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Copyright of Der Urologe B is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The general advances made in minimal invasive surgery in the last 15 years has also led to the introduction of several new techniques for treating female incontinence. In the further development of bladder neck suspension according to Stamey-Pereyra, the use of miniature bone anchors received considerable support. Bladder neck suspension according to Stamey-Pereyra yields good initial results with a low complication rate but achieves permanent continence in only 40-71%. The anterior percutaneous implantation of miniature bone anchors with the attached suspension effects continence rates between 24% and 94%. Healing rates for transvaginal application of miniature bone anchors range from 52% to 100%. Reactions to foreign bodies are particularly common with synthetics but also occur with autologous materials. They are often associated with detrusor instability or sensory urge symptoms. Though these minimally invasive techniques can reduce the severity of stress incontinence, long-term healing is only achieved in about half the cases. The techniques described appear to be particularly unsuitable for treating grade III stress incontinence. The morbidity is unacceptable, especially when synthetic material is used in combination with bone anchors. Impaired vaginal wound healing often occurs in conjunction with irritative symptoms. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The quality of well-being scale (QWB) and the Medical Outcome Study 36-item short form (SF-36) are alternative methods for measuring general health outcomes. Few studies compare these approaches against one another and no studies have compared German language versions.Method: A German language version of the self-administered quality of well-being scale (QWB-SA) was developed using forward and back translation methods. The German QWB-SA and a German language version of the SF-36 were administered to clinical population groups with current diagnoses of prostate cancer, benign hyperplasia of the prostate, colon cancer, and rectal cancer. Data were obtained from four German clinics. In addition to the quality of life measures, data on cancer stage and disease state were obtained.Results: The QWB-SA and SF-36 were highly correlated. The QWB-SA was systematically related to disease state. Those with no symptomatic evidence had the highest scores followed by those who were stable with no metastatic disease and those with metastatic progression. Similar patterns were found for most SF-36 scales although the SF-36 failed to discriminate between those with no evidence of disease and those with stable disease without metastasis.Conclusions: Both the QWB-SA and SF-36 perform as expected using German language translations. Although both measures differentiate patients with metastasis from those without symptoms, the QWB-SA better differentiated those with no evidence of disease from those with stable disease without metastasis. [ABSTRACT FROM AUTHOR]

Adhesion molecules play an important role in organogenesis, would healing, inflammation, and progression of malignant tumors. Three major classes of adhesion molecules may be discriminated by function: (a) calcium-dependent homotypic adhesion molecules (e.g. cadherins), (b) substrate adhesion molecules (e.g. integrins) and (c) heterotypic adhesion molecules (e.g. ICAM-1). Molecules of each of the three classes have been identified in urologic tumors. Results of research on substrate adhesion molecules and heterotypic adhesion molecules have not yet led to new clinical concepts. In contrast, loss of E-cadherin in tumors of the bladder and prostate has been clearly associated with de-differentiation of tumors and diminished survival of patients. Loss of another adhesion molecule, C-CAM, has been observed in prostate cancer. This has led to new therapeutic approaches, which are in an experimental stage at present. It may be expected that, in the future, new therapeutic concepts will be based on research on adhesion molecules in urologic tumors. [ABSTRACT FROM AUTHOR]

In 35 consecutive patients who underwent esophagectomy for malignancy the nutritional status was evaluated. 15 patients were estimated to be malnourished and were therefore treated by total parental nutrition (TPN) for 7 days. In the control group ( n = 20, no TPN) the nutritional status was normal. TPN corrected abnormal serum parameters with short half-life time. Therefore the nutritional status of both groups was equal at time of operation. The postoperative clinical outcome of both groups was as follows: In TPN-treated patients postoperative hospital stay for 26 days was shorter compared to 32 days in controls, no patient died (vs n = 4), one patient developed sepsis (vs n = 4), no patient developed acute renal failure (vs n = 3). These differences did not reach levels of significance due to the small patient groups. In conclusion our study shows that patients with esophageal cancer and regarded as well nourished seemed to suffer from nutritional deficits. Assessment of the nutritional status by commonly used nutritional parameters does not reveal these deficits. Bei 35 konsekutiven Patienten, die sich einer Oesophagusresektion wegen eines Malignoms unterzogen, wurde der Ernährungsstatus prospektiv erfaßt. 15 Patienten wurden als mangelernährt angesehen und präoperativ im Median für 7 Tage hochcalorisch parenteral ernährt. In der Kontrollgruppe ( n = 20, keine TPN) wurde der Ernährungsstatus als normal bewertet. Durch die parenterale Ernährung konnten bestehende Defizite bei Parametern mit kürzerer Halbwertszeit ausgeglichen werden, so daß am Tage vor der Operation der Ernährungsstatus beider Gruppen vergleichbar war. Auch hinsichtlich präoperativer Risikofaktoren, Tumorstadium und Operationstrauma waren beide Gruppen vergleichbar. Der postoperative Verlauf präoperativ parenteral ernährter Patienten war verglichen mit der Kontrollgruppe insgesamt günstiger. So lag die postoperative stationäre Behandlungszeit bei 26 gegenüber 32 Tagen, kein Patient verstarb (versus n = 4), ein Patient bekam eine Sepsis (versus n = 4), kein Patient entwickelte ein akutes Nierenversagen (versus n = 3). Diese Unterschiede waren jedoch wegen der kleinen Gruppengrößen statistisch nicht signifikant. [ABSTRACT FROM AUTHOR]

