[Plastic penile induration].
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4-Aminobenzoic Acid↗
Biomedical subjects
G Jakse
Publications and source records attributed to G Jakse.
Local expression of cytokines in rat bladder carcinoma tissue after intravesical treatment with Nocardia rubra cell wall skeleton and bacille-Calmette-Guerin.
This study aimed to investigate local immunotherapy with Nocardia rubra cell wall skeleton (N-CWS) and bacille-Calmette-Guerin (BCG) in chemically induced rat bladder carcinoma. After being fed with 0.025% N-butyl-N-(4-hydroxybutyl) nitrosamine for 26 weeks, female Wistar rats were treated once a week by intravesical instillation of 100 microg N-CWS or 5 x 10(6) Colony-Forming Units (CFU) BCG. Tissue specimens were obtained 4 h after the ninth instillation and analyzed by reverse transcription polymerase chain reaction (RT-PCR) for mRNA expression of rat cytokines. The analysis showed high expression of interleukin (IL)-1 alpha, tumor necrosis factor (TNF)-alpha, IL-2, and interferon (IFN)-tau in BCG (7/7, 7/7, 7/7, 5/7) and N-CWS (9/9, 9/9, 8/9, 8/9) treated tumors in comparison to low expression in controls (3/9, 0/9, 3/9, 3/9). Interestingly, intravesical instillation of N-CWS tended to be less effective at preventing local invasion of the tumors. It is speculated that this difference may result from a more strongly induced expression of T-helper cell-derived lymphokines (IL-2, IFN-tau) by BCG.
Actins↗
[Improved discrimination between prostatic carcinoma and benign prostatic hyperplasia by determination of free prostate-specific antigen percentage].
We investigated whether the free-to-total prostate-specific antigen (PSA) ration (f-PSA/t-PSA ratio; i.e. percentage of free PSA) represents a better discriminator for the detection of cancer of the prostate (CaP). In a retrospective analysis, the percentage of free PSA was determined in the sera of 35 patients with histologically proven benign prostatic hyperplasia (BPH) and 35 patients with clinically localized CaP. Patients with urolithiasis (n = 33) served as a control group. Serum levels of free PSA and total PSA were determined employing a chemiluminescent enzyme immunoassay. Patients with CaP demonstrated a lower percentage of free PSA (median: 8.7) than patients with BPH (median: 20.0; P < 0.001). Determination of the percentage of free PSA enhances the differentiation between BPH and CaP and may reduce the number of unnecessary biopsies in patients with an elevated PSA. Confirmation of our preliminary results is required.
Aged↗
Cystoplasty in pigs: a suitable model for the functional and morphological examination of urinary diversion.
Although in the last years surgery for urinary diversion became routine in clinical practise, various problems have to be solved. Therefore, a safe, universal animal model is necessary. An ileal pouch anastomosed to the subtotally resected urinary bladder was formed in 6 domestic pigs. Ureters remained untouched and the reservoir was not drained by any tubes. Animals were followed up for 3 months, every 3-4 weeks blood was drawn for electrolytes, renal and hepatic function and blood gas analysis. The animals were sacrificed after 3 months and a thorough pathohistological examination of the reservoir was performed. No intraoperative or operation-related postoperative complications were seen. Laboratory parameters were stable and no micturition problems appeared. Upper urinary tract was normal. The animal model presented is safe with regard to inflammatory or metabolic side effects and to disturbances of supravesical urinary tract. Therefore, this model is suitable to serve for short- as well as long-term studies of various forms of urinary diversions.
Animals↗
Direct invasion of the renal vein by metastatic testicular cancer.
We report a case of metastatic seminoma with direct invasion of the left renal vein. A tumor thrombus was found in the renal vein while the vena cava thrombosis proved to be a noncancerous blood clot developing as an extension of the tumor thrombus. Primary chemotherapy could not be completed because of thrombotic growth requiring surgical intervention. Although surgical specimens were free of viable tumor and two cycles of adjuvant chemotherapy were applied, the tumor relapsed in the area of renal vein invasion.
Adult↗
Evaluation of possible tissue damage in patients undergoing extracorporeal shock wave lithotripsy employing C-reactive protein.
Extracorporeal shock wave lithotripsy (ESWL) has become the most common treatment for stones in the upper urinary tract. Tissue injury related to ESWL has been documented. C-reactive protein (CRP) is the classical acute-phase protein most recognized as an early marker in diseases characterized by inflammation and tissue injury. Possible tissue trauma by ESWL was evaluated by serial CRP determinations in 150 patients with kidney stones, whose follow-up was uneventful. The mean CRP-concentration prior to ESWL was 6.34 mg/l. The majority of patients did not show any further elevation of CRP-levels. Mean CRP-levels were 7.62 mg/l on the first, 6.12 mg/l on the third and 5.09 mg/l on the fifth day after ESWL. No correlation was observed between the number of shock waves and CRP levels. Judged by CRP-determinations tissue damage induced by ESWL can be considered to be minimal as no marked CRP-elevations could be observed in patients with an uneventful follow-up after ESWL.
