摘要:

119 patients with stage-IV renal cell carcinoma were treated using immunotherapy with autologous tumor vaccine. The immunization was carried out at monthly intervals, the patients were restaged every 3 months using X-ray, ultrasound scanning or computed tomography as well as bone scintigraphy in the follow-up. The patients’ follow-up periods run from 6 to 66 months averaging in 38.5 months. 6 complete remissions, 4 partial responses and 29 stable diseases were seen, whereas 54 patients had progressive disease. Patients with a T1 primary tumor all survived the follow-up period irrespective of whether lymph node metastases (n = 2), venous invasion (n = 12) or distant metastases (n = 6) were present at the time of operation. Follow-up periods run from 12 to 48 months (averaging 23 months). Patients with T2 tumors showed survival up to 50 months postoperatively, of these only 3 died. Follow-up averages 30 months. The 3 patients died within the first year after operation. Patients with very large primary tumors showed the poor prognosis normally expected. 23 of these 40 patients died after a mean follow-up of 15 months. These results may indicate that immunotherapy can slow down tumor progression and induce objective responses. Those patients with small primary lesions apparently benefit from the treatment even though metastases are present at the time of diagnosis.

ISSN:0042-1138    

DOI:10.1159/000281439

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Local immunocompetence in patients with bladder tumors was evaluated immunohistochemically using monoclonal antibodies. As well as investigating the subsets of peripheral blood lymphocytes by flow cytometry, the subpopulations of tissue-infiltrating lymphocytes were investigated in frozen specimens from bladder cancers (n = 25) and from noncancerous tissues (n = 4). Six serial sections were stained with Leu4, Leu7, Leu 10, LeuM3, OKT4, and OKT8 antibodies, respectively. Marked lymphocytic infiltration into bladder tumors was a favorable prognostic sign. T cell infiltration was marked in the noninvasive group and was prominent around tumor cells, whereas B cells were rare in the stroma. T cells predominated over B cells in 19 of 25 bladder tumors. In patients with low-stage tumors, OKT8 cells were more prominent than OKT4 cells. NK cells accumulated around the cancer cells and infiltrated within cancer nests; NK cell infiltration was scanty in high-stage cases. There was a slight scattering of macrophages in 13 cases. In contrast to the findings in subsets of tissue-infiltrating lymphocytes, subsets of peripheral blood lymphocytes did not correlate with stage of disease. These findings suggest the presence of local immunosurveillance against bladder tumors. To elucidate host immune response against tumor, it may be important to characterize tissue-infiltrating lymphocytes.

ISSN:0042-1138    

DOI:10.1159/000281440

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The intravenous administration of cytostatics in cases of locally extended carcinomas of the bladder seems to promise success. As concomitant disadvantage however we have to mention that the drugs in high concentrations needed for this treatment give rise to systemic toxic effects limiting the rational use of the drug. A further rise of cytostatic tissue concentration seems possible by performing a synchronous tumor injection of cytostatics and microspheres. An additional anticancer effect and the synergistic activation of cytostatic effectivity must be assumed by a following local transurethral high-frequency hyperthermia of the bladder. Our first urological experiences with this integrated therapy in six locoregional (T3–4N0M0) and six advanced metastasizing (T3–4N1M0–1) bladder cancers are presented consisting of a combined intraarterial cytostatic microspheres carcinoma infusion (CMCI) and scheduled adjunctive transurethral high-frequency hyperthermia (TUHH). In the case of locoregional tumor the aim was cancer destruction or debulking and in the case of metastasizing tumor palliation of local disease. Mechanisms of action, methodical procedures, indications, results as well as side effects of the intraarterial CMCI and TUHH treatment as developed by our department are presented and discussed.

