[Traumatic stress. Combat reactions and post-traumatic stress. The war is not over when peace is declared--it is still alive in people's minds].
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Adult↗
Biomedical subjects
U Otto
Publications and source records attributed to U Otto.
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↗
Transplantation of human benign hyperplastic prostate tissue into nude mice: first results of systemic therapy.
Xenografts of human benign hyperplastic prostate tissue (BPH) have been established as a model for the investigation of the etiology of BPH. In this paper it is our aim to answer the question of whether this model is useful for the established therapy of the disease. Additionally we try to evaluate the value of a commonly used plant extract for the therapy of BPH. Is there any influence of the extract from Sabal serrulatum on the BPH tissue in our model? Human BPH tissue from 2 patients was transplanted into athymic nude mice and treated with three different regimens. Animals of group I did not receive any treatment and served as control, in groups II and III the tissue was stimulated by application of silicone tubes containing crystalline 5 alpha-dihydrotestosterone and estradiol. Animals of group II additionally were treated orally with the lipophilic extract of S. serrulatum (contained in Prostagutt N), which is commonly used for the treatment of BPH clinically. Significant inhibition of tissue growth was observed in group III when compared to group II. In group I (control) atrophy of the graft was observed as expected. However, histologically no differences were visible between groups II and III. Our experiment shows a significant growth-inhibiting effect of the plant extract for human BPH tissue in our model (p less than 0.05). We conclude that the nude mouse model can be useful for the evaluation of systemic therapy modalities of human BPH and that the plant extract may have a certain value for clinical treatment, which is not only due to subjective criteria.
Animals↗
Swedish UN soldiers in Cyprus, UNFICYP: their psychological and social situation.
Two Swedish rifle batallions serving as UN soldiers in Cyprus (UNFICYP) have been investigated with respect to their demographic background and motives for application for UN service. The comparison of symptoms of stress in general, of posttraumatic stress disorder specifically, and some other variables of reaction with various studies of Swedish UN soldiers in different settings has given the following results. Very few interviewees experienced 'personal nervous breakdown' (0.5%). The soldiers reported in general very few psychological or psychosomatic complaints in the short time perspective. There seemed, however, to be two groups of persons at risk, namely those who were repatriated and those with a high consumption of alcohol.
Adult↗
[Obstructive uropathy after kidney transplantation. Experiences with endourologic incision of ureteral stenoses].
Between 1985 und March 1991 we have managed 8 upper urinary tract obstructions in kidney transplants using an endourological approach. After a graft rejection was excluded an obstruction was initially diagnosed by nephrosonography and further confirmed by IVP or antegrade pyelography. To investigate the urodynamic relevance of the stenosis, all patients underwent preoperative diuretic isotope renography. In all cases a percutaneous pyelostomy was done to preserve renal function. 7 of these 8 patients demonstrated a stenosis of the ureter, while in one case, the obstruction was caused by a coagulum in the renal pelvis. Incision of the stricture then was performed with a flexible knife antegrade or retrograde and stented for 4-6 weeks. In 6 out of 7 cases with a proven stenosis of the ureter, the cold knife incision lead to a successful outcome, while in one patient, the kidney had to be removed due to uncontrolled bleeding 12 days after successful percutaneous incision. Our results indicate, that the cold-knife-technique for the management of upper urinary tract obstructions in kidney transplants is a promising, fast and in most of the cases effective method. Due to its minimalinvasive character and excellent results, this approach is able to replace open reintervention in most cases.
Adolescent↗
[Vasovasostomy after vasectomy. The surgical results 1986-1989].
The frequency of vasovasostomy has increased dramatically in recent years. A significant percentage of men who have previously undergone vasectomy are now seeking restoration of their fertility. The most common reason for requesting a reversal is remarriage. There were 90 bilateral vasovasostomies performed in 90 patients between 1986 and 1989. The procedure was done according to the technique described by Howards, in a single layer with 7 x 0 prolene and under fourfold magnification. The success rate was 87% for presence of spermatozoa in the ejaculate, 48% for pregnancy. The fertility rate decreases slowly with increasing interval between vasectomy and reanastomosis. These results are statistically significant. In cases of good anatomical and andrological conditions, the chance of restoration of fertility is good. The experience of the urologist is often more important than the details of the technique.
