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W F Thon

Publications and source records attributed to W F Thon.

At least 19 recordsLinked to original sources
PubMed2003

[Blunt testicular injury - conservative or surgical treatment?].

INTRODUCTION: Testicular trauma can be classified into blunt or penetrating injury. While every case of penetrating trauma is subjected to surgical treatment, the decision between surgery and conservative treatment must be made for each case of blunt injury. Inspection, palpation and duplex sonography may be helpful in finding the correct decision. Herein we present a case report and review of the current literature. CASE REPORT: A 14-year-old boy was admitted to an urological department after blunt scrotal trauma. Ultrasound examination revealed a peritesticular hematoma. After 9 days of conservative treatment, surgical exploration and orchidectomy for rupture of the tunica albuginea was performed. CONCLUSIONS: The following recommendations can be made for treatment of blunt testicular injury: if rupture of the testis is detected sonographically, immediate surgical exploration is indicated. Every change in testicular structure must be considered a possible sign of testicular rupture. Sonographically detected hematoceles without visible signs of rupture are not given clear recommendations in the literature. However, early surgical intervention (within 72 hours) seems to increase the likelihood of preserving the testis. In every case of unclear clinical or sonographic findings, surgical exploration of the scrotum should be done. If offers a safe and quick diaganosis with a very low complication rate.

Adolescent↗
PubMed1999

Angiomyolipoma of the kidney and lymph nodes.

Angiomyolipoma (AML) is a benign mesenchymal tumor predominantly occurring in the kidney. Despite its low incidence of 0.07-0.03% in an unselected population, this tumor is well known, because the typical AML can be diagnosed without histological confirmation by a combination of ultrasound (US) and computerized tomography (CT) imaging in up to 95% of cases. In contrast, simultaneous involvement of the kidney and the regional lymph nodes is less known and might be confused with metastasizing malignant tumor. We report a case of the very uncommon simultaneous involvement of the kidney and the lymph nodes in AML.

Adult↗
PubMed1999

Expression of the MRP2 gene-encoded conjugate export pump in human kidney proximal tubules and in renal cell carcinoma.

Human kidney proximal tubule epithelia express the ATP-dependent export pump for anionic conjugates encoded by the MRP2 (cMRP/cMOAT) gene (symbol ABCC2). MRP2, the apical isoform of the multidrug resistance protein, is an integral membrane glycoprotein with a molecular mass of approximately 190 kD that was originally cloned from liver and localized to the canalicular (apical) membrane domain of hepatocytes. In this study, MRP2 was detected in human kidney cortex by reverse transcription-PCR followed by sequencing of a 826-bp cDNA fragment and by immunoblotting using two different antibodies. Human MRP2 was localized to the apical brush-border membrane domain of proximal tubules by double and triple immunofluorescence microscopy including laser scanning microscopy. The expression of MRP2 in renal cell carcinoma was studied by reverse transcription-PCR and immunoblotting in samples from patients undergoing tumor-nephrectomy without prior chemotherapy. Clear-cell carcinomas, originating from the proximal tubule epithelium, expressed MRP2 in 95% (18 of 19) of cases. Immunofluorescence microscopy of MRP2 in clear-cell carcinoma showed a lack of a distinct apical-to-basolateral tumor cell polarity and an additional localization of MRP2 on intracellular membranes. MRP2, the first cloned ATP-dependent export pump for anionic conjugates detected in human kidney, may be involved in renal excretion of various anionic endogenous substances, xenobiotics, and cytotoxic drugs. This conjugate-transporting ATPase encoded by the MRP2 gene has a similar substrate specificity as the multidrug resistance protein MRP1, and may contribute to the multidrug resistance of renal clear-cell carcinomas.

ATP Binding Cassette Transporter, Subfamily B↗
PubMed1996

Prostate-specific antigen density--a reliable parameter for the detection of prostate cancer?

We compared the prostate-specific antigen density (PSAD) in clinically and surgically staged patients with specimen-confined prostate cancer (n = 57) and in patients with benign hyperplasia (n = 69), who underwent transvesical adenomectomy. The PSAD was calculated from the preoperative PSA level and the specimen volume. The prostate volume was determined by dividing the prostate weight by the specific gravity of the tissue. The mean tissue values used for PSAD calculation were 51.9 g in men with prostate cancer (PCA) and 62.9 g in men with benign prostatic hyperplasia (BPH). The PSAD values showed significant differences (BPH 0.19 versus PCA 0.37, P = 0.029). Receiver operator characteristic (ROC) curves demonstrated the best cutoff value to be 0.15, with the sensitivity being 58%; the specificity, 51% and the positive predictive value of PCA, 49%. At a serum PSA level below 10ng/ml, the best cutoff value was 0.1 and the positive predictive value was 51%. The PSAD results we calculated from an accurate prostate volume (surgical estimate) show that PSAD is not a significant predictor of prostate cancer.

