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Biomedical subjects

L Weissbach

Publications and source records attributed to L Weissbach.

At least 127 records · Page 7Linked to original sources
PubMed1985

Value of enucleation of tumor in solitary kidneys.

An untreated malignancy of an anatomic or functional single kidney is fatal. However, tumor enucleation, including examination of the abscission surfaces by immediate per operative section should be considered as a curative treatment. Of 15 patients who underwent tumor enucleation during the past 10 years, 1 died of postoperative complications, while 3 patients died of tumor progression; 9 are alive at 9-49 months with no evidence of disease, and 2 are alive, one with a metastasis and the other with a locoregional relapse in the contralateral kidney bed. Because of the low incidence of complications, superficial hypothermia with ice should be preferred to extracorporeal surgery. The characteristic pseudocapsule allows an enucleation of the malignoma with protection of vessels and optimal preservation of the healthy parenchyma.

Adult↗
PubMed1985

Modified RLND as a means to preserve ejaculation.

According to the results of this trial it is evident that radical RLND constitutes an overtreatment in NSGCTT pathological stage I. The modified RLND limiting the areas of dissection to recognized sentinel nodes combines accurate pathological staging with low morbidity and equal success in terms of postoperative relapse; it is superior to radical RLND in preserving ejaculatory ability. It will thus come to replace the radical approach and will compete favorably with expectant therapy for some time to come. Results of prospective and long-term investigations will help to define subsets of stage I patients for whom RLND may be unnecessary (DeWys et al. 1983; Oliver et al. 1984).

Adolescent↗
PubMed1984

Amino acid activation of amino acid transport System N early in primary cultures of rat hepatocytes.

System N, a neutral amino acid transport system characterized in rat hepatocytes, shows significant changes in activity during the first 24 hr of primary culture (Weissbach, L., Handlogten, M.E., Christensen, H.N., and Kilberg, M.S. [1982] J. Biol. Chem. 257:12006-12011). Experiments presented in the present report demonstrate that during the first 12 hr of primary culture System N can be stimulated by individual amino acids in the culture medium by a cycloheximide-insensitive mechanism. This enhanced activity results from an elevation in the Vmax of the transport system, and the magnitude of the increase is related to the concentration of the amino acid in the culture medium. Nonsubstrates as well as substrates of System N are effective, and trans-stimulation does not appear to play a role in this phenomena. Transport by Systems ASC, Gly, and L is enhanced by the presence of amino acids in the culture medium, but these systems are significantly less sensitive than System N. The results suggest that amino acids act at a posttranslational step to activate System N activity.

Amino Acids↗
PubMed1984

Five-year register and multicenter study for testicular tumours Bonn.

Register and Multicenter Study for Testicular Tumours Bonn was founded in September 1976. Until August 1981, from 46 institutions participating in Austria and the Federal Republic of Germany the data from a total of 1508 patients with testicular tumours have been collected and evaluated. This paper gives an overview on the data available at the moment, and especially informations on the age distribution (children 3.6%, men over 50 years 6.3%), predisposing factors (maldescensus testis 8%, atrophy 6%), masking factors (hydrocele 7%, trauma 7%) and duration of anamnesis (average 136 days).

Adolescent↗
PubMed1984

Therapy in stage I non-seminomatous testicular tumor. A critical review of current strategies.

Currently administered forms of treatment after orchiectomy of non-seminomatous testicular tumor include unilateral (modified) or bilateral (radical) retroperitoneal lymph node dissection (RLND), adjuvant chemotherapy with or without RLND, radiotherapy, and a watch policy with close follow-up ('wait and see'). As diagnostic techniques and therapy concepts improve and new results become accessible, an up-to-date appraisal of these strategies in view of accuracy of staging procedures, of risk of progression, and of morbidity of treatment is being attempted. Our own results of modified and radical RLND are presented. 4 of 55 patients (9.5%) relapsed within 2 years after modified RLND. 1 of 26 patients (Urological Clinic, Bonn) and 13 of 106 patients (Bonn Register of Testicular Tumor) relapsed within 2 years after radical RLND. Relapse rates are 4 and 13.4%, respectively. Correlation between pT stage and rate of progression was found to be significant (95 cases; alpha = 0.01). From data published in the literature and our own data, we conclude that modified RLND with close follow-up is still preferable to other strategy, for reasons of exact staging, low morbidity, and curativity for all patients in clinical stage I. Expected results from current trials on a 'wait and see' approach for patients with low risk of progression may alter this conclusion. The therapeutic advantage of adjuvant chemotherapy for patients with high risk of progression has yet to be demonstrated.

