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Biomedical subjects

D Schultheiss

Publications and source records attributed to D Schultheiss.

At least 19 recordsLinked to original sources
PubMed2003

[James Israel (1848-1926). His contribution to oral and maxillofacial surgery].

The Berlin surgeon James Israel (1848-1926) is generally known as one of the leading kidney surgeons of his time. Furthermore, he is commemorated for describing actinomycosis bacteria, named after him in 1878: Actinomyces israelii. It is less well known that he also made several important contributions to maxillofacial surgery. This special aspect as well as Israel's biography is presented in this article from the history of medicine.

Germany↗
PubMed2002

[From wound healing to modern tissue engineering of the skin. A historical review on early techniques of cell and tissue culture].

The early precursors of modern techniques of keratinocyte transplantation and tissue engineering of the skin are reviewed, starting with histological research into the processes of wound healing and of skin transplantation in the 19th century and continuing with the introduction of cell and tissue culture techniques in early 20th century medicine. The later experimental and clinical application of this research in dermatology and plastic surgery is also explored.

Animals↗
PubMed2002

History of the microscope and development of microsurgery: a revolution for reproductive tract surgery.

In the mid-1970s urologists in the field of paediatric and andrologic surgery felt that operating loupes did not provide sufficient magnification for their surgical work. Thus, urology finally introduced the operating microscope in the operating room, which was rather late in comparison to other surgical disciplines. Almost three decades later we can hardly imagine performing a vasovasostomy, a testicular autotransplantation or a penile reconstruction without the use of this sophisticated instrument. The following article from the history of medicine reveals the main steps in the technical development of the microscope, from early magnifying tools to the pioneering inventions of Carl Zeiss (1816-1888) and his successful company in Jena, Germany in the 19th century. Finally, the clinical application of microsurgery in the 20th century is described, focusing on reconstruction of the reproductive tract in andrology and gynaecology.

Female↗
PubMed2001

Central effects of sildenafil (Viagra) on auditory selective attention and verbal recognition memory in humans: a study with event-related brain potentials.

The purpose of this study was to assess possible central side-effects of sildenafil (Viagra) on attention and memory functions. Sildenafil and placebo were administered in young male subjects in a double-blind balanced cross-over design. Behavioral patterns and event-related brain potentials (ERP) were recorded in a spatial auditory attention and a visual word recognition task. While behavioral patterns did not reveal any overt effects of sildenafil, auditory ERPs were indicative of an enhanced ability to focus attention (amplitude enhancement of Nd-effect) and to select relevant target stimuli in the sildenafil condition (P3 component). In the memory task, CNS-effects of sildenafil were evident in a reduction of a negativity in the 150-250 ms range. No overt effects on behavior were observed. Nevertheless, the data reveal CNS-effects of sildenafil necessitating further studies.

Adult↗
PubMed2001

The portrait of James Israel by the German impressionist Max Liebermann: a selected pictorial view on the early twentieth century development of surgical urology in Berlin.

On the occasion of his retirement from the position as head of the Jewish Hospital in Berlin in 1917, the famous kidney surgeon James Israel (1848-1926) was portrayed by Max Liebermann (1847-1935). At that time both men were leading members of their professions--medicine and fine arts--and represented the Jewish community in Berlin. Private contacts between the surgeon and the artist had been established when Liebermann and his wife needed surgical treatment themselves some years before. Liebermann's later friendship with the surgeon Ferdinand Sauerbruch (1875-1951) culminated in one of the best-known portraits of a member of the medical profession. This biographical article from the history of medicine and fine arts reflecting the relation of these men provides a special view of the development of urological surgery in Berlin at the beginning of the twentieth century.

Berlin↗
PubMed2001

Phosphodiesterase 1 inhibition in the treatment of lower urinary tract dysfunction: from bench to bedside.

Anticholinergic drugs are currently the therapy of choice to treat urgency and urge incontinence. However, muscarinergic receptor blockers with adequate selectivity for detrusor smooth muscle are not available. Also, in contrast to the normal detrusor, the unstable detrusor neurotransmission seems to be at least partially regulated by non-cholinergic (NANC) pathways. These factors may explain the common side effects and the limited clinical efficacy of these compounds. Specific modulation of intracellular second messenger pathways offers the possibility of organ selective manipulation of tissue function, specifically contraction and relaxation of smooth musculature. Because of their central role in the intracellular regulation of smooth muscle tone phosphodiesterases (PDEs) are an attractive pharmacological targets. The PDE 5 specific inhibitor sildenafil (Viagra) has revolutionized the treatment of patients with erectile dysfunction. Numerous other PDE inhibitors are currently under investigation for the treatment of various disorders. We investigated the role of PDEs in human detrusor smooth muscle. Our data demonstrate the presence of five PDE isoenzymes in human detrusor and suggest, for the first time, that the cAMP pathway and the calcium/calmodulin-stimulated PDE (PDE 1) are of functional importance in the intracellular regulation in this tissue in vitro. In addition. initial clinical data with the PDE 1 inhibitor vinpocetine in patients not responding to standard anticholinergic therapy indicate a possible role for vinpocetine in the treatment of urgency, urge incontinence and, possibly, low compliance bladder and interstitial cystitis. The results of a larger randomized, double-blind, placebo-controlled, multicenter trial with vinpocetine show a tendency in favor of vinpocetine over placebo; however, statistically significant results were documented for one parameter only. This might be due to the rather low dosage chosen and the small sample size. Further studies are necessary and currently underway to delineate the optimal dosage, indications and patient population. Modulation of intracellular key enzymes effecting second messenger metabolism, i.e. isoenzyme-selective PDE inhibition is a novel approach which possibly avoids the limitations of anticholinergic therapy in patients with lower urinary tract dysfunction.

