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Biomedical subjects

B Schmitz-Dräger

Publications and source records attributed to B Schmitz-Dräger.

12 recordsLinked to original sources
PubMed2000

Use of markers in defining urothelial premalignant and malignant conditions.

Markers have revealed the presence of phenotypically abnormal areas in histologically benign urothelium in bladders containing transitional cell carcinomas. This finding strongly suggests that at least some bladder cancers are associated with changes in the field and that markers can detect these lesions before they reach a grossly malignant stage. Markers have been used clinically for the detection of cancer in patients who are under regular surveillance for recurrence of bladder cancer. Much less information is available regarding the use of markers to detect bladder cancer without a prior history of the disease and for the prediction of which tumors are biologically more aggressive. However, ongoing clinical trials are addressing the latter issue. The type of specimen and its preparation will determine what type of markers can be analyzed. Although marker performance is based upon sensitivity and specificity, the prevalence of bladder cancer in the population being tested will dramatically affect the positive predictive value of an assay. Markers with high positive predictive value are indicators for interventions, such as biopsy, while markers with high negative specific values are useful for avoiding interventions. Cytology is used to detect occult high-grade neoplasms such as carcinoma in situ. While not yet clinically validated, tests with high negative predictive value could be used to decrease the frequency of cystoscopic evaluation. Markers must be validated by testing them prospectively using previously defined cut-off values. Furthermore, markers that will be used to alter treatment should be tested prospectively to determine the safety and cost-effectiveness of this strategy. Recommendations for future work include: (1) evaluation of markers in patients with dysplasia defined by the current pathologic classification; (2) evaluation of markers as indicators of tumor recurrence; (3) evaluation of markers as indicators of tumor progression; and (4) evaluation of markers in chemoprevention studies.

Biomarkers, Tumor↗
PubMed1999

[Reconstructive surgery of the efferent urinary tract in pelvic exenteration of gynecological tumors].

In locally advanced or recurrent tumors of the female genital tract anterior or total exenteration may be mandatory in case of tumor invasion into the lower urinary tract or if a second course of radiation therapy is not feasible. The management of resection and reconstruction of the affected lower urinary tract has to be well integrated into the gynecological therapeutic concept. In 11/32 patients the reconstruction of the partially resected lower urinary tract was feasible with preservation of a functionally intact urinary bladder. Urinary diversion following pelvic exenteration was achieved in 13/17 patients with a continent urinary reservoir and in 4/17 patients with an ileal conduit. Operative reinterventions were needed only in patients with continent urinary diversion in 5 cases. All these patients had a past history of primary radiation therapy of their gynecological tumor. In the remaining other 11 patients with a history of primary radiation therapy no complications occurred. 9 of 32 patients survived the operative procedure 40.8 (25-57) month with no evidence of recurrent tumor. Continent urinary diversion represents an excellent therapeutic option for replacement of function lost due to exenterative pelvic surgery. Stringent selection of patients is mandatory to consider the presented therapeutic concept a reasonable tool in the management of the described clinical situations.

Adult↗
PubMed1995

Angiocentric lymphoma of the kidney in the acquired immunodeficiency syndrome.

Angiocentric lymphoma, which is the malignant counterpart of angiocentric immunoproliferative lesions, comprises a rare group of non-Hodgkin's lymphomas of T-cell origin. It is characterized by marked invasion and destruction of small vessels by lymphomatoid cells, predominantly in the lungs. The prognosis is poor and many patients die within several months. To our knowledge primary involvement of the genitourinary tract has not been previously reported. We report a case of a solitary primary angiocentric lymphoma of the kidney in a patient with the acquired immunodeficiency syndrome. Therapy consisted of nephrectomy without adjuvant treatment. Histological characteristics as well as diagnostic and therapeutic options are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1995

High-intensity focused ultrasound (HIFU) in the treatment of benign prostatic hyperplasia (BPH).

Transurethral resection of the prostate (TURP) and open adenectomy are regarded the golden standard in the management of patients with symptomatic benign prostatic hyperplasia (BPH). Various alternative treatment forms (microwaves, laser, radiofrequency, focused ultrasound) have been introduced recently. They all aim at reduction of morbidity related to TURP keeping a comparable efficacy at the same time. Since December 1992, 50 patients with BPH have been treated by high intensity focused ultrasound (HIFU-P) at our department. Six weeks following HIFU-P mean Qmax improved from 5.7 ml/s to 11.6 ml/s. Post voiding residual volume (RV) dropped from 215 ml to 100 ml, the International Prostate Symptom Score (IPSS) from 19.8 to 9.9. Both, IPSS and RV further improved during the following weeks. Follow-up data one year after treatment demonstrate that results remained stable in the majority of patients. Urinary tract infections were observed in 3 patients, macrohematospermia in all and macrohematuria (caused by the suprapubic catheter) requiring blood transfusion in 1 patient.

Aged↗
PubMed1995

[High energy focused ultrasound in treatment of benign prostatic hyperplasia].

Transurethral resection of the prostate (TURP) and open adenectomy are regarded the "golden standard" in the treatment of benign prostate hyperplasia (BPH). Various alternative treatment forms (microwaves, laser, radio frequency, focused ultrasound) have been introduced recently. They are all aimed at reducing the morbidity related to TURP while achieving comparable efficacy at the same time. Since December 1992, 35 patients with BPH have been treated with high-intensity focused ultrasound (HIFU-P) in our department. By 6 weeks after HIFU-P, mean Qmax had improved from 6.5 ml/s to 12.1 ml/s. Residual volume dropped from 207 ml to 95 ml, IPSS from 20.1 to 9.7. Both subjective as well as objective improvements remained stable after 3 and 6 months. Urinary tract infections were observed in 3 patients, macrohemato-spermia in all, and macrohematuria (caused by the suprapubic catheter) requiring blood transfusion in 1 patient.

