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Biomedical subjects

H Schulze

Publications and source records attributed to H Schulze.

At least 145 records · Page 8Linked to original sources
PubMed1989

[Stuttering in children as a problem of phoniatric outpatient clinics].

Stuttering in young children is an extremely complex phenomenon. On all levels of intervention such as evaluation, differential diagnosis between stuttering and normal disfluency, diagnostic guidance of therapy process or direct and indirect treatment a number of questions arise for which answers have not been yet found. But realizing that the disorder is most difficulty to cure in adults and adolescents prevention or early treatment is essential. So diagnosticians and therapists need a high level of knowledge about the onset, the maintenance and the development of the disorder in every individual case of stuttering in young children. Decisions concerning the indications for diagnostic and therapeutic interventions must not be made by intuition but by professionally balancing the influencing factors such as psycho-social variables or marked deficits in mental, motor or sensory areas of the child's development. We want to demonstrate the different dimensions of the diagnostic and therapeutic process and the amount of professional time and effort which is necessary for the handling the stuttering child and his family.

Diagnosis, Differential↗
PubMed1989

[Current status of stuttering therapy in preschool and school-age children in the Federal Republic of Germany: results of a questionnaire study among therapists and analysis of the literature].

It is evident that no empirical research has been carried out within the preschool age-group of stuttering children and also that information on the subject published in international and especially in the Anglo-American literature has not received the attention of German therapists. Rather than concentrating upon the stuttering child's speech and language, they attempt to convey to the child a greater pleasure in speaking and in communicating; this may result in symptoms that could aggravate prognosis. More than half of the therapists maintain the same attitude toward school-age children. The review of the literature and the replies to the questionnaire show that German therapists require new orientation toward scientific investigation and new concepts in the treatment of stuttering preschool children.

Child↗
PubMed1989

[Simuliosis--dermatosis caused by black flies. A forgotten epizootic infection?].

Bites of black flies (Simuliidae) can produce strong ictus reactions in humans, associated with rubor, central hemorrhages, swellings, hemorrhagic erythema and edema. This can be accompanied by impairment of the general state of health. Suitable weather conditions may result in mass multiplication of the species. As a consequence man and animals may be seriously molested. Starting from strong ictus reactions of a patient the case report and therapy of simuliosis (simuliotoxicosis) as well as some points of the biology of black flies are described.

Adult↗
PubMed1988

Long-term followup in 1,003 extracorporeal shock wave lithotripsy patients.

We evaluated 1,003 patients treated with extracorporeal shock wave lithotripsy after a mean followup of 19.1 months (range 12 to 26 months). Followup excretory urograms were normal in 97 per cent of the patients. Two-thirds of the patients reported further discharge of residual fragments, mainly during the first 3 months. Rehospitalization was necessary in 57 patients. Over-all, the rate free of stones after followup was 72.2 per cent and it was not different for primary and recurrent stone patients. Rates free of stones were influenced mainly by the primary stone location and the number of stones in a renal unit. Patients with lower caliceal stones had a rate without calculi of only 57.8 per cent. Almost identical results were obtained for stones other than in the lower calix, when fragments were found in the lower calix at the time the patient was discharged from the hospital. The pre-treatment stone volume, as determined by measuring the stone area in square millimeters, did not influence the final rates free of stones for calculi up to 400 mm.2, that is 2.4 cm. of a sphere. Only calculi larger than 400 mm.2 showed an inverse relationship to the final rate free of stones. Multiple stones yielded a success rate of 64 per cent, with 90 per cent of the patients having regrowth of residual fragments. Serious complications during followup were not encountered.

Adolescent↗
PubMed1988

Evaluation of total versus partial androgen blockade in the treatment of advanced prostatic cancer.

In order to evaluate the proposed benefit of complete androgen blockade in the treatment of patients with advanced prostatic cancer, we initiated a multicenter prospective and randomized study. At the time of this report 99 patients with newly diagnosed, previously untreated prostatic cancer were randomly distributed to one of the following treatments: group I, orchiectomy plus antiandrogen Flutamide; group II, depot LH-RH analog Zoladex plus Flutamide; group III, orchiectomy alone, and group IV, Zoladex alone. Our preliminary data fail to demonstrate a superiority of total androgen blockade over partial androgen blockade in the treatment of patients with advanced cancer of the prostate.

Androgen Antagonists↗
PubMed1988

[Recent findings on the pathogenesis and therapy of prostatic cancer].

Presently, there is no effective therapy for increasing survival of metastatic prostatic cancer. New approaches to this major disease are, therefore, urgently needed. One approach is to study the biology of prostatic carcinogenesis in order to develop a therapeutic modality to prevent the development of clinically manifest prostatic cancer. Based upon international epidemiological data, it should be possible to lower the incidence of clinical prostatic cancer by more than 10-fold among the males of the western industrial states. An alternative approach is to study the tumor biology of prostatic cancer in order to identify new modalities to better treat already established clinical prostatic cancer. Such studies have already demonstrated that individual prostatic cancers are composed of clones of cancer cells which are phenotypically heterogeneous even before therapy is initiated. Due to this tumor cell heterogeneity, the direction of future studies should be towards combining androgen ablation plus chemotherapy early in the disease in order to affect both the androgen-dependent and -independent cancer cells present within individual prostatic cancers.

