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A Schlichter

Publications and source records attributed to A Schlichter.

32 records · Page 2Linked to original sources
PubMed1997

Serum transforming growth factor-beta1 in patients with renal cell carcinoma.

PURPOSE: A major problem of renal cell carcinoma is the prediction of metastases via tumor prognostic markers. Therefore, much effort has been committed to the development of new prognostic markers. MATERIALS AND METHODS: The level of transforming growth factor-beta1 was measured by enzyme-linked immunosorbent assay in serum samples collected from patients with renal cell carcinoma before radical nephrectomy. RESULTS: In serum samples from 21 patients with renal cell carcinoma and 21 healthy controls mean transforming growth factor-beta1 levels were 177 +/- 54.1 versus 65.6 +/- 15.8 ng./ml., respectively. This difference was statistically significant (Mann-Whitney U test p <0.001). CONCLUSIONS: Increased levels of transforming growth factor-beta1 are common in serum of patients with renal cell carcinoma.

Carcinoma, Renal Cell↗
PubMed1997

[Adrenal cortex insufficiency caused by metastatic tumors].

Clinical features and the management of adrenal insufficiency are considered with reference to etiology, diagnosis, and treatment. Specifically considered are the management of patients with Addison's disease and metastases. Adrenal insufficiency may go unrecognized in the cancer patients because features such as nausea, vomiting, anorexia as well as orthostatic hypotension are not specific and may be mistakenly attributed to advancing malignancy or side effects of therapy. Prompt recognition and treatment of adrenal insufficiency can avert potentially life-threatening situations.

Addison Disease↗
PubMed1996

Changes in telomere lengths in renal cell carcinomas.

Telomeres, the extreme ends of chromosomes, play an important role in chromosome structure and function. The shortening of telomeres is one of the supposed mechanisms of cellular aging and death. Because of end replication problems the length of telomeres decreases with every cell cycle. This may lead to chromosome instability and additional genetic alterations possibly responsible of significant tumor development. In many cancer cells the length of telomeres depends on a balance between the loss of telomeric repeats, at each replication cycle, and the telomere lengthening, by the enzyme telomerase, which is repressed in most normal somatic cells. Many tumor cells demonstrate shortened telomeres in comparison to the corresponding normal tissue. In some types of human cancers the reduction of telomeric repeats was correlated with increasing disease severity. We analyzed Southern blots of HINF1-digested DNA of a large number of renal cell carcinomas (RCC) including different tumor areas, secondary tumors and metastases (76 cases with 142 tumor samples) for changes in the length of telomeric repeats using the oligonucleotide probe (TTAGGG)3 and found telomere shortening in 54%, suggesting that a reduction of the telomeric repeat length is not a general characteristic in RCC. Intratumor heterogeneity was demonstrated in seven cases. But also two RCC, with elongated telomeres in the tumor tissue, were observed. Shortened telomeres do not seem to be associated with advanced stages of tumor development or specific histopathological subtypes of RCC.

Adult↗
PubMed1996

[Cyto- and molecular genetic studies of renal cell carcinoma with special reference to multifocal carcinoma lesions].

In 86 consecutive radical nephrectomies we found in 12 kidneys (13.8%) a total of 17 multicentric foci of carcinoma. Beside the usual histopathological investigations we performed in seven secondary tumors further cyto-and molecular genetic analyses. The structural and/or numerical chromosome aberrations in the small secondary tumors were similar to the changes in the main tumors. We conclude that these foci have malignant potential. In eight of these results and the multicentricity that was found, we continue to recommend elective radical nephrectomy in renal cell carcinoma.

Aged↗
PubMed1991

Lonidamine versus high-dose tamoxifen in progressive, advanced renal cell carcinoma: results of an ongoing randomized phase II study.

