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Biomedical subjects

D Hauri

Publications and source records attributed to D Hauri.

At least 55 records · Page 3Linked to original sources

[Surgical possibilities in treatment of vascular-induced erectile impotence].

We are of the opinion that in most cases of erectile dysfunction morphological factors are involved. These have to be defined by means of adequate diagnostic procedures. When vascular disease is responsible it is necessary to distinguish between arterial, venous and arteriovenous conditions. Whereas arterial failure can often be corrected, the treatment of venous leakage is problematic, as the primary disease seems to affect the cavernous bodies directly.

Arterial Occlusive Diseases

[Extracorporeal shock wave lithotripsy (ESWL) in the treatment of bile duct stones].

Ten patients with common bile duct stones not removable by endoscopic measures after sphincterotomy were treated by extracorporeally generated shock waves. In 9 patients stones up to 30 mm in diameter were disintegrated. Two patients became free of stone fragments spontaneously within one day and in 7 patients the stone fragments were extracted endoscopically. No complications occurred. Extracorporal shock wave treatment represents a promising alternative to surgery in cases where common bile duct stones cannot be extracted endoscopically.

Adult

Morphological changes in canine kidneys following extra-corporeal shock wave treatment.

Extracorporal shock wave lithotripsy has rapidly become established world wide as a routine method for treatment of nephro- and ureterolithiasis. Although initial studies showed no tissue damaging effect by the shock waves, we found in an animal experiment using canine kidneys, the ESWL induced damage to the renal parenchyma is more marked than originally assumed. The damage is limited to the area that was focused on, and heals relatively rapidly by connective tissue encapsulation with final cicatrisation without any further residual effects being observed until now. This parenchymal damage is probably also the cause of the macrohaematuria that is always observed during therapy. The resulting tissue damage is not extensive enough to cause demonstrable reduction of function as measured by the usual methods (serum creatinine, creatinine clearance, isotopy renography, i/v-urography). The main clinical complication is the large subcapsular haematoma which, according to present knowledge, could well result from a lesion of the larger peripheral vessels. Damage to other organs such as subserous colonic and small bowel haematomata are to be expected although they do not lead to clinical symptoms.

Animals

Arterially originated erectile disturbances: surgical possibilities and their alternatives--some personal thoughts.

The arterially originated erectile disturbances are the most common form of impotence due to morphological reasons. The concepts of therapy range from the surgical revascularization, to the intracavernous self-injection of vasoactive substances and to the implantation of penis prostheses. The advantages and disadvantages are discussed and weighed against each other.

Architecture

[Retroperitoneal lymphadenectomy in non-seminomatous stage I, IIa and IIb testicular tumors].

Between 1961 and 1985, 190 retroperitoneal lymph node dissections (RLND) have been performed in the Urological Clinic of the University Hospital of Zurich in patients with low stage (I, IIa, IIb) non seminomatous germ-cell testicular cancer. Indication, operative technic, complications (8,9%, dry ejaculation in 27%) and the results of the operation are pointed out (relapse rate in stage I: 10%, IIa: 35%, IIb: 59% without and 14% with adjuvant chemotherapy). The question is analysed if this primary surgical approach in this primary surgical approach in these stages, simultaneously a diagnostic and therapeutic procedure, is still indicated in the era of efficacious chemotherapy.

Ejaculation

[Bacteriology of the ejaculate--a useful study?].

In a retrospective study we analyzed the results of 318 bacteriologic tests of ejaculates from 175 patients with suspected infections of the prostate, epididymis and urethra. Only 55% of all bacteriologic tests were positive, and the bacteria most frequently found were those normally present in the anterior male urethra, enterococci and coagulase-negative staphylococci. These results indicate that bacteriologic testing of the ejaculate does not yield such reliable results as the segmented urine culture technique and the examination of expressed prostatic secretions.

Adolescent

[An incidental finding of renal cysts: routine occurrence or a finding deserving clarification?].

Since the introduction of new non-invasive diagnostic techniques such as abdominal ultrasound and computerized tomography, simple renal cysts are diagnosed with increasing frequency. Over 30% of patients over 50 years of age are found to have simple renal cysts of different size. A cystic renal mass may represent a simple renal cyst without clinical relevance, a cystic renal carcinoma, early evidence of polycystic kidney disease in a young patient, a rare cause of renal hypertension, a source of infection in a symptomatic patient (infected renal cyst), or a manifestation of an infectious disease (renal abscess, echinococcus cyst). The differential diagnosis and management of a cystic renal mass therefore remain a clinical problem. In the past, surgical exploration of a cystic renal mass was frequently performed. Today, modern diagnostic techniques such as ultrasound-guided percutaneous cyst puncture with cytological analysis of the cyst content, or computerized tomography, are considered the methods of choice. They are particularly useful in case of doubt about the dignity of a cystic renal mass. The determination of renal venous renin levels may be useful in differentiating the causal role of a renal cyst in a patient with hypertension. The management of a cystic renal mass depends on the underlying disease.

Diagnosis, Differential

[Angiographic, cavernosonographic and clinical differentiation of two forms of priapism with different prognoses].

Based on the findings upon arteriography, cavernosography and clinical features two different kinds of priapism are differentiated: Type I ("low flow priapism") is characterized by severe blood stasis within the corpora cavernosa and reduction of arterial perfusion through compression of the deep arteries of the penis. The penis is very hard and painful upon palpation. A delay of treatment over 48 hours will result in a damage of the corpora cavernosa and impotence. Type II ("high flow priapism") is characterized by arterial hyperperfusion. Outflow obstruction is absent. The penis is erected but of an elastic consistence, pain is absent. Even with a delay of treatment of up to 6 months the corpora cavernosa remain intact, normal erectile function is preserved.

Diagnosis, Differential

The ultrastructure of the erectile tissue in priapism.

The ultrastructure of erectile tissue from the corpora cavernosa penis of patients suffering from stasis priapism and high-flow priapism has been studied. Trabecular interstitial edema was confirmed as the first reaction of the tissue to the hemodynamic impairment. At the cellular level trabecular smooth muscle cells were found to be the first affected by the altered environmental conditions. Their reaction consisted of structural and functional transformation to fibroblast-like cells. Severe cellular damage and widespread necrosis were not seen in high flow priapism; such damage existed in stasis priapism, but only when the priapic episode lasted more than 24 hours. Blood clot formation within the cavernae and destruction of the endothelial lining occurred in stasis priapism lasting over 48 hours. At this time trabecular inflammation became conspicuous and most of the smooth muscle cells were either transformed to fibroblast-like cells or had undergone necrosis. This stage was not reached in high flow priapism, a fact supporting the view that high flow priapism is a more benign and prognostically more favorable form of priapism. Massive smooth muscle cell transformation and the loss of contractile trabecular elements may play an important role in the evolution of irreversible erectile failure following stasis priapism persisting longer than 24 hours.

Adult