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Biomedical subjects

H Huland

Publications and source records attributed to H Huland.

At least 181 records · Page 10Linked to original sources
PubMed1991

[The diagnosis of prostatic carcinoma].

Thanks to the combination of high-resolution transrectal ultrasound and the "Biopty-Gun", it has now become possible for the first time to obtain multiple punch biopsies of the prostate, painlessly and with few complications. "Mapping" of the prostate by 6 randomized punch biopsies permits an evaluation of the sensitivity and specificity of such screening procedures as digital rectal examination (DRE), prostate-specific antigen (PSA) and transrectal ultrasound (TRUS). In addition, randomized biopsies provide reliable information about prostatic carcinomas with a significant volume. The indications and efficacy of the various diagnostic methods are discussed in detail.

Aged↗
PubMed1991

Residual tumor discovered in routine second transurethral resection in patients with stage T1 transitional cell carcinoma of the bladder.

When a second transurethral resection was routinely performed 8 to 14 days after the initial transurethral resection in 46 patients for stage T1 bladder tumors residual disease was found in 20 despite the surgical report of complete resection in 40. In only 13 patients was residual tumor noted at repeat resection by the senior urologist performing the operation and residual tumor was confirmed histologically in 10 of them. The extent of the lesion is easily misjudged even by experienced surgeons. Early cystoscopy cannot exclude residual tumor. Residual tumor is an important cause of early recurrence and repeat resection of stage T1 lesions is recommended.

Carcinoma, Transitional Cell↗
PubMed1991

Comparison of 15 monoclonal antibodies against tumor-associated antigens of transitional cell carcinoma of the human bladder.

Quantitative urinary immunocytology with our monoclonal antibody (mab) 486p 3/12 proved to be valuable for diagnostic use in bladder-cancer patients' urine, especially in the followup of patients with superficial bladder carcinoma. To evaluate the use of other monoclonal antibodies in bladder cancer, we compared 15 mabs directed against bladder-tumor-associated antigens from seven research groups in a broad panel of cellular and tissue specimens (bladder tumor, prostatic adenoma, and kidney stone). Quantitative evaluation was done in cytocentrifuged preparations and tissue specimens. None of the 15 mabs was bladder-tumor-specific. All 15 stained normal urothelium to some extent and six stained granulocytes. Each of the 15 seemed to identify a different cellular antigen, as can be clearly demonstrated by the staining pattern of different regions in the normal kidney. The sensitivity of quantitative urinary immunocytology in bladder-tumor patients can be improved by using a panel, rather than one mab in bladder-tumor patients, but specificity decreases simultaneously. A main reason for the poor specificity of quantitative urinary immunocytology with all 15 mabs is that false-positive results are obtained with all mabs in kidney-stone patients. Our quantitative urinary immunocytology method is a general tool for the diagnostic use of all mabs in bladder-tumor patients. Mabs that have a high sensitivity might be useful in the followup of patients with superficial bladder carcinoma. None of the 15 mabs (because of their poor specificity) seems to be helpful in quantitative urinary immunocytology for screening a population for bladder carcinoma.

Antibodies, Monoclonal↗
PubMed1991

Sensitivity of urinary quantitative immunocytology with monoclonal antibody 486 P3/12 in 241 unselected patients with bladder carcinoma.

We investigated the sensitivity of quantitative immunocytology with our monoclonal antibody 486 P3/12 in 241 unselected patients with transitional cell carcinoma. Immunocytology yielded a sensitivity of 91.8%, 89.4% and 92.9% for grade 1, 2 and 3 tumors, respectively. Standard cytology was positive in 59.2%, 63.8% and 84.7%, respectively. Deoxyribonucleic acid flow cytometry, used in the first 69 patients, was positive in only 27.7%, 48.6% and 57.1%, respectively.

Antibodies, Monoclonal↗
PubMed1991

Modified surgical technique to correct congenital and acquired penile curvature.

We treated 37 patients with severe congenital or acquired penile curvature with a modified Essed-Schroeder corporoplasty without excision of the tunica albuginea. After penile straightening, 34 of the 37 patients (91.9%) were able to resume normal coitus and 29 (78.4%) had excellent results, cosmetic and sexual. Postoperative progression of Peyronie's disease and shortening of the erect penis were rare. In 4 patients, partial necrosis of penile shaft skin or of the prepuce complicated the postoperative course, but there were no long-term sequelae in any case. In patients with concomitant preoperative erectile dysfunction, the dysfunction did not improve after corporoplasty; such patients should be treated primarily with a penile implant. We recommend the modified Essed-Schroeder corporoplasty as a safe and simple method to correct penile curvature.

Adult↗
PubMed1991

Complicated urinary tract infections.

Complicated urinary tract infections (UTIs) are defined as those infections causing severe complications, such as urosepsis, renal scarring, and end-stage renal disease. Major complicating factors are infection stones, infected atrophic kidney, renal papillary necrosis, indwelling catheters, and other causes of bacterial persistence, as well as vesicoureteral reflux and urinary tract obstruction in recurrent UTI. Operative therapy is mandatory in all types of persistent UTI besides chronic bacterial prostatitis, as well as in UTI associated with urinary tract obstruction. Recurrent UTI complicated by vesicoureteral reflux, on the other hand, should be managed conservatively.

Atrophy↗
PubMed1991

[Diagnosis of localized prostate cancer: screening and preoperative staging].

