[Smallpox--a review].
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Biological Warfare↗
Biomedical subjects
G Zöller
Publications and source records attributed to G Zöller.
Bladder dysfunction in children with bilateral single ectopic ureters.
BACKGROUND: Single ectopic ureters are a rare malformation in children. Therapy consists of ureteral reimplantation. However, in case of bilateral single ectopic ureters, subsequent malformation of the bladder trigone and bladder neck may result in additional voiding dysfunction, and ureteral reimplantation alone may not solve the urologic problems. METHODS: The authors report their experience with 2 girls, in whom bilateral single ectopic ureters were treated by ureteral reimplantation in early childhood and who did not gain adequate bladder control during following years. RESULTS: Videourodynamic evaluation was done in both girls. No bladder overactivity was found during the urodynamic studies. However, cystography showed a widely open bladder neck during filling with no sufficient bladder neck closure shown by urethral pressure profile studies. When blocking the bladder outlet by balloon catheters, adequate bladder filling volume was achieved. Incontinence was cured by implantation of an AMS 800 artificial sphincter system in a 10-year-old girl. A 7-year-old girl was regarded to be too young for sphincter implantation and is waiting for surgery within the next years. CONCLUSION: Insufficient development of trigone and bladder neck with subsequent urinary incontinence has to be kept in mind when deciding on surgical procedures in children with bilateral single ectopic ureters.
Abnormalities, Multiple↗
Differences in cortical microcirculation in the kidneys of unilaterally congenital hydronephrotic rats.
The surgically induced split hydronephrotic kidney has been generally accepted as a valid model for the assessment of renal microcirculation by means of intravital microscopy. Whereas nearly all previous work on this issue has been done with a transillumination technique, we used an epiillumination model that is suitable for investigation of microvascular perfusion in both normal and hydronephrotic kidneys without surgical manipulation of the ureter. By means of the congenital unilaterally hydronephrotic Tauchi rat, microcirculation of the hydronephrotic and that of the nonhydronephrotic kidney were compared. For that purpose both the hydronephrotic and the nonhydronephrotic kidneys of Tauchi rats were exteriorized on a specially designed microscopy stage. After injection of FITC-dextran and rhodamine 6G, microvascular perfusion was assessed in both kidneys. The new model allowed visualization of arterioles, capillaries, and postcapillary venules in both the hydronephrotic and the nonhydronephrotic kidneys. Glomeruli could only be regularly seen in the hydronephrotic kidney, but also in some normal kidneys. Capillary blood cell velocity was significantly higher in the hydronephrotic kidneys (0.67 +/- 0.03 mm/s) compared to the normal kidney (0.32 +/- 0.05 mm/s; P < 0.05), whereas capillary diameters were smaller (4.2 +/- 0.02 microm vs. 5.7 +/- 0.2 microm; P < 0.05). In addition, the hydronephrotic kidney showed a significantly lower density of perfused microvessels compared to the normal controls. Epiillumination intravital microscopy allows assessment of the cortical microcirculation in both the hydronephrotic and the nonhydronephrotic kidneys without surgical induction of hydronephrosis. The hydronephrotic kidney shows significant microcirculatory differences compared to normal kidneys that should be taken into account when using a hydronephrotic model for pharmacological testing.
Animals↗
Impaired nephrogenesis in rats with congenital obstructive uropathy.
PURPOSE: Alterations caused by renal obstruction in developing kidneys are of particular interest in basic research of congenital obstructive uropathy. In rats nephrogenesis mainly occurs 7 to 10 days postnatally. Therefore, surgically induced neonatal ureteral obstruction in rats has been suggested to be analogous to congenital obstruction in the fetus. An attempt less prone to surgical artifacts and assessing even earlier developmental stages is to monitor the development of obstructed kidneys in rats with congenital obstructive uropathy. MATERIALS AND METHODS: Rats from an inbred strain with congenital renal obstruction in 70% of their littermates were observed. Morphologically, significant hydronephrosis was not detected before day 5 post partum and progressed with age. Unilateral obstructed kidneys were compared with contralateral kidneys and kidneys from healthy control animals at ages of 1, 5, 10, 18 and 32 days. A total of 72 renal units were investigated. The renal messenger RNA expression of renin and transforming growth factor-beta1 (TGF-beta1) was quantified by competitive quantitative reverse transcription polymerase chain reaction using a gene specific complementary RNA standard. RESULTS: In controls the gene expression of renin decreased from day 1 to day 18 and remained stable. TGF-beta1 expression increased during the first 10 days and then decreased again. Renin expression of the obstructed kidneys was reduced (p <0.05) on day 1, increased to a maximum versus controls (p <0.01) on day 10 and decreased to an unchanged elevated level (p <0.01) on days 18 and 32. Renin expression of the contralateral kidneys showed no significant alterations to control kidneys. Messenger RNA expression of TGF-beta1 of obstructed kidneys stayed decreased during the first 10 days (p <0.05), then increased excessively on day 18 (p <0.01) and slightly decreased on day 32. TGF-beta1 expression of the contralateral kidneys was parallel to controls on a slightly elevated level, increased on day 18 and returned to control level on day 32. CONCLUSIONS: Within the postpartum period of nephrogenesis gene expression of renin and TGF-beta1 was decreased in obstructed kidneys compared to controls. As the renin angiotensin system and TGF-beta1 have important functions in normal kidney development, these results suggest impaired nephrogenesis of congenital obstructed kidneys even before the onset of morphological signs of hydronephrosis. These features differ from surgical induced unilateral ureteral obstruction at birth and promise new insights into the pathophysiology of congenital obstructive uropathy.
