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Biomedical subjects

B Ulshöfer

Publications and source records attributed to B Ulshöfer.

At least 19 recordsLinked to original sources
PubMed2003

[Veno-occlusive dysfunction as a cause of erectile impotence: therapy of venous leak with retrograde embolization of the internal pudendal vein].

"Venous leak impotence" remains a therapeutic challenge as long term success rates with all interventions are only 50%. Surgical venous ligation is a well established procedure, yet not all pathological venous groups can always be occluded. Retrograde embolisation of angiographically identified pathological venous groups represent a promising alternative to surgical isolation and antegrad embolisation of deep dorsal penile veins. Four young men (19-42 years) presented with complete loss of erection. Vaginal intercourse was impossible. Pharmaco-duplex sonography with Prostaglandin E, 10-20 micrograms demonstrated normal arterial flow in all 4 penile arteries but even after intra-cavernosoal injection of Prostaglandin E, 20 micrograms no complete erection was achieved. Dynamic infusion cavernosometry showed increased maintenance flow. Cavernosography showed a venous leak involving the deep dorsal penile vein in all four cases. Embolisation was carried out via the femoral vein by coaxial technique using Histoacryl-Lipiodol solution in order to embolise all angiographically identified insufficient veins. At one year follow up all 4 patients still achieved spontaneous erections without any additional medical treatment.

Adult↗
PubMed1995

Hemostaseological management of urological operations in patients taking aspirin using the Thrombostat 4000.

A clinical study was started in order to examine the suitability of the Thrombostat (in vitro bleeding test) (IVBT) as a diagnostic tool to prevent perioperative bleeding due to aspirin (ASA) and/or platelet function disorders of other origins. This report is based on preliminary data. Eighty three patients who had ingested ASA in the last two weeks and/or with a history of bleeding and/or documented hemorrhagic disorders requiring distinct urological operations, were included in the study. In all patients the IVBT with CaCl2, in addition to common coagulation tests, were performed. Thirteen patients stopped ASA ingestion until IVBT became normal and did not show any increased bleeding tendency. The residual patients were classified by the various operations. The following operation groups were formed: Male genitals (n = 11), inguinal/suprapubic operations (n = 7), transurethral tumor resections of the bladder (TURB) (n = 17), transurethral prostate resection (TURP) (n = 12), tumor nephrectomy (n = 8), radical prostatectomy (n = 9). Thirty six patients with a history of ASA use, but normal IVBT, served as control group (C). Thirty one patients with a history of ASA ingestion had normal in vivo bleeding times (BT) and abnormal IVBT with CaCl2 (A). Seven patients had a bleeding history and/or documented hemorrhagic disorders (B). None of the patients (A) with abnormal IVBT but normal BT displayed clinically relevant bleeding. However, the blood loss was somewhat higher compared to the controls (C), especially in patients with TURB and radical prostatectomy (not significant).(ABSTRACT TRUNCATED AT 250 WORDS)

Aspirin↗
PubMed1995

[Pseudothrombocytopenia: case reports and review of the literature].

BACKGROUND: Pseudothrombocytopenia (PTP) is an in vitro phenomenon with falsely low platelet counts determined automatically. Usually the thrombocytopenia is noticed accidentally without a corresponding tendency to bleeding. If this phenomenon is not recognized, misinterpretation may bring the patient into a considerable risk by diagnostical and therapeutical mistakes. By own cases and analysis of the literature, causes, appearance. incidence, as well as diagnostic and clinical problems of PTP shall be explained in detail. CASUISTICS: We report on three patients who showed a significant decrease of platelet counts after surgery DIC (disseminated intravascular coagulation) and heparin-induced thrombocytopenia type II (white clot syndrome) were assumed primarily. In all three cases the reason for the low postoperative platelet counts was found to he due to PTP caused by cold agglutinins. CONCLUSION: From the cases described it can he concluded that PTP may develop during postoperative clinical course. Due to the broad differential diagnostic spectrum in the postoperative situation. PTP is hardly considered. Therefore, there is a greater chance of misinterpretation and therapeutic mistakes. In case of low platelet counts PTP should always be excluded, even when thrombocytopenia seems to be explicable differently.

