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Biomedical subjects

P Rathert

Publications and source records attributed to P Rathert.

At least 19 recordsLinked to original sources
PubMed1992

Analysis of criteria for grading bladder cancer in urine cytological tumor diagnosis by means of an expert system.

An inductive expert system was used for the analysis of criteria for grading bladder carcinoma in urine cytological tumor diagnosis. This analysis seems necessary in order to provide a better standardization of grading and to avoid tumor grades, which are rather inhomogeneous with respect to morphology and prognosis. The analysis of the database by the inductive system shows a considerable variation of the cytomorphology of different bladder carcinomas graded as G2 tumors, whereas G1 and G3 tumors are more homogeneous groups respectively. Especially nuclear morphological criteria are important features for the detection of highly differentiated carcinomas, whereas nucleolar features might be helpful to assess the proliferative nature of the carcinoma. The future goal of avoiding a grading system with prognostically inhomogeneous tumor grades seems possible when using an inductive expert system for consultation.

Carcinoma, Transitional Cell↗
PubMed1992

Half-life of prostate-specific antigen after radical prostatectomy: the decisive predictor of curative treatment?

Prostate-specific antigen (PSA) half-life calculated in 51 patients subsequent to radical prostatectomy was found to identify patients with residual disease earlier and more reliably than the criterion of not achieving undetectable PSA levels postoperatively. It is proposed that residual tumor affects the half-life by contributing to the serum level of PSA. When PSA half-life was calculated solely in potentially cured patients, we found a half-life of 1.5 days being considerably shorter than in the previous reports based on patient populations regardless of the outcome of disease in the follow-up.

Adenocarcinoma↗
PubMed1992

[The Bourne's test: a relevant contribution to the diagnosis of vesico-enteric fistulas].

Diagnostic verification of vesicoenteric fistulae is necessary in order to establish the indication for surgical therapy, but this is frequently difficult. This is because uroradiological and endoscopic methods are unreliable and the symptoms are often nonspecific. The Bourne test is a simple noninvasive screening method. If necessary, it can be supplemented by computer tomography. The problems are discussed with reference to a case report.

Adult↗
PubMed1991

Microscopic hematuria: advances in identification of glomerular dysmorphic erythrocytes.

The high diagnostic sensitivity and specificity of microscopically visible, typically glomerular dysmorphic erythrocytes for identification of the cause of glomerular bleeding have been recognized worldwide. Although glomerular dysmorphic erythrocytes are simple to detect on phase contrast microscopy, immediate microscopic diagnosis still is indispensable, since a change in the morphology of the erythrocytes with restriction of the diagnostic relevance is anticipated because of the high autolytic potency of the urine. It may be postulated that this need for immediate diagnosis has led to the method being neglected owing to the high work load at hospitals and physician offices. Moreover, a physician who does not perform microscopic investigations or who lacks experience with the method will not be able to use this diagnostic technique, since it appeared to be impossible to transport urine samples by mail. In the context of a study comprising 30 patients, of whom 10 had histologically confirmed glomerulonephritis, we have shown that glomerular dysmorphic erythrocytes have a manifest form stability for at least 3 days. The preservative used was thimerosal. Also, the urine can be investigated independent of time even after alcoholic Papanicolaou staining without an alteration of erythrocyte morphology. The practicality of the form stability of glomerular erythrocytes can be exploited in everyday medical routine. There are well founded prospects that the rate of early diagnosis of glomerulonephritis will increase.

Erythrocytes, Abnormal↗
PubMed1991

Fourier analysis as a planimetric procedure--application to malignant and normal urothelial cells with reactive changes.

The shape of urothelial cell nuclei in 27 urinary cytological preparations has been quantified by means of Fourier analysis. Fourier amplitudes were calculated as parameters of the nuclear shape. The T-test and a discriminance analysis showed significant differences in nuclear shape between preparations with malignant urothelial cells and nonmalignant cells with reactive changes. Only one preparation was reclassified false-negatively. No preparation was reclassified false-positively. No significant differences were found between normal cells with and without reactive changes. Thus it can be concluded that nuclear shape is an important criterion for the diagnosis of urothelial carcinomas in urinary cytological preparations. Fourier analysis allows the complete reproduction of the convex shape of a nucleus and it seems to be useful as an additional quantitative procedure in the diagnosis of malignant tumours.

Carcinoma, Transitional Cell↗
PubMed1991

[Chemotherapy of penile carcinomas].

The value of chemotherapy in treatment of squamous epithelial carcinoma of the penis is still uncertain, and its clinical relevance is speculative. In locally delimited carcinoma (T1, T2), partial penectomy is still the first-line therapy, and the alternatives of bleomycin monotherapy or combination therapy with bleomycin and radiation should be applied only when patients rigorously reject surgery. The prospects of success are rather uncertain with these forms of treatment. Palliative chemotherapy for metastasized carcinoma has so far yielded data indicating that methotrexate administration is of therapeutic benefit, even if only for a short time. Elaborate multiple combinations must be considered critically, especially because of the appreciable burden on the patient, a rate of response that in the final analysis is still uncertain, and the small number of cases treated so far.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[Diagnosis of glomerular microhematuria. Study of general practice-relevant form stability and stainability of dysmorphic glomerular erythrocytes].

