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Biomedical subjects

H W Bauer

Publications and source records attributed to H W Bauer.

At least 19 recordsLinked to original sources

Recombinant interferon alfa-2a with or without vinblastine in metastatic renal cell carcinoma: results of a European multi-center phase III study.

A total of 178 patients with metastatic renal cell cancer were randomized to receive interferon alfa-2a (rIFN alfa-2a) or interferon alfa-2a+vinblastine (VLB). IFN alfa-2a was injected intramuscularly at a dose of 18 MIU 3 times a week and VLB was given intravenously at a dose of 0.1 mg/kg once every 3 weeks. The response rate was 11% for patients on monotherapy and 24% for those on combination treatment. The 5-year survival for 145 eligible patients was 9%, independently from the treatment arm. The performance status was significantly related to long-term prognosis, and 13% of the patients with performance status 0 were alive at 5 years, as compared to 6% and 0% for patients with a WHO grade of 1 and 2, respectively. The most frequent adverse events in both treatment arms were flu-like symptoms (95%), fatigue (70%) and gastrointestinal disturbances (68%). Leukopenia was observed more frequently with combination treatment (53%) than with IFN alfa-2a alone (30%). In conclusion, rIFN alfa-2a monotherapy at this dose and schedule has modest antitumor activity in metastatic renal cell cancer. The combination of rIFN alfa-2a+VLB results in a doubling of the response rate, but this does not translate into prolonged survival. Toxicity (except leukopenia) and tolerance were similar in both treatment arms.

Adult

[Benign prostatic hyperplasia].

More than 40% of men, aged 50 years and more, develop a benign prostatic hyperplasia. There is some evidence that a disturbance of the testosterone and estrogene metabolism within the prostate is involved in the pathogenesis. In relation to the symptoms, either a conservative therapy or a surgical treatment and resection of the prostate is performed. Retrograde ejaculation is a frequent consequence of surgical treatment.

Humans

Seminoma testis with elevated serum beta-HCG--a category of germ-cell cancer between seminoma and nonseminoma.

Serum beta-HCG was elevated in 10 of 83 consecutive patients with histologically pure seminoma (12%). Six patients with diagnostic stage I were successfully treated by radiation therapy. One patient with state IIc suffered a mediastinal relapse following retroperitoneal radiotherapy. Two other patients with high tumour burden achieved complete remission after induction chemotherapy followed by surgery and radiotherapy, respectively. One patient with retroperitoneal bulky disease reached permanent complete remission after radiation therapy alone. Beta-HCG-positive seminomas constitute a distinct category of germ-cell tumours on the basis of morphological and clinical features. Corresponding to the intermediate histological position between seminoma and nonseminoma, safe treatment of beta-HCG-positive seminoma can be achieved by radiotherapy in stage I, by retroperitoneal lymphadenectomy plus adjuvant chemotherapy in stages IIa, b and by induction chemotherapy in stages IIc and III.

Adult

Evaluation of the cytotoxic activity of diethylstilbestrol and its mono- and diphosphate towards prostatic carcinoma cells.

To evaluate a possible direct cytotoxic effect of diethylstilbestrol diphosphate (DESDP) in the treatment of prostate cancer we exposed three prostatic carcinoma cell lines (LNCaP, DU 145, and PC-3), 2 nonprostatic neoplastic cell lines (KB and EJ), and one nontransformed cell line (MRC-5) to diethylstilbestrol (DES), diethylstilbestrol monophosphate, and DESDP at levels occurring in patients' sera during p.o. DES therapy (2 to 5 ng/ml) or DESDP infusions (1 to 20 micrograms/ml), respectively. With 5 ng/ml of DES no effect was seen in LNCaP cells, even after 14 days of exposure. In contrast, drug levels attained during DESDP infusions showed marked, dose-dependent cytotoxicity towards all cell lines under study. Prostatic cells were not exceptionally sensitive. High-dose DES slightly stimulated the synthesis of prostatic acid phosphatase in LNCaP cells. Formation of foci of polygonal cells was induced by 5 micrograms/ml of DES in cultures of MRC-5 fibroblasts. We conclude that, at high doses, DES liberated from DESDP acts upon a regulatory or metabolic mechanism common to many if not all human cells. Preferential sensitivity of prostate cancer cells in vivo may be due to high local phosphatase activity and/or DES accumulation in prostatic tissue.

Acid Phosphatase

Simultaneous bilateral testicular germ cell tumors with dissimilar histology. Case report and review of the literature.

