[Principles of directed prevention of urinary calculi].
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Biomedical subjects
Publications and source records attributed to P Burchardt.
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83 prostatic carcinomas were analysed morphologically and clinically before and after combined therapy. The classification of these tumors is based on the proliferation pattern resulting in a group with only one and a group with a variety of growth patterns. The largest groups were carcinomas with glandular structures. On the basis of multiple biopsies the histologic regression of the tumors was determined. In 71% of the cases there was good agreement of morphological results and local palpation findings. Further analyses revealed a correlation between histological growth pattern of the carcinomas and degree of regression: prostatic carcinomas with glandular pattern showed more often a good regression after combined therapy than solid and(or) cribriform tumors. In the groups with a variety of structural pattern the degree of regression was dependent on the prevailing tumor structure. According to these results the organoid-glandular carcinomas of prostate are prognostically more favourable than all the other proliferation patterns. Nevertheless in a single case a prognosis of the therapeutic effect based only on the tumor differentiation can not be made.
Carcinomas of the prostate treated by orchiectomy, 60Co-radiation, and hormonal drugs a relatively short time prior to the time of biopsy were studied with the electron microscope. The following degenerative changes of tumor cells and fibromuscular stroma were found: The nuclei of the tumor cells were intensely heterochromatic, irregularly shaped, and the perinuclear rim dilated; large atypical sizes, multiple segmentations and "nuclear invaginations" were observed. The tumor cell cytoplasm showed vacuolar degeneration, and the limiting membranes of the tumor cells were extensively destroyed. Remarkable changes were also found in the fibromuscular stroma: There was a proliferation of collagenous fibers as well as degenerative transformations ending in hyalinization. The smooth muscle cells were dissociated and fragmented, sometimes showing vacuolar degeneration of the cytoplasm. The endothelium of the blood vessels was swollen, and the vessel walls were thickened. In spite of these radiation-induced lesions it remains undecided as to what degree the other therapeutic measures take part in the total therapeutic effects as seen in the ultrastructural findings. However, these regressive changes are much more pronounced than those seen after orchiectomy alone and partly resemble the findings which are characteristic of radiation induced structural lesions. The morphological changes are not uniform throughout the tumor. It is not unusual to find intact tumor cells next to totally degenerated cells. They represent poorly differentiated tumor cells. It is discussed whether these "embryonic" tumor cell types are and remain resistant to treatment and if a tumor recurrance may originate in them later on.
Nine cystinuric patients (8 females and 1 male) with recurrent L-cystine stone formation have been treated since 1971 with the new drug Thiola (alpha-mercaptopropionyl glycine). Thiola was found to be more effective than D-penicillamine in dissolving L-cystine. In two case a partial dissolution was observed after 20 months of Thiola administration. In four cases further stone growth was stopped. In the last two cases stone growth occurred even after administration of Thiola. Tolerance of the drug was good, and no serious effects were observed sufficient to interrupt treatment.
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