PubMed Health⌕ Search

Biomedical subjects

D Pestalozzi

Publications and source records attributed to D Pestalozzi.

15 recordsLinked to original sources
PubMed2001

[Autosomal dominant polycystic kidney disease. Case report of a 20 kg polycystic kidney].

Polycystic kidneys can reach huge dimensions as a result of their continuous growth and thus lead to a "mechanical problem." We report on a 69-year-old patient with enormous polycystic kidneys having been treated for 4 years with standard hemodialysis. In the last 12 months, the patient was suffering from a deterioration of his condition and progressively developed cachexy. The preoperative status of the multi-morbid patient jeopardized operability. It was decided to perform bilateral nephrectomy with a Chevron incision on the right side. The right kidney weighed 11 kg, the left 9 kg. There were no postoperative problems. The massive relief resulted in an impressive improvement of this risk-patient's fitness and quality of life. There is a clear indication of unilateral nephrectomy in case of a renal transplantation. The role and necessity of a bilateral nephrectomy in the event of polycystic kidneys is discussed based on the respective literature.

Aged↗
PubMed1998

Effect of carboplatin on response and palliation in hormone-refractory prostate cancer. Swiss Group for Clinical Cancer Research (SAKK).

To assess the efficacy of carboplatin in patients with hormone-refractory prostate cancer in terms of response rate and palliation, the Swiss Group for Clinical Cancer Research (SAKK) conducted this phase II clinical trial (SAKK 08/91). Carboplatin 400 mg/m2 was administered i.v. every 28 days to 27 patients. The prostate-specific antigen (PSA) level was monitored and compared with the clinical response. Tumour response was evaluated according to EORTC criteria. For patients with nonmeasurable disease, response was defined as the absence of progression in any tumour localization, with no increase in PSA and a decrease of at least 2 points in the WHO pain score. Selected aspects of quality of life (QL) and use of analgesics were assessed to describe patients' experience of toxicity and palliation. Only 1 patient with measurable and 2 patients with nonmeasurable disease achieved partial remission or a response according to our criteria. However, 13 of the 27 evaluable patients had some benefit from carboplatin therapy, as indicated by an improvement in performance status, reduction of pain, and stabilization of metastases. There was no clear-cut association between clinical response and PSA level. QL data suggested that carboplatin was relatively well tolerated and confirmed the clinically documented palliation. In particular, from baseline, for at least two consecutive cycles 7 patients reported either an improvement in pain by 1 point or more on a 4-point scale (> or = 33%) without an increase in analgesic intake or a decrease by 50% or more in analgesic intake without an increase in pain. With the dose and schedule used in this study, carboplatin had only limited objective activity in advanced prostate cancer, but induced palliation in about half the patients.

Aged↗
PubMed1997

A phase II study of oral idarubicin as a treatment for metastatic hormone-refractory prostate carcinoma with special focus on prostate specific antigen doubling time. Swiss Group for Clinical Cancer Research, Berne, Switzerland.

BACKGROUND: Treatment of hormone-refractory prostate carcinoma with chemotherapy is purely palliative, and reported response rates have been low. At the time this study was conducted, there was an urgent need for a trial using potentially efficacious drugs, with quality of life (QL), and serial prostate specific antigen (PSA) behavior as endpoints. METHODS: In this Swiss multicenter Phase II study, 30 patients were enrolled to receive oral idarubicin. Patients were administered 35 mg idarubicin on Days 1 and 8 of each cycle, and treatment was repeated every 3 weeks. Assessment was based on response rates, sequential PSA measurements in serum, toxicity, and selected aspects of QL. RESULTS: Twenty-six of 30 patients were evaluable for response, and none of them achieved a response. Three patients had stable disease as their best response, and their PSA levels also remained stable. In all other patients, PSA increased exponentially over time; the median PSA doubling time was 2.1 months (mean, 2.6; range, 0.7-6.1). Toxicity was minimal and consisted mainly of myelosuppression and nausea/vomiting. QL did not change significantly during therapy with regard to general well-being, fatigue, or nausea/vomiting. However, there were improvements in patient-rated and physician-rated pain. CONCLUSIONS: At the dose and schedule used in this study, oral idarubicin showed only minimal efficacy against hormone-refractory prostate carcinoma. In patients who did not respond, PSA doubling times were similar to those in patients who relapsed while receiving only antiandrogen therapy. In future clinical trials, QL and serial PSA behavior should be included in analysis.

