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Biomedical subjects

J E Altwein

Publications and source records attributed to J E Altwein.

At least 127 records · Page 7Linked to original sources
PubMed1979

Alterations of peripheral testosterone matabolism after induced hypoprolactinemia in patients with prostatic carcinoma.

In 12 patients with advanced prostatic carcinoma the effect of bromocriptine-induced hypoprolactinemia on the peripheral androgen metabolism was investigated after 3H-testosterone injection under conditions that each individual served as his own control. After a 5-day significant prolactin suppression, the elimination of 3H-label 1 h after testosterone injection was about 45% and equal to pre-bromocriptine values. The recovery of dihydrotestosterone separated by silica gel T.L.C., however, was significantly augmented, resulting in a marked decrease of the testosterone/dihydrotestosterone ratio from 12.2 to 6.3. This induced 5alpha-reductase activity after prolactin suppression is in accordance with our earlier findings on prostatic carcinoma tissue, matches well with observations of Magrini et al. on induced hyperprolactinemia and may be a new approach to the understanding of androgen dependent disorders.

Aged↗
PubMed1979

Percutaneous nephropyelostomy using a fine-needle puncture set.

The authors describe an improved method of percutaneous nephropyelostomy using a long, fine, flexible needle combined with a wider and shorter cannula. The needle facilitates atraumatic puncture of the renal collecting system and antegrade pyelography and subsequently serves as a guide over which the nephrostomy cannula is inserted. This technique was successful in 105 of 115 procedures (93 patients) over a period of 15 months and has replaced operative nephrostomy in the author's hospital.

Humans↗
PubMed1979

[Bromocriptine for palliation of advanced prostatic carcinoma. Experimental and clinical profile of a drug (author's' transl)].

Since prolactin has several modes of action on prostatic growth and physiology, the effect of the antiprolactin bromocriptine on plasma kinetics and intraprostatic metabolism of testosterone was studied in patients with untreated prostatic cancer; a therapy protocol was deduced which was controlled in 27 patients with advanced inoperable prostatic adenocarcinoma. Bromocriptine resulted in a significant suppression of prolactin and testosterone as well and favored testosterone elimination from the plasma pool. Prostatic androgen uptake was enhanced and the intraprostatic metabolism altered in relation to tumor grade. Adjunctive administration of bromocriptine to 27 patients, mostly in the state of hormone resistance, resulted in an overall objective regression of 22.2% and in stable disease in 55.6% of the patients. In half of the individuals a prompt relief of bone pain from osseous metastases was observed as well as improvement of micturition and decline of phosphatase activity. This preliminary data justify further investigations under controlled and randomized conditions.

Adenocarcinoma↗
PubMed1979

[Adenocarcinoma of the bladder (author's transl)].

During a 10 year follow-up, 18 patients with primary adenocarcinoma of the bladder or urachus were treated operatively. We report on the therapy and results. The criteria for differentiation between primary adenocarcinoma of the bladder and urachal carcinoma are stressed. Chronic irritation of the urothelium is most likely involved in the natural histroy of primary adenocarcinoma. Cystectomy should be the therapy of choice for the adenocarcinoma of the bladder. A partial resection is recommended for urachal carcinoma. Palliation is possible with cytotoxic agents. Irradiation seems to be of no beneficial effect on tumor growth.

Adenocarcinoma↗
PubMed1979

[Bromocriptine and prostatic carcinoma: testosterone metabolism in relation to tumor grading (author's transl)].

Since Prolactin has intra- and extrapostatic effects on growth and function of the prostate, the influence of the anti-prolactin bromocriptine (PRAVIDEL) was investigated in 15 patients with untreated prostatic carcinoma of various grades of differentiation in vivo. A five-days treatment with 15 mg Pravidel daily significantly suppressed prostatic androgen uptake, unrelated to tumor grading. 5 alpha-Reductase was favored in poorly differentiated lesions with a decreased testosterone/dihydrotestosterone ratio. The pretherapeutic accumulation of 5 alpha-androstanediol was diminished after Pravidel and the tissue/plasma ratio decreased. The 17 beta-hydroxy-pathway of testosterone is predominant as compared to the 17-keto pathway; both pathways are favored after Pravidel in poorly differentiated tumors. Intraprostatic metabolic effects of Pravidel are not related to peripheral androgen levels nor are they dependent on altered prostatic hormone uptake. In the poorly differentiated prostatic tumors Pravidel initiates a metabolic situation as observed in prostate cancer responding to androgen depletion or estrogen therapy.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1979

[Cystectomy as "ultima ratio" after failure of radiotherapy in bladder cancer (author's transl)].

20 patients were cystectomized an average of 2 years after unsuccessful curative radiotherapy. This technically difficult procedure has a high mortality rate of about 10--20%. None of the patients survived more than 5 years, but improved quality of life was the main subjective impression. A tumor-free specimen -- the effect of radio-induced downstaging -- is no guarantee of long-term survival. 4 of 6 patients without histological tumor cells in the cystectomy or lymph node specimens died of metastic disease. The indications for "salvage" cystectomy were: untreatable bladder hemorrhage, in some instances as emergency; frequently recurrent tumors; and subjectively unbearable state of disease.

Aged↗
PubMed1978

Testosterone metabolism in patients with advanced carcinoma of the prostate: a comparative in vivo study of the effects of oestrogen and antiprolactin.

