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Biomedical subjects

G Riedasch

Publications and source records attributed to G Riedasch.

At least 19 recordsLinked to original sources
PubMed1994

[The value of diagnostic imaging in benign prostatic hyperplasia and prostatic cancer].

Diseases of the prostate are of high socioeconomic importance owing to their high incidence and prevalence rates. Benign prostatic hyperplasia (BPH) can be detected in 80% of males over the age of 80. Clinical symptoms do not correlate with organ enlargement. Only 10% of patients with BPH need surgical treatment. The decision for surgical treatment is made as a result of objective findings and the symptoms reported by the patient. Preoperative evaluation of BPH must include digital rectal examination (DRE), measurement of peak flow rate, sonographic estimation of residual urine, transrectal ultrasound (TRUS), urethrocystography and the assessment of subjective complaints using symptom scores. Prostatic carcinoma is the most common malignancy in men. An abnormal DRE, increased PSA level and/or hypoechogenic lesions in TRUS are indications for prostate biopsy. The sensitivity of TRUS is superior to that of CT and MRI. New MRI techniques are promising with regard to local tumour extent. Whereas CT and MRI are not useful in screening of patients, these methods are valuable diagnostic tools in the follow-up of prostate cancer.

Humans↗
PubMed1994

[Local recurrence after organ saving kidney tumor surgery].

Although excellent survival rates for nephron-sparing surgery in mandatory indications (solitary kidney, bilateral renal neoplasms) have been documented, parenchymasparing surgery in elective indications (normal contralateral kidney) is a point of controversy. Local tumor recurrence is the most important argument against this approach. From January 1971 to December 1989, 107 patients suffering from renal cell carcinoma in solitary kidneys or bilateral renal carcinoma underwent nephron-sparing surgery. Thirteen patients (12%) suffered from local recurrence between 4 and 112 months after tumor resection. A high proportion of these recurrences were seen within the first 2 years after resection, followed by a almost linear increase thereafter. Thus-there are possibly two different entities for local recurrence. A correlation between tumor grade and interval from resection to local recurrence could be found, with a long average interval for grade 1 tumors--longer than the published follow-up times for patients undergoing elective tumor resections. Although most of the patients described in this report do not fulfil the surgical criteria for elective resection, we cannot recommend parenchyma-sparing surgery in elective indications.

Adult↗
PubMed1993

[Is organ saving kidney operation in extensive traumatic parenchyma lesions justified?].

The management of renal trauma is facilitated by using modern imaging techniques such as ultrasound and CT-Scan. Regarding the sequelae of conservative treatment we recommend an early operation within three days after the trauma. The complication rate after an organ preserving technique is low, and good functional results reaffirm our concept of early operation. Even in cases of severe parenchymal disruption organ preservation should be achieved. In polytraumatized patients the decision of organ preservation versus nephrectomy should be made depending on the blood loss and the cardiocirculatory stability of the patient.

Diagnostic Imaging↗
PubMed1992

Nitrosamine excretion in patients with continent ileal reservoirs for urinary diversion.

Adenocarcinomas are a recognized complication following ureterosigmoidostomy for which the endogenous formation of N-nitroso compounds may be a risk factor. As an alternative means of urinary diversion, the continent ileal reservoir has recently been developed. Microbiological and chemical investigations on the urine of patients with an ileal reservoir showed the presence of bacteria, nitrate, nitrite and N-nitrosamines formed endogenously in the ileal pouch. The role of nitrosamines in carcinogenesis in these patients as a late stage complication resulting from the use of a continent ileal reservoir is discussed.

Adult↗
PubMed1991

Do antibody-coated bacteria prove bacterial prostatitis?

Using the immunofluorescence technique in 187 patients with bacteriologically proven prostatitis according to the Meares-Stamey test demonstrated a significant amount of antibody-coated bacteria (ACB) in their ejaculates. The ACB test was useful to discriminate between chronic bacterial prostatitis and prostatodynia with a sensitivity of 65% and a specifity of 92%; likewise the ACB test is superior to complement and coeruloplasmin estimation in the ejaculate by radial immunodiffusion usually recommended for the differential diagnosis of inflammatory and psychosomatic diseases of the prostate.