Humans↗
PubMed2000

Pilot study of the transdermal application of testosterone gel to the penile skin for the treatment of hypogonadotropic men with erectile dysfunction.

Androgens influence important central and peripheral mechanisms of the erectile system. The relevance of a moderate decrease of serum testosterone level for erectile dysfunction (ED) has not been clarified so far. The aim of our study was to offer an easy transcutaneous method of androgen application. A previous study on the pharmacokinetic profile of the testosterone gel applied, showed marked elevation of the serum levels of testosterone. In our study, 46 hypogonadal patients with ED and total lack of vaginal penetration applied testosterone gel (4 mg/day; supplied by Azupharma, Germany) to the penile skin twice a day over 6-8 weeks, after a run-in period with placebo gel of 2 weeks. All patients showed decreased testosterone serum levels (<3 ng/ml) in at least two morning samples over a period of 3 weeks before treatment. Psychogenic etiology was excluded by a sexual psychologist. Patient age was 37-69 years (mean 53.5). Three patients (6.5%) responded to placebo in the run-in phase and were withdrawn from further treatment. Fifteen patients (32.6%) showed improved erection, allowing penetration and sexual intercourse. Twenty-eight patients (60.9%) did not respond to therapy. Local genital skin irritation was not observed. Elevation of peripheral testosterone was not correlated to a positive therapy response. A success-rate of 32.6% in this group of patients after exclusion of psychogenic patients and placebo-responders seems to justify further investigations. A medication period of 6-8 weeks is most probably too short to induce imaginable regenerative effects of testosterone on the erectile system. We therefore suggest that future double-blind and placebo-controlled studies should be designed for a minimum of 3 months. Testosterone gel may be a cost effective form of androgen administration.

Administration, Cutaneous↗
PubMed2000

Initial clinical experience with the selective phosphodiesterase-I isoenzyme inhibitor vinpocetine in the treatment of urge incontinence and low compliance bladder.

Current pharmacological treatment modalities for urge incontinence and low compliance bladder are limited by a low clinical efficacy and the significant side effects of the standard drugs available. Previous in vitro studies indicated a possible functional relevance of the intracellular phosphodiesterase (PDE)-1 isoenzyme in the regulation of human detrusor smooth muscle contractility. We therefore investigated the effect of the PDE-1 inhibitor vinpocetine in nonresponders to standard pharmacological therapy. In 11/19 patients (57.9%) clinical symptoms and/or urodynamic parameters were improved. Although these initial data are preliminary, they represent the first evidence that isoenzyme-selective PDE inhibition may be a novel approach to the treatment of lower urinary tract disorders.

Compliance↗
PubMed2000

[Andy Warhol's plastic nose revision reflected in his work].

Andy Warhol underwent dermabrasion in 1957 because of a nasal skin lesion, which is best diagnosed as a rhinophyma on the basis of the available biographical literature. Throughout his creative life, the artist worked on different aspects of plastic surgery especially in the nasal area. As one of the founders of Pop-Art, Warhol left essential marks on the modern society and influenced our standards of aesthetic shapes.

Dermabrasion↗
PubMed2000

[Andy Warhol's plastic nose revision reflected in his work].

Andy Warhol underwent dermabrasion in 1957 because of a nasal skin lesion, which is best diagnosed as a rhinophyma on the basis of the available biographical literature. Throughout his creative life, the artist worked on different aspects of plastic surgery especially in the nasal area. As one of the founders of Pop-Art, Warhol left essential marks on the modern society and influenced our standards of aesthetic shapes.

Dermabrasion↗
PubMed2000

The history of endocrine therapy of benign and malignant diseases of the prostate.

The discovery of endocrine therapy of diseases of the prostate can be regarded as one of the most important events in the history of medicine and in urology in particular. This article delivers an overview about scientists and clinicians involved in this work during the last 200 years. A close historical relation between the endocrine therapy of benign prostatic hyperplasia and prostate cancer can be recognized. The historical framework between the work of John Hunter in the late eighteenth century, that of Charles Brenton Huggins in the late 1930s, and that of Andrew Schally in the 1970s has been assembled herein. With respect to all the other men who contributed greatly to this medical achievement, e.g., Edward L. Keyes and Russell S. Ferguson, with their first report on radioorchiectomy for the treatment of metastatic prostate cancer in 1936, this historical vignette is intended to make them part of the historical record.

