Die Perforation bei Morbus Crohn als Komplikation in der Schwangerschaft

The manifestation of Crohn's disease with perforation in pregnancy has been described in one case only. In our case, a 25-year-old woman in the 28th week of pregnancy was admitted to our hospital with signs of an acute abdomen. Due to deterioration of the maternal and foetal situation, the child was delivered by a Caesarean section. Subsequently, exploration of the abdomen showed an ileum perforation with diffuse fibrinous peritonitis. In this case, the definitive diagnosis could not be made prior to laparotomy. The aim of surgical therapy in such cases should be the limited resection with end to end anastomosis. In diffuse peritonitis, discontinuous resection and secondary reconstruction a…

Ein neues Konzept zur Behandlung von Beckenwandrezidiven gynäkologischer Malignome

Beckenwandrezidive gynakologischer Krebserkrankungen haben eine sehr schlechte Prognose, obwohl etwa die Halfte der Patientinnen geheilt werden konnte, wenn eine lokale Sanierung erreicht wurde. Aus tumor- und strahlenbiologischen Uberlegungen haben wir fur Patientinnen mit unilateralen Beckenwandrezidiven ein neues kombiniertes operatives und strahlentherapeutisches (CORT) Behandlungskonzept entwickelt, das seit 1989 in unserer Klinik angewandt wird. Die Grundlagen und Aspekte der Durchfuhrung des CORT-Konzep-tes haben wir kurzlich veroffentlicht (Hockel et al. 1989).

Abstract of the 68th Meeting (Spring Meeting) 6–9 March 1990, Heidelberg

Hypoxie beim Zervixkarzinom: Pathogenese, Charakterisierung und biologische/klinische Konsequenzen 1

Approximately 60% of locally advanced carcinomas of the uterine cervix exhibit hypoxic and/or anoxic tissue areas which are heterogeneously distributed within the tumor mass. Hypoxia is caused by structural and functional abnormalities of the newly formed tumor vessels arising from neovascularization, by a disturbed microcirculation, enlarged diffusion distances and by tumor- or therapy-associated anemia. The extent of pretherapeutically measured hypoxic tissue areas is independent of clinical size, FIGO stage and histopathological grade of squamous cell carcinomas of the uterine cervix. Anemia can intensify tumor hypoxia. O2-tensions in local recurrences are even lower than those in the pr…

The influence of oral contraceptives on the composition of bile.

The increased risk of cholelithiasis during intake of oral contraceptives may be due to estrogen-induced saturation of the bile with cholesterol. In a randomized, prospective, crossed-over double-blind study 20 healthy women after roentgenological exclusion of gall-stones received either 1.0 mg of norethindrone acetate and 50 microgram ethinyl estradiol daily - as usual in oral contraception - for 21 days with 7 days of placebo treatment in each cycle or one fifth of this hormone dose in form of a continuous daily medication. After a 4 month's treatment the medication form was crossed-over. At the beginning of the study, before the cross-over and after the study bile was collected by duoden…

Therapeutische Möglichkeiten beim Rezidiv des Zervixkarzinoms

Rezidive von Zervixkarzinomen nach Operation und adjuvanter Strahlentherapie oder nach alleiniger primarer Strahlenbehandlung haben eine extrem schlechte Prognose und stellen eine Herausforderung fur den gynakologischen Onkologen dar. Bei ca. 35% der Patientinnen mit invasivem Zervixkarzinom zeigt sich im weiteren Krankheitsverlauf ein solches Rezidiv. Die Lokalisation dieser Rezidive betreffen in etwa einem Drittel der Falle ausschlieslich den Scheidenstumpf (27%) und den unteren Teil der Vagina (6%), uber 40% der Rezidive sind uberwiegend im Parametrium und an der Beckenwand lokalisiert. Nur ca. 20% der Patientinnen weisen Fernmetastasen auf [10, 27, 32, 33]. Treten solche Rezidive nach a…

Die kombinierte operative und radiotherapeutische Behandlung (CORT) von Beckenwandrezidiven: Erfahrungsbericht nach 3 Jahren

CORT has been developed to treat recurrent gynaecological malignancies infiltrating the pelvic wall unilaterally. The surgical part consists of: (i) staging laparotomy/lymphadenectomy, (ii) maximum tumour resection at the pelvic wall and exenteration of infiltrated central pelvic organs, (iii) implantation of guiding tubes on the residual tumour/tumour bed on the pelvic wall, (iv) pelvic wall plasty with muscle, musculocutaneous and omentum flaps, (v) operative reconstruction of bowel, bladder and perineo-vulvo-vaginal functions. Radiation is performed as interstitial high dose rate brachytherapy through the implanted tubes. Patients without prior pelvic irradiation receive in addition, who…

Metabolic changes in the rat liver during pregnancy

During pregnancy the rat liver shows alterations in metabolism which apparently do not to occur in the non-pregnant animal. In our study, the following metabolite concentrations and enzyme activities in the liver of pregnant and non-pregnant rats were measured after fasting periods of 6 and 12 h: malate, fumarate, isocitrate, alpha-keto-glutarate, glutamate, malate-dehydrogenase, fumarate-hydratase, glutamate-dehydrogenase, isocitrate-dehydrogenase, aspartate-aminotransferase and after 12 h fast, the concentrations of acetyl coenzyme A and citrate. These results are discussed with regard to their possible importance for the maternal and fetal energy supply.

Eine neue experimentelle Methode zur Behandlung von Beckenwandrezidiven gynäkologischer Malignome

Pelvic side wall recurrences of gynecological malignancies subsequent to primary or adjuvant radiation therapy have a bad prognosis, although in almost half of the cases, distant metastases are not present at the time of diagnosis of the local tumor progression. A radical operative resection of the pelvic wall recurrence is rarely possible and a second conventional percutaneous or intracavitary irradiation with a tumoricidal dose is no longer feasible, because of the limited radiation tolerance of the surrounding pelvic tissue. The different forms of chemotherapy applied at present are not curative. Based on considerations of tumor and radiation biology, we propose a new experimental treatm…