Focal orchitis--a diagnostic dilemma.
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Adult↗
Biomedical subjects
C R Riedl
Publications and source records attributed to C R Riedl.
Prognostic value of prostate-specific antigen minimum after orchidectomy in patients with stage C and D prostatic carcinoma.
OBJECTIVE: To determine the significance of the minima of prostate-specific antigen (PSA) levels after orchidectomy in patients with advanced carcinoma of the prostate (stage C and D disease), to thereby discriminate patients who have a statistically significant difference in prognosis and thus individualize their adjuvant treatment. PATIENTS AND METHODS: A retrospective analysis of 50 patients (mean age 75.8 years) with extracapsular prostate cancer (58% stage C, 42% stage D disease) was performed. PSA measurement and clinical assessment were continued at 3-monthly intervals until there was evidence of clinical progression. The minimum values of PSA were determined, the patients grouped at intervals of 1 ng/mL and the groups compared statistically on the basis of disease progression. RESULTS: Serum PSA levels decreased in all patients to a minimum after 3-6 months. There was a statistically significant difference in the probability of, and time to, disease progression for PSA minima at 1 ng/mL and 10 ng/mL. Of the 13 patients in group 1 (with PSA minima < 1 ng/mL), 11 stayed in remission during a mean follow-up duration of 45.9 months. Of 25 patients in group 2 (with PSA minima between 1 and 10 ng/mL) 19 developed progression after a mean remission period of 16.7 months, while all 12 patients in group 3 (with PSA minima > 10 ng/mL) progressed after a mean remission period of 12.5 months. CONCLUSION: Post-orchidectomy PSA minima are an excellent prognostic factor with significant predictive value. While patients in group 1 tend to have a favourable prognosis after orchidectomy alone, group 2 and 3 patients need adjuvant treatment as early as possible. Group 3 patients, with their high probability of early progression, also form a uniform cohort for studies concerning new therapeutic modalities. If the PSA minimum was included in further examinations, the results of treatment should improve.
Aged↗
Laparoscopic hemi-nephrectomy in a horseshoe kidney.
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Adult↗
The effect of iontophoresis on bacterial growth in urine.
PURPOSE: To determine the effect of iontophoresis (electrical current for therapeutic purposes) on the growth of pathogenic bacteria in human urine. MATERIALS AND METHODS: Pathogenic bacteria were isolated and inoculated into a dynamic in vitro artificial bladder model. Pooled sterile human urine was regulated through the artificial bladder by intravenous tubing and pumps to simulate filling and emptying of the human bladder. The effect of electrical current on bacterial growth in the system was then studied. RESULTS: When iontophoresis is applied at low bacterial concentrations ( < 10(8) colony forming units [CFU]/l.), inhibition of bacterial growth occurs. However, when iontophoresis is applied after fulminant growth of bacteria ( > 10(8) CFU/l.), no inhibition of bacterial growth occurs. Iontophoresis was not found to enhance the antibacterial action of gentamicin to resistant Pseudomonas aeruginosa. CONCLUSIONS: Iontophoresis inhibits bacterial growth at low bacterial concentrations. It does not inhibit bacterial growth after infectious levels have been attained, and it does not potentiate the action of gentamicin on resistant Pseudomonas aeruginosa.
Equipment Design↗
[Asynchronous bilateral hydronephrosis in retroperitoneal fibrosis with an interval of 44 months].
The case of a man, now aged 53 years, with bilateral, asynchronous (44 months apart) hydronephrosis caused by retroperitoneal fibrosis is reported. A review of the literature with reference to the reported side effects of H2-antagonists (which the patient had taken immediately before developing the hydronephrosis) does not reveal any definite relation between the disease and these drugs. Stenosis and medialization of the middle third of the ureter (mostly bilateral) should suggest retroperitoneal fibrosis to the urologist, as early surgical treatment is mandatory to preserve renal function. Postoperatively, immunosuppression for at least 6 months is highly recommended to prevent recurrence.
Cimetidine↗
[Clinical efficacy and nephrotoxicity of gentamicin in single-dose parenteral administration of total individually adapted daily dosage].
The efficacy of gentamicin given intravenously once daily in a single, individually-adapted dose in form of a short infusion was confirmed in 30 patients with febrile urogenitary infections, taking nephrotoxicity into consideration. Antibiotic therapy was given for 7 days in each case, the individual dose of gentamicin being chosen from the dosage schedule according to Mawer. Depending on weight, age and renal function we used daily doses ranging from 160 to 480 mg (i.e. 2 to 5 mg/kg) of gentamicin. All patients were cured and all gram-negative bacteria were eliminated; no nephrotoxicity was recorded, as verified by constantly low serum levels of gentamicin (below the recommended peak level of 2 micrograms/ml) and non-significant changes in serum creatinine level. According to our results and to the findings of other investigations cited in the literature we conclude that in gentamicin therapy the once-daily individually--adapted intravenous dosage regimen is superior to to continuous administration by means of repeated daily doses with regard to efficacy and absence of nephrotoxicity.
Adult↗