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T Senge

Publications and source records attributed to T Senge.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Quality assurance in tumor surgery--the effect of tumor surgery interventions on the quality of life of patients with urologic tumors].

During the last 20 years important improvements in diagnosis, staging and indications as well as in operative and conservative treatments of urological malignancies have been achieved. In consequence the prognoses of patients with these cancers have been improved. One remaining question concerns the impact of curative radical surgery on the individual's quality of life and life perspective. The purpose of this prospective study was to obtain relevant data upon which to develop tumor-specific modules according to the guidelines of the EORTC, so that this question can be studied. Between July, 1993 and July, 1994 data from 106 cancer patients with non metastatic urological malignancies (prostate, kidney and bladder) were gathered for analysis. Patients include 37 with prostatic cancer, who were treated by a radical prostatovesicalectomy. Fourty-two patients with renal cell carcinoma underwent radical nephrectomy. In 30 bladder cancer patients radical cystoprostatovesicalectomy with an ileum conduit was carried out. The first step was to describe the symptomatology in these patients by means of open interviews. In addition, one day postoperatively, the day before discharge and one year after surgery the patients completed self-administered symptomatic and psychological questionnaires. The symptomatic questionnaire contained 20 items, each with six response choices. For evaluating subjective well-being, we selected the "Basler Befindlichkeitsbogen" (Basler Psychological Balance), which has four dimensions: Vitality, vigilance, social extrovertivity and psychological balance. Descriptive and comparative analyses were performed with an SPSS programme. Comparing the preoperative and one year postoperative values, all patients groups showed a significant deterioration in the four dimensions of the psychological parameters. The data from the present study were the basis for the development of EORTC-specific tumor modules for urological cancer according to the guidelines of the EORTC.

Adaptation, Psychological↗
PubMed1995

[Diagnosis and therapy of primary malignant fibrous histiocytoma of the kidney].

Malignant Fibrous Histiocytoma (MFH) is an unfrequent mesenchymal tumor first described by O'Brian in 1964 [1, 16]. The most common site of this malignancy is the limbs area and the retroperitoneum. Primary involvement of the kidney is extremely rare. Only thirteen cases are well documented in the literature. We report an additional case of such primary renal tumor.

Aged↗
PubMed1993

Influence of hormone application by subcutaneous injections or steroid-containing silastic implants on human benign hyperplastic prostate tissue transplanted into male nude mice.

To study the influence of androgens and estrogens on human benign prostatic hyperplasia (BPH) tissue, BPH fragments were grafted subcutaneously (s.c.) into male nude mice. Testosterone alone (group I) or in combination with 17 beta-estradiol (group III) were administered either by s.c. injections as oil suspensions or continuously by s.c. implanted steroid-containing Silastic implants (groups II and IV). Intact mice without transplants and treatment served as a control (group V). After 4 weeks of treatment, animals were exsanguinated, transplants were removed, and serum was obtained. Ninety-six percent of the BPH fragments were located; they displayed histologically typical BPH acini and stroma. In transplants of all treatment groups, the majority of secretory, as well as basal, cells displayed a proliferation comparable to the original tissue. In glandular cells of all transplants, prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) could be demonstrated immunohistochemically. Specimens removed from animals bearing testosterone implants displayed a very well preserved ultrastructure that was found less frequently in samples from injection-treated animals. Acini-bearing metaplastic epithelium were more often present in transplants treated by steroid injections and seemed to be due to lower androgen or higher estrogen serum levels. Endogenous serum testosterone levels (ng/ml +/- SD; n) were lower and more variable (i.e., higher standard deviation) in groups treated by injections (group I: 3.68 +/- 2.12; n = 5 and group III: 3.86 +/- 1.13; n = 5) and were similar to those seen in intact controls (3.93 +/- 1.62; n = 6) compared with groups treated by Silastic implants (group II: 5.11 +/- 1.14; n = 10 and group IV: 10.20 +/- 0.52; n = 4). These results indicate that by application of steroids via Silastic implants, reproducible hormone effects can be obtained on BPH tissue transplanted into male nude mice, thus providing a reliable new model system for study.

Acid Phosphatase↗
PubMed1993

Immunohistochemical determination of age related proliferation rates in normal and benign hyperplastic human prostates.

