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Biomedical subjects

G J Mast

Publications and source records attributed to G J Mast.

At least 19 recordsLinked to original sources
PubMed1993

[Fournier's gangrene].

Today Fournier's gangrene ranks among necrotizing fasciitis. Most of the cases reveal the origin of the disease (proctogenic, urologic, gynecologic). Untreated, the polybacterial synergistic infection will overwhelmingly spread along anatomically defined fascias of the pelvic floor. Thus the lethality rate is high, especially in patients with risk factors i.e. diabetes, alcoholism, arterial occlusive disease, chronic consumptive disorders and obesity. Only by instant and radical surgical excision of the total gangrenous tissue the spreading of the disease and the developing of sepsis can be stopped together with calculated antibiotic therapy and intensive care. Mutilating operations (i.e. penectomy, orchiectomy) are seldom necessary; thus plastic reconstructions will show good results both in function and cosmetic. Based on the experience with 6 patients, a pathogenic concept, concerning both diagnosis and therapy, is presented: after radical emergency surgery in the first risky stage, an elective approach can safely be performed in a second stage for the repair of functional lesions.

Aged↗
PubMed1991

Segmental renal hypoplasia of vascular origin causing renal hypertension in a 3-year-old girl.

A rare case of renal hypertension in a 3-year-old girl caused by segmental renal hypoplasia of vascular origin is presented. Resection of the hypoplastic segment of the kidney permitted successful treatment of the high blood pressure with preservation of renal function. Elevated plasma renin activity in the renal vein of the affected side and biochemical investigations demonstrated that the resected segment of the renal cortex was the source of the renin leading to hypertension by activation of the renin-angiotensin-aldosterone system.

Child, Preschool↗
PubMed1991

[Complexity-oriented surgical strategies in vesicovaginal fistulas].

Since 1975 a total of 55 patients with vesicovaginal fistulas have undergone surgery at the Clinic of Urology, University of Saarland, Homburg/Saar. A majority (55%) of the cases were complicated. In 9 cases supravesical urinary diversion was necessary. Successful closure of the fistula was achieved in 45 patients (81.8%); only in one case is the fistula still present. In 5 patients with uncomplicated fistulas successful closure was accomplished by a vaginal approach. In the presence of complications, e.g., previous radiotherapy or accompanying lesions of the ureter or rectum, a transvesical/transabdominal approach was preferred; surgery was successful in 93.3% of such cases.

Adolescent↗
PubMed1990

Value of selective reversible sacral nerve blockade in the diagnosis and treatment of the urge syndrome.

Interstitial cystitis, neurogenic disturbances of bladder emptying resulting from incomplete supranuclear lesions and idiopathic detrusor hyperreflexia are clinically always associated with frequency, nocturia, urgency or urgency incontinence (urge syndrome). These disturbances of bladder emptying are difficult to distinguish, even urodynamically. With selective sacral nerve blockade, it is possible to differentiate between forms urodynamically using a nerve-blocking anesthetic. Reversible selective sacral nerve blockade is also the treatment for idiopathic detrusor hyperreflexia.

Adult↗
PubMed1988

[Computed tomography of acute bacterial nephritis].

Five case reports are used to illustrate that it is possible by computed tomography to differentiate between acute diffuse, acute focal and abscess-forming types of renal infection. In acute diffuse renal inflammatory disease, intravenously injected contrast medium remains in various parts of the renal tissue after an interval of two to six hours following injection. Acute focal inflammatory disease and abscesses produce localised hypodense or isodense lesions. Sequential increase in density following a contrast bolus injection permits the distinction of focal nephritis from an abscess. These findings provides information concerning the type and duration of treatment.

Acute Disease↗
PubMed1985

[Unilateral atrophic kidney and hypertension--the value of plasma renin determination for assessing the indications for nephrectomy].

In unilateral atrophic kidney and hypertension the nephrectomy is the therapy of choice. The nephrectomy is, however, indicated only then, when a causal pathogenetic connection of atrophic kidney and hypertension is proved. As criterion of the proof of such a connection according to our experiences the side-separated determination of the plasma renin activity in the venous blood of the kidneys stood the test. A renal vein renin quotient greater than 1.5, moreover, permits a rather reliable prognostic evidence concerning the behaviour of the postoperative blood pressure. In 26 out of 31 hypertensive patients with significant renal vein renin quotient who were nephrectomized for a unilateral atrophic kidney could be achieved a normalization of the blood pressure, in the other 5 patients an improvement of the blood pressure.

Adolescent↗
PubMed1985

[Micturition disorder as a sequela of sacral autonomic diabetic neuropathy].

Diabetic neuropathy may manifest itself also in the autonomous nervous system and thus lead to a functional disorder of the urinary bladder. Urodynamic studies carried out in 11 diabetic patients with unclear bladder dysfunction allowed 2 forms of bladder anomalies to be identified: 1. detrusor hyperreflexia, 2. hyporeflexia and areflexia of the detrusor. Whereas hyperreflexia is clinically characterised by signs of motor urgency, hyporeflexia is mainly identifiable by residual urine formation and recurrent infections of the urinary tract. Therapy depends on the type of dysfunction and consists of physiotherapeutic measures, drug therapy and occasionally surgery.

Aged↗
PubMed1984

[Microsurgery in urology].

