Biomedical subjects

C Sparwasser

Publications and source records attributed to C Sparwasser.

At least 19 recordsLinked to original sources

PubMed2005

Gene expression profiling in seminoma and nonseminoma.

PURPOSE: Gene expression profiles of seminoma were compared with nonseminoma to get insights into tumorigenesis. MATERIALS AND METHODS: Eleven testicular tumor biopsies (five pure seminoma, six nonseminoma; pT1N0M0 to pT2N2M1) and biopsies from unaffected sites were analyzed once per patient using a macroarray (1,176 genes). On the same patients, six genes were validated using real-time quantitative (RTQ) polymerase chain reaction (PCR). Additionally, in a separate cohort of 19 patients, 24 genes selected from the macroarray were measured using RTQ-PCR. RESULTS: (1) The agreement in gene expression was 94% between the two methods and two different patient cohorts. (2) Two features in gene expression were independent of the tumor entity: Most changes of gene expression occurred in five functional groups like "cell cycle" and "apoptosis." Genes within these groups were almost similarly (> 80%) up- or downregulated. (3) Nonseminoma were characterized by downregulated genes (75%), but in seminoma, upregulated genes (64%) prevailed. Furthermore, 64.4% of those genes that were differentially expressed in both tumor entities were usually upregulated in seminoma but downregulated in nonseminoma. A reverse pattern was found in 24.4% of such genes. Eleven percent of these genes showed a similar up- or downregulation in gene expression in both tumor entities. CONCLUSION: Seminoma in this preliminary study can be differentiated from nonseminoma due to almost opposing gene expression profiles (89% of the significantly differentially expressed genes) and are in line with the histological discrimination of both tumor entities. Underlying mechanisms and implications regarding the origin and tumor progression of both entities are discussed.

Adolescent↗

PubMed2005

Metanephric adenoma of the kidney: case report and review of the literature.

Metanephric adenoma is a rare tumor of the kidney. So far metanephric adenomas were considered to be benign, slowly growing and non-metastasizing tumors with an excellent prognosis. Only recently two cases of metastasized metanephric adenomas were published. Therefore, diagnostic work up, therapy and follow up of this tumor have to be reassessed. We report the case of a 42 year old male with metanephric adenoma. Current literature concerning metanephric adenoma is reviewed.

Adenoma↗

PubMed2005

Apoptosis in non-tumorous adult human testis tissue. Comparison of so-called 'normal' testis tissues.

INTRODUCTION: Apoptosis seems to play an important role in tumorigenesis, prognosis and therapy of testicular tumors. To understand its biological significance, it is important to quantify the amount of apoptosis and to compare the rate of apoptosis to that of a normal, unaffected reference tissue. Usually tissue from the unaffected site of the testis in patients with testicular cancer or testis tissue from patients who underwent surgical castration due to prostate cancer is used as the reference tissue. However it is not known, if both tissues are equivocal with respect to their apoptotic index. The purpose of the study was to compare the two most often used reference tissues for the quantification of apoptosis in testicular tissues with regard to their apoptotic index. MATERIALS AND METHODS: The apoptotic indices of both tissues were compared, using two standard apoptosis detection methods, i.e. in situ end labeling and a morphological approach. RESULTS: The apoptotic index in testis tissue from patients who were surgically castrated for anti-hormonal treatment of prostate cancer was shown to be significantly higher than the apoptotic index of tumor free but tumor-associated testicular tissue of testis cancer patients. There was a strong relationship between the apoptotic index and the age of the patients. CONCLUSION: Although there might be genetic changes in the tumor-associated testicular tissue influencing the apoptotic index, it seems advisable to use tumor-associated tissue rather than testis tissue of patients with prostate cancer as the reference tissue, due to the significant age dependence of the apoptotic index.

Adult↗

PubMed2004

[Clarification of tissue contamination in a suspected adenocarcinoma of the spermatic cord by microsatellite analysis].

