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  • 1
    Electronic Resource
    Electronic Resource
    Metastasenchirurgie beim Nierenzellkarzinom (2000)
    Springer
    Der Urologe 39 (2000), S. 362-367 
    Details
    ISSN: 1433-0563
    Keywords: Schlüsselwörter Nierenzellkarzinom ; Metastasen ; Chirurgie ; Key words Renal cell carcinoma ; Metastases ; Surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Renal cell carcinomas (RCC) are endowed with impressive metastatic potential. Patients with RCC who present with apparently solitary metastatic lesions represent a small cohort. Due to the different long-term results achieved with surgical resection of metastatic RCC lesions, a generally accepted judgement about this treatment modality is not possible. Several studies suggest that aggressive surgical management can provide an effective treatment, especially in patients with solitary pulmonary metastases. Most noteworthy is the fact that because of the organ distribution of RCC metastases, surgical therapy is dominated by general and thoracic surgeons, neurosurgeons, and orthopaedic surgeons. Therefore, an interdisciplinary approach is one of the most important key points for a successful outcome in these patients.
    Notes: Zusammenfassung Das Nierenzellkarzinom (NZK) ist durch eine ausgeprägte Tendenz zur Metastasierung charakterisiert, wobei solitäre Metastasen eine Minderheit darstellen. Die sehr unterschiedlichen Resultate der operativen Therapie von NZK-Metastasen erlauben keine pauschale Beurteilung dieser Vorgehensweise, sondern erforderen eine differenzierte Betrachtung der einzelnen Organsysteme. Dabei werden die besten Langzeitresultate verbunden mit einer akzeptablen Morbidität nach der Resektion von Lungenmetastasen erzielt. Entsprechend dem Verteilungsmuster der Metastasenlokalisationen wird die chirurgische Therapie des disseminierten NZK wesentlich durch die Nachbardisziplinen Allgemein- und Thoraxchirugie, Neurochirurgie und Orthopädie dominiert. Eine enge interdisziplinäre Zusammenarbeit, z. B. im Rahmen eines Tumorzentrums, ist daher für ein erfolgreiches chirurgisches Behandlungskonzept unerlässlich.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001200050371
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  • 2
    Electronic Resource
    Electronic Resource
    Efficient pathway for early detection of prostate cancer concluded from a 5-year prospective study (1993)
    Springer
    World journal of urology 11 (1993), S. 201-205 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a prospective study the statistical characteristics of digital rectal examination (DRE), transrectal ultrasound (TRUS), and serologic determination of prostate-specific antigen (PSA) were assessed in 1230 patients aged over 40 years. The sensitivity, specificity, and positive and negative predictive values were determined to be 80.3%, 69.7%, 58.9%, and 86.7%, respectively, for DRE; 76.5%, 62.3%, 52.3%, and 83.1%, respectively, for TRUS; and 87.9%, 49.6%, 48.5%, and 88.3%, respectively, for PSA (normal level, 4 ng/ml). The data clearly demonstrate the nonsuitability of each single measure for reliable early detection of prostatic carcinoma. Connection of the parameters in all possible combinations under various conditions demonstrated the superiority of the test “DRE and PSA 〉4 ng/ml” over DRE as the “gold standard” and all other options. The use of this approach as the first-line raster of an algorithm (outlined herein) would allow the detection of prostatic malignancy with a specificity of 86.5% and a positive predictive value of 74.0%. Supplementing this screen with short-term controls in cases in which only one parameter is positive (“DRE or PSA 〉4 ng/ml”) might enable the detection of almost all patients with prostate cancer. TRUS did not provide any additional information.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00185069
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  • 3
    Electronic Resource
    Electronic Resource
    Prostate-specific antigen — a true progress in diagnosis and follow-up of prostate cancer (1993)
    Springer
    World journal of urology 11 (1993), S. 187-187 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00185065
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  • 4
    Electronic Resource
    Electronic Resource
    Editorial (1991)
    Springer
    World journal of urology 9 (1991), S. 167-167 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00182834
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  • 5
    Electronic Resource
    Electronic Resource
    Single potential analysis of cavernous electric activity —a possible diagnosis of autonomic impotence? (1990)
    Springer
    World journal of urology 8 (1990), S. 75-79 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The aim of our study was to examine the cavernous smooth-muscle electric activity in normal and impotent patients as well as in those with (presumably) well-defined neurologic lesions. Single potential analysis of cavernous electric activity (SPACE) was done in 12 consecutive impotent patients, 34 normal patients, and 19 patients referred especially for SPACE. In the normal patients, similar potentials with a mean duration of 9.5 s, a mean amplitude of 153 μV and a mean polyphasity of 8.5 were recorded (cutoff frequencies, 2–2000 Hz), with cutoff frequencies set at 0.5–500 Hz, the mean duration was 12.8 s, amplitude was 444 μV and the mean polyphasity was 13.8 Upper spinal cord lesions showed potentials of long duration as well as whips and bursts. Patients with lower motor-neuron lesions showed either short potentials of high amplitude or potentials of small amplitude. In 49% of the impotent patients, abnormal SPACE was found. Our results suggest that SPACE is a reproducible and minimally invasive method for the diagnosis of autonomic neurogenic impotence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01576351
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  • 6
    Electronic Resource
    Electronic Resource
    Current clinical relevance of immunotherapy in metastatic renal cell cancer (1991)
    Springer