Adult↗
The cold-knife technique for endourological management of stenoses in the upper urinary tract.
Between 1985 and October 1989 we managed 13 patients with primary and 43 with secondary obstruction of the upper urinary tract with the endourological cold-knife technique. We treated 26 patients with stenosis of the ureteropelvic junction, 9 with infundibular stenosis, 12 with ureteral obstruction after inflammation or radiation therapy, 7 with stricture of the ureter in kidney transplants and 2 with stenosis of the ureter after ureterosigmoidostomy. Endourological management was successful in 42 of 56 cases with a decrease or total elimination of obstruction. Stenosis recurred in 9 patients. Our results indicate that the cold-knife technique should be attempted as the initial approach in all cases of primary or secondary obstruction of the upper urinary tract.
Adolescent↗
[Pheochromocytoma of the urinary bladder. Diagnosis and therapy based on a case report].
Micturition difficulties associated with unstable hypertension, tachycardia and profuse sweating could be a sign of pheochromocytoma of the urinary bladder. Of all pheochromocytomas, 10-36% are located extradrenally, in which case they are also referred to as paragangliomas, and 1-3% are found in the urinary bladder. The case history of a 44-year-old female patient with typical symptoms is described. Diagnosis required not only CT, NMR, excretory urography and MIBG scintigraphy, but also hormonal analyses. Histology reveals malignancy in up to 20%; it is thought that focal invasions of tumor into vessels and destruction of connective tissue might be pathognomonic. A precise history and careful diagnosis are necessary before a pheochromocytoma of the bladder can be disclosed and treated.
Adult↗
Antiproliferative and cytotoxic effects of single and combined treatment with tumor necrosis factor alpha and/or alpha interferon on a human renal cell carcinoma xenotransplanted into nu/nu mice: cell kinetic studies.
A human renal cell carcinoma serially transplanted into nude mice was treated with recombinant human tumor necrosis factor alpha (TNF-alpha), recombinant human alpha interferon (IFN-alpha), and a combination of both. All treatments resulted in a significantly reduced tumor growth. The greatest effect was obtained with the combination of TNF-alpha and IFN-alpha. This latter treatment completely eradicated tumors which were smaller than 50 mm3 at the beginning of treatment. Cell kinetic analysis using the bromodeoxyuridine technique and flow cytometry revealed a prolongation of the transition time through S-phase from 7.9 h in the case of control tumors to 10.5 h for tumors treated with IFN-alpha and TNF-alpha. Single treatment with either TNF-alpha or IFN-alpha had only minor effects. The bromodeoxyuridine labeling index was unaffected by IFN-alpha (16.6%; control, 15.2%) but was reduced to 12.1 and 11.7% when tumors were treated with TNF-alpha and IFN-alpha plus TNF-alpha, respectively. The calculated potential doubling times were 2.3 and 2.8 days, respectively, for tumors treated with TNF-alpha or IFN-alpha plus TNF-alpha. When treated with IFN-alpha, the potential doubling time (1.7 days) was similar to that of the control (1.6 days), indicating that the main effect of TNF-alpha was antiproliferative. Conversely, the calculated cell loss factors increased after IFN-alpha and combined treatment but not after TNF-alpha treatment. Combined treatment augmented cytotoxicity, but the cell kinetic characteristics of surviving cells remained similar to those of tumors treated with TNF-alpha alone. Histological analysis showed a distinctly reduced mitotic activity but no coagulative necroses after treatment with TNF-alpha. IFN-alpha and, in particular, IFN-alpha plus TNF-alpha induced cytoplasmic vacuolization, nuclear pyknosis, and cell death, which resulted in tumor regression. These data suggest that, in this particular tumor model, TNF-alpha produces mainly antiproliferative effects, whereas IFN-alpha acts via cytotoxic mechanisms.
Animals↗
Comparison of different schedules of cytostatic intravesical instillations in patients with superficial bladder carcinoma: final evaluation of a prospective multicenter study with 419 patients.
