Transurethral ultrasound guided laser induced prostatectomy (TULIP): U.S. Cooperative Study and University of Bochum results.
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Aged↗
Biomedical subjects
H Schulze
Publications and source records attributed to H Schulze.
Epithelial monolayers from human epididymal and efferent duct tubules; testosterone metabolism and effects of culture conditions on cell height and confluence.
Corpus epididymal and efferent duct epithelial cells on permeable supports formed confluent monolayers that resisted hydrodynamic equilibrium and created electrical resistance. Monolayers were formed sooner and were of better quality when fetal bovine serum (FBS), rather than bovine serum albumin (BSA), was present in glucose-free, rather than glucose-containing, media. Testosterone was converted to androstenedione by both cell types and conversion of both steroids to 5 alpha-reduced metabolites was higher in cells from the corpus epididymidis than from efferent ducts. Addition of heat-treated human spermatocoele fluid (similar to rete testis fluid) to the apical aspects of the cells increased cell heights when they were initially low, but some cytoplasmic damage was observed. New serum-free media (especially those designed for keratinocytes and mammary epithelial cells) could maintain cultured cells at heights found in situ.
Aged↗
Use of tiapride on stuttering in children and adolescents.
Reported here is the therapeutic efficacy of Tiapride with 10 10- to 17-yr.-old patients afflicted with severe stuttering problems. During the 20-wk. open, controlled study (baseline, low dose of Tiapride, high dose of Tiapride, follow-up observation without medication) the stuttering in various speech situations decreased markedly. No substantial change in different parameters of acoustic analysis and psychopathological characteristics accompanied the reduction in stuttering when group data were compared although positive effects concerning these variables could be seen in some cases. Several conclusions based on these results are presented. One assumed effect of the medication is improvement of central nervous regulatory mechanisms of speech motor coordination. Further, the value of the medication Tiapride in comprehensive stuttering therapy is discussed.
Adolescent↗
Influence of hormone application by subcutaneous injections or steroid-containing silastic implants on human benign hyperplastic prostate tissue transplanted into male nude mice.
To study the influence of androgens and estrogens on human benign prostatic hyperplasia (BPH) tissue, BPH fragments were grafted subcutaneously (s.c.) into male nude mice. Testosterone alone (group I) or in combination with 17 beta-estradiol (group III) were administered either by s.c. injections as oil suspensions or continuously by s.c. implanted steroid-containing Silastic implants (groups II and IV). Intact mice without transplants and treatment served as a control (group V). After 4 weeks of treatment, animals were exsanguinated, transplants were removed, and serum was obtained. Ninety-six percent of the BPH fragments were located; they displayed histologically typical BPH acini and stroma. In transplants of all treatment groups, the majority of secretory, as well as basal, cells displayed a proliferation comparable to the original tissue. In glandular cells of all transplants, prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) could be demonstrated immunohistochemically. Specimens removed from animals bearing testosterone implants displayed a very well preserved ultrastructure that was found less frequently in samples from injection-treated animals. Acini-bearing metaplastic epithelium were more often present in transplants treated by steroid injections and seemed to be due to lower androgen or higher estrogen serum levels. Endogenous serum testosterone levels (ng/ml +/- SD; n) were lower and more variable (i.e., higher standard deviation) in groups treated by injections (group I: 3.68 +/- 2.12; n = 5 and group III: 3.86 +/- 1.13; n = 5) and were similar to those seen in intact controls (3.93 +/- 1.62; n = 6) compared with groups treated by Silastic implants (group II: 5.11 +/- 1.14; n = 10 and group IV: 10.20 +/- 0.52; n = 4). These results indicate that by application of steroids via Silastic implants, reproducible hormone effects can be obtained on BPH tissue transplanted into male nude mice, thus providing a reliable new model system for study.
Acid Phosphatase↗
Endocrine therapy of advanced prostatic cancer.
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Androgen Antagonists↗
Immunohistochemical determination of age related proliferation rates in normal and benign hyperplastic human prostates.
To study whether benign prostatic growth in aging men correlates with an increase in proliferation, proliferation rates were determined immunohistochemically using the antibody Ki-67 in 20 benign hyperplastic prostates (BPH) and in four normal prostates (NPR). There was no significant correlation between age and proliferation rate in epithelium or stroma in BPH. In addition, no significant correlation between prostate weight and proliferation rate could be demonstrated in either compartment. In NPR the proliferation rate in epithelium and stroma was 9 times and 37 times lower, respectively, than in BPH. Obviously the induction of BPH from NPR may be associated with a distinct increase in proliferation. The further increase in BPH volume, however, is not correlated with a further increase in proliferation rate.