Animals↗
Clear cell adenocarcinoma of the male urethra in association with so-called nephrogenic metaplasia.
A clear cell adenocarcinoma of the urethra associated with so-called nephrogenic metaplasia occurring in a 57-year-old male patient is presented. Ten months following total urethrectomy, multiple pulmonary metastases had developed. The patient died 2.5 years after surgery. The possible histogenesis of clear cell adenocarcinoma of the lower urinary tract - reported to develop in the male urethra only in a very few cases - is reviewed briefly. We favor an origin from preexisting nephrogenic metaplasia as one of the possible histogenetic pathways.
Adenocarcinoma, Clear Cell↗
["False positive" testicular perfusion in testicular torsion in power Doppler ultrasound].
We report about a patient with acute scrotal pain. Power Doppler sonography demonstrated arterial testicular perfusion. As no amelioration was achieved by conservative treatment, surgical exploration was done after 7 days. Intraoperatively, we found a partial testicular torsion with a 180 degrees rotation of the testis at the rete testis. This case demonstrates, that the detection of intratesticular arterial blood flow cannot exclude testicular torsion.
Adult↗
Histologic and molecular evidence of obstructive uropathy in rats with hereditary congenital hydronephrosis.
Partial obstruction of the upper urinary tract, a frequent challenge for the pediatric urologist, leads to renal damage, if deobstruction is delayed. Several but sometimes unsatisfactory animal models have been developed to study this phenomenon. Obstruction created by surgical manipulation lacks adequate correlation with a developing congenital obstruction. In some animals with congenital hydronephrosis, evidence of renal obstruction is absent. A study of the renal morphology of rats with hereditary unilateral hydronephrosis has exhibited clear evidence of renal obstruction distinguishable from renal dilatation. The renal mRNA expression of renin and transforming-growth factor-beta1 (TGF-beta1) was measured by a semiquantitative RT-PCR technique. In hydronephrotic kidneys, a marked loss of parenchyma, atrophy and dilation of tubuli and collecting ducts and interstitial fibrosis was observed. The mRNA expression of renin was increased significantly in comparison to controls, whereas the contralateral kidneys showed renin activity below control levels. TGF-beta1 expression was markedly increased in hydronephrotic kidneys, whereas contralateral kidneys did not differ significantly from control values. These data suggest the presence of renal obstruction and not only renal dilatation in these rats with congenital hydronephrosis. This colony seems to be a representative animal model to study congenital renal obstruction even in the fetal period without the need of surgical manipulation.
Actins↗
Regression of human metastatic renal cell carcinoma after vaccination with tumor cell-dendritic cell hybrids.
Reports of spontaneous regressions of metastases and the demonstration of tumor-reactive cytotoxic T lymphocytes indicate the importance of the host's immune system in controlling the devastating course of metastatic renal cell carcinoma. Recent research indicates that immunization with hybrids of tumor and antigen presenting cells results in protective immunity and rejection of established tumors in various rodent models. Here, we present a hybrid cell vaccination study of 17 patients. Using electrofusion techniques, we generated hybrids of autologous tumor and allogeneic dendritic cells that presented antigens expressed by the tumor in concert with the co-stimulating capabilities of dendritic cells. After vaccination, and with a mean follow-up time of 13 months, four patients completely rejected all metastatic tumor lesions, one presented a 'mixed response', and two had a tumor mass reduction of greater 50%. We also demonstrate induction of HLA-A2-restricted cytotoxic T cells reactive with the Muc1 tumor-associated antigen and recruitment of CD8+ lymphocytes into tumor challenge sites. Our data indicate that hybrid cell vaccination is a safe and effective therapy for renal cell carcinoma and may provide a broadly applicable strategy for other malignancies with unknown antigens.