In a prospective multicenter study we compared the value of various protocols of mitomycin C and doxorubicin instillation for the prevention of recurrent tumors in patients whose superficial bladder tumors (stages TA and T1) had been removed by transurethral resection. The 3-year and short-term instillation protocols were compared to each other and to a combination of 2 protocols. Evaluation after a mean followup of 28 months confirmed the value of cytostatic bladder instillation in preventing recurrence and progression of tumor in patients with superficial bladder carcinoma. There was no significant difference between the results of long-term and short-term prophylaxis; their combination achieved the best results. Doxorubicin and mitomycin yielded similar results; mitomycin was better tolerated.
Administration, Intravesical↗
Tumor heterogeneity of renal cell carcinoma.
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Animals↗
Recombinant alpha-2 or gamma interferon in the treatment of metastatic renal cell carcinoma: results of two phase II/III trials.
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Animals↗
[Long-term results in the treatment of metastasizing kidney carcinoma using recombinant alpha-2 or gamma interferon].
To evaluate whether response to alpha-2- or gamma-interferon in metastatic renal cell carcinoma is associated with a prolonged survival, we studied a total of 65 patients being treated in two phase-II- or phase-III-trials between 1984 and 1986 with one of these interferons. After a median follow-up of 3 years for the alpha-interferon-treated patients and of more than 4 years for gamma-interferon-therapy, respectively, there is a significantly increased duration of survival for patients showing an objective response or stabilisation of the disease due to either therapy compared to those with continuing progression. Therapy with alpha-interferon leading to objective remissions in 26% or with gamma-interferon with an objective response rate of 36% therefore is beneficial for responding patients and can be performed with moderate side effects on an out-patient basis.
Adult↗
[Experimental microbiological research on instrument and denture disinfection with a disinfectant spray for dental practice and the use of patients. 2. Virological studies; the evaluation summary].
Carrier experiments using Echo- and Influenza-viruses on denture basis resins and fragments of orthodontic appliances resulted in good and even very good virucidal effects of disinfectant sprays Desident and Fesia-sept. The application of the disinfectant as spray seem to be advantageous, but is not recommendable. The diverse causes of this conclusion are discussed and an alternative way is proposed.
Aerosols↗
[Experimental microbiological research on instrument and denture disinfection with a disinfectant spray for dental practice and the use of patients. 1. The formulation of the problem and bacteriological studies].
Three disinfectant sprays (Arugeen, Desident and Fesia-sept) proved to be very efficient against pure cultures of aero bacteria species, Cand. albicans, saliva flora and entero- and influenza viruses. The methods included carrier experiments using denture basis resins, fragments of orthodontic appliances and screws (instead of instruments).
Aerosols↗
[Use of electronic data processing at a urologic polyclinic--a program packet for recording and evaluating data of specialized consultations].
A software package was developed for computerized recording and processing of clinical data in a urological out-patient clinic. In a pilot study this program proved to be useful for the rapid evaluation of all important clinical and laboratory results of patients with renal cell carcinoma, and its use also accelerated the preparation of medical reports. The experience gained in this initial project shows that the application of this newly developed concept of data processing can easily be extended to routine out-patient followup in other special areas within the field of oncology.
Aftercare↗
[Initial experiences in diagnosis of graft rejection following clinical heart transplantation. Detection of graft-directed activated T-cells].
The binding of antigen-loaded carrier to mononuclear cells of heart transplant recipients has been investigated by means of an antigen-specific rosette technique. The increase of rosette forming cells and the inhibition of this reaction with monoclonal antibodies against activated T-cells is a sign of a beginning rejection. 3-6 days later infiltrating immunological competent cells are seen in biopsy.
Adult↗
The panorama of psychiatric emergencies in three different parts of Sweden.
A total of 1226 psychiatric emergencies from three socially different catchment areas in Sweden were analyzed. Data were obtained over 28 consecutive days at the beginning of 1985. Very small differences were found between urban and rural catchment areas, which is probably due to a high degree of equality for both social and medical services throughout Sweden. The largest diagnostic subgroup was patients with an alcohol problem (33%). A measure of the patients network of close relatives, yielded small differences between the diagnostic subgroups.
Adult↗