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Biomedical subjects

G Lunglmayr

Publications and source records attributed to G Lunglmayr.

At least 19 recordsLinked to original sources

The prevalence of lower urinary tract symptoms in Austrian males and associations with sociodemographic variables.

The aim of our study was to assess the prevalence of lower urinary tract symptoms (LUTS) in Austrian males and to correlate the findings with sociodemographic variables. In a population-based cross-sectional study in Austria in the year 1995, data on voiding symptoms were collected from a representative sample of men by using the International Prostate Symptom Score (IPSS). Only 28.6% of the males aged 15 to 89 years (total n = 939) reported no LUTS at all (IPSS = 0). In the group of males who report symptoms, a positive correlation of the IPSS with age is found. Furthermore IPSS correlates with weekly alcohol and nicotine consumption, but not with the respondent's body-mass index (BMI), educational status and monthly household income. The bothersomeness of LUTS increases with age, leaving more than 12% of the males aged 40 to 89 dissatisfied with urinary symptoms. Extrapolated to population numbers, more than 87,000 males in Austria (aged 15 to 89 years) would feel 'terribly' if they were to spend the rest of their lives with urinary symptoms as they were at the time of the survey. Due to an estimated future increase of the proportion of older people in Austria, the number of males with LUTS will rise significantly, thereby placing increased burden on medical resources in the future.

Adolescent

[Sexual function after transurethral prostate resection].

The possible effects of transurethral resection of the prostate were investigated in a prospective trial. 46 patients who underwent surgery for benign prostatic hyperplasia were recruited. All patients had to have a sexual partner and had to be sexually active within 3 months prior to surgery. Sexual function was assessed with the Rust and Golombok Inventory of Sexual Satisfaction (GRISS). Statistical analysis of GRISS scores exhibited a significant decrease in the erectile capacity 6 months after surgery. However, only 2 men were impotent and unable to perform sexual intercourse. 41 men developed retrograde ejaculation which was reported to interfere with sexual satisfaction in 16 men and 9 of their female partners.

Aged

Assisted reproductive technology in the management of azoospermic men--the Austrian experience.

Experience with intracytoplasmic injection of epididymal (MESA) and testicular spermatozoa (TESE) in Austria is summarized. Data from recent publications in scientific journals and results presented at different meetings were stratified for male factors, sperm retrieval methods, assisted reproductive techniques and conceptions. Four cooperative groups of andrologists and gynaecologists reported on MESA and TESE in Austria. They achieved five deliveries (one twin) and two ongoing pregnancies in 40 couples.

Austria

Fertilization and pregnancies following intracytoplasmic injection of testicular spermatozoa.

PURPOSE: Intracytoplasmic injection (ICSI) with testicular sperm was performed in 16 couples. All men had ductal obstruction and failed previous attempts of epididymal sperm microaspiration. METHODS: Testis tissue was obtained by excisional biopsies and incubated in HEPES buffered EBSS medium over 24 h at 37 degrees C. Motile sperm (Grade 1 to 2) were recovered in 13 patients and fertilized a total of 62 oozytes. Four pregnancies were achieved. RESULTS: One healthy boy and two girls (twin pregnancy) were born. CONCLUSIONS: The ongoing pregnancies revealed no fetal abnormalities on ultrasound scanning.

Adult

Efficacy and tolerability of Casodex in patients with advanced prostate cancer. International Casodex Study Group.

The efficacy and tolerability of Casodex, a new non-steroidal antiandrogen, were studied in 267 patients with advanced prostate cancer. All patients received Casodex, 50 mg daily, as monotherapy. The objective response rate was 55.5% and the subjective response rate was 56.1%. The most common adverse events were the expected pharmacological effects of breast tenderness, gynecomastia and hot flushes. No other adverse events were reported in more than 5% of patients. There was minimal occurrence of impotence, loss of libido and diarrhea. The results show that Casodex 50 mg is effective and well tolerated in the treatment of advanced prostate cancer.

Aged

A randomised comparison of monotherapy with Casodex 50 mg daily and castration in the treatment of metastatic prostate carcinoma. Casodex Study Group.

Casodex (Bicalutamide, ICI 176,334) is a potent, non-steroidal, selective anti-androgen with a long half-life allowing once-daily oral administration. In this randomised, open, multicentre study, Casodex 50 mg monotherapy was compared with castration (medical, using goserelin acetate, [Zoladex], or surgical) in 245 patients with advanced prostate cancer. Primary end-points were time to treatment failure, time to objective progression and survival. Subjective responses, quality of life and tolerability were also evaluated. There was no significant difference between the groups in terms of objective progression or subjective responses. Treatment failed in 59 of 119 patients (50%) randomised to Casodex and in 61 of 126 patients (48%) randomised to castration (no statistically significant difference). An updated analysis showed that survival was similar in the two groups. Casodex was well tolerated with a low incidence of diarrhoea and sexual dysfunction. On the basis of this study, Casodex monotherapy is an effective alternative to castration in the treatment of metastatic prostate cancer.

Aged

Pathological and morphometric assessment of testicular parameters in patients with metastatic prostate cancer following treatment with either the antiandrogen Casodex (ZM176,334) or bilateral orchidectomy.