To study whether benign prostatic growth in aging men correlates with an increase in proliferation, proliferation rates were determined immunohistochemically using the antibody Ki-67 in 20 benign hyperplastic prostates (BPH) and in four normal prostates (NPR). There was no significant correlation between age and proliferation rate in epithelium or stroma in BPH. In addition, no significant correlation between prostate weight and proliferation rate could be demonstrated in either compartment. In NPR the proliferation rate in epithelium and stroma was 9 times and 37 times lower, respectively, than in BPH. Obviously the induction of BPH from NPR may be associated with a distinct increase in proliferation. The further increase in BPH volume, however, is not correlated with a further increase in proliferation rate.

Adolescent↗
PubMed1993

Management of benign prostatic hyperplasia with particular emphasis on aromatase inhibitors.

The pathogenesis of human benign prostatic hyperplasia (BPH) has not been fully elucidated. There is, however, evidence that estrogens--besides other factors--might play an important role for the growth of the prostate. Consequently, estrogen deprivation might be a new, useful principle for a conservative treatment of BPH. Atamestane, a new, highly selective steroidal aromatase inhibitor has been proven to be successful in antagonizing experimentally-induced estrogen-related stromal overgrowth of the prostate in dogs and monkeys. Double-blind placebo controlled studies are now underway in Europe and the U.S.A. It is anticipated that these studies will give us a definite answer of the clinical validity of this concept in BPH patients in the near future. However, it is very important to take into consideration that for an effective treatment of BPH, a reduction of both the glandular and stromal elements has to be achieved. In other words, both androgens and estrogens seem to be involved in the regulation of (over)growth of the prostate. Therefore, a combination of an androgen and estrogen deprivation might be a more promising approach than any single treatment.

Androstenedione↗
PubMed1993

Effects of estrogen deprivation on human benign prostatic hyperplasia.

Sex steroids are thought to play an essential role in the pathogenesis of human benign prostatic hyperplasia (BPH). Since recent studies in animal models and in men have shown that estrogens might be causally linked to the onset and maintenance of BPH, we examined the effect of 1-methyl-androsta-1,4-diene-3,17-dione (Atamestane), a newly developed aromatase inhibitor, in men with BPH. In an open multicenter study 49 men (mean age 70.1 years, range 55 to 84) with obstructive BPH were treated with atamestane (3 x 200 mg/day) for 3 months. Of the 49 patients 44 completed the treatment period; the other patients discontinued the study for reasons unrelated to treatment. With treatment BPH-related symptoms such as daytime voiding frequency, nycturia, peak flow and residual urine improved considerably; however, these parameters did not reach statistical significance. The mean prostatic volume decreased significantly from 74.2 +/- 31.7 to 64.0 +/- 31 ml (mean +/- SD). Serum estrogen levels decreased markedly during treatment. In addition intraprostatic estrogen concentration decreased with treatment as compared to estrogen levels in hyperplastic prostates from untreated patients. The following conclusions can be drawn from this study: first, estrogens appear to have an important supportive role in established BPH, and second, estrogen deprivation improved BPH-related symptoms and reduced significantly prostatic volume.

Aged↗
PubMed1993

The Swiss Lithoclast: a new device for endoscopic stone disintegration.

Even in the presence of extracorporeal shock wave lithotripsy there is still the need for endourological treatment of stones in the urinary tract. Stone fragmentation usually is achieved with either ultrasonic, electrohydraulic or laser lithotripsy. We report our early experience with a new, simply constructed machine at a reasonable cost for endoscopic stone disintegration--the Swiss Lithoclast. The principle of this lithotriptor is based on pneumatic shock waves induced by the central compressed air system of a hospital or by a compressor. This device was used to treat 151 patients with stones in the kidney, ureter, bladder or a Kock pouch continent urinary diversion. Endoscopic fragmentation was successful in all patients. Independent of the composition, all stones were disintegrated within a short period, indicating that the device may well represent an attractive alternative to standard endoscopic lithotriptors.

Adolescent↗
PubMed1993

[TULIP--transurethral ultrasound-controlled laser-induced prostatectomy: an alternative to TURP?].

