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Biomedical subjects

G Rutishauser

Publications and source records attributed to G Rutishauser.

At least 19 recordsLinked to original sources
PubMed1997

[Transurethral thermotherapy of the prostate--a very promising treatment method for benign prostatic hyperplasia].

Transurethral resection of the prostate remains the most common method for the treatment of benign prostatic hyperplasia (BPH). Due to unsatisfactory results in about 18% of the patients new methods to treat BPH have been developed. We evaluated 45 patients 6 and 12 months after transurethral microwave thermotherapy using the Prostatron device with Prostasoft 2.5 software. There was a significant improvement of the urinary symptoms and of the quality of life index from 18 to 9.5 and from 3.2 to 1.6 points, respectively. Urinary flow rate improved from 8.8 to 12.1 ml/sec and residual urine was reduced from 101 to 52 ml. The treatment was well tolerated and side effects were minimal. High-energy transurethral microwave thermotherapy is an effective and safe minimal invasive alternative to treat BPH in selected patients. As no anesthesia is required transurethral microwave thermotherapy can also be offered to high risk and elderly patients.

Aged↗
PubMed1997

Minor residual fragments after extracorporeal shockwave lithotripsy: spontaneous clearance or risk factor for recurrent stone formation?

The aim of this study was to follow the fate of residual stone fragments (RF) < 5 mm after extracorporeal shockwave lithotripsy (SWL) over a sufficiently long period to determine how many are spontaneously cleared and after what time interval. A further aim was to clarify their role in clinical outcome and stone recurrence and regrowth. The clinical and radiologic data of 266 patients were analyzed. The patients were followed up for a mean of 387 days. After SWL, 55 patients (21%) had residual fragments < 5 mm in diameter. There were no significant differences between the stone-free patients and those with RF with regard to age, sex, relevant medical history, or SWL treatment. After a mean follow-up of 2.5 years, 12.7% of the residual fragments had not passed spontaneously, but all of them were clinically silent and located exclusively in the lower calices and the proximal ureter. Only 2% of the patients with RF showed stone regrowth, and no stone recurrences were observed within the follow-up period. In conclusion, although a minor pathophysiological role of RF < or = 5 mm cannot be discounted in recurrence and regrowth of kidney stones after SWL, more invasive attempts to clear all minor fragments do not seem warranted.

Adolescent↗
PubMed1997

Impact of minimal lymph node metastasis on long-term prognosis after radical prostatectomy.

OBJECTIVES: In the management of clinically localized prostate cancer, understanding is of major concern. There is a considerable therapeutic dilemma in those patients in whom staging lymphadenectomy prior to intended radical prostatectomy reveals lymph node metastases. METHODS: Pelvic lymph node dissection and radical retropubic prostatectomy were performed in 132 consecutive patients. Patients with extracapsular disease and/or positive lymph nodes received adjuvant radiotherapy. Median follow-up after surgery was 7 years and 2 months. To study the influence of minimal lymph node metastasis, category pN1 was further subdivided into pN1.1 and pN1.2. Involvement of the prostatic capsule was either classified as infiltration (pT3.1) or performation (pT3.2) of the capsule. RESULTS: Disease-free survival after 10 years was 58% in patients with negative nodes, 37% in category pN1.1, 25% in category pN1.2 and 10% in category pN2. Corrected overall survival was 83% for node-negative patients and 73% for category pN1.1, but it was only 33% for pN1.2 and 29% for pN2. Patients in category pT3.1 had a statistically significant better survival than those in pT3.2. CONCLUSIONS: We conclude that radical prostatectomy combined with adjuvant radiotherapy is a valuable option in prostate cancer patients with minimal lymph node metastasis. When compared to infiltration of the capsule, complete capsular perforation does adversely affect prognosis.

Adenocarcinoma↗
PubMed1994

Polycystic kidneys associated with Marfan syndrome in an adult.