Animals↗
PubMed1987

Immunocytochemical localization of estrogen receptors in spontaneous and experimentally induced canine benign prostatic hyperplasia.

Estrogens are believed to play a critical role in the etiology of canine benign prostatic hyperplasia (BPH); however, the mechanism has not been elucidated. To gain insight into this problem, we investigated the immunocytochemical localization of estrogen receptors (ER) in normal prostates, spontaneous BPH, and experimentally induced BPH by using a monoclonal ER antibody (H222). In all canine prostates the majority of ER was localized in nuclei of the same histological components: (1) transitional epithelium and subjacent stroma of the prostatic urethra, (2) periurethral prostatic ductal epithelium, and (3) prostatic stroma. ER content in the stroma was highest in the periurethral region of the prostate. Among the different groups of dogs, differences in ER location were seen only in the glandular epithelium. No ER was found in the glandular epithelium of normal prostates of young untreated dogs. In striking contrast, glandular epithelium of spontaneous BPH contained specific nuclear ER staining, though this staining was heterogeneous and was observed in only a minority (less than 10%) of the acinar epithelial cells. ER-positive acini in BPH were located predominantly in the periurethral region. These data demonstrate anatomical and biochemical heterogeneity of prostatic components and indicate that the estrogen sensitivity of prostatic cells is heterogeneous. If estrogen does play a role in BPH, it appears to act selectively rather than uniformly throughout the prostate. We reasoned that if glandular epithelial ER are involved in the development of spontaneous BPH, one might expect to find the same location of ER in BPH that was induced experimentally by specific types of treatment with androgens +/- estradiol. However, among hormone-treated dogs the presence of ER-positive prostatic glandular epithelium varied with the type of hormonal treatment but did not correlate with the experimental induction of glandular BPH. Some treatment groups with induced BPH had ER-positive prostatic glandular epithelial nuclei (with the same extent and pattern of ER localization as in spontaneous BPH); however, other treatment groups with induced BPH had ER-negative glandular epithelium. These data indicate either that glandular epithelial ER may not be involved in the pathogenesis of canine BPH or that there may be different types of BPH that have different etiologies. Possible mechanisms by which estrogen may affect the canine prostate are discussed in light of these new data on ER location.

Androgens↗
PubMed1987

5 alpha-androstane-3 beta,17 beta-diol hydroxylating enzymes in stroma and epithelium of human benign prostatic hyperplasia (BPH).

As enzymatic hydroxylation of 5 alpha-androstane-3 beta,17 beta-diol (3 beta-diol) may be a factor in controlling the 5 alpha-dihydrotestosterone (DHT) content in the prostate, we were interested in activity and distribution of these enzymes in epithelium and stroma of human benign prostatic hyperplasia (BPH). The enzyme activities were measured after mechanical separation of BPH tissue from 15 patients of various ages into stroma and epithelium, and optimization of the in vitro transformation of 3 beta-diol to hydroxylated products, which were analyzed by HPLC. The main results were: (1) 3 beta-diol was hydroxylated at C-7 alpha, C-7 beta, C-6 alpha, and C-6 beta. (2) The mean Michaelis constant Km (nM +/- SEM) for hydroxylation at C-7 alpha(beta) (168 +/- 21) was significantly lower than at C-6 alpha(beta) (601 +/- 43) without differences between stroma and epithelium. (3) Hydroxylation at alpha position dominated significantly over that at beta. (4) The mean maximal metabolic rate Vmax (pmol . mg protein-1 . h-1) of hydroxylation at C-6 alpha was about 7-fold lower in stroma (3.4 +/- 0.2) than in epithelium (23.8 +/- 4.1), concerning the other hydroxylations, Vmax was about 1.6-fold lower in stroma. (5) With increasing age of the patients there was a significant decrease of the 3 beta-diol hydroxylation in stroma and epithelium. It is discussed that the significantly lower activity of 3 beta-diol hydroxylation in stroma compared to epithelium and the decrease of activity with increasing age might potentiate the DHT accumulation in stroma of BPH.

Aged↗
PubMed1987

Inability of complete androgen blockade to increase survival of patients with advanced prostatic cancer as compared to standard hormonal therapy.

It has been proposed that early treatment of patients with advanced prostatic cancer by surgical or medical orchiectomy when combined with a direct acting antiandrogen will result in a more complete form of androgen blockade, thereby increasing response and survival rates compared to orchiectomy alone. We treated 55 patients with previously untreated advanced prostatic cancer by bilateral orchiectomy and additional administration of 50 mg. of the direct acting antiandrogen cyproterone acetate orally per day. Therefore, these patients have undergone a combination therapy that meets the requirements of the proposed complete androgen blockade. All 22 patients with metastases at hospitalization died during the first 4 years of treatment. Among the 33 patients without clinical evidence of metastases at hospitalization 18 were alive after 5 years. Retrospectively, the direct observed 5-year survival rate for the patients treated with a complete androgen blockade did not show any advantage compared to reported data with orchiectomy alone.