ISSN:0042-1138    

DOI:10.1159/000281441

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Correlation of tumor volume to tumor stage in 134 patients with nonseminomatous testicular tumors, which were classified according to the TNM system, revealed similar tumor load for N0 and Ni patients. CT scans (n = 92), lymphangiography (n = 47), intravenous pyelography (IVP) (n = 134), sonography (n = 118) and serial tumor markers (n = 82) were evaluated for sensitivity, specificity and accuracy, both separately and in different combinations. The best individual results were obtained by lymphangiography (sensitivity 0.77, specificity 0.73, accuracy 0.75) and CT scan (sensitivity 0.52, specificity 0.91, accuracy 0.70). In combination CT scan and lymphangiography were the most valuable diagnostic tools (accuracy 0.79) with high sensitivity (0.88) and specificity (0.77). For patients with negative CT scans, subsequent lymphangiography is recommended for accurate staging, as seems mandatory in stage 1 patients entering surveillance programs.

ISSN:0042-1138    

DOI:10.1159/000281442

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

An unusual case of a double testicular tumor, with different histology and the same marker chromosome, led to a search of the literature for cases of testicular tumors that were double, bilateral, or familial. The literature on abnormal chromosomes in tumors of the testis is also reviewed. After a discussion of the facts, it is suggested that most of the histological variants of germ cell tumors of the testicle are so closely related that they could be grouped together under the title of ‘orchidomata’.

ISSN:0042-1138    

DOI:10.1159/000281443

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Forty-four consecutive female patients, who were scheduled for operation for genuine stress incontinence but instead treated pharmacologically with an α-agonist or placebo for 3–4.5 months, were evaluated after a median observation period of 30 months. Ten patients (23%) underwent colposuspension. Fourteen patients (32%) claimed to be continent or so much improved that further treatment was considered unnecessary by the patients themselves. Of the remaining 20 patients who still claimed to have stress incontinence, 11 (25%) preferred to resume the pharmacological treatment whereas 9 patients (20%) had not decided whether they wanted further treatment. These results suggest that some operations for stress incontinence may be avoided by introduction of a standard trial of medical therapy prior to intended surgical intervention.

ISSN:0042-1138    

DOI:10.1159/000281444

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Thirty-three women with urinary stress incontinence were treated with the α-adrenoceptor-stimulating agent, norfenefrine (Nevadral Retard). Treatment was administered during 3–24 weeks at a daily dosage of 90 mg. Judged by a 1-hour pad weighing test, a significant effect could be demonstrated. With the exception of 1 case of allergic reaction and 1 case of recurrent vomiting, a simultaneously performed tolerability test revealed only minor side effects.

ISSN:0042-1138    

DOI:10.1159/000281445

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A total of 172 ureterorenoscopies were performed in 112 patients with 131 ureteric and renal calculi. The success rates for retrieval were 65, 59 and 79% in the upper, middle and lower third of the ureter, respectively. 32% of renal calculi were removed by ureterorenoscopy. By combined endourological techniques 89% of all stones were removed. Few complications occurred, and no late sequelae were recorded. It is concluded that ureterorenoscopic stone retrieval is an efficient and safe procedure, especially for lower ureteric stones. In the hand of a trained endourologist it might be attempted for upper ureteric calculi as well, and for certain renal stones in selected patients.

ISSN:0042-1138    

DOI:10.1159/000281446

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

We investigated the effect of extracorporeal shock wave lithotripsy (ESWL) on the urinary exrection of N-acetyl-β-D-glucosamidase (NAG) activities. No significant increases in NAG excretion were recognized between, before and after ESWL. However, there were significant increases in patients with renal calculi who received over 1,000 shock waves. Therefore, we should not neglect renal impairments which could be caused by extracorporeal shock wave exposure.

ISSN:0042-1138    

DOI:10.1159/000281447

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A total of 600 patients underwent 696 treatments of extracorporeal Shockwave lithotripsy (ESWL) during the period between June and November 1987. Our progressively increasing experience with the second-generation device shows that this new unit is as effective as the conventional one, and reveals several advantages. The focusing of the stone is easier; therapy time is shorter; general or regional anesthesia is no longer necessary; distal ureteral stones can be disintegrated, and adjuvant procedures are easily performed during the ESWL session. Of the last 400 patients of our series, 76% were treated on an outpatient basis without any major complications.

ISSN:0042-1138    

DOI:10.1159/000281448

出版商:S. Karger AG    

年代:1989

数据来源: Karger