A 41-year-old man with Marfan syndrome was found to have polycystic renal disease and underwent emergency surgery for dissecting aneurysm of the ascending aorta. To our knowledge only two cases of this rare combination of hereditary disorders have been described in the literature.

Adult↗
PubMed1994

[Primary detection of malignant mesothelioma of the tunica vaginalis testis using the BMA-120 monoclonal antibody].

Malignant mesothelioma of the tunica vaginalis testis is an extremely rare tumor, with only 40 cases previously described in the literature. Treatment consists of inguinal orchiectomy with close-follow up [1]. Asbestose exposure, trauma and hydrocele have been implicated as risk factors. We describe a histopathological examination with the BMA antibody (Behring, Marburg, Germany) and the Lu-5 antibody (Hoffmann-La Roche, Basel, Switzerland). Furthermore, we describe the patient's history and the management according to preceding reports in the literature.

Aged↗
PubMed1994

Tamm-Horsfall glycoprotein: role in inhibition and promotion of renal calcium oxalate stone formation studied with Fourier-transform infrared spectroscopy.

Tamm-Horsfall glycoprotein (THP) from healthy probands inhibits the precipitation of calcium oxalate, whereas THP from individuals who repeatedly develop calcium oxalate stones has no effect or even promotes precipitation. Using Fourier-transform infrared spectroscopy, we found a structural differentiation between these functionally different THPs: a decisive difference in sialic acid content. Quantitative analysis for sialic acid showed the same results. THP from healthy probands had a high sialic acid content (51 +/- 9 g/kg), whereas THP from recurrent stone formers had a decreased sialic acid content (21 +/- 4 g/kg). This explains the dual role of THP in the precipitation of calcium oxalate and the formation of renal stones and shows the importance of glycosylation in the function of this glycoprotein.

Calcium Oxalate↗
PubMed1993

Adverse effect of transurethral resection on disease-free survival in locally advanced prostatic cancer treated with irradiation.

PURPOSE: The purpose of this study was to analyze the impact of transurethral resection of the prostate on prognosis in patients with localized prostate cancer who received definitive external beam radiotherapy. METHODS AND MATERIALS: Out of the 431 patients treated diagnosis was established by needle biopsy in 198 and by transurethral resection of the prostate in 233 cases. Disease-free survival and relative survival as a function of transurethral resection of the prostate and needle biopsy were calculated for all stages and within each tumor stage and grade. RESULTS: An adverse effect of transurethral resection of the prostate on disease-free survival was observed only in patients with T3 T4 tumors of intermediate and poor differentiation (p < 0.05). The incidence of local recurrence and distant metastases as well as the distribution of pretreatment prostate specific antigen-levels was not significantly different between the transurethral resection of the prostate and needle biopsy groups. CONCLUSION: We conclude that transurethral resection of the prostate has an adverse effect on disease-free survival in a selected group of patients and discuss the implications of this finding.

Aged↗
PubMed1992

Investigations on macromolecular precipitation inhibitors of calcium oxalate.

Certain important aspects of the urine oxalate tolerance test (OTT) have been revised. The stirring system has been changed and the test has been adapted to the kinetics of calcium oxalate precipitation. True equilibrium conditions are now ensured during the measurements. Furthermore, the endogenous oxalate concentration is determined and taken into consideration. As a result of these changes, the significance of the test results has greatly improved. The effects of the addition of small amounts of zinc on the precipitation of calcium oxalate have been used in a new variation of the OTT. This new test makes it possible to discriminate much faster and more simply between recurrent stone-formers and other subjects. Tamm-Horsfall protein (THP) has been tested for its effect on the precipitation of calcium oxalate by means of OTT. THP inhibits the precipitation of calcium oxalate, but THP of stone-formers has a diminished inhibitory activity. The inhibitory activity of this protein strongly depends on the method by which it is isolated.

Calcium Oxalate↗
PubMed1992

[Malignant mesothelioma of the tunica vaginalis testis].