Sixty patients with metastatic renal cell carcinoma were entered into an ongoing randomized phase II study with lonidamine, 350 mg/m2 orally daily (arm A) and high dose tamoxifen, 150 mg/m2 orally daily for 6 months, afterwards 50 mg/m2 (arm B), until tumor progression. All patients had measurable disease and documented tumor progression prior to treatment. There were 1 complete and 1 partial remission among 19 evaluable patients in arm A (10.5%) and 2 complete and 1 partial remission among 25 evaluable patients (12%) in arm B. Objective responses were observed in pulmonary, nodal, and cutaneous metastases. In addition, in 63% and 64% tumor progression could be stopped in arm A and B, respectively. Median response duration was 100 days (range, 20-361) in arm A and 150 days (range, 28-355) in arm B. One year survival rate was 37.5% with lonidamine and 35% with tamoxifen. In arm A patients with tumor progression within 12 weeks after diagnosis of metastatic disease survived significantly shorter than patients with a longer interval (P less than 0.05). Nephrectomy or number and localization of metastatic sites failed to significantly influence probability of remission or survival. Toxicity was mostly mild to moderate. Four patients in the lonidamine arm had to discontinue treatment because of intolerable myalgias, which were immediately reversible. These data suggest that lonidamine and high-dose tamoxifen are moderately effective in widespread renal cell carcinoma where treatment intention is palliative.

Adult↗
PubMed1990

Glycose aminoglycane excretion and concentration in the urine of patients with frequently recurrent calcium-oxalate lithiasis prior to and following Diclofenac-Na therapy.

Excretion and concentration of glycose aminoglycans were measured in 19 patients with frequent relapses of calcium-oxalate lithiasis, prior to and two weeks after onset of Diclofenac-Na therapy. In most patients, markedly enhanced glycose aminoglycan concentration and excretion could be demonstrated. Elevation of the high-molecular inhibitor potential in the urine results in reduced risk of calcium-oxalate lithogenesis, which may explain the therapeutic success of nonsteroidal anti-inflammatory drugs in the treatment of therapy resistant calcium-oxalate lithiasis.

Calcium Oxalate↗
PubMed1990

[Urinary calculus protective side effects of anti-rheumatic therapy].

In a retrospective study two patient groups suffering from recurrent calcium oxalate lithiasis are compared before and after antirheumatic therapy using Diclofenac-Natrium alone or in combination with xanthine oxidase inhibitors and/or hydrochlorothiazides. The examination of concentration and excretion of lithogenic important parameters show a partly significant reduction of the concentration mean values of calcium, oxalic acid and uric acid. The influence of non-steroidal antiphlogistics (NSAP) on calculus recurrence rate in calcium oxalate lithiasis is recognized.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Cavo atriopulmonary anastomosis via a nonprosthetic medial tunnel.

A surgical technique is described to perform a total bypass of the venous ventricle (TBPVV) via a cavo atriopulmonary anastomosis wherein a medial atrial tunnel is constructed using autologous tissue. The procedure offers the advantage of maintaining low atrial pressure at the sinus node area without the use of prosthetic material. It also represents a good method for conversion of a bidirectional Glenn to a TBPVV avoiding surgical damage of the sinus node area.

Anastomosis, Surgical↗
PubMedDate not supplied

Differentiation of multifocal renal cell carcinoma by comparative genomic hybridization.

Multifocality occurs in 12-22% of all renal cell carcinoma (RCC) cases. In order to differentiate multifocal RCC, we performed comparative genomic hybridization (CGH) and correlated the results with histopathological and clinical data. After histopathological examination of multifocal tumors, tumor areas were dissected from histopathological sections. Isolated DNA was amplified by DOP-PCR. CGH was performed according to standard protocols. Twenty cases were analyzed. In eight cases, at least one identical aberration was detected in the related tumors. Another eight cases showed different chromosomal changes in tumors of the same kidney. In the small additional clear cell tumors typical genetic alterations of clear cell carcinomas were detected whereas in the chromophilic tumors aberrations characterizing both adenomas and carcinomas were found. From these results we conclude that multifocal RCC represents a heterogeneous group of tumors. The malignant potential of small additional tumors in multifocal RCC cannot be excluded.

