Biomedical subjects
Publications and source records attributed to G Rutishauser.
A 41-year-old man with Marfan syndrome was found to have polycystic renal disease and underwent emergency surgery for dissecting aneurysm of the ascending aorta. To our knowledge only two cases of this rare combination of hereditary disorders have been described in the literature.
Malignant mesothelioma of the tunica vaginalis testis is an extremely rare tumor, with only 40 cases previously described in the literature. Treatment consists of inguinal orchiectomy with close-follow up [1]. Asbestose exposure, trauma and hydrocele have been implicated as risk factors. We describe a histopathological examination with the BMA antibody (Behring, Marburg, Germany) and the Lu-5 antibody (Hoffmann-La Roche, Basel, Switzerland). Furthermore, we describe the patient's history and the management according to preceding reports in the literature.
PURPOSE: The purpose of this study was to analyze the impact of transurethral resection of the prostate on prognosis in patients with localized prostate cancer who received definitive external beam radiotherapy. METHODS AND MATERIALS: Out of the 431 patients treated diagnosis was established by needle biopsy in 198 and by transurethral resection of the prostate in 233 cases. Disease-free survival and relative survival as a function of transurethral resection of the prostate and needle biopsy were calculated for all stages and within each tumor stage and grade. RESULTS: An adverse effect of transurethral resection of the prostate on disease-free survival was observed only in patients with T3 T4 tumors of intermediate and poor differentiation (p < 0.05). The incidence of local recurrence and distant metastases as well as the distribution of pretreatment prostate specific antigen-levels was not significantly different between the transurethral resection of the prostate and needle biopsy groups. CONCLUSION: We conclude that transurethral resection of the prostate has an adverse effect on disease-free survival in a selected group of patients and discuss the implications of this finding.
Certain important aspects of the urine oxalate tolerance test (OTT) have been revised. The stirring system has been changed and the test has been adapted to the kinetics of calcium oxalate precipitation. True equilibrium conditions are now ensured during the measurements. Furthermore, the endogenous oxalate concentration is determined and taken into consideration. As a result of these changes, the significance of the test results has greatly improved. The effects of the addition of small amounts of zinc on the precipitation of calcium oxalate have been used in a new variation of the OTT. This new test makes it possible to discriminate much faster and more simply between recurrent stone-formers and other subjects. Tamm-Horsfall protein (THP) has been tested for its effect on the precipitation of calcium oxalate by means of OTT. THP inhibits the precipitation of calcium oxalate, but THP of stone-formers has a diminished inhibitory activity. The inhibitory activity of this protein strongly depends on the method by which it is isolated.
Malignant mesothelioma of the tunica vaginalis testis is an extremely rare tumor, with only 37 cases previously described in the literature. Treatment consists of inguinal orchiectomy with close follow-up [1]. Asbestos exposure, trauma and hydrocele have been implicated as risk factors. We describe a patient's history and the pathological findings as well as the management according to preceding reports in the literature.
In 1872 the Viennese dermatologist Moritz Kaposi first described a pigment sarcoma of the skin. A modification of the epidemiology and the follow-up results in the accumulation of reports about the Kaposi-sarcoma after organ transplantation in the sixties and in the beginning of the eighties frequently Kaposi-sarcomas by the immunodefect syndrome AIDS were noticed. The incidence of Kaposi-sarcomas after kidney transplantations is estimated to be 0.3 to 1.8 per thousand. We report about a patient developing a Kaposi-sarcoma of the bladder during an immunosuppression therapy with Imurec and Sandimmun.
For the first time Bernhard Marfan described the Marfan-Syndrome in 1896; it is a meso- and ectodermed variety with the conducting symptom of "arachnodactyly". Marfan-Syndrome is an autosomal dominant hereditary disorder with high penetrance and variable expressivity. In our opinion this case of a 41-year-old patient with kidney cysts and aneurysma dissecans of the arteria ascendens by Marfan-Syndrome was described in the literature only twice. The casuistics of this Marfan-Syndrome patient shows a particular rare associated organ-change--the kidney cysts--and illustrate the frequency of this hereditary disease.
