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Biomedical subjects

H Rübben

Publications and source records attributed to H Rübben.

At least 181 records · Page 10Linked to original sources
PubMed1989

Morphological changes of urothelial and intestinal mucosa after ureterosigmoidostomy during experimental urogenic carcinogenesis.

To analyze the effect of chemical carcinogens on urothelial and intestinal mucosa on 214 female Wistar rats an ureterosigmoidostomy was performed. After 10-14 days 123 surviving rats were randomly divided into 4 groups: Group I-III received 0.05 per cent N-Butyl-N-(4-hydroxybutyl)-nitrosamine (BBN) in drinking water over a period of 15 weeks. Group IV received normal drinking water over the same period. The defunctionalized bladders were instilled each second day: Group I: physiologic saline solution, Group II: urine of normal rats, Group III and IV: urine of BBN-treated rats. 30 rats without diversion but BBN treatment served as a control. The evaluation of the histological data gave the following results: In the control group urothelial tumors were found in the bladder exclusively. Dependent on the grade of obstruction in the BBN-treated groups, with diversion urothelial tumors in the renal pelvis and ureter could be documented, whereas in the bladder no tumor growth could be shown. In the intestinal mucosa of BBN-treated animals a high incidence of adenocarcinoma was found. The chemical tumor induction by BBN is related to the urine and takes place by direct contact to the mucosa when the metabolites excreted by the kidneys are activated in the urine. BBN or other urogenic carcinogens seem to have no urothelial specificity. The incidence of bowel carcinoma after diversion must lead to intensive long-term follow up.

Adenocarcinoma↗
PubMed1989

Morphological changes following ESWL in the rat kidney.

Fifty four Wistar rats were treated with 500, 1,000 or 2,000 shock waves, using the modified DORNIER HM 3 system with the new SG40 shock wave generator. The animals were sacrificed after a period of 24 hours, 7 days or 35 days. Histological examination, scanning electron microscopy (SEM) and magnetic resonance imaging (MRI) were used to evaluate acute and long term effects after extracorporeal shock-wave lithotripsy (ESWL). Acute morphological changes such as glomerular bleeding, tubular dilatation, atrophy and partial necrosis occurred immediately after ESWL throughout the kidney. SEM revealed a tubular loss of microvilli and cilia. There was restitutio ad integrum of these diffuse lesions. The extent of the long term lesions was determined by the following mechanism: venous rupture occurred during ESWL, especially in thin arcuatae veins which are, tortuous their and run between two different tissue densities. This resulted in interstitial haematoma, demonstrable by MRI; in the long term groups, the haematomas progressed to interstitial fibrosis with segmental retraction of renal convexity. The blood supply in these areas was reduced and secondary changes such as glomerular-tubular atrophy and sclerosis followed. The degree to which long-term renal lesions resulted was determined by the extent of these changes, which were shock-wave dose dependent up to a dose of 2,000 shock waves.

Animals↗
PubMed1989

Variation of the immunosystem by ciclosporin and keyhole-limpet hemocyanin--are there effects on chemically induced bladder carcinoma?

Ciclosporin (CsA) and keyhole-limpet hemocyanin (KLH) are potent immunomodulators. Their effects on the induction of bladder carcinoma were investigated in Wistar rats using N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) as a known initiator of bladder carcinoma. In a first series the immunosystem was suppressed by CsA. Rats treated with 0.05% BBN + CsA 5 mg/kg/day or CsA 12.5 mg/kg/day orally developed a CsA dose-dependent (2- to 4-fold) enhancement of bladder tumor expansion as compared to 0.05% BBN application alone. In contrast, immunovariation by stimulation with KLH 12.5 mg i.ves. + 0.5 mg s.c. 2 X/week after being sensitized with 1 X 1 mg KLH s.c. resulted in a reduction of BBN-induced bladder tumors. The results confirm the immunosurveillance theory that effective expression of immunoresponse may be important in the control of tumor development. The effective immunostimulation by KLH support the concept of immunotherapy in bladder cancer.

