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Biomedical subjects

G Haupt

Publications and source records attributed to G Haupt.

At least 37 records · Page 2Linked to original sources
PubMed1997

Use of extracorporeal shock waves in the treatment of pseudarthrosis, tendinopathy and other orthopedic diseases.

PURPOSE: The use of shock waves in orthopedic diseases was reviewed with special regard to the clinical applications. MATERIALS AND METHODS: Findings in the literature and results from our own studies were analyzed and summarized. RESULTS: Extracorporeal shock waves induced osteoneogenesis in animal models with intact and fractured bones. Based on these findings shock waves were used for the treatment of pseudarthrosis in humans. Most patients had at least 1 unsuccessful operation before shock wave therapy. Complete reunion was noted in 62 to 91% of cases and shock waves are recommended by some as the first choice of treatment for hypertrophic pseudarthrosis. After failed nonoperative therapy shock waves were used for the treatment of patients with various diseases as secondary treatment. The success rate for treatment of tendinopathies, such as tennis elbow, periarthritis humeroscapularis or calcaneal spur, was approximately 80%. For calcific tendinitis shock wave therapy seems to be superior to all other minimal or noninvasive techniques without compromising a potential later operation. CONCLUSIONS: Shock waves have changed medical therapy substantially. Accounting for the epidemiology of the treated diseases, this new change may equal or even surpass the impact of extracorporeal shock wave lithotripsy.

Animals↗
PubMed1997

Glans hyperemia after penile revascularization: a late complication following alpha-1-receptor blockade for benign prostatic hyperplasia.

Surgical revascularization of the penile vessels is one treatment choice for patients with vasculogenic impotence. Hyperemia of the glans is a rare but severe complication which usually occurs early. We report a patient who developed this complication more than 3.5 years after surgery following onset of medical treatment of benign prostatic hyperplasia with a vasodilating alpha 1-receptor blocker.

Adrenergic alpha-Antagonists↗
PubMed1997

Orchitis due to vasculitis in autoimmune diseases.

Autoimmune diseases can affect the blood vessels, causing systemic vasculitis. Although testicular manifestation of some autoimmune diseases is not uncommon, only a few cases of acute orchitis are described in the literature. The underlying pathological condition in testicular manifestations of autoimmune diseases is severe vasculitis causing inflammation and infarction. In patients with recurrent episodes of scrotal swelling and pain, testicular vasculitis as the first sign of a systemic disease should be taken into consideration.

Acute Disease↗
PubMed1997

Transurethral resection of the prostate with microprocessor controlled electrosurgical unit.

PURPOSE: We analyzed the efficacy and side effects of a microprocessor controlled high frequency unit for transurethral resection of the prostate. MATERIALS AND METHODS: A high frequency device with microprocessor control was used in 934 consecutive patients undergoing transurethral resection of the prostate. Indications for transurethral resection, medical history, preoperative findings, operative parameters, operative and immediate postoperative complications, and postoperative peak flow rate and residual urine were evaluated. RESULTS: Postoperative peak flow rate and residual urine were comparable to those with standard transurethral resection of the prostate. One patient died on postoperative day 1 for a mortality rate of 0.1%. The immediate morbidity rate was 6.9%. CONCLUSIONS: Morbidity and mortality in this study were lower than those in previous series on transurethral resection of the prostate.

Aged↗
PubMed1996

In vitro comparison of two ballistic systems for endoscopic stone disintegration.

Endoscopic stone disintegration can be performed with various lithotripsy techniques. We compared two ballistic systems in vitro: the Swiss Lithoclast and the Combilith (Olympus). Measurements of the probe movement; i.e., maximum velocity and displacement, were performed using an optical high-speed technique based on a frame transfer camera. The Lithoclast and Combilith both achieve excellent probe velocities. However, the Lithoclast achieves equal velocity with less probe displacement.

Lithotripsy↗
PubMed1996

Acute multifocal skin necrosis: synergism between invasive streptococcal infection and cocaine-induced tissue ischaemia?

A 30-year-old pregnant woman with full thickness skin necrosis following parenteral abuse of cocaine and heroine is described. Three lesions occurred simultaneously on the trunk and right knee subsequent to an abscess on the left thigh from which S. pyogenes group A and S. aureus were isolated. Histology revealed necrotic subcutaneous tissue with obliterated vessels and a mixed inflammatory infiltrate. The sequence of events suggests a synergism between the effects of bacterial proteases and cocaine-induced impairment of soft tissue perfusion. In the present case, this synergism may have been further enhanced by decreased cocaine tolerance during pregnancy.

Adult↗
PubMed1996

Urodynamic and rectomanometric findings in urinary incontinence.