CD44 is the principal cell surface receptor for hyaluronate. Variant forms of the receptor, produced by alternative splicing, have been found to be associated with tumor progression in a variety of cancers. Based on investigations at the RNA level, it has recently been proposed that expression of CD44 variant V2 was present in urothelial cancer but not in normal urothelium. Since a distinctive marker for urothelial cancer would be extremely useful, frozen sections of normal urothelium and urothelial cancer were examined for expression of standard CD44 and CD44V2. Frozen sections of specimens of 35 patients with transitional cell carcinoma of the bladder, 16 specimens of normal bladder and 5 ureters were examined. Immunohistochemical staining was performed using a polyclonal antibody to CD44V2 (PAB CD44V2), a monoclonal antibody to CD44V2 (MAB CD44V2) and a monoclonal antibody to CD44S (MAB CD44S). CD44V2 and CD44S were also measured in lysates of urine sediments from 21 patients by enzyme-linked immunoabsorbent assay (ELISA). All investigated transitional cell carcinomas expressed CD44V2. There was no differentiation between invasive and noninvasive carcinoma. CD44V2 was also expressed in normal urothelium. Standard CD44 was expressed by the transitional cell carcinoma, normal urothelium, musculature and interstitial tissue. The amount of CD44V2 and CD44S in lysates of urine sediments is not correlated to diagnosis. In contrast to investigations at the RNA level, CD44V2 on the protein level seems not to be a distinctive marker for urothelial cancer. Therefore, CD44V2 will not be a useful diagnostic marker for detection of transitional cell carcinoma. [ABSTRACT FROM AUTHOR]

Intercellular adhesion molecule-1 (ICAM-1) is the natural ligand of the T-lymphocyte adhesion molecule LFA-1 (lymphocyte-function-associated antigen-1). ICAM-1 is involed in target cell recognition by T-lymphocytes, LAK cells and natural killer cells. The molecule has also been detected on a variety of normal cells and on human tumors. Renal cell carcinoma (RCC) is one of the few tumors that respond to immunotherapy, but clinical results are generally disappointing. We therefore analyzed, by immunohistochemistry, the expression of ICAM-1 in pairs of normal kidneys, RCC, and RCC metastases. Moreover, serum ICAM-1 was determined in RCC patients and compared with surface expression of cell-bound ICAM-1. Strong glomerular expression of ICAM-1 was observed in all specimens of normal kidney examined. Proximal tubuli were weakly stained in the majority of specimens. Of the tumors, 80% stained positive for ICAM-1. Although ICAM-1 was detected on the majority of extrarenal tumor specimens examined, staining was generally weaker in the metastases. Patients without metastases at initial presentation more frequently expressed ICAM-1 in their primary tumors than did patients with metastases. Levels of serum ICAM-1 (sICAM-1) were significantly higher in RCC patients than in controls with non-malignant renal diseases. Patients with an unfavorable prognosis, e.g. with advanced tumor stage or metastasis at initial presentation, had higher levels of sICAM-1 than patients with low-grade and/or low-stage tumors. An inverse correlation was observed between expression of ICAM-1 in tumors and levels of sICAM-1. On the basis of our data we suggest that cell-bound or soluble ICAM-1 is correlated with tumor-host interaction in RCC. [ABSTRACT FROM AUTHOR]

Frozen sections of primary and metastatic human renal cell carcinoma (RCC) were analyzed for the expression of endogeneous binding sites for carbohydrates. Fluorescent neoglycoproteins, carrying chemically linked carbohydrate residues on bovine serum albumin as a carrier protein, were applied to 44 primary tumor specimens. In the majority of specimens, accessible binding sites with specificity for maltose and N-acetylgalactosamine were detected. In specimens of normal kidney no specific binding of carbohydrate ligands was observed under these experimental conditions. Specimens of both the primary tumor and a metastasis were available in 10 cases. When the expression of specific binding sites of primary tumors and metastases was compared, the respective patterns were similar with no clear gain or loss of certain lectins in the metastases. We conclude that binding sites with specificity for maltose and N-acetylgalactosamine are present on human RCC and their corresponding metastases. [ABSTRACT FROM AUTHOR]

Metastasis to distant organs is the principal cause of death from renal cell carcinoma (RCC). No commonly accepted therapy is available for disseminated RCC at present. Immunotherapy is a mode of therapy that either interferes with the immune system or makes use of drugs that have been derived from soluble mediators of the immune system. Several lines of evidence suggest that combinations of genetically engineered cytokines (e.g. interleukin-2 and interferon alpha) may be particularly active in the treatment of advanced RCC. There are two major rationales for considering immunotherapy for RCC: (1) there is currently no other therapy available, and (2) there is hardly any innovative approach besides immunotherapy. Still, immunotherapy is far from being a standard therapy for disseminated RCC. [ABSTRACT FROM AUTHOR]

Therapy for disseminated renal cell carcinoma (RCC) is a major problem, as RCC is almost completely resistant to standard therapeutic approaches such as chemotherapy or radiotherapy. The search for innovative strategies has led to new concepts based on the assumption that the cellular or soluble mediators of the immune system can be rendered cytotoxic or cytostatic for RCC. The near-unlimited availability of genetically engineered, recombinant, soluble mediators of the immune response, the cytokines, has led to numerous clinical studies for therapy of RCC. Of all approaches under study, protocols employing interleukin-2 alone or in combination with other cytokines or chemotherapeutic drugs appear to be most promising. Despite much effort in this field, all protocols mentioned in this review concern therapies under study rather than established regimens. [ABSTRACT FROM AUTHOR]