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Biomedical subjects

J E Altwein

Publications and source records attributed to J E Altwein.

At least 145 records · Page 8Linked to original sources
PubMed1978

[Double malformations of the upper urinary tract: complications in adults (author's transl)].

Forty-five adult patients underwent surgical treatment for complications of double malformations of the upper urinary tract. Compared with children, the percentage of incomplete duplications rose from 3--43%, and nephrectomy was necessary in 25% instead of 0 to 8%. The possible effect of the yo-yo phenomenon is discussed. Early surgical intervention might improve the possibilities of saving the organ.

Abnormalities, Multiple↗
PubMed1977

[Kidney stones].

Explore the source record for details and available documents.

Female↗
PubMed1977

Renal lymphangioma.

Lymphangioma cavernosum of the kidney is a benign tumor. Metastasis has not been found in any of the 20 cases reported to date. The sex ratio of patients is 1.5 to 1, favoring female subjects. Average patient age is 33.7 years. Treatment has consisted of nephrectomy in 18 patients, since the possibility of a malignant tumor could not be eliminated preoperatively.

Adenocarcinoma↗
PubMed1977

Long-term followup of children with colon conduit urinary diversion and ureterosigmoidostomy.

Sixty-four children underwent colon conduit urinary diversion because of a neurogenic bladder owing to myelomeningocele and 39 children required a ureterosigmoidostomy because of bladder exstrophy. The average length of followup was 4.6 years after colon conduit and 5.6 years after ureterosigmoidostomy. Colon conduit diversion was secondary in 3 children and ureterosigmoidostomy was secondary in 5. Of the children with a colon conduit 9.4% and of those with ureterosigmoidostomy 12.8% had postoperative surgical complications. Late surgical complications were encountered after colon conduit in 14.5% and after ureterosigmoidostomy in 20%. Of the children with normal renal function preoperatively 8.3% showed late deterioration after colon conduit and 8.7% after ureterosigmoidostomy. Conversely, only 16.7% with impaired renal function preoperatively did not improve at long-term followup after colon conduit. Of the renoureteral units 91% were normal after colon conduit and 95.2% were normal after ureterosigmoidostomy. The colon conduit halted the preoperative pyelonephritis in 74% of 31 affected kidneys.

Adolescent↗
PubMed1977

Ultrasound litholapaxy of a staghorn calculus.

A method for removal of a staghorn calculus from the kidney through 1 channel of a U-tube nephrostomy is presented. An ultrasound lithotriptor provided a safe and quick alternative to surgical treatment.

Female↗
PubMed1977

Followup of irradiated prostatic carcinoma by aspiration biopsy.

Of 66 patients with irradiated prostatic carcinoma 53 were controlled regularly by repeat aspiration biopsy every 6 months. Local sterilization was achieved in 43 per cent but the results of combined radiotherapy (endocrine therapy plus irradiation) were only 8 per cent more favorable than those in patients treated by radiotherapy alone. Thus, endocrine therapy is not warranted before the radiation effect is evaluated. Post-radiation treatment should be determined by the clinical and bioptic findings.

Aged↗
PubMed1977

[Megacaliosis--diagnosis and differential diagnosis (author's transl)].

Megacaliosis is a renal dysplasia which is characterised by rudimentary papillae. The pathogenesis, clinical features and radiological appearances in fire cases are described and the differential diagnosis from other types of calyceal ectasia is discussed, In typical cases the diagnosis of megacaliosis can be made from the excretion urogram. We regard divided renal function studies as essential before making the diagnosis. Where the renal changes are not quite typical, it is necessary to exclude obstructive and inflammatory disease, vesico-ureteric reflux and renal tuberculosis.

Adult↗
PubMed1977

[Fine needle puncture for antegrade pyelography and percutaneous nephropyelostomy (author's transl)].