Aged↗
[Langerhans-cell histiocytosis of the penis].
Involvement of the male genitalia by langerhans cell histiocytosis ist very rare. It has been reported in only three cases yet. We present a patient with recurrent disease of the skin of the penis and by proliferation involvement of the distal urethra and the corpus cavernosum. An overview of the disease and its therapy is given.
Adolescent↗
Development of a testicular tumour after negative biopsy for carcinoma in situ.
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Biopsy↗
Comparison of questionnaire-based and serological screening for natural latex allergy in children with neurogenic bladder dysfunction.
OBJECTIVE: We evaluated the prevalence of sensitization to natural latex in children with congenital neurogenic bladder dysfunction by patient history and serological examinations. METHOD: 50 consecutive children aged from 6 months to 17 years were included into the study which comprised questionnaires of patient and family histories, serological screening tests for common inhalational allergens (CAP SX1), and determination of total serum immunoglobulin E (IgE) and of latex-specific serum IgE by solid-phase immunoassays. RESULTS: 5 children had a history of allergic reactions to natural latex; a history of atopic disposition or allergic reactions other than to latex was present in 16 children. In 10 children, latex-specific IgE levels were elevated: > 0.35 kU/l; 6 out of these 10 children had no history of allergic reactions to latex. Elevated latex-specific IgE values were statistically correlated with the number of past operations (p < 0.006) and a history of atopic or allergic reactions (p < 0.0067). Clean intermittent catheterization, however, was not associated with an increased risk of latex allergy (p = 0.408). CONCLUSION: When screening children with congenital neurogenic bladder dysfunction for sensitization to natural latex, serological examinations of latex-specific IgE in addition to patient history may better identify patients at risk.
Adolescent↗
In vitro investigations of new therapeutic agents on bladder tumor cell lines.
In this study sensitivity of human transitional cancer cells to the anticancer agent paclitaxel, an antimicrotubular drug, and to gallium nitrate, a group IIIa metal, was compared to that of the standard MVAC (methotrexate, vinblastine, doxorubicin and cisplatin) drugs. The reduction of cell proliferation was evaluated after 48 h of incubation of six different cell lines with each agent using the mean transit time (MTT) assay. We investigated both monolayers and spheroids. Paclitaxel showed significantly higher growth inhibitory effects on monolayers than vinblastine, both agents targeting the antimicrotubular apparatus. This could not be reproduced on spheroids, where a survival fraction of 50% was observed even at high concentrations (10 microM). High concentrations of gallium nitrate were needed to achieve sufficient toxicity. These concentrations are beyond the concentration achievable by systemic application. Our findings suggest that paclitaxel may be a clinically useful agent for systemic and intravesical use in bladder cancer.
Antibiotics, Antineoplastic↗
[Microproteinuria and enzymuria in fever and pyelonephritis in childhood. A prospective study of 180 children].
In 180 children (87 children belonging to a control group, 68 with fever of non-renal origin, and 25 with pyelonephritis) albumin and immunoglobulin G (markers for glomerular dysfunction), alpha-1-microglobulin and beta-NAG (markers for proximal tubular dysfunction) and apolipoprotein A1 (marker of "postrenal' dysfunction) were measured in second-voided morning urine. In children with fever of non-renal origin, glomerular dysfunction was encountered in 8.8%, tubular dysfunction in 17.6% and mixed glomerular-tubular dysfunction in 14.7% of cases. Among children with pyelonephritis, 28% revealed glomerular dysfunction and 44% mixed glomerular-tubular dysfunction. No case of solitary proximal tubular dysfunction was observed in children with pyelonephritis. There were highly significant differences in presence and expression of glomerular dysfunction between children with fever of non-renal origin and children with pyelonephritis (P < 0.0001), whereas with regard to proximal tubular dysfunction, the differences were only moderately significant (beta-NAG: P < 0.01) or of low significance (alpha-1-microglobulin: P < 0.05). This may indicate that morphologic changes occur during interstitial pyelonephritis due to inflammation of glomeruli, resulting in glomerular dysfunction, while proximal tubular dysfunction may additionally be due to fever-associated function processes.
Acetylglucosaminidase↗
[Influence of DNA ploidy and grading on survival in primary metastatic prostate carcinoma].
