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  • 1
    ISSN: 1432-198X
    Keywords: Continent urinary diversion ; Bladder augmentation ; Young-Dees technique, modified ; Ileocaecal pouch ; Iatrogenic bladder loss, therapy of
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The formation of a bowel reservoir of large capacity at low pressure by using small and large bowel (ileocaecal segment) has proved reliable for achieving continent urinary diversion (n=80), for bladder augmentation (n=42) as well as for total bladder replacement (n=24). Encouraged by the results we obtained in our adult patients, we have used this technique during the last 3.5 years in 29 children. Indications for urinary diversions in children have been: neurogenic bladder with diplegia (n=8), bladder exstrophy (n=2), traumatic loss of the bladder (n=1), urogenital sinus (n=1) and rhabdomyosarcoma of the prostate or bladder (n=2). Bladder augmentation was indicated in 6 children with iatrogenic bladder loss, in 5 children with neurogenic bladder without diplegia and in 4 boys with incontinent epispadias or exstrophy. In children with bladder exstrophy or incontinent epispadias, continence was achieved using a modified Young-Dees technique with formation of a long intra-abdominal muscular tube made out of the bladder plate or the low-capacity bladder. The capacity of the urinary reservoir was guaranteed by bladder augmentation or bladder replacement with an ileocaecal pouch. During a mean follow-up period of 26 months (bladder augmentation) and 21 months (continent diversion) there was only one postoperative complication (intussusception ileus) which required operative revision. Two children had to undergo reoperation because of nipple problems. Follow-up, with monitoring of biochemical and metabolic parameters, is necessary to show whether this technique will provide a long-term successful solution for these problems.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1435-2451
    Keywords: DNA-analysis ; Prognosis ; Papillary thyroid carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 19 Patienten, bei denen wegen eines papillären Schilddrüsenkarzinomes eine Resektion durchgeführt worden war, wurde neben der TNM-Klassifikation und den üblichen morphologischen Beurteilungskriterien zusätzlich eine bildanalytische DNS-Zytometrie durchgeführt. Es fanden sich 13 diploide and 6 aneuploide Tumoren. Bei Patienten mit diploiden Tumoren betrug die rezidivfreie Überlebensrate Bowie die Überlebensrate nach 103 Monaten 84% bzw. 92%, wäh-rend 3 von 6 Patienten mit nichtdiploiden Tumoren in nerhalb von 70 Monaten ein Rezidiv erlitten. Zwischen dem DNS-Gehalt der Tumoren einerseits and dem Tumorstadium, der pT-Einteilung, dem Vorhandensein von Lymphknotenmetastasen and einer tumorbedingten Gefäβinfiltration andererseits fand sich kein Zusammenhang.
    Notes: Summary In this study we analysed DNA-ploidy as a potential prognostic parameter in papillary thyreoid carcinoma. Paraffin embedded histological material, obtained by resection from 19 patients with a papillary thyreoid carcinoma, was selected for analysis. Tumor areas within the paraffin-embedded material were identified by HE-stained reference sections. One 50 pin section was dewaxed, rehydrated and mechanically and enzymatically prepared to form a suspension of 10,000 cells/ml. 1 ml of the suspension, which contained bare nuclei with small rests of cytoplasma, was centrifuged on glass slides. The fixed nuclei were air-dried and stained by Feulgen SITS technique, which allows for the quantitative measurement of DNA. The DNA analysis was carried out with a computer-controlled single-cell cytophotometry. In contrast to using flow cytometry, only the tumor cells were measured by image-cytometry. Overlapping nuclei, dirt and other artifacts as well as inflammatory cells were efficiently eliminated. With DNA image-cytometry, we could differentiate between diploid (n = 13) and aneuploid (n = 6) tumors. Best prognosis with a survival rate of 92% after 103 months had patients with diploid tumors in contrast to patients with aneuploid tumors who did not survive more than 72 months.
    Type of Medium: Electronic Resource
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