In the light of the high incidence of cardiovascular side effects with oestrogen therapy in patients with prostatic cancer, other medications altering androgen metabolism are under investigation. The influence of the anti-prolactin bromocriptin (CB157) on plasma kinetics of testosterone and on endogenous hormones was studied and compared with the effect of ethinyl oestradiol in 25 patients with prostatic carcinoma. Bromocriptine significantly suppressed both prolactin and testosterone, inhibited the transfer of androgen from the inner pool into the deep compartment and favoured its degradation. Ethinyl oestradiol decreased testosterone, LH and FSH, and prolonged the biological half-life of testosterone. The effects of bromocriptine on androgen metabolism might be of therapeutic value in patients with prostatic carcinoma.

Bromocriptine↗
PubMed1978

Prostatic carcinoma: plasma kinetics and intraprostatic metabolism of testosterone in low-dose estrogen-treated patients in vivo.

Plasma kinetics, in vivo uptake, and intraprostatic metabolism of 3H testosterone was investigated in 9 patients with advanced carcinoma of the prostate. The metabolic effect of low-dose ethinyl estradiol was studied (estrogen suppressed testosterone, luteinizing hormone, and follicle-stimulating hormone). The production rate of testosterone was lowered, the elimination of androgen from plasma delayed. The uptake of testosterone and metabolites by the prostatic carcinoma was suppressed. Estrogen did not alter significantly the intraprostatic androgen turnover.

Aged↗
PubMed1978

The Lich-Gregoir antireflux plasty: experiences with 371 children.

The Lich-Gregoir antireflux procedure is a simple and safe method for the treatment of primary reflux of all grades if the ureter is not grossly dilated on the excretory urogram. Reflux was cured in 97.7 per cent of 429 ureters in 371 children. A stenosis of the terminal ureter requiring reimplantation occurred in 0.5 per cent. The over-all rate of reinterventions was 3.7 per cent. This low complication rate makes surgical correction of reflux advisable if urinary tract infection and primary reflux cannot be eradicated by continuous antimicrobial therapy within 6 months.

Adolescent↗
PubMed1978

Bromocriptine and prostatic carcinoma: plasma kinetics, production and tissue uptake of 3H-testosterone in vivo.

The influence of the anti-prolactin bromocriptine on plasma kinetics, production rate and tissue uptake of testosterone was investigated in 15 patients with newly diagnosed stages C and D prostatic carcinoma. Bromocriptine was given for 5 days in a daily dose of 15 mg. orally. The studies were performed with the single injection technique using the 2-compartment model. Plasma testosterone, serum prolactin, and luteinizing and follicle-stimulating hormones were determined initially. Blood samples were drawn up to 5 hours after the injection of 3H-testosterone. For tissue studies a transrectal needle biopsy was done 3 hours post-injection. Bromocriptine suppressed prolactin and the endogenous testosterone level. Furthermore, it favored the elimination of 3H-testosterone, lowered the production rate of testosterone and hampered the in vivo uptake of the 3H-label into prostatic carcinoma tissue. Finally, the grading of the tumor lesions affected only the pre-bromocriptine uptake of radioactive androgens and not the uptake in response to bromocriptine. The potential clinical impliications of these observations are discussed.

Aged↗
PubMed1978

[Percutaneous nephro-pyelostomy applications and results (author's transl)].

The use of percutaneous nephro-pyelostomy with a fine needle is described after 90 examination in 70 patients. Fine needle pyelography is used for antegrade demonstration of suspected ureteric obstruction when there is no renal excretion. Percutaneous nephro-pyelostomy can be used to assess the recovery of renal function after decompression, as well as for pressure measurements pre-operatively before carrying out plastic operations (Whitaker). Percutaneous nephropyelostomy offers the possibility of temporary or permanent urinary diversion in the presence of obstruction. In our own experience, the percutaneous method has almost totally replaced operative nephrostomy whenever supravesical drainage is necessary. In addition, it can be used for treating fistulas, antegrade splinting of the ureter or percutaneous removal of stones. Complications of renal puncture consisted of two small perirenal haematomas and two patients with short-lived haematuria, as well as one case of septicaemia with rapid recovery.

Adolescent↗
PubMed1978

[Differential therapy of vesico-intestinal fistulas].

40 patients with vesico-intestinal fistulas (50% inflammatory, 30% traumatic, 20% neoplastic) were treated within 10 years. Closure was achieved in 97% of 31 patients operated on with curative intention. The remaining 9 patients had palliative surgery, i.e. colostomy or cystostomy. The decision single- or multiple-stage procedure depends upon the etiology, localization and extent of the fistula.

Colostomy↗
PubMed1978

[Urological Hodgkin's disease (author's transl)].

Manifestations and complications of Hodgkin's disease in the urinary tract can appear as alterations of the kidneys (stag's antlers type), compression and displacement of the ureter (ureteric type), or as chemotherapeutically induced cystitis (Endoxam type). All these complications were found consecutively in the case documented here. The diagnosis was made on the basis of the symptoms, the findings in the i.v. urogram, and cystoscopy; it was confirmed post mortem by the autopsy. In this advanced case of Hodgkin's disease, only the hemorrhagic cystitis warranted therapy.

Adult↗