摘要:

Chemotaxis is one of the most important functions of the polymorphonuclear leukocyte (PMN). In the host defense against pyelonephritis, the renal medulla is a site of interaction between bacteria and PMNs. At this site the osmotic pressure is elevated due to a high concentration of NaCl and urea. We evaluated the in vitro chemotactic activity of PMNs under the hyperosmolar conditions created by high concentrations of NaCl and urea. This activity was suppressed by the stimulation of opsonized zymosan and formyl-methionyl-leucyl-phenylalanine. The inhibition of chemotaxis was partially preserved by phosphoenolpyruvic acid (PEP), a precursor of adenosine triphosphate (ATP), in hyperosmolar NaCl but not in urea. The intracellular content of ATP was increased by supplementing the hyperosmolar NaCl with PEP. These observations suggest that inhibition of the chemotactic activity of PMNs is due to differing mechanisms for each NaCl and urea, and that PEP may protect the PMNs against hyperosmolar NaCl by maintaining ATP content.

ISSN:0042-1138    

DOI:10.1159/000282438

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

To clarify the relative importance of clinicopathological factors affecting survival in patients with renal cell carcinoma, univariate and multivariate analyses by Cox’s proportional hazards model were performed for 121 patients undergoing nephrectomy between 1980 and 1991. The 5-year survival rate was 67% for all 121 patients. Univariate analysis revealed that distant metastasis, local invasion, venous involvement, infiltration pattern, grade, lymph node metastasis, sex, and tumor size were significantly associated with patient survival. Multivariate analysis using a method of stepwise selection revealed that presence or absence of distant metastasis is the most significant determinant (p < 0.0001) for survival, followed by venous involvement (p < 0.001), treatment period (p < 0.02) and local invasion (p < 0.02), in this order. A four-factor model of the above determinants yielded adjusted hazard ratios of 5.3 for distant metastasis (positive vs. negative), 3.7 for venous involvement (pV1a-pV2 vs. pV0), 3.9 for treatment period (1980–1984 vs. 1985–1991), and 3.1 for local invasion (pT3-pT4 vs. pT1-pT2). The present study revealed recent improvements in the patient survival and justified the clinical application of Robson’s staging system implying local invasion, venous thrombus formation and distant metastasis as prognostic deter

ISSN:0042-1138    

DOI:10.1159/000282439

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

In 47 patients with transitional cell carcinoma (TCC) of the bladder, we investigated the relationship between tissue laminin distribution and serum laminin levels. The results were compared with those obtained from 6 patients with pathologically proven normal bladder mucosa as well as those obtained previously from 50 controls and 16 patients with benign bladder disorders. Interruption of the basement membrane (BM) laminin staining pattern was correlated with high serum laminin levels (r = 0.34; p < 0.01). The majority of patients with discontinuous BM laminin staining (82%) showed elevated serum laminin levels above the upper limit of normal range. In addition, the mean value of serum laminin PI was significantly higher in patients with discontinuous BM than that in patients with intact BM (t = 3.18; p < 0.005). These data suggest that the high serum laminin levels in TCC patients are largely caused by the process of BM breakdown and loss.

ISSN:0042-1138    

DOI:10.1159/000282440

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Staging of bladder tumors is based primarily on the depth of tumor invasion (T category) and is important to treatment planning and prognosis. The problem is that clinical evaluation by T category alone often understages the pathologic extent of disease and does not reliably predict treatment results. The current analysis suggests that the presence of a mass palpable on bimanual examination is of prognostic value and incorporation of this feature with microscopic tumor invasion may enhance the usefulness of clinical staging.

ISSN:0042-1138    

DOI:10.1159/000282441

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

1,900 cytological analyses of urine and bladder washings were made in 127 patients with urothelial bladder carcinomas before, during and after therapy. Following transurethral resection, all patients were treated by intravesical instillation of mitomycin C or thiotepa. Because of a locally advanced bladder cardinoma, 26 patients who were not candidates for radical cystectomy were given an integrated treatment of radiotherapy and chemotherapy. Intravesical administration of mitomycin C and thiotepa as well as integrated radiotherapy and chemotherapy induce a variety of cytological effects (toxic and/or metabolical) which may lead to cytological misinterpretations in the follow-up. DNA measurements by means of single-cell spectrocytophotometry show that the cytological effects induced by the above-mentioned therapies are not accompanied by an increase in the nuclear DNA content. It is concluded that the knowledge of these induced effects is mandatory for a correct interpretation of urinary cytology in the follow-up. Considering these effects and the clinical history, bladder carcinoma recurrences during and after intravesical chemotherapy or integrated radiotherapy and chemotherapy may be detected early by urinary cytology in the hands of an experienced cytopathologist or urologist. Furthermore, alterations of the urinary cytology occur after systemic application of cyclophosphamide and under immuno-suppressive therapy.

