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Biomedical subjects

F Recker

Publications and source records attributed to F Recker.

49 records · Page 3Linked to original sources
PubMed1989

Morphological changes following ESWL in the rat kidney.

Fifty four Wistar rats were treated with 500, 1,000 or 2,000 shock waves, using the modified DORNIER HM 3 system with the new SG40 shock wave generator. The animals were sacrificed after a period of 24 hours, 7 days or 35 days. Histological examination, scanning electron microscopy (SEM) and magnetic resonance imaging (MRI) were used to evaluate acute and long term effects after extracorporeal shock-wave lithotripsy (ESWL). Acute morphological changes such as glomerular bleeding, tubular dilatation, atrophy and partial necrosis occurred immediately after ESWL throughout the kidney. SEM revealed a tubular loss of microvilli and cilia. There was restitutio ad integrum of these diffuse lesions. The extent of the long term lesions was determined by the following mechanism: venous rupture occurred during ESWL, especially in thin arcuatae veins which are, tortuous their and run between two different tissue densities. This resulted in interstitial haematoma, demonstrable by MRI; in the long term groups, the haematomas progressed to interstitial fibrosis with segmental retraction of renal convexity. The blood supply in these areas was reduced and secondary changes such as glomerular-tubular atrophy and sclerosis followed. The degree to which long-term renal lesions resulted was determined by the extent of these changes, which were shock-wave dose dependent up to a dose of 2,000 shock waves.

Animals↗
PubMed1989

Extracorporeal shock wave lithotripsy as monotherapy of staghorn renal calculi: 3 years of experience.

From May 1985 to February 1988, 61 patients with renal staghorn calculi (41 with incomplete C4 and 20 with complete C5 lesions) underwent extracorporeal shock wave lithotripsy monotherapy. Of the patients 37 were treated without preoperative Double-J* stenting, while 24 underwent Double-J stenting before extracorporeal shock wave lithotripsy. Of the patients with incomplete staghorn calculi (C4) and a preoperative ureteral stent 85% were free of stones after 6 months in contrast to only 52.4% of those without a stent and 85.7% of those with infected C4 calculi who underwent preoperative stenting. Hospitalization decreased from 17.7 days in patients without a stent to 14.2 days after stenting, followed by the number of auxiliary procedures (nephrostomy, Zeiss loop and ureteroscopy) and postoperative complications. Complete staghorn calculi (C5) without a preoperative stent had the smallest success rate of stone elimination: only 43.7% of the patients were free of stones after 6 months with a rehospitalization rate of 62.5%. For incomplete staghorn renal calculi (C4) extracorporeal shock wave lithotripsy monotherapy with a preoperative Double-J stent is the noninvasive method that offers excellent stone elimination (85%), comparable to the results of percutaneous nephrolithotripsy (with or without complementary extracorporeal shock wave lithotripsy) and anatrophic nephrolithotomy.

Combined Modality Therapy↗
PubMed1989

Variation of the immunosystem by ciclosporin and keyhole-limpet hemocyanin--are there effects on chemically induced bladder carcinoma?

Ciclosporin (CsA) and keyhole-limpet hemocyanin (KLH) are potent immunomodulators. Their effects on the induction of bladder carcinoma were investigated in Wistar rats using N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) as a known initiator of bladder carcinoma. In a first series the immunosystem was suppressed by CsA. Rats treated with 0.05% BBN + CsA 5 mg/kg/day or CsA 12.5 mg/kg/day orally developed a CsA dose-dependent (2- to 4-fold) enhancement of bladder tumor expansion as compared to 0.05% BBN application alone. In contrast, immunovariation by stimulation with KLH 12.5 mg i.ves. + 0.5 mg s.c. 2 X/week after being sensitized with 1 X 1 mg KLH s.c. resulted in a reduction of BBN-induced bladder tumors. The results confirm the immunosurveillance theory that effective expression of immunoresponse may be important in the control of tumor development. The effective immunostimulation by KLH support the concept of immunotherapy in bladder cancer.

Animals↗
PubMed1989

Management of ureteral stones by extracorporeal shock wave lithotripsy. 3 years of experience.

