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Biomedical subjects

G Bartsch

Publications and source records attributed to G Bartsch.

At least 271 records · Page 15Linked to original sources
PubMed1989

[Benign prostatic hyperplasia: a stromal disease].

Morphometric studies show that benign human prostatic hyperplasia is a stromal disease caused by the activation of smooth muscle cells. This activation manifests itself in increased amounts of cytoplasmic organelles, which are preferably localized in the perinuclear region. Moreover, marked vesicular activity is present. Besides considerable overproduction of type I and III collagens, the architecture of the extracellular matrix is altered distinctly. In spite of strong evidence that androgens and estrogens regulate the growth of epithelial and stromal cells in the prostate and the induction of fibromuscular overgrowth in various animal models, the exact role of steroids in the pathogenesis of benign prostatic hyperplasia still remains to be elucidated.

Androgens↗
PubMed1989

The National Marrow Donor Program: how it works, accomplishments to date.

As the use of bone marrow transplantation increases, the lack of a suitable matched sibling donor for approximately 60% of patients is a growing problem. Recently, marrow transplantation has been done successfully using HLA-matched unrelated donors. In an effort to provide more donors, the National Marrow Donor Program (NMDP) was established. It involves 50 blood banks and 20 marrow transplant centers throughout the United States. More than 20,000 HLA-typed apheresis donors from these blood banks have agreed to be listed in the NMDP registry. A preliminary search for donors has been carried out for 1,116 patients. Donors suitably matched for HLA-A and B antigens were located for 99% of the patients.

Bone Marrow Transplantation↗
PubMed1988

Transrectal ultrasonography as a follow-up method in prostatic carcinoma after external beam and interstitial radiotherapy.

Transrectal ultrasonography and ultrasonometrics were employed for follow-up in a total of 28 prostatic carcinoma patients subjected to external beam or interstitial radiotherapy. These two methods permit more accurate staging of prostatic carcinoma and have also proved to be valuable in the follow-up care of patients suffering from locoregional prostatic carcinoma. Of the 20 patients subjected to external beam radiotherapy four patients initially did not show capsular infiltration, 2B2, 2A2, whereas 16 patients presented with infiltration of the capsule and seminal vesicles. After external beam radiotherapy the ultrasonomorphologic findings of four patients revealed a sharply demarcated capsule and unremarkable seminal vesicles, which indicated tumour regression. Of five patients with infiltration of the pelvic floor and/or seminal vesicles, three showed definite tumour regression, whereas the ultrasonograms of the other two patients demonstrated tumour progression despite radiotherapy. In eight patients the greatest reduction in tumour volume was found one year after interstitial radiotherapy. Only one patient, initially presenting with slight infiltration of the capsule, was shown to have infiltration of the capsule and seminal vesicles after interstitial radiotherapy. At follow-up, evaluation of the echo patterns in these patients was inaccurate on account of the dense echoes reflected by the seeds implanted.

Brachytherapy↗
PubMed1987

Unilateral testicular disease: effect on the contralateral testis (morphometric study).

Unilateral testicular disease has been reported to damage the contralateral testis. In order to find out whether this detrimental influence is permanent in nature or can be avoided by therapeutic measures, and furthermore to quantify the damage, the following experiments were performed. Seventy-five rats were classified into the following five groups: I) testicular torsion persisting for eight hours; II) ipsilateral semicastration after torsion persisting for eight hours; III) semicastration; IV) sham operation as control; V) immunosuppression with azathioprine after torsion persisting for eight hours. The contralateral testes were removed two months later and perfused with fixative via the testicular artery. Stereologic techniques were employed to obtain quantitative morphologic data. Serum hormone levels were determined. The volume density of the contralateral germinal epithelium was not decreased two months after torsion for eight hours, torsion following by semicastration or torsion followed by immunosuppression. The same was true of the total volume of germinal epithelium per rat testis. The hormone levels remained essentially unchanged.

Animals↗
PubMed1987

Light-microscopic stereologic analysis of spontaneous and steroid-induced canine prostatic hyperplasia.

A combined light-microscopic and stereologic analysis of the canine prostate was performed under the following experimental conditions: intact and castrated dogs, spontaneous benign prostatic hyperplasia, intact and castrated dogs after treatment with testosterone, 5 alpha-dihydrotestosterone or 3 alpha-androstanediol in combination with estradiol. Regarding the absolute amounts of the glandular and stromal parts of the prostate as well as the glandular cells, no difference was found among the testosterone, 3 alpha-androstanediol and 5 alpha-dihydrotestosterone treated castrated dogs. Treatment with 5 alpha-dihydrotestosterone or 3 alpha-androstanediol in combination with 17 beta-estradiol induced a four-fold increase in glandular and a two-fold increase in stromal tissue. The glandular to stromal tissue ratio equals that found in spontaneous canine hyperplasia, which is indicative of the glandular type of spontaneous canine hyperplasia. Therefore, it can be stated that treatment with 5 alpha-dihydrotestosterone or 3 alpha-androstanediol combined with 17 beta-estradiol not only induces prostatic overgrowth but also leads to prostatic hyperplasia of the glandular type. However, the stereologic analysis of canine prostates following steroid administration shows that canine hyperplasia is primarily a glandular disease, while human benign prostatic hyperplasia shows more stromal activation.