To investigate the correlation of urinary and fecal incontinence, 52 patients with urinary incontinence underwent cystometry and rectomanometry. Twenty-five patients suffered from stress, 20 from urge and 7 from overflow urinary incontinence. The rectomanometry showed normal results in 29 patients, 5 presented with a compensated and 18 with a partially compensated sphincter incompetence. Whereas 18 of 20 urge incontinent patients had a normal rectal sphincter function, in contrast 16 of 25 stress incontinent patients suffered from rectal sphincter incompetence. In conclusion, there is a marked correlation between stress urinary incontinence and rectal sphincter incompetence. This supports the general thesis that a weakness of the entire pelvic floor is one of the characteristic features of urinary incontinence.

Adult↗
PubMed1996

Influence of continent ileal urinary diversion on vitamin B12 absorption.

PURPOSE: Because vitamin B12 is mainly absorbed in the terminal ileum, we evaluated potential absorption deficiencies in continent ileal reservoirs. MATERIALS AND METHODS: Eight to 25 months (mean 13) after surgery we evaluated 25 patients with a Kock pouch and 29 with an ileal neobladder. A Schilling test and red blood count were done, and serum levels of vitamin B12 and folic acid were determined. RESULTS: Absorptive capacity was decreased in 20 of the 25 Kock pouch patients but none of the 29 ileal neobladder patients. Four patients in each group had low vitamin B12 levels. No patient had megaloblastic anemia. Folic acid levels were normal in all patients. CONCLUSIONS: A loss of 50 cm. of terminal ileum seems to be the critical margin sufficient vitamin B12 absorption.

Female↗
PubMed1995

Impact of the preparation technique on DNA content measured by image analysis in early stage human testis cancer.

Current clinical staging which includes serum tumour markers and imaging techniques fails to identify 30-40% of clinical stage I nonseminomatous germ cell testicular tumour (NSGCT) patients who have occult metastatic disease at time of orchiectomy and who will, therefore, develop clinically evident metastases, usually within two years of follow-up. Therefore, there is a real clinical need to evaluate new biological parameters of the primary tumour which might be useful as predictors for occult metastatic disease. Some investigators have described that DNA content measured by image cytometry is of prognostic value in early stage NSGCT to detect patients at risk for occult metastatic disease. However, optimal preparatory techniques are mandatory in establishing new tumour biological markers in order to obtain reliable and reproducible results. This study has analyzed the impact of the sedimentation technique in comparison to the cytocentrifugation technique on DNA measurement in early stage NSGCT obtained by image cytometry. Different tissue blocks of formalin fixed, paraffin embedded primary testicular tumours (NSGCT) of 50 clinical stage I patients, who underwent retroperitoneal lymph node dissection between 1985 and 1989, were analyzed. Thirty (60%) patients had histologically proven lymph node involvement (pathological stage B), whereas 20 (40%) patients (pathological stage A) had neither lymph node metastases nor tumour recurrence during follow-up. The samples were prepared according to a modified Hedley technique: Individual tissue digestion times were monitored closely to avoid overdigestion. The times varied from 30 to 60 min depending on the constituents of the tissue section. Prolonged digestion times did not correlate with poor quality of the preparations and brief digestion times did not always yield optimal specimens. The impact of two different techniques (cytocentrifugation and gravity sedimentation) on the Feulgen staining results were compared. Cytocentrifuged samples consistently provided larger and paler nuclei with less well defined borders compared to slides from the same cell suspension processed by the sedimentation technique. Nuclei from pathologic stage II samples were more vulnerable to cytocentrifuge alteration than those of stage I. According to the results obtained in this study, the sedimentation slide preparation technique should be preferred for DNA ICM in NSGCT, and possibly in other human malignancies as well.

DNA, Neoplasm↗
PubMed1995

Transurethral ultrasound-guided laser-induced prostatectomy: clinical outcome and data analysis.

