Renal cell cancer correlated with occupational exposure to trichloroethene.

A previous cohort-study in a cardboard factory demonstrated that high and prolonged occupational exposure to trichloroethene (C2HCl3) is associated with an increased incidence of renal cell cancer. The present hospital-based case/control study investigates occupational exposure in 58 patients with renal cell cancer with special emphasis on C2HCl3 and the structurally and toxicologically closely related compound tetrachloroethene (C2Cl4). A group of 84 patients from the accident wards of three general hospitals in the same area served as controls. Of the 58 cases, 19 had histories of occupational C2HCl3 exposure for at least 2 years and none had been exposed to C2Cl4; of the 84 controls, 5 had been occupationally exposed to C2HCl3 and 2 to C2Cl4. After adjustment for other risk factors, such as age, obesity, high blood pressure, smoking and chronic intake of diuretics, the study demonstrates an association of renal cell cancer with long-term exposure to C2HCl3 (odds ratio 10.80; 95% CI: 3.36-34.75).

Antimicrobials for the treatment of bacterial prostatitis. Historical developments and current trends.

The treatment of bacterial prostatitis has always been difficult since only few substances have proven effects in clinical practice. The reason for this was investigated by animal studies in two steps. First a model of experimental bacterial prostatitis was developed. Then pharmacological studies with determination of penetration of various antimicrobial substances into serum, interstitial fluid, urine and prostatic secretion were performed. As a result we could show, that the place of the inflammatory process is the interstitium with only little effects in the prostatic acini. Thus only substances with good concentration in the interstitium can be expected to be effective in the eradication of bacterial invasion of the prostate gland. These are the basic macrolide erythromycin for gram-positive germs, the amphoteric tetracyclines or the newest quinolones for gram-negative bacteria, mycoplasma or chlamydiae.

Retroperitoneal lymph node metastasis from testicular tumor hidden by vena cava transposition.

We herein report a case of a retroperitoneal lymph node metastasis from a malignant teratoma with yolk-sac admixtures originating from the right testicle. The metastasis was missed on CT scanning due to a vena cava crossing over with the aorta in the region of the metastatic disease, but typical tumor marker elevation was seen on follow-up.

[Percutaneous nephrolithotomy and litholapaxy. Endoscopic destruction and removal of kidney calculi]. / Perkutane Nephrolithotomie und Litholapaxie. Endoskopische Zertrümmerung und Entfernung von Nierensteinen.

With the development of the ultrasonically guided punction of the kidney it has become possible nowadays to achieve direct access to the kidney without much difficulty. The puncture tract can be widened and used for the entrance of the so-called nephroscope, which enables the sitting and extraction of renal calculi, which are not able to drain away by themselves. The calculi are removed through the shaft by small forceps. Larger calculi are chiefly removed by means of ultrasonic probes or electro-hydraulic shock waves. This method of percutaneous lithotripsy or litholapaxy is also suitable for the extraction of calculi from kidneys with impaired drainage. Since the procedure can be carried out in a large proportion of patients with local anaesthesia, there are hardly any contraindications--except in cases of complete staghorn calculi. In contrast to the extracorporeal shock wave lithotripsy little apparatus is needed and it is not too expensive; therefore, it is also suitable for smaller hospitals and departments. The percutaneous lithotripsy represents a safe method of renal calculus extraction with little stress for the patients.

[Non-operative treatment of ureteral calculi using ureterorenoscopy]. / Nicht-operative Behandlung von Harnleitersteinen mit Hilfe der Ureterorenoskopie.

Rigid transurethral ureteroscopy was used in the treatment of 31 patients with 32 ureteral calculi. The stones could be visualized in 90% of cases. The aim of treatment was immediate extraction under visual control for smaller calculi and retrograde advancement into the renal pelvis with subsequent extracorporeal shock wave lithotripsy for larger calculi. The aim of treatment was reached in 92% (11/12) of stones in the lower third of the ureter, in 67% (4/6) in the middle third and in 64% (9/14) in the upper third of the ureter leaving 12 calculi extracted and 12 pushed up into the renal pelvis. Electrohydraulic lithotripsy in the ureter was used in 3 cases before extraction. Ureterolithotomy had to be carried out in 3 patients only (9%) following the endoscopic procedure.

[Effect of preoperative radiation on the success rate in the transplantation of human kidney cancer into thymus-aplastic nude mice]. / Einfluss der präoperativen Vorbestrahlung auf die Angangsrate menschlicher Nierenkarzinome in der thymusaplastischen Nacktmaus.

The authors investigated the influence of a preoperative irradiation on the rate of successful implantations and the growth behavior of human hypernephromas implanted into nude mice. No successful implantation was observed in hypernephromas preirradiated with a dose of 2000 rd, which was also confirmed by histologic examinations. The rate of successful implantation of 17 non-preirradiated hypernephromas (10/17) is below that of the total group, and the rate of successful implantation in serial passage (6/17 = 35%) is markedly inferior. The clinical observation that the incidence of local recurrences is reduced by a preoperative irradiation is explained by our experimental findings.

[Urologic symptoms in the abdominal muscle deficiency syndrome (author's transl)]. / Urologische Probleme beim Bauchdeckenaplasiesyndrom.

The abdominal muscle deficiency syndrome ("prune belly syndrome"(, a symptom triad of aplasia of the abdominal wall musculature, malformations of the urinary tract, and cryptorchism, is described from the urologist's point of view, citing nine cases. With modern diagnostic procedures the early detection of the correct diagnosis in the usually very young patients is possible. While the urologic symptomatology is due to the malformations in the urinary tract, the life expectancy depends mainly on the degree of renal function impairment. Combat of infection together with proper operative repairs are the treatments of choice to date. Instrumental procedures should be limited as much as possible. The survival changes following kidney transplantation appear promising.

[Bacterial prostatitis--therapeutic principles]. / Bakterielle Prostatitis - therapeutische Grundlagen.

The authors examined the possibilities of the treatment of bacterial prostatitis and yielded the following result: A medicament suited for the treatment of prostatitis must fulfil such chemical criteria, as they are at present to be found only in alkaline marcolids (e.g. erythromycin) and trimethoprim. Since trimehtoprim has a good spectre of action against gram-negative germs, it seems to be the suited remedy, for these pathogens are frequent and dominating in the pathogenesis of prostatitis. Gram-positive bacteria should be accessible to a therapy with erythromycin.