Acute-Phase Reaction↗
Adenocarcinoma of the urachus: 3 case reports and a review of the literature.
Urachal carcinoma of the bladder is a very rare tumor which has to be differentiated from primary adenocarcinoma of the urinary bladder. The treatment of choice is extended partial cystectomy with inclusion of the umbilicus and the peritoneum. Symptoms occur late and the diagnosis has to be made by preoperative transurethral biopsy. We herein report on 3 cases of urachal adenocarcinoma of the urinary bladder and reviewed the literature.
Adenocarcinoma, Mucinous↗
Determination of local tumour extension in cases of carcinoma of the prostate.
OBJECTIVE: Since most cases of carcinoma of the prostate (CaP) are still diagnosed at a time when the tumour has already spread beyond the prostatic capsula and therefore is incurable, recent impetus has been given to early detection with the chance of curative therapy. METHODS: This paper reviews of the literature concerning the ability of prostate-specific antigen (PSA), digital rectal examination (DRE), transrectal ultrasonography (TRUS), TRUS directed sextant biopsies, computerized tomography (CT) and magnetic resonance imaging (MRI) to determine the pathological stage of clinically organ-confined CaP. RESULTS: The combination of PSA, DRE, TRUS and TRUS directed sextant biopsies yield the best information about the pathological extent of clinically organ-confined CaP. However, while this is true for a cohort of patients, the individual patient may still suffer from locally advanced disease that was unpredictable preoperatively by applying these tests. Positive surgical margins after radical prostatectomy are a logical consequence of advanced disease and therefore will be seen as long as no better clinical staging is available to the urologist and as long as CaP does not get diagnosed earlier in the course of the disease. CONCLUSION: At the present time the determination by PSA, DRE, TRUS and TRUS directed sextant biopsies are the diagnostic procedures of choice for the clinical staging of patients with potentially organ-confined CaP, CT and MRI are unable to markedly enhance the accuracy of clinical staging in this disease.
Biomarkers, Tumor↗
Seizures associated with cisplatin administration.
A 50-year-old patient with a diagnosis of a primary extragonadal germ cell tumor received cisplatin-containing polychemotherapy and developed seizures after the first course of drug administration. We discuss this very rare toxic side effect of cisplatin and present a review of the literature concerning the experience with neurotoxic effects exerted by this agent.
Antineoplastic Combined Chemotherapy Protocols↗
[The prostate-specific antigen in the early recognition of prostate carcinoma].
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Age Factors↗
[Laparoscopic lymphadenectomy in prostate carcinoma. Experiences with 120 patients].
Laparoscopic pelvic lymph node dissection was performed in 120 patients scheduled to undergo either radical perineal prostatectomy or radiation therapy. On average 13 lymph nodes were resected in each patient, and 21 patients were found to have metastatic disease in 1-9 lymph nodes. After an initial learning curve, mean operative time was reduced significantly, allowing laparoscopic lymph node dissection and radical prostatectomy to be performed as a one-stage procedure. The overall complication rate was 10%; open revisions were necessary in only 2 of 120 patients. Postoperative hospital stay was 2 days in patients undergoing laparoscopic lymph node dissection only. This minimally invasive procedure is particularly beneficial to patients with lymph node metastases not undergoing radical prostatectomy, as well as to patients planned to be treated by radiation therapy. The combination of laparoscopic lymph node dissection and radical perineal prostatectomy avoids an abdominal incision and thus shortens both the hospital stay and the period of convalescence.
Adenocarcinoma↗
Oculo-bulbar myasthenia gravis induced by cytokine treatment of a patient with metastasized renal cell carcinoma.
OBJECTIVE: The occurrence of autoimmune diseases or deterioration of pre-existing disorders has recently been described after cytokine treatment. The present report gives evidence for acquired myasthenia gravis induced by externally administered interferon-alpha and interleukin-2 in a patient with metastasized renal cell carcinoma. Electromyographic investigations did not reveal generalised myasthenia gravis. However, a highly elevated titre of antibodies against the human acetylcholine receptor and a significant improvement in clinical symptoms during therapy with anticholinesterase drugs, combined with a decremental response in electronystagmography, indicated an intermittent mainly oculo-bulbar form of myasthenia gravis.
Carcinoma, Renal Cell↗
Gemcitabine: a phase II study in patients with advanced renal cancer.
Gemcitabine is a fluorine-substituted cytarabine analog with broad experimental antitumor activity. It's activity was explored in chemotherapy-naive patients with advanced progressive renal-cell carcinoma. A total of 39 patients were included in the study, of whom 37 were fully evaluable. In five patients the primary tumor remained in situ. Gemcitabine at 800 mg/m2 was given as a weekly 30-min infusion for 3 consecutive weeks followed by 1 week of rest. One complete response and two partial responses were observed giving a response rate of 8.1% [95% confidence interval (CI), 2-22%]. The duration of the responses is currently 32, 15, and 19 months, respectively. The median survival for all patients was 12.3 months. Gemacitabine was generally well tolerated, with nausea and vomiting (20.5% grade III) and neutropenia (5.3% grade III) being the most significant side effects. Gemcitabine given at this dose level and on this schedule has only limited activity in advanced renal-cell carcinoma.