An aneuploid pattern of prostatic cancer defined by flow cytometry was shown to be of value in predicting progression rates and patient survival times. We evaluated the long-term value of DNA analysis in prostatic cancer in 61 patients with advanced disease. We performed flow cytometry on 61 fresh prostate specimens obtained-from a transrectal needle biopsy or a transurethral resection. All patients received antihormonal therapy. Time until death was evaluated in all patients. Of the DNA histograms analyzed, 37% showed a diploid pattern, 63% an non-diploid pattern, and 37% a tetraploid or hypertetraploid pattern. Kaplan-Meier plots were generated for analysis of the probability of survival. Mean survival time was 44 months for patients with diploid (range 1-126 months) and 40 months for patients with non-diploid tumors (range 1-96 months). This difference is not statistically significant. However, the combination of non-diploid and low-differentiated (G3) tumors reduced survival time significantly (mean 20 months, range 1-62 months). There was no patient with combination of a diploid and highly differentiated tumor.
Aged↗
The influence of temperature on changes in pH, lactate and morphology during testicular ischaemia.
OBJECTIVE: To examine the role of temperature in the irreversible changes that occur within 4-6 h as ischaemic atrophy develops in the testis during testicular torsion, by determining effects on testicular pH, lactate accumulation and morphology. MATERIALS AND METHODS: Tissue acidification (pH), tissue lactate and structural changes were measured at temperatures of 35, 25, 15 and 5 degrees C in 34 human testes obtained as orchidectomy specimens from patients with metastatic prostatic cancer, and in 19 testes taken from young dogs. RESULTS: At a normal testicular temperature of 35 degrees C, the pH decreased to 6.0 within 2 h of the onset of ischaemia; cooling to 15 degrees C extended this delay to 6 h. Tissue lactate increased from 25 mumol/g dry weight to about 200 mumol/g at 35 degrees C. Semi-thin sections of the canine testes showed swelling of the intratubular tissue with loss of interstitial space; lower temperature delayed these changes. CONCLUSIONS: In the present study, 6 h of torsion was relatively prolonged, in that the pH decreased to 5.8 and testicular tissue was destroyed. Acidification and histological damage can be prevented by cooling. The critical pH of the testis beyond which irreversible changes occur is unknown; a pH of < 6.0 is likely to provoke such changes.
Aged↗
Distribution of neurofilament-positive nerve fibres and sensory endings in the human anterior cruciate ligament.
The present immunocytochemical study describes the distribution of neurofilament-containing nerve fibres and corpuscular-like endings in the human anterior cruciate ligament. The entire anterior cruciate ligament of a non-injured knee joint from a child was cut into serial 15-microns-thick frozen sections, which were processed for immunofluorescence staining with a monoclonal antibody against the 68-kDa neurofilament subunit. Numerous neurofilament-positive fibres were found in bundles. These bundles were mostly located near blood vessels in the subsynovial layer and in interfascicular gaps. Only a few single nerve fibres were found independent of blood vessels in interfascicular gaps and between collagen bundles. Neurofilament-containing nerve fibres were preferentially located near the bony attachments of the anterior cruciate ligament. Two types of corpuscular-like endings were found, i.e. "spiral-like" (type I) and "spray-like" (type II) endings. Similarly to nerve fibres, both types of corpuscular-like endings were found mainly near the tibial and femoral attachment sites (15 of 17), whereas only two were found in the middle third of the ligament. Most likely, the type I and type II corpuscular-like endings serve a mechanoreceptive function involved in the sensory control of normal movements and in stress protection.
Anterior Cruciate Ligament↗
Renal cell carcinoma during pregnancy.
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Adult↗
A modified technique for nerve-sparing retroperitoneal lymph node dissection in stage II nonseminomatous germ cell tumors using intraoperative measurement of bladder neck pressure alterations following sympathetic nerve fiber electrostimulation.
We present a simplified method for nerve-sparing retroperitoneal lymph node dissection in patients with nonseminomatous testicular cancer. The sympathetic fibers involved in antegrade ejaculation are identified by intraoperative electrostimulation, resulting in an increase of bladder neck closure pressure. This increase is demonstrated by intraoperative monitoring of both the intravesical pressure and the pressure within the bladder neck by a two-channel microtip measuring catheter. 4 patients with stage I and 6 patients with stage II nonseminomatous testicular cancer were operated on with this modified technique. Ejaculation was preserved in all cases. Semen volume ranged from 2.2 to 4.0 ml. Sperm cell count ranged from 2 to 22 x 10(6)/ml with 20-50% motile spermatozoa, except for 2 of the 3 patients who initially presented with preoperative azoospermia following chemotherapy. In 1 of these 3 patients, postoperative semen analyses revealed a recovery of germ cell function demonstrated by oligoasthenozoospermia.
Adrenergic Fibers↗