    World journal of urology 9 (1991), S. 228-231 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Existing compilations of data recorded in clinical trials involving cytokines as single compounds and in combination with each other and with cellular immuno-effectors or chemotherapeutic agents are analyzed. Antitumor activity for interferon alpha (IFN-α) and for interleukin-2 (IL-2) could be established at 14.5% and 13.7%, respectively, when used in single-agent regimens with considerable toxicity for IL-2 at high, intravenous doses. When IL-2 is combined with cellular effectors, these side effects together with the problems associated with the complexity of culture techniques when adding LAK (lymphokine-activated killer) cells or CTILs (cytotoxic tumor-infiltrating lymphocytes) impact unfavorably on future clinical application, and this combination must be considered investigational. IFN-α or IL-2 coupled with a chemotherapeutic agent only exhibited a limited advantage over single cytokine administration. The most promising combination seems to be IFN-α combined with IL-2, giving improved prospects for nearly 30% of the patients with metastatic renal cell cancer (RCC), simultaneously allowing for significant reduction of toxicity and for an outpatient treatment. A precise assessment of the underlying immunologic mechanisms is needed, as are controlled prospective and randomized trials comparing the various cytokines with each other and with conventional approaches in single and combination regimens with the ultimate purpose of defining the role of biotherapy within a clinical strategy for metastatic RCC before it can be considered a standard treatment modality.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00182846
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  • 7
    Electronic Resource
    Electronic Resource
    Preliminary report on the effect of the nitric oxide donor SIN-1 on human cavernous tissue in vivo (1991)
    Springer
    World journal of urology 9 (1991), S. 237-239 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Recent experimental studies showed an important role of endothelium-derived relaxing factor in penile erection. Therefore, an in vivo study was done to examine the effect of the nitric oxide donor SIN-1 on human erection. Eight patients with erectile dysfunction received doses of 0.1 to 1 mg SIN-1 intracavernously. In all patients, SIN-1 induced a dose-dependent erectile response. Although applied in 2 patients with prolonged erections to minimal doses of a papaverine-phentolamine combination, the duration of the full erection achieved in response to 1 mg SIN-1 was limited to about 60 min. The erectile response was due to an increase in arterial inflow and to cavernous smooth muscle relaxation. There were no systemic or local side-effects. Our preliminary study suggests SIN-1 to be an attractive alternative for autoinjection therapy in the treatment of erectile dysfunction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00182848
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  • 8
    Electronic Resource
    Electronic Resource
    Single potential analysis of cavernous electrical activity (1991)
    Springer
    Urological research 19 (1991), S. 277-280 
    Details
    ISSN: 1434-0879
    Keywords: Erectile dysfunction ; Autonomic innervation ; Cavernous electric activity ; Diagnosis of autonomic dysfunction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Recording of cavernous electric activity was performed in 178 patients with erectile dysfunction and in 37 normal patients. In 34/37 normal patients, potentials of a uniform shape were recorded during flaccidity: At cut-off frequences of 0.5–500 Hz, the length was 8–18 (mean 12.8, SD 2.8), the amplitude 250–750 (mean 444, SD 109) μV, and the polyphasity 8–22 (mean 13.8, SD 3.3). In impotent patients with upper motor neuron lesions or peripheral lesions, specific types of potentials were observed. In 11/14 impotent patients with insulin-dependent diabetes for over 20 years and clinical findings of cavernous myopathy, potentials showed low amplitude, irregular shape, and slow depolarizations. In 51% of the consecutive impotent patients, abnormal findings of cavernous electric activity were recorded. Our clinical study suggests that single potential analysis of cavernous electric activity (SPACE) may be useful in the diagnosis of cavernous autonomic neuropathy and cavernous smooth muscle myopathy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00299057
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  • 9
    Electronic Resource
    Electronic Resource
    Effects of cytokines on growth in vitro of primary human renal cell carcinoma (1992)
    Springer
    Urological research 20 (1992), S. 369-373 
    Details
    ISSN: 1434-0879
    Keywords: Renal cell carcinoma ; Cytokines ; Colony-stimulating factors ; Proliferative behaviour
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In clinical trials different haematopoietic active cytokines such as granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) have been proven to alleviate myelosuppressive side effects of intensive chemotherapy in different non-urological malignancies. On the other hand, these cytokines can directly stimulate the proliferation of cells originating from some non-urological tumours. To clarify the impact of these cytokines on the proliferative behaviour of human renal cell carcinoma (RCC), 29 previously untreated RCC tumours were prepared for culturing in vitro using the cell cluster technique. The success rate for growth in vitro was 82.8% (24/29). The malignant renal cells were treated with different cytokines (GM-CSF, G-CSF and interleukin-3) in different dosages. Cell number and proliferation rates detected by immunostaining were used for treatment evaluation. A dosage-dependent stimulation of cell growth could not be observed compared to untreated cells. From the data presented in this study, proliferative stimulation of RCC by administering colony-stimulating factors in clinical trials cannot be assumed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00922751
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