Adolescent↗
17 beta-hydroxysteroid oxidoreductase in epithelium and stroma of human prostate.
It is conceivable that androstenedione contributes indirectly to 5 alpha-dihydrotestosterone formation in human prostate by its intraprostatic conversion to testosterone. This reversible conversion is catalyzed by the enzyme 17 beta-hydroxysteroid oxidoreductase (17 beta-HSOR). At present, rather limited information on kinetic parameters like specific concentration (Vmax), affinity to steroid substrates (KmS) and to pyridine nucleotides (KmN) of 17 beta-HSOR is available. Thus, we determined those aforementioned kinetic parameters in epithelium and stroma of normal human prostate (NPR) and benign prostatic hyperplasia (BPH). The main results were: (1) the mean KmS of 17 beta-HSORred/NADPH was significantly (P < 0.0001) lower than those of all other 17 beta-HSORs. (2) In almost all cases the mean Vmax was higher in BPH than NPR. (3) In all cases, the mean Vmax/KmS ratios of 17 beta-HSORred were higher than those of 17 beta-HSORox. The highest ratio was found regarding 17 beta-HSORred/NADPH in BPH stroma. (4) In stroma, a significantly positive correlation of Vmax/KmS of 17 beta-HSORred/NADPH with age was found. (5) The lowest KmN was found regarding NADP+, followed by NADPH. It is concluded that in human prostate the balance of the reversible conversion of testosterone to androstenedione is shifted potentially towards testosterone, particularly in BPH stroma.
17-Hydroxysteroid Dehydrogenases↗
Effects of estrogen deprivation on human benign prostatic hyperplasia.
Sex steroids are thought to play an essential role in the pathogenesis of human benign prostatic hyperplasia (BPH). Since recent studies in animal models and in men have shown that estrogens might be causally linked to the onset and maintenance of BPH, we examined the effect of 1-methyl-androsta-1,4-diene-3,17-dione (Atamestane), a newly developed aromatase inhibitor, in men with BPH. In an open multicenter study 49 men (mean age 70.1 years, range 55 to 84) with obstructive BPH were treated with atamestane (3 x 200 mg/day) for 3 months. Of the 49 patients 44 completed the treatment period; the other patients discontinued the study for reasons unrelated to treatment. With treatment BPH-related symptoms such as daytime voiding frequency, nycturia, peak flow and residual urine improved considerably; however, these parameters did not reach statistical significance. The mean prostatic volume decreased significantly from 74.2 +/- 31.7 to 64.0 +/- 31 ml (mean +/- SD). Serum estrogen levels decreased markedly during treatment. In addition intraprostatic estrogen concentration decreased with treatment as compared to estrogen levels in hyperplastic prostates from untreated patients. The following conclusions can be drawn from this study: first, estrogens appear to have an important supportive role in established BPH, and second, estrogen deprivation improved BPH-related symptoms and reduced significantly prostatic volume.
Aged↗
The Swiss Lithoclast: a new device for endoscopic stone disintegration.
Even in the presence of extracorporeal shock wave lithotripsy there is still the need for endourological treatment of stones in the urinary tract. Stone fragmentation usually is achieved with either ultrasonic, electrohydraulic or laser lithotripsy. We report our early experience with a new, simply constructed machine at a reasonable cost for endoscopic stone disintegration--the Swiss Lithoclast. The principle of this lithotriptor is based on pneumatic shock waves induced by the central compressed air system of a hospital or by a compressor. This device was used to treat 151 patients with stones in the kidney, ureter, bladder or a Kock pouch continent urinary diversion. Endoscopic fragmentation was successful in all patients. Independent of the composition, all stones were disintegrated within a short period, indicating that the device may well represent an attractive alternative to standard endoscopic lithotriptors.
Adolescent↗
Changes in movement characteristics of human spermatozoa along the length of the epididymis.
It has been established in laboratory mammals that sperm motility and fertilizing capacity develop during epididymal transit, but sperm maturation along the human epididymis is less well characterized. Spermatozoa were prepared from 5 regions of 8 epididymides from 8 prostatic carcinoma patients undergoing castration and from 8 epididymal spermatocoeles located adjacent to the head of the epididymides and the testes of 5 patients. Sperm movement was characterized by computer-aided sperm analysis (CASA), and percentage motility was estimated by conventional methods. The efferent ducts and spermatocoeles contained the same percentage of motile spermatozoa with similar kinematics. Percentage motility increased from 22.9 +/- 4.8 (mean +/- SEM) in the efferent ducts to a maximum of 68.3 +/- 7.9 in either the mid- or distal corpus epididymidis and declined in the cauda region. Straight line velocity increased from 20.3 +/- 3.7 microns/sec to reach a plateau value of 44.0 +/- 5.3 microns/sec in the mid-corpus epididymidis; this was more marked than the increase in curvilinear velocity, although the trend was the same. Similar trends in linearity and straightness of the swim paths were not accompanied by any significant changes in the amplitude of lateral head displacement. This objective quantification of sperm movement documents the maturation of sperm motility in the human epididymis, confirming that this maturation pattern is similar to that in other mammals.