Aged↗
PubMed1992

Silver-stained nucleolar organizer proteins in urothelial bladder lesions. A morphometric study.

The diagnostic value of image analysis of silver-stained nucleolar organizer regions (AgNORs) has been investigated in 170 urothelial bladder lesions obtained by transurethral biopsies in the same number of patients. According to the WHO classification 25 specimens showed a flat non-invasive growth pattern with simple hyperplasia or mild dysplasia (H/D1 = 10), as well as moderate (D2 = 10) to severe atypia (Cis = 5). 135 samples were of papillary and/or infiltrating type including polypoid cystitis (pC = 5), true papillomas (G0 = 7), and carcinomas of different malignancy grade (G1 = 30, G2 = 55, G3 = 38). 10 biopsies served as normal controls. Benign non-neoplastic urothelium (controls, H/D1, pC) exhibited few but large AgNORs (mean number [MNN] = 3.3 +/- 0.5, mean area [MNA] = 0.29 +/- 0.08 micron 2), whereas carcinomatous lesions (Cis, G1-G3) showed numerous small silver-stained dots within their nuclei (MNN = 6.9 +/- 1.1; MNA = 0.12 +/- 0.04 micron 2). Both parameters, MNN and MNA, were inversely correlated (r = -0.69, p less than 0.001); their quotient (NQ = MNN/MNA) revealed a clear cut difference in the AgNOR content of benign (control, H/D1:NQ = 12.8 +/- 2.5) and moderate to severe atypical flat urothelial lesions (D2, Cis: NQ = 44.2 +/- 12.8, p less than 0.001). This parameter also discriminated between G1 (NQ = 40.7 +/- 17.3), G2 (NQ = 57.5 +/- 18.8), and G3 carcinomas (NQ = 79.0 +/- 21.8, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Histocytochemistry↗
PubMed1991

Silver-stained structures in prostatic carcinoma: evaluation of diagnostic and prognostic relevance by automated image analysis.

The comparison of the diagnostic and prognostic significance of histology, immunohistochemical parameters (PSA, PSP), and silver-stained nucleolar organizer regions (AgNORs) was estimated in paraffin sections taken of 63 prostatic carcinomas prior to therapy. AgNORs were visualized with a one-step silver staining technique with the appropiate staining time determined by preliminary staining-time series. The mean AgNOR number per cell (n) and the mean AgNOR area per silver-stained dot (A) were determined by means of an automatic image analysis system. Thereby prostatic carcinomas exhibited multiple small AgNORs within their nuclei (n = 4.7, A = 0.09 micron 2), whereas benign prostatic epithelium showed few but large silver-stained particles (n = 1.8, A = 0.27 micron 2; p less than 0.001). This relationship was then calculated as a quotient of AgNOR number and area (NQ = n/A) which provided additional information for the diagnosis of malignancy as well as survival. Univariate survival analysis disclosed a set of four variables predicting death from prostatic cancer; cribriform growth pattern, AgNOR quotient, histological grade, and PSA immunoreactivity. Of these parameters, immunoreactivity of PSA failed to prove its prognostic significance in multivariate survival analysis (Cox model). No relation to prognosis was found for the number as well as the area of AgNORs alone. Therefore, image analysis proved to be a prerequisit for the feasibility of this promising technique by providing objective and reproducible results.

Acid Phosphatase↗
PubMed1991

[Experience with uretero-neocystostomy in 338 kidney transplantations].

In 338 consecutive human kidney transplants since 1972 uretero-neocystostomy was performed in a typical manner. The technique is a modification of Leadbetter's ureterosigmoid anastomosis and it is used for all cases of ureteral reimplantation at our institution. The rate of operative complications belonging to the urinary tract is 4.8%. In 29% out of 31 reexamined patients a vesico-ureteral reflux to the transplant appeared. We believe that the demonstrated method is useful for reconstruction of the urinary tract in renal transplants.

Anastomosis, Surgical↗
PubMed1990

[Study of large cross sections of infiltrating renal cell carcinoma (pT3) and long-term observation (more than 4 years)].