A method for antegrade pyelography and pyelonephrostomy is described using a long, thin needle with a shorter, wider Seldinger cannula. Puncture with a thin needle reduces the risk during antegrade demonstration of the upper urinary tract and can also be used for puncturing collecting systems which are only slightly dilated. When necessary, the Seldinger cannula can be advanced over the needle; subsequently, with the aid of a J-wire, a nephropyelostomy can be performed. The method has been used in 20 patients. In one case of intended bilateral nephropyelostomy the puncture was successful on only one side. There were no serious complications. In only one patient a small perirenal haematoma was found at operation.

Catheterization↗
PubMed1977

Kinetics of 3H-testosterone and 3H-dihydrotestosterone metabolism in patients with benign prostatic hypertrophy. Effect of cyproterone acetate.

The response of 3H-testosterone and 3H-dihydrotestosterone to the administration of cyproterone acetate (CA) over a period of 5 days was investigated. Both tracers were injected intravenously in patients with benign prostatic hypertrophy. Blood was withdrawn for up to 5 h. Benign prostatic hypertrophy tissue was obtained by transurethral resection. Nine patients served as controls. Eleven patients received 300 mg CA intramuscularly. Cyproterone acetate suppressed testosterone and FSH, but not LH. 3H-testosterone was cleared more rapidly from plasma in the patients given CA presumably due to increased metabolism in the liver. 3H-dihydrotestosterone, however, remained virtually uninfluenced. Moreover, CA did not significantly alter the 3H-testosterone and 3H-dihydrotestosterone uptake and metabolism within prostatic tissue.

Aged↗
PubMed1977

[Bladder carcinoma: therapeutic concept of the Urology Department of the University Hospital, Mainz].

A therapeutic concept based on tumor staging and grading is presented: T0N0M0 - urine cytology positive - cystoscopy every 3 months. Transitional cell carcinoma (90%): T(iS)N0M0 - carcinoma in situ - cystoscopic biopsy every 3 months. Cystectomy with commencing tumor infiltration. T1N0M0 (80% of all bladder tumors): T1N0M0G0 - TUR; cystoscopy every 3 months. T1N0M0G1-3 - TUR; control-TUR 6 weeks later with systematic biopsy. G3 with tumor recurrence - cystectomy. T2N0/N1M0; G1-2 - TUR; local chemotherapy (adriamycin). G3 - cystectomy; high voltage treatment in inoperable patients. T4NxMx - symptomatic-palliative therapy: TUR, urinary diversion. Squamous cell carcinoma (2-5%): as transitional cell carcinoma; with high voltage therapy adjuvant chemotherapy using bleomycine. Adenocarcinoma (2-3%): as transitional cell carcinoma; cystectomy including part of the anterior abdominal wall and umbilicus. Immunostaging (assessment of the immunocompetence) should be part of the diagnostic procedures and follow-up examination.

Adenocarcinoma↗
PubMed1977

[Pelvic lymphadenectomy as a staging operation for prostate carcinome (author's transl)].

As a staging operation for prostate carcinomas in clinical stages B (6/27) and C (21/27), 27 pelvic lymphadenectomies were performed. In stage B, a radical prostatectomy was performed; patients in stage C also received radiation. Preoperatively, lymphographic and histologic findings that were in agreement were available for only 74%. The immediate mortality was 0%, the postoperative morbidity 29%.

Abscess↗
PubMed1976

Effect of prolactin and the anit-prolactin bromocriptin on the testosterone uptake and metabolism in androgen-sensitive and insensitive canine organs.

Prolactin promotes the growth and function of the prostate in low doses, whereas high doses or previous castration reduce this effect. The antiprolactin bromocriptin should reverse the prolactin action. In the castrated dog the highest accumulation of H3-testosterone given i.v. occurred in the prostate as compared with muscle, urethra, penis, liver and kidney. Prolactin pretreatment increased the radiosteroid uptake only in the liver. Converseley, bromocriptin suppressed the tracer incorporation into the liver, but increased prostatic accumulation. The highest testerone reduction occurred in the prostate of the untreated castrated dogs as compared with other organs. Prolactin suppressed 5 alpha -dihydrotestosterone formation but otherwise did not significantly influence testosterone turnover. Bromocriptin, however, stimulated dihydrotestosterone formation in the prostate and caused complete inhibition of hepatic testosterone reduction.

