摘要:

Previous results on the peripheral blood immune status of renal cell carcinoma had indicated immunosuppression in metastatic disease, possibly mediated by prostaglandin E2 (PGE2). In the present study the immunologic effects of inhibition of PG synthesis by piroxicam in combination with interleukin 2 (IL 2) + lymphokine-activated killer (LAK) cell therapy were tested by immunomonitoring. In additon to peripheral blood parameters (lymphocyte subpopulations, neopterin, β2-microglobulin, TNF, IL 1, IFNγ) we recorded in vitro cellular activity by incubating the patients’ peripheral blood mononuclear cells (PBMC) in media containing fetal calf serum (FCS) or autologous serum, and either IL 2 or buffer. After 24 h of incubation we measured PGE2 and cytokine levels in supernatants. Systemic application of IL 2 induced in vivo lymphocyte proliferation and clearly influenced the serum levels of neopterin, β2-microglobulin and TNF. There was minor affection of IFNγ and none of IL 1. PBMC in vitro produced high amounts of PGE2, IL 1 and TNF pretherapeutically, during therapy in vitro synthesis of these parameters decreased. Consistent production of IFNγ was detected in supernatants only when FCS and IL 2 were added to the medium. Lack of affection of IFNγ production in the autologous system during therapy indicated impaired cellular activity, which could neither be improved by therapy of the patient using IL 2 nor by adding IL 2 to the culture medium. Immunosuppression seems to interfere in a complex way with immunotherapy. Therapeutical influence of immunosuppression based on the results of immunomonitoring, however, seems to be a promising strategy for improving the still limited clinical results of immuno

ISSN:0042-1138    

DOI:10.1159/000282469

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The regulation of prostaglandin (PG) synthesis was characterized in microsomes of bovine bladder epithelium. Coenzyme A (CoA) and its metabolite cysteamine drastically decreased total PG synthesis. Furthermore, CoA inhibited solubilized cyclooxygenase which was precipitated by anti-cyclooxygenase antibody. Reduced glutathione (GSH) slightly increased total PG production and changed the pattern of PG synthesis. Other thiols, cysteine and ergothioneine, did not change total PG production. None of the thiols stimulated the incorporation of arachidonic acid into the phospholipid fraction. These findings suggest that CoA may directly regulate cyclooxygenase activity and GSH may subsequently change the pattern of PG production in bovine bladder epithelium.

ISSN:0042-1138    

DOI:10.1159/000282470

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A prospective immunohistochemical study of 66 human bladder biopsies with and without transitional cell carcinoma (TCC) of the bladder was performed to assess the diagnostic and prognostic value of laminin staining in TCC of the human bladder. In all normal and nonmalignant inflammatory specimens, a continuous intact basement membrane (BM) laminin could be identified. In bladder cancer specimens laminin staining revealed focal interruption of the subepithelial BM with microinvasion in 2 of 6 specimens initially diagnosed as Tis (Pis) and 7 of 25 specimens initially diagnosed as pTa tumors. A statistically significant association between the pT category and BM interruption was found (p 0.25). In a short-term follow-up (mean 16 months) a statistically significant correlation (p = 0.01) could be observed between tumor recurrence and BM integrity in that a higher recurrence rate and shorter recurrence-free interval was found in patients with interrupted BM versus those with intact BM. Assessment of the vascular BM-staining pattern revealed interruption in specimens from 5 patients who died from advanced metastatic tumors. The metastatic process was found to be closely associated with focal interruption of the subendothelial BM (p < 0.001). From our results it appears that the adjunct use of immunohistochemical laminin staining in the histopathologic examination of TCC of the bladder is essential in more exact identification of the different pathologic stages and is also of help in the more detailed prediction of tumor behavior and prognosis.

ISSN:0042-1138    

DOI:10.1159/000282471

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Bladder tumors were staged preoperatively before and/or after M-VEC polychemotherapy using transrectal ultrasonography and magnetic resonance imaging in 46 patients. The resultant findings were each compared with histomorphologic results. The sensitivity of both methods compared with pathohistology was 88%. Using this technique, the degree of tumor invasion of the bladder wall could be evaluated and the appropriate therapy selected. Further applications included the monitoring of transurethral resection determine its adequacy as a treatment modality.

ISSN:0042-1138    

DOI:10.1159/000282472

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Prostaglandin E1 (PGE1) has been shown to relax the muscles of the corpora cavernosa and inhibit spontaneous activity, and clinical trials have proved its safety and effectiveness when given intracavernously to induce erection. Through use of a specific PGE1 receptor binding assay, we undertook this study to quantify its receptor density and measure binding affinity. The cavernous tissue of normal and impotent men as well as that of monkeys and dogs was studied in an attempt to understand their different responses to the intra-cavernous injection of PGE1. Our results showed a lower receptor density in impotent men than in normal men and monkeys and a complete absence of receptors in dogs. These findings correlated well with the clinical response to intracavernous injection of PGE1.

