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Biomedical subjects

H D Adolphs

Publications and source records attributed to H D Adolphs.

At least 19 recordsLinked to original sources

Comparison between tissue antigen analysis and plasma determinations for TPA and CEA in transitional cell carcinomas and in tumorfree urothelium of the urinary bladder.

Plasma determinations for TPA and CEA resulted in a sensitivity of 90% and 19-42%, respectively, for urothelial bladder cancer. By immunohistochemical staining TPA was positive in 100% and CEA in about 80% of the cases. The CEA staining in cancer tissue seemed to correlate with the WHO grade. Because TPA resulted in strong positive staining and high sensitivity in the plasma, contrary to CEA, showing less positive staining and a lower sensitivity, there seemed to be a good correlation between staining and plasma sensitivity for both markers.

Antigens, Neoplasm

Value of intravesical sonography in tumor classification of bladder carcinoma.

The possibility of a T classification for bladder carcinoma by intravesical sonography was investigated in a 3-year field study (1982-1985) at the Urological Clinic, Bonn University. In a total of 571 patients with histologically verified bladder cancer, the sonographic classification was compared with the histological T category. There was an agreement of 70.1%. While the infiltration of superficial tumors (above all of large tumors) was frequently overestimated (28.7%), understaging predominated in invasive carcinomas (20.9%). The overall precision of conventional staging techniques was 67%. Ultrasonography showed a marked superiority, above all in infiltrative papillary tumors of low diameter (precision 76% compared to 12% with the conventional T classification). The sensitivity of the method with regard to the detection of tumor infiltration (90%) was also markedly higher than that of earlier techniques (66%). Particularly helpful in the evaluation of more deeply infiltrating tumors, intravesical sonography constitutes a major extension of the diagnostic spectrum for T classification of bladder carcinoma.

Aged

[Chemo-immunoprevention in superficial bladder cancer].

We performed chemoimmune prophylaxis in 130 patients with superficial urothelial transitional cell carcinoma of the bladder. Two weeks after complete TUR 700 mg Cyclophosphamide (CTX)/m2 were injected intravenously followed by 6 weekly intravesical instillations of 120 mg BCG/50 ml saline together with BCG skin scarifications two weeks later. After 5 years the calculated frequency of recurrence was 18% in the treated group compared with 54% in the untreated historical control group. In a sub-group of 48 patients with recurrent tumors the CTX/BCG treatment success was well documented by comparison of the tumor recurrences during the appropriate time intervals before and after chemoimmune prophylaxis. The progression rate of the disease was generally more favourable in patients treated by CTX/BCG. No significant side effects of this treatment were noticed.

BCG Vaccine

Urinary cytology in workmen engaged in the petrochemical industry with reference to non-industrial risk factors.

Urine cytology was evaluated in 8,406 male workers of 8 petrochemical factories in western and northern Germany during the routine medical check-up performed by the department of industrial medicine of the respective factory. All relevant data referring to possible private and occupational risk factors were registered and evaluated. Four percent (n = 358) of the 8,406 workers examined exhibited Pap 3/4 cytology. Urological examination did not reveal any bladder tumor in those workers with either a single Pap 4 or a repeated Pap 3 finding on cytology. Our study showed that deterioration of cell differentiation correlated significantly with age and cigarette smoking. Furthermore, a risk group (males above 40 years of age exposed to occupational chemicals, smokers, and coffee drinkers) differed from a non-risk group. Age and cigarette smoking seemed to be the determinant factors. No correlation could be adduced between any kind of industrial exposure and urine cytology.

Adult

Comparison between cell kinetical and immunohistochemical studies on carcinoma and atypia/dysplasia of urinary bladder mucosa.

Results of cell kinetic analyses on transurethrally obtained material from urinary bladder are compared with parallel immunohistochemical tests on carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA), performed on the same material. Labelling index increases from 1.4% in slight to 20% in marked urothelial atypia. CEA reaction in slight atypia is slight or moderate, slight, moderate or distinct in atypia, and moderate to distinct in carcinoma in situ. TPA always shows moderate to distinct reactions. Cell kinetically, urothelial carcinomas yield similar gradations. They were positive for CEA in 70% and for TPA in 100%. In GO and GI carcinomas, negative and slightly positive reactions predominate, poorly differentiated lesions yield predominantly distinct reactions. In all grades, TPA ranges from slight to distinctly positive. As in cell kinetic analyses, there is a relationship between differentiation grade and stage for CEA expression. This does not apply for TPA. The results permit us to draw conclusions on the different biological and histogenetical behavior of urothelial carcinomas. There are undoubtedly differences in the behavior of papillary-exophytical and solid invasive carcinomas in terms of both cell kinetics and immunohistochemistry.

