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Biomedical subjects

R Hartung

Publications and source records attributed to R Hartung.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Nerve preserving retroperitoneal lymph node excision in non-seminomatous testicular cancer].

Thirty-nine patients with a non-seminomatous testicular tumor underwent retroperitoneal lymphadenectomy (RPLND) between 12/90 and 7/93. Twenty-four patients with stage I disease were operated on with a modified nerve-sparing RPLND, while 7 patients with stage IIA and 8 patients with stage IIB had bilateral RPLND. Twelve of fifteen patients with stage IIA and IIB had preservation of their sympathetic postsynaptic fibers. Intraoperative electric stimulation of the fibers resulted in ejaculation in 25/26 patients. Semen analysis revealed 21 patients with necrospermia and maturation arrest, while 3 had aspermia. Antegrade ejaculation was restored after 1.1 months following nerve-sparing RPLND and 7 months following radical RPLND. Ejaculation did not return in one patient. No patient showed relapse. Our results show that the sympathetic postsynaptic fibers can be preserved during RPLND. Nerve-sparing RPLND is superior to radical and modified RPLND with regard to preservation of ejaculation without compromising the radicalness of the tumor surgery.

Adult↗
PubMed1994

[Microsurgical techniques in urology].

Microsurgery is an established operative technique for refertilization by vasovasostomy, tubulovasostomy and microsurgical epididymal sperm aspiration. Other andrological indications for the use of a microscope are penile revascularization, resection of varicocele and surgical treatment of Peyronie's disease. Autotransplantation of intra-abdominal testicles and hypospadia correction are indications for microsurgical techniques in pediatric urological surgery. Renal transplant, sex-change surgery and replants of penis and scrotum are further indications for use of microsurgery. Microsurgery will move into new fields of urological surgery, especially neurourology.

Adult↗
PubMed1994

[Microsurgical therapy of occlusive azoospermia].

From 5/88 to 8/93 148 patients were operated on for obstructive azoospermia using a microsurgical technique. In 68 patients we performed a vasectomy reversal by vasovasostomy (VT), 42 patients underwent a tubulovasostomy (TT), and 8 patients had a VT with contralateral TT. Two patients had implantation of an alloplastic spermatocele, 9 patients had microsurgical epididymal sperm aspiration (MESA), and 19 patients microsurgical exploration. Patency was achieved in 89% of patients after VT and in 32% after TT. A pregnancy occurred in 34% after VT and in 13% after TT. No pregnancy was achieved after MESA or alloplastic spermatocele. A microsurgical procedure is necessary for the treatment of congenital or acquired obstructive azoospermia.

Adult↗
PubMed1994

[Report of experience in reconstruction of the lower urinary tract in the man and woman].

For some decades uretero(ileo) cutaneostomy and ureterosigmoidostomy were the methods of choice for urinary diversion in cystectomized patients. In recent years, lower urinary tract reconstruction with an anastomosis from an intestinal urinary reservoir to the urethra has established itself as an alternative for male patients undergoing cystectomy. We present the results obtained in 35 patients (32 men, 3 women) who chose to have a ureteroileal urethrostomy to the residual urethra after radical cystectomy for bladder cancer. These patients were followed up by clinical, serologic, radiographic, and urodynamic evaluation conducted at short intervals according to a strict protocol. There was no perioperative mortality, and the early postoperative complication rate was 17% (6/35 patients). For all patients, including those followed only for 3 months so far, the diurnal continence rate was 87% and the nocturnal continence rate was 78%. In every patient, male and female, the maximum urethral pressure (average value in the urethra pressure profile 50.8 cm H2O) was higher than the average resting intraluminal pressure in the pouch (average 12 cm H2O) with physiologic capacity (250-550 ml) of the urinary bladder. Patient acceptance, measured on a numerical self-rating scale, was high (average value 8.75 out of 10).

Adult↗
PubMed1993

Detection of somatic changes in human renal cell carcinomas with oligonucleotide probes specific for simple repeat motifs.

The purpose of our study was to detect somatic changes in renal cell carcinoma by multilocus fingerprinting. DNA fingerprints were generated from the DNA of normal and malignant renal tissue samples of 29 patients with nonhereditary kidney carcinoma by using oligonucleotide probes specific for simple repeat motifs such as (GTG)5, (CA)8, (GACA)4, or (TTAGGG)3. Each probe rendered a typical fingerprint pattern, because it is specific with respect to the target regions recognized in the genome. The restriction enzymes used were HinfI and HaeIII. Changed banding patterns were detected by using (GTG)5 in 20% of the tumors, in 20% for (CA)8 after HinfI digestion, and in 10% after HaeIII digestion. Even more informative probes were (GACA)4, showing 70% changes after HaeIII digestion, and (TTAGGG)3, with 80% changes after digestion with either enzyme. Since the simple repeat motifs recognized by (GACA)4 are localized on the short arms of the acrocentric chromosomes (13, 14, 15, 21, and 22), it is possible that sequences important for renal carcinogenesis are present in these regions. The observation of changes in regions to which (TTAGGG)3 hybridizes points to an involvement of DNA elements in telomeric sequence related regions in human kidney tumor formation.

