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Biomedical subjects

J M Wolff

Publications and source records attributed to J M Wolff.

At least 19 recordsLinked to original sources
PubMed1996

Laparoscopic bilateral ureterolysis in Ormond's disease.

We report a case of retroperitoneal fibrosis with dilation of the upper urinary tract on both sides and impaired renal function in a 66-year-old female. The patient was successfully treated by laparoscopic ureterolysis and intraperitonealization of both ureters with subsequent immunosuppressive medication. Due to intraoperative subcutaneous emphysema, surgical therapy had to be performed as a two-step procedure but postoperative morbidity was minimal with quick recovery. Laparoscopic ureterolysis is a reconstructive procedure and the ureters are accessible in full length either transperitoneally or retroperitoneally.

Aged↗
PubMed1996

Metabolic imaging of untreated prostate cancer by positron emission tomography with 18fluorine-labeled deoxyglucose.

PURPOSE: We evaluated positron emission tomograph (PET) with 18fluorine (18F)-labeled deoxyglucose for metabolic grading of untreated primary prostate cancer, and differentiation of benign and malignant prostatic disease. MATERIALS AND METHODS: A total of 48 patients with untreated prostate cancer of different stages and 16 with histologically confirmed benign prostatic hyperplasia (BPH) underwent static PET after intravenous injection of 150 to 300 MBq. 18F-deoxyglucose. 18F-deoxyglucose accumulation was quantitated by calculating differential uptake ratios and prostate-to-skeletal muscle ratios. RESULTS: Low 18F-deoxyglucose uptake was noted in the majority of primary tumors (81%). 18F-deoxyglucose accumulation did not correlate with increasing tumor grade or stage. There was a significant overlap in uptake values in BPH and malignant prostatic disease. A trend towards statistical significance was noted with lower prostate-to-skeletal muscle ratios in patients with BPH (p < 0.07). Increased 18F-deoxyglucose accumulation was detected in some patients with BPH and malignant prostatic disease, as well as in those with lymph node and bone metastases of prostate cancer. CONCLUSIONS: 18F-deoxyglucose PET does not allow for metabolic labeling in the majority of untreated primary prostate cancers. BPH and primary prostate cancer cannot be reliably differentiated on the basis of PET. Increased 18F-deoxyglucose accumulation occurs in some primary prostate tumors and in metastatic deposits of prostate cancer.

Antimetabolites↗
PubMed1995

Levels of circulating intercellular adhesion molecule-1 in patients with metastatic cancer of the prostate and benign prostatic hyperplasia.

Current reports suggest a role for intercellular adhesion molecule-1 (ICAM-1) in the progression of malignancy. The availability of a new antibody makes it possible to measure circulating ICAM-1 (cICAM-1) in human body fluids including serum; this might help in monitoring tumour burden and in providing additional prognostic information. In this study, serum levels of cICAM-1 were measured by an ELISA assay in patients with benign prostatic hyperplasia (BPH; n = 20) and metastatic cancer of the prostate (CaP; n = 25). Serum ICAM-1 concentrations were also measured in a group of healthy men (n = 8). The mean +/- S.E.M. cICAM-1 level for BPH was 339.52 +/- 15.30 ng/ml compared with 263.55 +/- 18.54 ng/ml for CaP. Even though the difference between the two groups was significant (P < 0.005), there was a marked overlap between the individual values in both groups, thus minimising the prognostic value of these measurements in prostate cancer. Endocrine therapy had no notable effect on the serum levels of cICAM-1. The mean +/- S.E.M. cICAM-1 concentrations in serum from a younger group of healthy volunteers was 204.1 +/- 10.38 ng/ml, and this value was significantly lower than that measured in serum from either BPH or CaP. We also undertook some immunohistochemical studies to examine the distribution of ICAM-1 in prostate tissue. We observed focal epithelial cell membrane staining which was exceedingly patchy in both the BPH and cancer specimens. On the basis of these studies, we suggest that cICAM-1 levels do not provide additional information on patients with metastatic CaP.

Adult↗
PubMed1995

Non-traumatic rupture of the urinary tract during pregnancy.