The use of microsurgical techniques offers operative perspectives also in urology. Microsurgery is indicated for reconstructive vascular surgery in the kidneys, in cases of erectile impotence, and in high maldescended testicles, for recanalisation of the vas deferens and in early childhood for plasty surgery of malformations of the upper urinary tract and such of the male genitals. Certain indications are presented under reference to own clinical experiences.

Adult↗
PubMed1984

Treatment of detrusor instability of the urinary bladder by selective sacral blockade.

Detrusor instability and its associated incontinence frequently impair activity and the results of pharmacological and operative treatment have often been unsatisfactory. Twenty-two patients with idiopathic detrusor instability were treated by selective local anaesthesia of both sacral roots S3. The follow-up period ranged from 4 months to 2 years. In patients with neuropathic detrusor instability, local anaesthesia had no permanent effect, but in four such cases it was possible to achieve continence by permanent blockade of S3 using phenol injections. A disadvantage of the latter procedure was that bladder emptying was achieved only by manual abdominal compression or catheterisation.

Female↗
PubMed1984

[Selective sacral nerve blockade in the treatment of detrusor hyperreflexia of the bladder].

Hyperreflexive detrusor instability causes severe impairment of the patients private and professional life. Involuntary detrusor contractions lead to incontinence. The results of previous pharmacological and operative therapeutic procedures are unsatisfactory. 22 cases with idiopathic hyperreflexive detrusor instability were cured by selective local anaesthesia of both sacral roots S3. The follow-up period ranges from 4 months to 2 years. In case with neurogenic detrusor instability local anaesthesia of the sacral roots S3 has no permanent effect. But in 4 such cases it was possible to reach continence by permanent interruption of the roots S3 using phenolglycerin injections. Unavoidably this success, which enables social rehabilitation, results in voiding disturbance of the bladder which makes voiding by manual bladder compression or even catheterization necessary.

Adult↗
PubMed1983

[Renal hypertension - a threatening complication of blunt kidney injuries].

The therapeutic management of renal trauma is mainly determined by the type and grade of kidney damage. However, imminent complications of renal trauma should already be considered during the primary therapy. The posttraumatic development of the arterial blood pressure was analysed in 153 kidney injuries by a retrospective study during a period of 17 years. Posttraumatic high blood pressure was found in 17 of 86 cases (19.7%) being managed by conservative therapy, and most of them had a grade I-renal trauma (classification according to Hodges). On the contrary, those with a primary operative therapy i.e. when the kidney could be saved or had to be removed, did not show high blood pressure. The high frequency of late complications after conservative treatment of renal trauma supports the necessity of a more active therapy even in slightly damaged kidney.

Adult↗
PubMed1981

[Urological diseases causing renal hypertension (author's transl)].

Based on experimental and clinical findings the publication demonstrates the pathogenesis of renal hypertension. The diagnostic and prognostic value of split renal function test and a split estimation of plasma renin activity is pointed out for the surgical management of renal hypertension. New urosurgical methods for the correction of renovascular diseases are described.

Humans↗
PubMed1978

Reversal of renal hypertension: effects on renin, salt and water balance.

The effect of removal of one renal artery stenosis on renal sodium and fluid excretion and on the activity of the renin-angiotensin system (RAS) has been investigated in three types of renal hypertension of rats. Blood pressure fell in all experimental models after declamping, independently of changes in urinary sodium and water excretion or plasma angiotensin II (ANG II). Plasma concentrations of ANG II did not rise in response to salt and fluid loss induced by declamping when the contralateral kidney had been removed or when it was depleted from renin. A high renin content of the declamped kidney prevented major salt and fluid loss, whereas renin depletion of this kidney was accompanied by an exaggerated natriuresis and diuresis. Besides this tubular modulation of renal salt and water handling by the local RAS, glomerular filtration rate could be reduced by a stimulated activity of this system in plasma, indicated by a close relationship between serum urea and plasma ANG II levels.

Angiotensin II↗
PubMed1975

Aldosterone and corticosterone production in renal hypertensive rats.

The development of hypertension, which had been elicited by clamping one renal artery in the presence of an untouched contralateral kidney, has been pursued in rats for up to six weeks after operation, and aldosterone and corticosterone production was studied at various intervals.

Aldosterone↗
PubMed1975

[Effects of amantadine on heart and circulation].

The effect of amantadine-hydrochloride on heart and circulation is studied in 7 anesthetized, otherwise normal dogs with a mean body weight of 27.2 kg and in 8 heart-lung preparations of dogs. Arterial blood pressure, right atrial pressure, cardiac output and heart rate are measured and continuously monitored. Stroke volume and peripheral resistance are calculated. Left ventricular peak- and enddiastolic pressure, the rate of rise of intraventricular pressure and t-dp/dt are additionally measured in the heart-lung-preparations. Below 3 mg with kg(-1) in anesthetized dogs and 10 mg in the heart-lung preparation, respectively, a positive inotropic effect of amantadine is observed. This effect is caused by a liberation of catecholamines. Higher dosage of amantadine decreases cardiac contractility significantly. Therefore the negative inotropic influence of the drug itself has to be distinguished from the indirect sympathomimetic effect resulting from local release of myocardial catecholamines. Cardiac arrhythmias which occur in several experiments, can mostly be eliminated with propranolol or other drugs like lidocaine or sparteinsulphate.

Amantadine↗