摘要:

The tumor specimens of 20 patients who underwent radical nephrectomy for nonfamiliar unifocal renal cell carcinoma were evaluated with conventional histopathology, cytogenetic analysis and evaluation of nuclear ploidy with cytofluorometry. The pathological stages were 1 T1N0M0, 10 T2N0M0, 1 T2N+M0, 6 T3N0M0 and 2 T3N+M0. Eleven tumors presented clonal chromosomal abnormalities, 2 had chromosomal instability and 7 normal karyotype. Rearrangement of chromosome 3 was documented in 2 cases only, in contrast with previous observations in the literature. Ten patients had a diploid or peridiploid DNA tumor content, 1 tetraploid, 4 triploid and 5 multiclonal. No correlation was found between nuclear ploidy and karyotype. Chromosomal abnormalities did not impact on survival, while a statistically significant correlation was found with diploid nuclear DNA content, since with a mean follow-up of 45.7 months, 9 out of 10 patients with diploid and peridiploid tumors are alive (p < 0.02), while 8 out of 10 nondiploid died of disease progression.

ISSN:0042-1138    

DOI:10.1159/000282935

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0042-1138    

DOI:10.1159/000282936

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In a phase II clinical trial 23 patients with metastatic renal cell carcinoma were treated with a cyclic regimen of interferon alpha-2b (IFN-α). To these 23 patients IFN-α at a dose of 10 MU/m2 12 months) of the disease with a good quality of life. In summary, in advanced renal cell carcinoma patients, the objective response rate of a cyclic treatment with IFN-α is rather low. However, a long-lasting stabilization of the disease including a good quality of life can be expected in a modest proportion of the pati

ISSN:0042-1138    

DOI:10.1159/000282937

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We divided 53 consecutive patients with transitional cell carcinoma of the ureter into two groups. Group A consisted of patients treated in the 1970s and group B of patients treated in the 1980s. Clinical features and outcomes were compared between the groups. Group B patients saw an increased use of new diagnostic modalities, including antegrade pyelography, computed tomography, and bone scintigraphy. Regional lymphadenectomy was added to the operative routine in group B and combined chemotherapy, using methotrexate, vinblastine, adriamycin and cisplatinum, the most effective regimen at present, was used in 9 patients in group B and no patients in group A. In spite of new diagnostic modalities and treatments, the survival rate for ureteral cancer failed to improve from the 1970s to the 1980s.

ISSN:0042-1138    

DOI:10.1159/000282938

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We determined whether a carbohydrate antigen in serum, CA19-9, serves as a marker for embryonal carcinoma. Serum CA19-9 was serially measured in 18 male patients with a germ cell tumor. Five of 8 patients with an embryonal carcinoma had an elevated serum CA19-9. The elevated serum CA19-9 returned to normal in parallel to the clinical response to the treatment. Patients with a seminoma had a normal serum CA19-9 irrespective of their tumor size. Paraffin-embedded specimens of germ cell tumors from 9 of the 18 patients and 10 other patients were stained with the monoclonal antibody against CA19-9. These immunohistochemical stainings showed that embryonal carcinomas and mature teratomas were consistently positive and seminomas were often faintly positive for CA19-9, whereas choriocarcinomas, yolk sac tumors and immature teratomas were negative for CA19-9. These results indicate that serum CA19-9 may be a useful serum marker for embryonal carcinomas.

ISSN:0042-1138    

DOI:10.1159/000282939

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The use of irrigating fluid containing a small amount of ethanol allows fluid absorption to be monitored by means of expired-breath tests during transurethral resection of the prostate (TURP). There is, however, no consensus concerning how the breath ethanol data should be converted into the volume of irrigant absorbed. The present study examines the use of the product of concentration and time (area under the curve) to predict how much fluid is absorbed. Intermittent infusions of ethanol in 5 volunteers showed that the relationship between area under the curve and ethanol load was best described by a polynomial expression. This was also applicable to the uptake of small volumes of irrigating fluid during 16 TURPs. When patients with large-sized absorption ( > 1,000 ml) were also considered, however, the precision was better when the absorbed volume was predicted by a multiple linear regression formula where the ethanol level in the exhaled breath at the end of any 10-min period during TURP and the time during which ethanol had been detected served as independent factors.

