Post-prostatectomy radiotherapy adversely affects urinary continence irrespective of radiotherapy regime.

PURPOSE: To investigate the influence of different postoperative radiotherapy (RT) regimes on post-prostatectomy continence and QoL. METHODS: Men after prostatectomy (RP) and RT were assigned in adjuvant (ART), early salvage (ESRT) and salvage radiotherapy (SRT) groups depending on time of initiation, indication and pre-RT-PSA (≤/>0.5 ng/ml). Continence and QoL outcomes were evaluated by validated questionnaire. Statistical analysis included students t test, Chi square, Fisher's test, ROC- and McNemar-Bowker-Analyses. RESULTS: The mean follow-up was 5.1 years. 33.5, 38.2 and 28.3% received ART, ESRT and SRT, respectively. Mean time to RT was 0.3 (±0.4), 1.8 (±2.5) and 3.3 (±3.6) years respectively. Differences in age at RP (p = 0.54) and RT (p = 0.47) between groups were not significant. Mean-RT-dose was similar (p = 0.70). Differences in continence distribution between groups before (p = 0.56) and after RT (p = 0.38) were not significant. No significant differences were observed for frequency (p = 0.58) or amount (p = 0.88) of urine loss, impact on QoL (p = 0.13) and ICIQ-SF scores (p = 0.69) between groups. Even though no significant difference in post-RT-continence (p = 0.89) was observed in the direct comparison between groups, a significant worsening of long-term continence was observed in all groups (p < 0.001). We found no cutoff and no time-point after RP at which this negative effect of RT on continence became insignificant (AUC = 0.474). A subgroup with apparent local recurrence showed no differences for ICIQ-SF-score (p = 0.155), QoL (0.077), incontinence grade (p = 0.387), frequency (p = 0.182) and amount (p = 0.415) of urine loss. Proportionally more men in this subgroup remembered deterioration of continence after RT (p = 0.029). CONCLUSION: Postoperative RT adversely affects long-term continence; this negative effect is irrespective of time of initiation or indication for RT. These results suggest a need for innovative strategies of prostate cancer therapy with lasting oncological, functional and QoL outcomes.

Sindrome de Youssef: a proposito de tres casos. / Youssef's syndrome: report of three cases

Sao apresentados tres casos de fistula vesicouterina atendidos no Hospital das Clinicas da Universidade Federal do Parana.As pacientes apresentavam menuria ciclica (mentruacao vesical) secundaria a fistula vesicouterina, nao tinham incontinencia urinaria, mas apresentavam amenorreia aparente. A frequencia de casos observada pode ser justificada pela atual alta de incidencia de operacoes cesarianas. Dois eventos interessantes sao destacados pelos autores como fatores etiologicos:a presenca de corpo estranho na bexiga de uma paciente e a rotura uterina previa sofrida por outra. A histerossalpingografia e a cistoscopia foram uteis na localizacao da fistula. Todos os casos foram tratados cirurgicamente, mediante disseccao de bexiga e do utero, que foram suturados separadamente. Nao houve recidivas pos-operatoria

[Experience with Jakobi's logatom test. Recommendations for international speech audiometry]. / Erfahrungen mit dem Logatomtest nach Jakobi. Ein Vroschlag für eine internationale Sprachaudiometrie.

Since 1959 in the Univ. ENT-clinic of Halle/S. a so called Logatomtest from Jakobi with senseless syllables is in use for paedoaudiology. It was proved in cases of adults with hearing losses as well as in normal patients too. The results were nearly the same as with the test of Hahlbrock in german language. For international use we checked the distribution of consonants and vowels in 10 european languages. We often need speech audiograms for patients from foreign countries, who are not familiar enough with the german language. So it seems to us, that a senseless test is more reliable. In the 10 languages the distribution of the consonants was very similar but not of the vowels. Because the discrimination in speech is based on the consonants, we think out test can be recommended for international use.

[Standardized examination methods for smell and taste and their clinical value]. / Standardisierte Riech- und Schmeckprüfungsmethoden und ihr klinischer Wert.