OBJECTIVE: To review published cases of rupture of the urinary tract during pregnancy and illustrate the clinical manifestations of this serious complication of pregnancy. METHODS: Reported cases of urinary tract rupture were reviewed and a new case described. RESULTS: Spontaneous rupture of the urinary tract during pregnancy is rare; a review of the literature revealed only 24 cases, most commonly occurring in diseased kidneys. In the majority of cases the rupture was associated with underlying diseases of the kidney, the most common being renal tumours. Of the 25 cases examined, 12 had ruptures of the collecting system and 13 had ruptures of the renal parenchyma: 21 were diagnosed during pregnancy in the second and third trimester and four within the first 24 h postpartum. CONCLUSION: Pregnancy-induced changes in the urinary tract exaggerate any weakness of the parenchyma or collecting system. Pregnant patients with overdistension of the upper urinary tract should undergo routine ultrasonography and be observed carefully for infection or haematuria.

Adult↗
PubMed1995

Evaluation of patients with diseases of the prostate using prostate-specific antigen density.

OBJECTIVE: To compare the efficacy of two tests, prostatic-specific antigen (PSA) and the PSA/prostate volume ratio (PSAD), as diagnostic and staging markers to discriminate patients with benign prostatic hyperplasia (BPH) from patients with cancer of the prostate (CaP). PATIENTS AND METHODS: Prostate gland volumes were estimated in 60 patients with BPH and 88 patients with clinically organ-confined CaP by performing transrectal ultrasonography (TRUS) and using the prolate ellipse formula. Serum PSA concentration was determined using an enzyme immunoassay. In patients with BPH, the prostates were removed either by transurethral resection or retropubic prostatectomy. Patients with CaP underwent laparoscopic pelvic lymphadenectomy followed by radical perineal prostatectomy. PSAD was calculated by relating the serum PSA level to the TRUS-estimated prostate volume. RESULTS: The median PSA level was 4.4 ng/mL in patients with BPH, 9.3 ng/mL in patients with CaP-NO disease and 24 ng/mL in those with CaP-N+ disease. However, imposing a PSA limit of 4 ng/mL for the diagnosis of CaP gave a positive predictive value of only 64.8%, whereas a limit of 10 ng/mL gave a positive predictive value of 71.4%. In contrast, the median PSAD was 0.086 ng/mL/cm3 in patients with BPH, but was 0.295 ng/mL/cm3 in patients with NO-disease and 0.775 ng/mL/cm3 in those with N(+)-disease. With a limit of 0.15 ng/mL/cm3 the positive predictive value of PSAD was 81%. Furthermore, a limit of 0.6 ng/mL/cm3 revealed a positive predictive value of 81% for the diagnosis of metastatic lymph node involvement. CONCLUSIONS: There was a considerable overlap of PSA concentrations in patients with BPH and CaP, and PSA was not sufficiently accurate to distinguish between them. In contrast, PSAD enhanced the discrimination between BPH and CaP and may provide additional information about the status of the lymph nodes in patients with CaP.

Aged↗
PubMed1995

Spontaneous kidney rupture--symptom of renal tumors.

Spontaneous ruptures of the kidney frequently require an emergency surgical intervention and the underlying pathology often only becomes clear intraoperatively. On the basis of our own cases the clinical management of the symptom 'rupture of the kidney' is discussed particularly referring to renal tumors.

Adenoma, Oxyphilic↗
PubMed1995

Determination of prostate gland volume by transrectal ultrasound: correlation with radical prostatectomy specimens.

Estimation of the prostate gland volume employing transrectal ultrasound provides important additional information in patients with benign and malignant diseases of the prostate. Twenty-five patients underwent transrectal ultrasound of the prostate prior to radical prostatectomy for organ-confined cancer of the prostate. The prostate gland volume was calculated employing two different methods. The prostate specimen weights were compared with the results of each of the volume estimation method. The prolate ellipse formula, widely used as an alternative to planimetry, demonstrated a correlation coefficient of r2 = 0.831. However, a variation of the prolate ellipse formula expressed as (width x width x height) x pi/6, which is easier to perform as described by Terris and Stamey, exhibited a correlation coefficient of r2 = 0.829. It appears to be a reliable means of estimating prostate gland volume, especially in cases in whom the original formula is difficult to apply.