ISSN:0042-1138    

DOI:10.1159/000282940

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

From September 1989 to February 1993, 11 patients with localized adenocarcinoma of the prostate were treated with pelvic external-beam radiation therapy followed by high dose rate (HDR) transurethral brachytherapy as a boost dose. External-beam radiation therapy was administered through opposed pelvic fields using a 60Co teletherapy unit to a tumor dose of 46–50 Gy in 23–25 fractions and followed by three fractions of transurethral brachytherapy, delivered using a 60Co HDR remote afterloading equipment. The treatment time was calculated using the prostatic capsule as the reference point. The dose calculated to be delivered to the capsule was 5 Gy/fraction, making a total of 15 Gy. The follow-up period ranged from 11 to 65 months, with a median follow-up time of 30 months. Local control was achieved in all patients. The prostate-specific antigen levels were normalized within 3 months of radiotherapy in 9 patients and within 3–6 months in the remaining 2. Transurethral brachytherapy appears to be a simple and feasible form of brachytherapy. Preliminary local control and radiotherapy-related morbidity rates are comparable to those of other forms of brachytherapy. Further follow-up is required for assessment of long-term local control and delayed radiotherapy-related morb

ISSN:0042-1138    

DOI:10.1159/000282941

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Although in the last years surgery for urinary diversion became routine in clinical practise, various problems have to be solved. Therefore, a safe, universal animal model is necessary. An ileal pouch anastomosed to the subtotally resected urinary bladder was formed in 6 domestic pigs. Ureters remained untouched and the reservoir was not drained by any tubes. Animals were followed up for 3 months, every 3–4 weeks blood was drawn for electrolytes, renal and hepatic function and blood gas analysis. The animals were sacrificed after 3 months and a thorough pathohistological examination of the reservoir was performed. No intraoperative or operation-related postoperative complications were seen. Laboratory parameters were stable and no micturition problems appeared. Upper urinary tract was normal. The animal model presented is safe with regard to inflammatory or metabolic side effects and to disturbances of supravesical urinary tract. Therefore, this model is suitable to serve for short- as well as long-term studies of various forms of urinary diversion

ISSN:0042-1138    

DOI:10.1159/000282942

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Variations of Hauri’s penile revascularization have been in clinical use since 1983. The hemodynamics of the so-called three-vessel anastomosis remain uncertain despite successful, clinically reproducible results. The goal of this study was to depict the increased perfusion of the erectile system of the penis following revascularization by means of the inferior epigastric artery. Ten mil-liliters of heparinized peripheral venous blood was drawn from 10 patients prior to surgery. The radioactively tagged erythrocytes (1 mCi 99mTc) were reinjected via an additional incision in the donor vessel proximal to the anastomosis following completion of the three-vessel anastomosis and intracaver-nous injection of 20 µg PGE1 Once again, blood was drawn during the tumescence phase from both a peripheral vein and the corpora cavernosa within the normal circulatory duration and compared to the original specimen. Eight of ten patients displayed evidence of primary reperfusion of the corpora cavernosa via the inferior epigastric artery as the donor vessel. Using strict indications, revascularization of the penis is an effective mode of therapy for arterial erectile dysfuncti

ISSN:0042-1138    

DOI:10.1159/000282943

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

To evaluate the fragility of Ca-oxalate monohydrate stones in terms of high energy shock wave effectivity, we measured the glycosaminoglycan (GAG) content of the organic stone matrix of 35 patients who had undergone extra-corporeal shock wave lithotripsy (ESWL) treatment for renal pelvic stones. The patients were classified into 3 different groups with respect to the rate of stone disintegration. While group I consisted of patients in whom only one ESWL session was needed to complete disintegration, in group II there were patients requiring 3 or more sessions for complete stone disintegration. On the other hand, patients in whom no sign of disintegration was observed despite 3 ESWL sessions constituted group III. Following this procedure, comparative evaluation of the GAG content of the stone matrix per dry stone weight in each group revealed a statistically significant difference between the first 2 and the 3rd group (p < 0.05). Our results indicated that as the GAG content of the stone matrix decreased, the efficiency of the shock waves on stone disintegration also prominently decreased, disintegration being impossible in some cases. On the other hand, the stones which were found to have higher amounts of GAGs in the organic matrix tended to be more fragile and were easily disintegrated with shock waves. In our study group the chemical composition of Ca-oxalate monohydrate stones, e.g. the matrix GAG content, seemed to be important with regard to the disintegrative effect of high energy shock waves.

ISSN:0042-1138    

DOI:10.1159/000282944

出版商:S. Karger AG    

年代:1997

数据来源: Karger