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Biomedical subjects

R Schwarz

Publications and source records attributed to R Schwarz.

At least 19 recordsLinked to original sources
PubMed1992

Soft tissue sarcomas of the extremities and trunk in the adult. Report of 124 cases.

Between 1970 and 1988 surgery was performed on 124 patients with soft tissue sarcomas of the extremities and trunk in the University Clinics of Hamburg. Liposarcoma, malignant fibrous histiocytoma, fibrosarcoma and malignant schwannoma were the most common histological types. High-grade sarcomas (G3) predominated, with 41%, while 26% were graded G2 and 33% G1. Resection with wide margins all round was achieved in only 54% of the patients. The quality of the operation proved to be only therapy-related prognostic factor. In addition, tumour grade, size, regional lymph node and distant metastasis and histological type proved to be relevant to the prognosis. With multivariate analysis, distant metastasis, grade, resectability and histological type retained prognostic significance. The efficacy of adjuvant chemo- and radiotherapy was related to the quality of the preceding tumour resection. In case of gross tumour the rate of either partial or complete response was 28% for chemotherapy and 22% for radiotherapy. The mean survival time was 102 months; the 5- and 10-year survival rates were 48% and 37%, respectively.

Adolescent↗
PubMed1992

[Occlusion of a vesicovaginal fistula with Latzko-repair].

UNLABELLED: The Latzko procedure is a well-known method for the closure of small vesico-vaginal fistulas occurring in the vaginal dome after hysterectomy. This method is favoured by gynaecologists. In three Departments of gynaecology, a total of 104 patients were treated. 76% had been referred from other hospitals. 56.7% resulted from gynaecological operations. In 69.2% was a benign and in 28.8% a malignant disease. In only 2 cases, the primary disease remained unknown. RESULTS: In 97 of 104 (= 93.3%) cases, the procedure according to Latzko succeeded at the first attempt. 5 of 7 recurrences were resolved by the second attempt with the same operative technique according to Latzko, signifying a secondary success rate of 98%. There were only 2 notable complications: the one, where a postoperative bladder haemorrhage attributed to anticoagulants, and the second with a bladder stone noticed 11 years after the Latzko procedure. This technique can be performed in 95% of all vesico-vaginal fistulas occurring. The fundamental advantages of its use are: short duration of the procedure, high cure rate and few complications.

Female↗
PubMed1992

[The gynecologist and hysterectomy].

Often it is postulated by mass media that too much hysterectomies would be performed by gynaecologists. Hysterectomy is today a relatively safe routine intervention. This may tempt to a generous indication. Elective hysterectomy has been looked at critically. Two factors play an important role, firstly the position of the women to her uterus, i. e. how does the women settle down her fertility in her life and secondly the position of the gynaecologist, which will be transmitted from him to the patient cousciously or instinctively. Then our position to alternative methods like endometrial ablation by hysteroscopic laser coagulation or laser assisted or pelviscopic hysterectomies has been demonstrated.

Female↗
PubMed1992

Retroperitoneal sarcoma in a series of 51 adults.

Fifty-one patients with retroperitoneal sarcoma underwent surgery at the University Clinics of Hamburg from 1970 to 1988. Malignant schwannoma, liposarcoma and malignant fibrous histiocytoma were the most common histological types. High grade sarcomas (G3) predominated (42%), while 26% were graded G2 and 33% G1. Complete resection was possible in 59% of cases. Reoperation for local recurrence and debulking in case of not completely resectable disease was common. Regional lymph node metastasis was found in 20% of cases. The peritoneum was the preferred location of metastatic spread. All adjuvant chemotherapies were followed by tumour recurrences. After adjuvant radiotherapy three of six patients remained free of disease. In cases of residual tumour we observed few partial responses on chemo- and radiotherapy, and all patients died because of the disease. The mean survival time was 60 months, the 5- and 10-year survival rates were 35% and 15%, respectively. Factors influencing prognosis in univariate analysis included grade, size, resectability, presence of metastatic spread, histological type, microscopic local growth (infiltrative vs intact pseudocapsule of fibrous tissue) and local recurrence. With multivariate analysis grade, size and lymph node metastasis retained their prognostic significance.

Adolescent↗
PubMed1992

Advantage of three-dimensional treatment planning for localized radiotherapy of early stage prostatic cancer.