Epididymis↗
Rat brain glyceraldehyde-3-phosphate dehydrogenase interacts with the recombinant cytoplasmic domain of Alzheimer's beta-amyloid precursor protein.
Abundant senile plaques are a histological hallmark in the brain of Alzheimer's disease patients. Such plaques consist of, among many other constituents, aggregated beta A4 amyloid peptide. This peptide is derived from an amyloid precursor protein (APP) by irregular proteolytic processing and is considered to be involved in the development of Alzheimer's disease. To study possible interactions of brain proteins with beta A4 amyloid or other fragments of APP, beta A4 amyloid and beta A4 amyloid extended to the C-terminus of APP were recombinantly produced as fusion proteins termed "Amy" and "AmyC," respectively. Using Amy and AmyC affinity chromatography, a 35-kDa protein from rat brain was isolated that bound tightly to AmyC but not to Amy, thus indicating an interaction of the protein with the C-terminus of APP. This 35-kDa protein was identified as the glycolytic enzyme glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Binding of GAPDH to AmyC but not to Amy was confirmed by gel filtration. Although AmyC slightly reduced the Vmax of GAPDH, the same reduction was observed in the presence of Amy. These findings suggest that the interaction of the cytoplasmic domain of APP with GAPDH is unlikely to influence directly the rate of glycolysis but may serve another function.
Alzheimer Disease↗
[TULIP--transurethral ultrasound-controlled laser-induced prostatectomy: an alternative to TURP?].
Transurethral resection of the prostate (TURP) is the most effective treatment for prostatic obstruction secondary to benign prostatic hyperplasia (BPH). This procedure has a high success rate with a very low mortality rate. Over the last 30 years, however, an unchanged morbidity rate of about 20% following TURP has been reported in the literature. In addition, haemorrhage requiring blood transfusion may occur in 6.5-22% of cases, and 68-92% of sexually active men have retrograde ejaculation following TURP. The side-effects and complications associated with TURP have led to the search for alternative therapies. The TULIP system represents a new treatment modality. TULIP is an acronym for transurethral ultrasound-guided laser-induced prostatectomy. The basic TULIP system consists of an ultrasound imager and a 20-F transurethral probe with an ultrasound transducer and a laser window at the distal end. Under ultrasound guidance laser treatment results in a coagulation necrosis effect in the hyperplastic prostate tissue. Coagulation necrosis is basically a bloodless tissue removal procedure as the tissue subsequently sloughs away in the fine particles during spontaneous micturation within 4-6 weeks after the procedure. Early results obtained in the first 18 patients with symptomatic, obstructive BPH treated by TULIP and with a follow-up of 6 weeks to 6 months demonstrate a significant improvement in both subjective and objective symptoms. The peak flow rate increased by up to 142% on average; the residual volume decreased by up to 75%; and there was a 77% decrease in average symptom scores compared with preoperative scores.(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
[Immunotherapy of prostate cancer].
In recent years immunotherapy of prostate cancer has developed into an innovative field of investigation. Nevertheless, in contrast to some other human tumors in which immunotherapy has been demonstrated to be effective, no breakthrough has been achieved with respect to a successful clinical application of this modality to prostate cancer. So far studies focus either on immunologically specific or nonspecific treatment concepts. Based on this, the modes of action of monoclonal antibodies, adoptive immunotherapy techniques, tumor cell vaccination, various biological response modifiers and substances with immunological as well as tumoritoxic/-static attributes are studied. Not all of the results obtained so far offer new insights into tumor biology. Ongoing studies in all fields continue to pursue immunological mechanisms for effective systemic therapy of prostate cancer. Major impulses may be seen only via immunologically specific concepts. Through these, new therapeutic modalities for patients with advanced prostate cancer may be developed which are more efficacious than androgen ablation.
Antibodies, Monoclonal↗
[Iodine-induced hyperthyroidism in urology caused by using roentgen contrast media. Risks and prevention].
