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Biomedical subjects

W Kühn

Publications and source records attributed to W Kühn.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Preoperative immunocytochemical estrogen receptor determination in fine needle aspirates in breast cancer using monoclonal antibodies].

The biochemical detection of ER in breast cancer is of high value for the prognosis and planning of treatment. The conventional biochemical assays of ER are expensive, time-consuming and give little information on the topography and heterogeneity of receptor-protein in the tissue. Observations of different study groups showed a good correlation between the results of the biochemical assay and the monoclonal method in frozen sections. This ER-detection method was used on 34 fine needle aspirates from patients with breast cancer. 30 samples (88.2%) contained sufficient cells for analysis. The value of this method was proven and the results correlated to the measurement resulting from the biochemical assay. In 24 of the 30 fine needle aspirates we found good semi-quantitative correlation between the biochemical assay and the monoclonal method. Cytology, including ER-detection, permits definition not only of the receptor state, but also of the definition of the tumor. The employment of ER-detection in fine needle aspirates is useful in the following cases: Small tumors, which do not supply enough tissue to practice all in vitro tumor tests, as well as in metastasising tumors, in which surgical intervention or histological confirmation is not always necessary. The preoperative knowledge of ER may soon permit a different surgical therapy.

Antibodies, Monoclonal↗
PubMed1988

[Diagnosis of occult fallopian tube cancers by intraoperative peritoneal cytology].

Clinical and ultrasonographic examination are the usual methods of diagnosis for carcinomas of the fallopian tubes and ovarian carcinomas. It is only in rare cases that the diagnosis is based on the cytology of the cervical smear. The use of cytology--more exactly, the cytological examination of secretion in Douglas' space in cases of vaginal hysterectomies--for the detection of ovarian and tubal carcinomas that cannot be diagnosed by clinical and paraclinical procedures, is a rather unusual and rarely described method. However, it is quite justified, as demonstrated by the detection of two carcinomas of the fallopian tubes within a short time.

Adenocarcinoma↗
PubMed1988

[Preoperative diagnosis, pathologic anatomy and clinical significance of mucoceles of the appendix from the gynecologic viewpoint].

Owing to their proximity to the true pelvis and their topography, mucoceles of the appendix frequently cause clinical symptoms which call a gynecologic condition to mind. Sonographically, the structures of mucoceles are often similar to those of ovarian tumors. Within 12 months four patients with mucoceles underwent surgery at Heidelberg University Gynecological Clinic following diagnosis of a gynecologic disease (two tentative diagnoses of ovarian carcinoma, one of advanced ovarian carcinoma, one chance finding during Wertheim's operation). The problems of this rare condition are discussed with reference to the clinical findings, the intraoperative site, and the different morphology and maturity. Pathoanatomically and biologically, however, the clinical picture is not uniform. In mucoceles there is an accumulation of mucus with cystic dilatation of the lumen of the appendix. This is usually due to a tumor, which may be anything from a simple mucous membrane hyperplasia with extreme mucous formation, or an adenoma, to a mucilaginous adenocarcinoma. The rupture of a mucocele or metastasization of a carcinoma often lead to peritoneal mucous spread or peritoneal metastasization: in their patterns of distribution these are similar to a pseudomyxoma peritonei or a metastasizing ovarian carcinoma.

Aged↗
PubMed1988

Psammomabody content and DNA-flow cytometric results as prognostic factors in advanced ovarian carcinoma.

138 advanced ovarian serous carcinoma--all FIGO stages III/IV--were investigated by prognostic morphological factors like tumour grading and rate of psammomabody content--subdivided in to serous carcinoma with a high, a moderate and a low rate of psammomabodies and a group of serous carcinoma without psammomabodies. Additionally 91 of these tumours were examined by DNA-flow-cytometry--respectively DNA-ploidy and s-phase-fraction. All prognostic factors were correlated to the overall survival time. The psammomabody content factor is only important if histologically a high or moderate rate of psammomabodies is found in the tumour tissue. Tumours with a low rate of psammomabodies do not differ from serous tumours without psammomabodies. DNA-flow-cytometry is a qualified method to demonstrate a slow tumour growth tendency. The majority of carcinomas with a high rate of psammomabodies is DNA-diploid and has a low -phase-fraction. The overall survival rate for these tumours is much better. Tumour grading--a more subjective method--is also of high value, but there is a certain difficulty in reproducing the results in individual cases. By the combination of the two morphological methods--semiquantitative assessment of psammomabodies and DNA-flow-cytometry--we were able to discover a small group of patients with advanced ovarian cancers who have a favourable prognosis.

DNA↗
PubMed1987

[Morphologic criteria of prognosis and clinical course in ovarian tumors of the borderline type].

Borderline tumors of the ovary are morphologically characterized by histologic and cellular criteria and by lack of evidence of invasion. During an observation period of 12 years at Heidelberg University Gynecological Clinic, 49 patients with borderline tumors underwent surgery and the clinical course was followed up. In 15 cases the tumor was at an advanced stage (FIGO III/IV); chemotherapy was instituted after surgery in 12 of these women. None of the patients with early-stage tumors (FIGO I/II) were lost due to the tumor during the period of observation; the death rate among patients with stage III/IV tumors (FIGO) was 40%. However, the death of three of these women was also due to their advanced age and high internal risks. As in the case of ovarian carcinomas, the survival rates improve if the postoperative residual tumor mass is smaller than 2 cm. Subsequent histologic work-up of archived, formalin-fixed tumor tissue and metastases thereof showed that two forms of the metastasizing borderline tumor exist: one with a favorable prognosis, a "pure" form with borderline changes in the ovary and metastases, and one with a less favorable prognosis, with borderline changes in the ovary and destructive-invasive portions of tumor in the metastazation areas. Impulse cytophotometric studies (ICP) showed that all primary tumors had the same degree of ploidy i.e., diploid. However, detection of an aneuploid distribution pattern in a metastasis correlated with subsequent histological confirmation of tumor invasion and rapid tumor death. The S-phase fraction was low, at 2.02% +/- 1.3.(ABSTRACT TRUNCATED AT 250 WORDS)

Combined Modality Therapy↗
PubMed1987

[Clinical course of ovarian cancer in relation to morphologic prognostic factors and cell kinetic parameters].

