Biomedical subjects

S Leodolter

Publications and source records attributed to S Leodolter.

169 records · Page 10Linked to original sources

PubMedDate not supplied

[Causes of lactation inhibition in the early puerperium (author's transl)].

In a retrospective study in 213 puerperal women, who had delivered at the 1st Department of Obstetrics and Gynecology of the University of Vienna before 1980, the individual cause for the primary or secondary inhibition of lactation with drugs in the early puerperium was evaluated. In 77.4% the lactation was carried out for maternal, in 22,6% for neonatal indications. Concerning the maternal causes in 23,9% the mother did not want to breast feed, in 17,8% "too little milk" and in 12,7% anamnestic breast-feeding problem at preceding deliveries were found. Maternal diseases were diagnosed in 9,4%, breast-feeding complications, like sore nipples, breast engorgement and mastitis in 5,2%, state after mammasurgery in 2.8%, an important drug therapy in 2,3%, sunken nipples in 1,9%, and several rare causes like adoption or arrest. Concerning the neonatal reasons prematurity was predominating in 16.9%, followed by antenatal fetal death and perinatal death in 3,3% and rarer diseases of the infant with reduced sucking power in 1,9% and one malformation (0.5%). Although several maternal and neonatal conditions still require the suppression of lactation, this could be avoided in a considerable percentage by adequate medical advise and encouragement for the patient. This should be a concern of all obstetricians today.

Breast Feeding↗

PubMedDate not supplied

Magnetic resonance imaging in the preoperative evaluation of suspected ovarian masses.

Meticulous pretreatment evaluation is basic to the successful management of suspected ovarian masses. Among currently available imaging techniques, sonography and computerized tomography are the most important diagnostic modalities. The purpose of our study was to determine whether magnetic resonance imaging provided additional information on masses in the true pelvis. 73 patients with masses in the true pelvis underwent preoperative magnetic resonance imaging. MRI was done with a 1.0 T supraconductive magnet (Magnetom Impact, Siemens). The results obtained were compared with sonographic (transabdominal and transvaginal), intraoperative and histopathologic findings. MR images were evaluated for their information on differentiation between benign and malignant neoplasm, tumor staging, lymph node involvement, peritoneal spread, local extension and organ relation. MRI correctly characterized malignant and benign tumors in 97% of cases versus 81% on ultrasound. The site of the primary tumor was correctly diagnosed in 94% of cases on MRI images versus 86% on ultrasound images. Invasion of adjacent intestinal segments as well as peritoneal carcinomatosis and omental metastases (metastasis > 1 cm) were also detected in the majority of cases. Based on our results MRI performs well at lesion detection and characterization in the evaluation of suspected ovarian masses. MRI should be considered in the investigation of patients with complicated findings on ultrasound.

Diagnosis, Differential↗

PubMedDate not supplied

The use of color-coded Doppler sonography in the diagnosis of breast cancer.

87 women with mammographically suspicious breast lesions were investigated prior to surgery. Color Doppler signals were obtained in 80 patients. 32 breast carcinomas and 55 benign lesions were evaluated for the RI (resistance index), the PI (pulsatility index), the flow velocity and the Al (acceleration index). Our study showed the RI > 0.7 an optimal threshold value to differentiate benign from malignant tumors. In this series, the sensitivity of duplex Doppler ultrasound for the detection of breast carcinoma was 84%, and the specificity 80%. The positive predictive value was 71%, the negative predictive value 90% and the accuracy 82%. Color Doppler scanning is a possible method for further investigation of patients with mammographic abnormalities and can be useful to reduce the number of unnecessary breast biopsies.

Adult↗

PubMedDate not supplied

Triptorelin (D-Trp-6-LHRH) in combination with carboplatin-containing polychemotherapy for advanced ovarian cancer: a pilot study.

In experimental and clinical phase II trials GnRH agonists were shown to possess antitumor activity in ovarian cancer. The outcome of prostatic cancer was also improved experimentally by a combination of cytostatic chemotherapy and GnRH analogs. Encouraged by these results, we administered micro-encapsulated triptorelin (Decapeptyl CR), 3.75 mg on the first day of each chemotherapy course, to 15 patients with advanced ovarian cancer in addition to adjuvant, carboplatin-containing chemotherapy (Carboplatin, Epirubicin, Prednimustine and Carboplatin, Etoposide) after radical surgery. Patients received a total of 6 courses. After the completion of combined chemotherapy GnRH analogs were continued for another 6 months at 28-day intervals. Results were compared with those obtained in a group of 15 ovarian cancer patients receiving the same chemotherapy regimen without GnRH medication. At a median follow-up of 36 months no significant differences were seen in terms of response, survival and time to progression. However, patients undergoing chemotherapy+triptorelin tended to show a more positive outcome than those on chemotherapy alone. G1 and G2 tumors in particular were found to respond better to the combined treatment regimen.

