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Biomedical subjects

H Frohmüller

Publications and source records attributed to H Frohmüller.

At least 19 recordsLinked to original sources
PubMed1997

[Immunochemotherapy of metastatic renal cell carcinoma with interleukin 2, interferon-alpha and 5-fluorouracil].

Interleukin-2 (IL-2) and interferon-alpha (IFN-alpha) were both administered subcutaneously (SC) in combination with intravenously (IV) applied 5-fluorouracil (5-FU) for the treatment of patients with metastasized renal cell carcinoma (RCC). The therapy protocol consisted of a treatment cycle of 8 weeks, which could be carried out in an outpatient regimen. The IFN-alpha was given in each of the 8 weeks (6-9 MU/m2 once to three times weekly SC) combined sequentially with IL-2 (5-20 MU/m2 three times weekly SC for 4 weeks) and 5-FU (750 mg/m2 IV weekly for 4 weeks). Among the 30 consecutive patients treated, in 2 cases a complete, and in 9 cases a partial, remission was achieved in patients with mostly lung and skeletal metastases, with an overall objective response rate of 37%. Mean response duration was 8 months (range 3-18 months). A stable state of the disease lasting 3-18 months was observed in 10 cases. The side effects were only slight and corresponded to toxicity grade I (n = 2), grade II (n = 22) and grade III (n = 6), according to the WHO classification. In conclusion, this triple-drug biochemotherapy demonstrated significant clinical effectiveness comparable with that of an aggressive IL-2 treatment regimen (applied IV), but without its high toxicity.

Adult↗
PubMed1996

Atypical findings in a patient with a renal milk-of-calcium cyst.

A case of an atypical renal milk-of-calcium cyst is presented. Although this cyst contained a colloidal suspension of calcium crystals, other signs and findings typical for a milk-of-calcium cyst were lacking. No connection of the cyst to the collecting system could be identified, no "half moon" phenomenon was found on upright and cross-sectional radiography, and the biopsies taken from the wall of the cyst showed sclerosis instead of urothelium. From the present case it was concluded that renal milk-of-calcium cysts may sometimes occur in the absence of findings that are typical of this particular entity. Therefore, this disease should be considered in the differential diagnosis of renal calcifications of unknown origin.

Adult↗
PubMed1996

[Cosmetic and functional long-term outcome after operation of Fournier gangrene].

The study documents the long-term cosmetical and functional sequelae in 12 patients treated for Fournier's gangrene after an average of 5 years follow-up. Only 50% of the patients were free of pain. In the majority of cases, the sexual function was impaired by penile deviation or penile torsion as well as by a loss of sensitivity of the penile skin or pain during erection. Two patients suffered from temporary stool incontinence. Despite major complaints due to extensive scarring, most (10 of 12) patients considered their cosmetic result as well as their quality of life to be satisfactory.

Adult↗
PubMed1996

[Fournier gangrene].

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Anti-Bacterial Agents↗
PubMed1995

Myelolipoma of the adrenal gland associated with contralateral renal cell carcinoma: case report and review of the literature.

Adrenal myelolipoma is a rare benign hormonally inactive tumor. It is frequently detected incidentally on new imaging procedures, such as sonography and computerized tomography and, thus, the question of treatment arises. The association of myelolipomas with obesity, hypertension and malignant tumors has been described previously. We report the second case of myelolipoma associated with renal cell carcinoma. Pathogenesis, differential diagnosis and therapy are discussed.

Adrenal Gland Neoplasms↗
PubMed1995

[Results of 15 years of radical prostatectomy].

From July 1969 to May 1994, radical prostatectomy was performed in 630 patients with clinically localized prostate cancer at the Department of Urology, University of Würzburg Medical School. These included 74 patients subsequently followed up for 15 years or more 15 years (15-23 years, mean 17.5 years), who were the subjects of the present study. Of these 74 patients 59 had pT2 tumors and 10 had pT3 tumors according to the staging criteria of the 1992 edition of the UICC TNM classification. The remaining 5 patients had microscopic lymph node metastases detected at staging pelvic lymphadenectomy (stage pT2-3pN1-2). Patients with lymph node involvement were treated by immediate orchiectomy. All other patients received no further treatment until progression occurred. The overall 15-year survival rate actually observed the 74 patients was 50% (37/74) and the disease-free survival rate was 43.2% (32/74 pts). Stage-related overall and disease-free survival rates were found to be 54.2% and 49.1%, respectively, for patients with pT2 tumors, 40% and 30% for those with pT3 tumors, and 20% and 0 for patients with lymph node metastases. Progression (either local recurrence or distant metastatic spread) was noted in 22 of the 74 patients (29.7%) within the 15-year period following radical prostatectomy. Mean time to progression was 7.9 years (3 months to 17 years). Within the follow-up period, 17 patients (23%) died of prostate cancer. These actual 15-year follow-up data show radical prostatectomy to be the most effective means of achieving long-term disease-free survival, if not cure, in patients with clinically localized prostate cancer.

Adult↗
PubMed1995

[Indications].

