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Biomedical subjects

D Hauri

Publications and source records attributed to D Hauri.

At least 91 records · Page 5Linked to original sources
PubMed1986

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↗
PubMed1986

Incontinence operation for postprostatectomy incontinence.

The pathophysiological considerations for regaining continence are discussed first. Our operation method for postprostatectomy incontinence is described and the results enumerated. The success rate is approximatively 80%.

Follow-Up Studies↗
PubMed1986

Surgical therapy.

Conventional stone operations have decisively receded into the background due to modern methods of stone removal, e.g., extracorporeal shock-wave lithotripsy and endoscopic stone removal. The disadvantages of these modern methods are discussed. Because there are no complications by the conventional technics, which are still practised, the technical details are also discussed.

Humans↗
PubMed1985

Curable renal parenchymatous hypertension: current diagnosis and management.

Unilateral parenchymatous kidney disease associated with high blood pressure represents a potentially curable form of hypertension. Surgery may normalize blood pressure in a substantial number of these patients. Curable renal parenchymatous hypertension includes unilateral tubulointerstitial kidney diseases such as chronic pyelonephritis, reflux nephropathy, segmental hypoplasia and radiation nephritis, hydronephrosis, simple renal cysts, traumatic kidney lesions and renal tumors associated with high blood pressure. Renal ischemia and in turn activation of the renin angiotensin system is involved in the pathogenesis of hypertension in most of these patients. In patients with unilateral kidney disease and hypertension, both an operative and a medical therapeutic approach have a high success rate. Good candidates for nephrectomy are young patients with severe hypertension, strict unilateral disease, normal plasma creatinine levels and minimal function of the involved kidney. In unilateral hydronephrosis reconstructive surgery or nephrectomy may cure or improve hypertension in the vast majority of the patients. Surgically correctable hypertension has also been reported in some patients with large renal cysts and renal tumors (hemangiopericytoma, Wilm's tumor, hypernephroma, renal pelvic tumor).

Antihypertensive Agents↗
PubMed1985

Unilateral parenchymatous kidney disease and hypertension: results of nephrectomy and medical treatment.

In the present study 43 patients with unilateral parenchymatous kidney disease and hypertension were investigated. 20 patients were nephrectomized, 23 treated with antihypertensive drugs. Both therapeutic approaches showed an excellent and sustained blood pressure-(BP)-lowering effect. BP fell from 185 +/- 27/116 +/- 13 to 138 +/- 20/86 +/- 10 mm Hg in the operated and from 194 +/- 32/116 +/- 13 to 149 +/- 22/95 +/- 12 mm Hg in the medically treated patients after 2 and 6 weeks, respectively (p less than 0.001). BP was 142 +/- 16/89 +/- 11 and 136 +/- 16/90 +/- 10 mm Hg at the long-term follow-up in the 2 subgroups. In the operated group 70% (n = 14) were cured, 20% (n = 4) were improved and 10% (n = 2) unimproved. In the medically treated group 65% (n = 15) were normotensive, 26% (n = 6) improved and 9% (n = 2) treatment resistant. No significant correlation between postoperative BP reduction and lateralization of renin secretion (PRA-ratio greater than or equal to 1.5) was found. Although cured patients showed a higher mean PRA-ratio, 4 patients with a PRA-ratio less than 1.5 were cured (n = 2) or improved (n = 2) postoperatively. Our results document an excellent and sustained antihypertensive effect of both nephrectomy and medical treatment in patients with unilateral parenchymatous kidney disease and hypertension. They further limit the predictive value of renal venous renin determination in the preoperative workup.

Adolescent↗
PubMed1985

The role of surgery in stage IIC and III nonseminomatous testicular cancer.