Aged↗
PubMed1995

Denovo urothelial carcinoma of the upper and lower urinary tract in kidney--transplant patients with end-stage analgesic nephropathy.

Patients with end-stage analgesic nephropathy bear a higher risk for urothelial cancer than do patients with other renal diseases. In a retrospective study in patients with analgesic nephropathy and kidney transplants we analyzed the prevalence and clinical course of de novo urothelial cancer. Diagnosis of analgesic nephropathy was based on the patients' history and clinical data. Only patients under cyclosporine treatment were included. Between 1968 and 1993, 2,371 kidney transplants were performed on 2,072 patients in the Department of Abdominal and Transplant Surgery. The prevalence of analgesic nephropathy was 3.1%. Of 65 patients with analgesic nephropathy and kidney transplants, 10 (15.4%) developed urothelial carcinoma; 10.8%, bladder cancer; and 9.1%, renal pelvic cancer. The mean age at diagnosis was 56.1 years. Urothelial cancer occurred on average at 33.6 months posttransplantation. On average, 6 of 10 patients with urothelial cancer died of the disease at 16.9 months after the diagnosis. All patients with urothelial bladder cancer had a muscle-infiltrating tumor of moderate or high grade. Since urothelial renal pelvic cancer occurred in 9.1% of our patients with analgesic nephropathy and urological screening is insufficient in patients on dialysis, we suggest that prophylactic nephroureterectomy be performed on one side before transplantation and on the contralateral side at 3-6 months after transplantation. An aggressive approach is indicated in patients with urothelial cancer of the bladder.

Analgesics↗
PubMed1994

Effects of magnesium citrate and phytin on reducing urinary calcium excretion in rats.

The aim of this study was to determine and compare the effects of both magnesium citrate and phytin on reducing urinary calcium excretion under high-calcium-diet conditions during single and combined treatments. An animal experiment was carried out over a period of 4 weeks in 35 male rats. Urinary calcium excretion was reduced significantly by magnesium citrate and/or phytin in rats fed on high-calcium diets. The hypocalciuric effect of magnesium citrate was more evident than that of phytin. Urinary magnesium excretion was high in all experimental groups. However, the urinary magnesium/calcium ratios showed a consistent increase only in the groups treated with magnesium citrate. Urinary citrate excretion showed a relative increase with the introduction of magnesium citrate plus phytin; however, in both the high-calcium-diet group and the magnesium-citrate group this was found to be reduced. Urinary phosphate excretion was slightly higher in the groups treated with phytin. There was no definite difference in urinary oxalate concentration between the groups. No significant change was noted in the serum concentration of calcium, magnesium, or phosphate.

Animals↗
PubMed1994

Detection of P53 tumor-suppressor-gene protein in bladder tumors and prostate cancer: possible clinical implications.

For a variety of human malignancies such as breast cancer and cancer of the prostate, p53 oncoprotein overexpression indicating an alteration of the p53 tumor-suppressor gene has been described as a prognostic factor for a poor clinical outcome. To investigate the overexpression of p53 oncoprotein in transitional-cell carcinoma of the bladder, 58 bladder cancer specimens of different clinical stages and histological grades were investigated using an immunohistochemical approach. A correlation between p53 positivity and tumor stage was observed, with an increase from 38.5% of superficial (Ta) tumors to 83.3% of muscle-invasive (T3/T4) tumors staining positively for p53 oncoprotein. Furthermore, an increase from 46.7% of G1 tumors to 75% of G3 tumors was observed. In 22 of 25 (87%) informative patients the results of the immunohistochemical staining could be verified by the determination of p53 mutations as detected by polymerase chain reaction (PCR)-directed analysis of restriction-fragment-length polymorphisms (RFLP). To determine the prognostic value of p53 immunohistochemistry for the clinical course of superficial bladder cancer, the overexpression of p53 oncoprotein was investigated in 41 patients with superficial bladder tumors (T1) undergoing complete transurethral tumor resection. The detection of p53 protein was correlated with further clinically important variables such as sex, age, histological grading, former instillation therapy, and immunohistochemical determination of the proliferation rate by staining for PCNA (proliferating-cell nuclear antigen; monoclonal antibody PC10).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Prognostic factors for the postoperative outcome of penile venous surgery for venogenic erectile dysfunction.