Malignant tumors of the spermatic cord are rare with primary neoplasms being mostly sarcomas. Adenocarcinomas of the spermatic cord are found extremely seldom and are predominantly metastases of extragonadal tumors. We present an asymptomatic 47-year-old patient who was referred to our clinic after a vasectomy had been performed and the histological examination had surprisingly shown adenocarcinoma of the left spermatic cord. Extensive laboratory analysis and diagnostic imaging did not demonstrate any testicular, spermatic cord, or extragonadal tumor. To exclude a mix-up of specimens, we performed DNA analysis. Microsatellite PCR clearly demonstrated the different origins of the tumor and the vasectomy specimen. Specimen mix-up or contamination may happen in any phase of surgical or pathological processing. In any case of clinical uncertainty concerning the identity of a tissue specimen, this possibility has to be taken into consideration. Microsatellite PCR can clearly identify the origin of tissue samples even on embedded material.

Adenocarcinoma↗

PubMed2004

Possible hemodynamic pathways of intraurethral prostaglandin-E1 (MUSE).

Intraurethral application of prostaglandin-E1 (MUSE) is a well-tolerated pharmacotherapy for erectile dysfunction. However, the physiological mechanisms of drug transfer into the cavernous bodies are not completely clear. Using spongiosography in 35 patients, our study tried to elucidate existing shunt mechanisms. The X-rays show venous drainage through the deep dorsal vein up to the plexus Santorini. The circumflex veins are also contrasted and the cavernous bodies show opacification in their distal portion only. Structures shunting directly between the corpus spongiosum and the cavernous bodies were not demonstrable. Retrograde filling of the cavernous bodies through the deep dorsal vein and its circumflex braches seems to be the most relevant way of drug transfer after intraurethral application of prostaglandin-E1. Diffusion into the cavernous bodies or a systemic mechanism of action does not seem probable.

Adolescent↗

PubMed2003

Significance of apoptosis in metastasizing testis tumors.

Testis tumors of embryonal origin (ten metastasized, six non-metastasized) and 17 mixed testis cell carcinomas (eight metastasized, nine non-metastasized) were examined. A triple immunofluorescence microscopic labeling procedure allowed the simultaneous detection of two features of apoptosis, namely morphological changes in the nucleus (DNA condensation visualized by DAPI staining) and the process of DNA fragmentation (TdT-assay) in tumor cells as well as T-cells (recognized by their CD45RO epitope). Both methods for apoptosis detection showed similar apoptotic indices (AI) only in 2.6% of all tumors. Most tumors (81.6%) showed more cells with DNA fragments than condensed chromatin, but in a number of cases (10.5%) the opposite pattern was found. These data add to the few published in vivo examinations of apoptosis using different methods and help to explain differences in the judgment of apoptosis significance for tumor prognosis. With regard to tumorigenesis, non-metastasized testis tumors were characterized by higher AIs of tumor cells and T-cells compared with metastasized tumors, which could be interpreted as a characteristic of tumors in an earlier stage of their development into an apoptosis-resistant phenotype. For the first time, in metastasized tumors a 5 to 25-fold increase of the T-cell's AIs over the corresponding AIs of tumor cells was shown. This suggests a successful counterattack of tumor cells, thus supporting the process of metastasis. However, only ten out of 33 tumors revealed these AI changes, which again highlights that tumor biology cannot be predicted by a single parametric approach. It remains to be seen whether these characteristics might be suitable for a reliable prediction of metastasis.

Adult↗

PubMed2002

[Intravesical migration of a polypropylene mesh implant 3 years after laparoscopic transperitoneal hernioplasty].

The repair of an inguinal hernia is the surgical procedure most often performed. Complication rates after laparoscopic hernioplasty amount up to 19%, with hematoma/seroma, neuralgia, urinary retention, and chronic pain most frequently reported. Significant complications such as trocar site bleeding or bowel injury occur in 0.4-5.6%, and sporadic intraoperative lesions of the bladder have been mentioned. We present a 48-year-old patient with recurrent dysuria 3 years after transabdominal preperitoneal hernioplasty (TAPP). The preoperative diagnostic evaluation led to the assumption of an intravesical mesh dislocation. In spite of extensive adhesions between the mesh and the bladder wall, the mesh including five fixation coils could be removed via a suprapubic access. The postoperative period was without complications, and the patient has no complaints. The incidence of complications after laparoscopic hernioplasty is low. Still, severe problems such as mesh rejection, spermatic granuloma, or mesh migration into the small and large intestine do occur. Migration of a mesh into the urinary bladder has only been described twice.

