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Biomedical subjects

H Huland

Publications and source records attributed to H Huland.

At least 199 records · Page 11Linked to original sources
PubMed1990

[Tumor markers and prognostic parameters in urinary bladder cancer].

Ideal tumor markers for use in the primary diagnosis or follow up of superficial or invasive cancers have not yet been found. Nonetheless, the literature contains references to parameters that are relevant to prognosis and to markers for bladder tumors, and many of these are certainly of value when specific questions are addressed. Urinalysis has been considerably refined and yields information on superficial tumors. Quantitative immunocytology is used to check whether prophylactic treatments are indicated and, if so, for how long; conventional cytology is helpful in the clinical follow up after BCG treatment of carcinoma in situ. In the present paper all important markers for urothelial cancer are reviewed and their value in diagnosis and treatment is discussed.

Biomarkers, Tumor↗
PubMed1990

[Ambulatory carboplatin monotherapy in advanced seminoma].

Six patients with advanced seminoma (stage IIc) received single-agent carboplatin therapy. The drug was administered to outpatients without prior hyperhydration. All five patients who completed the regimen of three to four cycles achieved complete remission, which was confirmed histologically in four patients by retroperitoneal lymph node dissection. No severe side-effects were observed. Single-agent carboplatin therapy is a highly efficient regimen with very little toxicity. This treatment seems to be the therapy of choice in patients with advanced seminoma.

Adolescent↗
PubMed1989

Local continuous high dose interleukin 2: a new therapeutic model for the treatment of advanced bladder carcinoma.

Because efficient i.v. administration of interleukin 2 (IL-2) in tumor patients leads to severe cardiopulmonary side effects, we developed a new form of IL-2 application that allows activation of all IL-2-responsive immune cells directly at the tumor site. In five patients with T4N0M0 transitional cell carcinoma of the bladder, we used high-dose, continuous IL-2 perfusion of the bladder (1000 units/ml, 2 ml/min, 24 h/day), for 5 days after incomplete transurethral resection of the tumor. The total dose, 15 million units, was repeated after 4-12 weeks. None of our patients showed any evidence of side effects. In blood and especially in urine, the number of eosinophil leukocytes was remarkably increased. Eosinophils were attached to the tumor cells and degranulated on them. Before treatment, no cells positive for IL-2 receptors were found in urine, and only 0-3% of lymphocytes positive for IL-2 receptors were detected in blood. After the first cycle and especially after the second, a distinct increase in positive cells up to 17% occurred. One patient had a complete histologically confirmed remission and is free of tumor 6 months after therapy. Another patient died of a vertebral metastasis 8 weeks after the first (and only) therapeutic cycle. Local administration of a high dose of IL-2 induces local and systemic immunopotentiation diagnosed by activation marker analysis without any side effects and can be used in inoperable transitional cell carcinoma of the bladder. The optimal dosage still needs to be defined. Bladder carcinoma is an ideal model that offers a unique chance to use urine cytology to study the cooperation and activation of immune cells at the tumor site.

Administration, Intravesical↗
PubMed1989

Renal transplantation using cyclosporine with and without regard to HLA matching: a randomized prospective unicenter study.

A randomized prospective unicenter study produced no significant difference in 2-year outcome between the use of well matched cadaver renal allografts shared among transplantation centers, and the use of organs of local origin matched only for blood group. Graft and patient survival rates, transplant function and incidence of rejection were compared. On the basis of 1 and 2-year outcome with well matched and shared allografts we conclude that cyclosporine therapy makes HLA matching unnecessary.

Adolescent↗
PubMed1989

[Anatomy and sonography of the prostate].

According to the data of John McNeal, a three-dimensional model of the prostate is presented; this is based on his serial sections of the prostate in different, carefully selected planes. The urethra is the anatomical reference point. The proximal urethral segment is covered by the transition zone, periurethral tissue and the preprostatic sphincter. The two main glandular regions of the prostate are the central zone and the peripheral zone. Carcinoma arises mainly in the peripheral zone, while benign prostatic hyperplasia (BPH) arises mainly in the transition zone.

Adenocarcinoma↗
PubMed1989

[Carcinoma in situ of the testis: clinical significance, diagnosis and therapy].

The term "carcinoma in situ (CIS) of the testis" is used to mean the presence of atypical neoplastic spermatogonia exhibiting distinct morphological and immunohistological characteristics that differentiate them from normal germ cells. The lesion is considered to be the uniform precursor cell of all germ cell tumors, and it can usually be detected many years before manifestation of the tumor by surgical biopsy and subsequent immunohistological staining for placental alkaline phosphatase (PIAP). This paper gives a review of the theoretical and clinical features of CIS. The description is based on data in the literature and on the authors' experience with two recently detected cases of CIS in the contralateral testis of patients with germ cell tumors. In view of the observation of intraepithelial spread inside the seminiferous tubules, the term "testicular intraepithelial neoplasia" (TIN) is suggested instead of carcinoma in situ.

