[Laboratory methods for the regulation of estrogen therapy in patients with prostatic carcinoma].
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Biomedical subjects
Publications and source records attributed to E Hradec.
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During transurethral electroresection in the posterolateral bladder neck, trigone and posterior urethra, unintentional contractions of the thigh-adductor muscles may occur due to irritation of the obturator nerve. The sudden displacement of the bladder wall against the cutting loop may cause a perforation of the bladder. The authors describe the topographic relation of the bladder wall to the passage of the obturator nerve in the minor pelvis. The technique of obturator nerve block by local anaesthesia is described and its efficacy is demonstrated in 21 patients.
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Serum and urinary amylase isoenzyme activities were evaluated in 70 patients with carcinoma of the prostate. The results were compared with amylase isoenzyme activities fo 20 healthy man and 30 patients with benign prostatic hypertrophy. Increased serum S-type amylase activity was found in 13 patients (18%) with carcinoma of the prostate, whereas no changes of this isoenzyme was found in benign prostatic hypertrophy. No significant changes of serum P-type amylase activities were observed in our patients.
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Optical internal urethrotomy is a safe operative procedure for the management of a prevailing number of strictures of the male urethra. During the years 1976--1978, urethrotomy was carried out in 149 patients and the results are evaluated 1--3 years postoperatively. In the series of patients treated by urethrotomy without corticoid injection the rate of recurrent stricture was 19.4%. Using a specially constructed needle for injection of triamcinolone acetonide (Kenalog), we were able to reduce the recurrence rate to 4.3%.
Criteria for the screening, diagnosis and therapy of primary aldosteronism (PA) were defined on the basis of its symptoms analysis in 40 PA patients. A diagnosis of PA was proved in 4.12% of 970 patients admitted for arterial hypertension. The presence of polyuria, nocturia, neuromuscular disorders, hypertension, hypopotassaemia, alkalosis, elevated urinary potassium excretion, improving after Spironolactone, was most valuable for the purposes of screening. High plasma aldosterone concentration (PAC) and suppressed renin activity (PRA) provided evidence of the presence of PA. The most successful technique to differentiate aldosterone producing adenoma (APA) from idiopathic hyperaldosteronism (IHA) proved to be adrenal phlebography combined with determination of PAC in the adrenal veins. APA was associated with a 5.9 fold higher PAC in the vein of the adenoma - affected adrenal in contrast with a symmetric PAC rise in both adrenal veins in IHA. A paradoxical decrease of PAC occurred in the peripheral blood of most patients with APA after standing up, but 23.8% exhibited the same orthostatic increase as IHA patients. In all APA patients, unilateral adrenalectomy eliminated the symptoms of hyperaldosteronism and improved or cured hypertension. Spironolactone was indicated preoperatively for all surgical candidates, for non-operated APA patients, and for all IHA patients.
Unexpected carcinoma was found in 69 cases (7.7%) our of 891 patients subjected to surgery for clinically benign hyperplasia. The incidence was higher in specimens removed by suprapubic or retropubic approach (10.2%) than by transurethral resections (2.7%). Carcinoma was found most frequently in patients aged 70 to 80 years (50.8%), next being the age group 60 to 70 years. A statistically significant prevalence of carcinoma was in th medium sized prostases (30-40 grams = 12.4%) well compared to smaller or larger prostates. The principles for a systematic topographically oriented microscopic examination are described. Morphological categories of latent carcinoma are defined as microcarcinoma, focal, multifocal or diffuse carcinoma. Adenocarcinoma was the uniform pattern of these latent carcinomas. The therapeutic attitude towards the microscopically diagnosed clinically latent prostatic carcinoma is discussed.
Normal ranges for urinary spermidine have been determined as 0.0 to 1.9 mg per 24 hours. In benign prostatic hyperplasia and urinary infection the urinary spermidine excretion ranges between 1.2 and 2.6 mg/24 hours. Significantly elevated excretion has been noted in 10 patients with prostatic carcinoma (4.5 to 11.4 mg). The high-performance liquid column chromatography was used as the method for separation of urinary polyamines and spermidine determination.
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The thyroidal content of calcitonin was investigated in patients with euthyroid goitre, patients undergoing laryngectomies or neck operations and finally patients with primary hyperparathyroidism using method of biological titration. Patients with primary hyperparathyroidism had markedly decreased content of calcitonin in the thyroid gland when compared with the content of calcitonin of both groups of patients without calcium metabolism disturbance. Decreased content of calcitonin in patients with primary hyperparathyroidism can be explained by long lasting hypercalcaemia during which the rate of biosynthesis of calcitonin in the C cells does not keep up with the rate of release of calcitonin into the circulation.
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Cytotoxicity of mononuclear cell (MNC) preparations isolated from peripheral blood of patients with urinary bladder carcinomas of a transitional (BTCC) or squamous (BSCC) type and from blood of control subjects was examined on the target cells of T24 cell line. In pilot experiments the percentage of cytotoxic MNC preparations was found to be similar in patients with tumors of BTCC (European, 56%;African, 60%) and BSCC (54%) type. Cytotoxicity of MNC prepared from control subjects was detected in 10% of cases or less. These data suggest an antigenic cross-reactivity between urinary bladder carcinomas of transitional and squamous cell type. The cytotoxic MNC from peripheral blood of patients with BTCC and control subjects were fractionated by adherence in nylon wool columns, and the cytotoxicity of adherent and nonadherent MNC subpopulations was examined. In the majority of cytotoxic MNC preparations from both donors with and without BTCC, the cytotoxic activity was associated with nonadherent MNC. Comparison of immunosensitivity of T24 cell population with the cloned T24 subpopulations indicated that clones with various digrees of immunosensitivity are present in the T24 cell population. However, immunosensitivity of the clones was never higher than the immunosensitivity of the T24 cell population. A search for oncornavirus particles produced spontaneously or after treatment with virus production activators performed with regard to the possible association of oncornaviruses and antigens responsible for cell-mediated cytotoxicity gave thus far negative results.