Search PubMed⌕ Search

Biomedical subjects

H Huland

Publications and source records attributed to H Huland.

At least 19 recordsLinked to original sources
PubMed1995

[Status of PSA determination for early detection of prostate carcinoma].

Prostate Specific Antigen (PSA) appears to be useful in the early detection of prostate cancer when used in conjunction with digital rectal examination (DRE) and transrectal ultrasonography (TRUS). Recent studies suggest that the addition of PSA to the routine digital rectal examination leads to detection of prostate cancer at an earlier stage than when digital rectal examination is used alone. In patients with elevated PSA or abnormal DRE prostate biopsies are recommended. However, the routine use of PSA to detect early prostate cancer is limited due to the PSA elevation in patients with prostatic hyperplasia. Possibilities to distinguish BPH from prostate cancer among men who have minimal PSA elevation (4.0 to 10.0 ng/ml) are the use of PSA velocity, PSA density, age adjusted PSA, and analysis of free and complexed PSA. Screening programs for prostate cancer will increase the percentage of localized prostate cancer, which can be cured by radical prostatectomy.

Adult↗
PubMed1995

In vivo system to detect long-term continuous release of bioactive interleukin-2 by immunopharmacological depot preparations in nude mice with human tumors.

For continuous release of cytokines for local application at tumor sites, we developed depot preparations consisting of a carrier substance (ethylene vinyl acetate copolymer) and either natural interleukin-2 (nIL-2) at 5 x 10(5) BRMP U or natural interferon-alpha (nIFN alpha) at 3 x 10(5) IU. We transplanted human tumors in nude mice and placed depot preparations next to the tumors to confirm the in vivo long-term biological activity of the depots according to the ability of IL-2 to inhibit growth of the tumors. Five different human tumors were used. Mice with each tumor were divided into groups of six to eight receiving different treatments: control (no treatment), human serum albumin, but no cytokine, IL-2 depot, IFN alpha depot and IFN alpha plus IL-2 depot. After proven in vivo tumor growth, these depot preparations were implanted subcutaneously directly at the tumor sites. Tumor growth was significantly reduced by IL-2 and IFN alpha plus IL-2 for 3 weeks after depot implantation. Complete tumor remission was not achieved. IFN alpha alone did not influence tumor growth. Our data show that the nude mouse is a valuable model for testing biological activity and release time of IL-2 depot preparations in vivo.

Animals↗
PubMed1995

Toxicity of local, continuous and cyclic, high-dose bladder perfusion with recombinant and natural interleukin-2 in advanced cancer of the urinary bladder.

We evaluated the toxicity of high-dose local interleukin-2 (IL-2) in 18 patients not eligible for standard treatment of advanced transitional cell bladder carcinoma. Seven received continuous high-dose local natural IL-2 via pump system in the bladder for up to 420 days. 11 received cyclic high-dose local natural IL-2 or recombinant IL-2 for up to 420 days. Treatment was well tolerated and, considering the low rate of toxicity, could be offered in an outpatient setting. Except for local contrast-media hypersensitivity, no serious side-effects were observed. This study provides a basis for the non-toxic use of local IL-2 in future studies to evaluate effectiveness of the treatment or prophylaxis of patients with superficial bladder cancer in order to prevent recurrences.

Administration, Intravesical↗
PubMed1995

Long-term monitoring of 486P 3/12 antigen pattern (quantitative immunocytology) before, during, and after mitomycin C prophylaxis in patients with superficial bladder cancer.

OBJECTIVES: Quantitative pattern of 486p 3/12 antigenicity in urine cytologies (Quic) of patients with superficial bladder carcinoma during operation and chemoprophylaxis was evaluated to determine the duration of prophylaxis on an individual patient-oriented basis. METHODS: Thirty-six patients with superficial bladder carcinoma during chemoprophylaxis (43 [range, 3 to 90] weeks of mitomycin C) have been evaluated monthly for 99 (range, 36 to 141) weeks. RESULTS: Only 6 of 36 patients (16.7%) had tumor recurrence after mean follow-up of 67.5 weeks. During mitomycin instillations, only 5 patients converted from positive to repeated negative Quic. None of them developed tumor. Thirty-one did not convert and only 6 of them developed recurrent tumor. CONCLUSIONS: Quic seems not to be a reliable marker during mitomycin prophylaxis. After mitomycin prophylaxis, a repeated positive Quic, however, was associated with a high risk of recurrence occurring in 3 of 8 Quic-positive patients. A repeated negative or alternating Quic identified a lower risk group, showing 3 recurrent tumors in 28 patients only. We conclude that Quic cannot be used during, but after, prophylaxis to identify risk patients requiring further treatment. During prophylaxis, its value is limited to a subgroup of patients developing negative Quic, for whom prophylaxis can be stopped individually.

Adult↗
PubMed1995

Dyeing: a simple method for detecting positive or negative surgical margins.