Conventional two-dimensional (2-d) treatment planning was compared to three-dimensional (3-d) treatment planning for patients with prostatic carcinoma. Both types of treatment planning were performed for all ten patients with five fixed fields. In 3-d planning we used irregular shaped fields. For further evaluation we performed conventional planning in rotation technique in two patients. The target volume included prostate, seminal vesicles and a surrounding security margin of 2 cm. Using the MPR-version of the MEVAPLAN planning system, the three-dimensional dose calculations were performed. For the volumes of interest (VOI's) we discussed quality of the dose distribution concerning homogeneity in the target volume and isodose distribution in the organs at risk, which are the rectum and the urinary bladder. We defined the tumor encompassing reference isodose (ca. 95%) for the calculation of the involved rectum- and bladder volume. Using the five-field technique our results show a reduction of the radiation related rectum- and bladder volume concerning the tumor encompassing reference isodose (ca. 95%) for the rectum in between 9.5 and 36.6% (median: 19%, n = 10) and for the urinary bladder in between 15.7 and 47.8% (median: 28%, n = 10). Calculated for 80% of the reference isodose the difference for the rectum was 15.7 to 31.3% (median: 23%) and for the urinary bladder 24.5 to 56.7% (median: 42%). A significant reduction of radiation related side-effects concerning rectum and urinary bladder can be expected by a reduction of volume involvement and a consecutive dosage limitation.

Humans↗
PubMed1992

[Compartment resection as therapy of choice in subfascial soft tissue sarcoma exemplified by the thigh].

Soft-tissue sarcomas tend to have local recurrences after inadequate therapy. So reactions with wide margins are required. If a sarcoma is localized subfascially, such wide margins are often hard to achieve in a "wide resection". Concerning the growth behavior of soft-tissue sarcomas and the intraoperative orientation it makes more sense to resect these tumors with their whole anatomical compartment. This kind of operation is described by the three large compartmental resections of the thigh.

Adult↗
PubMed1992

Experience with recent modifications in the treatment of invasive squamous cell carcinoma of the vulva.

Analyzing retrospectively our results in treating 113 cases of squamous cell carcinoma of the vulva during the years 1973-1985, 5-years survival was identical with 70 per cent in 53 cases with radical vulvectomy and bilateral inguino-femoral lymphonodectomy as standard therapy, as well as in 60 cases with individualized treatment. These recent modifications had better anatomic results and improved the quality of life considerably. Therefore in author's opinion standardized therapy of vulvar cancer is no longer justified.

Carcinoma, Squamous Cell↗
PubMed1992

[Functional cytology of the apocrine glands of the anal sac in cats, Felis silvestris f. catus].

Apocrine glands of the anal sacs in cats (Felis silvestris f. catus) were examined by transmission and scanning electron microscopy. The secretory cells exhibit a typical equipment with organelles that varied according to the season as well as the animal's sex and state of reproduction. This can be mainly explained by seasonal differences in secretory activity. The cytological dynamics observed are, particularly, related to the smooth endoplasmic reticulum, which, for the first time, can be demonstrated in its crystalloid form in apocrine glands.

Animals↗
PubMed1991

Wound-factor-induced and cell cycle phase-dependent expression of 9E3/CEF4, the avian gro gene.

The gro genes encode for secreted proteins with sequence homologies to inflammatory mediators. Little is known about the function of these proteins or their regulation. The chicken gro (9E3/CEF4) is expressed abundantly in the cells of proliferating cultures but at very low levels in confluent cultures. In vivo, this gene is expressed in connective tissue and overexpressed at sites of injury, especially in areas of neovascularization. Here we provide a bridge between these observations by examining in culture the effect on 9E3 expression and DNA synthesis induced by cell damage and by addition of factors known to be released on wounding. We mimicked wounding by scraping swaths across confluent cultures of embryonic fibroblasts and determined the time dependence of expression of 9E3 mRNA and incorporation of 3H-thymidine. We find that 9E3 is (1) transiently expressed after "wounding" or serum-stimulation; (2) expressed in a cell cycle phase-dependent manner; it is triggered during the G0-G1 transition or early in G1 and subsides during S-phase; and (3) stimulated to high levels by a-fibroblast growth factor (aFGF), bFGF, transforming growth factor alpha (TGF alpha), and TGF beta, to intermediate levels by platelet-derived growth factor and not stimulated by epidermal growth factor. We also find that cells that are constantly cycling do not express 9E3, indicating that they skip either the portion of the cell cycle where 9E3 is induced or that they constitutively express a repressor of transcription or an RNA-degrading enzyme. Taken together, these observations suggest that the product of this gene could play more than one role in vivo. For example, in normal tissues the 9E3 protein could be involved in the exit of cells from the resting stage, whereas during wound healing the secreted protein or its cleavage products also could play a role in angiogenesis.

