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Biomedical subjects

M Rist

Publications and source records attributed to M Rist.

At least 55 records · Page 3Linked to original sources

[Diagnostic accuracy of prostate needle biopsies in cancer of the prostate].

The carcinoma of the prostate can be diagnosed with high certainty in needle biopsy. Among 450 cases only one false diagnosis was found. Under routine diagnostic conditions, semiquantitative evaluation showed that 50% of the investigated morphological parameters in carcinomas of the prostate can be reproduced by one and the same or different investigators with a sufficiently high degree of certainty. Comparison between needle biopsy and transurethral resection material showed that the overall coincidence of tumor classification (according to the predominant part of tumor) was only 50%. The authors conclude that tumor therapy should not predominantly be based on morphology present in a single needle biopsy.

Biopsy, Needle↗

[Prognostic significance of clinical and morphological parameters in prostate cancer].

In 269 patients with carcinoma of the prostate, a retrospective statistical evaluation was done to correlate prognosis with different clinical and morphological criteria. All prostate biopsies were reviewed, the clinical staging redone and compared to survival of the patients. The most reliable criteria for prognostic prediction are clinical staging (rectal palpation, radiological examination and prostatic acid phosphatase). The morphologic parameters (histologic type of tumor, perineural invasion and perifocal inflammation) are of additional but of limited value.

Age Factors↗

Autoregulation in rats with transplanted supernumerary kidneys.

Autoregulation of mammalian renal function is implicit in the fact that a few hours after removal of one kidney the activity of the intact nephrons in the other kidney suddenly increases, both in glomerular filtration and tubular reabsorption. There follows a slower but easily measured increase in renal mass-compensatory hypertrophy in each residual nephron. That response to a reduction of nephrons has been well studied, but the adaptation of normal renal function to additional nephrons could not be tested until microsurgical techniques made it possible to transplant one or two additional kidneys into normal rats. We report here sequential measurements of the total renal function of rats with three and four kidneys. Our results indicate that autoregulation maintains total renal function at normal levels in spite of a doubling in the number of nephrons and apparent renal mass.

Animals↗

[Phenacetin abuse IV. Are cytological urine studies successful and usable in the prevention of tumors in phenacetin abusers?].

971 samples of urine and washes of the urinary bladder in 643 patients were investigated cytologically. Urothelial carcinoma was present in 27 patients. In 11 cases the carcinoma was diagnosed by urinary cytology; 7 of the carcinomas were localized in the urinary bladder, 3 in the renal pelvis and 1 in the ureter. By contrast, all 19 tumors diagnosed in washes were localized in the urinary bladder. Diagnostic sensitivity was 100% in urine and about 75% in bladder washes. In 5 other patients cytologic diagnosis of carcinoma could not be confirmed by histology. In 4 of these, urothelial papillomas were present and in 1 patient a carcinoma of the bladder had been resected previously. Thus, the diagnostic accuracy of urinary cytology is good if essential methodological prerequisites are fulfilled. Therefore, urinary cytology appears to be an appropriate method for screening programmes in high risk patients such as phenacetin abusers. The estimated costs of a screening programme in Basel are 50 000-150 000 Swiss francs. However, a preliminary study to verify the value of such a screening programme is suggested.

Humans↗

[Phanacetin abuse III. Malignant urinary tract tumors in phenacetin abuse in Basle 1963-1977].

In 442 inhabitants of Basel 451 malignant tumors of the lower urinary tract were found at autopsy or biopsy from 1963 to 1977. 69/442 patients were abusers of phenacetin containing analgesics. Carcinomas and sarcomas of the lower urinary tract were nearly 13 times as frequent in abusers as in non-abusers. Carcinomas of the renal pelvis were 77 times, carcinomas of the ureter 89 times and those of the urinary bladder 7 times as frequent among abusers. The differences in incidence of malignant tumors are statistically highly significant for all localizations and for multiple carcinomas as well, even if smokers are excluded. "Phenacetin tumors" occurred in younger patients and were more common in women than in non-abusers. They were ofen, though not always, accompanied by analgesic nephropathy. Comparison with other etiological factors such as aromatic amines or thorotrast demonstrated that phenacetin abuse is of greatest importance. The significance of smoking cannot be established unequivocally. Because of the occurrence of a large number of malignant tumors in phenacetin abusers it is very important to prohibit by legislation the use of phenacetin or paracetamol containing analgesics without medical prescription. In addition, these drugs should be replaced by other analgesic compounds.

Female↗

[Management of intra-abdominal abscesses and space with pedicled omentoplasty].

The greater omentum is an organ of excellent absorption ability and or infect defence. Transposition at vascular pedicle is a simple and very useful procedure. According to our experience with 8 patients it is most suitable to fill hollow spaces for example in the liver (echinococcus cysts); it is also very useful for covering huge contaminated irradiation defects frequently occurring with pelvic exenteration.

Abdomen↗

Prognostic significance of peritumoural inflammation in invasive urothelial bladder carcinoma.

Peritumoural inflammation consisting of lymphocytes, plasma cells and lymph follicles is present in two thirds of invasive urothelial bladder carcinomas. This type of inflammation is significantly rarer in advanced tumour stages (P3, P/) and its presence is a favourable prognostic factor. The mean survival time in patients with this type of inflammation is 26.1 months compared to only 14.8 months in patients without. All other forms of inflammation e. g. eosinophilic or polymorphonuclear leukocytes have no relation with prognosis. The significant prognostic value of lympho-plasmocytic inflammation may be considered as local expression of immunological host resistance.