The high diagnostic sensitivity and specificity of microscopically visible, typically glomerular dysmorphic erythrocytes for identification of the cause of glomerular bleeding is now recognized all over the world. Although glomerular dysmorphic erythrocytes are simple to detect in phase-contrast microscopy, immediate microscopic diagnosis is still indispensable, since a change in the morphology of the erythrocytes with reduced accuracy of the diagnosis must be anticipated because of the high autolytic potency of urine. It may be postulated that this need for immediate diagnosis has led to neglect of the method, owing to the high workload in hospitals and doctor's surgeries. Moreover, a physician who does not carry out microscopic investigations him/herself or who lacks experience with the method has not been able to use this diagnostic technique, since it appeared impossible to send urine samples by post. In the context of a pilot study comprising 30 patients, 10 of whom had developed histologically confirmed glomerulonephritis, we have shown that glomerular dysmorphic erythrocytes have manifest form stability for at least 3 days. The preservative used was thiomersal. Also, the urine can be investigated regardless of the time lapse since sampling, even after Papanicolaou alcohol staining, with no alteration of erythrocyte morphology by alcoholic dehydration, which would limit the value of the diagnosis. The practicability of the form stability of glomerular erythrocytes can be exploited in everyday medical routine. This would increase the rate of early diagnosis of glomerulonephritis and make it more likely that patients will receive adequate nephrological therapy in good time.

Erythrocyte Deformability↗
PubMed1989

[Questionable hyperparathyroidism: diagnostic value of thallium-technetium subtraction scintigraphy].

The diagnostic exclusion of hyperparathyroidism belongs to the standard repertoire of a practicing urologist involved in stone prophylaxis. Primary indicators of hyperparathyroidism are increases in serum calcium and in parathyroid hormone. Additional diagnostic methods are needed, since the methods most often used so far are inadequate, especially insofar as adenomas and ectopic tumors or recurrences can remain unrecognized. Exploratory surgical intervention means a difficult and traumatizing operation. Therefore, a sensitive technique for localization of adenomas is an urgent necessity. Thallium-pertechnetate subtraction scintigraphy was first introduced for localization of an adenoma of the parathyroid by Ferlin's group. This technique yielded better results than any previously known methods, with a success rate of 92%. The object of the present paper is not only to present a method that is not yet sufficiently well accepted among urologists, but also to offer a critical evaluation of the examination results known so far. The method cannot yet make exploratory surgery unnecessary, even when clinical and biochemical examinations give rise to a strong suspicion. However, since ectopic adenomas and possible relapse can be recognized with 90-100% accuracy, which is important in deciding on the surgical strategy, the method should be included in the preoperative diagnostic armamentarium.

Adenoma↗
PubMed1989

[Ileocystoplasty and enteropathies].

The formation of a neobladder by the transformation of sections of the terminal ileum has become an important alternative to supravesical urinary diversion. The discussion about the optimal urosurgical technique however has, so far ignored the problems of consecutive enteric defunctionalization and deficiency symptoms resulting from the anatomical shortening of the ileum. The analysis of experimental investigations and functionally comparable syndromes, such as Crohn's disease, permits an insight into the pathophysiological consequences. These relate to disorders in the bile acid and vitamin B12 metabolism and to the potential induction of a secondary hyperoxaluria, with a subsequent oxalate calculus diathesis. Further more, the reduction of the absorption area in the ileum can lead to calcium and vitamin D malabsorption with the development of intestinal osteopathy. These pathophysiological relationships must be taken into account in the long-term medical care of patients with ileal neobladder. The preventive and therapeutic measures are described.

Calcium↗
PubMed1989

[Aneurysm of the abdominal aorta as a retroperitoneal urologic emergency].

Ten percent of the patients with a symptomatic abdominal aortic aneurysm have initial complaints of genitourinary disorders. From April 1985 to May 1988 12 aortic aneurysms have been seen primarily in the division of urology Düren. In 9 of these 12 cases it was ultrasonography, which led to the diagnosis. The treatment must be individualized, and in case of obstructive uropathy the question of an adjuvant or monotherapeutic urological proceeding depends upon the age and symptoms of the patient. Urinary diversion by ureteral splint or nephrostomy contains risks, so that control strategy (watchful waiting) or treatment with steroids have to be considered.

Aorta, Abdominal↗
PubMed1988

[The urologic spirale: a therapeutic possibility in the treatment of prostatic carcinoma].

The urological spirale used exclusively as an intraprostatic catheter without communicating with the extracorporeal space offers patients with obstructive invasive prostatic carcinoma, who are unsuitable for surgical intervention, an additional treatment. Without interfering with the function of the urethra the danger of an ascending infection caused by a foreign body and the discomfort of a foreign body can be avoided. Occasionally normal micturition can be established. This was successful in 4 out of 8 patients for 3-12 months approximately, although in 2 of the 4 patients the spirale had to be removed on account of persistent irritation and infection. In the other 2 the spirale was successful until death after approximately 12 months. Even if we do not agree with the high rate of acceptability claimed in men suffering from cancer of the prostata, the attempt to use the spirale seems justified in special circumstances.

Carcinoma↗
PubMed1988

[Vesico-enteral fistulas: solutions to a diagnostic dilemma].

The diagnostic proof of vesico--enteral fistulas is necessary before proceeding to surgical treatment. The detection, however, can often be difficult because of nonspecific symptoms and unreliable uro-radiologic and endoscopic investigations. Additional and more sensitive diagnostic procedures are evaluated like computer tomography, the simple Bourne-test and a radioisotopic test.

Adult↗
PubMed1987

[Paracetamol].

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Acetaminophen↗