Cystoscopy↗

PubMed1999

Apoptosis in human embryonal cell carcinoma: preliminary results.

Disorders in the regulation of apoptotic cell death may contribute to cancer. Furthermore, lymphocytes are supposed to play a role in counteracting tumorigenesis by inducing apoptosis in different human tumors. In this study, for the first time, tumor cell and lymphocyte apoptosis were investigated systematically in human embryonal cell carcinoma. DNA fragmentation and DNA condensation were measured simultaneously on double-fluorescence-labeled testis tumor sections using immunofluorescence microscopy. Different apoptotic indices (AIs), based either on biochemical (DNA fragmentation) or morphological criteria (DNA condensation) alone or on a combination of both, were determined in different histological regions in and around the tumor. Using morphological criteria alone, 40-75% of all apoptotic cells were not detected. Based on previous observations this finding might be related to subsets of apoptotic cells which induce the process of DNA condensation without activation of processes responsible for DNA fragmentation. Moreover, the AIs of tumor cells and lymphocytes were highest in the tumor region, compared with regions around the tumor and distant from it; these findings are discussed in the context of the Fas/FasL system.

Apoptosis↗

PubMed1999

Modified approach for apoptosis detection reveals changes in apoptotic processes in the seminoma-associated tissue.

Apoptosis morphology (DNA condensation) and internucleosomal DNA cleavage (TdT assay) were measured simultaneously on double fluorescence labeled testis tumor sections, employing conventional immunofluorescence microscopy. Six different apoptosis indices (Al) were determined based either solely on morphological or biochemical criteria, or on a combination of both processes. Measurements were performed in metastasized and non-metastasized seminoma, and in histological regions located distantly and associated with the tumor. Preliminary results on 19 histologies revealed that up to 66% of apoptotic cells were not detected, depending on the method used for apoptosis detection. Besides, no changes of solely morphologically defined Al was found in the different histological regions. By contrast, significant changes (p < 0.0004) in the different histological regions were detected when measuring Als, e.g., defined by DNA fragmentation occurring without DNA condensation in apoptotic cells. Those changes were not detected in metastasized seminoma. These data, for the first time allow a comparison of two widely used approaches for apoptosis detection. Furthermore, the results revealed differences in apoptotic processes in tissue associated with non-metastasized seminoma detectable by a modified evaluated TdT assay but not by morphological changes, although this TdT method fails to show the total amount fo apoptotic cells.

Journal Article↗

PubMed1998

Intercomparison of apoptosis morphology with active DNA cleavage on single cells in vitro and on testis tumours.

Apoptosis morphology (DNA condensation) and endonucleolytical DNA cleavage (TdT assay) were measured simultaneously on double fluorescence labelled cells employing confocal laser scanning and conventional immunofluorescence microscopy. In vitro experiments on irradiated HL-60 cells revealed a high correspondence of non-apoptotic (normal) cells without detectable DNA cleavage, versus apoptotic cells and apoptotic bodies showing DNA cleavage. Experiments performed on histological slides of testis tumours reflected a heterogeneous picture: non-apoptotic (normal) cells, apoptotic cells, and apoptotic bodies appeared either with or without detectable DNA cleavage. These data allowed the characterization and quantitation of the grade of disturbance/heterogeneity of the apoptosis programme in vivo. Furthermore, the measured apoptotic index (AI) based on apoptosis morphology was lower than the AI assessed by DNA cleavage, in contrast to published work. Taken together, these methods represent a new approach and might be suitable for improved correlation with clinical parameters. In addition, the data presented confirm frequently published doubts regarding the ability of the TdT assay to detect apoptosis as defined by morphological criteria in tumours.