From April 1985 to March 1987 181 patients with ureteral stones were treated by means of extracorporeal shock wave lithotripsy (ESWL). Management for proximal calculi changed from in situ ESWL treatment (group n = 27) or placement of a ureteral catheter below calculi (group II, n = 30) to retrograde stone manipulation into renal pelvis (group IV, n = 52) or ESWL treatment under intraoperative irrigation of saline in cases where repositioning failed (group III, n = 50). The best stone-free rate for upper ureteral stones was obtained in group IV with 96% after 6 weeks, presenting also the shortest hospital stay (4.2 days) and lowest quota of postoperative auxiliary procedures (2%). Stones, not being dislodged into renal pelvis (49%), could be treated successfully in 86% by irrigation with saline during ESWL (group III). The stone-free rate decreased in patients with in situ treatment (group I: 67%) or ureteral catheter placement (group II: 83%). Treatment of these stones increased the need of postoperative ancillary procedures to approximately 30%. For distal ureteral stones ESWL and preoperative Zeiss placement achieved a stone-free rate of 95%.

Adult↗
PubMed1989

[The staghorn calculus: anatrophic nephrolithotomy versus percutaneous litholapxy and extracorporeal shockwave therapy versus extracorporeal shockwave lithotripsy monotherapy. A report of over 6 years' experience].

From 1982 to December 1987, 71 with incomplete (C4 by Rocco) and 37 with complete (C5 by Rocco) staghorn calculi underwent anatrophic nephrolithotomy (AN; n = 29), or combined percutaneous nephrostolithotomy and ESWL (PCNL + ESWL; n = 21), or ESWL monotherapy without or with preoperative JJ stenting (n = 37/21). The patients with incomplete staghorn calculi (C4) and preoperative ureteral stenting were free of stones after 6 months in 15 of 17 cases (88%), which is comparable to our results with AN (90%) and combined PCNL + ESWL (85%). ESWL without JJ stenting were free of stones in only 52%. The treatment of infected C4 calculi with JJ stenting was especially successful (92%). Complete staghorn calculi (C5) represented the best results after AN (78%) and combined PCNL + ESWL (75%), in contrast to ESWL without JJ stenting (44%). Four patients with C5 calculi were treated with ESWL and preoperative stenting, three of them were free of stones after 6 months. For incomplete staghorn calculi (C4), ESWL monotherapy with JJ stenting seems to be a justifiable noninvasive method which offers excellent results in stone elimination (88%), with lower costs than AN or PCNL + ESWL. More invasive procedures should be reserved for complete staghorn calculi.

Combined Modality Therapy↗
PubMed1988

Enhancement of chemically induced bladder carcinoma by cyclosporin A.

The effects of cyclosporin A (CsA) on the induction of bladder carcinoma were investigated in Wistar rats using N-butyl-N (4 hydroxybutyl) nitrosamine (BBN) as a known initiator of carcinogenesis. Rats treated with 0.05% BBN + 5 mg/kg per day CsA or 0.05% BBN + 12.5 mg/kg per day CsA developed a dose-dependent (two to fourfold) enhancement of bladder tumor expansion and infiltration as compared to those treated with 0.05% BBN alone. In control rats receiving CsA at doses of 5 mg/kg per day or 12.5 mg/kg per day, no bladder carcinoma occurred. All CsA-treated groups, with or without 0.05% BBN, displayed slight or moderate medullary atrophy of the thymus. The results indicate that immunosuppression with CsA enhances the induction of bladder tumors by BBN. Furthermore, the immunosurveillance theory that effective expression of the immune response may be important in the control of tumor development was confirmed in the carcinogenesis of epithelial cell tumors.

Animals↗
PubMed1987

[Perioperative antibiotic prophylaxis in heart and vascular surgery. A prospective randomized comparative study with cefazolin and ceftriaxone].

Two different forms of cephalosporin prophylaxis were investigated in a prospective randomized comparative study: a one-day cefazoline prophylaxis (Kefzol 0.5 g every six hours) and a single dose of ceftriaxone (Rocephin 2 g). A total of 541 patients were included in the study over 10 months: 272 in the cefazoline (CFZ) group and 269 in the ceftriaxone (CRO) group. The patients were checked postoperatively for an infection. The total rate of infections was 4.7%; 4.6% in the CFZ group and 4.8% in the CRO group. A wound infection occurred in 1.1% of the cases, in 0.4% of the CFZ group and in 1.8% of the CRO group. Septicemia was diagnosed in 1.5% of the operated patients; in 1.2% of the patients treated with CFZ and in 1.8% of the patients treated with CRO. 1.3% of the patients developed pneumonia, 1.8% in the CFZ and 0.8% in the CRO group. Only one patient had a urinary tract infection (CFZ group). Furthermore, two double infections occurred in the CFZ group. A double infection was observed only once in the CRO group. Fever of unclear etiology developed in 3.6% of the patients in both groups. There was no statistically significant difference with regard to the rate of infection between the two groups. A single administration of ceftriaxone prophylaxis is accordingly just as effective as a one-day cefazoline prophylaxis. Despite reduction of the antibiotic application, the rate of infection has not risen in the last five years. The single application is advantageous compared to longer-term applications.

