The role of annexins I, II and IV in tumor development, progression and metastasis of human penile squamous cell carcinomas.

PURPOSE: The outcome of patients with penile squamous cell carcinomas (PSCC) largely depends on occurrence of metastasis. Therefore, prognostic markers indicating the risk for tumor cell spreading would be useful. Since Annexins are potential prognostic markers in a variety of tumors, we immunohistochemically examined the expression of Annexins I, II and IV (ANX AI, ANX AII and ANX AIV) in PSCC. METHODS: Samples originated from 29 patients subjected to surgical resection of invasive PSCC. Immunohistochemistry was done on paraffin-embedded sections using monoclonal antibodies against ANX AI, ANX AII and ANX AIV. Expression of ANXs was compared with clinical data. RESULTS: ANX AI expression was found in conventional PSCC and was absent in basaloid and sarcomatoid subtypes. High ANX AI score was significantly associated with higher T stages (P = 0.006). Strong expression in the invasion front of carcinomas was significantly associated with the occurrence of lymph node metastasis (P = 0.001). ANX AIV expression was weak in conventional PSCC, while it was strong in basaloid and sarcomatoid subtypes. Strong expression of Annnexin IV in the invasion front also showed a significant association with metastasis (P = 0.019). CONCLUSION: Expression of ANXs was different in histologic subtypes of penile carcinomas. Strong expression of ANX AI and ANX AIV in the invasion front seems to indicate a higher risk of lymph node metastasis.

[The current state of the art of chemotherapy of penile cancer: results of a nationwide survey of German clinics]. / Die aktuelle Situation der Chemotherapie des Peniskarzinoms : Ergebnisse einer deutschlandweiten Klinikumfrage.

INTRODUCTION: The prognosis for advanced penile carcinomas is extremely poor. Due to the low response rates and relevant side effects of current chemotherapy regimens, several attempts have been made to improve chemotherapy in recent years. In a retrospective survey the current state of the art of chemotherapy for penile carcinoma in Germany was analysed. METHODS: The study took the form of a retrospective survey among all urological departments in Germany. The questionnaire contained seven questions concerning indications and modalities for chemotherapy of penile carcinoma in addition to general questions. RESULTS: Out of 280 departments 129 (46%) returned an answered questionnaire. Chemotherapy was reported to be carried out by 91 of the answering departments and overall 18 different chemotherapy regimens were used. The regimens cisplatin/methotrexate/bleomycin, vinblastin/methotrexate/bleomycin and cisplatin/5FU were the most frequently reported. Chemotherapy was carried out on average 2.3 times per year per department. The majority of the departments reported response rates under 30%. Finally 101 of the answering departments confirmed the necessity of new chemotherapy regimens. CONCLUSIONS: The current state of the art for chemotherapy of penile carcinoma showed a very large variation in Germany. The response rates were disappointing. A nationwide study with new chemotherapy approaches is urgently needed (information under www.uni-rostock.de/peniskarzinom).

[Sex therapy for male sexual dysfunction]. / Sexualtherapie bei sexuellen Funktionsstörungen des Mannes.

A high prevalence and incidence of sexual dysfunctions as well as the availability of orally effective medications cause a rising interest in professional help. In diagnosing and treating sexual disorders, a holistic, biopsychosocial understanding of sexuality and a thorough analysis of the specific needs of the couple are of the utmost importance. Furthermore, the typical physician-patient relationship has to be transformed into a physician-couple relationship wherever possible. Sex therapy, then, focuses on the universal psychosocial fundamental needs and their relevance for the complaints of the couple. In this way the main focus of attention is shifted from the sexual dysfunction to the communicative meaning of sexuality within the relationship and to the quality of the partnership as a whole. Thus the sexual problem is put into a new perspective and sexual functions are relieved from the pressure of performance anxiety. Simultaneously intimacy and mutual satisfaction are promoted. The possibility of obtaining an additional qualification in sexual medicine (since 1997 in postgraduate, curricular trainings) is offering new opportunities for urologists to integrate aspects of sexual medicine into their clinical practice and thus to propose a more extensive form of therapy to their patients. This paper reflects the process of this integration, illustrating it with respective case reports; it stresses the necessity of a holistic approach to the treatment of sexual dysfunctions, also in regard to the economic advantages of a biopsychosocially oriented sex therapy.