Aged↗
PubMed1987

Antibody responses to hemodialysis-related antigens in chronic hemodialysis patients.

Allergic-type reactions during hemodialysis are sometimes due to sensitization to ethylene oxide. To examine the possibility that additional antigens might be a basis for unexplained reactions, antibodies to formaldehyde and phthalate-related antigens and to dialyzer extracts were measured. Unselected sera from 113 chronic hemodialysis patients (CHP) and 200 control subjects were tested for IgG antibodies to formaldehyde-treated human serum albumin (HSA). The IgG antibody activity was confirmed in sera of five CHP who had used formaldehyde-treated dialyzers. These antibodies also reacted with formaldehyde-treated red blood cells. Sera from 71 CHP and 80 controls were tested for IgE antibodies to diethylphthalate-treated HSA; antibody was detected in two CHP sera. With extracts from hollow-fiber dialyzers, IgG antibody was detected in approximately 1/3 and IgM antibodies in approximately 1/2 of CHP sera. This antibody was found in comparable numbers of control sera. It was concluded that these additional substances are immunogenic and could be involved in allergic-type reactions.

Anaphylaxis↗
PubMed1987

Dialyzer membranes: effect of surface area and chemical modification of cellulose on complement and platelet activation.

Using an ex vivo model, the effects of membrane composition and surface area on both the complement system (as reflected by plasma C3a levels) and platelets [as indicated by plasma concentrations of thromboxane B2 (TXB2) and platelet factor 4 (PF4)] were studied. In this model, polyacrylonitrile (PAN) was associated with less complement activation than cuprammonium cellulose (CC). A new "modified cellulose" (MC) membrane, in which a small number of the free hydroxyl groups on cellulose are substituted with a tertiary amino compound, was also associated with a low degree of complement activation, similar to that with PAN. However, the extent of hydroxyl group substitution in four MC membrane subtypes did not correlate with the reduction in complement activation. In studies using CC, the amount of generated C3a correlated with the membrane surface area, although the relationship was curvilinear. Plasma concentrations at the "dialyzer" outlet of TXB2 and PF4 were similar with CC, PAN, and MC. In studies with the MC subtypes, increasing the extent of hydroxyl group substitution paradoxically increased, albeit slightly, the amount of TXB2 generation. In studies with CC, a linear relationship between membrane surface area and TXB2 generation was found. The results suggest a dissociation between platelet and complement effects among different dialyzer membranes, and underline the importance of membrane surface area.

Acrylic Resins↗
PubMed1987

Immunocytochemical localization of estrogen receptors in the normal male and female canine urinary tract and prostate.

We have used the monoclonal estrogen receptor (ER) antibody H222Sp gamma to localize ER by immunocytochemistry in frozen sections of the normal canine urinary tract of both sexes and of the normal prostate of the male. Striking regional heterogeneity of ER location was observed. In the urinary tract, specific ER staining was confined to nuclei of the transitional epithelium (mucosa) and subjacent stroma (submucosa) of the prostatic urethra in the male dog and of the proximal urethra in the female dog. In both sexes there was a gradient of ER staining intensity along these urethral segments. In the male, ER staining intensity was highest in the region of the verumontanum. The pattern and intensity of staining were similar in the male prostatic urethra and female proximal urethra, indicating a similar concentration of ER in these tissues, which have the same embryological origin. No specific staining was found in the kidney, ureter, bladder, or distal urethra of either sex. In the normal prostate, specific immunocytochemical ER staining was confined to nuclei of the prostatic stroma and prostatic ductal epithelium. Specific staining intensity appeared to be higher in the periurethral region of the prostate than in the periphery. No specific staining was found in the acinar epithelium of the prostate. Based on overall staining intensity there appeared to be a higher concentration of ER in the urethra than in the prostate. Scatchard analysis of [3H]estradiol binding confirmed a similar ER content in the urethra of male and female dogs and a higher ER content in the prostatic urethra than in the prostate itself (P less than 0.001). The location of ER in the normal canine prostate and prostatic urethra is consistent with the location of histological changes induced by estrogen administration, indicating that these immunoreactive ER probably represent biologically functional receptors.

Animals↗
PubMed1986

Combined treatment of branched calculi by percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy.

Eighty-seven patients with branched renal calculi were treated by a combination of percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy. Stone debulking was achieved by percutaneous nephrolithotomy and residual stone fragments were destroyed by shock wave lithotripsy. Of the patients 70 (80 per cent) required 2 to 3 treatments, 12 (14 per cent) required 4 treatments and 5 (6 per cent) required 5 to 6 treatments. Results after 3 months indicated that 58 patients were free of stones, 3 had recurrent stones and 12 had disintegrated stone particles (less than 3 mm.) in the collecting system, while 13 were lost to followup. One patient had undergone nephrectomy. This treatment plan minimized the disadvantages of either technique when used alone and made open operative intervention unnecessary. Procedural and fluoroscopy times were reduced drastically compared to reported data on percutaneous nephrolithotomy only. We believe that more than 90 per cent of all branched calculi can be treated with this combined technique.

Adolescent↗