Apoptosis↗

PubMed1998

[Metastatic spread of renal cell carcinoma in the area of the ethmoid and frontal sinuses].

Metastatic lesions represent 1-8% of all malignant tumors of the mouth and jaws, with rare sites of metastasis originating from different primary tumors, especially the lung and breast. The vast majority of these lesions (up to 90%) have been observed in the mandible and maxilla (5-20%). Another rare type of cancer that usually metastasizes to the lungs, lymph nodes, bones, liver or brain may occasionally also show spread to the paranasal sinuses. In the present paper we report our management of a 50-year-old male with renal cell carcinoma who developed metastases to the frontal and ethmoid sinuses.

Carcinoma, Renal Cell↗

PubMed1998

Role of intracellular Ca2+ stores in smooth muscle of human penile erectile tissue.

OBJECTIVE: In human erectile tissue smooth muscle contraction and detumescence are highly dependent on an increase in cytosolic [Ca2+]. The Ca2+ influx can be derived from the extracellular space or from intracellular sarcoplasmic stores. The role of both pathways was evaluated in an organ bath study on human cavernosal strips. PATIENTS AND METHODS: The tissue was obtained from 12 patients with chronic erectile dysfunction. The effects of Ca2+-free solution, ryanodine, caffeine and of nifedipine on electrically and adrenergically induced contractions were evaluated. RESULTS: Following an incubation period of 10 min in Ca2+-free solution the electrically induced contraction was reduced to 20%, whereas the contraction induced by phenylephrine (PE) was only reduced to 64 +/- 6% (mean +/- SEM). Ryanodine inhibited the PE-contraction to 30 +/- 6% and the additional application of caffeine or nifedipine further reduced the contraction to 11% and 8%. CONCLUSION: The results give evidence for a role of intracellular Ca2+-stores in human cavernosal tissue. Whether the more marked effect of ryanodine in tissue from patients with erectile failure in comparison with similar experiments in rabbit cavernosal tissue might be a sign of an increased cavernosal contractility in these patients remains to be shown in future experiments with normal erectile tissue.

Animals↗

PubMed1997

[Problems in diagnosis and therapy planning in a patient with retroperitoneal yolk sac tumor. Case report and review of the literature].

The case of a 26 years old patient with a primary paraaortic extragonadal yolk sac tumor is presented. After operative reduction of the tumor polychemotherapy with PEB was performed. Following chemotherapy testicular biopsy did not show histological changes typical for testicular intraepithelial neoplasia (TIN). Three years after the initial manifestation of the yolk sac tumor, a malignant tumor of the testis with components of undifferentiated teratoma and yolk sac tumor was observed. In this paper the problems of development of testicular malignancy after polychemotherapy and the validity of a small exploratory excision of testicular tissue in retroperitoneal germ cell tumors and following chemotherapy are discussed.

Adult↗

PubMed1997

Effect of contrast medium on corpus cavernosum smooth muscle.

RATIONALE AND OBJECTIVES: Changes in contractility of corpus cavernosum (CC) smooth muscle caused by radio contrast medium may result in misinterpretations of cavernosography used diagnostically in erectile dysfunction. METHODS: The authors investigated the direct effect of various contrast media on rabbit CC smooth muscle tissue strips in an in vitro model by adding contrast medium to the tissue in a perfusion bath and recording the resulting contractions. Glucose addition was used as control. RESULTS: Application of high-osmolar, ionic contrast medium diatrizoate-induced CC smooth muscle contractions of 57% of the control potassium chloride (124 mM) induced contractions. The low-osmolar (862 mOsm/kg) nonionic monomer contrast medium, iohexol, and the iso-osmolar (300 mOsm/kg) nonionic-dimer contrast medium, iodixanol, elicited contractions of 34% and 36% of the potassium chloride control contractions, respectively. High- and Iso-osmolar glucose solutions caused contractions of 51%, 38%, and 24% of the control, respectively. Cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) regulate CC smooth muscle contractions. These are influenced by different drugs including phosphodiesterases (PDEs), forskolin, and 3-morpholinsydnonimine hydrochloride (SIN-1). The nonspecific PDE inhibitors papaverine (0.1 mM) and theophylline (1 mM) reduced the contrast medium-induced contractions to 66% and 69%, respectively. The specific PDE inhibitor milrinone (0.1 mM) reduced the contractions to 69%; 0.1 mM forskolin and SIN-1 reduced the contractions to 34% and 41%, respectively. CONCLUSIONS: Contrast medium induces CC smooth muscle contractions, depending mainly on the osmolality of the solution. The contractions are reduced but not abolished by elevating the intracellular cAMP and cGMP concentrations. The clinical applications in cavernosography are discussed.

