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Biomedical subjects

D Hauri

Publications and source records attributed to D Hauri.

At least 127 records · Page 7Linked to original sources
PubMed1988

[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↗
PubMed1988

[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↗
PubMed1987

[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↗
PubMed1987

[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↗
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↗