Adult↗
PubMed1991

Induction of mediator release from human glomerular mesangial cells by the terminal complement components C5b-9.

Exposure of cultured human glomerular mesangial cells (GMC) to normal human serum and an activator of the complement system results in rapid uptake of the terminal complement proteins C5b-9 by the cells. This 'innocent bystander' complement attack, however, does not result in cell killing, but in the stimulation of the GMC to release prostaglandin E (PGE), interleukin 1 (Il-1) and tumor necrosis factor (TNF). Endogenously synthesized Il-1 in turn activates PGE release, indicating that the C5b-9 attack initiates an autocrine feedback stimulation. Together with the fact that C5b-9 is found in many forms of glomerulonephritis, the data point to a role of the terminal complement proteins in the initiation and perpetuation of an inflammatory response.

Complement Membrane Attack Complex↗
PubMed1991

[Intravesical prevention of recurrence of superficial urinary bladder cancer with BCG and KLH. A prospective randomized study].

In a prospective randomized trial intravesical prophylaxis for recurrence of superficial bladder cancer with BCG versus KLH was performed in 42 patients, 38 of whom were then evaluable. After a mean observation period of 20 +/- 7 months (8-32 months) 41.2% (7/17) of the patients in the KLH and 14.3% (3/21) of the patients in the BCG group developed recurrent bladder tumours. The recurrence rate according to EORTC was 1.95 in the KLH group versus 0.76 in the BCG group. Among the BCG treated patients, 60% (15/25) had cystitis and 28% (7/25) fever, whereas only 1 of 19 (5.3%) patients treated with KLH had cystitis. BCG is a highly effective prophylactic against recurrence of superficial bladder cancer. Intravesical instillation therapy with KLH has only a slight prophylactic effect if treatment is started 6 weeks postoperatively.

Adjuvants, Immunologic↗
PubMed1990

[Diagnostic tumor resection in kidney tumors of unclear quality].

From 1985 to June 1989 diagnostic tumour resections have been performed on 37 kidney tumours with unknown dignity following the preoperative imaging techniques. The kidney tumours were completely excised with about 1 cm of adjacent parenchyma outside the pseudocapsule during temporary ischemia. The tumours and biopsies from the resection margins were sent to quick frozen section. In case of benign histology or low grade clear cell carcinomas with exophytic growth and a size of less than 5 cm in diameter the operation was finished without removing of the kidney. In 21 patients with benign and 11/16 with malignant disease the kidneys could be preserved. In 5/16 patients the kidneys were removed after tumour resection and result of the quick frozen section. In our opinion the diagnostic kidney tumour resection in cases of kidney tumours with unknown dignity should be preferred to fine needle biopsies combining diagnostic and therapeutic proceeding in selected cases. On the other hand tumour resections without nephrectomy in patients with renal cell carcinoma and normal contralateral kidney should be done only in low grade tumours of small size.

Humans↗
PubMed1988

Extrarenal abnormalities in Tc-99m DTPA renal perfusion studies due to hypervascularized tumors.

In cases of impaired renal perfusion and/or function, Tc-99m DTPA renal flow studies are often used as screening procedures. Besides the demonstration of pathological changes in renal perfusion and/or function, various extrarenal abnormalities may sometimes be detected. Three cases of hypervascular tumors were detected during the course of Tc-99m DTPA renography. These findings stimulated further diagnostic clarification revealing extended extrarenal lesions associated with several different etiologies: angiomyolipoma in tuberous sclerosis, extramedullary manifestations of plasma-cytoma, and metastasis of renal carcinoma. One should be aware of these extrarenal abnormalities in renal flow studies since these three tumor entities frequently exhibit increased vascularity.

Adolescent↗
PubMed1987

Renal oncocytoma: origin from the collecting duct.

