PubMed Health⌕ Search

Biomedical subjects

T Senge

Publications and source records attributed to T Senge.

At least 19 recordsLinked to original sources
PubMed2000

Combined intravesical and oral oxybutynin chloride in adult patients with spinal cord injury.

OBJECTIVES: Detrusor hyperreflexia with elevated storage pressures presents a major risk factor for renal damage in patients with neurogenic lower urinary tract dysfunction. If standard anticholinergic treatment is unsuccessful, surgical treatment must be considered. We evaluated the effects of intravesical oxybutynin treatment on detrusor hyperreflexia in patients in whom standard oral treatment had failed. METHODS: Twenty-five patients (mean age 36. 7 years) with storage pressures greater than 40 cm H(2)O despite standard anticholinergic treatment received intravesical (15 mg three times daily) and oral oxybutynin chloride treatment. The follow-up evaluations included urodynamic testing, renal ultrasound, urine examination (urinalysis and urine culture), and evaluation of side effects. RESULTS: The mean follow-up was 6 months. Intravesical treatment led to an increase in bladder storage volume from 349 to 420 mL. The mean maximum storage pressure was significantly reduced from 54 to 26.5 cm H(2)O. Detrusor storage pressures returned to values less than 40 cm H(2)O in 21 of 25 patients. Dysreflexia was treated successfully in 3 of 5 patients. No patient developed renal damage. No severe side effects or drug-related discontinuation of treatment were observed. CONCLUSIONS: Intravesical oxybutynin therapy seems to be a safe and effective treatment option for detrusor hyperreflexia in adults and avoids surgical treatment in most patients. Long-term observations concerning side effects, acceptance, and efficacy are needed.

Administration, Intravesical↗
PubMed2000

Treatment of symptomatic benign prostatic hyperplasia with beta-sitosterol: an 18-month follow-up.

OBJECTIVES: To determine the long-term effects of phytotherapy with beta-sitosterol (the trade name for beta-sitosterol used in this study is Harzol(R)) for symptomatic benign prostatic hyperplasia (BPH). Patient and methods At 18 months after enrolment in a 6-month multicentre double-blind placebo-controlled clinical trial with beta-sitosterol (reported previously), patients were re-evaluated using the modified Boyarsky score, the International Prostate Symptom Score and quality-of-life index, the maximum urinary flow rate (Qmax) and postvoid residual urine volume (PVR). In this open extension of the original trial (after 6 months of treatment or placebo), patients were free to chose their further treatment for BPH. RESULTS: In all, 117 patients (59%) were eligible for analysis during the follow-up. Of the formerbeta-sitosterol group, 38 patients who continued beta-sitosterol treatment had stable values for all outcome variables between the end of the double-blind study and after 18 months of follow-up. The 41 patients choosing no further therapy had slightly worse symptom scores and PVR, but no changes in Qmax. Of the former placebo group, 27 patients who started beta-sitosterol after the double-blind trial improved to the same extent as the treated group for all outcome variables. The 18 patients choosing no further therapy showed no signs of improvement. CONCLUSION: The beneficial effects of beta-sitosterol treatment recorded in the 6-month double-blind trial were maintained for 18 months. Further clinical trials should be conducted to confirm these results before concluding that phytotherapy with beta-sitosterol is effective.

Double-Blind Method↗
PubMed2000

[Ultrasound elastography of the prostate. A new technique for tumor detection].

AIM: Prostate tumours are often of harder consistency than the surrounding tissue. During digital rectal examination, this fact can be used not only to detect hypertrophy but also localized hardenings. The examination by digital palpation is inaccurate and, even in combination with PSA-value and a transrectal ultrasonic examination, the result is often not reliable. Ultrasound elastography enables us to measure and visualize the elastic properties of a tissue region and is a useful supplement to the examination by digital palpation. Ultrasound elastography is able to measure and visualize the elastic properties of a tissue region, therefore it is a useful supplement to commonly used diagnostic procedures. METHOD: We have developed a new system for elastographic prostate diagnosis which can be used during the transrectal ultrasonic examination. During the examination a sequence of ultrasonic images is acquired while the organ is slightly compressed by the ultrasound probe. Using numerical analysis of image pairs for the acquired sequence we calculate the tissue strain which represents the spatial elasticity distribution of a specific cross-section of the organ. This enables us to distinguish hard areas in the tissue. Image artifacts resulting from lateral motion components, i.e., orthogonal to the direction of the applied force, are compensated for by a special approach. RESULTS: We present results obtained from a typical elastography phantom and also the first in vivo images from patients who were undergoing radical prostatectomy. Our images prove that ultrasound elastography has the potential to detect malignant tissue areas, which are inconspicuous in the B-mode image. Our findings are confirmed by the corresponding histological specimens.

