J Giedl’s research while affiliated with Universitätsklinikum Erlangen and other places

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Publications (30)


Knotenbildungen in Basedow-Strumen aus Jodmangelgebieten
  • Chapter

December 1990

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1 Read

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1 Citation

J. Marienhagen

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W. Becker

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[...]

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F. Wolf

Polypoide Läsionen der Gallenblase [Polypoid lesions of the gallbladder].

March 1990

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9 Reads

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17 Citations

Deutsche Medizinische Wochenschrift

Ultrasound examination of the gallbladder was performed in a prospective study (from 1985 to 1988) of 14,841 consecutive patients. Polypoid changes were found in 224 (129 men, 95 women; mean age 54 [18-88] years), sonographically classified as cholesterol polyps in 212, as polypoid lesions of uncertain benignity in 12. Mean observation time of 92 patients with cholesterol polyps was 9 (3-48) months. In six the polyp diameter increased by up to 5 mm: only two of them were operated upon and the diagnosis was confirmed in both. A total of 21 patients suspected of having cholesterol polyps were operated upon, the diagnosis confirmed in 17, chronic cholecystitis in two and, in one case each, thickened wall-adherent bile or wall-adherent concrements as cause of the ultrasound changes. Six of the 12 patients with polypoid lesions of uncertain benignity were operated upon: two had an adenoma, one each had tissue heterotopy, malignant melanoma metastasis, gall-bladder carcinoma and adenomyomatosis.


Two Programmes for Examination of Regional Lymph Nodes in Colorectal Carcinoma with Regard to the New pN Classification

January 1990

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12 Reads

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59 Citations

Pathology - Research and Practice

The new pN classification for colorectal carcinoma requires not only a statement on absence or presence of regional lymph node metastases but also, if present, a knowledge of the site and number of involved nodes. Subdivision of the fatty tissue with nodes adhering to the tumor resection specimen into two compartments is therefore the first step in pathological examination of lymph nodes. The methods for this as well as the different techniques used in searching for nodes and further histological processing of nodes are presented. We outline a minimal programme for pN classification in which step-wise sequence of examination reduces work load. An extended programme designed to answer special questions regarding lymphatic spread and surgical method is recommended only within the framework of special clinico-pathological studies.



Polypoide Läsionen der Gallenblase [Polypoid lesions of the gall bladder]

January 1990

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598 Reads

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25 Citations

Deutsche Medizinische Wochenschrift

In einer prospektiven Studie wurde zwischen 1985 und 1988 bei 14 841 konsekutiven Patienten eine sonographische Untersuchung der Gallenblase vorgenommen. Bei 224 Patienten (129 Männer, 95 Frauen, mittleres Alter 54 [18-88] Jahre) wurden polypoide Veränderungen der Gallenblasenwand gefunden. Davon wurden 212 aufgrund sonographischer Kriterien als Cholesterolpolypen bezeichnet und die übrigen zwölf als polypoide Läsionen unklarer Dignität. 92 Patienten mit Cholesterolpolypen wurden im Mittel 9 (3-48) Monate beobachtet. Bei sechs nahm der Durchmesser der Polypen um bis zu 5 mm zu. Nur zwei von ihnen konnten operiert werden, bei beiden wurde die Diagnose bestätigt. Insgesamt wurden 21 Patienten mit der Verdachtsdiagnose Cholesterolpolyp operiert. In 17 Fällen wurde die Diagnose bestätigt, in zwei Fällen bestand eine chronische Cholezystitis, und in je einem Fall war eingedickte wand-adhärente Galle oder wand-adhärente Konkremente Ursache der sonographischen Veränderungen. Von den zwölf Patienten mit polypoiden Läsionen unklarer Dignität wurden sechs operiert. Dabei fand sich in zwei Fällen ein Adenom, in je einem Fall eine Gewebsheterotopie, eine Melanom-Metastase, ein Gallenblasenkarzinom und eine Adenomyomatose.


[Malignant somatostatinoma of the papilla major and minor]

December 1989

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7 Reads

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6 Citations

DMW - Deutsche Medizinische Wochenschrift

Bei einem 50jährigen Patienten mit extrahepatischer Cholestase und Eisenmangelanämie konnte ein 4 cm großer submuköser Tumor der Papilla major nach lokaler chirurgischer Exzision histologisch und immunzytochemisch als Somatostatinom identifiziert werden. Bei der nachfolgenden Duodenopankreatektomie wurden im Resektat noch zusätzlich eine Lymphknotenmetastase und ein 5 mm großes Somatostatinom der Papilla minor nachgewiesen. Unter einer Substitutionstherapie mit Pankreasenzymen ist der Patient inzwischen seit 12 Monaten beschwerdefrei.