Adult↗
Free-to-total prostate-specific antigen serum concentrations in patients with prostate cancer and benign prostatic hyperplasia.
OBJECTIVE: To determine whether the proportion of total serum prostate-specific antigen (tPSA) which is unbound or free (free PSA) offers a better discriminant for the detection of patients with prostate cancer (CaP) and those with benign prostatic hyperplasia (BPH) than does serum tPSA alone. PATIENTS AND METHODS: In a retrospective analysis, the proportion of free PSA was determined in the sera of 60 patients with histologically confirmed localized (n = 39; pT1-3NoMo) and metastatic (n = 21; T2-4NxM+) CaP and 45 patients with BPH. Forty patients with urolithiasis served as a control group. Serum levels of free and total PSA were determined using a chemiluminescent enzyme immunoassay. RESULTS: Patients with CaP had a lower percentage of free PSA (localized CaP median 8.8%; metastatic CaP median 7.1%) than patients with BPH (median 19.5%) and those with urolithiasis (median 18.8%: P < 0.001). The percentage of free PSA did not differ significantly between patients with clinically localized and metastatic disease. CONCLUSION: The determination of the proportion of free PSA enhanced the discrimination between BPH and CaP and may reduce the number of unnecessary biopsies in patients with an elevated PSA. The results warrant further investigations in a broader population to improve the clinical use of serum PSA as a tumour marker for discriminating patients with an early, potentially curable CaP from men with BPH.
Aged↗
The continent sigmoid urinary reservoir--an experimental study in pigs.
OBJECTIVE: To evaluate the function of a continence mechanism in combination with a colonic urinary reservoir in a pig model. MATERIALS AND METHODS: A colonic urinary reservoir was constructed as a bladder augmentation in six domestic pigs. The pouch was connected to a narrowed and tunnelled ileal tube as a continence mechanism. The closure pressure was measured intra-operatively and 3 months post-operatively. RESULTS: The mean difference between the pressure in the continence mechanism and in the reservoir was 74 cmH2O (range 50-100). Continence was complete both intra-operatively and 3 months post-operatively. CONCLUSION: The modified narrowed and tunnelled ileal tube is a safe continence mechanism when combined with a colonic urinary pouch.
Animals↗
Genital self-mutilation: sub-preputial space--the final frontier?
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Adult↗
Role of lasertripsy in the management of ureteral calculi: experience with alexandrite laser system in 232 patients.
In 232 patients with ureteral stones, lasertripsy was used as primary treatment or as second-line therapy after extracorporeal shockwave lithotripsy (SWL). In all patients, a semirigid 6.5F ureteroscope or a flexible 6F ureteroscope was used. Lithotripsy was performed employing an alexandrite laser with an energy of 50 to 65 mJ. The immediate success rate was 67.5% for stones in the upper ureter, 86.1% for those in the midureter, and 94.5% for those in the distal ureter. In 16.5% of the treatments, it was necessary to insert a double-J stent. A perforation of the ureter happened in two patients (0.9%), but no laser-related complications were seen. Stone fragmentation was not dependent on stone composition or size. Using small semirigid or flexible ureteroscopes, lasertripsy of ureteral stones is a minimally invasive treatment with an insignificant complication rate. In case of midureteral stones, our results revealed a higher immediate stone-free rate than is reported in the literature after treatment by SWL, and we can therefore recommend lasertripsy as primary treatment. For upper ureteral stones, lasertripsy can be recommended as a helpful auxillary procedure. Furthermore, in cases of distal ureteral stones, lasertripsy challenges SWL as the primary treatment.
Adolescent↗
Early detection of infected ureteral obstruction after SWL employing C-reactive protein.
Infection of the obstructed upper urinary tract is a severe complication of stone disease. Early detection and therapy is crucial to prevent septicemia. The authors investigated prospectively whether C-reactive protein (CRP) might act as a marker for the early detection of infected upper urinary tract obstruction. The serum concentration of CRP was compared with the classic markers of inflammation--white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and temperature--in the follow-up of 85 patients undergoing 173 extracorporeal shockwave lithotripsy (SWL) treatments. Post-SWL, 69% of the patients showed dilation of the upper tract on ultrasonography and 16.5% became symptomatic and required intervention. In this group, the mean CRP value was increased 18-fold, whereas the WBC count, ESR, and temperature were not markedly raised. In contrast, patients with no need for additional treatment showed no more than a 2-fold increase in CRP. C-Reactive protein seems to be a useful indicator for the early detection of infected upper urinary tract obstruction.
Adult↗