Aged↗
PubMed1994

Spontaneous bladder rupture following enterocystoplasty can be treated conservatively.

Spontaneous bladder rupture following enterocystoplasty has been reported recently. The etiology remains unclear but appears to be multifactorial. Common factors are a high outlet resistance with total urinary continence and the presence of an augmented, dysfunctional native bladder, which may result in the development of high intravesical pressures or increased wall tension. We present a case of spontaneous bladder rupture 4 weeks following enterocystoplasty in which a segment of detubularized ileum was used to augment a contracted bladder. Our patient was treated by continuous bladder drainage for 21 days, antibiotics and appropriate supportive care.

Aged↗
PubMed1994

Retinoblastoma and p53 genes as prognostic indicators in urological oncology.

Recent studies of the malignant phenotype have suggested that cumulative genetic changes are necessary for a malignant cell to develop. Alterations in particular genes associated with cell growth and division have been identified and two main classes of genes have been characterized. Oncogenes are those genes which when mutated promote tumour growth, whereas tumour suppressor genes (antioncogenes) inhibit tumour growth. Oncogenes have been investigated in some depth, but relatively little is known about tumour suppressor genes. Recent studies have shown that inactivation of normal tumour suppressor genes is a common mechanism in cancer progression and this may be of prognostic value. The present review focuses on the potential of tumour suppressor genes as prognostic markers in urological cancers.

Biomarkers, Tumor↗
PubMed1994

Differentiation of benign prostatic hyperplasia and prostate cancer employing prostatic-specific antigen density.

To enhance the ability of prostate-specific antigen (PSA) to distinguish benign prostatic hyperplasia (BPH) from cancer of the prostate (CaP) Benson et al. defined a new parameter, PSA density (PSAD), which is the ratio of the serum PSA concentration to the volume of the prostate. We have employed this parameter in a prospective study of 28 patients with clinically localised CaP and 57 patients with BPH. Mean PSAD was 0.116 for the BPH patients and 0.46 for the CaP patients (p < 0.005). The authors conclude that the information provided by PSAD is superior to absolute PSA values in the differentiation between BPH and CaP.

Biomarkers, Tumor↗
PubMed1994

Spontaneous kidney rupture due to a metastatic renal tumour. Case report.

Spontaneous rupture of the kidney is an uncommon entity. In most cases the non-traumatic rupture is associated with underlying diseases of the kidney, the most frequent being renal tumours. We report the case of a spontaneous kidney rupture due to a renal metastasis from an adenocarcinoma of the colon.

Abdomen, Acute↗
PubMed1994

Laparoscopic pelvic lymphadenectomy.

We analyzed our first 41 patients with localized prostate cancer treated with laparoscopic pelvic lymph node dissection (LPLND) as staging procedure followed either by radical perineal prostatectomy or interstitial radiotherapy. 7/41 patients (17%) had pelvic lymph node metastases and received endocrine therapy. Overall complication rate was low (7.5%) and no major complication occurred. LPLND is minimally invasive and provides staging accuracy in prostate cancer.

Ecchymosis↗
PubMed1993

Tumor suppressor genes in urologic tumors.

During the last decade remarkable progress has been made in our understanding of the malignant phenotype. There is evidence that a series of genetic changes are involved in the conversion of a normal cell to a malignant one. These changes have been directly identified with mutations in various genes usually involved in cell growth and proliferation. Two main classes of genes have been characterized: oncogenes, which promote growth and tumor suppressor genes, which restrain growth. While oncogenes have been studied in relative detail, little is known about tumor suppressor genes. However recent studies revealed that loss of tumor suppressor genes are a common mechanism for the progression of cancer and are of prognostic value. In this review we focus on the role of these tumor suppressor genes in urologic tumors in experimental as well as clinical studies.

Genes, Retinoblastoma↗
PubMed1992

The chicken neural extracellular matrix molecule restrictin: similarity with EGF-, fibronectin type III-, and fibrinogen-like motifs.