Since penile venous surgery is usually associated with a poor postoperative outcome, a study was done to evaluate possible prognostic factors for this procedure. A total of 77 patients with erectile dysfunction underwent ligation of all dorsal penile veins and resection of the deep dorsal penile vein for venous incompetence. In all patients a comprehensive evaluation was done preoperatively. All patients did not respond to pharmacotherapy and had a venous leak. After a followup of 6 months, patients were classified as having full spontaneous erections, failure and response to pharmacotherapy. Of the 77 patients 31 (40.3%) had full spontaneous erections, 8 (10.3%) were currently responding to pharmacotherapy and 38 (49.4%) failed. The maintenance flow was 75 +/- 45 ml. per minute in the group with spontaneous erections and 103 +/- 60 ml. per minute in the failure group (p = 0.20). Mean patient age was 49.8 +/- 11.7 and 49.1 +/- 10.2 years, respectively (p = 0.23). Of the 41 patients wih normal single potential analysis of cavernous electrical activity 28 had full erections postoperatively, 5 responded to pharmacotherapy and 8 failed, compared to 3, 3 and 30, respectively, of the 36 patients with abnormal single potential analysis of cavernous electrical activity. After a mean followup of 21 months (range 6 to 47 months), 4 patients with full erections at 6 months postoperatively currently require intracavernous pharmacotherapy. Our results indicate that single potential analysis of cavernous electrical activity seems to be an important prognostic factor for the postoperative outcome of penile venous surgery for venogenic impotence.

Adult↗
PubMed1994

Orchitis following mumps vaccination in an adult.

An acute epididymo-orchitis, followed by a viral arthritis of the left hand, occurred as complications of a mumps vaccination. In the last 17 years 4 certain cases of orchitis following vaccination have been published in Germany. We describe an additional case and discuss the possible consequences.

Adult↗
PubMed1994

Intracavernous calcitonin gene-related peptide plus prostaglandin E1: possible alternative to penile implants in selected patients.

The implantation of a penile prosthesis is still the ultima ratio for patients with erectile dysfunction who fail other treatment options such as pharmacotherapy and penile venous surgery. Despite mostly favorable results regarding restoration of erectile capacity, penile allografts are often not accepted for various reasons. Therefore, pharmacotesting with a mixture of calcitonin gene-related peptide and prostaglandin E1 (CGRP/PGE1) was offered to different selected patients populations: 28 patients with erectile dysfunction and venous leakage who failed penile venous surgery, 28 patients with erectile dysfunction and venous leakage (who refused penile venous surgery) and 12 patients without venous leakage, but poor response to maximum doses of papaverine/phentolamine, received 5 micrograms CGRP plus 10 micrograms PGE1. Erections sufficient for intercourse were noted in 19/28 (67.9%), 20/28 (71.4%) and 11/12 (91.7%) patients, respectively. Our data show that a combination of CGRP and PGE1 may be an alternative to penile implants in selected patients.

Alprostadil↗
PubMed1994

[Metastatic adult teratoma of the testis. Possibilities of chemotherapy and surgical treatment].

We report on a patient with the diagnosis of an adult teratoma metastasizing as choriocarcinoma. The 49-year-old man died of dysfunction of the liver caused by massive metastatic involvement. This case demonstrates the malignant potential of adult teratoma and emphasizes the need for chemotherapy of the same kind as for other malignant germ cell tumours if undifferentiated metastases of the teratoma are present. The chemotherapeutic modalities and the options for surgical treatment of metastatic adult teratomas of the testis are discussed.

Carcinoma, Squamous Cell↗
PubMed1993

[Effectiveness and safety of cavernous body auto-injection therapy with papaverine/phentolamine. Study group].

A multicenter long-term study at 13 urologic clinics in Germany and Austria tested the efficacy and safety of a papaverine (15 mg/ml) and phentolamine (0.5 mg/ml) mixture (ANDROSKAT) in achievement of pharmacologically aided erection. The study population of 157 men with chronic erectile dysfunction received a total of 559 injections administered by physicians, to establish the individual minimal dose of the mixture needed by each patient for a rigid erection. Rigidity sufficient for intercourse was achieved by 94% of these men. In the second phase of the study, 92 men administered a total of 4717 self-injections (mean 51.2, SD 7.7), with an average follow-up of 14 months. The mean therapeutic dose was 1.02 ml (SD 0.72). The latency time to full erection averaged 10.3 min (SD 5.5). The average duration of the erection induced was 67.1 min (SD 40.8, min. 11.2, max. 236). Sexual intercourse, orgasm and ejaculation were reported following 90%, 88% and 86%, respectively, of all injections. In the initial diagnostic phase, prolonged erections were seen in 13 patients (3%) and minor bruises at the injection site in 12 men. Side effects of self-injection during home therapy were pain (1.2%), haematoma (2.6%) and prolonged erection (0.9%). We conclude that self-injection with a combination of papaverine and phentolamine is an efficient and safe long-term treatment for erectile dysfunction.

