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We describe a new sensitive and specific method for determination of oxalate in human serum. By using the chemiluminescence decay of monoperoxyoxalic acid very low concentrations of oxalate (200 nmol/L) can be determined. The mean serum oxalate level in apparently healthy controls was 14.5 +/- 8.5 mumol/L. Supplementation of ascorbic acid leads to an increase in serum oxalate level. While serum oxalate concentrations of calcium oxalate stone formers (x = 16.4 +/- 9.8 mumol/L) are not significantly different from the control group, an extreme increase of serum oxalate is evident in haemodialysis patients. The serum oxalate concentration decreased during dialysis treatment from 141.4 +/- 32.1 mumol/L to 36.4 +/- 12.7 mumol/L.

The therapeutic decision in the management of Peyronie's disease depends on the confirmation or exclusion of inflammatory activity. Plain films of the penis in mammographic technique demonstrate the presence of fibrotic or calcified areas, in which conservative treatment is not more effective. In twelve out of 32 patients, we found calcifications of various size.

Of 117 formers of relapsing calcium oxalate calculi 75.2% showed a hyperuricaemia, 64.1% a hyperlipoproteinaemia, 19.7% a diabetes mellitus, 44.4% a hypertension, 11% a hyperuricuria (greater than 1.0 g/a day) and 7.5% a hypercalciuria. In 30 formers of relapsing uric acid calculi we could establish a hyperuricaemia in 93.3%, a hyperlipoproteinaemia in 76.7%, a diabetes mellitus in 36.7%, a hypertension in 80%, a hyperuricuria in 11% and a hypercalciuria in 3.8%. In comparison to formers of calcium oxalate calculi patients with uric acid calculi had a significantly higher body-weight. The results of our examinations make clear that in relapsing formation of urinary calculi frequently a complex disturbance of the metabolism is present which in every case must be established and treated.

17 cystine stone patients were treated with high doses of ascorbic acid (5 g p. d.). During the observation period, a total of only two natural passages of cystine stones could be observed. For five patients the therapeutic strategy was altered because the recurrence rate did not change and the cystine concentration in the urine was enhanced. One mixed calcium-oxalate/cystine stone had to be resected. In this case as well as on the occasion of further medical check-ups of other patients, an increased risk of calcium-oxalate stone formation was signalled by an enhanced oxalic-acid concentration in the 24-hour urine. Changes in blood serum and impairment in hepatic and renal functions were not observed. With three patients, the therapy had to be interrupted because of gastritis symptoms. The use of high-dose ascorbic acid therapy is recommended and is continued. In special cases, an additive of low do ses of alpha-mercaptopropionyl-glycine is recommended.

A new sensitive method for the determination of oxalate is presented. By using the chemiluminescence decay of monoperoxyoxalic acid very low concentrations of oxalate can be determined (up to 100 nmol/l). Oxalate determinations in urine require the precipitation of calcium oxalate, in order to avoid oxalate-unspecific side emissions. This could be avoided by combination with a specific enzymatic partial reaction, which would also permit the determination of low concentrations of other organic species (e.g. citrate, pyruvate, malate).

Auf die engen Beziehungen zwischen Purinstoffwechselstorungen und dem Auftreten einer Urolithiasis sind wir zwangslaufig im Rahmen der Betreuung eines umfangreichen Gichtdispensaires aufmerksam geworden. Wir fanden bei 250 Patienten mit primarer Hyperurikamie ohne Zeichen einer Skelettmanifestation (Gruppe 1) in 30% und bei 180 Patienten mit einer typischen Arthritis urica (Gruppe 2) in 41% der Falle eine Urolithiasis (1). Das entspricht einer Steinbildungsrate, die signifikant hoher liegt als die der Durchschnittsbevolkerung. Aufgrund dieser Ergebnisse wurden 160 unausgewahlte rezidivierende Harnsteinbildner (Gruppe 3) dem gleichen komplexen Untersuchungsprogramm unterzogen wie die Patienten mit Purinstoffwechselstorungen. In allen 3 Gruppen wurden nur Manner berucksichtigt.

The UJOLYT cation exchange was checked in a clinically controlled study over a long period using 6 male test persons with chronically recidive calcium oxalate lithiasis and absorptive hypercalciuria. The PAK calcium load test proved clinically valuable in the differentiation of idiopathic hypercalciuria. The paraclinical findings revealed an average reduction of urinary calcium excretion by 40% and an increase of urinary magnesium excretion by 11.7% compared to the initial situation. The recidive frequency was clearly reduced. No serious side-effects were observed in the patients presented.

The effectiveness of orchiectomy plus an antigonadotropic therapy alone (ethinylestradiol sulfonate), of orchiectomy plus a combined hormone and chemotherapy (ethinylestradiol sulfonate plus vincristine/vinblastine, cyclophosphamide, methotrexate) and of orchiectomy plus chemotherapy (vincristine/vinblastine, cyclophosphamide, methotrexate) alone for the initial treatment of advanced (stage IV) carcinoma of the prostate was compared. The cumulative 4-year survival rate was better after combined hormone and chemotherapy. Our results do not justify the administration of combined hormone and chemotherapy in previously untreated advanced carcinoma of the prostate.

Under out-patient conditions 13 testicular endotheses of silicone rubber were implanted in local anaesthesia. The mean age of the 11 patients was 44.6 years and minimum follow-up was one year. In all but one case the clinical course was uneventful, in this patient the prosthesis was rejected after a secondary intervention. The follow-up examination did show in all cases clinical, ultrasonographical and cosmetical good results with the 14 g variant for the adult patient. This prosthesis is recommended the further use because of low operative risk, uneventful follow-up and improved body image.

Primary tumours of the ureter are to be regarded as rare tumours. Etiopathogenesis, pathology and clinic are discussed, taking into consideration own experiences. The authors cannot subscribe to the widespread view of operating primary solitary tumours of the ureter on principle only radically in form of the nephroureterectomy. A differentiated, individual approach with a primarily conservative-reconstructive orientation is recommended.

At present the antiandrogenic hormone therapy is a main form of the treatment of the carcinoma of the prostate. It is a palliative treatment. With reference to the testosterone metabolism the extra- and intraprostatic effect is explained. The present state of the hormone receptor research is critically explained, and by reason of the still uncertain prognosis of the effectiveness of the hormone treatment the necessity of a curative therapy (radical operation, radiotherapy with curative aim) is evident.

A new sensitive method for the determination of oxalate is presented. By using the chemiluminescence decay of monoperoxyoxalic acid very low concentrations of oxalate can be determined (up to 100 nmol/l). Oxalate determinations in urine require the precipitation of calcium oxalate, in order to avoid oxalate-unspecific side emissions. This could be avoided by combination with a specific enzymatic partial reaction, which would also permit the determination of low concentrations of other organic species (e.g. citrate, pyruvate, malate).