Castration↗
PubMed1984

Second-look lymphadenectomy in the treatment of germ cell testis tumors.

A retroperitoneal relapse of germ cell tumors following retroperitoneal lymphadenectomy (RLA) demands a new treatment regimen aiming towards cure. The combination of primary chemotherapy and subsequent second-look operation has proved successful. The results reviewed are concerned with a revision operation (n = 22) usually following cytostasis (n = 15). In 6 cases, a nonoperable situs was discovered after false-positive findings on examination. In 7 other patients the proposed radical removal of the relapse tumor was successful. Nine times the operation only had a palliative character. After histological examination of the dissectate, we found highly malignant tumor fragments in 9 cases; five times we resected 'mature teratomas'; two times we found only necrotizing or fibrotically degenerated malignoma remnants. The result of the pathological-histological examination has a decisive meaning for the younger patient.

Adolescent↗
PubMed1984

Germinal testicular tumors in childhood. Report of observations and literature review.

1,124 case observations, published from 1955 to 1981, and 45 of our own cases of childhood testicular tumor are evaluated. The age distribution, histology (WHO classification), stage and prognosis are compared to 1,062 adult cases. Diagnostic procedures are itemized. Priorities in the therapeutic approach and the effectiveness of various methods, depending on stage and histology, and toxic side effects and other complications are documented. In children, 29% of childhood testicular tumors are non-germinal, as compared to 8% in adults. 49% are yolk sac tumors. The age distribution differs depending on histology. Metastases occur less frequently (9%) than in adults (61%). Dissemination is predominantly hematogenic. Prognosis is best in teratoma which is cured by orchiectomy. Yolk sac tumor limited to the testicle, in infants less than 2 years old, is sufficiently treated with orchiectomy alone. Older children require adjuvant chemotherapy. Overall, chemotherapy was indicated in 15% of the evaluated cases of childhood testicular malignoma.

Adolescent↗
PubMed1983

[One-time therapy of acute cystitis in women. Comparison between gentamycin and amoxicillin].

In a randomized trial 65 women with symptoms of acute cystitis and significant bacteruria were treated with 120 mg gentamycin intramuscularly or 3 g amoxicillin orally. The patients were selected by excluding those with recurrent infection and involvement of the upper urinary tract (by history and clinical examination). The urine was sterile in 53 patients (82%) after a one-week treatment-free interval. The results indicate that there was no statistically significant difference between the two treatment groups. Further diagnostic tests revealed an underlying urological disease in five of the 12 remaining patients.

Acute Disease↗
PubMed1983

[Incidence of varicocele. Results of serial studies on 3 groups of probands].

Varicoceles were encountered in 21.9% of 2752 men at draft and in 16% of 818 sanatorium patients. There was no decreasing incidence in the latter with increasing age. Fathers were encountered almost equally frequently among men with varicoceles as in men without varicoceles. Varicocelectomy seems to be indicated only when further children are wanted, when abnormalities of the spermiogram are present or testicular abnormalities can be detected on palpation. The validity of preventive removal of varicoceles in adults needs to be ascertained in a randomised and prospective study with concomitant registration of pregnancy rate and spermiograms.

Adolescent↗
PubMed1983

Bilateral testicular tumor.

Of 396 cases of bilateral testicular tumors reported in the literature through 1979 the tumors were the same histologically in 217 cases (seminoma in 163 and nonseminoma in 54), different in 47 and malignant lymphomas in 68; no histological details were given in 64 cases. In our 18 cases of bilateral testicular tumors the tumors were the same histologically in 5 patients (seminoma in 4 and nonseminoma in 1), different in 6 and malignant lymphomas in 7. The epidemiology, interval between the first and second tumors, histology, diagnosis, therapy and prognosis are discussed. Diagnostic measures are determined by the histology of the first tumor and its treatment. Therapy of the second tumor depends on the interval between the 2 tumors as well as on histologic differentiation of the second tumor. The exceptions in the diagnosis, therapy and prognosis for malignant lymphomas are discussed. We do not believe that the prognosis in cases of bilateral germinal cell tumors is poor.