In 712 patients, mapping of the prostate by six systematic ultrasound-guided core biopsies was performed without major side effects using the "biopyt gun". The histologic findings provided data on patients with normal and those with abnormal prostates on digital rectal examination (DRE). Only 3 of 72 (4%) nonurologic patients with normal prostate-specific antigen (PSA; less than 4 ng/ml) had prostate cancer. In patients with firm prostates on DRE and normal PSA, 13 out of 101 (13%) had prostate cancer. In patients in whom PSA was greater than or equal to 4 ng/ml, 92 of 158 (58%) had prostate cancer. In patients with clinical stage B or C and PSA less than 4 ng/ml, 20/56 (36%) had prostate cancer, compared to 155 of 187 (83%) patients with PSA greater than or equal to 4 ng/ml. Transrectal ultrasound (TRUS) seemed not to be useful in screening for prostate cancer, due to its low specificity of 54%, although in patients with clinical stage B or C TRUS identified 157/175 (90%) patients with prostate cancer. For staging prostate cancer we compared in 103 men with pelvic lymph node dissection the value of digital rectal examination, computerized tomography (CT), magnetic resonance imaging (MRI), PAS, TRUS, and random systematic biopsy for identification of lymph-node-positive patients before radical prostatectomy. CT had a sensitivity of only 7% and a specificity of 96% in detecting lymph nodes, whereas MRI had a sensitivity of 50% and a specificity of 100%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Morphologic principles for radical prostatectomy].

As a result of studies by P. Walsh, better anatomical knowledge of the prostate and the periprostatic tissue has considerably improved the surgical technique of radical prostatectomy over the last 10 years. The improvement is reflected by markedly lower morbidity and mortality rates after radical prostatectomy, which has led to a wider use of this operation for the treatment of localized prostate cancer in nearly all centers. Additional information has been obtained since Walsh performed his studies. The present state of the art is presented in this paper. A survey of the literature reveals that many of the new insights into the anatomical structure were already known at the beginning of the last century, some even in 1776.

Humans↗
PubMed1990

Comparison of different schedules of cytostatic intravesical instillations in patients with superficial bladder carcinoma: final evaluation of a prospective multicenter study with 419 patients.

In a prospective multicenter study we compared the value of various protocols of mitomycin C and doxorubicin instillation for the prevention of recurrent tumors in patients whose superficial bladder tumors (stages TA and T1) had been removed by transurethral resection. The 3-year and short-term instillation protocols were compared to each other and to a combination of 2 protocols. Evaluation after a mean followup of 28 months confirmed the value of cytostatic bladder instillation in preventing recurrence and progression of tumor in patients with superficial bladder carcinoma. There was no significant difference between the results of long-term and short-term prophylaxis; their combination achieved the best results. Doxorubicin and mitomycin yielded similar results; mitomycin was better tolerated.

Administration, Intravesical↗
PubMed1990

Quantitative immunocytology in the management of patients with superficial bladder carcinoma. I. A marker to identify patients who do not require prophylaxis.

We used monoclonal antibody 486P 3/12 to monitor 55 patients after transurethral resection of stages Ta and T1 transitional cell bladder carcinoma. The method has a high sensitivity (89%) in detecting grades 1 to 3 lesions. We examined voided urinary specimens taken every 4 weeks after transurethral resection for a mean of approximately 2 years. Of the 55 patients 22 remained negative for marker without prophylaxis and only 2 of them had another tumor. Only 6 of 33 patients who were positive for marker after transurethral resection were negative for marker at least once immediately after transurethral resection. Of the 33 patients 14 had a recurrent tumor. In all 14 patients a marker-positive urine specimen preceded visible tumor recurrence by several months. Monoclonal antibody 486P 3/12 is a safe marker to identify patients with superficial bladder carcinoma after transurethral resection who do not require prophylaxis. The 22 patients who remained negative for marker after transurethral resection had an almost equal distribution of stages Ta to T1 lesions (9 versus 13) and equal distribution of grades 1 and 2 lesions (11 versus 11).

Antibodies, Monoclonal↗
PubMed1990

Hydronephrotic atrophy after stable mild or severe partial ureteral obstruction: natural history and recovery after relief of obstruction.

After stable mild or severe partial unilateral ureteral obstruction in rats, the ratio of renal dry weight to whole body weight changes in two phases. In a "destructive phase" of two to six weeks, slight weight reduction occurs in the kidneys with mild obstruction and pronounced weight reduction occurs in those with severe obstruction. Then, in a "steady-state phase", there is no further weight reduction in kidneys with either mild or severe obstruction. Relief of ureteral obstruction during the steady-state phase does not result in an increase in renal dry weight. We conclude that the development of hydronephrotic atrophy after stable mild or severe partial unilateral ureteral obstruction can not be influenced by relief of obstruction in the steady-state phase.

Animals↗
PubMed1990

[Kidney and bladder injuries: diagnosis and therapy].

Classification of renal trauma is given. Perforated trauma requires operation, blund trauma is treated conservatively, at least in stage I and II. Severe hemorrhage is reason for surgical exploration and nephrectomy in stage III and IV renal trauma. Renal trauma is best diagnosed by sonography and CT-scan. Bladder trauma is best diagnosed by cystogram and classified to intraperitoneal leasons which require immediate operation and to extraperitoneal leasons which are treated conservatively.

Humans↗