Elasticity↗
PubMed2000

Effect of beta-sitosterol on transforming growth factor-beta-1 expression and translocation protein kinase C alpha in human prostate stromal cells in vitro.

BACKGROUND: Today, plant extracts are widely used in the treatment of benign prostatic hyperplasia (BPH). However, the complete mode of action of the active substance, beta-sitosterol, is under investigation. The purpose of this study was to investigate the effect of beta-sitosterol on the expression of transforming growth factor beta 1 (TGF-beta1) and the activity of protein kinase C alpha (PKC-alpha) in primary prostate stromal cell cultures in vitro. METHODS: Tissue samples for primary cell cultures were obtained from patients undergoing transurethral resection of the prostate (TURP). TGF-beta1 levels in stromal cell conditioned media following a culture with beta-sitosterol were detected in a TGF-beta1 specific ELISA assay. Following different incubation periods with beta-sitosterol, cells were lysed and fractionated into a Triton-soluble membrane fraction and a cytosol fraction. PKC-alpha protein was detected using immunoblot analysis. RESULTS: Beta-sitosterol was able to induce the expression and secretion of TGF-beta1 significantly between 1.26- and 1.86-fold compared to a cholesterol and the nonsupplemented control in 6 of 8 individual cultures. The total amount of secreted TGF-beta1 varied in cells from different patients. Based on its presence in both membrane fraction and cytosol, PKC-alpha appeared to be constitutively expressed in stromal cells. In the absence of beta-sitosterol PKC-alpha was predominantly found in its membrane-associated active form. Following a culture with beta-sitosterol, a translocation of PKC-alpha from the membrane to the cytosol was observed. This effect was specific for beta-sitosterol as compared to cholesterol. CONCLUSION: This study describes the effect of beta-sitosterol on the expression of a multifunctional growth factor (TGF-beta1) and the activity of PKC-alpha membrane in stromal cells of the human prostate in vitro.

Cell Division↗
PubMed1999

Suramin treatment in hormone- and chemotherapy-refractory prostate cancer.

OBJECTIVES: Suramin, a polysulfonated naphtylurea with anti-growth factor activity, was used in the treatment of metastatic, hormone- and chemotherapy-refractory prostate cancer. Recent studies have proved the effect of suramin on prostate cancer. METHODS: Between March 1990 and January 1994, 27 patients with metastatic prostate cancer were enrolled in this study. Treatment regimen consisted of a loading phase, allowing patients to reach suramin serum levels between 180 and 250 microg/mL using a suramin dose of 1.4 g/m2 at 3-day intervals. Constant suramin serum levels were maintained by a 0.5 to 1-g/m2 dose every 7 to 10 days. Because previous studies showed suramin to have serious toxicity, compromised organ status was excluded by repeated examinations. RESULTS: Six patients did not complete the suramin loading phase because of side effects and were removed from the study. With an average cumulative suramin dose of 14.2 g, 33% of the assessable patients (7 of 21) experienced a more than 50% reduction of prostate-specific antigen (PSA) and/or alkaline phosphatase (AP) serum levels. Mean survival in these suramin-responsive patients was 495 days. Two of these patients experienced a remarkable reduction of metastases in bone scan examinations. Another 48% of the patients (10 of 21) had essentially unchanged AP and PSA serum levels during suramin treatment, indicating stable disease. Mean survival of these patients was 341 days. In 4 patients undergoing suramin treatment, continuous clinical progression of the disease was observed (mean survival 79 days). Toxicity was less or comparable to prior reported studies; the most common side effects were polyneuropathy, allergic skin rash, and vortex keratopathy. CONCLUSIONS: Suramin has limited, but significant, efficacy even in chemotherapy- and hormone-refractory prostate cancer, without serious toxicity.

Aged↗
PubMed1998

Review of recent placebo-controlled trials utilizing phytotherapeutic agents for treatment of BPH.

BACKGROUND: In order to assess the efficacy of phytotherapeutic agents for the treatment of benign prostatic hyperplasia (BPH), a review of recently published double-blind placebo-controlled trials was undertaken. METHODS: Only those studies reviewed by the Other Medical Therapies Committee of the Fourth International Consultation on BPH were included. RESULTS: These studies suggest a possible benefit for the use of phytotherapeutic preparations in the treatment of BPH. CONCLUSIONS: These studies need to be confirmed in larger long-term placebo-controlled studies in order to ascertain the true efficacy of these agents.

Anti-Bacterial Agents↗
PubMed1998

Value of the Danish Prostate Symptom Score compared to the AUA symptom score and pressure/flow studies in the preoperative evaluation of men with symptomatic benign prostatic hyperplasia.