The histo- and cytogenesis of two cases of renal oncocytoma have been studied by cytomorphological and cytochemical methods. Transitions from collecting ducts into oncocytic tubules were observed at the light and electron microscopic levels. The fine structure of the oncocytes in tubules and tumors is described in detail. Cytochemically, the oncocytic tubules and oncocytomas share many characteristics with the distal nephron, especially the collecting ducts. A striking difference is the enhanced activity of succinic dehydrogenase which corresponds to the increase in the number of mitochondria in oncocytes. All the results suggest that renal oncocytoma originates from the collecting duct.

Adenoma↗
PubMed1984

Do antibody-coated bacteria reflect local immune response in the urinary tract?

We examined whether antibody-coated bacteria (ACB) reflect local immune response or passive adsorption of immune globulins (Ig). For this purpose, bacterial subcultures from infected urines and third-party bacteria were incubated with Ig preparations. These were obtained from infected urine either by removal of Ig from ACB (dissociation in alpha-methylmannoside, 0.1 M glycine-HCl, or 3 M NaSCN) or by staphylococcal protein A affinity chromatography from the supernatant of infected urine. Coincubation of either Ig preparation with bacterial substrains of the original urine and with third-party strains (Pseudomonas aeruginosa, Proteus mirabilis, several Escherichia coli strains, enterococci, Serratia marcescens, Klebsiella pneumoniae, Staphylococcus aureus) caused coating of the bacterial surface with Ig. Coating was not measurably influenced by coincubation with various carbohydrates or by preincubation of bacteria with glucosidases. Adsorption of Ig was observed after heat denaturation and formalin treatment of bacteria and was independent of bacterial growth phase. Coating was observed both with intact IgG and with F(ab)2 fragments. We further examined the proportion of bacteria coated with IgA, IgG, and IgM in urines of 200 bacteriuric women with symptomatic urinary tract infection. The frequency histogram plot showed a continuous nonlinear unimodal distribution. Consequently, any selection of a 'normal range' is arbitrary. It is concluded that coating of the bacterial surface with Ig may not necessarily reflect local immune response. A major problem of the ACB test is definition of the normal range.

Antibody-Coated Bacteria Test, Urinary↗
PubMed1984

Antibody-coated bacteria in ejaculate in bacterial prostatitis.

In patients with bacteriologically proved prostatitis (Stamey test) ejaculate was examined for antibody-coated bacteria (ACB). Forty-four of the 68 patients (65%) with bacteriologically proved prostatitis had ACB in the ejaculate, but only 7 of 89 patients (8%) with prostatodynia. Concomitantly, coeruloplasmin and complement (C3) concentrations in the ejaculate were examined by radial immunodiffusion (RID). The ACB test had much higher specificity (92%) than RID, and the sensitivity of ACB was 65 per cent.

Adult↗
PubMed1983

Estrogens influence antibody coating in experimental urinary tract infection.

Female rats were infected with E. coli 0.25 by intravesical instillation. After 4 weeks, significantly higher bacterial counts (bladder puncture and renal homogenates) were found in estradiol treated rats (0.5 mg/kg/week) than in solvent controls, but the proportion of antibody-coated bacteria was significantly (P less than 0.01) lower in bladder urine and renal homogenates. There was no influence of estrogens on renal histology or ureteral width. The results are compatible with an effect of estrogens on local immune response in the urinary tract.

Animals↗
PubMed1983

Does low urinary sIgA predispose to urinary tract infection?

