PubMed Health⌕ Search

Biomedical subjects

R Lippold

Publications and source records attributed to R Lippold.

15 recordsLinked to original sources
PubMed1995

[Effect of the proliferation rate on the course of node negative breast carcinoma].

In 250 patients with node-negative breast cancer and no systemic adjuvant therapy the impact on the prognosis of the variables age, histological tumour type, tumour size, histological grade, receptor status and localisation of the tumour within the breast, was studied. Patients were followed over a mean period of 60 (range 7-164) months. In a subset of 124 cases additional examination of the growth fraction rate, detected by immunohistochemical determination of antibody Ki-67 and semiquantitative measurement of the stained tumour cell nuclei was performed. In 43 cases, measurement of S-phase fraction by flow cytometry was also performed. By univariate analysis, the histological tumour type (ductal/non-ductal), histological grade and growth fraction rate (< = 20%/> 20% tumour cell nuclei stained by antibody Ki-67) were found to exert a significant influence on distant disease-free and overall survival. Cox' multivariate regression exhibited histological tumour type and growth fraction rate to be independent predictors of distant disease-free and overall survival. Additionally, age was found to be an independent variable of distant disease-free survival. Measurement of growth fraction rate by immunohistochemical detection of Ki-67 antigen is a fairly simple and easily applicable procedure. It should be discussed whether a growth fraction rate of more than 20% could be an indication for adjuvant chemotherapy in patients with node-negative breast cancer.

Adult↗
PubMed1993

Endoventricular patch plasty improves results of LV aneurysmectomy.

From May 1985 to December 1991 52 patients were operated upon for postischemic left ventricular aneurysm (LV-A). Between May 1985 and July 1989 25 patients (group I) with a mean age of 59 (46-72) years underwent conventional aneurysmectomy with direct closure of the left ventricle (LV) and a mean of 1.9 (0-3) additional bypass grafts (54% triple-vessel disease). The hospital mortality was 8% (2/25) and the late mortality during a median follow-up time of 34 months was 28% (7/25) with a 4-year survival of 66%. Improvement in the quality of life (NYHA from 2.6 to 2.1, P = 0.078) and global left ventricular ejection fraction (EF) (from 35 to 38%) proved to be unsatisfactory in conjunction with the high late mortality rate. Between August 1989 and December 1991 a prospective series of 27 consecutive patients (group II) with a mean age of 61 (45-71) years underwent endoventricular patch plasty guided by two-dimensional transthoracic echocardiography (TTE) before and after surgery. The patch size and position were calculated preoperatively by measuring the distances from the mitral annulus to the infarct area which were reproduced during surgery with a simple ruler. A mean of 2.1 (0-4) bypass grafts were added with 62% of the patients having triple-vessel disease and 19% left main stenosis (P = 0.05, group I versus II). All patients have survived to date. One patient had to be excluded, giving a median follow-up time of 14 months for 26 patients. At the 6 months' control, the mean NYHA class was improved from 2.7 to 1.6, (P = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Risk assessment of future myocardial infarction from automated serial ECG analysis.

From 1980 to 1990 a cohort of 7,542 employees took part in the MARISK study. This study was designed in order to explore the utility of computerized electrocardiographic (ECG) measurements for predicting future myocardial infarction. After an initial period of annual examinations, follow-up information was collected by mailed questionnaires and obtained from 89.3% of all study participants with a median follow-up time of more than 7 years. Eighty-three participants suffered from myocardial infarction during the course of the study. Multivariate logistic regression analysis revealed that automated ECG measurements contribute significant additional information to risk estimates obtained from classical risk factors. Serial ECG analysis yields stronger risk indicators than single measurements. Results are represented via receiver operating characteristic (ROC) curves and regression coefficients, which can be used in independent applications. The results of this study indicate that it is useful to include automated serial ECG analysis in cardiovascular screening programs. It still has to be evaluated whether successful preventive measures may be based on such screening programs.

Cohort Studies↗
PubMed1989

Prognostic parameters in renal cell carcinoma--a new approach.

The prognostic potential of the parameters TNM staging, Robson staging, grading, cell type, growth pattern, and patient age was investigated for 431 patients with operated renal cell carcinoma (RCC). In the individual analyses, staging and grading attained the best results, whereby Robson staging proved to be superior to TNM staging by comparison. Morphological parameters had a more modest effect on the prognosis, but this should not be underestimated. A scale of points based on a comparative biometric evaluation of the various parameters was devised. From this scale, three significantly distinct prognostic groups evolved with a correct prognosis of over 80% on the average for an individual case. In comparison with other proposals for assessing prognosis for RCCs, the suggested scale of points had the greatest prognostic potential.

Adult↗
PubMed1987

Automated serial ECG-analysis within an epidemiological study.

Since 1980 we have performed a cohort study in order to develop diagnostic and predictive algorithms for myocardial infarction. These algorithms shall be based on cardiovascular risk factors, ECG-measurements and serial measurement changes. An intermediate analysis of 5524 study participants describes observed measurement changes stratified by age and sex. The values thus obtained may serve for reference purposes and illustrate the influence of age and sex on intraindividual ECG-measurement changes. Specific suggestions are made for future program developments in order to overcome some present problems in serial ECG-analysis.

Age Factors↗
PubMed1976

[Relationship between frequency components of phonocardiography, vectorcardiography parameters and anatomic data].

Regarding heart volume, fundamental frequency of the first and second part of first heart sound (SI), vectorcardiographic parameters and constitutional data, the formerly found strong correlation between fundamental frequency of the first part of SI and heart volume was re-established. Heart volume guess got even better utilizing certain VCG-parameters, whereas constitutional measurement data gave no further approach. Correlations between VCG-data and fundamental frequencies of both parts of SI are referred to.

Adolescent↗
PubMedDate not supplied

[Premature cervical ripening--surgical or conservative therapy?].

We studied the effect of the cerclage operation as treatment of premature ripening of the cervix in the 15.-35. week of gestation with a retrospective matched pair analysis (n = 142). For each patient in the group treated operatively (n = 71) a patient was selected, who was clinically comparable in parity, gestational age and cervix score at the time of diagnosis but was managed conservatively (n = 71). The study showed that the cerclage operation is not generally advantageous as treatment of premature cervical ripening. Because of the higher perinatal morbidity in the group treated by an operation, the unselected indication for a therapeutical cerclage is questioned. To define indications for cervical cerclage as operative treatment for premature cervical ripening we selected subgroups by history and clinical data treated either operatively or conservatively and evaluated their parameters of gestation, delivery and puerperium as well as the perinatal outcome. We found that the operative treatment was superior to the conservative therapy only in patients with premature cervical ripening before the 25th week of gestation and in patients with an "open cervix" and a history of miscarriage, abortion or premature delivery. The results of this study led to a proposal for the treatment of patients with premature ripening of the cervix, which has to be confirmed by prospective controlled studies.

Adult↗