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  • 1
    ISSN: 1433-0563
    Keywords: Key words Erectile dysfunction • Medical history • Aetiology ; Schlüsselwörter Erektile Dysfunktion • Anamnese •Ätiologie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Ätiologie und Ausmaß einer erektilen Dysfunktion (ED) bleiben auch mit invasiven Abklärungen oft unklar. Unabhängig von der Ätiologie sind die intrakavernöse Injektion vasoaktiver Substanzen und Vakuumpumpen sehr effiziente Behandlungsmethoden. Diese beiden Tatsachen und der Kostendruck begünstigen eine therapieorientierte Abklärung ohne ätiologische Diagnose. Es stellt sich die Frage, ob in einer quantifizierenden Anamnese trotzdem eine ätiologische Diagnose der ED möglich ist. Bei 74 nicht behandelten Patienten mit ED im Alter zwischen 25–75 Jahren wurden sexuell stimulierte Erektionen anamnestisch quantifiziert und mit duplexsonographisch und klinisch erhobenen Daten pharmakostimulierter Erektionen verglichen. Die Patienten beschrieben eine erhebliche Verschlechterung der Penetrationsfähigkeit, der Erektionsdauer und der Rigidität (p 〈 0,0001). Die duplexsonographisch gemessenen Parameter sowie die klinisch beurteilte Reaktion, korrelierten mit pharmakostimulierten Erektionen (r = 0,72). Der Vergleich dieser gemessenen Daten mit anamestisch quantifizierten, zeigte keine nachweisbare Relation (r = 0,05). Wurde aber die erektionsbedingte Volumenzunahme mit anamestisch quantifizierten (r = 0,26–0,34; p 〈 0,03) Daten und pharmakostimuliert (r = 0,44–0,55; p 〈 0,0001) gemessene Parameter verglichen, zeigten sich signifikante Korrelationen. Sexuell- und/oder pharmakostimulierte Erektionen sind proportional zur Volumenzunahme des Penis. Trotz nachweisbarer Beziehung zwischen sexuell- und pharmakostimulierten Erektionen reichen die quantitativen Angaben über sexuell stimulierte Erektionen nicht aus, um eine Ätiologie zu diagnostizieren und aufwendigere Abklärungen einzusparen.
    Notes: Summary Even complex diagnostic tests may not establish aetiology and degree of erectile dysfunction (ED) in many patients. Therefore, we evaluated a self-report method with a restrictive focus to quality of erections which may yield information sufficient to make an aetiologic diagnosis. We studied 74 patients 25 to 75 years of age with untreated ED. Sexually stimulated erections were quantified and compared to duplexsonographically and clinically evaluated data from pharmacostimulated erections. Patients reported that there was a marked decrease in ability to penetrate the partner, to sustain an erection and of penile rigidity (p 〈 0.001). Parameters from duplexsonography and clinically assessed response to pharmacostimulation correlated (r = 0.72). Direct comparison of these data with quantified history showed no relation (r = 0.05). Using change in penile volume due to erection as a basis to compare with, showed significant correlation with quantified data from history (r = 0.26–0.34; p 〈 0.03) and measured parameters from pharmacostimulated erections (r = 0.44–0.55; p 〈 0.0001). Sexually- and pharmacostimulated erections are proportional to change in penile volume. Although there is a relation between erections emerging from both stimulations, quantifying history on sexually stimulated erections does not qualify to make an aetiologic diagnosis without using complex tests.
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  • 2
    ISSN: 1434-0879
    Keywords: Renal cell carcinoma ; Prognosis ; p53 ; mdm-2 ; Survival ; Proliferation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The clinical course of renal cell carcinoma (RCC) is highly variable. Overexpression of the p53 protein has been suggested as a possible prognostic parameter in RCC. Overexpression of the mdm-2 oncogene product has been shown to interact with the p53 function. To investigate the immunohistochemical overexpression of mdm-2 protein in comparison with that of p53 protein in RCC, 50 nonpapillary pT3 RCCs were immunostained for p53 protein (DO-7) and mdm-2 (1172). Tumor growth fraction (Ki-67 labeling index; MIB-1) was determined by immunohistochemistry. p53 positivity was detected in 16% of tumors. mdm-2 overexpression was seen in 30% of RCCs. There was a significant association between p53 and mdm-2 immunostaining (P=0.0006), suggesting that mdm-2 protein may contribute to p53 protein stabilization in RCC. p53 overexpression was associated with a high Ki-67 LI (P=0.0002), suggesting that p53 overexpression is involved in growth control in RCC. Survival analysis showed that Ki-67 LI (P=0.04) and p53 overexpression were associated with poor prognosis (P=0.0021), whereas mdm-2 overexpression was not related to patient outcome (P=0.73). A Cox regression analysis revealed tumor stage (P〈0.001) and p53 overexpression (P〈0.05) to be independent prognostic parameters. It is concluded that p53 but not mdm-2 may be of practical relevance in predicting patient prognosis in RCC.