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Cost-Benefit Analysis↗
PubMed1994

Are auxiliary methods necessary prior to ESWL in patients with a solitary kidney?

Between January 1985 and October 1991, 54 patients with calculi in a solitary kidney were treated by ESWL using the Dornier HM-3 lithotriptor. The mean age of the patients was 53.9 years (range 24-77 years). In 51.9% of the cases the stones measured > 1 cm in diameter, in 42.6% between 0.4 and 1 cm, and in 5.5% < 0.4 cm in diameter. In 39 of the 54 patients (72.2%) the calculi could be disintegrated by a single ESWL treatment. In 12 patients (22.2%) 2 ESWL treatments were necessary, and another 3 patients (5.6%) needed 3 ESWL treatments. In 6 cases (11.1%) percutaneous nephrostomy (PCN) was needed, and in 8 other patients ureteric stents were inserted prior to ESWL because of obstruction of the upper urinary tract, causing impending urosepsis in 8 of these 14 cases. Following ESWL, PCN was performed in 4 cases (7.4%) and a ureteric stent was inserted in 2 patients (3.7%) because of urinary obstruction. At discharge from the hospital 15 of the 54 patients (27.8%) were stone-free and 34 patients (63.0%) had small residual fragments of < 0.4 cm in diameter. One year after treatment, 42 patients could be evaluated at a control examination. 37 of these 42 patients (88.1%) were stone-free and 3 patients (7.1%) showed residual fragments of < 0.4 cm. In conclusion, our results demonstrate that, if there is no ureteric obstruction present prior to ESWL, the majority of patients with a solitary kidney do not present extraordinary problems and do not need auxiliary procedures.

Adult↗
PubMed1994

Radical prostatectomy in patients with incidental prostate carcinoma.

Radical prostatectomy was carried out in 30 patients with an incidental carcinoma of the prostate. A tumor stage T1a (A1) was present in 7 cases and a tumor stage T1b (A2) in 23 cases. None of the 30 patients died postoperatively. As intraoperative complication, a rectum perforation occurred in 1 case. In the 23 patients with a T1b tumor, a pT2pN0M0 lesion was found in 10 cases and pT3pN0M0 lesion in 11 cases on pathohistological examination after radical prostatectomy. In 5 out of 30 patients the carcinoma could no longer be detected in the radical prostatectomy specimen. In 1 patient with a T1a tumor, pelvic lymphadenectomy revealed a single lymph node metastasis. Tumor progression did not occur in any of the 7 patients with a T1a tumor after an observation period of 9 months up to 16 years (average 4.6 years). The percentage of progression-free patients in stage T1b was calculated as 81.4% 10 years after surgery. The calculated overall survival time of patients in stage T1b was 76.3% after 10 years and the tumor-related survival was 87.5%.

Actuarial Analysis↗
PubMed1993

[Synchronous growth of a mixed mesodermal tumor and an adenocarcinoma of the urinary bladder].

The case of synchronous growth of a mesodermal mixed tumour and an adenocarcinoma in the bladder is presented. This is a rare phenomenon. Mesodermal mixed tumours are malignancies with both epithelial (carcinoma) and mesenchymal (sarcoma) differentiation. The term carcinosarcoma is frequently used in the literature. In most cases the prognosis of mesodermal mixed tumours, which depends mainly on the high rate of local recurrences, is poor. Therefore, cystectomy with suprapubic urinary diversion is the treatment of choice. However, results reported in the literature show that transurethral resection of the tumour may be adequate when there is only superficial growth of mesodermal mixed tumours. Short follow-up intervals are absolutely essential for patients treated this way.

Adenocarcinoma, Papillary↗
PubMed1993

[Treatment of ureteral calculi in bone coverage using in situ ESWL in prone position].

From January 1988 to February 1992, a total of 26 patients with calculi in the middle third of the ureter underwent primary in situ ESWL in the prone position. All treatments were performed in sedoanalgesia using the Dornier HM 3 lithotriptor. During and after ESWL in the prone position, severe complications did not occur. Of the 26 patients, 10 (38%) were treated by a single application of ESWL. No auxiliary measures were necessary, and they became stone-free within 3 months following treatment. In another 9 patients (35%) auxiliary measures were required for visualization of radiolucent calculi or to relieve a urinary tract obstruction with incipient septicemia. All these auxiliary measures could be performed in sedoanalgesia. In the remaining 7 patients (27%), in whom stone disintegration following ESWL was incomplete, ureteroscopic lithotripsy techniques had to be applied. One of these 7 patients had to undergo an additional open operative procedure. The results of the present study demonstrate that a majority of patients with calculi in the middle portion of the ureter can become stone-free without invasive lithotripsy techniques following ESWL in the prone position, if necessary plus auxiliary measures, in sedoanalgesia. From these results it can be concluded that primary ESWL in the prone position should be considered for patients with calculi in the middle third of the ureter before invasive lithotripsy techniques are applied.

Adult↗
PubMed1993

[Pneumoscrotum. Case report and review of the literature].

