metastatic disease in comparison to stage I and control population. In head and neck cancer NK activity was normal in tumor stage 1-2 and significantly impaired in stage 3-4. Mononuclear cells (MNC) isolated from primary tumor-draining lymph nodes (LNs) had significant NK activity in 12 of 25 (48%) of melanoma and 9 of 19 (47%) of head and neck lymph nodes at E:T 40:1. Reactivity was always significantly lower than in autochthonous Preincubation (+37 degrees C, 18 h) of lymph node mononuclear cells (LNMNC) resulted in a significant increase in cytotoxicity in 36% of melanoma and 32% of head and neck LNs. Simultaneous incubation with interferon (IFN)-alpha resulted in 24% of melanoma and 44% of head and neck LNs in a significant further augmentation of NK activity. LNMNC were furthermore found to react in 2-24% (mean 7.79 +/- 2.1) with the monoclonal antibody HNK-1, which identifies a certain proportion of NK cells. No correlation was found between percentage HNK-1+ cells and the expression of NK activity. From these studies it may be concluded that tumor draining LNs contain cells which are active against K562 targets expressing low but variable levels of cytotoxicity. NK cell activity can be increased by incubation of LNMNC at 37 degrees C with or without addition of IFN. These results suggest that modulation of NK activity in tumor draining LNs might be achieved by local application of biological response modifiers, which might finally lead to an increase of local tumor defense mechanisms.

Antibodies, Monoclonal↗
PubMed1983

[Medullary thyroid cancer].

This paper attempts to review current opinions on medullary thyroid carcinoma. Histologically described for the first time in 1951 belongs to the endocrine-secreting group of tumours (APUD). It can be sporadic as well as hereditary. The histological classification nowadays is increasingly performed immunohistologically via calcitonin. Clinically the tumour ranges from the very small, but hormonally highly active form, to the aggressive, mostly undifferentiated form. According to this the therapy must be radical. Our study group recommends thyroidectomy and functional neck dissection, followed by radio-chemotherapy. A close interdisciplinary follow up of the patients is necessary. Our surgical department treated 1048 thyroid malignancies between 1949 and 1982. 26 patients (2.4%) were diagnosed to have medullary thyroid carcinoma. Follow up time was between 1 month and 17 years. The recurrence--free interval was 4.5 years. The 5 and 10 year survival rate was 52% and 26%, respectively.

Adult↗
PubMed1983

[Experiences with recurrent malignant goiter].

At the Surgical Department of the Kaiserin Elisabeth Spital, Vienna, 30,301 thyroid operations have been performed from 1949 to 1981. Out of this number thyroid carcinomas were 1051 cases, 112 of them developed in recurrent goiter. Recurrencies of benign goiter were 2,743 (9.1%) cases. Overall frequency of thyroid carcinoma was 3.5% and they had a recurrency rate of 8.3% where reoperation was necessary. The percentage of thyroid carcinoma developing in operated benign goiter was 6.9%.

Female↗
PubMed1982

Gastric blood flow, mast cell degranulation and micromorphology of gastric mucosa following experimental haemorrhagic shock in dogs.

Ischaemia of the gastric mucosa in haemorrhagic shock appears to be one of the principal factors underlying acute bleeding from the upper gastrointestinal tract. In the present experimental study on dogs the changes of blood flow in the upper gastrointestinal tract were recorded by direct flow measurement in the pertinent vessels. Fourteen mongrel dogs were subjected to haemorrhagic shock lasting for 3 and 4 h. A decline of 46 per cent cardiac output was observed while coeliac artery blood flow decreased by 40 per cent and gastric artery blood flow by 60 per cent. All stages of stress ulcers were documented by light and electron microscopy. In addition, pronounced degranulation of mast cells preceding major tissue damage was observed. In the light of these findings a cascade of events is thought to be present resulting in the development of stress ulcer.

Animals↗
PubMed1982

[Study of principles in pathogenesis and therapy of fat embolism. IV. In vivo studies of drug-induced mobilization of embolized lung fat].

Pluronic F 108 added to serum in a concentration of 1 g/dl proved as the optimal means to increase the fat emulgatory capacity. Similar concentrations were achieved in living rabbits by infusing 4.5 g per kg body weight. In spite of this higher dosage we failed to mobilize 131 J labelled fat, embolized into the lungs of the animals. It is concluded that also in humans there exists no possibility to mobilize fat emboli from the lungs by the application of tensides (non-ionic detergents, lecithin-preparations, bile salts) or of organic solvents (alcohol, ether). All these agents are capable to emulsify fat in vitro, however, only under vigorous shaking.--Because of the side effects of those agents their application on patients, suffering from posttraumatic fat embolism seems not to be justified.

Animals↗
PubMed1981

Results following surgical treatment of hyperthyroidism.

In the years 1965-1978 1,222 patients with different types of thyrotoxicosis underwent surgical treatment at the 1st Department of Surgery, University of Vienna. Wherever possible a sparing selective surgical approach was considered preferable: autonomous adenoma (45%) enucleation resection or subtotal uni-lateral resection; multinodular toxic goiter (36%) and Graves disease (5%) uni- or bilateral subtotal resection. The remaining 5% were rather rare types of goiter (recurrent goiter, thyroiditis, adenocarcinoma). Overall mortality due was 0.7%. One-hundred and seven patients (8.76%) were over 70 years old at the time of the operation. Post-operative death occurred in the group of patients with toxic adenomas (2.7%). Four-hundred and ninety-five patients were followed up from 3-13 years postoperatively: the rate of recurrent thyrotoxicosis was 4.4%, 4.8% of the patients with hypothyroidism. In this paper the significance of the rapid effect of surgery in cases of hyperthyroidism is discussed and the results are compared with findings in other studies.