Animals↗
PubMed1989

Long-term interferon treatment in metastatic renal cell carcinoma.

20 patients with progressive metastatic renal cell carcinoma entered a trial in which the effect of a long-term 6-month regimen of recombinant interferon alpha-2b (rIFN) was studied. 15 patients were evaluable. 4 remissions were detected: 1 complete, and 3 partial. All remissions were seen within 3 months of the start of treatment. We conclude that a 3-month rIFN treatment in metastatic renal cell carcinoma is sufficient to make a distinction between responders and non-responders. A review of the recent literature supports this conclusion.

Aged↗
PubMed1988

Unilateral adrenal hemorrhage in forty-five-year-old woman.

We herein describe a case of adrenal hemorrhage on the right side in a forty-five-year-old woman. Her medical history did not show any evidence of an acute bleeding. The hematoma was removed and adrenalectomy performed. A veinectasis and a localized vasculitis are discussed as causes of bleeding.

Adrenal Gland Diseases↗
PubMed1988

Natural history and treatment of low and high risk superficial bladder tumors.

Since 1979 a prospective randomized trial was done to examine the efficacy of intravesical doxorubicin as prophylaxis against recurrence. After complete transurethral resection of the tumor, patients were divided into 3 groups at random: group 1-no further treatment after transurethral resection, group 2-doxorubicin twice weekly for 6 weeks and group 3-doxorubicin for 1 year. A total of 268 patients entered the study. Neither frequency of recurrences, tumor progression nor survival rate was improved significantly by the adjuvant treatment, so that only a limited number of patients will profit by instillation therapy. Analysis of previously reported data suggests that patients with superficial bladder tumors can be stratified into groups with appreciable differences in risk of progression. With regard to these results a differentiated use of a "wait and see" adjuvant intravesical therapy and more aggressive treatment after transurethral resection of superficial bladder tumors seems to be indicated rather than a general practice of chemoprophylaxis.

Administration, Intravesical↗
PubMed1988

Enhancement of chemically induced bladder carcinoma by cyclosporin A.

The effects of cyclosporin A (CsA) on the induction of bladder carcinoma were investigated in Wistar rats using N-butyl-N (4 hydroxybutyl) nitrosamine (BBN) as a known initiator of carcinogenesis. Rats treated with 0.05% BBN + 5 mg/kg per day CsA or 0.05% BBN + 12.5 mg/kg per day CsA developed a dose-dependent (two to fourfold) enhancement of bladder tumor expansion and infiltration as compared to those treated with 0.05% BBN alone. In control rats receiving CsA at doses of 5 mg/kg per day or 12.5 mg/kg per day, no bladder carcinoma occurred. All CsA-treated groups, with or without 0.05% BBN, displayed slight or moderate medullary atrophy of the thymus. The results indicate that immunosuppression with CsA enhances the induction of bladder tumors by BBN. Furthermore, the immunosurveillance theory that effective expression of the immune response may be important in the control of tumor development was confirmed in the carcinogenesis of epithelial cell tumors.

Animals↗
PubMed1988

Superselective embolization of inoperable renal carcinoma in patients with solitary kidney.

Arterial embolization is a palliative procedure in the management of advanced renal carcinoma. In solitary kidneys tumors may also be embolized under certain circumstances, i.e. patients with resectable tumors but inoperable because of poor general condition or patients with nonresectable tumors presenting with hemorrhage or paraneoplastic activity. Experience with 2 cases of selective embolization of inoperable renal cancer in solitary kidneys is presented and the indications for embolization, considering deterioration of renal function, are outlined.

Aged↗
PubMed1987

Multicellular bladder tumor spheroids in coculture with human endothelial cell monolayers.