Adult↗
PubMed1993

Inhibitory effects on in vitro cell growth of human urothelial tumor cell lines under the combined administration of hematopoietic growth factors and clinically relevant antineoplastic agents.

In five of eight human transitional carcinoma cell (TCC) lines a proliferative response has been reported during exposure to interleukin-3 (IL-3), granulocyte-macrophage colony stimulating factor (GM-CSF) and granulocyte colony stimulating factor (G-CSF). To elucidate possible growth-modulating effects of these factors combined with clinically relevant antineoplastic agents, cells of the human TCC lines EJ28 and T24 were exposed to methotrexate (MTX), vinblastine (VBL), doxorubicin (DXR) and cisplating (CDDP) with and without single or continuous exposure to IL-3, GM-CSF and G-CSF at concentrations of 1-100 ng/ml. Compared with cells exposed only to chemotherapy, significant inhibitory effects occurred as a result of continuous exposure to IL-3 or GM-CSF at the highest activities with CDDP and MTX in the T24 and EJ28 lines; continuous G-CSF administration (100 ng/ml) in combination with MTX led to significant growth inhibition in the EJ28 line. In contrast, no significant growth modulation was found on combined administration of DXR or VBL with any one of the three colony stimulating factors tested.

Antineoplastic Agents↗
PubMed1993

Angiotensin II enhances insulin sensitivity in healthy volunteers under euglycemic conditions.

OBJECTIVE: It has been postulated that vasoconstrictors cause insulin resistance. This effect has been documented for epinephrine but not for angiotensin II (Ang II). The aim of this study was to investigate the effect of the latter on insulin sensitivity. DESIGN: In order to study the influence of subpressor doses of Ang II on insulin-mediated glucose uptake under euglycemic conditions, eight healthy volunteers were allocated in random order to sham infusion or infusion of Ang II (first 0.75 ng/kg per min and subsequently 1.5 ng/kg per min). In addition, in seven of the subjects Ang II was infused after 3 days of indomethacin pretreatment (150 mg/day). METHODS: Insulin-mediated glucose uptake (expressed as M value) was measured with the euglycemic clamp technique. Insulin levels were measured enzymatically, plasma renin activity, Ang II, aldosterone and C-peptide levels by radioimmunoassay, blood pressure by Dinamap and muscle blood flow by plethysmography. RESULTS: The M value after sham infusion was 7.81 +/- 1.52 mg/kg per min and after 1.5 ng/kg Ang II per min was 9.76 +/- 1.26 mg/kg per min (P < 0.001). Indomethacin pretreatment did not abolish the Ang II-induced rise in the M value. Mean arterial blood pressure during the euglycemic clamp was unchanged with sham infusion and the low dose of Ang II. It increased slightly with the higher dose of Ang II. Inferior limb muscle perfusion was higher after infusion of Ang II than after sham infusion; this effect was not obliterated by indomethacin pretreatment. CONCLUSIONS: Ang II increases insulin-mediated glucose uptake: that is, it enhances insulin sensitivity by mechanisms independent of prostaglandins. The observations are of potential relevance to the changes in insulin sensitivity in some forms of hypertension.

Adult↗
PubMed1993

Contrasting renal haemodynamic effects of protein in normal subjects and glomerulonephritic patients with impaired renal function.

The effects of a protein load on renal haemodynamics in patients with renal failure are controversial. We measured insulin clearance (Cin) and PAH clearance (CPAH) by constant infusion technique in six healthy subjects and 13 patients with biopsy-confirmed glomerulonephritis and chronic renal failure. The subjects were pre-equilibrated on their usual diet and studied before and 2 h after 1 g protein/kg as cooked red meat. In healthy subjects this caused a significant increase of Cin (from 136 +/- 7.2 (SD) to 148 +/- 7.9 ml/min/1.73 m2) and of CPAH (from 547 +/- 142 to 639 +/- 89). In contrast Cin decreased from 72.7 +/- 7.7 to 60.3 +/- 8.4 in patients with chronic renal failure, whereas CPAH showed no significant change (from 275 +/- 67.8 to 278 +/- 72.7). A similar decrease of Cin was also seen with acute infusion of amino acids (AA). The change in Cin was not related to changes of PRA or concentrations of plasma amino acids. While absolute and fractional Na excretion increased in controls, they decreased in patients in parallel with the decrease of Cin. The decrease of Cin after infusion of AA was amplified by pre-equilibration on low-sodium diet (20 mmol Na/day). The effect of meat ingestion on Cin was not obliterated, however, by pretreatment with captopril (25 mg b.i.d. for 7 days). In conclusion, in patients with chronic renal failure, a paradoxical decrease in Cin is seen both after oral protein and after amino-acid infusion.

Adult↗
PubMed1992

Modulation of in vitro cell growth of human and murine urothelial tumor cell lines under the influence of interleukin-3, granulocyte-, macrophage- and granulocyte-colony-stimulating factor.