Female↗
PubMed1980

[Papillary carcinoma of the thyroid gland (author's transl)].

Records were examined of 174 patients with papillary thyroid carcinoma operated on at the 1st Department of Surgery of the University Hospital in Vienna between 1948 and 1976. The overall mortality rates amount to 20 +/- 8% after 5 years, rising to 70 +/- 21% after 20 years. Clear relationships are demonstrated between lymph node metastases, distant metastases, extrathyroid tumours and higher mortality rates. An older age correlates in the extrathyroid tumour group only with a higher risk of death. In our material reclassified by the criteria of the WHO classification (1974) between 1965 and 1976 the incidence of papillary carcinoma is 25% of all thyroid carcinomas. The incidence of this tumour subgroup varies in the literature between 25 and 90% and is influenced by regional differences in the use of childhood radiation on the one hand and iodine uptake on the other hand, different methods of thyroid examination and the subjectivity of the pathologist.

Adult↗
PubMed1980

[Anaplastic spindle and giant cell carcinoma of the thyroid (author's transl)].

77 cases of spindle and giant cell carcinoma of the thyroid were reviewed. This rapidly fata neoplasm extended beyond the capsule of the thyroid gland in all cases but one, with infiltration of the trachea or oesophagus in 3/4 of these cases at the time of diagnosis. 60% of the patients had lymph node metastases and 26% distant metastases. Due to the advanced stage of the primary tumour at the time of presentation, total resection was feasible in 13% of cases only. The prognosis is very poor; all patients died within 18 months. Correlations were demonstrated between lymph node metastases, distant metastases, tumour infiltration of trachea or oesophagus and shorter survival times. The survival time is prolonged in patients with partial tumour resection by adjuvant radiotherapy. 28% of all thyroid carcinomas seen at the 1st Department of Surgery of the University Hospital in Vienna between 1965 and 1976 were anaplastic. The high incidence in Austria is caused, in our opinion, by the higher rate of anaplastic transformation of long-standing, differentiated carcinomas in adenomatous goitres, which remain undetected clinically for years in this endemic goitre region because of their slow rate of growth.

Adult↗
PubMed1979

[The biological classifications of malignant thyroid tumours (author's transl)].

Carcinomas of the thyroid gland display large pathological and clinical variation. Favourable prognostic factors accompary well-differentiated tumours, whereas poorly differentiated or anaplastic carcinomas tend to invade early and are usually rapidly fatal. Experience has demonstrated the difference in rate of growth, subsequent recurrence and late spread even in identically well-differentiated thyroid carcinomas. Biological difference must be the underlying reason for the clinical difference in behaviour of histologically similar cancers. This report demonstrates the correlation between in vivo radioactive iodine uptake, tumour staging and recurrence-free interval in 30 thyroid carcinomas. The uptake by well-differentiated carcinomas staged T2N0M0 is significantly higher than that by tumours staged T3N1M0, whereas the latter show a higher uptake than those tumours staged T3N1M0. A high tumour uptake rate is correlated with long recurrence-free interval (up to 24 months) within all groups of staging and vice versa.

Humans↗
PubMed1979

The structure of tight junctions in human thyroid tumors. A systematic freeze-fracture study.

Tight junctions of normal human epithelium comprise 6--8 intramembranous ridges. Tight junctions of adenomas and one case of follicular carcinoma were morphologically identical with normal controls. Another follicular carcinoma (clinically less malignant than the case mentioned above), however, showed loss of junctional polarity with spreading of ridges on lateral cell membranes. One case of papillary carcinoma (clinically low malignancy) displayed only focal attenuations of the tight junction belt. Another more malignant tumor of the same histologic type showed breaks of ridges and focal interruptions of the tight junction meshwork. Cell membranes of two anaplastic carcinomas of high malignancy were completely devoid of tight junction ridges. We conclude that tight junction alterations are not necessarily implicated in malignant transformation and that they correspond with tumor differentiation rather than directly with a single parameter of thyroid tumor malignancy.

Adenocarcinoma↗
PubMed1977

[Stress ulcer-an experimental study (author's transl)].

This experimental study demonstrates by means of electromagnetic flow measurements that hypovolaemic shock results in a significant decrease in gastric flow. 14 mongrel dogs were subjected to haemorrhagic shock for 3 or 4 hours. Significant histological changes are seen in the gastric mucosa as a result of the haemodynamic changes, especially when the duration of shock was 4 hours. All stages of stress ulcer from the superficial erosion to deep ulcers were documented. The possibility that the mast cell plays a pathogenetic role as mediator in the origination of a stress ulcer is considered.

Animals↗
PubMed1975

[Results of thoracoscopic sympathectomy in hyperhidrosis of the upper extremities (author's transl)].

Thoracoscopic sympathectomy bei Kux's method was undertaken on 256 occasions for the treatment of 168 patients suffering from hyperhidrosis of the upper extremities. There were no operative fatalities. Thoracotomy was required in only 2 cases, the indication being intraoperative bleeding. 2 further patients developed a tension pneumothorax postoperatively necessitating drainage. The operation was successful in all but 2 cases. Division of the sympathetic chain between T1 and T2 suffices to achieve dryness of the hands; if underarm perspiration is to equally influenced then division of the sympathetic trunk must be extended caudally to the level of T5. On follow-up examination of 104 patients 2 and 10 years after the operation, a successful result was noted in 94% of cases. Unwanted side effects were vicarious and gustatory perspiration, which arose in 39% and 56% of cases respectively, but did not affect the successful outcome of the operation.

Adult↗