The Danish Prostate Symptom Score (DAN-PSS) is a new questionnaire for the assessment of lower tract urinary symptoms (LUTS), which claims to be able to predict bladder outlet obstruction. We evaluated the ability of the DAN-PSS to assess LUTS, to predict obstruction, and to predict treatment outcome in men with symptomatic uncomplicated BPH. Twenty-five consecutive men with symptomatic uncomplicated BPH filled in the AUA symptom score and the DAN-PSS and underwent uroflowmetry and pressure-flow studies prior to transurethral prostatic resection (TURP). Patients were reevaluated 4 days and 8 months after surgery. AUA score and DAN-PSS both assessed LUTS and were sensitive to symptom changes after therapy. Compared to pressure/flow studies, neither score correlated with bladder outlet obstruction. Peak urinary flow, however, correlated significantly with obstruction. None of the diagnostic tools used was able to improve patient selection for surgical treatment. The DAN-PSS is a valid and sensitive questionnaire for the assessment of LUTS. It is not able, however, to predict bladder outlet obstruction. In men with uncomplicated BPH, urodynamic evaluation of bladder outlet obstruction did not improve the subjective outcome of TURP.

Aged↗
PubMed1998

Species differences in the glutathione transferase GSTT1-1 activity towards the model substrates methyl chloride and dichloromethane in liver and kidney.

Glutathione transferase (GST) GSTT1-1 is involved in the biotransformation of several chemicals widely used in industry, such as butadiene and dichloro methane DCM. The polymorphic hGSTT1-1 may well play a role in the development of kidney tumours after high and long-term occupational exposure against trichloroethylene. Although several studies have investigated the association of this polymorphism with malignant diseases little is known about its enzyme activity in potential extrahepatic target tissues. The known theta-specific substrates methyl chloride (MC) dichloromethane and 1,2-epoxy-3-(p-nitrophenoxy)propane (EPNP) were used to assay GSTT1-1 activity in liver and kidney of rats, mice, hamsters and humans differentiating the three phenotypes (non-conjugators, low conjugators, high conjugators) seen in humans. In addition GSTT1-1 activity towards MC and DCM was determined in human erythrocytes. No GSTT1-1 activity was found in any tissue of non-conjugators (NC). In all organs high conjugators (HC) showed twofold higher activity towards MC and DCM than low conjugators (LC). The activity in human samples towards EPNP was too close to the detection limit to differentiate between the three conjugator phenotypes. GSTT1-1 activity towards MC was two to seven-times higher in liver cytosol than in kidney cytosol. The relation for MC between species was identical in both organs: mouse > HC > rat > LC > hamster > NC. In rats, mice and hamsters GSTT1-1 activity in liver cytosol towards DCM was also two to seven-times higher than in the kidney cytosol. In humans this activity was twice as high in kidney cytosol than in liver cytosol. The relation between species was mouse > rat > HC > LC > hamster > NC for liver, but mouse > HC > LC/rat > hamster/NC for kidney cytosol. The importance to heed the specific environment at potential target sites in risk assessment is emphasized by these results.

Animals↗
PubMed1998

History of urinary diversion.

In 1852, Simon was the first to describe a urinary diversion using intestinal segments. In the late 19th and early 20th century, in the absence of antibiotics, urinary diversion using bowel segments carried a high risk of peritonitis. When Coffey introduced a new method for ureteric implantation in 1911, ureterosigmoidostomy became the most frequently used technique. The ileal conduit, first described by Zaayer in 1911, was established as a standard technique by Bricker in 1950. At the same time, Ferris and Oedel demonstrated a hyperchloremic metabolic acidosis in 80% of the patients with ureterosigmoidostomy, and the ileal conduit became the preferred from of urinary diversion. The first attempts to create a continent urinary diversion were undertaken by Tizzoni and Foggi in 1888. Mauclaire, in 1895, used the isolatec rectum as a urinary reservoir. Two findings were essential for the development of modern continent urinary diversion: Kock established the principle of bowel detubularization to create a low-pressure reservoir, and Lapides popularized the use of clean intermittent catheterization. Utilizing these techniques, a variety of continent reservoirs were introduced. The majority of these used either ileal segments, like the Hautmann neobladder, or ileocecal segments, like 'Le Bag'. Sinaiko was the first to use the stomach for the creation of a urinary reservoir in 1956. Continent urinary diversion is the method of choice in a large number of patients today. Experimental work demonstrated that the creation of a new bladder using cultured urothelial and muscle cells with biodegradable polymers as a scaffold is feasible, and future developments may be vastly influenced by these techniques.

History, 19th Century↗
PubMed1997

Quality of life of patients with renal cell carcinoma or prostate cancer after radical surgery.