Biopsy↗
PubMed1989

[Monoclonal antibodies in diagnosis and therapy].

The value of monoclonal antibodies (mAb) produced against renal, bladder and prostate cancer antigens is demonstrated. These mAb allow a molecular classification of urological cancers as well as therapeutic approaches in cancer treatment. Anti-T-cell mAb can also be used in cellular rejection of kidney transplants.

Antibodies, Monoclonal↗
PubMed1989

[Quantitative immunocytology as a marker for indications and follow-up of recurrence prevention of superficial urinary bladder cancers].

In 1985, we initiated a prospective clinical trial to evaluate the risk of recurrence for superficial bladder cancer. Up to now, 41 patients subjected to TUR have subsequently been monitored by immunocytology with a monoclonal antibody (mab 486 p) recently developed in our laboratory. Of these patients, 15 (36.6%) remained marker-negative and received no prophylactic therapy. There was only one recurrence (6.7%) in this subset of patients, whereas 10 out of 26 (38.5%) marker-positive patients have so far developed recurrent malignancies. In all cases, the conversion of immunocytological characteristics preceded visible recurrence by 2-5 months. These preliminary results indicate that immunocytology might make it possible to identify patients at low risk of recurrence more accurately than has so far been feasible with standard cytology or flow-cytometry.

Administration, Intravesical↗
PubMed1988

A new test to predict reversibility of hydronephrotic atrophy after stable partial unilateral ureteral obstruction.

In previous studies we showed that hydronephrotic atrophy develops only in the first weeks after stable partial ureteral obstruction, and does not progress thereafter. Relief of obstruction only in the "destructive phase" and not in the later "steady-state phase" seems to improve or prevent hydronephrotic atrophy. Since the duration of partial ureteral obstruction is often not known, we studied urinary enzymes of rat kidneys after stable partial unilateral ureteral obstruction to identify the destructive phase. We chose as an example of the tubular lysosomal enzyme N-acetyl glucosaminidase (NAG) and as an example of the brush border enzyme gamma-glutamyl-transferase (Gamma-GT). NAG concentration but not so much Gamma-GT concentration was higher in the urine of the obstructed kidneys than in the urine of the contralateral control kidney, in the first two weeks after operation, and then returned to normal. These observations lead to the conclusion that the "destructive phase" after ureteral obstruction can be identified by the appearance of high urinary tubular lysosomal enzyme content. The clinical implication is that the timing of relief of asymptomatic stable partial ureteral obstruction of unknown duration can be based on the concentrations of urinary lysosomal enzymes.

Acetylglucosaminidase↗
PubMed1988

Treatment of acute cellular rejection in renal transplantation patients on ciclosporin with antithymocyte globulin.

Our treatment of acute renal cellular rejection in patients on ciclosporin (cyclosporin A) involves the almost complete elimination of T cells (according to individual T cell monitoring in peripheral blood) through antithymocyte globulin (ATG) therapy. We present here the results of treatment of 44 histologically or cytologically proven acute rejection episodes in 33 of 62 consecutive renal transplantation patients. ATG therapy resulted in a 95.5% success rate when duration and dosage were individually adjusted according to T cell elimination in peripheral blood. Only two grafts were lost, both because of vascular occlusions. In neither case could it be clarified whether the loss was due to primary vascular lesions or the result of severe rejection or side effects of ATG. Our data show that the elimination of primed T cells with ATG permits the use of ciclosporin even in the presence of an established immune response.

Adolescent↗
PubMed1988

Cytostatic intravesical instillation in patients with superficial bladder carcinoma for the prevention of recurrent tumors.

The value of various protocols of mitomycin C and adriamycin instillation for the prevention of recurrent tumors in patients whose superficial bladder tumors (TA, T1) had been removed by transurethral resection was compared in a prospective multicenter study. Three-year and short-term instillation protocols were compared with each other and with the combination of the two. Evaluation after a mean follow-up of 20 months confirmed our previous conclusion of the great value of cytostatic bladder instillation to prevent recurrent tumors and tumor progression in patients with superficial bladder carcinoma. There is no significant difference between long-term and short-term prophylaxis, but combination has achieved the best results. Similar results were obtained with adriamycin and mitomycin but adriamycin was less well tolerated.

Administration, Intravesical↗