Retrograde intrarenal surgery (RIRS) utilizing flexible, actively deflectable instruments has become a valuable asset in the diagnosis of upper urinary tract pathology and the treatment of stone disease. Flexible endoscopic surgery of the proximal ureter and in the intrarenal collecting system constitutes the natural extension of rigid instrumentation in the upper urinary tract. At our institution retrograde ureteral and intrarenal surgery has become an +integral part of our diagnostic and therapeutic armamentarium. This is documented by almost 300 treatments and diagnostic procedures performed in the upper urinary tract over the past 3 years.

Carcinoma, Transitional Cell↗

PubMed1989

Anatomy of penile venous drainage in potent and impotent men during cavernosography.

Recent data suggest that approximately 80 per cent of the men with vasculogenic impotence have evidence of failure to store blood (venous leakage) within the corpora cavernosa. To identify the venous channels into which corporeal blood drains in impotent men, we performed cavernosograms after intracorporeal injection of papaverine in 44 consecutive men presenting with erectile dysfunction and these were compared to studies in 10 potent men. The cavernosograms were examined for evidence of venous drainage from the penis and the site of leakage was identified. It was determined that among the impotent population with vasculogenic impotence 37 of 40 evaluable men (92.5 per cent) demonstrated contrast medium in the venous system draining the penis: the deep dorsal vein was visualized in 55 per cent, proximal cavernosal and crural veins in 55 per cent, deep dorsal and proximal veins in 22.5 per cent and corpus spongiosum in 25 per cent. Only 2 of the 10 potent men demonstrated contrast medium in the venous channels draining the penis. From these observations we conclude that in men suspected of having venogenic impotence identification of the drainage vessels by cavernosography appears to be important in planning any surgical approach to occlude these veins. However, the finding of a venous leak by cavernosography must not be considered a sine qua non diagnosis of venogenic impotence, since a certain percentage of potent men will demonstrate this radiographic finding.

Adult↗

PubMed1989

Funding in California.

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Budgets↗

PubMed1989

[Complications of extracorporeal shockwave lithotripsy].

The authors reviewed treatments performed worldwide using extracorporeal shock wave lithotripsy since its introduction in West Germany in 1980 to determine the efficacy of this treatment modality and its potential risks. The prevention of complications related to patients or shock wave energy are discussed, as well as the cardiovascular complications related to immersion, prevention of lesions to nearby organs, treatment of ESWL-induced bleeding, treatment of post-ESWL ureteral obstruction, prevention and treatment of infection, and long-term biological effects. Currently, less than 5% of patients are excluded from treatment with ESWL due to technical reasons or increased risk of periprocedural complications. Patients with cardiac pacemakers have been treated safely. Calcifications of the ipsilateral renal artery or aorta are considered only relative contraindications. However, certain technical limitations exist; i.e., the Dornier HM-3 cannot support patients weighing more than 135 kg., and patient height is also a limiting factor. There is an impressively low incidence of complications related to the energy of the shock wave. The severity and extent of damage are dose- and pressure-dependent. The potential for induction of cardiac arrhythmias secondary to the shock wave exists; however, effective prevention is achieved by coupling the shock wave discharge to the electrocardiogram. Complications of immersion are also extremely rare and can be avoided by careful preoperative evaluation. Damage to nearby organs such as pulmonary, gastric, duodenal or colonic contusions, constitute a very infrequent complication. Elevations of liver enzymes have also been noted post-lithotripsy. However, all these changes were transient and had no significant clinical consequences. Management of post-ESWL ureteral obstruction is by endourological procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Infections↗

PubMed1976

Visually evoked potentials in cortical and subcortical brain structures of conscious rabbits with chronically implanted electrodes. Standardized normal values and the influence of some psychopharmacological agents on them.

By means of a modified and simplified surgical and implantation technique, standardized values for visually evoked potentials (EP) from 7 brain structures (caudate nucleus, posterior hypothalamus, mesencephalic reticular formation, intra-laminar thalamic nuclei, amygdala, dorsal hippocampus and visual cortex) are obtained. The importance of a careful selection of the animal material, constant test conditions and the selection of test parameters as a prerequisite for the assessment of psychotropic drugs is emphasized and discussed. As an example of the specific influence on visually evoked potentials in the above named brain structures, the effects of haloperidol and amytriptyline on latencies and amplitudes of the individual parameters of EPs are described. It is assumed that the method described can be of great assistance for investigation and classification of newly developed substances.

Amitriptyline↗

PubMed1975

Modified method for recording cortical and subcortical visually evoked potentials in the conscious rabbit with chronically implanted electrodes.

A modified stereotaxic surgical and implantation technique for animal EEG studies in rabbits is described. The use of a stereotaxic "socklet unit" with a minimum of operational equipment, high accuracy, simple handling, and good tissue compatibility permits the repetition of EEG studies in the same animal with a large number of electrodes and over a period of several months. For example for this technique an experimental arrangement for recording visually evoked potentials is described. The importance of a careful selection of the experimental animals, of maintaining constant test conditions, and of the selecting of test parameters as a prerequisite for assessing induced alterations is emphasized and discussed.

Amygdala↗