Adolescent↗
PubMed1983

Specificity and sensitivity of human chorionic gonadotropin radioimmunoassays. A comparison of two different approaches.

Two different procedures for determination of HCG in plasma from patients with testicular germ cell tumors, patients with benign disease, and normal controls were applied: (1) measurement of the amount of HCG and its beta-subunit, and (2) assay of the isolated beta-subunit alone. The test which measured the free beta-subunit and the HCG molecule gave 13% more sensitivity in patients with nonseminomatous germ cell tumors. The specificity in blood donors was 100% for both tests. In benign diseases the measurement of the complete molecule gave 100% specificity, whereas the other procedure had a specificity of 95%. For these reasons, the determination of the complete molecule seems to be preferable for patients with nonseminomatous germ cell tumors.

Chorionic Gonadotropin↗
PubMed1983

Primary lymphadenectomy or primary chemotherapy in advanced metastatic testicular tumor?

The treatment of advanced metastasized germ cell tumor consists in a combination of chemotherapy and surgical tumor resection. The sequence of treatment measures is still not uniform. 55 patients with clinically apparent retroperitoneal metastases ('bulky disease') and/or extensive parenchymal metastases are reported. Chemotherapy was performed initially in 40 cases with subsequent resection of the retroperitoneal or parenchymal residues. Of 28 patients with the finding of necrosis/fibrosis or mature teratoma in the dissection preparation, 23 b1e alive and free of tumors. Of 14 patients with the finding of highly malignant tumor, 9 died. In 15 cases, we carried out 'surgical debulking' before chemotherapy: 5 of these patients died as a result of progression in the further course. The advantages and disadvantages of the two treatment modalities are described and discussed. Advanced stages of germ cell tumor with distant metastases should initially be treated with inductive chemotherapy and the tumor residues should subsequently be removed by delayed resection. The sequence in the case of a retroperitoneal 'bulky tumor' without distant metastases is a matter of further discussion and needs a prospective randomized study.

Castration↗
PubMed1983

[Treatment of undescended testis with IH-RH nasal spray].

23 boys from one to 12 years old with 39 undescended testes were treated with LH-RH. This releasing hormone was administered in the form of a nasal spray six times a day. Irrespective of the body weight, the daily dose was 1.2 mg. The treatment was continued for a total of four weeks, even when success was already visible after two weeks. 16 testes reached the desired scrotal position. In addition, pendulous testes developed four times; five testes showed a partial descensus. Of twelve testes which did not alter their position in the craniocaudal direction, four were significantly better mobilizable than previously. Genital and extragenital side effects were rare. In this novel treatment principle, children are spared intramuscular injection (up to now with chorionic gonadotropin). According to available communications, the descensus rate is between 22 and 68% and is comparable to that after HCG therapy. With the release of LH and FSH, LH-RH imitates a physiological hormone phase and thereby leads to descensus. Accordingly, the side effects are less than after HCG. Taking into account the guidelines for treatment of maldescensus testis worked out by the National Health Foundation, this new therapy principle is to be recommended.

Aerosols↗
PubMed1983

[Chemotherapy of malignant testicular tumors].

The role chemotherapy plays in the improvement of prognosis of malignant testicular germ cell tumors is discussed in the light of the development of chemotherapeutic conceptions and stage related strategies. The course of disease in 117 own patients being subjected to cytostatic treatment in 1978-1982 is analysed in detail. In 70% of the cases a complete remission was achieved. Partial remissions generally were of short duration. All toxic side effects are described, the vital threat of panmyelopathy with resulting septicaemia being emphasized. The therapeutic countermeasures are mentioned. Protocols of two prospective clinical trials attempting to answer some of the still open questions regarding chemotherapy are presented.

Adolescent↗