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Biomedical subjects

A Herrlinger

Publications and source records attributed to A Herrlinger.

At least 19 recordsLinked to original sources
PubMed1992

[The significance of tumor diameter in renal cell carcinoma].

The data of 740 patients who were operated on for renal cell carcinoma between 1975 and 1986 have been evaluated. We studied the relation between tumour size and other factors influencing the prognosis, such as tumour stage, infiltration of renal veins and incidence of metastases at the time of nephrectomy, and between tumour grading and postoperative survival. Sixty-six patients with small tumours were divided in groups according to tumour size: less than 20 mm, less than 25 mm, less than 30 mm, less than 40 mm. All 740 patients were separated into groups according to tumour size: less than 4 cm, 4-6 cm, 6-8 cm, 8-10 cm and greater than 10 cm. Stage pT1 carcinomas (less than 25 mm) occurred in 1.4% of patients and tumours exceeding 10 cm in size in 30%. The prognosis with regard to survival becomes worse the greater the diameter of the tumour: the incidence of renal vein involvement, metastases and higher grades of malignancy increases. Postoperative survival decreases in relation to the increase in tumour size. Carcinomas less than 30 mm in diameter were found to have distant metastases in only 1 case, while invasion of renal veins occurred in 2 cases. In tumours up to 3 cm in diameter, a kidney-preserving tumour resection seems possible without limiting the radicalness of the surgery.

Carcinoma, Renal Cell↗
PubMed1991

What are the benefits of extended dissection of the regional renal lymph nodes in the therapy of renal cell carcinoma.

In a prospective study of 511 patients we compared the data of 320 who underwent systematically extended dissection of the regional lymph nodes with data of 191 who underwent only facultative dissection of the lymph nodes, which means that no lymph nodes had been removed or only a few were taken for staging purposes. Only patients without distant metastases and who were less than 72 years old were included. All patients were treated with a transabdominal approach. The incidence of positive nodes in the patients with systematically extended lymphadenectomy was 17.5% and for patients with facultative lymphadenectomy it was 10%. Survival rates of patients with facultative lymphadenectomy were 58% after 5 years and 40.9% after 10 years, compared to 66% and 56.1%, respectively, for patients with systematically extended lymphadenectomy (p less than 0.01). Patients with stage pT1-2 (Robson stage I) and pT3aN0M0 (Robson stage II) tumor obviously had the highest benefits with extended lymphadenectomy. Operative mortality was less than 1% after systematically extended lymphadenectomy and 3.8% after facultative lymphadenectomy. We conclude from our data that the systematic and extended lymphadenectomy improves the prognosis of patients with renal cell carcinoma without any additional operative risks.

Carcinoma, Renal Cell↗
PubMed1990

[What is the benefit of systematic regional lymph node dissection in tumor nephrectomy?].

What is the benefit of an extended dissection of the regional lymph nodes in the treatment of renal cell carcinoma (RCC)? We evaluated the results of 511 consecutive patients which we operated on RCC. The data of 320 patients (SLD) who had an extended dissection of the regional lymph nodes have been compared with those of 191 patients (FLD) who had a dissection of none or only of a few nodes for staging reasons. All patients were nephrectomized under curative intent (M0) with a transabdominal approach. 1. The incidence of N+ in the SLD group was 17.5% and 10% in the FLD group. 2. The overall 5-year survival rates were 58% after FLD and 66% after SLD, the 10-year survival rates 38% after FLD and 54% after SLD (p less than 0.01). 3. The perioperative mortality of patients with extended dissection was 0.9%. We conclude from our data that the extended dissection of the regional lymph nodes significantly improves the prognosis of patients which were operated for RCC.

Carcinoma, Renal Cell↗
PubMed1989

[Improved actuarial results in the treatment of kidney cancer by systematic lymph node excision].