Tumour-related enzyme alterations in the clear cell type of human renal cell carcinoma identified by two-dimensional gel electrophoresis.

To identify tumour-related enzyme alterations we have used 2D-gels to analyse the proteome from dissected malignant and benign kidney areas from patients with clear-cell-type renal carcinoma. The expression of 12 proteins was diminished in tumour. Four proteins were characterized by mass spectrometry and were identified as enoyl-CoA hydratase, alpha-glycerol-3-phosphate dehydrogenase, aldehyde dehydrogenase 1 and aminoacylase-I.

[Leiomyoma of the kidney. Differential diagnostic aspects of renal cell carcinoma with increasing clinical relevance]. / Das Leiomyom der Niere. Ein differentialdiagnostischer Aspekt des Nierenzellkarzinoms mit zunehmender klinischer Relevanz.

Renal leiomyoma is a rare benign tumor which has its origin in smooth muscle cells of different structures of the kidney. The clinical incidence of renal leiomyoma is much lower than the frequency described in large autopsy studies. Renal leiomyomas are mainly located in the renal capsula and pelvis or next to those structures. Clinical symptoms are nonspecific (e.g., flank pain or flank tumor) or completely absent, making most of the leiomyomas an incidental finding during routine diagnostics. A differential diagnosis between renal leiomyoma and renal cell carcinoma on the basis of medical imaging is extremely difficult. Therefore, laparotomy and nephrectomy are performed in most cases of suspected renal cell carcinoma. The definitive diagnosis of a leiomyoma is only possible after histological examination of the tumor. Due to the rising number of diagnoses resulting from improved medical imaging, renal leiomyomas are gaining more importance in the differential diagnosis of renal cell carcinoma, especially with respect to kidney-sparing surgery.

Prediction of metabolic activity from genotype: the gene-dose effect of N-acetyltransferase.

Metabolic activity of the polymorphic N-acetyltransferase (NAT2) is determined by the mutation pattern of the NAT2 gene. This results in interindividual differences in the metabolic capacity (the phenotype), with continuous distribution of the activities rather than qualitative distinction between rapid and slow acetylators. To determine whether the phenotype might be predicted solely from the mutation pattern of NAT2, quantitative relationships were calculated between mutation patterns of the NAT2 gene and the phenotype of NAT2 assessed either in vitro or in vivo. Healthy volunteers were examined for the velocity at which they metabolized sulfamethazine, and human liver cytosols were measured for NAT2 enzymatic activity, obtaining in vivo and in vitro metabolic phenotype, respectively. Typing of the NAT2 gene was performed by polymerase chain reaction, restriction fragment length analysis, or allele-specific polymerase chain reaction. Multiple linear regression analysis provided quantitative relationships between allelic pattern and the NAT2 activities measured in vivo and in vitro. Estimates showed the influence of particular allelic configurations on enzyme activity in vitro and the extent of acetylation of the probe drug in vivo, resulting in a strict gene-dose effect. Comparison of in vitro results with in vivo phenotyping figures showed a high degree of correspondence, indicating that the one is the reflection of the other.

Efficacy and local tolerability of povidone iodine and octenidine hydrochloride solution for the antiseptic preparation of the orificium urethrae.