Animals↗

PubMed1997

Gallbladder metastasis of renal cell carcinoma. A case report and review of the literature.

Although renal cell carcinoma is known to metastasize mainly to lungs, lymph nodes, bone, liver, brain or adrenal glands, unusual metastatic spread has been published in many case reports and autoptical studies. The gallbladder is rarely the site of distant metastases, and in most cases of gallbladder metastasis malignant melanoma is the primary tumor. A review of the literature revealed only 7 cases of renal cell carcinoma metastasizing to the gallbladder, and these were mainly found at necropsy. The case of a clinically detected gallbladder metastasis is presented.

Carcinoma, Renal Cell↗

PubMed1995

Ryanodine-sensitive intracellular Ca2+ stores in isolated rabbit penile erectile tissue.

Norepinephrine release from adrenergic nerve terminals leads to a rise in intracellular Ca2+, which promotes penile smooth muscle contraction and detumescence. Ca2+ sources are the extracellular space and sarcoplasmic Ca2+ stores. To elucidate the role of intracellular stores strips from rabbit erectile tissue were investigated in an organ bath study. Contractions were elicited by phenylephrine (PE) and electrical stimulation. Incubation in Ca(2+)-free solution as well as exposure to nifedipine did not abolish electrical or PE-induced contraction. Ryanodine (10(-5) mol/l), a functional blocker of sarcoplasmic Ca2+ channels, significantly reduced PE response. In the presence of caffeine (10(-3) mol/l) the effect was significantly enhanced. Addition of nifedipine nearly abolished the contraction. These results provide evidence for intracellular Ca2+ pools in cavernosal tissue and indicate that the alpha 1-adrenoceptor-induced contraction requires the opening of voltage-gated Ca2+ channels and the release of Ca2+ from intracellular stores.

Animals↗

PubMed1995

[Long-term results of transurethral prostate incision (TUIP) and transurethral prostate resection (TURP). A prospective randomized study].

TUIP (transurethral incision of the prostate) or TURP (transurethral resection of the prostate) was performed in 120 patients to treat small-volume (< 20 g) benign prostatic hyperplasia in a prospective randomized study. The mean follow up was 43 months. Preoperatively and at regular follow-up visits obstructive and irritative symptom scores were obtained, sexual function was evaluated, and a uroflow study was performed. Both treatments achieved a marked improvement of symptoms. The obstructive, irritative and the total symptom scores did not differ significantly between TURP and TUIP. After 2-3 years the scores slowly increased in both groups. Subjective satisfaction rates averaged about 60% after more than 3 years and remained at this level. Initial significant differences in the peak flow rate in favour of TURP were no longer seen after more than 2 years. In smaller prostates TURP and TUIP are equally effective and since TUIP has fewer side effects and entails lower costs it appears to be an acceptable alternative to TURP.

Adult↗

PubMed1995

[Modified retroperitoneal lymphadenectomy in non-seminomatous stage I, IIa and IIb testicular tumors].

In 60 patients with non-seminomatous testicular germ cell tumours in clinical stages I, IIa and IIb inguinal orchiectomy was performed as primary treatment, followed by modified retroperitoneal lymphadenectomy (RLA). In stage II disease chemotherapy was given in addition. After a follow-up period of at least 24 months only 5% of the patients showed progression of disease. Normal ejaculatory function was preserved in 88% of our patients. Modified RLA seems to be a safe procedure with an acceptably low rate of complications not only in stage I disease, but also in metastatic stages IIa and IIb.

Adult↗