Aged↗

Experimental approach to the correlation of hemodynamic changes with increases in urinary lactate dehydrogenase as a new parameter reflecting serious renal tissue damages.

From previous investigations with nephroptotic patients increased urinary LDH was assumed to be a reliable marker indicating a renal tissue defect due to the organs descent in erect position. Animal experiments now allowed correlation of this enzymatic activity with controlled changes of anatomical and physiological parameters. Changes of the renal hemodynamics or urinary flow induced in acute experiments in dogs simulated kidney displacement in nephroptotic patients. Both ureters were cannulated for separate urine collection and one kidney was manipulated. The renal arterial or venous flow was reduced or the ureter was occluded under electromagnetic blood-flow control. Arterial constriction alone (30%/15 min) selectively caused a drastic decrease (approximately 80%) of Xenon wash-out (= nutrient-flow) in the renal cortex. Under the same conditions radio-labeled microspheres injected intracardially showed a centralization of the renal capillary blood flow from the outer cortex to the juxtamedullary zone. Urinary LDH activities increased up to 800% immediately after arterial constriction. In accordance with total LDH activity the percentage distribution of isoenzymes changed: LDH-I increased and the LDH-V decreased. Neither constriction of the renal vein nor ureteral occlusion had similar effects. In long-term experiments backward fixation of one kidney in rats would reflect the effects of kidney displacement over years in nephroptotic patients: animals were unilaterally nephrectomized and the remaining kidney was dislocated backwards (approximately 2,5 vertebrae) and fixed to the lateral pelvic wall. "Ptotic" rats showed during the following examinations a constant increase of urinary LDH up to 50% by 26 weeks postoperatively. In accordance with increased LDH the isotope nephrogram was pathological and arteriographies showed a stretched and narrowed renal artery. In a number of rats "ptotic" fixation was not effective enough. All these animals showed normal LDH, isotope nephrograms and arteriographies. Both animal experiments documented that reduced flow/hypoxia is essentially responsible for the tissue damage in the kidney manifested by increased release of urinary LDH.

Animals↗

Diagnostic relevance of urinary lactate dehydrogenase determination in nephroptosis and for the indication to nephropexy.

Previously reported experiments with animals suggested that reduced renal arterial flow might be the actual cause for the pathogenicity of nephroptosis. Clinical studies now give evidence that measurements of urinary LDH may be a criterion equal to the isotope nephrogram (ING) in considering this disease. Patients with a "mobile" kidney verified by i.v. pyelography were examined by an ING and a 1-day test for urinary LDH. In accordance with periodic kidney displacement total urinary LDH activities were measured in a 8-h urine volume in the supine position and a 8-h urine volume in the erect position of the patients. Evaluations were all expressed as percentage increase of LDH activity of the patient in the erect versus supine position and correlated with his ING-pattern. Among 45 nephroptotic individuals 34 showed, in accordance with a pathological ING, a mean LDH increase of more than a 100%. Eleven individuals had normal INGs and less than 20% increase equal to a group of 16 normal controls. We postulated a 30% increase as the upper limit between normal and pathological urinary LDH. The percentage distribution of isoenzymes was also altered within the pathological LDH range: LDH-I, which increases in normal controls, now decreased in nephroptotic patients. LDH-IV and V, which decrease in controls, now increased. Homomeric isoenzymes obviously show reciprocal behavior. The degree of kidney descent in cm does not correlate with percentage increase of urinary LDH, i.e. it is not a criterion for pathogenicity. Biopsies taken during nephropexy revealed that from an anamnestic duration of 50 weeks onwards the kidney is significantly affected and tissue damages become evident. If patients were re-investigated after nephropexy they showed normal i.v. pyelograms and normal LDH and no longer had clinical symptoms.

Humans↗

[Transsexualism and its therapy].

After a review of the historical development of ideas about transsexualiam and the discussion of possible somatic and psychological causes of this condition, the results of explorations of 12 male and 6 female transsexuals who desired a hormonal and surgical approximation to the opposite sex are reported. Two of the nine patients whose chromosomes were examined were found to suffer from Klinefelter's Syndrome. From the personal history it was apparent that 8 of the 12 male transsexuals had difficulty in identifying with an absent, alcoholic or brutal father. The wish to be a member of the opposite sex could be traced in 10 of the 12 male and all 6 female transsexuals to the first five years of life. 7 of the 12 male transsexuals and 3 of the 6 female transsexuals were found to have attempted suicide or to have had suicidal tendencies in the past. In 9/12 male transsexuals and 5/6 female transsexuals the "change of sex" operation was considered to be indicated. The average age at operation was 28 for the male transsexuals and 26 for the female transsexuals. The follow-up studies were done 2 months to 3 years after operation for the male transsexuals (average 1, 7 years) and 2 to 3 3/4 years post operatively (average 2, 9 years) for the female transsexuals. 7/8 of the male transsexuals from whom we have katamneses and both female transsexuals reported that they felt subjectively better than before the operation. The present legal situation concerning the registration of change of name and sex in various countries is described.

Adolescent↗