The rare case of a pneumopenis and pneumoscrotum after a thoracic operation is reported. Two subtypes--pneumatocele and subcutaneous emphysema of the scrotum--are differentiated on the basis of anatomy. The cases reported in the literature so far are reviewed. A therapeutic regimen is recommended.

Diagnosis, Differential↗
PubMed1992

M-VAC versus CisCA--chemotherapy in the treatment of advanced bladder cancer.

The results of this study do not demonstrate a superiority of M-VAC chemotherapy over a modified CisCA regimen chemotherapy. M-VAC, however, proved less toxic than CisCA in terms of side effects. Neither CisCA nor M-VAC was effective as a curative treatment for patients with distant metastases. A durable complete remission of 22.5 months was seen in only 2 of the 12 patients with locally advanced tumors without distant metastases treated with M-VAC, and one of 35 months was observed in only 1 of the 6 cases with locally advanced tumors treated with CisCA chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Urologic characteristics of 7 patients over 100 years of age].

In the last few decades the old old have increased continuously in numbers. Diseases of the genitourinary organs are a frequent part of the multiple morbidity we are familiar with in such patients. In the 9th decade of life the renal parenchyma is reduced by 30-50%. The decreased glomerular filtration combined with tubular insufficiency leads to disturbances of the electrolyte, water and acid-base balance. In contrast to these involutionary changes in the kidneys, the prostate increases in size owing to varying degrees of hyperplasia, and the incidence of malignant growth increases progressively. A total of 575 patients over the age of 100 years were observed at the Medical Policlinic of Würzburg University, and 7 of these who had pronounced urological disorders are described in detail. The variations in the ageing process are considerable. Urological illnesses in the course of the multiple morbidity usual in this group have a particularly unfavourable influence in the terminal phase of these old old patients.

Aged↗
PubMed1991

Radical prostatectomy for carcinoma of the prostate: long-term follow-up of 115 patients.

From July 1969 to September 1990, 370 patients with prostatic cancer underwent radical prostatectomy at our institution. Of these 370 patients, 115 consecutive patients could be followed for more than 10 years (mean 12.5). Patients with stage pT1-pT3 tumors received no further treatment until progression occurred. Patients with regional lymph node metastases (stages pT2-3pN1-2M0) were treated by either an immediate orchiectomy or an adjuvant hormonal therapy. No radiotherapy was applied prior to radical prostatectomy or thereafter. Of the 115 patients followed for more than 10 years, 84 had stage pT1-2, 22 had stage pT3, and 9 had stage pT2-3pN1-2 tumors. The observed 10-year survival rate of all 115 patients (including those with regional lymph node metastases) was found to be 67.0%. The 10-year disease-free survival rate was 58.3% and the tumor-related survival rate was 83.5%. Considering only patients with locally confined (stage pT1-2) tumors, the 10-year survival rate was 75.0%. This observed survival rate equals the 10-year survival expectancy of a male age-matched control population (69.9%). Progression (local recurrence or distant metastatic spread) was noted in 27.8% of patients within the 10-year interval after radical prostatectomy. Within this time interval, 16.5% of the patients died from their disease.

Adult↗
PubMed1991

Screening for prostatic cancer. The German experience.

The principles for screening for detection of early prostate cancer in the Federal Republic of Germany are described. Men are entitled from the beginning of their 45th year of life to an examination for early detection of cancerous diseases once annually and this examination is paid for by the insurance system. In the age group around 60 years about 15% of the men participate. Among 1,341,833 men participating in 1987, 1,638 new cases of prostate cancer were detected. The proportion of cases suitable for total prostatectomy has increased considerably since the screening program was introduced and now stands at about 25% in the author's department. The survival rate of this group is comparable to that of the general population, when adjusted for age distribution. It is suggested that screening for prostate cancer might reduce the mortality of this disease.

Germany, West↗
PubMed1991

[Selection criteria for radical prostatectomy with reference to long-term results].

Between July 1969 and May 1991 radical prostatectomies were performed in 410 consecutive patients with prostate cancer at the Department of Urology, University of Würzburg. The calculated survival rates for these 410 patients up to 15 years after surgery are very similar to the life expectancy of the normal male age-matched population. In 127 of the 410 cases radical prostatectomy was carried out more than 10 years ago, so that the data relating to these cases have been definitely observed, not merely statistically evaluated. In order to permit a comparison of our results with those reported in the literature, the TNM classification of 1979 was utilized in this study. This means that only tumors penetrating through the capsule of the prostate were classified as stage pT3. Those tumors that are only infiltrating the apex or the prostatic capsule, are classified as stage pT2. For patients with stage pT1pN0M0 and pT2pN0M0-tumors, 10-year survival rates (90.5% and 70% respectively) were recorded which are even slightly better than those of the normal male age-matched population. For patients with tumors extending through the capsule, the 10-year survival rate was found to be 60%. Forty percent ot these patients with stage pT3pN0M0 disease are alive tumor-free after more than 10 years and can thus be regarded as cured. When lymph node metastases were present (stage pT2-3pN1-2M0), some of the patients appeared to benefit from radical prostatectomy, since 4 out of 11 patients with this stage disease survived for more than 10 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