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T Otto

Publications and source records attributed to T Otto.

At least 91 records · Page 5Linked to original sources
PubMed1996

Results of postchemotherapy adjunctive retroperitoneal lymph node dissection in non-seminomatous germ cell cancer patients.

Cisplatin-based chemotherapy is highly effective in non-seminomatous testicular cancer. Patients with advanced disease receive two to four cycles of polychemotherapy. Residual retroperitoneal masses after chemotherapy are suspected to contain active tumour tissue as well as mature teratoma. Therefore, a delayed retroperitoneal lymph node dissection remains necessary. A total of 123 patients with advanced non-seminomatous germ cell cancer underwent retroperitoneal surgery after two different regimes of cisplatin-based chemotherapy. The first group (n = 55) received a sequential alternating chemotherapy with Adriamycin/cisplatin and bleomycin/vinblastine (8.5 +/- 5 cycles, 1979-1985), the second group (n = 60) got a standard PEB scheme (cisplatinum /etoposide/bleomycin; 5.7 +/- 2.1 cycles, 1985-1991). Eight patients got other cisplatin-based combinations. All patients received adjunctive retroperitoneal surgery. After a mean follow-up period of 72 months, the patients treated with the sequential alternating scheme showed a survival rate of 50% (27/54, 1 patient lost to follow-up). After the PEB scheme a survival rate of 79% (46/58, 2 patients lost to follow-up) was found. 86% of the patients with retroperitoneal necrosis after retroperitoneal lymph node dissection (RPLND; n = 58) survived with no evidence of disease, as well as 82% of the patients with adult teratoma (n = 18). Only 47% of the patients with residual active carcinoma after RPLND (n = 47) survived within a follow-up period of (median) 72 months, despite further chemotherapy after RPLND. Residual tumor burden and type of histology after RPLND can partially predict the clinical outcome. A necrotic specimen in RPLND could not be predicted by any means, so that surgical removal of a residual retroperitoneal mass after chemotherapy remains necessary. Standard PEB chemotherapy is superior to sequential alternating chemotherapy.

Adult↗
PubMed1996

Recent considerations for hypospadias repair: results of 252 operations from 1985 to 1990.

OBJECTIVES AND METHODS: 252 hypospadias operations were performed at our department from 1985 to 1990. We conducted 173 primary repairs and 79 reoperations. In distal hypospadias (n = 98), we used the meatoplasty and granuloplasty procedure as well as the Mathieu technique. In penile hypospadias (n = 40), a tubularized dorsal preputial flap (Duckett procedure) was performed. Proximal and scrotal hypospadias (n = 23) were operated using a combination of Duckett's tube and the Thiersch-Duplay procedure. RESULTS: We saw a 15% complication rate in distal hypospadias, 36% in penile hypospadias, and 27% in proximal hypospadias. CONCLUSION: The Mathieu technique gave a complication rate of 35.5% in our hands, and so it was replaced by the island onlay flap technique as described by Duckett.

Adolescent↗
PubMed1996

Phase II study of interferon-gamma versus interleukin-2 and interferon-alpha 2b in metastatic renal cell carcinoma.

PURPOSE: In a randomized phase II study we evaluated response, survival and side effects of low dose recombinant interferon-gamma in 30 patients (group 1) versus recombinant interleukin-2 and interferon-alpha 2b in 30 (group 2) with metastatic renal cell carcinoma. MATERIALS AND METHODS: Group 1 received 200 micrograms interferon-gamma subcutaneously once a week. Group 2 received 4 x 4.8 x 10(6) IU/m.2 interleukin-2 subcutaneously on days 1 and 22, 2 x 4.8 x 10(6) IU/m.2 on days 2 and 23, and 2 x 2.4 x 10(6) IU/m.2 combined with interferon-alpha 2b subcutaneously at 3 x 10(6) IU/m.2 on days 3, 5, 24 and 26, and 6 x 10(6) IU/m.2 3 times weekly for 6 weeks. RESULTS: Toxicity grades 2 and 3 (World Health Organization) were observed in group 2 only. After followup of 13 months there was no remission in group 1 compared to 7 remissions in group 2, with 23 cases of progressive disease detected. CONCLUSIONS: Combination therapy showed an objective response rate of 23% (p = 0.01). Although survival was not a primary aim of the study, there was a tendency toward no significant difference in survival when evaluating these relatively small groups (p = 0.49).