In a randomized clinical study, 61 hospitalized men were examined to test the local tolerability and antimicrobial efficacy of antiseptic treatment of the genitals with povidone iodine versus octenidine hydrochloride solution. Antibacterial efficacy was established by comparing the total aerobic bacterial colony count from standardized swabs from the orificium urethrae externum before, immediately after, and 30 and 60 min after antisepsis. Tolerability was assessed by dermatoscopy, applying a scale to rate the criteria of reddening, erosions and microbleeding. pH-value was taken and the nitracin yellow test carried out at several intervals. Patients assessed sensations (itching, burning, warmth, cold tension) in visual analogue scales. The test for equivalence in efficacy of both antiseptic agents produced no significant result (P = 0.3). The sum score of tolerability produced a better result for povidone iodine. In addition, the drop in the pH value after observed antisepsis with povidone iodine provides an additional protective mechanism against bacterial colonization.

[Mesoblastic nephroma in adulthood]. / Mesoblastisches Nephrom des Erwachsenenalters.

We report a 44-year-old female patient who underwent surgery because of a suspected primary tumor of the renal pelvis in imaging procedures. Histology revealed the diagnosis of mesoblastic nephroma. This tumor represents a special entity of nephroblastoma that rarely occurs in adults. There is no unanimous opinion on the biological behavior of mesoblastic nephroma because the tumor behaves differently. The question of whether nephrectomy is indicated if there are no malignant features is also open. The decision depends on the given case. Nephrectomy can only be avoided if the intraoperative situation allows the tumor to be removed with an adequate distance from healthy tissue. The safety margin is necessary because mesoblastic nephroma shows fingerlike spread into the surrounding tissue.

[Cellular immunity in prostatic cancer modified by Cytonal, Estrazyt and Turisteron]. / Die zellvermittelte Immunität (CMI) beim Prostatakarzinom unter Einfluss von Cytonal, Estrazyt und Turisteron.

The influence on the specific cell-mediated immunity (CMI) of the carcinoma of the prostate gland by the contra-sexual hormone therapy with Cytonal, Estrazyt and Turisteron is controlled. For this purpose the macrophage-electrophoresis-mobility test on the basis of allogenic tumour-associated antigen of the carcinoma of the prostate gland is used. As a result the use of Cytonal at least in the dosage hitherto used is no longer worth being advocated. Turisteron and Estrazyt, respectively, taking into consideration their pharmacokinetics and indication, prove to be immunologically optimal and without hesitation, respectively. Turisteron is the basic therapeutic in the androgen-dependent carcinoma of the prostate gland. Estrazyt should be reserved to primarily and secondarily hormone-refractory tumours. For the application of Estrazyt an additive immune stimulation seems to be worth taking into consideration.

Development of human polymorphic N-acetyltransferase.

Age dependence of activity of polymorphic N-acetyltransferase in the fetal human liver was estimated and compared with the hepatic enzyme of adults.

[En bloc perfusion of donor kidneys--a report on 2 1/2 years' experience]. / Die En-bloc-Perfusion der Donornieren--Ein Bericht über ihre 2 1/2 jährige Anwendung.

The methodology of the extracorporal en-bloc-perfusion of donor kidneys is described. After an application of nearly three years its advantages are explained and clearly confirmed on the basis of very good functional results after transplantation of kidneys preserved in such a way.

[Test suitable for assessing the immunocompetence of the tumor host in prostatic carcinoma]. / Studie zur Ermittlung geeigneter Teste für Einschätzung der Immunkompetenz des Tumorwirtes beim Prostatakarzinom.

The aim of our investigations is a control of the immunocompetence of the host of the tumour during the course of the tumour disease with the help of the spontaneous rosette test (proof of the T-lymphocytes). The results hitherto got are traced back to 21 patients with adenoma of the prostate and 9 patients with carcinoma of the prostate compared with healthy persons. The methods of the test is explained. Issuing from the formation of spontaneous rosettes which is anyway decreased in patients older than 60 years up to now no clear difference could be found between patients with adenoma and carcinoma. The decrease of the formation of spontaneous rosettes is unequivocal after operation as well as in the cytonal therapy.