Transurethral resection of the prostate (TURP) is the most effective treatment for prostatic obstruction secondary to benign prostatic hyperplasia (BPH). This procedure has a high success rate with a very low mortality rate. Over the last 30 years, however, an unchanged morbidity rate of about 20% following TURP has been reported in the literature. In addition, haemorrhage requiring blood transfusion may occur in 6.5-22% of cases, and 68-92% of sexually active men have retrograde ejaculation following TURP. The side-effects and complications associated with TURP have led to the search for alternative therapies. The TULIP system represents a new treatment modality. TULIP is an acronym for transurethral ultrasound-guided laser-induced prostatectomy. The basic TULIP system consists of an ultrasound imager and a 20-F transurethral probe with an ultrasound transducer and a laser window at the distal end. Under ultrasound guidance laser treatment results in a coagulation necrosis effect in the hyperplastic prostate tissue. Coagulation necrosis is basically a bloodless tissue removal procedure as the tissue subsequently sloughs away in the fine particles during spontaneous micturation within 4-6 weeks after the procedure. Early results obtained in the first 18 patients with symptomatic, obstructive BPH treated by TULIP and with a follow-up of 6 weeks to 6 months demonstrate a significant improvement in both subjective and objective symptoms. The peak flow rate increased by up to 142% on average; the residual volume decreased by up to 75%; and there was a 77% decrease in average symptom scores compared with preoperative scores.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Non-invasive treatment of long-bone pseudarthrosis by shock waves (ESWL).

Non-invasive treatment of non-union of diaphyses by application of the shock waves known from lithotripsy has proved successful in three out of four cases. Two thousand shock waves with a single-wave energy of 18 kV were applied by the MFL 5000 and HM3 Lithotripters of the Dornier Medizintechnik Company with manual detection of the lesion. The shock waves induced a kind of callus formation in the non-union soft tissue within about 6 weeks, which was successfully maintained and transformed into bony union in all cases but one by dynamic fixation less rigid than a plaster cast. Four cases are documented and the effects of the shock waves and principles of bony union discussed.

Adult↗
PubMed1992

[Effect of TUR and transvesical prostatectomy on symptomatology and quality of life].

The influence of transurethral resection and transvesical prostatectomy on symptoms and quality of life in patients with benign prostatic hyperplasia was evaluated and compared in a prospective study. Two groups of 20 patients each were matched for preoperative symptoms, flow and residual urine. A detailed questionnaire was completed by the patients preoperatively and at various intervals postoperatively. In the patients' judgement both operations brought about a fast and significant improvement of their symptoms. Sexuality, erectile function and libido were not reduced. During the 6-month follow-up no significant differences was found between the two operative procedures in their effects on the parameters examined. Thus, the choice of operation can be based entirely on other parameters, such as prostate weight.

Aged↗
PubMed1992

[New conservative therapeutic approaches in benign prostatic hyperplasia].

The efficacy of treatment for benign prostatic hyperplasia (BPH) is presently under critical consideration. In addition, various new therapeutic modalities are currently being evaluated. When medicamentous treatment is planned, in particular, the natural history of the disease must be carefully considered. Summarized data from several studies indicate that spontaneous improvement of symptoms may occur within 3-6 months, while in most cases deterioration takes a longer period of time. As intraprostatic urethral pressure depends on prostatic volume as well as on tone of the prostate smooth muscle, different medical treatment modalities seem reasonable. The dynamic component of the smooth muscle cells may be influenced by alpha-blockers. Administration of selective alpha 1-blockers will be advantageous as these have fewer side effects. Prostate volume represents the static component, which can be influenced by hormone treatment. Androgen deprivation via surgical castration must now be regarded as of historical interest only. Antiandrogens or LH-RH analogues have undesirable side effects and are expensive, making such treatment unacceptable for routine use. 5 alpha-Reductase inhibitors may emerge as a new treatment form allowing androgen suppression with a low rate of side effects. As it has been proposed that estrogens play an important role in the regulation of prostatic growth, aromatase inhibitors, which inhibit metabolization from androgens to estrogens, may receive special attention in the near future. Based on the theory that androgens may be of special importance for the epithelium, while estrogen action may be concentrated on the stroma, a combined treatment with inhibitors of 5 alpha-reductase plus aromatase may be even more effective.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Antagonists↗
PubMed1992

Primary retroperitoneal tumors.