Animals↗
PubMed1991

Characterization of two insertion sequences, IS701 and IS702, from the cyanobacterium Calothrix species PCC 7601.

We describe the characterization of two insertion elements, IS701 and IS702, isolated from Calothrix species PCC 7601. These insertion elements were cloned from spontaneous pigmentation mutants. Both show the characteristics of typical bacterial insertion sequences, i.e. they present long terminal inverted repeats and they duplicate target DNA upon insertion. These elements share no homology with the only other cyanobacterial insertion sequence described so far, IS891. At least 15 copies of IS701 and 9 copies of IS702 were detected by hybridization experiments in the Calothrix 7601 genome. Their occurrence in several cyanobacterial strains is also reported.

Amino Acid Sequence↗
PubMed1991

[Value of inpatient after-care in coping with illness by tumor patients].

In a panel study consisting of two interviews within one year with 100 patients of the Chirurgische Universitätsklinik of Heidelberg it was tried to evaluate the use and the success of impatient aftercare for cancer patients and their coping with disease. The knowledge concerning disease and therapy turned out to be a more important criterion as for the participation in the 'Kur' than severity of disease, age and sex. A high degree of suffering and a relatively stable psyche were prerequisites to productive coping with the disease. The success of coping as well as the success of the treatment at a sanatorium cannot be implicitely objectified. In individual cases rather than with statistical methods, it was possible to identify risk patients who need intensive care. All in all, the 'sanatorium arrangements' gave a high degree of subjective satisfaction. Their positive effects were made evident in a 'sanatorium behaviour', which seems to be characteristic for cancer patients.

Adaptation, Psychological↗
PubMed1991

[The cardiovascular system in pre-eclampsia. Pathophysiology and sequelae to be treated].

Physiologic alterations of the cardiovascular system during normal pregnancy are the basis of all discussions about the problem of preeclampsia and treatment. The main point has to be the sufficient blood supply to the fetus. In this review cardiovascular alterations in high and low pressure system have been reported. High arterial blood pressure, elevated total peripheral resistance, reduced plasma volume, hemoconcentration, reduced suspension stability and hyperviscosity are symptoms which can be treated. Clinical experiences with a hemodynamic adjusted treatment, giving firstly infusionary therapy for correcting hypovolemia with the aim of an improvement within the low pressure system which cause an increase of cardiac output and then secondly the use of only such antihypertensive drugs having favourable effects on the uteroplacental blood flow are good and confirm theoretical considerations.

Cardiovascular System↗
PubMed1991

[Postoperative evisceration].

From 1930 to 1989 postoperative rupture of abdominal wound occurred in 0.42 per cent (n = 82) in the Department of Obstetrics and Gynaecology of the University of Rostock. 60 per cent of the patients were younger than 50 years. Patients of reduced general condition and anaemia were predisposed to this complication. We observed postoperative alterations of the respiratory tract in 13 per cent and alterations of the gastro-intestinal tract in 20 per cent which lead to increased intra-abdominal pressure. We observed postoperative wound rupture only in 8 cases after Pfannenstiel's incision, but all other times after median section, predominantly during the 7th and 12th postoperative day. All patients were treated by secondary suture, immediately. 8 patients came to death, three of them had no direct link to wound rupture. For prophylaxis the use of non-absorbable suture material, safety sutures, intraoperative blood and protein substitution and prevention of affections of the respiratory system and gastrointestinal tract are recommended.

Female↗
PubMed1991

[Microscopic studies of the skin of the Turkish angora goat. II. Functional morphology of the hair follicle].

The study supplies a detailed description of the development, morphology and function of anagen hair follicles in the Turkish Angora goat. In this connection, the formation of the hair root and the epithelial root sheaths is of specific interest. Furthermore, the intensive structural alterations and disintegrative processes occurring during the catagen phase are presented. The telogen hair follicle development is also referred to with special regard to typical structural and functional features.

Animals↗