Autoradiography

Proliferative pattern of urothelial bladder cancer and urothelial atypias.

For early diagnosis of urinary bladder tumors, autoradiographic, cytological, and impulse cytophotometric examinations were performed on fresh bladder tissue with carcinomas of different grades of malignancy and various depths of infiltration, and also on tissues with concomitant urothelial atypias. Cell kinetic examinations of urothelial atypias of mild, moderate, and severe grade revealed labeling indices comparable to those of urothelial carcinomas grade I, II, and III, respectively. The labeling indices of the carcinomas increased with both the grades of malignancy and the depth of invasion up to factor 5. Cytophotometrically mild atypias showed euploidy, while moderate to severe atypias revealed aneuploidy. By means of cytologic, cytophotometric, and cell kinetic analyses, two subgroups of G I urothelial carcinomas were distinguished. Subgroup I a corresponded to highly differentiated papillary urothelial carcinomas with low labeling indices, pap I-III differentiation, and euploidy. Subgroup I b, on the other hand, revealed pap differentiations of IV-V, aneuploidy, and higher labeling indices. This subgroup seems to be more prone to recurrences and apparently indicates higher grades of malignancy and depths of infiltration. The data presented provide evidence that a combination of these methods is helpful for early recognition of precursors of bladder cancer atypias as well as for exact evaluation of the biological potential of carcinomas.

Adult

Flow-cytophotometric studies on urine sediments of patients treated with anti-cancer-drugs.

Urine specimens of 24 patients receiving polychemotherapy for malignancies of the gonads were examined by flow cytophotometry (FCM) and routine cytology. The results show abnormal DNA histograms during chemotherapy due to an arrest of the cell cycle at the S- and G2M level. In treatment protocols with ifosfamide leucocyturia develops. No cytological changes of the urothelial cells occur during treatment. All these alterations are completely reversible within 4 weeks. It is concluded that the measurable nuclear changes of urothelial cells may serve as parameters for cellular events during polychemotherapy.

Adult

Improved application of impulse cytophotometry for the diagnosis of urinary bladder carcinoma.

Using pulse cytophotometry, almost quantitative separation of the leucocyte fraction from DNA histograms was possible by means of an anticoincidence discrimination device, This modified technique was employed for biparametric DNA/protein measurements of voided urine samples, bladder washings, and tumour tissues. The results show a high degree of correlation between these samples so that, for tumour diagnosis from DNA histograms, voided urine specimens can be used rather than bladder washings. The criteria for the bladder tumour diagnosis are derived from DNA measurements of 32 controls and 35 tumour patients. The diagnostic sensitivity of this method is 0.91 and the specificity 0.75.

Carcinoma

Effect of intralesional and systemic BCG-application or a combined cyclophosphamide/BCG treatment on experimental bladder cancer.

Infiltrating transitional cell carcinomas of the urinary bladder were induced by ingestion of 0.188% N-[4-(5-nitro-2-furyl)-2-thiazolyl] formamide (FANFT) in 145 female Wistar rats. After 8 months of carcinogen exposure, the animals were divided into different treatment groups. They received cyclophosphamide intraperitoneally as a single injection or BCG either once intralesionally or weekly subcutaneously or a combination of cyclophosphamide followed by subcutaneous BCG. The treatment effect was determined by body weight measurements and bladder tumour weight after 12 months. Compared with a control group statistically significant differences of bladder tumour weights were found after treatment with BCG alone or in combination with cyclophosphamide. Intralesional BCG resulted in an insignificant increase of tumour weights.

Animals

Avian pox virus. An ultrastructural study on a cherrug falcon. Brief report.

The ultrastructure and maturation of avian pox particles is described in the rare case of a naturally infected hawk (Falco cherrug). As in other cells infected by fowlpox virus two types of inclusion bodies are encountered in the cytoplasm: firstly assemblies of fluffy filamentous material apparently giving rise to immature virions. They are thought to present virus factories (inclusion body B). Secondly mature virus particles budded into extensive groupings (Bollinger bodies, inclusion body A) which display a fine structure identical to other strains of fowlpox virus.