Artists' pigments have been used in more than 150 radical prostatectomy specimens and many other malignant surgical specimens for detecting positive surgical margins. Their advantages are rapid drying, resistance to tissue processing, and the ability to mark many planes of excision simultaneously with different colors.

Coloring Agents↗
PubMed1995

The etiology of bladder cancer--are there any new clues or predictors of behavior?

It is well documented that the etiology of bladder cancer involves environmental factors. Most chemical carcinogens probably affect the urothelial cells via their presence in the urine. As an important cofactor, cell proliferative activity may be increased by urinary bladder infection, irritation by bladder stones or through the action of a variety of endogenously produced direct acting chemicals or agents. Among the known causative factors, avoidable major ones are occupational exposure to certain chemicals such as benzidine and 4-aminobiphenyl, cigarette smoking and bilharzial infection, which could be eradicated by a combination of praziquantel, antihelminth therapy, education and improvements in social welfare. An anticarcinogenic drug, cyclophosphamide, used as an immunosuppressive agent also seems to be associated with a high risk of idiopathic induction of bladder cancer and physicians should therefore pay particular attention to its diverse effects when considering its prescription. In contrast to the above, the consumption of coffee and tea including artificial sweeteners is now thought unlikely to be major risk. So far there is no good biochemical tool to predict individual exposure to bladder carcinogens/or relative risk of bladder cancer development. However, acetylation capacity can be applied to assess susceptibility to carcinogenic amines in people exposed in their working environment. Progress in molecular biological analysis will hopefully bring to light etiology-specific DNA damage in the bladder tumors and prove useful for prediction of tumor behavior in the near future.

Diet↗
PubMed1995

Autologous blood transfusion in radical prostatectomy: results in 263 patients.

The principal benefit of using autologous blood is avoidance of complications associated with conventional homologous blood transfusion such as viral infections, immunosuppression, and allogenic immunization. Since December 1991, a ruling of the Federal Supreme Court has obliged physicians to disclose to their patients the risk of contracting an infection from an intraoperative or postoperative blood transfusion and the possibility of donating their own blood for transfusion into them later. Of 263 patients with localized prostate cancer who underwent radical retropubic prostatectomy, 194 (73.8%) elected to have their blood collected for possible transfusion. Of the patients who needed transfusion, 80.7% received only autologous blood and haemodilution for substitution of haemoglobin. Nearly all patients with blood loss below 1,500 ml used only autologous blood transfusions during their operations. Increasing the number of units of autologous blood collected decreases the likelihood that homologous blood will be needed and thus the risks associated with transfusion of homologous blood.

Blood Loss, Surgical↗
PubMed1995

[Preoperative assessment of tumor aggressiveness in localized prostatic carcinoma].

In 106 consecutive patients with localized prostate cancer digital rectal examination (DRE), preoperative prostate-specific antigen (PSA) determination and results of systematic sextant biopsies (TRUS 6Bx) of the prostate were analyzed for their value in the estimation of the aggressivity of tumors. In all patients with negative pelvic lymph nodes radical retropubic prostatectomy was performed. Tumor aggressiveness was defined as capsular penetration (pT2 versus pT3) or positive surgical margins in patients with pT3 tumors. Neither DRE nor preoperative PSA level was helpful in predicting capsular penetration or positive surgical margins. However, the number of positive core biopsies and the identification of Gleason 4 or 5 tumors within positive biopsy specimens correlated with capsular penetration and positive surgical margins. These results can be used to create a score, based on DRE, PSA, TRUS 6Bx, and Gleason 4 or 5, that might be helpful in predicting tumour aggressivity in patients with localized prostate cancer.

Adult↗
PubMed1995

[Transurethral laser therapy of benign prostatic hyperplasia].

During the last 4 years, transurethral laser therapy for benign prostatic hyperplasia (BPH) has become an increasingly popular alternative to transurethral resection of the prostate (TURP) for the treatment of obstructive BPH symptoms. Clinical data so far published prove the efficacy of this new therapeutic modality, although the results are up to now possibly inferior to those achieved with TURP. On the other hand, the incidence of severe perioperative complications is significantly lower in patients treated with laser prostatectomy than in those undergoing TURP. Therefore, laser prostatectomy is a reasonable adjunct to the therapeutic spectrum for BPH in high-risk patients. Nevertheless, its role in the treatment of obstructive BPH in low-risk patients cannot be defined until long-term follow-up data are available.

Contraindications↗
PubMed1995

[Value of determining prostate-specific antigen for early detection or prostatic carcinoma].