Apart from the stage of the tumour and the method of surgical approach, factors of special importance in prognosis are the histological type of tumour and the histological and cytological grading of malignant ovarian tumours. To supplement the prognostic factors, DNA flow cytometry has recently been introduced to determine parameters of cell kinetics such as ploidy (the status of the chromosome set in the karyotype) and the number of DNA-synthesized cells. In the present study 81 patients with a malignant tumour of the ovary--most of them classified according to FIGO stage III/IV--were followed up for 12 to 56 months (FIGO = Fédération Internationale de Gynécologie et d'Obstétrique). The survival times are correlated with clinical, morphological and cell kinetics data. The FIGO stage is the most important prognostic factor. None of the patients in stage I/II (FIGO) died during the study period, whereas of 63 women in stage III/IV (FIGO) 41 have already died. The histological tumour type is not so significant for prognosis. The survival curves show that of all the examined prognostic factors in stage III/IV (FIGO) the S-phase proportion (i.e. the proportion of DNA-synthesized cells) is the most important one. Statistically significant differences are also seen in ploidy and in grading. However, in histological grading of tumours the differences are noticeable only in grading G 1 and in grading G 3. G 2 carcinomas--which, by the way, account for one-third of all carcinomas-are a kind of collecting "pool" of tumours whose prognosis cannot be assessed.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Division↗
PubMed1987

[Development of cancer (vulvar cancer) in the Netherton syndrome (ichthyosis, hair anomalies, atopic diathesis)].

So far there has been only one incidence of a malignant tumour associated with Netherton's syndrome, a rare skin disease consisting of congenital ichthyosiform erythroderma, atopic dermatitis and trichorrhexis nodosa (bamboo hair). The aetiology and clinical consequences are discussed on the occasion of a carcinoma of the vulva occurring in a case of a patient with Netherton's syndrome, both phenomena being interlinked.

Biopsy↗
PubMed1986

[Potential malignancy of cystosarcoma phyllodes of the breast. A contribution to the histogenesis of fibrosarcoma].

The present case report, which describes the transformation of a cystosarcoma phylloides into a "borderline case" and subsequently a fibrosarcoma, makes it clear that fibrosarcoma of the breast cannot always be regarded as a tumor which has developed primarily from mesenchymal breast tissue. Just as a benign cystosarcoma can turn malignant if therapy is inadequate, it can also turn into a purely sarcomatous tumor. The clinical consequences of this are that a cystosarcoma should not only be shelled out, but excised generously, with a wide border of healthy tissue. The "borderline" type of cystosarcoma phylloides, or respectively the fibrosarcoma, requires far more aggressive therapy, i.e., mastectomy. In fibrosarcoma cases additional selective lymphadenectomy may be considered, although the metastasization pattern is predominantly hematogenic. Overall, however, the prognosis for fibrosarcoma cases is better than for those with breast cancer.

Adipose Tissue↗
PubMed1986

[The second-look operation in advanced ovarian cancer--experiences since the introduction of cisplatin combination chemotherapy].

In cases of ovarian carcinoma the trend today is toward postoperative cytostatic follow-up therapy which is as aggressive as possible, though of limited duration. The aim is to achieve full clinical remission and to verify it histologically by a second-look-operation. This paper presents the results obtained in 41 women who underwent second-look surgery, out of a total of 87 women with advanced epithelial ovarian carcinoma (FIGO stage III and IV) who had been given combination chemotherapy with cisplatin postoperatively. Taking various well-known prognostic factors into account (stage, age, histologic grading, primary postoperative residual tumor mass), the situation before and after a second-look laparotomy was analyzed. The survival data (life table analyses according to Kaplan-Meier) indicate the importance of these prognostic factors. Approximately one-third of the patients had full clinical remission after aggressive cisplatin combination chemotherapy; complete remission was verified microscopically in 18% of all cases, with a mean of 12 biopsies. The long-term prognosis for such women, who can be cured even if they have primary advanced ovarian carcinoma, is likely to be good. In addition, present-day indications and the standard surgical procedure for a second-look operation are described.

Adult↗
PubMed1986

[Mesonephrogenous cervix papilloma in childhood and adolescence].

Five cases of mesonephric cervical papilloma have so far been described in children and adolescents. Basing on the observation of a further tumour of thus type in an eight-year old child, the authors discuss histogenesis, histological diagnosis and therapeutical consequences.

Adolescent↗
PubMed1985

[Carcinoma formation in a neovagina following vaginoplasty].

A carcinoma occurs only very rarely in a neovagina. This extremely rare occurrence is a suitable example of an exogenous carcinogenesis. Only 6 cases have so far been reported in literature. The clinical and morphological features are discussed on the basis of the author's own observations on one of his patients.

Adult↗