The diagnostic of disturbances of the chemical senses is from a clinical standpoint still insufficient, as the literature of the whole world shows. Ten years of experimental and clinical investigations as well as the collection and evaluation of the experiences at the University ENT-Clinic Halle/S., GDR--have helped to develop some new tests and tools like a big and a small smell-case, two electrogustometers, the documentation by means of olfacto- and gustograms and so on. Now in the whole GDR a special group of ENT-scientists, members of our ENT society, are working on standardisation. The experiences will be official in our country. After the representation of our diagnostic system from to-day, as we are using them in our clinic, we are giving clinical examples as the diagnosis of the cranial nerves, the control of the treatment and so on, which are showing the usefulness of such examinations in smell and taste.

[Results of treatment of the cancer of the larynx at the ENT-University-Clinic, Halle/Saale, 1940 to 1969 (author's transl)]. / Ergebnisse der Behandlung des Larynxkarzinoms an der HNO-Univ.-Klinik Halle von 1940 bis 1969.

The treatment-surgery and irradiation- of 722 patients with cancer of the larynx in the years 1940-1969 are being statistically evaluated. The classification was done accordingly to localisation, stage (TNM-system) and the kind of therapy. The evaluation of the results only considers the 5-years-healing. Surgical therapy and primary irradiation were confronted. The irradiation ranks equally to surgery only at stages I and II of the carcinoma of the vocal cords. Tumors at other localisation or at a different stage (III and IV) can only be successfully treated by surgery.

[Statistics on 1231 patients with cancer of the larynx 1940 to 1974 (author's transl)]. / Statistische Erhebungen an 1231 Patienten mit Kehlkopfkarzinom der Jahre 1940 bis 1974.

At the ENT-Univ. Clinic Halle/Saale 1231 patients suffering from an histological verified cancer of the larynx have been observed over the last 33 years. The numbers of male cases have been trebled within the last 30 years. This trend could not be observed in women. The increase is connected with a remarcable concentration of the supraglottic localisation. Despite of intensive information of the population most of the patients only turn to our clinic in the stage II and III (TNM-system). Only in 9.9% of the cases their fate remained unknown.

[Clinical and experimental use of ATP in internal ear diseases]. / ATP-Anwendung bei Innenohrerkrankungen in der Klinik und im Experiment

Intra-arterial ATP infusions with glucose and hyaluronidase were successful in 267 patients suffering from various inner ear disturbances but particularly in sudden deafness. Good clinical results were noted not only in early-treated but also in later cases. Recently, we have also used ATP with hyperbaric oxygen, being successful in cases which were previously treated without improvement. Investigations in guinea-pigs, using artificial hypoxia as a model for human sudden deafness failed because the patterns are not the same. So long as an increase of ATP in the cochlear cells cannot be demonstrated after the i.a. infusions, only an unspecific mechanism can be held responsible for the undoubted clinical successes.

[New animal experiments on aerobic and anareobic inner ear metabolism]. / Neue Tierexperiment zum Aeroben und Anaeroben Innenohrstoffwechsel

The inner-ear function is bound up with a permanent oxygen supply. The evidence of it are the patterns of the LDH subunits in inner-ear of eight species. The inner-ear energy turnover of glycolysis post-mortem was demonstrated at those species possessing glycogen storages. The MP2 are alterated by perfusion of glucose or iodoacetic acid. During oxygen respiration the MP are not decreased by iodoacetic acid.

ATP-atp. / Erste Beobachtungen bei kombinierter ATP-Sauerstoff-Uberdruckbehandlung von Hürzen

It has been known for some years that intra-arterial application of ATP as well as the only treatment with hyperbaric Oxygen is able to influence favorably a sudden hearing loss. In this study the combined application of both agents was used optimally. Up to now only few cases could be treated. The three above mentioned patients have shown remarkable results. A patient with a long lasting sensorineural hearing loss is especially interesting and this is the reason why we now publish the results gathered up to now.