Between 1983 and 1985, 257 infertile men were examined for any present varicocele by means of the Doppler sonography, telethermography and palpation. Based on these findings, the spermiogram and the infertility history, high ligation of the spermatic vein was indicated in 89 patients with varicocele and a median duration of infertility of 36 months (6-88 months). Postoperative sperm examinations have shown a significant improvement in sperm count and morphology, but not in motility. The most significant drop was observed in germ cell concentration from 1.68 to 1.06 mio/ml (p less than 0.025 Wilcoxon signed rank sum test). The follow-up examination 6 years after the beginning of the study has shown that only 56 out of the 89 patients underwent surgery, whereas 33 patients refrained from it. Pregnancy rates were 42% (23 out of 55, 1 patient lost to follow-up) in the operated group and 45% (14 out of 31, 2 patients lost to follow-up) in the nonoperated group. The comparison of the two graphs showing pregnancy incidence clearly demonstrates that pregnancies in the nonoperated group occur earlier than in the operated group; it has to be noted, however, that several patients only refrained from being operated on because pregnancy had occurred before surgery was planned. On the one hand, our study confirms other authors' results, i.e. that pregnancy rates in the nonoperated group are relatively high despite present varicocele. On the other hand, the operated group achieved practically the same high pregnancy rate when monitored over a longer period of time.(ABSTRACT TRUNCATED AT 250 WORDS)
Since 1976, 126 patients with clinically localised carcinoma of the prostate have been managed by radical retropubic prostatectomy. All patients with tumour spread beyond the capsule or metastasis in lymph nodes received radiotherapy. Tumour category pT3 was divided into invasion of the capsule or infiltration of the seminal vesicle. The disease-free 10-year survival rate in patients with minimal invasion of the capsule was 72% and in patients with infiltration of the seminal vesicles it was 26%. Unilateral lymph node metastases were classified as microscopic disease or macroscopic infiltration. The disease-free 10-year survival rate in patients with metastasis in 1 lymph node (micro- and macro-metastasis) was 65% in contrast to 0% in patients with bilateral disease.
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Microscopic crystals were found by SEM analysis in kidneys of stone forming patients as well as in kidneys of non-stone formers. In most samples calcifications were intratubular in the collecting ducts near the papillary tip. 1-2 micron sized particles lay in a gelatinous substance on the epithelium. The only difference in crystal composition is the higher phosphate content in the kidneys of the non-stone forming group. A correlation between the element concentration of the tissue and the occurrence of microliths is given by the cadmium content of the kidney samples. Both groups showed higher cadmium values in the cortex or medulla when crystals were found in the corresponding papillary samples. Urine supersaturation with respect to calcium oxalate was higher in the stone forming group caused by a higher calcium and oxalate but a lower magnesium excretion.
A commercially available radioimmunoassay (RIA) for prostate specific antigen (PSA) was investigated in respect to its analytical specificity and its clinical applicability for the diagnosis of prostate cancer. PSA detected in serum by RIA was immunochemically identical to PSA found in seminal plasma. PSA is not a single protein but rather a group of isoproteins with different isoelectric points (pI) in the pH range 6-8. Furthermore PSA could be split in subunits by means of denaturing electrophoresis under reducing conditions. Unlike prostatic acid phosphatase (PAP) serum PSA was stable at room temperature. In sera of patients with benign hyperplasia of the prostate (BPH) two significantly different populations were found. The lower group (0.5-5.8 ng/ml PSA) had PSA values comparable to the control group of apparently healthy males (0.5-6.3 ng/ml). The higher group between 7.7 and 12.2 ng/ml was also characteristic for early stages of prostate cancer (T0 and T1). PSA seemed to be correlated to the tumor volume and allowed to differentiate between early carcinomas of the prostate and BPH or possibly T0/1 staged prostate carcinoma. PSA may be a screening method for early cancer of the prostate.
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The influence of fluoride in drinking water on stone formation was studied in animals and in "in vitro" crystallization experiments. In male Wistar rats fluoride inhibits ethylenglycol induced calcification of the kidneys and stone formation. The in vitro results performed in synthetic urine exhibited a dose-dependent delay of crystal growth.
In undiluted urine portions the oxalate-concentration required for precipitation (= oxalate-tolerance) can be obtained by titration with sodium-oxalate and turbidimetric detection. The corresponding urinary calcium-concentration was measured and the two values plotted against each other. With regard to a standard-curve (measurements in synthetic urine) different behaviour between urines of stone forming patients and others can be observed.