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  • 1
    ISSN: 0378-4347
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Der Urologe 39 (2000), S. 260-266 
    ISSN: 1433-0563
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die kontralaterale Hodenbiopsie (Abb. 1) ist in Dänemark seit vielen Jahren ein obligater Bestandteil der Therapie des germinalen Hodentumors [36]. Auch im deutschsprachigen Raum hat es seit über zehn Jahren zahlreiche Empfehlungen zur routinemäßigen Durchführung der kontralateralen Biopsie gegeben [1, 14, 24, 28, 33, 41]. Im Jahre 1997 hat die interdisziplinäre Konsensuskonferenz zur Diagnostik und Therapie von Hodentumoren festgestellt, daß eine kontralaterale Hodenbiopsie bei der Therapie von Hodentumoren “durchzuführen ist” [40]. Trotz dieser vielfältigen und eindeutigen Empfehlungen ist die kontralaterale Biopsie ein kontroverses Thema geblieben.
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  • 3
    ISSN: 0021-9673
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Contralateral biopsies from 1810 consecutive patients with testicular germ-cell tumor were examined immunohistologically by staining for placental alkaline phosphatase. Contralateral testicular intraepithelial neoplasia (TIN; carcinoma in situ) was found in 89 patients (4.9%; 95% confidence interval, 3.9%–5.9%). Testicular atrophy was present in 45.9% of patients with TIN and in 13.1% of those without TIN (P〈0.01). There was a history of cryptorchidism in 16.2% of patients with TIN versus only 8.5% of those without TIN (P〈0.05). Patients with contralateral TIN presented at an earlier age (30.8 versus 33.3 years). In all, 23 patients with contralateral TIN had no specific risk marker. In 14 patients with contralateral TIN who had received local radiotherapy of 18–20 Gy to the testis, rebiopsy revealed the disappearance of TIN in all cases. Serum testosterone levels were within or above the normal range in 7 of 13 patients examined after local radiotherapy. Of 9 patients with contralateral TIN who had received chemotherapy, 2 were shown to have persistent TIN at rebiopsy. We conclude that all patients with testicular germ-cell tumor should be offered a contralateral biopsy. Local radiotherapy of the testis is the treatment of choice in patients with contralateral TIN.
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  • 5
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A total of 385 patients (83% men, 52% aged 16–30) with urogenital (UG) trauma were treated in 19 urological clinics between April 1984 and December 1986. In all, 41% of the accidents were due to traffic; 13% to work and sports each; 8% to sexual activities; and 6% to violence. The distribution of injury severity included 40% light, 21% moderate and 39% severe. Of 427 UG lesions, 27% were combined with intraabdominal and 24% with pelvic injuries. The kidneys were involved in 51% of cases and the bladder, urethra, penis and scrotum, including its content, in ca. 10% each. Of the renal traumas, 49% were ruptures; 48% contusions; and 7% hilar lesions,a nd in 6% the complete destruction of the organ occurred. In all, 76% of these traumas were treated conservatively, whereas 8% each required reconstruction or nephrectomy. Amongst the urethral ruptures, 46% were complete; 39% partial posterior; and 11% ruptures of the penile urethra. In 43% of cases the treatment was conservative and in 41% a primary reconstruction was carried out. All intraperitoneal (43%) and 2/3 of the extraperitoneal bladder ruptures (57%) were operated on. Gross hematuria was found in 73% of the renal, 83% of the vesical and 73% of the urethral injuries. Microhematuria occurred in 24%, 9% and 13% of cases, whereas no hematuria was found in 3%, 5% and 13% of the kidney, bladder and urethral injuries, respectively. The injury-relevant sensitivity of the imaging methods was computed to be 95% for cystograms, 91% for urethrograms and 83% for angiograms. When used to screen trauma patients, the sensitivity proved to be 69% for the CT scan, 55% for the intravenous pyelogram (IVP) and 54% for sonography. Overall, 37% of 161 complications involved the UG tract, followed by neurological complications, those due to the operation or treatment, to infections or to organ failure. In all, 11% of patients remained in the hospital for only 1 day; 50% for up to 13 days; 20% for 14–60 days; and 17% for 〉60 days.
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Histopathology 18 (1991), S. 0 
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 66 (1988), S. 337-339 
    ISSN: 1432-1440
    Keywords: Seminoma ; HLA-association ; Genetic factors ; Pathogenesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Clinical and epidemiological studies suggest that genetic factors may be involved in the etiology and pathogenesis of testicular germ-cell tumors (GCTs). Previous HLA studies have tried to support the concept of genetic anticipation of GCTs, however, the results obtained have been inconsistent. The reasons for the divergent results are mainly statistical problems, i.e., small patient populations, high numbers of antigens tested, and inhomogeneous study populations. In the present retrospective study, 52 patients with histologically pure seminoma were typed for their HLA-A, B, C, and DR antigens. Only BW41 proved to be significantly increased in frequency after correction for the number of antigens tested (chiQ=12.73;P=0.0005). HLA-DR1 was shown to be decreased, however, the difference was not significant. Regarding metastatic seminoma alone, there was a trend towards an increase of A29, BW41, and DR7. Our study gives only weak evidence for the participation of genetic factors in the pathogenesis of seminoma. The statistical trend of HLA association observed in metastatic seminoma deserves further concern as does the question of whether MHC class II antigens are also involved in the pathogenesis of testicular seminoma.
