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Biomedical subjects

F J Marx

Publications and source records attributed to F J Marx.

At least 19 recordsLinked to original sources
PubMed1999

[Amifostine as protective agent in cisplatin-based chemotherapy of advanced bladder cancer].

Amifostine is an organic thiophsophate which protects normal cells from the effects of chemotherapy with reduced nadir and duration of cyclophosphamide induced neutropenia, reduced cisplatin derived renal and neurological complications being described. However, no data are available for urological malignancies treated with cisplatin-based chemotherapy. Aim of the study was to assess the efficacy of pretreatment with amifostine in terms of prevention of renal, hematopoietic and neurologic toxicity. 17 patients (mean age: 62.6 [45-74]) with advanced transitional cell carcinoma of the urinary bladder received inductive or adjuvant cisplatin based chemotherapy (1-6 cycles) with a cisplatin dose of 70 mg/m(2). Amifostine (740-910 mg/m(2)) was administered intravenously 30 minutes prior to chemotherapy. For all patients creatinine clearance, serum creatinine and electrolytes including magnesium, and blood cell count were determined prior to and after each cycle. A group of 12 patients (mean age: 61.9 [51-67]) did undergo MVEC chemotherapy (1-4 cycles) without receiving amifostine and served as control group. Amifostine was well tolerated and only 1 patient suffered from gastrointestinal discomfort, blood pressure remained unchanged in all patients. Amifostine prevented a significant reduction of creatinine clearance even in the 2 patients with known renal insufficiency: mean creatinine clearance was 125 +/- 20 ml/min prior to and 115 +/- 25 ml/min after chemotherapy. In the control group, however, creatinine clearance dropped from 121 +/- 30 ml/min to 85 +/- 20 ml/min after completion of MVEC chemotherapy. Serum creatinine levels did not increase significantly (1.1 mg/dl prior to and 1.2 mg/dl after chemotherapy), magnesium levels did not decrease significantly and normalized at the end of chemotherapy. Significant neutropenia and thrombocytopenia developed in 29 % and 12 % of the patients in the amifostine group and in 67 % and 33 % of the patients in the control group. Amifostine was shown to have a protective effect against cisplatin induced nephrotoxicity in the elderly patient undergoing systemic chemotherapy. Based on our data amifostine should be applied in the supportive management to prevent chemotherapy induced complications.

Aged↗
PubMed1987

[The acute external genital].

Under the heading "acute diseases of the external genital organs" affections of the scrotal contents and the penis (without urethra) demanding immediate therapy are summarized. Crucial is the differential diagnosis epididymitis vs. torsion of the spermatic cord for an error may have very serious consequences for the patient as well as for the physician undertaking primary care. As to the other acute diseases of the scrotal contents the increasingly important role of scrotal sonography is stressed. Among the relatively rare acute affections of the penis traumatic rupture of the corpus cavernosum and priapism of various origin deserve particular interest because delayed wrong treatment may lead to loss of erectile potency.

Acute Disease↗
PubMed1985

[Ureterotransversopyelostomy with unilateral nephrostomy].

Supravesical urinary diversion by ureterotransversopyelostomy (UTPS) with unilateral nephrostomy was performed in 57 patients. The age of the 33 women ranged between 42 and 86 (mean 65), of the 24 men between 39 and 77 (mean 62) years. With a single exception, the indication for diversion was palliative: 25 patients had advanced bladder cancer (T3/T4), and 19 had undergone irradiation; 24 patients showed vesico- (recto-) vaginal fistulas due to radiation for gynecological carcinomas. In 2 patients, the indication was urge-incontinence following former radiation therapy for uterine cancer, whereas 5 patients had advanced malignancies originating in the urethra, prostate, rectum or ovaries. The only case without malignant disease exhibited a contracted bladder of uncertain origin, together with an immunodeficiency syndrome. The approach used was an upper abdominal cross incision. In 35 patients, an anastomosis was done between the ureter and contralateral renal pelvis; in 22, a terminoterminal ureteral anastomosis was performed. For placement of the nephrostomy (49 terminal, 8 U-tube nephrostomies) we preferred the right side in 41 of 57 cases. The mean follow-up time in the 22 surviving patients was 36 months (range 2-108); the mean survival time in the 30 deceased patients was 12 months (range 0.5-87). With 4 exceptions, the cause of death was progression of the underlying tumors. Operative lethality was 1.75%, early surgical complication rate 7%, and rate of severe late complications 10.5%. The most frequent problems arose from the nephrostomy and from stenoses of the ureteropelvic or ureteral anastomosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Therapy of acute radiation cystitis. A case report].

We report a patient with prostate cancer who suffered from severe radiation cystitis after combined interstitial radiation with 125-Iodine-Seeds and external radiation (2000 rad). This patient was treated very successfully with intramural injection of Orgotein (Peroxinorm) into the bladder wall. Besides discussion of the aetiology of radiation cystitis we report our first favourable results with local and systemic treatment with Orgotein (Peroxinorm).

Acute Disease↗
PubMed1984

[The value of hypothermia methods in operative stone removal].