Adult↗
PubMed1996

[Therapy of hormone refractory prostate carcinoma with mitoxantrone. A clinical phase II study].

So far, no curative treatment is available for hormone-refractory prostate carcinoma. Therapy is thus focused on alleviating symptomatic tumor progression with the aim of improving quality of life. Therefore, anthracyclin-derived mitoxantrone was administered to 25 patients with hormone-refractory prostate carcinoma and symptomatic progressive disease. After a median treatment of 13 weeks, a median of 4 cycles and a follow-up of 14 months, 48% of the patients (12/25) reported improvement in tumor-related pain; in 60% (15/25) there was improvement of the self-assessment symptom score and 32% of the patients (8/25) gained weight. Additionally, partial tumor response with regression of lymph-node metastases occurred in 3/25 patients (12%). In 10/25 patients the serum level of prostate-specific antigen (PSA) decreased as well as the alkaline phosphatase (AP) in 7/25 patients. Side effects subsequent to chemotherapy were leucopenia WHO grade III in 25% of the patients and thrombocytopenia WHO grade III in 3/25 and grade V (treatment-related death) in 1/25 patients. Non-hematological toxicity occurred in 2 patients (cardiotoxicity n = 1, nephrotoxicity n = 1, WHO grade II each).

Aged↗
PubMed1996

[Pediatric ureteral ureteral outlet obstruction and obstructive megaureter: observation or operation?].

Stenosis of the ureteropelvic junction and obstructive megaureter are still a diagnostic and therapeutic problems. So far, there is no reliable prognostic factor to predict the outcome of a primary dilated upper urinary tract under the "wait and see" strategy and to decide which child must be operated upon and which should not. In practice, basic diagnostic evaluation with sonography, possibly i.v.-pyelography and voiding cystography is accompanied by quantifying isotope-based procedures such as DMSA-uptake or diuretic renography. The Whitaker test has become less important. Based on the investigation by Koff et al., it seems to be possible to follow the "wait and see" procedure in more than 85% of the children without any loss of renal function of the dilated kidney.

Child↗
PubMed1996

[Are their individual decisions for urinary diversion? Indications and results of 200 consecutive patients].

During the past 20 years many continent urinary diversions have been established. The indications includes pelvic tumors, especially bladder cancer, and structural and functional disorders of the lower urinary tract with irreversible damage of storage or continence function. Given the variety of surgical diversion techniques, it seems feasible to consider the patient's individual pathoanatomical situation as well as his/her personal wishes. We report on 200 consecutive patients with supravesical urinary diversion. The analysis includes indications surgical technique, intra-and postoperative complications and patients' quality of life. The peri- and postoperative morbidity rate was 18.5%. Complications mainly comprised infections and obstruction of the urinary tract. The mortality rate was 4.5% and causes of death included bleeding, infection, urinary extravasation and bowel atonia. Patients with malignant disease and only palliative treatment showed disappointing results after on operation including continent urinary diversion: 30% of them had early complications. Several female patients with a catherizable continent urinary diversion could not handle the catheterization of the pouch, although the function of the urinary diversion was excellent. Therefore an indwelling catheter was placed in all these patients. Our analysis shows that the choice of urinary diversion has to consider the patient's pathoanatomical situation, as well as his/her age, general condition, mental and manual skills. In addition, renal function, the metabolic situation and previous therapies may influence the decision regarding supravesical urinary diversion in an individual case.

Adult↗
PubMed1995

Prognostic factors for bladder cancer.

Cancer of the urinary bladder is the fifth most common cancer in men and the second most urological malignancy in Western society [17], with an incidence rate per year of 29.8/100,000 males. Bladder tumors are distinguished as either invasive or superficial: invasive tumors are generally associated with poor prognosis, while 20-30% of superficial carcinomas recur and progress to become invasive and metastic [26, 27]. The most common prognostic factors for classification of urothelial cancer are staging and grading, which are based on morphological criteria. In the past decade, however, other criteria have been developed as a possible prognostic aid to better disease management, such as expression of specific cell surface antigens, DNA content, chromosomal aberrations, gene rearrangements and point mutations [26, 7]. Since most tumors of the bladder are carcinomas and are associated with dedifferentiation and high metastatic capability, we investigated whether reduced expression of so-called differentiation factors in combination with increased cell motility might be correlated with tumor progression.