ISSN:0042-1138    

DOI:10.1159/000282473

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The composition of 2,755 calculi obtained from the upper urinary tract (1,409 by spontaneous passage and 1,346 by urological procedures) was analyzed using an infrared spectrophotometer, and the spontaneous passage rate was investigated in relation to the composition as well as other variables, such as stone size, and patient age and sex. Mixed stones of calcium oxalate and calcium phosphate were most frequently found, followed by those of calcium oxalate. The mean size (the maximum diameter) was largest in struvite stones and smallest in calcium oxalate ones. The sizes of stones from women were significantly larger than those from men (p < 0.01). As expected, the stone passage rates were inversely related to increasing stone size. The size of 55.6% of the stones passed was ≤ 5 mm, and that of 96.6% of the stones ≤ 10

ISSN:0042-1138    

DOI:10.1159/000282474

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Tissue damage by extracorporeal shock wave lithotripsy (ESWL) is assumed to be attributable to ischemic changes in the treated region surrounding the particular vessel which is first ruptured by shock waves. Such changes cannot take place without being accompanied by acceleration of coagulation and fibrinolysis. In the literature on renal damage by ESWL, no parameters of the coagulation and fibrinolysis of blood were used. The present study was designed to investigate renal damage by shock waves through the quantification of sequential changes in the following parameters between before and after ESWL: thrombin antithrombin III complex (TAT), α2-plasmin inhibitorplasmin complex (PIC), fibrin and fibrinogen degradation products (FDP) and D-dimer (D-D). In ESWL for renal stones, a significant acceleration of TAT occurred on the 1 st postoperative day, followed by acceleration of PIC on the 3rd postoperative day. A transient acceleration was observed for FDP and D-D after operation. The levels of these parameters, however, returned to normal by the 1st postoperative week. In ESWL for ureteral stones, unlike for renal stones, none of the parameters showed statistically significant acceleration. In the construction of percutaneous nephrostomy (PNS) cases for ureteral stones before ESWL, none of the parameters showed significant acceleration either. Changes in these parameters of coagulation and fibrinolysis due to ESWL for renal stones were greater than those of construction of PNS or ESWL for ureteral stones. The reason for the difference of the alteration in these parameters between renal stones and ureteral stones were more abundant vessels in the kidney than the ureter. All these changes in the parameters, however, disappeared within almost 1 week

ISSN:0042-1138    

DOI:10.1159/000282475

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

We report 8 patients with urolithiasis in a duplex system. These patients (7 males and 1 female) underwent 16 extracorporeal shock wave lithotripsy (ESWL) treatments. Five had renal and 3 had ureteral stones. The mean stone size was 21 mm (12–54 mm). Five patients had incomplete and 3 had complete duplication, of which one had an associated horseshoe kidney. Retrograde ureteropyelography was done in all the patients and in 7 a JJ stent was inserted. The JJ stent could not be inserted in 1 patient with incomplete duplication and retrograde catheterization with saline infusion was used as an auxiliary procedure. One patient with complete duplication had stones in both the ipsilateral ureters with a stone bulk of 54 mm and required two JJ stents. Only 1 paediatric patient required general anaesthesia. The 3-month stone-free rate was 100

ISSN:0042-1138    

DOI:10.1159/000282476

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Splenic gonadal fusion is a rare anomaly that is frequently associated with skeletal abnormalities or occasionally with cryptorchism. But the case of this anomaly accompanied by male pseudohermaphroditism here represents, to our knowledge, the first report of splenic gonadal fusion with persistent müllerian duct syndrome

ISSN:0042-1138    

DOI:10.1159/000282477

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Short-tailed spermatozoa were found in 3 men attending our subfertility clinic. Light microscopy revealed basically normal sperm heads, but a short tail was found in 90% or more of the spermatozoa. Scanning and transmission electron-microscopic examinations of the ejaculate revealed several types of short-tailed spermatozoa. In one case, the majority of the spermatozoa had a short, thick tail. In another case, all the spermatozoa were short-tailed, although two different types could be distinguished. As in the first case some spermatozoa were short- and thick-tailed, whereas others possessed an incomplete neck and middle piece, and a short, thick principal piece. In the third case, an elongated middle piece and short principal piece were found in almost all the short-tailed spermatozoa. Our electron-microscopic study revealed that the type of short-tailed spermatozoa was different in each patient.

ISSN:0042-1138    

DOI:10.1159/000282478

出版商:S. Karger AG    

年代:1993

数据来源: Karger