Administration, Oral↗
PubMed1996

[Preoperative T-staging of prostatic carcinoma: endorectal magnetic resonance tomography compared with other imaging and clinical methods].

PURPOSE: The diagnostic value of endorectal magnetic resonance imaging (MRI) in comparison to clinical information and other imaging modalities was analysed in order to define the most accurate preoperative staging method. METHODS: 54 patients with biopsy proven prostate carcinoma, who underwent subsequent prostatectomy, were examined with an endorectal surface coil. The results were compared to body coil MRI, digital rectal examination and prostate specific antigen levels. In 37 patients, results of endorectal ultrasound were available. RESULTS: Staging accuracy, sensitivity and specificity of endorectal coil MRI were 83.3%. For body coil MRI, staging accuracy was 59.2%, sensitivity 43.3% and specificity 82.6%, for transrectal ultrasound 59.5%, 36.4% and 91.7% and for the digital rectal examination 55.6%, 26.7% and 91.7%, respectively. Staging accuracy of endorectal MRI was significantly (p < 0.05) superior to that of the other imaging modalities. CONCLUSION: Endorectal coil MRI allows reliable distinction between localised and advanced tumour stages and is superior to other imaging techniques in this regard. It can thus be recommended for staging in patients with prostate carcinoma.

Biopsy↗
PubMed1993

[Experience with video transurethral resection].

During 14 months more than 300 endoscopic interventions were performed by video-control only: 160 TUR of prostate, 37 TUR of bladder-tumours, 7 ureteroscopies, 17 manipulations with bladder stones and stents, 9 sight-urethrotomies, 72 diagnostic cystoscopies, 2 percutaneous nephrolithotripsies and 12 laparoscopic interventions. Technical requirement is a light and rotatable camera, preferably a monitor mounted over the patient and a self-adjusting light-source. The advantages are better identification of tissue, the use where there is limited mobility of the patient's hip joint and the possibility of demonstration and documentation. The urologist's face is protected against blood contact (HIV-prophylaxis), and he is taking care of his spine. It is the best way of instruction for the learning urologist and even a good training for laparoscopic surgery.

Cystoscopes↗
PubMed1992

[Further observations of dyslexia patients with prism correction].

Report on 370 dyslexics, whereof 281 can be evaluated. The heterophoric cases were all corrected by Haase's method of prismatic binocular full correction. There are mainly esophorias but only little exophorias and strabisms. 3% are orthophoric. Visual acuity improved as well as sensory adaptations. The latter were mainly fixation disparities II. 82 operated cases resulted in a residual angle of 3+/-3 prism-diopters measured by Polatest. The influence on dyslexia is very good in 11%, good in 60%. 17% showed no influence on dyslexia but got rid of asthenopic symptoms. Only 12% failed. Good results are seen already after three months up to one year and in some cases even after 2 or 3 years. As optical and surgical corrections do not heal the dyslexia, it is discussed how to explain the obtained good results. The author's opinion is that prismatic corrections may save energy as the patients have no longer to compensate their heterophoria themselves. Thus they dispose on more energy e.g. for understanding of the text they are reading.

Adolescent↗
PubMed1992

[Problems with the intraurethral spiral].

In the last decade numerous attempts have been undertaken in non-surgical treatment of benign prostatic hyperplasia in order to enable the patient to void his bladder under control, without residual urine and without surgical resection. For the time being, attempts with drug therapy, as well as the more invasive methods with thermic or dilating effect on the prostatogenic infravesical obstruction are based on empiric studies. For many patients transurethral or suprapubic long-term catheterisation is, after all, the only solution. In this respect the "urologic spiral" represents a conservative alternative. In 1980 Fabian was the first to report on the successful clinical application of the intraprostatic "partial catheter" in 2 patients. 4 years later Fabian's remarkably good results in 48 patients are promising. However, what strikes first as an efficient innovation may also have its shortcomings and complications, as it was our experience in the first applications.

Aged↗
PubMed1991

[Results of full binocular correction versus conventional methods].

UNLABELLED: 163 patients suffering from different serious troubles were treated with binocular full correction (BFC) i.e. examination by Polatest and prismatic correction. Before, they all had seen other ophthalmologists. The former diagnose and therapy are listed and compared with those of the author. RESULTS: After a 2 2/3 years average follow-up period 68% of the patients were complaintless, 23% felt better. All patients reached at least binocular single vision, although initially 13% had no binocular vision and 1% complained about diplopia. 70% got ideal binocular vision (initially 0%). In the beginning 50 patients suffered from reduced visual acuity. It improved in all cases with differences of v.a. from 2-4/10 to 10/10. From the shown results the author concludes that conventional binocular diagnostic and therapeutic methods do no longer meet the state of the art. It is postulated that BFC should be accepted by school-medicine and that ophthalmologists and orthoptists should be trained in BFC. Only in this way ophthalmologists may fulfil their task to free patients from the many complaints caused by binocular troubles. The used terminology about BFC is explained in the appendix.