A 32-year-old male presented with simultaneous bilateral germ cell tumors of the testicles. Histological examination revealed dissimilar histology in both testes showing pure seminoma in the left side and mature teratoma with malignant transformation in the right testicle. A survey of the literature revealed a total of 151 previously described cases of synchronous bilateral germ cell tumors, the majority of which presenting as bilateral seminoma. Treatment of synchronous bilateral germ cell tumors with dissimilar histology should consist of bilateral orchiectomy and bilateral retroperitoneal lymph node dissection.

Adult

Acid phosphatase, alkaline phosphatase and prostate-specific antigen--usefulness in the diagnosis of metastatic disease and follow-up.

PSA and PAP are effective immunohistologic markers for prostatic cancer metastases. PSA seems to be more sensitive than PAP for diagnosing metastatic prostatic cancer. Simultaneous determination of PSA and PAP yields an additive clinical value in diagnosing and follow-up of prostatic cancer. The prognostic reliability for disease progression (recurrence and treatment response) seems to be PSA greater than PAP greater than AcidP greater than Alkal. P.

Acid Phosphatase

Adrenal myelolipoma: clinical, radiologic, and histologic features.

The adrenal myelolipoma is a benign, endocrinologically inactive tumor whose histologic structure consists of mature adipose tissue with foci of hematopoietic cells. A case is presented of a seventy-one-year-old woman in whom the diagnosis was established preoperatively by means of sonography, computerized tomography, and magnetic resonance tomography. In a review of the literature, the radiologic profile is discussed, and based on the analysis of 59 surgically treated cases a therapy recommendation is given.

Adrenal Gland Neoplasms

Inheritance and testicular cancer. Arguments based on a report of 3 cases and a review of the literature.

Cryptorchidism and antecedent contralateral testicular tumor formation are risk factors for the formation of testicular germ cell neoplasms. The question arises if familial occurrence of testicular cancer constitutes another risk factor. In a series of 184 patients, treated for testicular tumors, three pairs of non-twin brothers were recorded. The analysis of 82 cases reported in the literature to date as well as the clinical features of early age of onset, high incidence of bilateral testicular tumors in familial cases, ethnic differences in occurrence of testicular cancer, HLA studies and the detection of oncogenes give relevance to the concept of the participation of genetic factors in the etiology of testicular germ cell cancer.

Adolescent

Testicular tumors: presentation and role of diagnostic delay.

180 patients with testicular germ cell tumors were evaluated in a retrospective study concerning the features of presentation and diagnostic delay. Mean duration of symptoms was 170 days, being different for seminoma and nonseminoma, and showing a continuous decrease since 1969. Duration of symptoms was longest in stage I seminoma. In the nonseminoma group the longest interval was observed in stage III. It is concluded that only in nonseminoma a prolonged delay exerts adverse effects on prognosis. Short delay (cryosperm conservation) does not seem to cause any harm. A plea is made for periodic testicular self-examination.

Adult

Bilateral testicular germ cell tumors. Report of nine cases and review of the literature.

In a series of 181 patients with testicular germ cell tumors, the phenomenon of bilateral involvement of the testicles was observed nine times (5%). Two patients evidenced a simultaneous bilateral tumor, and, in seven others, a second tumor occurred after an interval ranging between 8 months and 6 years and 11 months. The incidence, histologic findings, therapy, and prognosis of bilateral testicular tumors are discussed on the basis of a survey of the literature. Emphasis is placed on the significance of a long-term follow-up period as well as on the important role of sonography in the early detection of a contralateral tumor.

Adolescent

Prophylaxis of complications after urological abdominal surgery by substitution of plasma proteins.

A prospective randomized trial on 94 patients undergoing urological-abdominal surgery has been carried out to evaluate the effect of postoperatively administered plasma proteins. A significant difference in the incidence of bronchopulmonary complications has been found between the treatment group and the control group. This may be due to the substitution of alpha 1-antitrypsin as indicated by assaying alpha-antitrypsin activity. A positive trend, but no significant differences, could be demonstrated for wound healing and the need for antibiotics, postoperatively.

Anti-Bacterial Agents

[Prostaglandin E2 in prostatitis and prostatic adenoma].

The measurement of prostaglandin E2 (PGE2) concentrations in the serum and prostatic fluid of healthy men, patients with prostatic hyperplasia and of patients with prostatitis was attempted and correlated to the state of disease, respectively. PGE2-concentrations with prostatic fluid of healthy men were found to be significantly lower than in patients with prostatitis. Corresponding to the course of treatment concentrations normalized, being favorably influenced by sitosterin as an adjuvant medication. Compared to healthy men, PGF2 concentrations in the prostatic fluid of patients with hyperplasia of the prostate incline to lower levels.

Adult