Malignant mesothelioma of the tunica vaginalis testis is an extremely rare tumor, with only 37 cases previously described in the literature. Treatment consists of inguinal orchiectomy with close follow-up [1]. Asbestos exposure, trauma and hydrocele have been implicated as risk factors. We describe a patient's history and the pathological findings as well as the management according to preceding reports in the literature.

Aged↗
PubMed1992

[Kaposi's sarcoma of the urinary bladder after kidney transplantation].

In 1872 the Viennese dermatologist Moritz Kaposi first described a pigment sarcoma of the skin. A modification of the epidemiology and the follow-up results in the accumulation of reports about the Kaposi-sarcoma after organ transplantation in the sixties and in the beginning of the eighties frequently Kaposi-sarcomas by the immunodefect syndrome AIDS were noticed. The incidence of Kaposi-sarcomas after kidney transplantations is estimated to be 0.3 to 1.8 per thousand. We report about a patient developing a Kaposi-sarcoma of the bladder during an immunosuppression therapy with Imurec and Sandimmun.

Adult↗
PubMed1992

[Marfan syndrome and cystic kidneys of the adult type].

For the first time Bernhard Marfan described the Marfan-Syndrome in 1896; it is a meso- and ectodermed variety with the conducting symptom of "arachnodactyly". Marfan-Syndrome is an autosomal dominant hereditary disorder with high penetrance and variable expressivity. In our opinion this case of a 41-year-old patient with kidney cysts and aneurysma dissecans of the arteria ascendens by Marfan-Syndrome was described in the literature only twice. The casuistics of this Marfan-Syndrome patient shows a particular rare associated organ-change--the kidney cysts--and illustrate the frequency of this hereditary disease.

Adult↗
PubMed1992

Long-term results of varicocelectomy.

Between 1983 and 1985, 257 infertile men were examined for any present varicocele by means of the Doppler sonography, telethermography and palpation. Based on these findings, the spermiogram and the infertility history, high ligation of the spermatic vein was indicated in 89 patients with varicocele and a median duration of infertility of 36 months (6-88 months). Postoperative sperm examinations have shown a significant improvement in sperm count and morphology, but not in motility. The most significant drop was observed in germ cell concentration from 1.68 to 1.06 mio/ml (p less than 0.025 Wilcoxon signed rank sum test). The follow-up examination 6 years after the beginning of the study has shown that only 56 out of the 89 patients underwent surgery, whereas 33 patients refrained from it. Pregnancy rates were 42% (23 out of 55, 1 patient lost to follow-up) in the operated group and 45% (14 out of 31, 2 patients lost to follow-up) in the nonoperated group. The comparison of the two graphs showing pregnancy incidence clearly demonstrates that pregnancies in the nonoperated group occur earlier than in the operated group; it has to be noted, however, that several patients only refrained from being operated on because pregnancy had occurred before surgery was planned. On the one hand, our study confirms other authors' results, i.e. that pregnancy rates in the nonoperated group are relatively high despite present varicocele. On the other hand, the operated group achieved practically the same high pregnancy rate when monitored over a longer period of time.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1990

Does microinvasion of the capsule and/or micrometastases in regional lymph nodes influence disease-free survival after radical prostatectomy?

Since 1976, 126 patients with clinically localised carcinoma of the prostate have been managed by radical retropubic prostatectomy. All patients with tumour spread beyond the capsule or metastasis in lymph nodes received radiotherapy. Tumour category pT3 was divided into invasion of the capsule or infiltration of the seminal vesicle. The disease-free 10-year survival rate in patients with minimal invasion of the capsule was 72% and in patients with infiltration of the seminal vesicles it was 26%. Unilateral lymph node metastases were classified as microscopic disease or macroscopic infiltration. The disease-free 10-year survival rate in patients with metastasis in 1 lymph node (micro- and macro-metastasis) was 65% in contrast to 0% in patients with bilateral disease.

Aged↗