In spite of the possibility of using ultrasound for identification of stone fragments and vascular localisation, it is still necessary to clamp the renal vascular pedicle in selected cases. In situ perfusion achieves a nearly complete restoration of renal function, but requires a more sophisticated technique and preoperative planning. Surface cooling on the other hand is universally applicable and can be used during surgery, when unforeseen clamping of the renal pedicle is needed.

Adult↗
PubMed1983

[Percutaneous nephrostomy as primary therapy of ureterovaginal fistula].

We report on our experience with 11 cases of ureterovaginal fistula primarily treated with percutaneous nephrostomy drainage. In 6 patients the fistula persisted and ureteral reimplantation with psoas hitch was performed. In 5 patients the ureterovaginal fistula closed during nephrostomy drainage. In 2 of these 5 cases a distal ureteral stricture developed and was in 1 case successfully treated by ureteral dilation under systemic corticosteroid treatment. In the second case of a ureteral stricture reimplantation was necessary. All 4 patients, that were managed without open surgery had IVP's more than a year after treatment with normal upper tracts. When ureteral reimplantation had to be performed this was an elective procedure with minimal risk and optimal preparation of the patient due to percutaneous nephrostomy drainage.

Female↗
PubMed1982

[Limitations and hazards of palliative renal tumor embolization].

Today the indication for palliative embolization of inoperable renal carcinoma is more restricted than several years ago. Reviewing 31 own palliative occlusions of the renal artery in 29 patients over a period of 5 1/2 years two main reasons for this attitude are presented: 1. Because of collateral or parasitic vascular supply of kidney tumors the occlusion of the renal arteries only results in a retarded tumor growth rate and does not seem to prolong patient survival. 2. the "postembolization syndrome" after tumor occlusion has a relatively high complication rate and lethality (20% serious side effects, 3% deaths directly related to embolization). Therefore embolization of inoperable renal carcinomas is justified only in patients whose remaining lifetime can be alleviated by this measure. Certain indications are: massive hematuria, severe local pain due to the tumor and life endangering endocrine tumor activity, e.g. hypercalcemia. Uncertain indications such as recurring but not perilous hematuria causing progressive anemia and refusal of tumor surgery should be carefully balanced against the hazards of embolization.

Adult↗
PubMed1981

Studies on the clinical significance of nonesterified and total cholesterol in urine.

Gas-liquid chromatographic determinations of nonesterified and total urinary cholesterol were performed in 137 normals, 264 patients with various internal diseases without evidence of neoplasias or diseases of the kidney or urinary tract, 497 patients with malignancies and 236 patients with diseases of the kidney, urinary tract infections or prostatic adenoma with residual urine. A normal range (mean +/- 2 SD) of 0.2-2.2 mg/24 hours nonesterified cholesterol (NEC) and of 0.3-3.0 mg/24 hours total cholesterol (TC) was calculated. Values of urinary cholesterol excretion were independent of age and sex and did not correlate with cholesterol levels in plasma. Patients with various internal diseases, without evidence of neoplasias nor diseases of the kidney or obstruction of the urinary tract, showed normal urinary cholesterol excretions, as did patients with infections of the urinary tract. However, elevated urinary cholesterol was found in patients with diseases of the kidney or urinary tract obstruction (prostatic adenoma with residual urine), malignant diseases of the urogenital tract and metastasizing carcinoma of the breast. In patients with other malignant diseases urinary cholesterol was usually normal. Lesions of the urothelial cell membranes are considered to be the most likely cause of urinary cholesterol hyperexcretion. The clinical value of urinary cholesterol determinations as a possible screening test for urogenital carcinomas in unselected populations is limited by lacking specificity, expensive methodology and low prevalence of the mentioned carcinomas, although elevated urinary cholesterol excretions have been observed in early clinical stages of urogenital cancers.

Adolescent↗
PubMed1981

A new technique for percutaneous nephropyelostomy.

Primary insertion of a large caliber catheter into the renal pelvis would provide the most favorable drainage in all cases in which urinary diversion by nephropyelostomy is indicated. Therefore, the puncture technique of Guenther and associates was modified. A specially designed balloon catheter was used to prevent dislocation.

Drainage↗
PubMed1981

[Radionuclide angiography (RNA) with 99mTc-DTPA to follow palliative embolization of renal cell carcinoma (author's transl)].

In 14 patients with renal cell carcinoma, not to be treated by nephrectomy, radionuclide angiography with 99mTc-DTPA (RNA) was employed before and after palliative tumor embolization. If RNA revealed remaining perfusion of the tumor, functional scintigraphy with 131J-hippurate was performed to detect and quantify residual function. Up to 16 months after embolization, 7 patients (50%) revealed neither residual perfusion nor function. In 5 patients (36%) remaining perfusion without functioning renal parenchyma and in 2 patients (14%) residual perfusion with additional function were found. In 4 cases (28%) a nuclear "tumor-halo" was imaged, describing a stripe of high radioactivity caused by capsular arteries surrounding the avascular tumor. RNA has proven to be a suitable non-invasive procedure for to blow-up of embolized renal cell carcinomas.

Adenocarcinoma↗