[Endocrine and exocrine function of the testis following spermatic cord torsion].
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Biomedical subjects
Publications and source records attributed to G Staehler.
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It has been shown in an animal experiment that alterations of the renal vasculature and parenchyma after hemostasis performed by Infrared-Contact-Coagulation are best shown by intravital magnification angiography (magnification factor 2.22). Following pole resection and hemostasis the final morphologic state is reached 6 weeks postoperatively. The resulting scar penetrates into the parenchyma up to 1 cm. The loss of function corresponds to the parenchymal defect. There was no additional loss of renal function or damage to the parenchyma on nuclear medicine or histologic examinations.
The specificity of commercially available hCG and hCG-beta antibodies (anti-hCG-beta from N.I.A.M.D.D. (SB6), Serono (S), Biosigma (B), Union Carbide (UC) (I.R.E.) and anti-hCG from Union Carbide) were compared. Using 125I-hCG (CR 115), the crossreactivity with LH (LER 960) was 5.5% for SB6, 0.25% for S and 0.3% for B. In the homologous hCG system UC, crossreactivity was 0.06% with hCG-beta and 1.2% with LH, in the hCG-beta system UC, it was 2.2% with hCG and 0.01% with LH. Parallel standard curves for hCG, the 2nd I.R.P. hCG and hCG-beta were found exclusively with the 125I-hCG, anti-hCG-beta system S. Consequently accurate estimates of the total hCG or hCG-beta content in serum and standardization with the 2nd I.R.P. is possible. This system is the most useful for clinical purposes. The serum half-life of hCG was calculated in 10 pregnant women after delivery and was found to be 10 to 34 h. AFP half-life time, determined by the double antibody radioimmunoassay was 4.0 +/- 1.8 (+/- SD) days in pregnant women after delivery (n = 60) and 3.8 +/- 0.9 days in neonates during the first 16 days of life (n = 26). Altogether, apparent half-life determinations were carried out in 29 patients with nonseminomatous germ cell tumors. The results indicate that half-life determinations of hCG and AFP may have a predictive value with respect to the monitoring of therapy.
After preliminary animal experiments, endoscopic Neodym-YAG laser irradiation of bladder tumors was performed successfully for the first time. Although no final statement can be made so far on the value of laser irradiation in bladder tumors because of the small number of cases, we believe that laser coagulation will attain a secure place in the transurethral treatment spectrum. A combination of transurethral resection and irradiation of the tumor bed for destruction of intramural tumor cell nests appears especially useful. Laser therapy cannot replace transurethral resection, but it can complement it.
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Tumors of the urinary bladder were destroyed successfully by the use of a Neodymium-YAG-laser for the first time at the Department of Urology of the University of Munich. A final estimation of the real value of this method cannot be made because the number of cases was too small and the period of follow-up too short. Nevertheless we hope to increase the spectrum of transurethral treatment of bladder tumors. The use of the Neodymium-YAG-laser irradiation seems to make sense especially in treatment of tumors reaching deep layers of the bladder wall.
Sixty-two patients with diseases of the scrotal area were examined sonographically. In 11 out of 12 testicular tumors, a preoperative diagnosis could be confirmed by examination with ultrasonication, including one case with large accompanying hydrocele, which made an exact palpation of the testicles impossible. Despite the still small number of cases, we feel that ultrasonic examination of the testicles makes it possible to speed up the diagnosis of testicular tumors, which is often drawn out over weeks or months, and to provide the patients with early operative therapy.
After i.v.-application of 2 grams of Cephaprin (= Bristocef) to 13 patients with prostatic adenoma the mean serum concentrations after 30 minutes were 50 microgram/ml and 21.5 microngram/ml after 60 minutes. The corresponding tissue values were 20.8 and microgram/g respectively in prostatic tissue. The evaluated serumand tissue cncentrations are suited to the therapy of infections with cephapirin sensitive rods.
Tumors of the bladder are second in frequency of all genito-urinary neoplasms. Because of their malignancy, the difficulties of early recognition and the advanced age of the patients they constitute one of the most difficult urologic problem. The most important medical check up is the demonstration of erythrocytes and malignant cells in the urine. The former can be easy established by the Sangur-test, the latter must be diagnosed by specialists.
Suspended material of Brown-Pearce carcinoma is qualified for producing bladder tumors in rabbits after injection into the wall of the exposed, but not opened bladder. The advantages are the rapid growing and the possibility of controlling by endoscopy and radiography. At present we use this tumor-pattern for examination of the effect of different laser beams in experimental bladder tumors.
15 patients with papillary bladder tumors were radiated with a Neodym-YAG laser beam since summer 1976. The seize of the tumors ranged from 5 to 10 mm in diameter. Neither complications nor tumor recurrency in the former tumor area could be observed. A final statement about the value of laser radiation in malignant tumors is not yet possible because of the small number of patients and the short control period. However, our preliminary experiences might be a beginning of a successful improvement of bladder tumor therapy by use of endoscopic laser radiation.
Alpha-fetoprotein (AEP) serum levels were determined by a new radioimmunoassay (sensitivity about 5 ng/ml) in 47 patients with teratocarcinoma of the testis and in 58 cases with seminoma before operation and during the postoperative course of the disease. In 140 healthy adult persons normal AFP levels below 15 ng/ml were measured. Of 14 preoperative cases with teratocarcinoma, 12 (86%) showed pathologic AFP levels over 20 ng/ml up to 3875 ng/ml. Postoperatively, cases free of metastases developed normal AFP concentrations within 4 to 10 weeks, whereas cases with distant metastases retained constant or increasing pathologic levels following a clinical deterioration. Only in three postoperative cases were Ouchterlony-positive results (AFP sensitivity about 10 000 ng/ml) observed. In contrast, patients with seminoma showed normal AFP levels below 20 ng/ml pre- and postoperatively. According to the results, AFP radioimmunoassay is recommended as an important tool for the differentiation of teratocarcinoma from other tumors of the testis and as a useful parameter for the control of therapy and the course of the disease.
Investigations on hemostasis with the infrared contact coagulator (ICC) after renal pole resections in dogs with and without clamping of the renal vessels are reported. Clamping the renal vessels led to less bleeding, but the coagulation time was distinctly prolonged. In addition the use of ICC in renal pole amputations in humans is described in two cases of urogenital tuberculosis. In both cases we were able to stop the bleeding quickly and satisfactorily without clamping the renal vessels. The results of animal experiments and the significance of using the ICC in man are discussed.
After developing a flexible fiber light guide and a special cystoscope it was possible to study the Argon laser beam effects on the bladder wall of rabbits and dogs. It could be proved that the Argon laser is qualified for the use in organs with thin walls, especially in the urinary bladder, because of its strong absorption in tissue with high blood flow and its minor penetretion depth. However, our further investigations showed--they shall be published--that the output of the Argon laser used in our studies not sufficient for destroying human bladder tumors. For this reason it is necessary to use neodymium YAG laser.