The presence of functionally autonomous portions of the thyroid is a precondition for the occurrence of iodine-induced hyperthyroidism after the administration of i.v. contrast media, in the form either of latent immunogenic hyperthyroidism (Basedow's disease) or of localized or diffuse autonomy. The normal thyroid can compensate an iodine excess in multiple ways. In the malfunctioning thyroid, however, autoregulation mechanisms may fail, resulting in complicated forms of hyperthyroidism. In Germany autonomy-correlated hyperthyroidism occurs much more often than in other countries in which sufficient alimentary iodine is present. Especially in elderly patients with long-standing nodular goitres, there is an elevated risk of iodine-induced hyperthyroidism arising from thyroidal autonomy. These cases may differ from those seen in younger patients. An existing hyperthyroidism may worsen dramatically after administration of contrast media. To prevent an iodine-induced thyrotoxic crisis, contrast media should only be given to patients with latent of manifest hyperthyroidism when vital indications are present, and then only after thyrostatics have been administered. To evaluate the morphology of the renal collecting system and ureter in these cases a retrograde rather than an intravenous pyelography should be performed. When this is combined with determination of serum creatinine and creatinine clearance, functional and morphological evaluation, respectively, of the upper urinary tract are possible.
Aged↗
[The disintegration of urinary calculi via endoscopy: the lithoclast].
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Adolescent↗
Composition of fluids obtained from human epididymal cysts.
The fluid composition of five epididymal spermatocoeles, one epididymal cyst and a hydrocoele was examined. The fluid obtained from the spermatocoeles was a dilute suspension of mainly immotile spermatozoa. The sperm-free fluid contained less protein, phosphate, glucose, triglyceride and cholesterol than serum but more testosterone and chloride than peripheral blood. It contained no epididymal secretion products. Proteins in the fluid differed from those in serum. From the fluid composition these cysts appeared to be continuous with the rete testis, either dilatations of efferent ducts or Haller's superior aberrant duct (vas aberrans of the rete testis). Fluid from an epididymal cyst containing no spermatozoa was mainly of similar composition. In contrast, hydrocoele fluid resembles blood serum.
Adult↗
Appearance and endocytic activity of epithelial cells from human efferent ducts in primary monolayer culture.
The culture of epithelial cells lining human efferent ducts, obtained from prostatic carcinoma patients, is described. Ciliated cells were observed to beat for at least one month on plastic. On previous filters low cuboidal cells characterized the monolayers. Cells comprising monolayers over the filter were 5 to 9 microns in height whereas taller cells were found over the original fragments (14 microns). Some non-ciliated cells contained dark and light vacuoles, others were found to lack them. Both non-ciliated and ciliated cells maintained tight junctional complexes restricting the paracellular movement of horseradish peroxidase. Both types of cultured cells exhibited fluid-phase and adsorptive endocytosis from both apical and basal surfaces. It is reported for the first time that the monolayers form high resistance barriers (150 omega.cm2) that prevent the apical medium from draining to the basal compartment over 24 h.
Cell Polarity↗
[New conservative therapeutic approaches in benign prostatic hyperplasia].
The efficacy of treatment for benign prostatic hyperplasia (BPH) is presently under critical consideration. In addition, various new therapeutic modalities are currently being evaluated. When medicamentous treatment is planned, in particular, the natural history of the disease must be carefully considered. Summarized data from several studies indicate that spontaneous improvement of symptoms may occur within 3-6 months, while in most cases deterioration takes a longer period of time. As intraprostatic urethral pressure depends on prostatic volume as well as on tone of the prostate smooth muscle, different medical treatment modalities seem reasonable. The dynamic component of the smooth muscle cells may be influenced by alpha-blockers. Administration of selective alpha 1-blockers will be advantageous as these have fewer side effects. Prostate volume represents the static component, which can be influenced by hormone treatment. Androgen deprivation via surgical castration must now be regarded as of historical interest only. Antiandrogens or LH-RH analogues have undesirable side effects and are expensive, making such treatment unacceptable for routine use. 5 alpha-Reductase inhibitors may emerge as a new treatment form allowing androgen suppression with a low rate of side effects. As it has been proposed that estrogens play an important role in the regulation of prostatic growth, aromatase inhibitors, which inhibit metabolization from androgens to estrogens, may receive special attention in the near future. Based on the theory that androgens may be of special importance for the epithelium, while estrogen action may be concentrated on the stroma, a combined treatment with inhibitors of 5 alpha-reductase plus aromatase may be even more effective.(ABSTRACT TRUNCATED AT 250 WORDS)
Adrenergic alpha-Antagonists↗