Multicellular tumor spheroids (MCTS) are avascular spherical tumors grown systematically out of single cells in vitro. The coculture of MCTS of the human bladder carcinoma cell line J 82 with confluent human endothelial cell layers serves as a model to study cell-cell interactions as an important feature in hematogenous tumor spread. Basic information is obtained by phase contrast microscopy and histochemistry. More detailed information is given by the application of scanning and transmission electron microscopy. Immunohistochemistry helps to differentiate endothelial cells from tumor cells (factor VIII-related antigen). The application of this coculture model and of the various methods of evaluation enables us to study cell-to-cell contact phenomena systematically.

Carcinoma, Transitional Cell↗
PubMed1987

Opioid analgesia in extracorporeal shock wave lithotripsy: fentanyl versus alfentanil.

More than 1,600 patients have been treated by extracorporeal shock wave lithotripsy (ESWL) under fentanyl analgesia without any complications or severe side-effects. As secondary respiratory depression is still under discussion, we investigated the value of alfentanil--a short-term acting opioid--with special interest in its efficacy and side-effects. Neither fentanyl nor alfentanil significantly influenced blood pressure, respiratory rate and blood gases. With regard to minor side-effects and patient's acceptance, alfentanil analgesia should be preferred during ESWL treatment.

Alfentanil↗
PubMed1987

[Painless extra-corporal shock wave lithotripsy using the HM3 Dornier lithotripter].

In a clinical study with a modified shock wave generator supplied by Dornier Medizintechnik for the Dornier Kidney Lithotripter HM3 the requirement of analgetics decreased significantly during Opioid-Analgesia. It could be shown that Extra-corporal Shock Wave Lithotripsy is possible without a central acting drug. Furthermore, a reduction of perioperative morbidity could be observed with the new generator.

Analgesia↗
PubMed1987

[Advanced prostate cancer--a therapeutic dilemma?].

The number of approaches available for the management of metastasizing prostatic carcinoma is overwhelming. If due attention is paid to prognostic factors, however, patients can be effectively treated in the urological practice. Once the condition has been diagnosed the first-line treatment carried out should be orchiectomy. Adjuvant drug therapies with such agents as progestogens and estrogens seem to be of little value. Data are not yet available from prospective studies performed to assess the value of complete androgen blockade. In addition, there is so far only experimental evidence that the effect of endocrine therapy is enhanced by an initial adjuvant chemotherapy in untreated prostatic carcinoma, and this should be investigated in randomized clinical trials. In the case of tumor progression estrogens or antiandrogens can be administered to relieve the symptoms; good effects have been achieved especially with estramustine phosphate. Further progression demands chemotherapy, which should be selected with reference to Berry's parameters. There is no agent or combination generally accepted as the chemotherapeutic agent of choice.

Antineoplastic Agents↗
PubMed1986

[Various staining procedures in exfoliative urine cytology. Use in routine urology].

Exfoliative urinary cytology should be included in the diagnostics and follow up of bladder carcinomas. Staining according to Papanicolaou is time consuming and expensive. Therefore the accuracy of cytology after methylene blue staining, use of prestained slides and Papanicolaou staining was investigated. Urine and bladder washouts were taken from 77 patients with histologically proven bladder tumors, 152 patients after resection of the tumor and 100 patients without tumor of the urinary tract. The results show comparable accuracy of the different staining techniques. Methylene-blue stained and prestained slides cannot be used for documentation; therefore all specimens, which show tumor or are suspicious should also be stained according to Papanicolaou.

Cystoscopy↗
PubMed1986

[Anesthesiologic aspects of extracorporeal shockwave lithotripsy (ESWL)].

Anesthesiological considerations are discussed on the basis of the limited literature available and our own experience with more than 2000 ESWL treatments. Guidelines concerning anesthesia technique and ESWL treatment of renal and ureteral stones are outlined and compared to our own results and those in the literature. The following techniques are discussed: intubation anesthesia with halogenated carbohydrogens (Fluothane, Ethrane), intubation anesthesia with Fluothane/Ethrane plus opiates, neuroleptic anesthesia, catheter peridural anesthesia (lumbar/thoracic), opiate analgesia and high frequency jet ventilation.

Analgesics, Opioid↗