Cell Adhesion↗
PubMed1995

Entorhinal-perirhinal lesions impair performance of rats on two versions of place learning in the Morris water maze.

The effects of entorhinal-perirhinal lesions in rats were studied with 2 versions of a place learning task in the Morris water maze. These lesions impaired performance on a multiple-trial task (3 days of 6 trials and a probe trial). This assessment was followed by a task in which rats were repeatedly trained to find novel locations with a variable delay (30 s or 5 min) imposed between each sample trial and retention test. Entorhinal-perirhinal damage produced a delay-dependent deficit in spatial memory: Rats with lesions were impaired at the 5-min delay relative to the control group and to their own performance at 30 s. These findings are discussed in relationship to memory impairment after entorhinal damage and spatial learning deficits observed after hippocampal damage.

Animals↗
PubMed1995

[Prognostic factors for predicting the success of immunotherapy in metastatic renal cell carcinoma].

Only approximately 20% of the patients with metastatic renal cell carcinoma who undergo systemic immunotherapy will respond to this form of treatment. Appropriate selection of patients could exclude many who will not benefit from immunotherapy from a toxic and expensive treatment. Several factors predicting the outcome of immunotherapy have been reported so far. These predictors can be classified into (1) patient-related factors, (2) tumour-related factors and (3) alterations of the immune system during immunotherapy. Performance status and the interval between tumour nephrectomy and metastasization are the most important patient-related factors. Liver metastases are apparently an unfavourable tumour-related prognostic factor. Various alterations of the immune system during immunotherapy are significantly linked with the outcome of the treatment. In consequence, the prospective investigation of prognostic factors within clinical trials appears to be mandatory.

Carcinoma, Renal Cell↗
PubMed1995

[Cytokine therapy of metastatic renal cell carcinoma].

Cytokine therapy of metastatic renal cell carcinoma reveals a remission rate of about 25% regarding to the different patients selection criteria, i.e. age, performance status, site of metastasis, tumour load. Remission is not correlated to patient's survival. Adjuvant or neoadjuvant immunotherapy is not a treatment option. Nephrectomy has no influence on distant metastases and should be limited to symptomatic primary tumours. In conclusion, cytokine therapy is not a standard treatment. Its value has to be evaluated in randomized trials.

Carcinoma, Renal Cell↗
PubMed1995

[Principles of tumor invasion and metastasis].

Histopathological and clinical parameters are of limited value in characterization of the individual course of disease in bladder cancer patients. Down-regulation of E-cadherin, an intercellular adhesion molecule, and upregulation of autocrine motility factor receptor (AMFR) expression have been shown to play a part in tumour cell invasion and metastasis. In a retrospective analysis concerning 95 different bladder specimens and a prospective study in 100 bladder cancer patients, reduction in E-cadherin concomitantly with an increase in AMFR expression was associated with a poor prognosis. The dual use of these two antigens may improve early diagnosis of high-risk bladder cancer patients and influence treatment decisions.

Cadherins↗
PubMed1995

[Initial experience with a new type of high energy neodymium laser in correcting stenosis of the airway].

The aim of the study was to assess the use of a new Nd:YAG laser--mediLas fibertom--in correcting malignant and benign stenoses of the airways. Eighteen patients were included in the study. In 9 these were caused by malignant tumors, in 3 by nonmalignant tumors, in 6 by post-inflammatory stenoses of the airways. Altogether 99 laser sessions were carried out. In patients with malignant diseases complete recanalization was achieved in 6 patients, in 2 partial. One patients did not benefit form the laser procedure. In patients with benign tumors complete recanalization was achieved in all of the patients. In 5 out of 6 patients the post inflammatory stenosis was corrected. Satisfactory results observed after the second, fourth and one year after the initial laser procedure encourage to use this from of therapy in cases of malignant and nonmalignant narrowing of the airways.

