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Biomedical subjects

R Lober

Publications and source records attributed to R Lober.

At least 19 recordsLinked to original sources
PubMed2000

[Diphtheria antitoxin level 2 years after booster vaccination].

In a prospective, controlled, randomized, multicenter study the immunogenicity of a single (day 0) and two (day 0, 28) booster vaccination against diphtheria were compared in subjects who had received their last diphtheria vaccination more than 10 years ago. Both short-term and long-term immunogenicity was assessed by determining diphtheria antitoxin levels four weeks after vaccination and after one and two years. 102 subjects received the first booster vaccination, and 83 were vaccinated twice. Prior to the first vaccination 27% of the subjects had a diphtheria antitoxin level below 0.01 I.U./ml; after the first booster only 5% were unprotected. The second booster did not show a significant effect, however, in 1 of the 5 subjects who were still unprotected after the first booster the second elicited an antitoxin level of more than 0.01 I.U./ml. After one and two years 7% and 8% of the subjects had diphtheria antitoxin level below 0.01 I.U./ml. A serological effect of a second booster vaccination four weeks after the first one could not be demonstrated neither after one nor after two years.

Adolescent↗
PubMed1998

[Endoscopic management of uterine perforation with the ENDO-UNIVERSAL surgical stapler].

The management of an uterine perforation occurring during a D & C, in which a bleeding could not be stopped by coagulation per laparoscopiam is described. The closing of the bleeding injury in the uterus wall was performed by ENDO-UNIVERSAL-clip-instrument. The wound was closed and the bleeding stopped. The possibility to manage an uterine perforation with this simple method is reported and discussed.

Aged↗
PubMed1997

[Initial experiences and outcome of gasless laparoscopic pelvic lymph node excision combined with Schauta vaginal radical hysterectomy in stage IB cervix carcinoma].

In 11 patients with a cervical cancer stage IB a gasless laparoscopic pelvic lymph node dissection in combination with a vaginal radical Schauta-Amreich-hysterectomy was performed. The technique of the gasless lymph node dissection with the Laparolift (ORIGIN Medsystems, Menlo Park) is described. Because of the advantages of this technique (ability to use conventional and endoscopic instruments, perform irrigation and suction, dot with sponge sticks, change instruments quickly, prepare and remove lymph nodes without influence on visibility) it was possible to obtain a radicality (45 lymph nodes-median value) according to oncological standards for an abdominal radical Wertheim hysterectomy. If the radicality is equivalent to a Wertheim hysterectomy the combination of the radical vaginal Schauta-Amreich-hysterectomy and the gasless laparoscopic pelvic lymph node dissection offers a real alternative to the abdominal Wertheim hysterectomy because of low postoperative morbidity and quick mobilisation.

Adenocarcinoma↗
PubMed1996

Gasless Laparoscopic-Assisted Radical Vaginal Hysterectomy with Lymphadenectomy for Cervical Carcinoma

We performed gasless lymph node dissection in a woman with cervical carcinoma FIGO stage Ib. The dissection of the parametrium was done vaginally by hysterectomy including the Schuchardt incision and the removal of 2 cm of vagina. We removed 45 lymph nodes. For the laparoscopic procedures we used a Laparofan and Laparolift (Origin Medsystems). The estimated blood loss was 250 ml and operative time 330 minutes. An advantage of the gasless method is that one can use endoscopic and conventional instruments. We combined advantages of laparoscopy (good visibility, enlargement of blood and lymph vessels) and of the gasless method (use of the same instruments as in laparotomy, quick change of endoscopic and conventional instruments without gas loss). This technique achieves the same surgical results as radical laparotomy in selected women with cervical carcinoma.

Journal Article↗
PubMed1996

[Early diagnosis of congenital and acquired intrauterine causes of abortion by post-abortion hysteroscopy].

A prospective study was conducted on the incidence of intrauterine pathology after abortions diagnosed by post-abortion hysteroscopy. In 80 patients outpatient hysteroscopy was performed 8-12 weeks after a dilatation and curettage for incomplete or missed abortions. Intrauterine pathological changes were found in 40 patients. There were 10 cases of uterus subseptus/ bicornis and 7 of uterus arcuatus, 2 submucous myoma and 1 corpus polyp. Intrauterine adhesions were diagnosed in 20 patients. The incidence of intrauterine adhesions was about the same after incomplete abortions and after missed abortions, but in patients with recurrent abortions the incidence was significantly higher than in patients after the first abortion (27.8% versus 14.9%). Post-abortion hysteroscopy is a simple and useful method for early diagnosis of congenital and acquired intrauterine pathology after abortions.

Abortion, Habitual↗
PubMed1996

[Hormonal premedication in endometrium ablation--results of a prospective comparative study].

In a prospective study in 40 patients the pretreatment for endometrial ablation with a gestagen (Orgametril 10 mg/die), danazol (600 mg/die) and an injection of a GnRH-analogon (Decapeptyl-Depot) was compared with a control group without pretreatment. The subjective estimation of the surgeon (endometrial thickness and depth of coagulation) showed a sufficient pretreatment in 90 % of all cases following danazol- and GnRH-analogon-pretreatment. In 90 % of the danazol- and GnRH-analogon pretreated group the histological findings showed also an atrophic or little proliferative endometrium. In a follow up of 6 months after endometrial ablation the highest amenorrhoea-rates were reached following danazol- and GnRH-analogon pretreatment. These two regimes should be used for the pretreatment for endometrial ablation.