In a series of 59 consecutive renal cell carcinomas (pT3) cross sections were performed and grading was reevaluated on a cytological basis as described by Thoenes. Follow-up was at least 4 years. Only 20.3% of all tumors revealed monoform grading (92 resp. 93), while 79.9% consisted of more than one grading (G1+G2, G2+G3: 45.8%; G1+G2+G3: 33.9%). Prognosis in this series depended highly significantly (p less than 0.002) on the percentage of G3-area of the vital tumor (NED greater than 4 ys.: 11.4%; DOD less than 2 ys.: 51.6%). It is concluded that measuring different G-areas in cross section of renal cell carcinomas raise considerably prognostic value of histopathology.

Carcinoma, Renal Cell↗
PubMed1986

Clinical aspects of stone formation and conservative treatment.

Clinical aspects of stone formation and conservative treatment need to consider the following factors: Epidemiological studies and their knowledge are necessary as they have permitted important conclusions with the regard to risk and history of urolithiasis. Laboratory diagnosis is a prerequisite to therapy. Mode and extent of laboratory investigations depend whether or not proven measures can result. The distinction between practice and research and their demands must clearly be made. Risk-orientated laboratory parameters must be assessed from a point of view which concentrates on the possibility of therapeutic influence. Looking for and finding abnormal values is more likely to satisfy the statistician than the clinician. The choice of treatment depends not only on laboratory values but also on the individual characteristics of the patient such as sex, age, occupation and education as well as general state of health and its impairment by stone recurrence. Classic (diuresis and diet) as well as drug therapy need clear indications, where risk and benefit must be balanced individually. Therapy needs to be controlled on the one hand in order to make indications safer through increasing experience, and on the other hand to make indications preciser by the analysis of failures.

Adult↗
PubMed1984

[Tuberculosis following kidney transplantation].

Morbidity of tuberculosis following kidney transplantation is about 1% (14/1719 kidney transplantations). All cases occurred within 1 year after transplantation; surprising was the relative high incidence in patients from outside Central Europe. Four patients with lack of clinical symptoms in whom the diagnosis was made by routine X-ray films of the chest survived after immediate therapy while five of ten patients with miliary tuberculosis died although proper treatment was performed. In cases of fever not caused by rejection or in pneumonia resistant to common antibiotics prophylactic antituberculous therapy should be considered even if microbiological evidence is not yet confirmed.

Antitubercular Agents↗
PubMed1981

[Laboratory diagnosis of Candida infections of the lower urinary tract].

Significant candida-infections of the lower urinary tract with clinical symptoms require specific treatment. The diagnosis is made by repeated microscopic evidence in untreated urine and colony counts greater than or equal to 10(5)/ml urine. Specific IgG- and IgM-titer and identification is not necessary in case of lower urinary tract infection. Before systemic treatment sensitivity to 5-fluorocytosine resp. miconazole should be established to avoid therapeutic failure. In case of local application (instillation) of amphotericin B or nystatin particularly in patients with urinary diversion, resistant species are not to be expected.

Candidiasis↗
PubMed1979

[New diagnostic examinations in patients with urinary calculi, taking into consideration primary hyperparathyroidism].

The serum levels of total calcium and anorganic phosphate have been the leading parameters in the diagnosis of primary hyperparathyroidism. In addition to these, it is now possible to measure ionized calcium (Ca++) by an ion-selective electrode and parathormone (PTH) by C- and N-terminal radioimmunoassays (RIA). Whereas Ca++ determination and C-terminal PTH RIA represent a diagnostic progress, this can not be claimed for the N-terminal PTH RIA in peripheral venous blood especially in border-line cases.

Calcium↗
PubMed1978

[Urologic findings in patients with kidney transplantations. Evaluation of a technic for uretero-cysto-neostomy].

74 consecutive human kidney transplants are reported. In 72 cases uretero-cysto-neostomies with an antireflux procedure were performed in a typical way. The technique, a modification of Leadbetter's uretero-sigmoido-neostomy, has been used by the author for years. The only urological complications were one proximal and one distal ureteral fistula. In 25% out of 20 reexamined patients a vesico-ureteral reflux was demonstrated by micturition cysto-urethrography. There was no correlation between urinary tract infections (25%) and vesico-ureteral reflux. The results are compared with the data given in literature.

Candida↗