Adolescent↗
PubMed1995

[Use of video-thoracoscopy for diagnostic and small surgical procedures in the chest].

The report introduces videothoracoscopy as a new diagnostic and therapeutical method in chest surgery. The main indications for thoracoscopic procedures were described. Also, 37 videothoracoscopic procedures performed on 35 patients were presented. In 5 cases procedure was therapeutical, in the rest of them diagnostic. In all diagnostic cases, thoracoscopic procedures allowed to determine accurate diagnosis. No significant complications were observed.

Biopsy↗
PubMed1995

Does [3H]2-methoxy-idazoxan (RX 821002) detect more alpha-2-adrenoceptor agonist high-affinity sites than [3H]rauwolscine? A comparison of nine tissues and cell lines.

The authors compared [3H]2-methoxy-idazoxan (RX 821002) and [3H]rauwolscine binding in rat cerebral cortex, spleen and kidney; guinea pig kidney; porcine kidney; human kidney and platelets and HEL and NG 108-15 cells. [3H]RX 821002 had less nonspecific binding and higher affinity than [3H]rauwolscine in most models. Although both ligands detected similar alpha-2 adrenoceptor numbers in rat, porcine and human kidney and in NG 108-15 cells in saturation experiments, [3H]RX 821002 detected more alpha-2 adrenoceptors than [3H]rauwolscine in rat cerebral cortex and spleen, guinea pig kidney, human platelets and HEL cells. These differences were seen in Tris and in glycylglycine buffer regardless of whether EDTA, MgCl2, MgCl2 plus GTP or GTP plus NaCl was added to the former and were not explained by additional labeling of serotonin or dopamine receptors or nonadrenergic sites; in contrast, [3H]rauwolscine also labeled nonadrenergic sites in porcine kidney. In prazosin competition experiments, both ligands differentially recognized alpha-2-adrenoceptor subtypes but this could not account for the observed differences in detected receptor numbers. In epinephrine competition experiments, both ligands labeled similar numbers of agonist low affinity sites in all models; [3H]RX 821002, however, labeled more agonist high-affinity sites than [3H]rauwolscine did in models in which it detected a greater total number of receptors. It was concluded that [3H]RX 821002 is a more suitable ligand for the detection of alpha-2 adrenoceptor than [3H]rauwolscine because of less nonspecific binding, higher affinity and greater specificity for alpha-2 adrenoceptors; moreover, [3H]rauwolscine appears not to detect all agonist high-affinity sites of alpha-2 adrenoceptors.

Adrenergic alpha-Agonists↗
PubMed1995

Keyhole-limpet hemocyanin immunotherapy in the bilharzial bladder: a new treatment modality? Phase II trial: superficial bladder cancer.

The efficacy of immunotherapy with keyhole-limpet hemocyanin or bacillus Calmette-Guerin for superficial bladder cancer is well known. A strong similarity has been noted between keyhole-limpet hemocyanin antigen and schistosomal antigen. In regard to this finding, we investigated the mechanisms of specific immunotherapy with keyhole-limpet hemocyanin in schistosomal associated transitional cell carcinoma. Keyhole-limpet hemocyanin was used for its ability to prevent tumor recurrence and because of its similarity to schistosomal antigen for intravesical specific immunotherapy in 13 patients with superficial transitional cell bladder tumors (Ta, Tis, T1) associated with urinary schistosomiasis. Keyhole-limpet hemocyanin immunotherapy reduced the recurrence rate of superficial bladder tumors to 15.4% compared to 76.9% before therapy.

Adjuvants, Immunologic↗
PubMed1995

[Pneumonia in patients after extracorporeal circulation].

Hospital infections are still an important problem of to-days medicine. The most common and dangerous one is pneumonia. The purpose of this study was to determine the cause of pneumonia in patients operated on under extracorporeal circulation. It was proved that micro-organisms responsible for pneumonia in our patients were Pseudomonas sp. and Staphylococcus aureus. No correlation between the bacterial flora cultured from the air in operating theatre and post-op. ward and bacterial flora responsible for pneumonia was found. It can be infer that pulmonary infections were rather caused by hospital cross-infections or endogenic infections in colonized patients.

Adult↗