Cystatin C predicts renal function impairment after partial or radical tumor nephrectomy

International Urology and Nephrology - To test the value of preoperative and postoperative cystatin C (CysC) as a predictor on kidney function after partial (PN) or radical nephrectomy (RN) in...     

Tumornachsorge in der Onkologie

Aftercare is the totally integrated care of the cancer patient after primary treatment has been completed. It remains extremely significant. The attending gynaecologist must do everything in his or her power to help re-establish the patient's usual pattern of life. Although this is the main goal, particular fundamental guidelines in medical aftercare must be looked at closely. In the course of individual aftercare, the check-ups must have a certain systematic organisation.     

Hormone receptor status in adenomatous hyperplasia of the endometrium and endometrial carcinoma

1. In glandular hyperplasia and endometrial carcinoma a correlation exists between the increased proliferation rate and the rise of the ER/PR-quotient. 2. The decline of both receptor concentrations and the increase of ER/PR-Quotient in the tumor and neighbouring, non-diseased tissue was demonstrated with increasing dedifferentiation, comparing endometrial carcinoma of different stages (G1 and G2, respectively). 3. In adenomatous hyperplasia the two receptors are significantly increased compared to normal cycling and glandular-hyperplastic endometrium, respectively; there the ER/PR-quotient is smaller than 1. After gestagen therapy decrease of both receptor concentrations demonstrates the success of therapy on one hand. On the other hand the higher decrease of PR shows, that duration and success of therapy could be limited temporally. 4. In endometrial carcinoma, especially in case of progression, recurrence and/or metastases, the determination of receptor status could be useful for therapy conception in the individual patient.     

Transposition of the ovaries for function preservation in radical surgery and post-irradiation of cervical carcinoma

It is recommended to leave behind the ovaries in their place in radical surgery of cervical cancer, if post-operative irradiation is not necessary. In cases of post-operative radiation therapy it is possible to preserve the function of the remaining ovaries by their transposition out of the irradiation area during operation. The operative technique for ovarian (adnexal) transposition will be demonstrated, and first informations about experiences and results are given. In 44 patients with cervical cancer from stage T1 b No Mo to T2 N1Mo a Wertheim-Meigs-operation with simultaneous ovarian transposition was performed, and 30 of them had a post-operative radiation therapy. In 44% of the radiation group was no change, in 24% a small restriction, and in 32% a total loss of ovarian function. The reasons of the unsuccessful lifting procedure are discussed, and possibilities for improvement of this management are shown.     

1st lymphogram and lymphographic course monitoring in the surgical management of cervix carcinoma]

The results of pre-lymphographic examinations and the post-operative control of 503 patients with cervix-cancers will be evaluated. In order to justify the lymphographic results, the histological results of 353 cases of examined patients could be analysed. Agreement between lymphographic and histological results amount to 75%. As a result of this, the individualized therapy of cervix cancers will be discussed. Thereby, special significance is given to the question of percutane radio-therapy. Only by micro-cancers with normal lymphogram, the lymphadenectomy will be desisted. Otherwise, the modified hysterectomy with vaginal cuff and bilateral lympadenectomy will be carried out. In 5% of the examined patients, primarily lumbar metastasis by operable cases could be diagnosed. New lymphnode metastasis appeared in 5% of the operated patients. Important for the individualized therapy is an exact praetherapeutic, especially histological diagnosis through conisation as well as a subtle histological examination of operated material including the exstirpated lymph-node.     

Use of viscous dye solutions for the vital staining of lymphnodes]

Animal-experimental and clinical results after applications of viscous solution with Fluorescein-Sodium and Erythrosin for representation of lympho-nodes and lymphatic ducts were published. In the frame of lymphography this application in form of a second infusion becomes possible preoperatively as well as intraoperatively. The lymphonodi inguinale, iliaci and lumbales represented even by lymphography were contrasty stained by this method over limited period.     

Comparison of the results of a prenatal care program in twin pregnancies in years with and without ultrasound screening

It should have been tested if a reduction of perinatal morbidity and mortality of twin pregnancies is possible by starting intensive care earlier. 68 gemini pregnancies of the report period I (1978-80) which were not diagnosed early and 66 gemini pregnancies of the report period II (1982-84) with early diagnosis by sonography-screening have been compared. The prenatal care programme carried out both in out-patients clinic and inside the hospital is illustrated. Perinatal mortality declined from 5.88 per cent in report period I to 3.79 per cent in report period II.     

Technics of induced abortion

From a survey, showing the available techniques at all the actual stand of abortion techniques in the different phases of pregnancy up to the second trimester are reported. Up to the 6th week of pregnancy vacuum curettage with a small canula, intravaginal and systemic application of prostaglandin-analoga as well as antigestagens are available. If there is an unproblematic situation in the first trimester up to the 12th week of pregnancy dilatation and curettage is the routine. In case of an individual risk there is a choice between save methods of dilatation with various applicable prostaglandins and - analoga as well as synthetic hydrophilic dilatators. Operation will be finished by section curettage or the classic curettage. In favour of the combined local systemic use of prostaglandins and analoga, installation methods are leaved. Oxytocin and application of synthetic hydrophilic dilatators are still important. Additional indications are necessary for operations at the uterus. Prophylaxis and metaphylaxis to avoid damages following treatment are reviewed.