Adult↗

PubMedDate not supplied

Tumor-associated trypsin inhibitor (TATI) and cancer antigen 125 (CA125) in patients with epithelial ovarian cancer.

In 180 patients with epithelial ovarian cancer and 214 women with benign pelvic pathologies, serum levels of TATI (cut-off point 21 ng ml-1) and CA 125 (cut-off point 35 U ml-1) were determined. Data were correlated with tumour stage, histological type and tumour grade. Overall, when used as a single marker, TATI showed a sensitivity of 63% and a specificity of 72%, whereas the sensitivity and specificity of CA 125 > 35 U ml-1 were 80% and 82% respectively. A combination of the two markers increased the sensitivity to 91% (TATI > 21 ng ml-1 or CA 125 > 35 U ml-1), whereas the specificity decreased to 65%. TATI was clearly superior in diagnosing mucinous carinomata of the ovaries; the rate of true positive findings was 64% versus 50% for CA 125. Unlike CA 125, TATI levels correlated well with tumour grade. In conclusion, CA 125 remains the single tumour marker of choice in the diagnosis of malignant epithelial ovarian cancer, while TATI appears to be a valuable complementory marker with a higher sensitivity in cases of poorly differentiated and mucinous carcinomata.

Adenocarcinoma, Mucinous↗

PubMedDate not supplied

The application of fibrin glue after axillary lymphadenectomy in the surgical treatment of human breast cancer.

Experimental studies point out that a reduction of lymph flow can be obtained by the local application of fibrin glue following axillary lymphadenectomy in the surgical treatment of breast cancer. In a prospective study the influence of human fibrin glue on postoperative axillary lymph secretion and the period of drainage of the wound cavity were evaluated. In 40 patients, 5 ml of fibrin glue (Tissucol) was applied to the wound cavity by the use of a spray applicator (Tissumat) immediately after axillary dissection of the lymph nodes. For drainage of the wound area Redon suction-drains were used. The daily amount of postoperative lymph secretion was measured and drains were removed at a lymph secretion of less than 20 ml. 40 patients who underwent surgery and axillary lymphadenectomy without subsequent application of fibrin glue sourced as control group. No significant difference concerning the total amount of lymph secretion, the mean period of drainage or the incidence of lymphatic cysts was observed. In our study, the expected occlusion of the wound cavity by the application of fibrin glue after axillary lymphadenectomy did not lead to any advantage when compared with the control group.

Adult↗

PubMedDate not supplied

Endometrial cancer after tamoxifen treatment: a descriptive study of 25 breast cancer patients who subsequently developed endometrial cancer.

The aim of this study was to determine whether tamoxifen affects the histopathological features and clinical outcome of endometrial cancer occurring after breast cancer. 25 patients with a history of breast cancer who subsequently developed endometrial cancer were identified by computer assisted linkage of the Lainz Medical Center Tumor Registry with the National Austrian Cancer Registry. 8 endometrial cancers were tamoxifen-associated, whereas 17 cases were not. The median time of tamoxifen use was 32 months, with a median cumulative tamoxifen dose of 27 g. Detailed histopathological data did not show substantial difference between the two groups. The distribution by stage (FIGO) in the tamoxifen group was Stage I, 7 (87.5) with 1 patient unstaged (12.5%); and Stage I, 13 (76%), II, 2 (12%) and, stage III 2 (12%) for the non-tamoxifen users. No risk of high-grade endometrial lesions with a poor prognosis was found. The only suggestion of a difference was a trend for the mean interval between detection of breast and endometrial cancer to be shorter in the tamoxifen group (50.5 vs. 88.1 months p = 0.07). The conclusion to be drawn from this study appears to be that endometrial cancers occurring after tamoxifen exposure are of the same tumor type. Due to the small number of cases described we were not able to disprove the hypothesis that tamoxifen associated tumors were different in terms of clinical outcome and survival. Regular gynecological examinations are recommended for all breast cancer patients.

Aged↗