OBJECTIVES: To analyze efficacy and side effects of the transurethral ultrasound-guided laser-induced prostatectomy (TULIP) procedure for the treatment of bladder outlet obstruction due to benign prostatic hyperplasia (BPH). Based on the results obtained so far, the influence of preoperative and intraoperative parameters on clinical outcome is analyzed. METHODS: Between May 1991 and March 1994, 89 men with symptomatic and obstructive BPH underwent a TULIP procedure and were followed after 3 and 6 weeks, and 3, 6, and 12 months postoperatively. RESULTS: On average, mean urinary peak flow increased from 7 to 15 mL/s, postvoidal residual urine decreased from 215 to 40 mL and symptoms (assessed by modified Boyarsky score) decreased from 17 to 5 at 12 months after TULIP: In about half of the patients peak flow increased to more than 20 mL/s on average, and approximately 85% of all men reported that their symptoms improved on average 80% during this time. Because of insufficient micturition, 7 patients subsequently underwent conventional transurethral resection of the prostate (TURP) and 1 had an open prostatectomy. Either partial or complete retrograde ejaculation was reported by 13 of 58 sexually active men. No blood transfusion was required and no post-transurethral resection syndrome occurred in any case. Analyses of preoperative and intraoperative parameters and clinical outcome with respect to prostate volume, urinary retention, type of BPH enlargement, sleeve size, and good and poor responders did not reveal any significant influence of any factor. There is, however, a trend toward a lower laser energy delivered in patients who failed or may be considered to be poor responders. CONCLUSIONS: In this unselected group of patients with BPH, who otherwise would have been TURP candidates, the TULIP procedure demonstrated the efficacy of this technique to relieve bladder outlet obstruction. Compared with TURP, the TULIP procedure proved to be advantageous in regard to less blood loss and rate of retrograde ejaculation. In addition, TULIP can be performed under analgesic sedation, which is especially advantageous in high-risk patients. Disadvantages, however, are that it takes a considerably longer time to obtain substantial improvements in subjective and objective symptoms and there are more irritative symptoms in the early postoperative phase.

Aged↗
PubMed1995

The Lithovac: new suction device for the Swiss Lithoclast.

Minimal invasiveness characterizes modern stone therapy. Several years ago, we presented the Swiss Lithoclast, a ballistic system for endoscopic stone therapy. Its disintegrational power is superior to that of the other intracorporeal lithotripsy devices, and it has gained great recognition. Now, special probes (Lithovac) have been developed to combine lithotripsy with suction. These probes differ in width (1.6, 3.5, or 4 mm) and length depending on the intended location of use (kidney, ureter, bladder). The probes were tested in a standardized stone model. The variable suction energy counteracts the propulsive energy of the Lithoclast. Clinical experience could be gained with stones in the urinary bladder, Kock pouches, the ureter, and the kidney. There were no complications related to either the Lithoclast or the Lithovac. In staghorn stones, small (< 2 mm) pieces could be removed easily during lithotripsy. Fragments as large as 3.5 mm could be evacuated with the Lithovac after removing the Lithoclast probe. Using the suction, clear vision could be achieved (especially useful in struvite stones). In the ureter, a learning curve had to be overcome to balance fluid inflow and suction pressure. Otherwise, the ureter may collapse. However, this was possible in all patients. Using the single-shot mechanism, stones were broken up fast. The fragments could be dragged to the Lithoclast probe with the Lithovac. No pushback happened. In bladder and Kock pouch stones, suction may not be enough to hold the stone to the probe, but it is of great value to keep a small volume in the bladder/pouch and still have excellent visibility. The Lithovac is a useful tool in all endoscopic applications of the Lithoclast.

Endoscopy↗
PubMed1995

[Multiple slab MR angiography of the A. carotis interna: a preoperative comparative study].

PURPOSE: With the introduction of MR angiography (MRA) into clinical routine, arteriosclerotic lesions of the supraaortic vessels may be well demonstrated. MATERIAL AND METHODS: The comparison between Multislab MRA (gradient echo, TOF) and X-ray angiography (XRA) as reference in 70 patients suspicious of stenotic lesions in the internal carotid artery proved the high reliability of these methods. RESULTS: In determining the degree of stenosis, according to the NASCET study (North American Symptomatic Endarterectomy Trial), a correlation between MRA and XRA of 92.3% could be calculated. The principal problem of MRA is the overestimation of high-grade stenoses; we observed 5 false-positive results in severe stenosis. Sensitivity and specificity were 95.6 and 92.6%, respectively, for detection of severe (> 60%) stenosis. CONCLUSION: Despite its limitations, MRA is a clinically important noninvasive technique for preoperative evaluation of patients undergoing carotid endarterectomy.

Adult↗
PubMed1993

The Swiss Lithoclast: a new device for endoscopic stone disintegration.

Even in the presence of extracorporeal shock wave lithotripsy there is still the need for endourological treatment of stones in the urinary tract. Stone fragmentation usually is achieved with either ultrasonic, electrohydraulic or laser lithotripsy. We report our early experience with a new, simply constructed machine at a reasonable cost for endoscopic stone disintegration--the Swiss Lithoclast. The principle of this lithotriptor is based on pneumatic shock waves induced by the central compressed air system of a hospital or by a compressor. This device was used to treat 151 patients with stones in the kidney, ureter, bladder or a Kock pouch continent urinary diversion. Endoscopic fragmentation was successful in all patients. Independent of the composition, all stones were disintegrated within a short period, indicating that the device may well represent an attractive alternative to standard endoscopic lithotriptors.

Adolescent↗