OBJECTIVES: To study the impact of radical tumour surgery in prostate and renal cell cancer patients on quality of life (QOL). METHODS: In 38 male patients suffering from organ-confined prostate or renal cell cancer, a prospective study was performed. For the evaluation of QOL, we used the EMPK (Erfassung multipler psychischer Konstrukte). Urologic symptoms were evaluated with a specially designed symptom score. The test instrument was filled out the day before surgery and one year after operation. RESULTS: The EMPK was able to detect and describe significant changes in certain aspects of QOL in renal cell cancer and prostate cancer patients. Moreover, there seems to be a difference between the two groups. A direct relation between QOL and the different quality and quantity of operation-related symptoms, however, could not be proven. CONCLUSIONS: In this pilot study, radical surgical therapy did not significantly change QOL in prostate cancer patients, but seemed to have a positive influence on the QOL of renal cell cancer patients.

Aged↗
PubMed1997

Cell kinetic in epithelium and stroma of benign prostatic hyperplasia.

The induction of benign prostatic hyperplasia (BPH) from normal prostate is obviously associated with a distinct increase in epithelial and stromal proliferation. We have shown previously that the further increase of BPH volume in aging men is not associated with a further increase in proliferation. We studied whether an imbalance between programmed cell death (apoptosis) and cell proliferation may explain continuing growth in aging men. In prostates of 17 men with BPH removed by open prostatectomy proliferating cells were localized immunohistochemically with the Ki-67 antibody. Apoptotic cells were detected with the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method. Proliferation and apoptotic index was calculated with a computer assisted image analysis system. Mean proliferation index +/- standard deviation in epithelium (0.142 +/- 0.097) and stroma (0.121 +/- 0.082) was nearly identical. Mean apoptotic index in epithelium (0.172 +/- 0.156) was negligibly higher than the corresponding proliferation index. In stroma, however, no apoptotic cells were detectable. Proliferation index and apoptotic index in epithelium and proliferation index in stroma showed no correlation to patient age or prostate volume. In the epithelium of BPH, obviously the cell kinetic is balanced. On the other hand, our results indicate stromal growth due to cell proliferation in the absence of cell death. This may explain the continuous increase of BPH volume in aging men.

Adult↗
PubMed1997

Glans hyperemia after penile revascularization: a late complication following alpha-1-receptor blockade for benign prostatic hyperplasia.

Surgical revascularization of the penile vessels is one treatment choice for patients with vasculogenic impotence. Hyperemia of the glans is a rare but severe complication which usually occurs early. We report a patient who developed this complication more than 3.5 years after surgery following onset of medical treatment of benign prostatic hyperplasia with a vasodilating alpha 1-receptor blocker.

Adrenergic alpha-Antagonists↗
PubMed1997

Transurethral resection of the prostate with microprocessor controlled electrosurgical unit.

PURPOSE: We analyzed the efficacy and side effects of a microprocessor controlled high frequency unit for transurethral resection of the prostate. MATERIALS AND METHODS: A high frequency device with microprocessor control was used in 934 consecutive patients undergoing transurethral resection of the prostate. Indications for transurethral resection, medical history, preoperative findings, operative parameters, operative and immediate postoperative complications, and postoperative peak flow rate and residual urine were evaluated. RESULTS: Postoperative peak flow rate and residual urine were comparable to those with standard transurethral resection of the prostate. One patient died on postoperative day 1 for a mortality rate of 0.1%. The immediate morbidity rate was 6.9%. CONCLUSIONS: Morbidity and mortality in this study were lower than those in previous series on transurethral resection of the prostate.

Aged↗
PubMed1996

In vitro comparison of two ballistic systems for endoscopic stone disintegration.

Endoscopic stone disintegration can be performed with various lithotripsy techniques. We compared two ballistic systems in vitro: the Swiss Lithoclast and the Combilith (Olympus). Measurements of the probe movement; i.e., maximum velocity and displacement, were performed using an optical high-speed technique based on a frame transfer camera. The Lithoclast and Combilith both achieve excellent probe velocities. However, the Lithoclast achieves equal velocity with less probe displacement.

Lithotripsy↗
PubMed1996

Cyproterone acetate in the treatment of advanced prostatic cancer: retrospective analysis of liver toxicity in the long-term follow-up of 89 patients.

Cyproterone acetate (CPA) was the first steroidal antiandrogen used for the treatment of prostatic cancer. In recent studies CPA has been linked with DNA adduct formation and increased DNA repair synthesis in vitro, suggesting an increased risk for the development of hepatic malignancies. To assess liver-toxic and carcinogenic effects, 89 patients who received CPA 50 mg/day p.o. over 4 (range 2-152 months) years for prostatic cancer treatment were retrospectively evaluated. 22 patients (28.2%) showed elevated liver enzyme concentrations. In none of the 89 patients alpha-fetoprotein serum levels were elevated. In no case hepatocellular carcinoma has been observed, and in no case CPA administration was discontinued due to side effects. Considering the life expectancy of patients with advanced prostatic cancer and the long-term and high-dose exposure to CPA necessary to possibly induce liver tumors, it appears highly unlikely that CPA treatment may account for a substantial number of liver carcinomas in such patients.

Aged↗