The use of prostate-specific-antigen in the early detection of prostatic carcinoma combined with digital-rectal examination results in a 2-3 times increase in prostatic carcinoma detection rate. 2/3 of PSA detected prostatic carcinoma are organ confined vs 40% of those which are detected by digital-rectal examination. 15-35% of all operated localized prostatic carcinoma have a normal PSA. A biopsy is indicated in men with a life expectancy of more than 10 years when the PSA value is above 10 ng/ml and/or digital-rectal examination is suspicious. This concerns only 2% of all men at the age older than 50 years. In 90% of all men older than 50 years the PSA is normal as well as the digital-rectal examination. In 4% of these the result of PSA and digital-rectal examination is false negative that means 4% have prostatic carcinoma. However, repeated digital-rectal examination and PSA determination on a yearly basis detects most of these overlooked prostatic carcinoma which still are organ confined in about 90% of the cases. In men with a minimal elevated PSA-value of 4-10 ng/ml, 25% will have a prostatic carcinoma regardless of the finding on digital-rectal examination. The indication to do a biopsy can be specified by the use of age specific PSA cut-off-levels and most likely in future by determining the free PSA vs the complex-bound PSA. Controversy exists about the usefulness of PSA-density and PSA-velocity.

Aged↗
PubMed1995

[Perioperative and postoperative complications of pelvic lymphadenectomy and radical prostatectomy in 320 consecutive patients].

To examine the intra- and postoperative morbidity of radical retropubic prostatectomy we analyzed the first 320 consecutive patients with clinical stages T1b, T2a-c and negative lymph nodes by frozen section. Patient age varied from 42 to 75 years (mean 63.5 years). In 74.7% the estimated blood loss was less than 1500 ml. With a preoperative autologous blood collection program the intraoperative blood requirement for homologous blood units was only 15%. Intraoperative complications included rectal injuries with vesical rectal fistulas in 2.5% and ureteral injuries in 1.6%. Within the perioperative period the mortality rate was 0.9%. At 12 months after surgery 199 of 218 men (90.9%) were continent, 5.1% had minimal urinary incontinence, and only 4.6% had urinary incontinence grade III. Postoperatively, PSA (prostate-specific antigen) decreased to < 0.5% in 90.4% of the patients after radical prostatectomy. At 12 months after operation PSA was < 0.5 ng/ml in 83.4%. We conclude that radical retropubic prostatectomy is a safe procedure for the curative treatment of localized prostate cancer.

Aged↗
PubMed1995

[Individualized therapy with alpha-interferon in metastatic renal cell carcinoma].

Thirty-two patients with metastatic renal cell carcinoma were treated as outpatients with individually dosed interferon alpha (IFN alpha). The individual maximum dose was based on the side effects. In 7 patients the course of the disease was influenced: 1 attained complete remission, 3 patients, partial remission and 3, stable disease. The outcome of therapy was not dose-dependent. Patients with lung metastases were more sensitive to IFN alpha than the others. Up to 20% of patients responded to the therapy.

Aged↗
PubMed1995

[Treatment of rectal injuries with vesicorectal fistulization in radical prostatectomy].

In the literature many different ways are described of treating rectal injured during radical prostatectomy. Therefore, following this procedure we evaluated our patients with rectal injuries. Rectal injury occurred in 16 of 299 patients with radical prostatectomy for treatment of localized prostate cancer. Seven developed a vesicorectal fistula, 4 of whom needed no further surgical intervention. Only 3 (1%) had to undergo an additional operation.

Follow-Up Studies↗
PubMed1994

Systematic sextant biopsies in 651 patients referred for prostate evaluation.

In 651 patients mapping of the prostate by 6 systematic sextant ultrasonography guided biopsies was performed without major side effects using the automatic biopsy gun. The histological findings provided data on patients with normal and abnormal prostates as determined by digital rectal examination. Only 3 of 72 nonurological patients (4%) with normal prostate specific antigen (PSA) levels of less than 4 ng./ml. had prostate cancer. Of the 259 patients with a firm prostate on digital rectal examination 105 (41%) had prostate cancer. For those with a PSA level of less than 4 and 4 ng./ml. or greater the positive biopsy rates were 13% and 58%, respectively. Of 56 patients with clinical stage B or C disease and a PSA level of less than 4 ng./ml. 20 (36%) had prostate cancer, compared to 155 of 187 (83%) with a PSA level of 4 ng./ml. or greater. Transrectal ultrasound was not helpful in screening for prostate cancer due to the low positive biopsy rate for hypoechoic lesions. However, among 175 patients with clinical stage B or C disease transrectal ultrasound identified 157 (90%) with prostate cancer.

Adult↗
PubMed1994

[MR tomography in prostatic carcinoma: comparison of conventional and endorectal MRT].

In a prospective study an attempt was made to determine the value of conventional MRI (354 patients) and MRI using the endorectal surface coil (ESC) (36 patients) in the preoperative staging of prostatic carcinoma. Local preoperative staging with conventional MRI was correct in 83.9% and 88.9% with ESC-MRI. Compared to conventional MRI, ESC-MRI was better in the delineation of the prostatic capsule and early detection of infiltration into the neurovascular bundle. Lymph node staging with MRI showed a sensitivity of 54.4% in detecting pelvic lymph node metastasis. MRI is as limited as CT in assessing pelvic lymph node metastasis.

Evaluation Studies as Topic↗