Carcinoma, Renal Cell↗
PubMedDate not supplied

The histopathological heterogeneity of small renal cell carcinoma.

BACKGROUND: Renal tumors resembling renal cell carcinoma but less than 3 cm in diameter historically have been regarded as adenomas because of their low frequency of metastases. However, this concept has been challenged, and it seems that all of these lesions should be considered carcinomas. Thus, the extent of radical surgery of these findings have been reconsidered, in view of the uncertainty regarding their malignant or benign nature. MATERIALS AND METHODS: 107 tumors 40 mm or less in diameter were accordingly divided into three groups and clinico- and histopathological criteria were correlated: group 1: 20 mm or less (n = 33), group 2: 21-30 mm (n = 28) and group 3: 31-40 mm (n = 43). RESULTS: Both lymph node metastases and distant metastases were well correlated with tumor size. Grade 1 renal cell carcinomas decreased in their frequency with an increasing tumor diameter. In grade 3 carcinomas an opposite result was found. With an increase of tumor size the frequency of venous involvement increases as well. Significant more multifocal malignant renal cell carcinoma were seen in renal cell carcinoma between 21-40 mm compared to tumors 20 mm or less in diameter. CONCLUSION: Although the metastatic potential and the biology of small renal tumors are not yet known, it seems that nephron-sparing surgery in patients with renal cell carcinoma more than 20 mm in diameter should only be performed when there is an absolute indication, such as bilateral carcinomas, single kidney or renal failure. The problem is that a long-term follow-up study is mandatory to justify partial nephrectomy as a nephron-sparing operation for renal cell carcinoma more than 20 mm in patients with normal function of the contralateral kidney.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

[Evaluation of the complications of different types of right ventricular bypass by contrast echocardiography].

We evaluated 54 patients with different right heart by-pass by means of contrast echocardiography with rapid venous injection of shaken saline (3 cc, < 20 k; 6cc, > 20 k), in order to detect venous collateral circulation in partial by-pass, pulmonary arteriovenous fistulae in partial and total by-pass, and right-to-left shunt in total by-pass. Forty three patients had partial by-pass: 29 had a bidirectional cavopulmonary anastomosis with additional pulmonary flow (systemic-pulmonary anastomosis and/or restrictive anterograde ventricular flow); 10 had a partial ventricular correction (bidirectional cavopulmonary anastomosis and non restrictive anterograde ventricular flow; two had classical Glenn procedures; two had Kawashima operations (bidirectional cavopulmonary anastomosis and non restrictive anterograde ventricular flow; two had classical Glenn procedures; two had kawashima operations (bidirectional cavopulmonary anastomosis with inferior vena cava interruption), and 11 with total by-pass (10 atriopulmonary anastomosis and 1 with total cavopulmonary anastomosis). The age ranged from 2.5 to 33 years (x = 12.2 years), and the mean postoperative period was 4.3 years. Venous collateral circulation: 32/43 patients (74%) with partial by-pass, specially in those without partial biventricular correction: 29/33 patients (88%) compared to those with partial biventricular correction: 3/10 (30%) p < 0.01. Pulmonary arteriovenous fistulae: 6/43 patients (14%) with partial by-pass; 6/33 (18%) with partial biventricular correction, 0/10 patients with partial biventricular correction, and 0/11 with total by-pass. Right-to-left shunt: 2/11 patients (18%) with total by-pass, all of them with atriopulmonary anastomosis. Contrast echocardiography is an excellent noninvasive method for the initial evaluation of specific dysfunctions of different right heart by-pass. We emphasize the higher frequency of collateral venous circulation in cavopulmonary anastomosis, that would explain the dysfunction with progressive hypoxia in the evolution of these patients. Pulmonary arteriovenous fistulae were detected only in partial by-pass, without partial biventricular correction (p < 0.01). The minor frequency of these fistulae in bidirectional cavopulmonary anastomosis would be due to additional pulmonary flow.

Adolescent↗