30 Patients with stage IIC and III nonseminomatous testicular cancer underwent surgery for residual tumor after induction chemotherapy (postinductive surgery). There were no operative deaths and surgical morbidity was not influenced by preoperative chemotherapy. A complete surgical remission was achieved in 9 of 15 patients with mediastinal or pulmonary deposits and in 6 of 12 patients with retroperitoneal metastases. Alphafetoprotein (AFP) levels over 10(4)ng/ml at diagnosis and persistently elevated AFP values preoperatively were associated with failure of surgery to achieve complete remission (p less than .05) and to achieve long-term survival even after surgical complete remission. Fifteen of 17 patients with radical surgery remained disease-free after a median follow-up of 33 months. Six of the 13 relapsing patients had elevated AFP levels prior to definitive surgery. In one patient a contralateral testicular cancer was diagnosed 60 months after postinductive surgery. Of the 17 disease-free survivors, 12 had no tumor, 4 had mature teratoma and only one patient had mature teratoma with malignant foci in the resected surgical specimen. We conclude that AFP levels at diagnosis, elevated AFP prior to definitive surgery, achievement of complete surgical remission and histology of residual tumor are important prognostic factors determining long-term survival in residual stage IIC and III nonseminomatous testicular cancer.

Adolescent↗
PubMed1984

Transluminal dilatation of experimental hydronephrosis in dogs: acute and chronic effects, haemodynamic changes, and histological findings.

In the present study the feasibility and effectiveness of transureteral dilatation with a double-lumen balloon-tipped dilatation catheter was investigated. In 6 dogs with experimentally induced unilateral fibrotic stenosis and hydronephrosis a total of 13 dilatations were performed through a cutaneous ureteroneostomy. The stenosis diameter could markedly be distended from 1.7 +/- 0.9 to 4.8 +/- 1.6 mm (p less than 0.001). The pyelon size changed not significantly during the intervention. Follow-up urographies 1 week after dilatation revealed partial or total restenosis in all but 2 dogs. The stenosis diameter had decreased by 2.6 +/- 1.5 mm (p less than 0.01). The mean pyelon size changed only slightly (28.2 +/- 14.7 vs. 26.1 +/- 6.2 cm2). In the 2 dogs with persistent distension of the stenosis a reduction in pyelon size was achieved. Blood pressure during acute ureteral ligation showed no change. Follow-up studies after 1 week revealed a significant fall of the mean arterial pressure from 100 +/- 22 to 83 +/- 19 mm Hg (p less than 0.005), which was also seen at the long-term follow-up in 5 dogs 13 +/- 8 weeks after ureteral ligation. Histological analysis showed mild to severe inflammation and distension of the collecting system and mild to moderate inflammation, atrophy, and glomerular cysts in the renal parenchyma. Interestingly, the 2 dogs with a successful result of dilatation showed no relevant inflammation in the dilated stenotic segment. In conclusion, transureteral dilatation of experimental ureteral stenosis with a balloon catheter proved to have an impressive acute effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1983

A new concept of priapism based on the results of arteriography and cavernosography.

Four patients with priapism - 3 with idiopathic and 1 with post-traumatic etiologies - were examined by arteriography and cavernosography. The findings of these examinations as well as distinct clinical findings suggest that there are 2 different types of priapism. One is characterized by severe blood stasis within the corpora cavernosa with resulting compression of the deep arteries of the penis and reduction of arterial blood flow. In the other type, arterial flow into the corpora cavernosa and drainage into the veins are substantially increased. In this type, long-standing priapism does not seem to produce fibrosis of the corpora cavernosa with resulting impotence.

Adult↗
PubMed1983

Erection and priapism: a new physiopathological concept.

For normal erection two mechanisms are essential: the first provides increased arterial inflow, most probably this is obtained due to the activity of the intimal cushions within the arteriae helicinae and within the shunt vessels. The second mechanism uses increased arterial blood flow; this could be obtained due to the activity of the trabecular muscle fibers of the corpora cavernosa. In consequence, we would deal with two different types of priapism: one type--high-flow priapism--occurs at the level of the arteriae helicinae and the intimal cushions and provokes a high-flow situation, and the second type, with blood stasis in the corpora cavernosa, occurs at the level of the trabeculae due to persistent contraction of the smooth muscle fibers. The prognosis of the second type is much less favorable and should be cured by surgery within the first 48 h.

Humans↗