Antineoplastic Agents, Hormonal↗
PubMed2000

Tissue engineering from Adam to the zygote: historical reflections.

Tissue engineering, long a matter of myth and dream throughout the history of medicine, is now a practical reality. A wide spectrum of biological materials are used in the field of urology to treat disease and to overcome human disabilities, including tissue grafts and organ transplantation. Laboratory-engineered bioproducts for the off-the-shelf replacement and reconstruction of tissue is now almost at hand. This article presents a glimpse into the past by highlighting a number of early pioneering works in the field of tissue transplantation and cell culture technologies.

Biocompatible Materials↗
PubMed2000

Sexual function and fertility after treatment of testicular cancer.

As a result of the introduction of effective cisplatin-based chemotherapeutic regimens into the clinical routine, even patients with metastatic testicular cancer at initial diagnosis can be cured of their disease. Sexual dysfunction and infertility are common long-lasting sequelae in testicular cancer survivors, affecting approximately 20% of patients after the application of the different treatment modalities currently available for the treatment of early and advanced clinical stages, including retroperitoneal surgery and systemic chemotherapy. Accordingly, it has been demonstrated that fertility distress and sexual disturbances, the latter occurring in only a minority of patients after surgical or chemotherapeutic treatment of testicular germ cell tumours, substantially alter the patients' quality of life. It is even worse because testicular cancer mostly affects men in the prime of their physical, sexual and reproductive function. Although semen quality is frequently poor at initial diagnosis and further deteriorates after orchiectomy, probably because of structural abnormalities in the remaining contralateral testicle, the advent of intracytoplasmatic sperm injection promises a fertile future to most patients, even if only a few sperms are present in the ejaculate. Further long-term investigations should be initiated to clarify the impact of the different treatment modalities on fertility and sexual life. The main objective should be the identification of patients who are at increased risk of developing therapy-related physical and psychological problems.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

Congenital and acquired penile deviation treated with the essed plication method.

OBJECTIVES: To evaluate our results with the Essed procedure for the correction of penile curvature, either congenital or due to Peyronie's disease, and compare it with the data from the literature, both for the Essed and the Nesbit procedure. METHODS: From 1991 to 1996 the Essed procedure was performed in 61 patients. 65.6% (n = 40) had congenital deviation and 34.4% (n = 21) suffered from secondary deviation due to Peyronie's disease. In all patients 2-6 nonabsorbable inverting interrupted sutures were placed bringing the knot between the plicated tunica. RESULTS: Patients' ages ranged from 15 to 65 (mean 31.3) years and the mean follow-up time was 39.8 (12-75) months. The preoperative penile deviation was between 20 and 90 degrees (mean 47.4 degrees ). Eighteen patients (29.5%) had a recurrent deviation following surgery. This failure rate was higher in the patient group with Peyronie's disease (42.9%) than in the group with congenital deformation (22.5%). Postoperatively, 2 patients (3.3%) with Peyronie's disease reported de novo erectile dysfunction. Twenty patients (32.8%) complained of persistent discomfort or pain at the area of the still palpable plication sutures, but this inhibited sexual intercourse only in 1 case. 45.9% stated penile shortening after surgery but only 21.3% felt bothered by this. CONCLUSION: The results reported are in accordance with the literature showing a higher recurrence rate of the deviation with the Essed compared to the Nesbit procedure. For both methods the risk of recurrent disease is higher in patients with Peyronie's disease and with both techniques, an equally low incidence of erectile dysfunction is evident. However, since with the Essed technique one third of all patients complained of discomfort from the nonabsorbable sutures, the Nesbit procedure seems to be superior.

Adolescent↗
PubMed2000

Historical aspects of the treatment of urinary incontinence.

Ancient reports on urinary incontinence are rather rare and mainly address cases of extraurethral incontinence, e.g. due to a fistula acquired during childbirth or overflow incontinence, e.g. in males with urinary retention or after spinal cord injury. In modern times several authors dealt with the problem of postoperative incontinence after perineal lithotomy. Surgical techniques for the cure of urinary incontinence were not introduced before the 19th century. First this was limited to fistula repair but at the turn of the century new procedures for stress incontinence were introduced and became standard clinical procedures. Other modern techniques, e.g. artificial sphincters or electrostimulation, were alternatives developed in urology during the second half of our century. This article from the history of medicine outlines early reports on urinary incontinence and reveals a more detailed review of the different treatment options including conservative therapies, incontinence devices, electrotherapy and surgical procedures, including injection therapies and artificial sphincters.

Equipment Design↗