Cardiac Surgical Procedures↗
PubMed1987

Antimicrobial prophylaxis in cardiovascular surgery.

In the past five years three prospective randomized studies compared five different prophylactic antimicrobial regimens in major cardiovascular surgery. In 1980/81 a 4 d cefazolin (CFZ) prophylaxis (16 X 0.5 g) was compared with a 2 d cefuroxime (CFX) administration (4 X 1.5 g). Of the 566 patients who entered the study 281 received CFZ and 285 were given CFX. In 1982/83 a 2 d CFX prophylaxis (4 X 1.5 g) was compared with a two shot ceftriaxone (CRO) prophylaxis (2 g i.v., + 1 g 24 h later). Of the 512 patients enrolled 258 received CFX and 254 CRO. In 1984/85 a 1 d CFZ prophylaxis (4 X 0.5 g) was compared with a single shot prophylaxis of CRO (1 X 2 g). Of the 541 patients who entered the study 272 received CFZ and 269 CRO. All patients of age 16 y or older who were undergoing open heart surgery (n = 1384) and surgery of the major arteries (n = 235) were eligible for trial entry with the following exceptions: patients with preoperative infections, those who had received an antibiotic within 48 h of operation, and any with known allergies to cephalosporins or who had suffered an anaphylactic reaction to any penicillin. The patients were allocated to one of the two treatments by means of a randomized code, stratified for cardiac and major vascular operations. The first dosis was always given prior to surgery at the beginning of anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1986

[Exogenous heat exposure--a cause of subfertility].

In the diagnostics of subfertility three main factors have to be considered: Endogenous testicular heat exposure, genitourinary tract infection and endocrinologic abnormality. The possibility of exogenous heat exposure is emphasized. An exact anamnesis is important, because exogenously induced subfertility is reversible in general.

Adult↗
PubMedDate not supplied

Perioperative antibiotic prophylaxis in cardiovascular surgery: a prospective randomized comparative trial of cefazolin versus ceftriaxone.

With a view of possible reduction in antibiotic dosage, several prospective randomized comparative trials performed in our institution showed that a 4-day prophylactic antimicrobial regimen with cefazolin was equally effective as a 2-day prophylaxis with cefuroxime and that the best regimen was equally as effective as a double dose of ceftriaxone prophylaxis in major cardiovascular surgery. In this prospective randomized comparative study, 1-day cefazolin prophylaxis (4 X 0.5 g intravenously) was compared with a single dose of ceftriaxone prophylaxis (2 g intravenously). Of the 900 patients enrolled in the study, 17 were subsequently excluded. Of the remaining 883 patients, 439 were in the cefazolin group and 444 were in the ceftriaxone group. The overall postoperative infection rate was 5.0% in the cefazolin group and 4.5% in the ceftriaxone group. In view of the almost identical infection rates in both groups, we considered that a single 2 g dose of ceftriaxone offers patients a reliable antimicrobial prophylaxis. The single-dose prophylaxis has the additional advantage of reducing the dosage administered and the costs of administration.

Bacterial Infections↗
PubMedDate not supplied

Effects of lithotripsy on rat kidney: evaluation with MR imaging, histology, and electron microscopy.

Magnetic resonance (MR) imaging at 1.5 T was used to evaluate the effects of extracorporeal shock wave lithotripsy (ESWL) in 30 rats and the findings on T1- and T2-weighted (spin echo 600/22, 1,600-2,000/90) images were compared with histology and scanning microscopy. The observed pathologic changes increased in severity with the number of shock waves given (500-5,000 15 kV). Post-ESWL MR findings in 54 kidneys included perirenal and subcapsular fluid (n = 30), diffuse loss of corticomedullary junction definition (n = 28), intrarenal foci of increased (n = 7) or decreased (n = 6) signal intensity, focal indentation of the renal contour (n = 5), and loss of distinction between the renal, splenic, or hepatic contour (n = 7). The subcapsular and intrarenal findings corresponded pathologically to areas of hemorrhage and hematoma formation--the contour changes to foci of renal scarring or perirenal adhesions. Electron microscopy demonstrated marked alterations of the renal tubules and vasculature. The study shows the feasibility of assessing the nature and chronology of renal damage post-ESWL in a rat model by MR.

Animals↗