Adult↗
PubMed1993

[Results of surgical therapy for venous insufficiency as a cause of erectile disorders].

Since penile vein ligation is usually associated with a poor postoperative outcome, a study was undertaken to evaluate possible prognostic factors for this procedure. A total of 44 patients with erectile dysfunction underwent ligation of all dorsal penile veins and resection of the deep dorsal penile vein for venous impotence. A comprehensive study of all patients was made. All patients did not respond to pharmacotherapy and had a venous leak. With a minimum follow-up period of 6 months, patients were categorized as follows: full spontaneous erections, those patients responding to pharmacotherapy and those showing no improvement. Out of 44 patients, 13 had full spontaneous erections postoperatively, 5 now responded to pharmacotherapy and 26 showed no improvement. The maintenance flow was 89 +/- 50 ml/min in the group with spontaneous erections and 85 +/- 49 ml/min in those showing no improvement (P = 0.78). Out of the 20 patients with normal single potential analysis of cavernous electric activity (SPACE), 12 had full erections postoperatively, 4 showed no improvement and 4 responded to pharmacotherapy. Of the 24 patients with abnormal SPACE, 1 developed full erections, 1 now responds to pharmacotherapy and 22 showed no improvement. Our results indicate that SPACE seems to be an important prognostic factor for the postoperative outcome of penile vein ligations for venous impotence.

Adult↗
PubMed1993

Symptomatic sulfadiazine crystalluria in AIDS patients: a report of two cases.

As the incidence of toxoplasma encephalitis (TE) in AIDS patients increases, sulfadiazine/pyrimethamine combination therapy is broadly administered. Two cases of acute and chronic renal sulfadiazine crystallization with acute renal failure and nephrolithiasis are reported. Controlled alkalinization of the urine and high fluid intake are recommended for prophylaxis of crystalluria.

AIDS-Related Opportunistic Infections↗
PubMed1992

The influence of anterior root stimulation (S2) in deafferented spinal cord injury men on cavernous electrical activity.

Registration of cavernous electrical activity (single potential analysis of cavernous electrical activity) was recently suggested for the diagnosis of autonomic cavernous dysfunction. For validation of this method the effect of sacral neurostimulation on cavernous electrical activity was examined. In 3 male patients with a complete spinal cord lesion (T3, T4 and T12, respectively), deafferentation was done at the S2 to S5 levels. Around the anterior roots of S2 to S5 electrodes for neurostimulation were placed. Cavernous electrical activity was recorded with an intracavernous needle electrode and with surface electrodes in the flaccid as well as in the erect states induced by neurostimulation (at 7, 8, 12, 18, 20, 30 and 45 Hz., 30 v. and 0.4 msec). In all patients similar potentials compared to the normal values, as well as additional pathological potentials were recorded during flaccidity. During neurostimulation all patients achieved full erection with no or markedly decreased cavernous electrical activity to frequencies of 12, 18, 20 and 30 Hz., while to 7, 8 and, more pronounced, 45 Hz. only partial erection with ongoing cavernous electrical activity was found. Our study strongly suggests that cavernous electrical activity and, subsequently, the cavernous smooth muscle tone are dependent on autonomic input. This finding supports the hypothesis that single potential analysis of cavernous electrical activity may be valid in the diagnosis of cavernous autonomic dysfunction. Furthermore, our results suggest a possible role for single potential analysis of cavernous electrical activity in the fine tuning of erection inducing neurostimulators.

Adult↗
PubMed1992

A new therapeutic concept for long-lasting iatrogenic priapism: a case report.

In a therapeutic attempt on an 18-year-old patient with iatrogenic priapism lasting for more than 2 weeks after internal urethrotomy, intracavernous lysis was commenced with 80,000 IU streptokinase per hour. Following a dosage of 300,000 IU streptokinase the lysis was stopped because of severe bleeding from the urethrotomy scar. At 4 weeks after the patient was discharged from the hospital he reported normal erections and intercourse, while single potential analysis of cavernous electrical activity and ultrasound returned to normal. Provided there are no contraindications, intracavernous lysis seems to be an effective treatment for long-lasting priapism induced by intracavernous thrombosis.

Adolescent↗