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  • 8
    ISSN: 1432-1440
    Keywords: Erythropoietin ; Renal cell carcinoma ; Paraneoplastic hormones ; Tumor cell marker
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The prevalence of increased serum immunoreactive erythropoietin (Epo) was determined in a prospective study of 49 patients with renal cell carcinoma. Measured by a monoclonal antibody based commercial enzyme-linked immunoassay, the Epo concentration was above the normal range, determined in nonanemic humans, in four of the renal carcinoma patients. Since three of these were anemic, their increased Epo level was considered to be appropriate. The high estimate of serum Epo (218 U/1) in the fourth patient, who was not anemic, was not confirmed when tested by radio immunoassay. Thus, in contrast with earlier studies, our results indicate that increased Epo is not a clear serological renal cell carcinoma marker. In addition, when monolayer cell cultures of 14 different established human renal carcinoma lines were screened, none of these released immunoreactive Epo in measurable amounts.
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  • 9
    ISSN: 1432-1335
    Keywords: Testis biopsy ; Testicular neoplasmus ; Testicular intraepithelial neoplasia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A routine biopsy of the contralateral testis obtained during orchiectomy for embryonal carcinoma in a 26-year-old patient was negative for testicular intraepithelial neoplasia (TIN; carcinoma in situ of the testis). However, a rebiopsy that was taken because of unexplained elevation of α-fetoprotein 15 months later proved to be positive for TIN. Six previously reported cases of false-negative testicular biopsies obtained during a search for TIN are reviewed. In the light of several thousands of biopsies performed world-wide to date, the number of false-negative biopsies is probably very low. Although TIN is obviously not randomly dispersed throughout the testis in all patients, a routine biopsy of the contralateral testicle in patients with testis cancer remains a valuable tool for early detection of bilateral testicular tumorscal distribution of TIN in testes removed for this lesion. Their results suggested that after puberty TIN is usually randomly dispersed throughout the testicle. Support for this concept was recently given by Mumperow et al. (1992). These authors examined tumor-bearing testes and they did not find differences in the presence of TIN in biopsies taken from a location close to the tumor and taken from a location distant from the tumor. Thus, one single biopsy is regarded to be representative for the entire testis and one biopsy taken after puberty is also assumed to be reliable for predicting whether the testis will ever develop cancer (Berthelsen and Skakkebaek 1981 a). Conversely, if the biopsy is negative for TIN, a future tumor manifestation in the testicle examined is not expected according to this theory (Skakkebaek et al. 1987). Taken together, the concept of TIN would constitute an ideal avenue for the early detection of testis cancer in high-risk populations with the biopsy being a safe means of discriminating between individuals who will or who will not develop testis cancer.
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  • 10
    ISSN: 1432-1335
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The traditional adjuvant therapy for seminoma stage I is abdominal radiotherapy. Although the relapse rate ranges below 5% this treatment is challenged because concerns about adverse late effects are accumulating. Carboplatin is effective in metastatic seminoma and two pilot studies have indicated effectivity in the adjuvant setting also. As this drug is almost non-toxic in moderate doses it could be an ideal adjuvant treatment for seminoma stage I. A group of 82 patients, mean age 37.5 years (range 22–73 years), with histologically pure seminoma stage I, were given carboplatin 400 mg/m2 after orchiectomy; 60 patients received only one course of carboplatin, and 22 patients received two courses. The median time of observation is 24 months, ranging from 2 to 48 months, and 66 patients have a minimum follow-up of 1 year. There is one relapse so far. Toxicity is rather mild with no severe nausea/emesis. Mean platelet counts were 164/nl after 3 weeks and 208/nl after 4 weeks; thus, myelotoxicity was negligible. Gonadal toxicity was measured by serial follicle-stimulating hormone levels. The mean level was 11.4 U/l before treatment, and 16.2 U/l after 5 weeks, 17.3 U/l after 4 months, 14.5 U/l after 8 months and 13.5 U/l after 12 months. Thus, gonadal toxicity also appeared to be mild. In summary, the efficacies of adjuvant carboplatin and of abdominal radiotherapy seem to be identical. As carboplatin, in the dosage used, involves no severe acute side-effects and probably few late adverse effects, this regimen constitutes a promising new treatment option in seminoma patients stage I that deserves to be studied in randomized trials.
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