The pathological classification, diagnosis and therapy of primary retroperitoneal tumors are presented. Three typical cases from our clinical experience are described. Ultrasonography is the most important screening method for the early diagnosis of primary retroperitoneal tumors. Early diagnosis and total surgical excision offer the only hope for successful treatment.

Adult↗
PubMed1991

Stented laser-welded vasovasostomy in the rat: comparison of Nd:YAG and CO2 lasers.

In 54 male Sprague-Dawley rats, 108 vasovasostomies were performed. Sutureless laser welding with the assistance of a removable stent was done using a CO2- and an Nd:YAG-laser system. Conventional two-layer microsurgical anastomoses served as controls. The Nd:YAG laser resulted in significantly lower patency rates, with a higher percentage of sperm granulomas; the CO2 laser produced results equivalent to conventional suturing. Sutureless laser welding utilizing a removable stent proved to be a time- and cost-saving procedure for vasovasostomies in the rat.

Animals↗
PubMed1990

Rupture of ileal neobladder due to urethral obstruction by mucous plug.

We report a case of ileal neobladder rupture after radical cystectomy due to mucus obstruction of the bladder neck. Since mucus production in bowel neobladders cannot be sufficiently influenced pharmacologically, patients with a continent urinary diversion connected to the urethra should learn self-catheterization.

Humans↗
PubMed1990

Influence of different types of antiandrogens on luteinizing hormone-releasing hormone analogue-induced testosterone surge in patients with metastatic carcinoma of the prostate.

The long-term effect of the luteinizing hormone-releasing hormone analogue-induced initial testosterone surge in the treatment of patients with metastatic carcinoma of the prostate still is unknown. However, acute worsening of the disease has been reported in up to 10% of the patients. To prevent such tumor flare we investigated the endocrinological effects of different types of antiandrogens administered in addition to a luteinizing hormone-releasing hormone analogue. Patients with newly diagnosed metastatic prostate cancer were pre-treated with either the steroidal antiandrogen cyproterone acetate (6) or the nonsteroidal antiandrogen flutamide (5) for 1 week before the initial injection of the depot luteinizing hormone-releasing hormone analogue Zoladex. In another 5 patients flutamide was first given 24 hours before Zoladex therapy was started. Luteinizing hormone, testosterone and prostatic acid phosphatase during month 1 of luteinizing hormone-releasing hormone analogue therapy were compared to data obtained in 5 patients treated by Zoladex alone. Only pre-treatment with cyproterone acetate was capable of preventing the Zoladex-induced testosterone surge. However, both pre-treatment regimens with either cyproterone acetate or flutamide for 1 week prevented an initial increase in prostatic acid phosphatase beyond pre-treatment levels in all patients. In contrast, in 4 of 5 patients treated with Zoladex alone and in 2 of 5 pre-treated with flutamide for 1 day an initial increase in prostatic acid phosphatase beyond the pre-treatment values was seen. Our data indicate that pre-treatment with flutamide for only 1 day may not be sufficient to prevent a luteinizing hormone-releasing hormone analogue-induced tumor flare in all cases.

Acid Phosphatase↗
PubMed1990

Vasectomy reversal in central Europe: results of questionnaire of urologists in Austria, Germany and Switzerland.

A detailed questionnaire was sent to urologists in Austria, Switzerland and West Germany on the frequency of contraceptive vasectomies, vasectomy reversal, technique and success rates. The response rate was 859 of 2,137 (40.2%). The rate of annual contraceptive vasectomies averaged 28,519 or 378 vasectomies per million inhabitants. The rate of vasovasostomies and vasoepididymostomies was 8.3 and 3.8 procedures per million inhabitants, respectively. A macroscopic technique was used by 9.5% of the responding urologists, loupes were used by 58.5% and an operating microscope by 32%. The majority (74.1%) preferred a 1-layer technique and an unstented anastomosis (84.4%). The average patency and pregnancy rates were 73 and 47%, respectively, for vasovasostomy and 45 and 18%, respectively, for vasoepididymostomy. A total of 78 alloplastic spermatoceles was reported, with detection of motile spermatozoa in 19 and pregnancy in 1.

Austria↗