[Limitations and possibilities of cytodiagnosis in benign breast diseases].
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Biopsy, Needle↗
Biomedical subjects
D Rohde
Publications and source records attributed to D Rohde.
Experimental and clinical efficacy of 2', 2'-difluorodeoxycytidine (gemcitabine) against renal cell carcinoma.
Preclinical and clinical studies have been performed to evaluate the efficacy of gemcitabine (2',2'-difluorodeoxycytidine; dFdC) in human renal cell carcinoma. Experimental data corroborated dFdC as an effective drug against cell lines from renal cell carcinomas (ACHN, A-498, SN12C) at concentrations much below clinically achievable doses. ACHN-bearing nude mice showed an overall response rate of 27% to dFdC (3 mice with complete response, 1 with partial response, 3 with stable and 8 with progressive disease). Objective response from 37 evaluable patients was 8.1% (1 patient with complete response and 2 patients with partial response). Gemcitabine was well tolerated thus, although gemcitabine at the dosage and schedule chosen had only small activity, the observed toxicity may permit further dose escalation or a more frequent administration of the drug.
Adolescent↗
Caring for individuals with severe and persistent mental illness: the contributions and challenges of residential case aides.
The challenge of helping individuals with mental illness live more independently and purposefully within the community warrants a collaborative system of caregiving between professional and paraprofessional caregivers. Residential community support aides are a crucial component of this system of care. However, current investigation of their daily work experiences is lacking. In this study, a team of researchers, employing an interpretive phenomenological approach, analyzed data from in-depth, individual interviews with 5 residential community support aides and identified a constitutive pattern: the teacher as learner. Examination of this pattern and its associated themes will identify those clinical practices that should be preserved and those that are in need of change.
Attitude of Health Personnel↗
Treatment of renal cancer patients with gemcitabine (2',2'-difluorodeoxycytidine) and interferons: antitumor activity and toxicity.
Combined therapy of gemcitabine with interferons on patients with histologically confirmed metastatic renal cell carcinoma is reported. Patients had an unfavourable disease due to documented tumor progression after various interferon-alpha-based immunotherapy (26 weeks on average). The median number of metastatic sites was 6.1 per patient and 78% of the patients exhibited >/= 4 lesions. Nine evaluable patients received at least 6 doses of gemcitabine and 8 doses of interferon-gamma. Overall, therapy resulted in a remission rate of 15% (4 x partial response; 4 x minor response) for single measurable lesions (n=53). Remissions were more often found for lesions, that did not progress at baseline evaluation (n=30; OR: 20%), compared to 8.7% for sites in progression (n=23). However, as a result of therapy, 43.5% of the progressive lesions did not continue to progress. Although only one of nine patients finally overall achieved a minor remission and one patient a stable disease, the median time to tumor progression (6.1 months) and the median survival (13.5 months) was favourable. In conclusion, the combination of gemcitabine and interferon demonstrated cytotoxic and cytostatic effects on metastases of renal cell carcinoma at a tolerable toxicity, thus controlled clinical studies for first line therapy with gemcitabine and interferon are in progress.
Adult↗
Age related changes of free and total prostate specific antigen in serum.
UNLABELLED: PSA in serum exists in several molecular forms. The amount of free and total PSA and ratio are discussed to be useful to increase the ability of PSA to distinguish prostate cancer from benign prostatic hyperplasia. Therefore, we tried to characterize the age related changes of free and total PSA in a German rural population. METHODS: Serum samples were obtained from 697 men. All study participants were between 20 and 79 years old and had no clinical evidence of prostate cancer by serum PSA, digital rectal examination and transrectal ultrasonography. The sera were kept frozen at -20 degrees C until analysis and were assayed within 3 months after sampling. Free and total PSA values were determined employing a chemiluminescent enzyme immunoassay (Immulite PSA and Freies PSA, DPC Biermann). RESULTS: Free PSA, total PSA and the free-to-total PSA ratio (f-/t-ratio) demonstrated a correlation with patient age (r = 0.855, p = 0.0141; r = 0.857, p = 0.0137; r = -0.788, p = 0.0352). Employing the median and the 95% percentile the age-specific reference ranges for free and total PSA were calculated. For the f-/t-ratio the median and the interquartile range (i.e. 25th-75th percentile) were calculated. CONCLUSION: In confirmation of a recent report, we found a direct correlation of free PSA, total PSA and the f-/t-ratio with age, whereas free and total PSA increases, the f-/t-ratio decreased with advancing age.
Adult↗
Altered prostate specific antigen reference range after transurethral resection of the prostate.