Restrictin is a chick neural extracellular matrix protein implicated in neural cell attachment and found to be associated with the cell surface recognition protein F11. Here we show by cDNA cloning that restrictin is a large multidomain protein composed of 4 structural motifs. At the N-terminus restrictin contains a cysteine-rich segment of about 140 aa that might link restrictin monomers into oligomers. This region is followed by 4.5 epidermal growth factor-like repeats and then by 9 consecutive motifs that are similar to fibronectin type III motifs. At the C-terminus restriction is related to the beta and gamma chains of fibrinogen, including similarity to a calcium-binding segment. Restrictin shows substantial sequence similarity with tenascin (cytotactin) throughout the polypeptide, and like tenascin, it forms oligomeric structures, as revealed by electron microscopy of immunoaffinity-purified restriction. The cell attachment site of restrictin is mapped to the C-terminal region by antibody perturbation experiments.

Amino Acid Sequence↗
PubMed1992

Structure of the axonal surface recognition molecule neurofascin and its relationship to a neural subgroup of the immunoglobulin superfamily.

The chick axon-associated surface glycoprotein neurofascin is implicated in axonal growth and fasciculation as revealed by antibody perturbation experiments. Here we report the complete cDNA sequence of neurofascin. It is composed of four structural elements: At the NH2 terminus neurofascin contains six Ig-like motifs of the C2 subcategory followed by four fibronectin type III (FNIII)-related repeats. Between the FNIII-like repeats and the plasma membrane spanning region neurofascin contains a domain 75-amino acid residues-long rich in proline, alanine and threonine which might be the target of extensive O-linked glycosylation. A transmembrane segment is followed by a 113-amino acid residues-long cytoplasmic domain. Sequence comparisons indicate that neurofascin is most closely related to chick Nr-CAM and forms with L1 (Ng-CAM) and Nr-CAM a subgroup within the vertebrate Ig superfamily. Sequencing of several overlapping cDNA probes reveals interesting heterogeneities throughout the neurofascin polypeptide. Genomic Southern blots analyzed with neurofascin cDNA clones suggest that neurofascin is encoded by a single gene and its pre-mRNA might be therefore alternatively spliced. Northern blot analysis with domain specific probes showed that neurofascin mRNAs of about 8.5 kb are expressed throughout development in embryonic brain but not in liver. Isolation of neurofascin by immunoaffinity chromatography results in several molecular mass components. To analyze their origin the amino-terminal sequences of several neurofascin components were determined. The NH2-terminal sequences of the 185, 160, and 110-135 kD components are all the same as the NH2 termini predicted by the cDNA sequence, whereas the other neurofascin components start with a sequence found in a putative alternatively spliced segment between the Ig- and FNIII-like part indicating that they are derived by proteolytic cleavage. A combination of enzymatic and chemical deglycosylation procedures and the analysis of peanut lectin binding reveals O- and N-linked carbohydrates on neurofascin components which might generate additional heterogeneity.

3T3 Cells↗
PubMed1991

Restrictin: a chick neural extracellular matrix protein involved in cell attachment co-purifies with the cell recognition molecule F11.

We report here the characterization of restrictin, a novel chick neural extracellular matrix glycoprotein associated with the cell recognition molecule F11. Immunoaffinity chromatography using monoclonal antibody 23-13 directed to restrictin yield a major relative molecular mass band at 170 x 10(3) and minor bands at 160, 180, 250 and 320 x 10(3) which are immunologically related to each other. Neural cells attach on immobilized restrictin in a short-term adhesion assay. This adhesion can be blocked specifically by monoclonal or polyclonal antibodies to restrictin but not by antibodies to F11 or by the peptide GRGDSP. Antibodies to restrictin do not interfere with the fasciculation of retinal axons and the isolated restrictin does not stimulate the outgrowth of axons. In the developing nervous system, restrictin is localized in very restricted regions and is found within areas of F11 expression. The timing and pattern of expression of restrictin and its cell attachment activity suggest that it participates in developmental events of the nervous system.

Animals↗