Androstane-3,17-diol↗
PubMed1987

Correlation of biochemical (receptors, endogenous tissue hormones) and quantitative morphologic (stereologic) findings in normal and hyperplastic human prostates.

In previous light and electron-microscopic analyses human benign prostatic hyperplasia was shown to be predominantly a stromal disease; the aim of the present study was to correlate the stereological data with the levels of the endogenous tissue hormones (androgens, estrogens, progesterone) in normal (N) and hyperplastic human prostatic tissues (BPH). BPH tissue specimens were obtained by open prostatectomy (n = 25); normal prostatic tissue was obtained from kidney donors (n = 5). No statistically significant difference was found between normal and hyperplastic tissue. Testosterone BPH 0.69 +/- 0.44, N 0.25 +/- 0.12; 5 alpha-dihydrotestosterone BPH 7.0 +/- 2.9, N 4.2 +/- 0.7; progesterone BPH 0.059 +/- 0.022, N 0.058 +/- 0.005; estrone BPH 0.10 +/- 0.03, N 0.14 +/- 0.03; estradiol BPH 0.07 +/- 0.02, N 0.05 +/- 0.02; estriol BPH 0.02 +/- 0.01, N 0.04 +/- 0.02. Using a Spearman rank correlation coefficient a statistical analysis was performed for age, weight of the prostate, absolute stereological data and the endogenous prostatic hormones. As can be seen from the statistical analysis there is a poor correlation for 5 alpha-dihydrotestosterone and the amount of the glandular epithelium; otherwise no correlation of the endogenous tissue hormones with the stereological data investigated was found. These data show that the stromal overgrowth of benign hyperplasia is not reflected in the tissue hormone levels.

Gonadal Steroid Hormones↗
PubMed1987

Traumatic renal artery occlusion: is late reconstruction advisable?

We report a case of traumatic renal artery occlusion treated successfully by reconstruction several years after the injury. Hypertension resulted in diagnostic investigation by means of excretory urography, computerized tomography, angiography and perfusion scintigraphy. Treatment consisted of a thin-walled polytetrafluoroethylene (Gore-Tex) bypass between the aorta and left renal artery near the hilus. When the patient was discharged from the hospital the creatinine level was normal and blood pressure was 180/90.

Adult↗
PubMed1987

Pseudovaginal perineoscrotal hypospadias. Clinical, endocrinological and biochemical characterization of a patient.

A 16-year-old adolescent with perineal hypospadias, a microphallus, a bifid, labia-like scrotum, a blind-ending vagina and bilaterally undescended testicles is presented. Despite normal development of the Wolffian duct derivatives--deferentography showed that both ejaculatory ducts opened into the urethra--the patient showed severe developmental abnormality of the external genitalia. On endocrinologic investigation, gonadotropin, testosterone and 17 beta-estradiol levels were within normal limits; in a genital skin fibroblast culture testosterone was not reduced into 5 alpha-dihydrotestosterone, however, androgen receptors could be identified. Since this patient was raised as a girl up to the age of 16 and had developed female identity, the patient was further raised as a female. Bilateral orchiectomy was performed and estrogen substitution therapy was started. Clitoroplasty as well as ileal vaginoplasty were performed.

Adolescent↗
PubMed1986

[Experiences in the treatment of advanced nonseminomatous testicular tumor].

48 patients with nonseminomatous testicular tumours were treated between 1980 and 1984. 19 patients had bulky stage II c or disseminated disease; according the Royal Marsden staging classification 5 patients had stage II c, 2 patients III and 12 patients stage IV. The pT stage of the primary tumour showed no correlation to low stage disease, but pT was only found in advanced disease. In disseminated disease histological examination revealed more cases of malignant teratoma undifferentiated (MTU) and malignant teratoma trophoblastic (MTT) than malignant teratoma intermediate (MTI). Before therapy 14 patients had elevated serum markers, whilst in 5 patients markers were negative. Combination chemotherapy with Vinblastin, Bleomycin and Cisplatin (Einhorn) was given and afterwards 13 patients had to undergo operation to remove a residual mass. Scarring was found in 4 patients (31%), teratoma in 6 (46%) and active tumour in 3 (23%). At a median survival time of 3 years 16 of 19 patients (84%) are alive. The two patients with elevated tumour markers before operation are also alive and disease-free. Altogether out of 48 patients with advanced nonseminomatous testicular tumours 94% of the patients are alive.

Adolescent↗
PubMed1986

Androgen and estrogen effect on guinea pig seminal vesicle muscle: a combined stereological and biochemical study.