From January 1st 1970 to December 31th 1985, 706 nephrectomies for renal cell carcinoma have been performed by the staff of the urologic clinic of the University of Erlangen-Nürnberg. 222 nephrectomies by lumbal and 484 by transabdominal incision. The following study compares the results of two groups of patients, who all have been operated transabdominally with curative goal (this means that there was no evidence for distant metastases). The two groups differ in the character of the associated lymph node dissection. The first group consists of patients on whom we performed a systematic lymph node dissection (LAS, n = 291). The second group consists of those patients on whome we performed a facultative lymp node dissection (LAF, n = 193). In this prospective study of postoperative survival rates, significantly better results are obtained in the LAS-group. The survival rates according to the stage of the tumor (Robson-classification) show that stage I and II profit most of the extended lymph node dissection. The bad prognosis for stage IIIa patients, determinated by tumor invasion into the renal vein, will not be changed after extended lymph node dissection. Patients with positive regional lymph nodes (stage IIIb + c) have a significantly better prognosis during the first three years after nephrectomy, obviously as the result of reduce tumor volume, but the benefit does not last over a longer period as 5 years. According to our results we are convinced that the systematically extended lymph node dissection is an important curative measure in the surgical therapy of renal cell carcinoma.

Actuarial Analysis↗
PubMed1987

[Possibilities of DNA impulse cytophotometry in kidney cancers].

DNA flow cytometry (DNA-FCM) is a modern technique allowing quantitative tumor cell analysis. In tissue samples from 62 renal carcinomas, ploidy was determined and cell cycle analysis performed by DNA-FCM. We checked for correlation between the FCM data and the tumor stage according to Robson the histological grade after Hermanek, and the condition according to the combined staging and grading system. With reference to the stage-grade system, the DNA aneuploidy rate increased significantly from tumors with increasing degree of malignancy. Tumors classed according to Robson's classification system as highly malignant exhibited higher DNA aneuploidy rates. The 15 tumors that had metastasized showed higher DNA indices and higher proportions of cells in S-phase than did the 47 tumors without metastases. When used in conjunction with the stage-grade classification for renal carcinomas, DNA-FCM analysis provides useful information about the proliferative behavior, including the susceptibility of these tumors to chemotherapy.

Adult↗
PubMed1985

[Adrenal myelolipoma. Case report].

Adrenal myelolipomas (a. M.) are rarely occurring, benign, unilateral, hormonally inactive, mostly asymptomatic tumors of the adrenal cortex, consisting of fat cells and myeloid tissue. The pathogenesis is not clear. There is no connection with hematologic diseases, but a strikingly frequent coincidence with chronic systemic diseases and obesity. Myelolipomas of the presacral as well as in the mediastinal space are very rare. Case report of an adrenal myelolipoma removed by lumbotomy.

Adrenal Gland Neoplasms↗
PubMed1984

[Method of radical transabdominal tumor nephrectomy with facultative or systemic lymph node dissection and results in 381 patients].

The prognosis of 381 patients without metastases operated on renal cell carcinoma depends on the extent of the lymph node dissection. After facultative lymph node dissection (FLD) the uncorrected actuarial survival rates (SR) are 64 +/- 8% after 3 years and 50 +/- 9% after 5 years compared to 77 +/- 7% (3 years) and 60 +/- 11% (5 years) when systematic lymph node dissection (SLD) was performed. For stage I the better results in the SLD-group (80 +/- 10% 5 years SR for SLD; 67 +/- 13% 5 years SR for FLD) are partially to be explained as a staging-effect, whereas in stage II the difference (92 +/- 10% 5 years SR for SLD; 45 +/- 25% 5 years SR for FLD) is due to the higher radicality of the systematic dissection. In stage III (35 +/- 14% 5 years SR for SLD; 37 +/- 12% 5 years SR for FLD) the predominant influence of the tumor invasion in renal veins cannot be influenced by local extension of the operation. The incidence of lymph node metastases was 16% (n = 170) in the FLD and 23% (n = 211) in the SLD group. When only facultative dissection is done, 30% of lymph node metastases escape detection. Without any lymph node dissection the number of unrecognized lymphmetastases can be expected to be still higher. The controversies about the role of lymph node dissection in radical tumor nephrectomy are mainly caused by the lack of standardized criteria for operative and patho-histological staging procedures. Any conclusions drawn from comparing reports in the literature should be related to these modalities.