Tissue reactions under piezoelectric shockwave application for the fragmentation of biliary calculi

June 1989

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9 Reads

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45 Citations

Gut

The tissue reactions that occurred during piezoelectric shockwaves for the fragmentation of biliary calculi were investigated in 10 surgically removed stone containing human gall bladders and in acute (six dogs) and chronic (six dogs) animal experiments. Before and after shockwave (500, 1500 or 3000) in the anaesthetised dogs, computed tomography (CT), magnetic imaging (MRI) and laboratory tests were done; treatment was carried out under continuous ultrasonographic control. Shockwave applications to the human gall bladders resulted in disintegration of the stones with no macroscopically or microscopically detectable tissue changes. In acute animal experiments, small haematomas were observed in all six animals at surfaces, but also inside the liver and gall bladder (max diameter 25 mm). Perforation or intra-abdominal or pleural bleeding did not occur. In chronic experiments, no macroscopic, and only slight microscopic residual lesions (haemosiderin deposits) were seen three weeks after shockwave. In almost all instances, the lesions were detected by CT, MRI, and ultrasonography, while laboratory tests were negative.


[The prognostic value of the new pTNM classification and staging of kidney cancers]

February 1989

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3 Reads

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1 Citation

Verhandlungen der Deutschen Gesellschaft für Pathologie

In comparison with the former pTNM classification of renal cell carcinoma, the 1987 edition is characterized by a simplification of the classification by inclusion of venous invasion (former separate V classification) into pT and an advantage in estimating prognosis by the new pN classification. The new defined stages are well correlated with survival. On the basis of the presented survival data the criticism of the new TNM/pTNM by the EORTC-GU group can be rejected.


Verrucous Carcinoma of the Esophagus

December 1988

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8 Reads

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20 Citations

Endoscopy

The special problems involving the histopathology of verrucous carcinoma of the esophagus are presented on the basis of two patients with this tumor seen at our department. The discussion centers on the question whether a verrucous carcinoma of the esophagus can infiltrate the basal membrane and give rise to metastases.


[News on the surgical pathology of colorectal cancer]

July 1988

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6 Reads

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12 Citations

Wiener Medizinische Wochenschrift

The incidence of regional lymph node metastases in colorectal carcinoma is influenced primarily by depth of invasion, but also by histological grade of malignancy and histologically demonstrable invasion of lymphatics. With regard to the indication for limited treatment of colorectal carcinoma, a differentiation between high risk and low risk tumors is recommended. In 6% of tumors with regional lymph node metastases only micrometastases are observed whose prognostic significance is not yet established. In most cases, lymphatic spread occurs regularly, in conformity with the anatomical situation, skipping of lymph nodes in less than 2% of cases with lymph node metastasis can be observed. The incidence and topography of lymph node metastases are important for the choice of surgical procedures. Because of the observed behaviour in lymphatic spread extended hemicolectomies are recommended for tumors of the transverse colon and the colonic flexures. The surgical treatment of rectal carcinoma should include the systematic node dissection along the inferior mesenteric artery.


Citations (11)


... Gallbladder polyps (GP) are a frequent finding on abdominal ultrasonography, occurring in as much as 4.5% of the adult population. 1,2 Although most are thought to have no malignant potential, a minority (ie, 4%-10%) are adenomas, which do have malignant potential. 3,4 Surgical series indicate that the size of polyp is the major risk factor for malignancy, with adenomatous polyps of 10 mm and larger having a 37% to 55% chance of malignancy. ...

Reference:

Outcomes of Gallbladder Polyps and Their Association With Gallbladder Cancer in a 20-Year Cohort
Polypoide Läsionen der Gallenblase [Polypoid lesions of the gall bladder]
  • Citing Article
  • January 1990

Deutsche Medizinische Wochenschrift

... 18 Las lesiones menores a cinco milímetros de diámetro usualmente son benignas y representan colesterolosis, por lo que no está indicada colecistectomía y sí seguimiento por USG. [1][2][3][4][5]9 conclusIones La prevalencia de poliposis vesicular en nuestro hospital está dentro de los rangos estimados a nivel mundial. Sin embargo, la prevalencia de cáncer secundario a poliposis en este estudio se encuentra muy por debajo de lo esperado. ...

Polypoide Läsionen der Gallenblase [Polypoid lesions of the gallbladder].
  • Citing Article
  • March 1990

Deutsche Medizinische Wochenschrift

... Synchronous tumors affecting both the ampulla of Vater and the minor papilla are rare. Most of the cases reported are somatostatinomas [3,4]. Only one report is available establishing the synchronous occurrence of adenocarcinomas in the major and minor papilla [5]. ...