OBJECTIVES: We investigated how transurethral resection of the prostate (TURP) affected the serum concentration of prostate specific antigen (PSA) and whether the reference range for PSA has to be altered in these patients following TURP. METHODS: 55 patients were retrospectively analysed. All had undergone TURP for bladder outlet obstruction due to benign prostatic hyperplasia which was confirmed by histopathological amination. PSA was determined pre-operatively and postoperatively every 6 months for 48 months. These patients were compared to 12 patients who had undergone radical perineal prostatectomy (RPP) for prostate cancer (CaP). In the latter group, in all patients a TURP had been performed up to 7 years before CaP was diagnosed. RESULTS: The median PSA concentration was 4.9 ng/ml before TURP and was subsequently reduced to 0.6 ng/ml after 48 months. There was a steady decrease of the PSA concentration during the observation period. In contrast in patients who subsequently developed a CaP, the median PSA concentration before TURP was 6.8 ng/ml and was reduced to only 2.2 ng/ml after 48 months. PSA levels started to rise before CaP was diagnosed. CONCLUSION: After a TURP with a benign histopathologic specimer) PSA levels decrease steadily to values below 2 ng/ml. In case these patients demonstrate a rising PSA in the follow-up after partial prostatectomy, a CaP should be ruled out.
Aged↗
Are age-specific reference ranges for prostate specific antigen population specific?
INTRODUCTION: At present PSA is Considered to be the leading screening test for prostate cancer. We determined whether in men 60 to 79 year old with a serum prostate specific antigen (PSA) within age specific PSA reference ranges prostate biopsy could be safely eliminated. METHODS: We retrospectively analysed all 60-79 year old men who had undergone radical perineal prostatectomy (RPP) for prostate cancer (CaP) at our institution. All patients had undergone prostate biopsy following an abnormal rectal examination and/or PSA greater than 4.0 ng/ml. We compared our results using the standard reference range of 0 to 4.0 ng/ml with those we had obtained using the age specific PSA reference ranges of Oesterling et al. RESULTS: 204 men between 60-69 years and 67 men between 70-76 years had undergone RPP for CaP. Applying age specific PSA reference ranges 56 CaP would have been overlooked. Of those 46% had a favourable histology. Taken together 54% of the cancers overlooked had an unfavourable histology. CONCLUSION: In contrast to previous reports of unfavourable histological characteristics in only 5-24% of missed cancers, applying age specific PSA reference ranges, 54% of missed cancers in our patients exhibited an unfavourable histology. We therefore conclude that age specific PSA reference ranges did not safely eliminate the need for prostate biopsy in our study population.
Age Factors↗
Tissue polypeptide specific antigen serum concentrations in patients with newly diagnosed prostatic diseases.
UNLABELLED: Recently, tissue polypeptide specific antigen (TPS), a cytokeratin 18 marker, was described to be discriminative between cancer of the prostate (CaP) and benign prostatic hyperplasia (BPH). In our study we investigated the ability of the TPS serum concentration as a staging marker in patients with newly diagnosed CaP. METHODS: Serum levels of TPS and PSA were determined in patients with newly diagnosed, untreated CaP (pT1-3pNoMo: n = 71; T1-4NxM+: n = 39) and BPH (n = 30). The TPS serum concentration was correlated to the PSA serum concentration. RESULTS: Median TPS concentration was 33.6 U/L in the pT1-3pNoMo-group; 113.5 U/L in the Tl-4NxM(+)-group and 59.7 U/L in the BPH-group. Although the TPS concentration failed to discriminate between patients with localized CaP and BPH, it discriminated very well between patients with (M+) and without (Mo) bone metastases (p < 0.001). Furthermore no correlation with PSA levels could be established. CONCLUSION: The TPS serum concentration seems to provide additional information in the initial staging of patients with newly diagnosed untreated CaP.
Aged↗
Serum levels of prostate specific antigen in men on hemodialysis.
UNLABELLED: The measurement of prostate specific antigen (PSA) is widely used for the early detection of prostate cancer. However the influence of renal failure on the serum levels of the PSA molecular forms is still a matter of investigation. We therefore examined the serum concentration of total and free PSA in patients undergoing hemodialysis and discuss the influence of renal failure on both types. MATERIALS AND METHODS: Serum concentrations of total PSA, free PSA and the free-to-total PSA ratio were measured in 48 men undergoing hemodialysis. Total and free PSA levels were measured employing a chemiluminescent enzyme immunoassay. RESULTS: Serum levels of total PSA, free PSA as well as the free-to-total PSA ratio did not change significantly in uremic patients after hemodialysis. Median total PSA concentration was 1.1 ng/mL before and 1.15 ng/mL after hemodialysis (p = 0.24); median free PSA concentration was 0.29 ng/mL before and 0.32 ng/mL after hemodialysis (p = 0.14). Median free-to-total PSA ratio was 0.29 ng/mL before and 0.31 ng/mL after hemodialysis (p = 0.66). CONCLUSION: Serum free PSA as well as total PSA is not eliminated by hemodialysis and the slightly elevated levels of free PSA and the free-to-total PSA ratio in uremic patients after hemodialysis may be caused by the concomitant decrease in binding proteins. We therefore conclude that the reference ranges for total PSA, free PSA and the f-/t-PSA ratio are applicable undergoing chronic hemodialysis.
Adult↗
[Effect of azathioprine on the LE-cell phenomenon in 10 patients with lupus erythematosus disseminatus].
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Azathioprine↗