Animals

[Nephrogenic adenoma of the urinary bladder with concomitant multiple adenomatous polyps of the large bowel. An abortive form of Gardner's syndrome? (author's transl)].

For the first time, a nephrogenic adenoma of the urinary bladder coinciding with multiple adenomatous polyps of the large bowel, in a 64-year-old male, is reported. The relationship of these tumors at different sites to a known clinical systemic disease is questionable; they could conceivably be ascribed to an abortive form of Gardner's syndrome. On the basis of a case report, the essential aspects of the nephrogenic adenoma of the urinary bladder are reviewed and discussed.

Adenocarcinoma

The natural history of nephrogenic adenoma of the urinary bladder.

The nephrogenic adenoma is a peculiar lesion of the urinary bladder characterized partly by villous and partly by gland-like structures. The two layered surface epithelium consists of an eosinophilic cell layer, which covers a clear cell layer, the latter resting upon a delicate basal layer. The clear cells disappear when approaching the tip of the villi. There exists a 200 micron wide zone of transition between the urinary bladder epithelium and that of the neprogenic adenoma. At the base of the villi there are scattered nodules of gland-like structures lined either by eosinophilic cells or by clear cells. These epithelial cells are derived from the corresponding surface epithelial cells from which they had separated by active downwards growth.

Adenoma

Induction of transitional cell carcinoma of the urinary bladder in rats by feeding N-[4-(5-nitro-2-furyl)-2-thiazolyl] formamide. Histological and ultrastructural findings.

After feeding with 0.188% N-[4-(5-nitro-2 furyl)-2-thiazolyl] formamide (FANFT), transitional cell carcinoma of the urinary bladder was induced in all female Wistar rats tested. Histological changes of the urothelium consisted of various degrees of hyperplasia and dysplasia. An infiltrating transitional cell carcinoma first appeared after 8 months. These results are compared with the findings of other authors, and divergencies of the tumour induction rates are discussed with respect to strain, sex and weight of experimental animals as well as concentration and amount of ingested carcinogen. Electron microscopy shows microvillous transformation of the luminal plasma membrane and appearance of a thick fluffy cell coat (glycocalyx). These changes are explained by an altered function of the Golgi complex occurring during malignancy and leading to a loss of the specific discoid vesicles of the urothelial cells.

Animals

Biological behavior of N-[4-(5-nitro-2-furyl)-2-thiazolyl]-formamide induced carcinoma of the transitional epithelium in the rat.

30 female Wistar rats weighing between 70 and 90 g were fed for 8 months with 0,188% N-[4-(5-nitro-2-furyl)-2-thiazolyl] Formamide (FANFT). After this period a papillary tumor of the urinary bladder was demonstrable in each animal. Histological examination always revealed a transitional cell carcinoma with prevailing medium tumor stages; no distant metastases were found. The grade of malignancy was classified as medium and high. No significant statistical relationship could be ascertained between tumor stage and grade or between grade and weight, but a correlation was established between tumor stage and weight. After 12 months, 36/60 kidneys were found to be normal, whereas in 20/60 dysplasias and in 2/60 transitional cell carcinomas of the renal pelvis were observed; secondary hydronephrosis due to bladder tumors occured 4 times. Other organ changes were not noticeable.

Animals

[Malignant lymphoma of the testis--an urological or nonurological disease?[].

Malignant lymphomas of the testis have a special position among the tumours of the testis. Also in such cases, in which only the testis is perceptibly diseased, nevertheless must be started from a systemic disease which is clinically not yet recognizable. These special problems demand a multidisciplinary, oncological collaboration in diagnostics and therapy. After establishment of the diagnosis and semicastration by the urologist further diagnostics and therapy should be performed by the representatives of other specialities.

Adolescent

[Primary tumors of the ureter (author's transl)].

13 own cases of primary tumors of the ureter are presented and discussed with reference to the presenting clinical symptoms, diagnostic procedures, and therapy. In our patients, excretory urography was not always of diagnostic value, whereas retrograde pyelography contributed to the correct diagnosis. The radiographic appearance of ureteral tumors has to be differentiated from strictures. In one case with a calcified papilloma, preoperative roentgendiagnosis suggested an ureteral stone.

Adult