Adult↗
PubMed1996

[Correlation between endometriosis and fallopian tube patency in sterility patients especially after microsurgical sterility operations].

In 130 sterile women undergoing first look laparoscopy we found in 86.9% patent tubes. In this group in 34.5% an endometriosis was discovered. All patients with closed tubes had no signs of endometriosis. In a second look laparoscopy we found in 50% an endometriosis after microsurgery if the tubes were open. In this group we didn't also find an endometriosis if the tubes were closed. The frequency of endometriosis in women with laparoscopic sterilisation is 3.3%. After microsurgery in sterile women a second look laparoscopy seems to be very necessary to check the operation success and to exclude an endometriosis.

Adult↗
PubMed1996

[Large cervix myoma after supra-cervical hysterectomy].

By means of laparoscopic supracervical and pelviscopic intrafascial hysterectomy (CISH) new minimally invasive hysterectomy methods for benign indications have been developed where the cervix or a portion of the cervix remain intact. The carcinoma risk is extremely small. Using the example of a large cervical myoma 25 years after a supracervical hysterectomy, the possibility of recurrent myomas is emphasized.

Cervix Uteri↗
PubMed1996

[Diagnostic laparoscopy with mini-optics--initial experiences].

The use of a 1.2 mm microendoscope is compared to the conventional laparoscopy technique in this study. In 22 sterility patients and 23 patients suffering from chronic pelvic pain the high diagnostic value of the microendoscope is shown. Only in one case endometriosis (EEC I) is overseen. The diagnostic laparoscopy by the microendoscope is a new minimal invasive procedure which could be important as a screening method in future.

Adult↗
PubMed1995

[The value of laparoscopy in diagnosis and therapy in patients with chronic pelvic pain].

The anamnesis, the preoperative diagnostics, the laparoscopic findings, and the therapeutic management are reported of 303 patients who underwent laparoscopy because of chronic pelvic pain during the years of 1989 and 1993. The most common laparoscopic diagnosis were adhesions of the bowel and omentum (34.7%), adhesions of the genital organs (24.1%) and endometriosis (19.8%). In 31.4% there were normal pelvic findings. In patients with a history of surgical or other gynecological procedures we found significantly more adhesions as compared to nontreated controls; the adhesions were predominantly confined to the bowel and rather than the gynecologic pelvis. PID-Patients had significantly more genital adhesions. The high frequency of surgical laparoscopies and therapeutic recommendations following a diagnostic laparoscopy emphasize the importance of a laparoscopic investigation in patients with chronic pelvic pain.

Adult↗
PubMed1995

[Laparoscopy-assisted vaginal hysterectomy (LAVH)--a comparison between vaginal and abdominal hysterectomy with reference to intra- and postoperative quality parameters].

First experiences after the introduction of LAVH with regard to intra- and postoperative parameters of quality in comparison with the classical abdominal and vaginal hysterectomies are shown. The main indications for LAVH were large myomas, previous pelvic surgery and adnexal mass. Intra- and postoperative complications, time of operation, uterine weight, estimated blood loss, the period of use of analgetics and discharge wishes of 40 patients after abdominal and 25 after vaginal hysterectomies were compared with the results of 30 patients after LAVH. Patients after abdominal hysterectomy need more and longer analgetics. The lowest perioperative morbidity we found in the LAVH group. In cases with enlarged uteri the high blood loss during the vaginal hysterectomy can be significantly reduced with LAVH. LAVH offers a new technique to convert a lot of abdominal hysterectomies with benign indications (large myomas, adhesions, adnexal mass) into vaginal hysterectomies.

Adult↗
PubMed1994

[Is there a seasonal incidence of ectopic pregnancy?--A retrospective analysis].

The seasonal incidence of 472 ectopic pregnancies in the years 1984-1993 in the Departments Obstetrics and Gynaecology Greifswald and Neubrandenburg were analysed. While the birth rate was decreasing in the third and fourth quarter of the year there was a low, no significant increase of ectopic pregnancies from 1.30% (April-June) to 1.75% (October-December). The monthly analysis did not show any significant differences. In the area Vorpommern/East-Mecklenburg climatic and meteorological factors do not seem to have an important influence on the incidence of ectopic pregnancies.

Cross-Sectional Studies↗
PubMed1994

[Hysteroscopy versus hysterosalpingography in diagnosis of sterility and infertility].

In a prospective study of 68 infertile patients the findings of hysterosalpingography and hysteroscopy have been compared. Hysterosalpingography showed in 3 cases false-negative results and in 10 cases false-positive results. Hysterosalpingography is especially limited for diagnostics of intrauterine adhesions. Hysteroscopy should be a necessary component of diagnostics of sterility, also in case of normal hysterosalpingographical findings.

Adult↗