[Malignant somatostatinoma of the papilla major and minor]
  • Citing Article
  • December 1989

DMW - Deutsche Medizinische Wochenschrift

... However, there is a tendency for higher number of retrieved nodes to be associated with increased incidence of nodal positivity. As was demonstrated in the study of node examination techniques, the fat-clearance technique enables upstaging of more than 50% of stage II cases to stage III, by allowing the identification and examination of previously undetected LNs.14 Therefore, there is a potential for stage migration when an inadequate number of LNs is harvested. ...

Two Programmes for Examination of Regional Lymph Nodes in Colorectal Carcinoma with Regard to the New pN Classification
  • Citing Article
  • January 1990

Pathology - Research and Practice

... There have been occasional reports of potentially life-threatening subcapsular hemorrhage and perirenal hematoma, urosepsis, venous thrombosis, biliary obstruction, intestinal perforation, lung damage, aortic aneurysm rupture, intracranial hemorrhage, pneumonia, cardiac arrhythmia and acute pancreatitis. [4][5][6][7][8][9][10][11][12][13][14][15] The incidence of these major complications is less than 1%. The incidence of acute pancreatitis developing post-ESWL has been reported as 0.4 to 0.7% in the literature. ...

Tissue reactions under piezoelectric shockwave application for the fragmentation of biliary calculi
  • Citing Article
  • June 1989

Gut

... The holmium laser wavelength can be delivered through conventional, low-hydroxyl silica optical fibers, which are mass-produced for use in telecommunications and industrial applications, making them cost-effective as a disposable, single-use, medical fiber-optic delivery system [56]. Nd:YAG lasers were first applied in endoscopic retrograde surgeries in 1986 [57]. Currently, the 2100-nm holmium: YAG laser is the gold standard for laser lithotripsy because it can target all stone compositions in the urinary and biliary systems [58,59]. ...

Laser Lithotripsy of Gallstone by Means of a Pulsed Neodymium-YAG Laser - In Vitro and Animal Experiments
  • Citing Article
  • June 1986

Endoscopy

... The first successful liver resection for metastatic colorectal cancer (mCRC) was performed in 1943. 1 However, despite this and the modifications to the original Dukes' classification 2 made by Astler and Coller in 1954, clinicians continued to group all CRC patients with distant metastases within an allencompassing group D. 3 Furthermore, the introduction and adoption of clinicopathological TNM staging by the American Joint Committee on Cancer (AJCC) in 1957 did nothing to alter the perception of the outcome for patients with distant metastases, stage IV simply replacing Astler-Coller stage D and including patients with any T stage, any N stage, and at least one metastatic site (M 1 ). ...

[News on the surgical pathology of colorectal cancer]
  • Citing Article
  • July 1988

Wiener Medizinische Wochenschrift

... Although verrucous carcinoma of the esophagus tends to be present for months to years before diagnosis and appears deceptively benign histologically, the first reported cases were generally associated with a poor prognosis. Of the first 14 reported cases, the patients' survival ranged from a short number of days to months, with only two patients surviving more than one year (1)(2)(3)(4)(5)(6)(7)9). The most common causes of death were respiratory failure related to esophagobronchial fistula and local recurrence. ...

Verrucous Carcinoma of the Esophagus
  • Citing Article
  • December 1988

Endoscopy

... This alternating hyperechoic and hypoechoic layers on abdominal US is called the "gut signature". 20,21 The appearance of these five layers depends on the resolution of the probe, the quality of the sonogram, and the depth of the gut being studied. In neonates, three layers are more easily discernible, the most prominent being the hypoechoic ...

Experimental Investigations into the Possibility of Differentiating Early from Invasive Carcinoma of the Stomach by Means of Ultrasound
  • Citing Article
  • December 1987

Endoscopy

... It has been suggested that the thin mucosa overlying a pulsating artery is eroded progressively by the mechanical pressure from the abnormal vessel [5]. Lesions of similar morphological and histological features have been found in the distal esophagus [6], the duodenal bulb [7], the jejunum [8,9], the colon [10][11][12], and the rectum [13,14]. Different theories were postulated about the etiology of that lesion and if it can be congenital or acquired vascular malformation but it is thought that the artery protrudes through a solitary, tiny mucosal defect (2-5 mm), commonly in the upper part of the stomach [15,16]. ...

Colonic Haemorrhage from Solitary Submucosal Vessels Diagnosed by Lower Gastrointestinal Doppler-Endoscopy
  • Citing Article
  • February 1987

Endoscopy