Animals↗
PubMed1976

Testosterone metabolism in benign prostatic hypertrophy: in vivo studies of gestonorone caproate and cyproterone acetate.

18 patients with obstructive benign prostatic hypertrophy were studied. A 5-day treatment with gestonorone caproate (200 mg daily and 200 mg on alternate days) and cyproterone acetate (300 mg daily) suppressed the plasma LH and serum LH levels. Subsequently, H3-testosterone was injected intravenously and its elimination from plasma and uptake and metabolism in the BPH tissue studied. The elimination of total radioactivity and H3-testosterone from plasma was not altered after the 3 treatment regimens as compared to the control group. The uptake of total radioactivity into BPH tissue and its intraprostatic metabolism particularly to dihydrotestosterone was significantly suppressed in the patients with daily injections of gestonorone. Cyproterone acetate and gestonorone caproate on alternate days did not cause this effect.

Aged↗
PubMed1976

The influence of the progestogen gestonorone caproate on testosterone turnover in renal cell carcinoma. An in vitro study.

To investigate the effect of gestagens on renal cell carcinoma 300-mg slices of normal, human kidney, renal cell carcinoma (RCC), and preoperatively irradiated RCC were subjected to a short term incubation with 200 pmoles of 3H-testosterone and 1 and 2 mug of gestonorone caproate. In the normal kidney 61.4 per cent of the testosterone added was metabolized, the oxidation products androstenedione and epitestosterone outweighing by 6:1 the reduction products 5alpha-dihydrotestosterone and androstanediol. In RCC only 22 per cent of the testosterone was metabolized, with 8.5 per cent being converted to 5alpha-androstanes. Gestonorone caproate essentially did not influence testosterone turnover. This can be explained by its action as an inhibitor of the reductive pathway of the testosterone metabolism only, which is insignificant in these tissues.

Adenocarcinoma↗
PubMed1975

A systematic study of testosterone metabolism in benign prostatic hypertrophy (BPH): in vitro results.

An in vitro system for testing steroids which might be effective in treating benign prostatic hypertrophy (BPH) has been developed based upon the transformation of H-3-testosterone into the 5-alpha-reduction products dihydrotestosterone and 3-alpha-androstanediol. In scrutinizing the influence of the amount of BPH-tissue, time, and pH, 300 mg of tissue incubated for 2 h at the physiological pH of 7.4 were used in the standard experiment. -The H-3-testosterone concentration was varied from 0.17-100 times 10-8 M. Plotting the resulting 5-alpha-reduction products as a function of testosterone concentration a hyperbolic pattern of enzyme kinetics ensued. Performing a double reciprocal plot of 4 experiments with double determination of each value regression lines could be computed. Those two regression lines most different in their slopes were considered "normal" limits. The rate of H-3-testosterone metabolism could not be enhanced after the endogenous testosterone content within the prostate glands had been used up by means of a preincubation. Scrutinizing the effect of heparin, a weak non-specific enzyme inhibitor, no suppression of the appearance of 5-alpha-reduction products was found. Damaging the BPH-cells, however, by repetitive freezing and thawing lead to an almost complete inhibition of H-3-testosterone turnover.

Androstane-3,17-diol↗
PubMed1975

Postpuberal castration and prostatic carcinoma.

The occurrence of prostatic carcinoma after postpuberal castration is rather unique since only one other case has been reported. However, there was no lack of androgens in the patient in this report, because the testicular ablation was compensated by nodular hyperplasia of the adrenal cortex maintaining a normal plasma testosterone.

Adenocarcinoma↗