Aged↗
PubMed1983

[Reflux persisting into adulthood. A clinical study].

UNLABELLED: 1. Incidence: about 1/10 of all cases; 9/10 mature with/without scarring, even in the case of complicated reflux. 2. SYMPTOMS: onset after age of 16; prior to this clinical silence or minimal symptomatology. 3. Grading and staging: all of them may persist, low as well as high stages; scarring usually progressing; Grade I reflux and Stage III scarring often occur together. 4. INFECTION: female: rare between age of 10 and 15, as the bladder has become stable, later on frequent again due to new instability caused by sexual activity. 5. THERAPY: a. Conversion of complicated reflux into uncomplicated reflux (infravesical relief of obstruction). b. Antirefluxiv operation when urinary tract infections recur and the kidney is worth saving. c. Extirpative operation when unilateral hypertension or grave renal scarring. 6. PROGNOSIS: depends on uni-/bilaterality. 7. Operative results (Gregoir): good in cases of primary reflux, discouraging in cases of complicated reflux.

Adult↗
PubMed1982

[The prune-belly syndrome].

All features of the Prune-Belly syndrome--the congenital deficiency of the abdominal musculature with associated malformations of the urinary tract--are presented. The report is divided into the following headings: definition, etiology, morbidity, pathomorphology, staging, correlated pathology and therapy. The therapeutic strategy as proposed 1978 by Woodard et al. is emphasized. A report on six own cases is included.

Adolescent↗
PubMed1982

[Sacral dysgenesis and its neuro-urologic pathologic correlates].

As an aspect of the caudal regression syndrome the dysgenesis of the sacrum, the correlating neuro-urological pathology, and a classification are presented, based on the literature and a report of ten cases. The sacral osteological anomaly--as a numerical and as a structural anomaly--and the neuro-urological defect exist to different extents. Therefore the diagnosis is made at several ages. The type of neurogenic bladder disturbance is the "lower neuron lesion". Use of a proper diagnostic approach and conservative or surgical therapy according to the type of lesion improve the prognosis by protecting the upper urinary tract and also ameliorate the social hardships resulting from incontinence. Irregularly correlated are disturbances of the rectum and of the lower extremities.

Adolescent↗
PubMed1979

[Recurrence of inguinal, undescended, testicle (author's transl)].

An analysis of 94 patients from 1970 to 1977 demonstrates the problems of recurrence of the inguinal undescended testis. In more than 2/3 of the patients operative deficiencies were considered as the cause. The technique of secondary corrective surgery is described. The special difficulties with short internal spermatic vessels are outlined. In 90% of the patients a good anatomical result was obtained but no data are available concerning later functional results.

Cryptorchidism↗
PubMed1978

[Transvenous perfusion, a new simple and effective technique of regional renal hypothermia. An experimental study (author's transl)].

In an experimental study, involving ten dogs, the feasibility of transvenous perfusion cooling of the kidney is proven. The theoretical basis of this new method of regional renal hypothermia is presented. The technique is easy to perform and requires cannulation of the renal vein. The perfusate leaves the kidney either via the capsular veins which were divided during renal exposure or through the proposed nephrotomy. Renal vein thrombosis or venous disruption have not been observed. The only complication encountered in one instance was hemorrhage from the puncture site of the renal vein.

Animals↗
PubMed1978

[The pharmacological treatment of the incontinent neurogenic bladder (author's transl)].

An attempt is made to describe the action of sympathic, parasympathic and somatic innervation of the urinary bladder by means of a receptor model and to present the theoretical basis of a successful treatment of the neurogenic bladder. Radiographic and urodynamic examination of 15 children revealed that ephedrine was successful in improving or curing urinary incontinence in 12 cases with congenital or required neurogenic bladder. The requirements and limitations of a successful sympathomimetic treatment of the neurogenic incontinence are presented.

Adolescent↗