Casodex is an orally active non-steroidal antiandrogen that is highly selective for androgen receptors in animals and man. It is indicated for the non-surgical treatment of advanced prostate cancer in man. The present open controlled study in 13 Casodex-treated and 21 orchidectomy-alone (control) patients addressed the hypothesis that chronic administration of antiandrogens will result in Leydig cell hyperplasia as a result of feedback inhibition of the pituitary resulting in increased luteinising hormone (LH) stimulation of Leydig cells. Although Casodex has been shown to produce a moderate rise in circulating plasma testosterone concentration on chronic treatment in prostate cancer patients, a controlled histopathological and morphometric assessment of the testis following orchidectomy in relapsed Casodex patients showed no effect on Leydig cell populations compared with an orchidectomy alone (control) group. No evidence for induction of Leydig cell hypertrophy or hyperplasia as a result of chronic oral administration of 50 mg Casodex daily was obtained in this study.

Androgen Antagonists

A multicenter randomized trial comparing the luteinizing hormone-releasing hormone analogue goserelin acetate alone and with flutamide in the treatment of advanced prostate cancer. The International Prostate Cancer Study Group.

A prospective randomized trial was conducted to compare the effects of the nonsteroidal antiandrogen flutamide (250 mg. 3 times daily) plus the luteinizing hormone-releasing hormone analogue goserelin acetate (Zoladex) (3.6 mg. subcutaneous depot injection every 28 days) with goserelin acetate alone in advanced prostatic carcinoma. A total of 571 eligible patients, of whom 57% had distant metastases, showed no difference in subjective or objective response rates, interval to progression, treatment failure or survival after a median followup of 2 years. In the combination group more patients had an early decrease in elevated levels of tumor markers and the small number of patients with an increase in signs and symptoms within the first 4 weeks showed a significant decrease. However, increased gastrointestinal and hepatic toxicity in the combination group resulted in 44 patients being withdrawn from the trial. These results indicate that the combination of goserelin acetate with flutamide provides no long-term clinical benefit in patients with advanced prostatic carcinoma compared to goserelin acetate alone.

Administration, Oral

In vitro fertilization with spermatozoa from alloplastic spermatocele.

This case report describes successful IVF of oocytes of a 22-year-old female with epididymal spermatozoa aspirated from alloplastic spermatocele of the husband presenting with bilateral congenital absence of the vas deferens. Motile spermatozoa were aspirated from the reservoir 3 months after implantation. Abortion occurred 22 days after embryo replacement.

Abortion, Spontaneous

Surveillance strategy for intratesticular cysts: preliminary report.

We treated 15 patients with all sonographic criteria of a simple testicular cyst. Of the patients 6 were operated on and the diagnosis was confirmed histologically, while 9 did not undergo an operation but are under close observation (mean surveillance 11 months). All patients are without any detectable malignancy. The possibility of a surveillance strategy in simple intratesticular cysts is discussed.

Adult

Has ultrasound influenced the therapy concept of blunt scrotal trauma?

We present the ultrasonic diagnoses and treatment of 44 patients with blunt scrotal trauma (rupture of the testis, hematocele, intratesticular hematoma and hematoma of the scrotal layers). Purely intratesticular hematoma without any other accompanying injury also can be detected sonographically. When massive scrotal swelling is present ultrasound is valuable to determine the status of the underlying testis even if discrete fracture planes of the tunica cannot always be detected. To achieve best long-term results early surgical intervention should be performed in cases of rupture of the testicle and hematocele, while hematoma of the scrotal layers and purely intratesticular hematoma can be treated conservatively.

Hematocele

Casodex (ICI 176,334), a new, non-steroidal anti-androgen. Early clinical results.

Following promising results in animal studies, Casodex (ICI 176,334) has been studied in the treatment of patients with advanced prostate cancer. At doses of 10, 30 and 50 mg, the drug was found to be well tolerated, with a moderate effect on sex hormone levels. The 50 mg dose of Casodex (daily) reduced previously elevated acid phosphatase levels by 50% or more in 71% of patients.

Acid Phosphatase

'Zoladex' versus 'Zoladex' plus flutamide in the treatment of advanced prostate cancer. First interim analysis of an international trial. International Prostate Cancer Study Group.

The first interim report of this multicentre prospective clinical trial to compare the efficacy of 'Zoladex' versus 'Zoladex' + flutamide in the treatment of advanced carcinoma of the prostate furnishes evidence of a reduction of the incidence of tumour flare within the first 4 weeks of therapy. The combination of 'Zoladex' and flutamide produced an earlier response in tumour markers (TAP, PAP) only. The combination, however, had no effect on subjective and objective response rates and had a negative effect on time to treatment failure. Flutamide produces a significant increase in toxicity and withdrawals due to toxicity. This interim analysis indicates that the continued administration of flutamide in combination with 'Zoladex' has no significant clinical benefit over that of 'Zoladex' alone. Further follow-up is required to determine whether combination treatment has any effect on time to treatment failure and survival.

Aged

Texture analysis--a new method of differentiating prostatic carcinoma from prostatic hypertrophy.

This study compares the results of a new computer assisted evaluation program of sonographic images of the prostate with the histological examination of the operative specimen. This computer program is based on the fact that the human eye is not capable of distinguishing picture distribution points which differ in higher than second order statistics. The sensitivity of the method was 89%, the specificity 86% and the diagnostic accuracy 88%. The results are discussed by comparing them to results of transrectal sonography and digital palpation as reported in the literature.

Evaluation Studies as Topic