A combined electron microscopic stereological and biochemical study of the smooth muscle cells of guinea pig seminal vesicles was performed in intact, castrated, castrated and dihydrotestosterone- or estradiol-treated adult animals. Castration led to cell atrophy as determined stereologically by a decreased single cell volume and biochemically by no change in DNA content coupled with an increase in the DNA concentration. Treatment of castrates with dihydrotestosterone restored both the stereological and biochemical parameters of the cell size to slightly supranormal levels. The estrogen-induced increase in muscle weight and DNA content appeared to be due only to hyperplasia of muscle cells and not to a proliferation of fibroblasts or to infiltration by inflammatory cells. In all treatment groups, including the estrogen-treated castrates, more than 95% of the cells in the tissue were smooth muscle cells, and there was no evidence that polyploidy contributed to changes in DNA levels. In addition, in the estrogen-treated muscles, DNA concentration remained high, and the stereologically determined cell size remained low. Therefore, both morphological and biochemical evidence indicate that androgen induces hypertrophy, whereas estrogen induces hyperplasia of muscle cells. The correction of stereological and biochemical data validates the application of stereological cell size determination for smooth muscle cells in organs that hardly can be separated into stromal and epithelial components; eg, the prostate.

Animals↗
PubMed1985

Correlated biochemical and stereological studies on testosterone metabolism in the stromal and epithelial compartment of human benign prostatic hyperplasia.

The growth and function of the human prostate is dependent upon a continuous supply of androgens, mainly 5 alpha-dihydrotestosterone, the 5 alpha-reduced metabolite of testosterone. Within the human prostate dihydrotestosterone is thought to be the intracellular mediator of androgen action. Although it is well documented that dihydrotestosterone is evenly distributed between the stromal and epithelial compartment of the prostate, the anatomical localization of dihydrotestosterone formation within the normal and hyperplastic prostate is still not established. To provide further insight into this problem we have measured, under conditions approximating the in vivo state, dihydrotestosterone formation in prostates obtained from 4 men with normal prostates and 36 men with benign prostatic hyperplasia. In addition to this we have performed histometric analysis of the cellular composition of the samples incubated, in order to correlate the morphological and the histochemical findings. Dihydrotestosterone is the major metabolite, and androstanediol and androstenedione were formed in smaller quantities. Under the given conditions metabolite formation from testosterone increased linearly for 60 minutes and the half maximum rate of dihydrotestosterone formation (Km) was observed at about 1.25 X 10(-6) M testosterone, a value similar to that reported for rat prostatic nuclei and human prostatic tissue. Dihydrotestosterone formation was higher in hyperplastic prostates than in the normal prostate. (Student's t test: p less than 0.05). The stroma in both the normal and hyperplastic tissue converts testosterone to dihydrotestosterone very actively. No significant relation was found between dihydrotestosterone formation and the per cent distribution of the stromal and epithelial compartment in any sample studied. In conclusion, our results are compatible first with the thesis that the rate of dihydrotestosterone formation is increased in the hyperplastic prostate and secondly with the concept that the rate of dihydrotestosterone formation is approximately the same in the epithelial and stromal compartments of the prostate.

Androstane-3,17-diol↗
PubMed1985

Correlation of hormone levels and quantitative histological findings in testicular biopsies.

Testicular biopsies of 84 oligo- or azoospermic males with gonades of nearly normal size and without chromosomal abnormalities were studied by morphometric methods. The mean Johnsen score and the results of the morphometric investigations were plotted against the results of the hormone assays (plasma testosterone, LH, FSH, prolactin). High LH and FSH levels showed a very good correlation with the loss of germ cells, the tubular shrinkage and interstitial fibrosis. Plasma testosterone levels, however, did not correlate with any morphological structure of the testicular parenchyma. The Johnsen score and the morphometric findings can to some degree explain the relationship between morphological abnormalities and endocrinological findings.

Biopsy↗
PubMed1985

Human chorionic gonadotropin-positive seminoma: is this a special type of seminoma with a poor prognosis?

Prognosis and treatment of HCG-positive seminomas with syncytiotrophoblastic giant cells are still a matter of discussion. Between 1977 and 1982 the serum HCG and alpha-feto protein levels were determined in a prospective study of a total of 51 patients presenting with histologically proven pure seminomas. A total of 13 of the 51 patients with pure seminoma had elevated serum HCG levels, but all of them were negative for alpha-feto protein. On clinical examination six patients had tumor Stage I, six had had tuor Stage II A-B and one patient had a tumor Stage III. The clinical stage was not found to correlate with HCG levels. In six patients presenting with tumors of clinical Stage II who underwent orchiectomy and subsequently radiation therapy there was a decrease in HCG levels following therapy. Five patients were followed for five years after therapy had been discontinued. There is no indication of a relapse in four patients, and the patients are negative or HCG. One patient suffering from a tumor, Stage IIB died three years later as a result of cirhosis of the liver. Autopsy did not reveal any signs of a residual tumor; the serum HCG levels were negative. For the time being HCG-positive seminomas should be classified and treated as a special morphologic form of seminoma.

Adult↗