To elucidate possible growth-modulating effects of interleukin 3 (IL-3), granulocyte-macrophage-colony-stimulating factor (GM-CSF) and granulocyte-colony-stimulating factor (G-CSF), human transitional cell carcinoma (TCC) cell lines T24, RT112, EJ and 647 V were solitarily and continuously exposed to these hematopoietic growth factors at concentrations of 1-100 ng/ml. The murine line MBT-2 was used as a negative and the colon carcinoma cell line HTB38 as a positive control, because of species specificity and known proliferation in response to growth factors, respectively. In the T24 TCC-line solitary and continuous exposure to IL-3, GM-CSF and G-CSF at the highest concentration of 100 ng/ml led to a significant proliferation of cell growth in vitro. Significant proliferation in the RT112 line was only achieved with continuous exposure to IL-3 and GM-CSF (100 ng/ml); G-CSF failed to induce growth modulation in the RT112 line. No significant proliferative effect of any of cytokines administered was observed in the 647V line. Exposure of the EJ line to cytokines at the highest activity levels had a proliferative effect only in suboptimal growth conditions.

Adenocarcinoma↗
PubMed1992

Adenosine triphosphate and adenosine diphosphate in human semen: correlation with sperm count and motility.

Adenosine triphosphate (ATP) and adenosine diphosphate (ADP) have been correlated with traditional semen parameters such as forward motility and sperm count. ATP and ADP were determined by a bioluminescence assay using the luciferin-luciferase reaction. Short boiling of the ejaculate was performed to inactivate phosphatases (ATPases) in the seminal plasma and the sperm tails. Fresh and deep-frozen semen samples from 45 men with oligozoospermia (n = 22) and normal sperm count (n = 23) were evaluated. Freezing of the sperm for 12 weeks did not effect the ATP or ADP content in the spermatozoa as compared to fresh semen. ATP and ADP concentration was in the range of picomoles/microliter and showed a significant correlation with the number of normal sperm per milliliter and a less marked correlation with the sperm motility. ATP and ADP concentration in the spermatozoa can be measured relatively easy and is reproducible. Unlike the monotonous evaluation of sperm motility by a technician, this biochemical method provides an objective parameter for semen quality. These qualities suggest that this method could be a way to determine the fertilizing potential of semen and to relate this to actual pregnancy rates.

Adenosine Diphosphate↗
PubMed1992

Implantation metastasis after a suprapubic catheter in a case of bladder cancer.

We report about a patient who was treated with a percutaneous suprapubic cystostomy in order to relieve repeated urinary retention. Two hours later a bladder tumor was found and the suprapubic catheter was removed. After transurethral resection of the bladder tumor the histological specimen showed a pT3 G3 squamous cell carcinoma. Because of the age and reduced performance status of the patient a radical cystectomy was contraindicated. In a second approach we performed again a transurethral resection of the bladder tumor simultaneously with a resection of the prostate. Eight weeks later the patient was admitted to our hospital because of reduced performance status and gross haematuria. We found a widespread bladder tumor with an implantation metastasis in the abdominal wall at the site where the suprapubic catheter was placed and multiple lung metastases. The patient died within one week after admission. The literature is reviewed and therapeutic strategies are discussed.

Aged↗
PubMed1992

Effect of digital rectal examination on serum concentration of prostate-specific antigen.

Prostate-specific antigen (PSA) is used for screening and follow-up of patients with prostate cancer. The effect of certain diagnostic procedures on PSA serum levels is not well defined. Therefore, the effect of digital rectal examination (DRE) on PSA serum levels was investigated. No significant difference was observed in PSA values before and after DRE when blood samples were taken 1-3 min after palpation of the prostate. Kinetic studies demonstrated a significant increase in PSA values up to the factor 3.2 in 14 of 19 patients 2-6 h after DRE. In 9 of 14 cases, PSA was within the initial range 24 h after DRE. That means that a urologist is allowed to take blood samples for the determination of PSA at least within 3 min after palpating a suspicious prostate without getting false-positive results.

Aged↗
PubMed1992

Patterns of ploidy in renal cell carcinoma.

In a prospective study the patterns of ploidy in 119 kidneys from patients with renal cell carcinoma were analyzed by flow cytometry. A rate of DNA aneuploidy of 53% was observed in the investigated tumors. However, in 4% of the kidneys aneuploid cell distributions were also proven in macroscopically intact tissue far away from the tumor. Although we do not know at present, if these were benign, premalignant or malignant cell alterations, this observation should be considered for decisions regarding conservative renal surgery.

Aneuploidy↗
PubMed1992

[Pedicled penis skin flap for unilateral correction of extensive urethral strictures including meatus reconstruction].

Many techniques have been described for the repair of recurrent urethral strictures. We report our experience with the use of vascularized island skin flap repairs of urethral strictures as a one-stage procedure in 24 patients and describe the rationale for selection of the procedure, surgical technique used, results and complications. Using the pedicled penile island flap and the inner preputial skin one-stage correction is possible in urethral strictures up to the tip of the penis. The combined use of scrotal skin increases the risk of complications and thus should be avoided. Meatal reconstruction as described by De Sy gives excellent functional and cosmetic results.

Adolescent↗