Median urinary secretory IgA (sIgA) (ELISA technique in unprocessed urine) was 1.36 mg/liter (range, 0.29 to 2.31) in healthy female controls at various times of the menstrual cycle. It was significantly lower in women with urinary tract infection (UTI) without antibody-coated bacteria. Such decrease was found both in women with acute UTI episodes (median, 0.16; range, 0.06 to 1.71) and in asymptomatic nonbacteriuric women with a history of UTI (median, 0.52; range, 0.05 to 2.13). In the latter women, sIgA in nasal secretions tended to be low, but salivary sIgA was unchanged. Urinary sIgA was elevated significantly in individuals with nephrostomy and antibody-coated bacteria (14.4 mg/liter, range, 3.6 to 20). The study showed that locally synthesized sIgA immunoglobulins were low in the urine of individuals with recurrent UTI independent of the presence or absence of bacteriuria at the time of the study. UTI per se did not interfere with sIgA secretion as shown by high sIgA in patients with upper UTI. Low urinary sIgA may represent one factor predisposing to recurrent UTI.

Adolescent↗
PubMed1981

Application of an improved methodology to demonstrate bacterial adherence during the menstrual cycle.

We studied bacterial adherence to uroepithelial cells of female patients in relation to the menstrual cycle. We determined the number of bacteria demonstrable on native cells and the number of adhering bacteria after incubation with E. coli. Free bacteria and uroepithelial cells with adhering bacteria were optimally separated by differential centrifugation using sodium metrizoate (9.6%) and dextran (5.6%) (Lymphoprep). Thus, contamination of the cell preparation by free (non-adhering) bacteria was avoided and results were well reproducible. A median of five bacteria/cell (range 0-19) was observed for uroepithelial cells obtained from urine of female patients. Such bacteria were mostly rods. After in vitro incubation with E. coli cultures, a median of 33 bacteria/cell (range 17-54) was counted. Our improved methodology failed to demonstrate a relationship between bacterial adhesion and the menstrual cycle.

Bacteriological Techniques↗
PubMed1981

Antibody coating of bacteria in experimental infection of the urinary bladder.

We studied antibody coating of urinary bacteria in experimental cystitis of the rat both in the absence and presence of a foreign body (polyacrylamide sphere). In the absence of a foreign body, inoculation of the bladder urine resulted in generally transient bacteriuria with no significant antibody coating or defects in the bladder uroepithelium, lymphocytic infiltration of bladder mucosa, or plasma cells in the bladder mucosa. Inoculation in the presence of a foreign body resulted in protracted bacteriuria with significant antibody coating of urinary bacteria, defects in the bladder mucosa surface, lymphocytic infiltration of the bladder mucosa, and numerous plasma cells. We conclude that the bladder mucosa is capable of mounting a local immune response against bacterial invasion which leads to antibody coating of urinary bacteria.

Animals↗
PubMed1980

Stauffer's syndrome in renal cell carcinoma evidence for intravascular coagulation.

In 40 patients with non-metastasising (n = 31) and metastasising (n = 9) renal cell carcinoma, evidence of Stauffer's syndrome (increase in alkaline serum phosphatase and prolongation of prothrombin time) was found in 18 patients. Prolongation of prothrombin time was not due to depletion of vitamin K-dependent coagulation factors or manifest fibrinolysis, but due to the presence of circulating fibrinogen fibrinmonomer-FDP complexes. Ethanol gelation test was found to be positive in 28/40 subjects and soluble fibrin monomer complexes were increased in 38/40 patients. The resulting disturbance of fibrinogen-fibrin conversion was reflected by an increase in thrombin coagulase time and reptilase time. These findings suggests a state of latent compensated intravascular coagulation (presumably triggered within the vascular tumor). For diagnostic purposes the most sensitive indicator is thrombin coagulase time. Thrombin coagulase time normalised after tumor resection and was positive in patients with recurrent metastases. The increase in alkaline serum phosphatase was due to an increase in the hepatic isoenzyme. Such an increase was much more common than the elevation of total alkaline serum phosphatase. Regan's isoenzyme was only found in 1 subject. In parallel, gamma-GT was elevated in 24 patients. The study shows that Stauffer's syndrome occurs more frequently than commonly assumed when thrombin coagulase time, gamma-GT and the hepatic isoenzyme of alkaline serum phosphatase are determined in patients with renal cell carcinoma. DIC and low grade fibrinolysis may account for the coagulation abnormalities of the syndrome.

Adenocarcinoma↗