Adolescent↗
PubMed1983

Immunohistochemical localization of alcohol dehydrogenase in human kidney, endocrine organs and brain.

Antibodies against human liver alcohol dehydrogenase (ADH) were produced in rabbits. Peroxidase-labeled protein-A with diaminobenzidine as substrate was used to detect anti-ADH binding in human tissue thin sections. In the kidney, ADH was localized in the epithelia of the tubuli; glomeruli and collecting tubules appeared negative. In prostata and epididymis, the epithelia stained strongly. In the testes, the seminiferous epithelium and the Leydig cells stained higher in the cortex than in the medulla. In the pancreas, the Langerhans islets exhibited particularly high ADH concentrations. In the brain, ADH was localized in neurons of the cerebral cortex, hypothalamus, infundibular stalk of the pituitary, and Purkinje cells of the cerebellum. In summary, ADH could be localized primarily in cells known as targets of ethanol toxicity.

Adrenal Glands↗
PubMed1983

The polymorphisms of alcohol and aldehyde dehydrogenase and their significance for acetaldehyde toxicity.

Evidence is growing that acetaldehyde is responsible for some toxic effects after ethanol intake. Large individual and racial differences in blood and breath acetaldehyde concentrations are observed after alcohol consumption. In many Orientals but few Caucasians extremely high blood acetaldehyde levels occur leading to an acute aldehyde syndrome also observed after treatment with aldehyde dehydrogenase inhibitors. Individuals suffering from the aversive symptoms of that syndrome will be protected from excessive drinking and the related problems. In chronic aldehydism slightly elevated aldehyde concentrations are observed possibly leading to organic injury due to the cytotoxic action of acetaldehyde. Sites exhibiting high alcohol dehydrogenase activity may specifically be affected in alcoholics.

Acetaldehyde↗
PubMed1980

[Surgical correction of esophorias].

A report covering 80 cases of esophoria in which surgery was performed. All the patients had previously suffered from severe headache and other complaints. Preoperative treatment consisted of full prismatic correction. The power of the prisms was measured by the "Polatest" method. We observed that the increase of the angle was initially very slow; sometimes two years or more were needed for it to reach 15 degrees. Subsequently the angle increased rapidly, stabilizing a few months later, whereupon surgery was performed. The peroperative angle varied from 15 degrees to 56 degrees. Postoperatively most cases attained orthophoria, some others a residual esophoria; there were only three cases of exophoria, these being among the 14 cases who had to undergo surgery twice. Sixty percent of the patients were subsequently free of complaints and the rest, with two exceptions, showed a distinct improvement. The average follow-up period was 2.2 years after surgery. One may conclude that esophorias which give rise to complaints can be treated with prisms, but that some of them may have to be operated on. For successful treatment a reliable instrument for measuring the angle of the phoria is indispensable. We found the Polatest best for this purpose. In most cases orthophoria and permanent relief of symptoms will result.

Adolescent↗
PubMed1979

[Better prognosis for amblyopics by means of full prismatic correction after monocular treatment (author's transl)].

Binocular training with full prismatic correction after the monocular therapy by occlusion brings a further improvement of the visual acuity as well as shown in a study of 29% (138 cases) of 469 selected cases with binocular problems and 43% (260 cases) of about 600 unselected cases of squint actually in treatment in the practice and orthoptic years the strength of the prisms is determined with the monocular covertest, in elder patients with the Polatest. If the amblyopia is connected with squint, an operation will only be performed after the amblyopia is improved and some degree of binocularity is reached by means of prisms. - 80% of the selected and 48% of the unselected cases reached a visual acuity of 1,0 on the amblyopic eye, including originally severe cases with eccentric fixation. In about 80% of all cases binocular single vision and stereopsis were reached. Failures were mainly due to remaining eccentric fixation, mostly connected with severe ARC, too advanced age at ting the prisms, too long intervals between controls etc.) - Finally, the importance of cooperation with an orthoptist and the social medical aspects of better chances for amblyopics are accentuated.

Adolescent↗