Aged↗
PubMed1994

Loss of heterozygosity at the NAD(P)H: quinone oxidoreductase locus associated with increased resistance against mitomycin C in a human bladder carcinoma cell line.

The human bladder carcinoma cell line RT112 and the mitomycin C-resistant cell line RT112MMC, derived from RT112 cells, were examined for their expression of NAD(P)H:quinone oxidoreductase (NQOR) and glutathione S-transferases (GSTs). RT112 cells were 40-fold more sensitive towards mitomycin C than RT112MMC cells. The NQOR mRNA level in RT112MMC cells was decreased to 15% as compared to RT112 cells. NQOR enzyme activity was 391 +/- 140 mU/mg protein in RT112 cells, whereas NQOR activity in RT112MMC cells was not measurable. As shown by a fast PCR-based assay and DNA-sequencing, the cell line RT112 is heterozygous, whereas RT112MMC is homozygous for a null allele of the NQOR gene without enzymatic activity. Accordingly, both wild-type and null allele mRNAs were present in RT112 cells, whereas only null allele mRNA was found in RT112MMC. The lack of NQOR enzyme activity in RT112MMC cells was thus associated with loss of heterozygosity at the NQOR locus. By a PCR-RFLP assay, three kidney carcinoma patients without measurable NQOR enzyme activity were shown to be homozygous for the null allele. The PCR assay described here is useful for examination of large numbers of samples. The relative amount of GST-Pi mRNA was decreased by 30% in RT112MMC as compared to RT112, contributing to a diminished level of GST enzyme activity, using CDNB as a substrate, from 95 +/- 62 mU/mg protein in RT112 to 26 +/- 6 mU/mg protein in RT112MMC.

Base Sequence↗
PubMed1990

Changes in erythropoietin serum levels by extracorporeal shock wave lithotripsy.

Erythropoietin (EPO) serum levels were measured in 30 patients before, during and immediately after shock wave treatment by an enzyme immunoassay. Shock wave treatment was performed in the Dornier lithotripter HM3 under a constant voltage of 18 kV. In 16 out of 30 patients, an increase in the EPO serum level of over 10 U/l more than the value obtained prior to the treatment was observed. Differences ranged from 11 to 50 U/l. In 3 patients EPO serum concentration after shock wave treatment rose above the physiological limit of 54 U/l. Increased EPO serum levels have been observed after applications both under and over 1,000 shock waves. The small number of cases does not allow a statistical correlation between the number of shock waves and the elevation of the EPO serum concentration. Further investigations are necessary to define the circumstances by which an increase in EPO serum level occurs under shock wave treatment.

Adult↗
PubMed1989

Prostatic carcinoma and benign prostatic hyperplasia: MR imaging with histopathologic correlation.

Twenty-eight patients with prostatic carcinoma who underwent magnetic resonance (MR) imaging and subsequent radical prostatectomy were studied. The resected prostates were sectioned axially, and the whole-mount prostatic specimen was compared with the corresponding MR images. The carcinoma could be identified in 20 cases (71%), but the tumor volume was underestimated in 12 patients (43%). In 19 of 20 visualized cases (95%), the carcinoma was seen as an area of low signal intensity within the peripheral zone on T2-weighted images. However, in one case the signal intensity of the carcinoma was higher than that of the remainder of the peripheral zone. All carcinomas were located within the peripheral zone. The accuracy of MR imaging in the prediction of extraglandular tumor spread was 82%, with a sensitivity of 37.5% and a specificity of 100%. Nineteen patients (67%) exhibited histologically benign hyperplasia, which could be identified on MR images in 10 cases (53%). The signal intensities of the nodules varied. All areas of benign hyperplasia were located within the central zone. The location of the pathologic changes must therefore be considered in differential diagnosis.

Adenocarcinoma↗
PubMed1989

[Magnetic resonance tomography of prostatic cancer. A histopathologic correlation].

A total of 52 patients with prostatic carcinoma were examined by MR imaging; 14 of them subsequently underwent radical prostatectomy and were included in this study. The resected prostates were sectioned axially and compared with the corresponding MR scans with special reference to the location and extent of the pathological changes. The prostatic carcinoma was visualized in 10 cases, but the size of the tumor was underestimated in 6 patients. In 9 of 10 patients the carcinoma was identifiable as an area of low signal intensity within the peripheral zone on T2-weighted images. The MR features of benign nodular hyperplasia are discussed.

Adenocarcinoma↗
PubMed1980

[Changes in the adaptation behavior in old age through piracetam intake (author's transl)].

The primary goal of all regulatory processes is to preserve the internal steady state. We summarize the elapsing mechanisms with the definition "adaptation". Statements about that without considering the vigilance are impossible. Adaptation and vigilance are closely related to each other. If the verified "Pirazetam" (Normabrain) influences the vigilance, it should be possible to proof changes in the adaptation, which according to hormonal results in insulin hypoglycemia might be registered. The behavior of cortisol ahd STH are the same before and after medication, however a significant higher noradrenalin secretion can be traced after treatment. This effect is rated as a positive influence of the medication on the suprarenal medulla, which on the contrary is regarded as a prolonged part of the brain.

Aged↗