Langenbecks Archiv für Chirurgie
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Langenbecks Arch Chir · Jan 1996
[Tumor cell dissemination in bone marrow and peritoneal cavity. An immunocytochemical study of patients with stomach or colorectal carcinoma].
The tumor spread and the radicality of surgical resection are the most important facts in a patient's prognosis. In spite of curative tumor resection many patients die from metastases or local tumor recurrence. One possible reason is early dissemination of tumor cells which cannot be detected with clinical methods of examination. ⋯ In bone marrow there was a good correlation of tumor cells with staging, but in peritoneal lavage fluid this was not so. Finally, we detected tumor cells more often in bone marrow and peritoneal lavage fluid of patients with poorly differentiated tumors (G3) or diffuse Lauren type than in patients with moderately differentiated tumors (G2) or intestinal Lauren type. After a median follow-up period of 12.5 months patients with disseminated tumor cells had a lower survival rate than patients without tumor cells.
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Carcinomas, mainly of the squamous cell type, may occur in burn scars from 3 months to 75 years after the burn injury, and they have a poor prognosis. Therefore, unstable scars, chronic ulcers and tumors must be subjected to histological examination as soon as possible. If a malignant tumor is present, the therapy of choice is wide local excision, though in the event of progressive tumor development an ablative procedure may be necessary. ⋯ Unstable scars should be investigated to allow prophylactic surgery to be performed if appropriate [4]. Early mobilization of the (mostly elderly) patients is important. Three case reports of patients with burn scar carcinoma are presented.
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Langenbecks Arch Chir · Jan 1995
[Pathologic fractures: diagnostic and therapeutic considerations and results of treatment].
Compared with bone fractures caused by trauma, pathologic fractures due to diseased bone are rare events. A pathologic fracture is one that occurs without adequate trauma and is caused by a benign or malignant bone lesion. Diagnosis of the basic disease is important for the subsequent therapy. ⋯ In 55 patients with fractures in the area of benign bone lesions complete healing was achieved, in 9 cases with conservative therapy. The rate of recurrence for solitary bone cysts treated by curettage or segment resection was 23.5%. Compared with the recurrence rates published by other authors this is a very good result.
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Langenbecks Arch Chir · Jan 1995
Randomized Controlled Trial Clinical TrialEffects of ozone on how well split-thickness skin grafts according to Thiersch take in war wounds. Results of prospective study.
In a prospective study on 35 wounded persons we examined the effects of ozone on how well split-thickness skin grafts took in war wounds. Each of the 35 wounded persons hat at least two similar gunshot wounds, one on the lower leg or forearm and the other on the upper leg or upper arm. During the first 10 days all wounds were treated with 10% NaCl water solution dressings until the moment when healthy granulations were observed. ⋯ More than 74.3% of the split-thickness skin grafts treated with ozone had a take of more than 75% of the covered surface as apposed to only 40% of the grafts treated with the conventional method. The results in these two groups were compared with a chi square matched pair test. Difference in take of the skin grafts in these two groups was statistically significant at P < 0.01.