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1.
Urologe A ; 49(4): 536-9, 2010 Apr.
Article in German | MEDLINE | ID: mdl-20063087

ABSTRACT

BACKGROUND: A number of bulking agents have been used for the endoscopic correction of vesicoureteral reflux in children. We present the long-term results of endoscopic use of dextranomer/hyaluronic acid copolymer (Deflux) for VUR grade I-IV in children. PATIENTS AND METHODS: Between 2004 and 2008, 21 children underwent endoscopic subureteral injection of Deflux in 30 ureters as an outpatient procedure. Twelve children had a unilateral reflux (two duplicated systems) and nine had a bilateral reflux. The median age was 5 years (6 months to 14.9 years). Six weeks postoperatively a voiding cystourethrogram (VCUG) was performed. This study examined the disappearance of VUR and urinary tract infection (UTI) as well as the quality of life (parents' questionnaire) during long-term follow-up. RESULTS: No intra- and postoperative complications were noticed. In 25 ureters (83%) VCUG showed no VUR 6 weeks postoperatively. In three children a second injection was done (two were successful). After a median follow-up of 2.5 years 27 ureters in 17 children (90%) had no UTI and VUR. The results of the questionnaire regarding quality of life were very good in the successfully treated children and the parents would choose the same treatment option again. CONCLUSION: Subureteral injection of Deflux for children with VUR is an effective treatment option for VUR with a low complication rate.


Subject(s)
Biocompatible Materials/administration & dosage , Dextrans/administration & dosage , Hyaluronic Acid/administration & dosage , Prostheses and Implants , Ureteroscopy , Vesico-Ureteral Reflux/surgery , Follow-Up Studies , Humans , Injections , Postoperative Complications/psychology , Quality of Life/psychology , Urodynamics/physiology , Urography , Vesico-Ureteral Reflux/classification , Vesico-Ureteral Reflux/physiopathology , Vesico-Ureteral Reflux/psychology
2.
Prostate Cancer Prostatic Dis ; 11(2): 166-72, 2008.
Article in English | MEDLINE | ID: mdl-17646850

ABSTRACT

The molecular mechanisms for hormone-resistant prostate cancer progression still remain elusive, mainly due to the limited availability of corresponding tissue. As transurethral resection (TUR) is a common palliative therapy for patients with hormone refractory prostate cancer (HRPC) who have subvesical obstruction, we aimed to demonstrate that TUR samples can be used to identify significantly affected biological pathways during the switch to HRPC using oligonucleotide microarray analysis. Among the most significantly deregulated pathways in HRPC, we observed an induction of oxidative phosphorylation and a repression of cytoskeletal components.


Subject(s)
Adenocarcinoma/genetics , Androgen Antagonists/pharmacology , Antineoplastic Agents, Hormonal/pharmacology , Drug Resistance, Neoplasm/genetics , Gene Expression Regulation, Neoplastic , Neoplasm Proteins/genetics , Prostatic Neoplasms/genetics , Transcription, Genetic , Transurethral Resection of Prostate , Adenocarcinoma/drug therapy , Adenocarcinoma/metabolism , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Aged , Aged, 80 and over , Androgen Antagonists/therapeutic use , Antineoplastic Agents, Hormonal/therapeutic use , Combined Modality Therapy , Disease Progression , Gene Expression Profiling/methods , Humans , Male , Middle Aged , Neoplasm Proteins/biosynthesis , Oligonucleotide Array Sequence Analysis , Prostatic Hyperplasia/genetics , Prostatic Hyperplasia/metabolism , Prostatic Hyperplasia/pathology , Prostatic Hyperplasia/surgery , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/metabolism , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgery , RNA, Messenger/biosynthesis , RNA, Messenger/genetics , RNA, Messenger/isolation & purification , RNA, Neoplasm/biosynthesis , RNA, Neoplasm/genetics , RNA, Neoplasm/isolation & purification , Signal Transduction/genetics
3.
Urologe A ; 46(11): 1551-6, 2007 Nov.
Article in German | MEDLINE | ID: mdl-17898983

ABSTRACT

Sertoli cell tumors of the testis are extremely rare (0.4-1.5% of all testicular neoplasms) and have a heterogeneous pathology. Histopathologically classic, large cell calcifying and sclerosing subtypes are differentiated.Up to now, 14 cases of sclerosing Sertoli cell tumor are known. This article presents a new case and compares the three subtypes. The subtypes differ in particular in age of onset, malignant potential, prognosis, and therapy. While no cases of sclerosing Sertoli cell tumor with a malignant course have been reported, both other subtypes have been found to be potentially malignant. In the case of malignancy the prognosis is very poor, and it is difficult to select the best treatment because there is so little experience with this type of tumor. Once the diagnosis of a Sertoli cell tumor has been confirmed, exact determination of the histological subtype is essential to allow appropriate risk-adapted therapy. The various histological subtypes are presented with the clinical features, prognosis and treatment of each.


Subject(s)
Sertoli Cell Tumor/diagnosis , Testicular Neoplasms/diagnosis , Adult , Biomarkers, Tumor/blood , Biopsy , Diagnosis, Differential , Fatty Liver, Alcoholic/blood , Humans , Male , Neoplasm Staging , Sclerosis , Sertoli Cell Tumor/pathology , Testicular Neoplasms/pathology , Testis/pathology , Ultrasonography , alpha-Fetoproteins
4.
Sportverletz Sportschaden ; 19(1): 22-7, 2005 Mar.
Article in German | MEDLINE | ID: mdl-15776325

ABSTRACT

AIM: Although the outcome of surgical treatment of rotator cuff tears is well documented in the literature, less is known about the efficacy of home exercises for symptomatic rotator cuff tears in correlation to the size of the defect. METHODS: A series of 30 patients (38 shoulders) with rotator cuff tears seen by ultrasonography were included in this prospective study. Rotator cuff tears were divided into partial defects (group A), full thickness tears of the supraspinatus tendon (group B), and massive rotator cuff defects (group C). Treatment consisted of a home program of stretching and strengthening exercises that were performed by the patients daily for a period of 12 weeks and controlled by a physician every 2 weeks. Range of motion, a modified constant score, and impingement signs at initial examination and after 12 weeks were compared. RESULTS: All groups experienced improvement in range of motion. The Constant scores improved significantly (p < 0.05) in all groups (A: 13.0 [+/- 7.9 SD], B: 13.2 [+/- 11.4 SD], and C: 17.5 [+/- 6.6 SD]). Impingement signs showed a downward trend in all groups. DISCUSSION: The results of this study show that patients with rotator cuff defects do benefit from simple home exercises independent from the size of the defect.


Subject(s)
Exercise Therapy , Rotator Cuff Injuries , Shoulder Impingement Syndrome/diagnosis , Adult , Aged , Female , Humans , Male , Middle Aged , Prospective Studies , Range of Motion, Articular , Rotator Cuff/diagnostic imaging , Rupture , Time Factors , Ultrasonography
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