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  • 3
    ISSN: 1434-0879
    Keywords: Bladder neoplasms ; Flow cytometry ; Fluorescence in situ hybridization ; Chromosome Y ; Chromosome X ; Chromosome 1 ; Chromosome 7 ; Chromosome 9 ; Chromosome 17 ; Aneuploidy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Detection of molecular alterations is of potential significance for diagnosis and prognosis in bladder cancer. Fluorescence in situ hybridization (FISH) allows visualization and quantitation of genes and chromosomes on a cell by cell level and can easily be applied to urinary cells. To evaluate the sensitivity of FISH for detection of DNA aberrations in bladder cancer, formalin-fixed tissues of 293 tumors were examined by FISH and flow cytometry (FCM). Centromere probes for the chromosomes X, Y, 1, 7, 9, and 17 were used for FISH analysis. FISH was more sensitive for detection of quantitative DNA aberrations than FCM. An aberration of at least one chromosome was found in 107 of 108 tumors (99%), which were tetraploid, aneuploid, or multiploid, and in 29 of 49 tumors (59%), which were diploid, by FCM. The frequency of FISH aberrations showed greater differences between pTa (47%) and pT1 tumors (85%;P〈0.0001) than between stages pT1 and pT2-4 (98%). The marked genetic difference between pTa and pT1 tumors argues against the concept of grouping pTa and pT1 tumors together as “superficial bladder cancer.” The frequency of tumors with chromosomal aberrations detected by FISH increased with the number of chromosomes examined. Aneusomy was seen in 68% of grade 1 tumors examined for ≥4 chromosomes, suggesting that the cytological diagnosis of bladder cancer recurrences could be substantially improved by FISH.
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  • 4
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Prostatakarzinom ; Zytogenetik ; Gen-Amplifikation ; Polysomie ; Key words Prostate cancer ; Cytogenetics ; Gene amplification ; Polysomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Development and progression of tumors is driven by a malfunction of specific genes. Although prostate cancer is one of the most frequent tumors, little is known about the genes involved. Cytogenetic and molecular examinations have shown that chromosomal deletions most frequently involve 7q, 8p, 10q, 13q, 16q, 17p and the Y chromosome. These loci may carry tumor suppressor genes with relevance for prostate cancer. DNA sequence copy number gains were most frequently observed at chromosomes 7, 8q, and 11q. These regions may carry currently un-known oncogenes. There is increasing evidence for a clinical relevance of genetic alterations. Polysomies of several chromosomes were shown to be associated with poor prog-nosis of prostate cancer patients. Androgen receptor amplification can be found in hormone-refractory carcinomas which may re-spond to total androgen blockage. For the future it is hoped that the identification of the genes involved in prostate cancer and the determination of their function could allow for significant improvements of treatment strategies for prostate cancer patients.
    Notes: Zusammenfassung Entstehung und Progression von Tumoren werden durch Funktionsstörungen von spezifischen Genen gesteuert. Obwohl das Prostatakarzinom zu den häufigsten Tumoren gehört, ist über die bei diesem Tumor involvierten Gene wenig bekannt. Zytogenetische und molekulare Untersuchungen haben gezeigt, daß chromosomale Deletionen besonders häufig das Y-Chromosom, 7q, 8p, 10q, 13q, 16q und 17p betreffen. Diese Loci dürften für das Prostatakarzinom relevante Tumorsuppressorgene enthalten. Häufige DNS-Sequenzvermehrungen von Chromosom 7, 8q und 11q deuten auf die Lokalisation von möglichen Onkogenen hin. Bereits heute bestehen Anhaltspunkte für eine Prognoserelevanz genetischer Veränderungen. Der Nachweis von Polysomien in Primärtumoren deuten auf eine ungünstige Prognose hin. Eine Amplifikation des Androgenrezeptors spricht für einen Hormontherapie-resistenten Tumor, welcher möglicherweise besonders gut auf eine totale Androgenblockade ansprechen wird. Die Identifikation der alterierten Gene und die Entschlüsselung ihrer Funktion könnte in Zukunft zu deutlich verbesserten Behandlungsstretegien für Patienten mit Prostatakarzinom führten.
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  • 5
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Um die Bedeutung von Zeitpunkt, Dosierung, und Dauer antimikrobieller Prophylaxe in der urologischen Chirurgie zu untersuchen, wurde eine experimentelle Studie an Meerschweinchen durchgeführt. Einer Gruppe von Tieren wurde vier Wochen vor den Experimenten ein subkutaner Fremdkörper implantiert. Sie diente als Riskikogruppe. Die Prostata und eine Niere wurden elektrokoaguliert. Durch intravenöse Injektion einerEscherichia coli-Suspension wurde eine Bakteriämie erzeugt. Ciprofloxacin wurde zu verschiedenen Zeitpunkten, in verschiedenen Dosierungen und unterschiedlich lange verabreicht. Antimikrobielle Prophylaxe war wirksam, wenn sie kurz vor oder nach den Bakterien verabreicht wurde. Ein Teil der normalen therapeutischen Dosis scheint für eine wirkungsvolle Prophylaxe auszureichen. Die Einmaldosierung war ebenso wirksam wie die Mehrfachdosierung. Die Fremdkörperinfektion konnte durch eine einzelne Dosis zuverlässig verhindert werden.
    Notes: Summary A study in guinea pigs was performed to investigate the importance of timing, dosage and duration of antimicrobial prophylaxis in urologic surgery. To simulate high-risk conditions, in one group a foreign body was implanted subcutaneously. The prostate and one kidney were cauterized and bacteremia was induced by intravenous injection of anEscherichia coli suspension. Various ciprofloxacin regimens were tested. The results indicate that antimicrobial prophylaxis is beneficial only if administered before or shortly after surgery. Full therapeutic dosage may not be necessary for prophylactic efficacy. Single-dose prophylaxis was as effective as multiple doses. Foreign body infection could be prevented by single-dose prophylaxis.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Infection 14 (1986), S. 253-254 
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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