ISSN:0042-1138    

DOI:10.1159/000282442

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

In a prospective multicentric double-blind trial, urapidil, an α1-adrenergic antagonist, was investigated for its efficacy in benign prostatic hypertrophy (BPH). After 1 week of baseline on placebo, 214 patients with BPH were randomly assigned to 4 groups; group P was given placebo, group L, 15 mg of urapidil b.i.d. for 3 weeks, group M, 15 mg b.i.d. for 1 week followed by 30 mg b.i.d. for 2 weeks, and group H, 15 mg b.i.d. for 1 week followed by 45 mg b.i.d. for 2 weeks. In all groups, day and night urinary frequency improved significantly (p < 0.01 or p < 0.05) compared to baseline, but the differences were not significant between groups. The residual urine rate was significantly (p < 0.05 vs. group P) decreased in group H. Average and maximum flow rate improved significantly (p < 0.01 or p < 0.05) in group M and group H, but intergroup differences were not noted. Overall impression evaluated by investigators improved significantly (p < 0.01 vs. group P) in group M and group H. More patients in group H (7/55) and group M (4/51) had side effects than in group P (2/54). None of them were severe. In summary, a daily dosage of 60 mg urapidil proved to be the most beneficial in the treatment of patients with BPH

ISSN:0042-1138    

DOI:10.1159/000282443

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

An immunohistopathological study using monoclonal antibodies for alkaline phosphatases demonstrated placental alkaline phosphatase (PLAP)-like substance in the tumor cells of 11 pure seminomas, 1 seminoma with embryonal carcinoma and 1 seminoma metastasis. Liver alkaline phosphatase (LAP) could also be demonstrated in all seminomas but a third intestinal alkaline phosphatase (IAP) was not demonstrable in any tumor. The PLAP-like substance and LAP had considerable enzyme activities. This provides two tumor markers of seminomas detectable in histopathological specimens.

ISSN:0042-1138    

DOI:10.1159/000282444

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The lipid composition of seminal plasma was studied in 15 control subjects and 21 patients consulting for hypofertility and showing a chronic infection of the urogenital tract. In the infected patients a significant reduction in total cholesterol, HDL cholesterol and total phospholipids was noted. Moreover, there is a significant correlation between the rates of total cholesterol and prostatic acid phosphatases and the rates of phospholipids and proteins in seminal plasma. Knowing the role of lipids in the phenomena of maturation and capacitation of spermatozoa, such modifications enable us to understand better the functional anomalies of sperm observed in patients with chronic infection of the urogenital tract and also enable us to explain the effects of the infection on fertility.

ISSN:0042-1138    

DOI:10.1159/000282445

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Eighteen patients who referred to our hospital with acute scrotal pain and swelling were evaluated with color-Doppler imaging (CDI) after the initial clinical examinations. Five of these subjects were considered to have testicular torsion as diagnosed with CDI. These diagnoses were surgically confirmed, and appropriate treatments were performed. CDI findings of 13 patients were in accordance with inflammatory pathologies (epididymitis and/or orchitis). These patients received medical treatment. The CDI diagnoses of all patients were in agreement with the final clinical diagnoses. We conclude that CDI, which is a practical, rapid and high-resolution technique, promises to be the leading and decisive scanning method in acute scrotal disorders.

ISSN:0042-1138    

DOI:10.1159/000282446

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Efficiency of clinical recommendations for curing and prevention of phosphate nephrohthiasis founded on physicochemical investigations is unexpectedly low and apparently did not exceed 50%. We tried to consider possible physicochemical causes of this fact. For this purpose the influence of changes of urine pH and of calcium, phosphate and complexon concentrations on the probability of different precipitation phases of solid calcium phosphate has been reviewed. The importance of tendencies of changing the urine dynamic physicochemical parameters such as the precipitation induction period and the amplitude of urine pH variations in time has been shown. It was established that the probability of the existence of Ca3(PO4)2, Ca8H2(PO4)6·5 H2O, CaHPO4·2 H2O and MgNH4PO4·6 H2O in urine depends on the time of its transition from the supersoluble state and is determined in the final analysis by the relationship of formation rates and solid phase dissolution rates. This was verified by experiments and by data obtained in the clinical laborato

ISSN:0042-1138    

DOI:10.1159/000282447

出版商:S. Karger AG    

年代:1993

数据来源: Karger