Biomedical subjects
Publications and source records attributed to H Trummer.
We report the case of a female patient presenting with flank pain. Abdominal ultrasound revealed a tumor of 8 cm in diameter. After abdominal computerized tomography, the tumor was classified as angiomyolipoma with a tumor thrombus in the inferior vena cava. After nephrectomy, the diagnosis was confirmed histologically. To our knowledge, this is the 11th case of a renal angiomyolipoma extending into the vena cava.
In infertile men thyroid hormone and antibody testing was performed and correlated with the results of semen analyses. Evaluation included semen analyses, physical examination, evaluation of sex steroid hormones, thyroid hormones (bTSH, fT4, fT3) and thyroid antibody testing (TGA, TPO-Ab, TRAK). Furthermore 45 men with normal thyroid function were scheduled for TRH testing. No one was diagnosed as having manifest hypo- or hyperthyroidism. Latent thyroid dysfunction had no effect on semen parameters. Elevated TPO-Ab were significantly correlated with reduction in motility of spermatozoa. The routine assessment of thyroid hormones and antibodies in infertile men is not recommended. Subclinical hypothyroidism as a result of TRH testing is a rare finding in infertile men.
Peripheral primitive neuroectodermal tumour in the kidney is a rare entity with high malignant potential. The distinctive demographic, clinical and radiological findings, as described in the present case, should suggest this aggressive tumour in the differential diagnosis of renal neoplasms in adolescents.
OBJECTIVE: To investigate the incidence of thyroid dysfunction, thyroid antibodies, and the correlation with semen and hormonal parameters in infertile men. DESIGN: Prospective study. SETTING: University-based andrology laboratory. PATIENT(S): Three hundred five infertile men with idiopathic infertility. INTERVENTION(S): Medical history, clinical examination, semen analysis, measurement of free thyroxin (fT4), free triiodothyronine (fT3), basal thyroid-stimulating hormone (bTSH), LH, FSH, T, free testosterone (fT), PRL, E2, sex hormone-binding globulin (SHBG), DHEAS, and the thyroid antibodies thyreoglobulin antibody (TGA), thyroid peroxidase antibody (TPO-Ab), and thyroid receptor antibody (TRAK). MAIN OUTCOME MEASURE(S): Incidence of thyroid dysfunction and thyroid antibodies, as well as the correlation with hormones and the results of semen analyses. RESULT(S): No manifest thyroid dysfunction was observed. Latent thyroid dysfunction and latent hypothyroidism were diagnosed in 11.5% and 3% of infertile men, respectively. No correlation between thyroid dysfunction and semen parameters was detected. bTSH correlated significantly with PRL (P<.001). Thyroid antibodies were elevated in 7.5%. Elevated TPO-Ab were significantly correlated with pathozoospermia (P=.036) and asthenozoospermia (P=.049). CONCLUSION(S): Latent thyroid dysfunction had no impact on semen parameters. In patients with elevated TPO-Ab levels, pathozoospermia or asthenozoospermia should be considered.
Erectile disfunction (E. D.) is more common in older men but may affect younger men too. Diabetes mellitus, coronary heart disease and hypertension are often associated with E. D. The majority of the patients are treated medically for erectile dysfunction and, recently, oral therapy has become most important since Viagra has been approved. New phosphodiesterase blockers are in preclinical evaluation since then. Phentolamine and apomorphine will become available soon for the treatment of E. D. It is important to know about the etiology of E. D. as well as the mechanisms by which drugs may improve erection in order to decide which drug is appropriate for a particular patient.
Androgen ablative therapy was introduced in the early 1940s and, even today, has remained the golden standard for the treatment of advanced prostate cancer. During the past decades, a variety of improvements have been achieved which, however, primarily aimed at a better tolerance or improved acceptance of androgen deprivation. However, after almost six decades of hormonal therapy it is appropriate to ask whether progress was also made in terms of efficacy, particularly as far as prolongation of survival or quality of life is concerned. During the last few years, two therapeutic strategies, maximal androgen blockade and intermittent androgen suppression, have been considered true conceptual advances. However, despite tremendous efforts and a huge number of studies so far, these concepts appear to produce more questions rather than answers. Therefore, it seems appropriate to raise some critical issues of maximal androgen blockade and intermittent androgen suppression.
OBJECTIVE: To evaluate the influence of cryopreservation temperature on human sperm motility and morphology. DESIGN: Controlled study, investigator was blinded to the type of cryopreservation. SETTING: University-based andrology laboratory. PATIENT(S): Sixteen semen samples with normal motility and sperm count from men after a fertility work up. INTERVENTION(S): Semen aliquots were either stored in a mechanical freezer at -70 degrees C or in liquid nitrogen at -196 degrees C for 7 days or 3 months. Test yolk buffer was used as a cryoprotectant. With use of a programmable freezing unit, all samples were cooled at a controlled rate. MAIN OUTCOME MEASURE(S): Sperm motility and morphology. RESULT(S): After 7 days of cryopreservation, there was a greater decrease in sperm motility among specimens maintained at -70 degrees C than among those maintained at -196 degrees C (47% versus 39% decrease). The difference in sperm motility was even greater after 3 months of cryopreservation (72% versus 39% decrease). No difference in postthaw sperm morphology was detected among sperm preserved at -70 degrees C versus -196 degrees C. CONCLUSION(S): Sperm cryopreservation at -196 degrees C is superior to cryopreservation at -70 degrees C. Sperm can be stored at -70 degrees C for a short period of time with a relatively modest loss of motility.
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OBJECTIVE: To evaluate the usefulness of serum immunosuppressive acid protein (IAP) as a marker for lymph node metastases in patients with renal cell carcinoma. PATIENTS AND METHODS: Serum IAP levels were studied in 73 patients with renal cell carcinoma, prior to therapy. Serum IAP levels were correlated with the clinical and the post-operative histopathological stage. A threshold value of 800 micrograms/ml was applied. RESULTS: Statistical analysis revealed a better correlation between IAP concentration and disease than with any other variable. Sensitivity and specificity were 94% and 84%, respectively, thus providing good positive (65%) and negative (98%) predictive values regarding lymph node involvement. CONCLUSION: Measuring serum IAP levels can be a valuable contribution to lymph node staging in patients with renal cell cancer. The choice of cut-off value of 800 micrograms/ml has yet to be supported by a larger series.
Intravesical electrostimulation activates bladder mechanoreceptors and can induce detrusor contraction. The latency of afferent impulses indicates that myelinated A-delta fibres are used for impulse transmission. Twenty patients, of whom twelve showed acontractile, and eight hypocontractile detrusor muscles, were treated by means of intravesical electrostimulation. Prior to treatment, the average residual urine was 218 ml. Eleven out of the 20 patients on completion of the stimulation programme had a residual urine of less than 100 ml. Only four patients remain on intermittent clean catheterization, in comparison with nine patients before electrostimulation was started. Bladder sensitivity improved in 75% and detrusor contractility in 40% of the patients. No adverse effects were seen.