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Biomedical subjects

G Wandschneider

Publications and source records attributed to G Wandschneider.

At least 19 recordsLinked to original sources

The permanent ureterocutaneostomy (UCST).

During a period of eleven years, ureterocutaneostomy (UCST) as a permanent urinary diversion was performed in 44 highly selected patients. Postoperative complications, in particular stenoses or strictures, can be avoided if subtle operative techniques are applied. Ureterocutaneostomy, which is functionally similar to an incontinent ileal conduit, turns out reasonable especially as a palliative procedure in patients with unresectable pelvic mass, dilated ureter, or solitary kidney. Thus, the authors conclude that UCST as a permanent urinary diversion still has to be considered valuable in a highly selected group of patients.

Adult

False positive prostate specific antigen values in the sera of women with renal cell carcinoma.

The assessment of serum prostate specific antigen (PSA) with a polyclonal radioimmunoassay in 22 women with renal cell carcinoma resulted in measurable values in 6 patients, with the values ranging from 0.5 to 27.0 ng./ml. Tumor stage was T3 in all of these patients and the morphological features showed an eosinophilic subtype according to the German nomenclature. Additional measurements with a monoclonal radioimmunoassay in 3 of these 6 patients were negative as were all subsequent measurements postoperatively, although performed with the polyclonal radioimmunoassay. Immunohistochemical staining was negative for PSA. However, positivity for alpha-1-antichymotrypsin was detected, which was reported to occur in complexes with PSA and other proteases. Cross reaction between the polyclonal antibodies of the radioimmunoassay and 1 of these complexes is concluded. As far as clinical considerations are concerned, such cross reaction must be considered just as likely in male patients. Thus, it is recommended that therapeutic considerations in patients who underwent radical prostatectomy, for example, should not be exclusively based on PSA measurement performed with a polyclonal assay.

Antigens, Neoplasm

Pituitary hyperplasia after goserelin (LHRH-analogue) therapy.

A 78-year-old male was treated with goserelin (Zoladex) for 16 months for metastasizing prostate carcinoma. This therapy is clinically equivalent to orchidectomy, as the application of the luteinizing hormone-releasing hormone (LHRH)-analogue Zoladex causes suppression of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) by down-regulation of pituitary receptors. Consequently, testicular androgen production is inhibited and testosterone levels are decreased to castration levels. In the present case we found diffuse, partially nodular hyperplasia of growth hormone (GH) and adrenocorticotropin (ACTH) producing cells in the anterior pituitary gland at autopsy. As Zoladex reduces pituitary receptors for releasing hormones (RH), a globally increased hypothalamic secretion of RH might be responsible for the ACTH- and the GH-cell hyperplasia. We cannot exclude that Zoladex may cause not only adenomas in rat pituitary glands as reported previously, but also a (nodular) hyperplasia of the pituitary gland in man.

Adrenocorticotropic Hormone

Renal cell carcinoma presenting as spontaneous retroperitoneal haemorrhage.

On the basis of a spontaneous retroperitoneal haematoma in a 55-year-old female patient the diagnostic and therapeutical problems of such an emergency situation will be discussed. Due to the high incidence of malignant tumours as the bleeding source, radical surgery becomes the necessary treatment, which may be needlessly burdened by high operative risk in the acute phase. For that reason the mode of treatment chosen in this particular case was immediate embolization subsequent to arteriography along with consecutive extracapsular nephrectomy and removal of the haematoma.

Carcinoma, Renal Cell

[Experiences with ureterosigmoidostomy].

It is reported on the experience with ureterosigmoideostomy in 59 patients. Because of the good long-term results with a maximum follow-up time of 20 years especially in patients suffering from benign congenital anomaly the authors emphasize the current value of ureterosigmoideostomy especially in the treatment of bladder extrophy and aplasy of the urethra and urethral sphincter. In 3 female patients some years after operation a healthy child was born on the natural way.

Adult

[Bulbocavernosus fatty tissue flap-plasty].

It is reported on the use of bulbocavernosus fat flap plasty according to Martius in 23 patients. In 6 cases it is performed as additional operation in the vaginal closure of vesicovaginal fistulas and in 17 cases as incontinence plasty in female stress incontinence. With the use of the described operative technique all vesicovaginal fistulas were closed successfully and only one recurrence was observed after stress incontinence operations.

Female

Peritoneal flap plastics in vesicocervical fistula.

The operational method described hereunder as peritoneal flap plastics has proved effective in the management of vesicocervical fistula. Reference is made to the conditions which have to prevail for the operation to be successful. Two forms of the abnormality, a superior and an inferior type of vesicocervical fistula are presented, both amenable to treatment with this operation technique.

Adult

[Renal cell carcinoma (hypernephroid carcinoma)].

Our own 215 patients who were operated on for renal cell carcinoma in a period of 10 years are examined, statistically established and the treatment performed is described. The 5-year survival rate of 58% of the curatively operated patients as well as the primary operation mortality of 1.4% are at the top. This is remarkable for that reason since we in our department our department are not fixed at the at present generally propagated transperitoneal approach in the tumour nephrectomy. We individually choose the operative approach according to location and size of the tumour. Apart from this we perform the removal of the regional lymphatic glands only when there is a suspicion of metastases. So the authors think that at present an improvement of the results is not so much to be seen in the choice of the operative approach but in the early recognition of the tumor by routine sonographies of the kidneys.

Carcinoma, Renal Cell

[Vesicocervical fistula].

Vesicocervical fistula appearing after transperitoneal transversal isthmic Caesarean section become manifest in two different clinical patterns, either as incontinence with normal menses or as "umeno-urias" with urinary continence. The reasons for the signs and symptoms are explained, differential diagnosis is discussed and an own case presenting as incontinence is demonstrated. The need for surgical treatment is pointed out and criteria for safe operative closure of fistula are given.

Adult

[Operative treatment of vesicovaginal fistulas and defects].

On the basis of 15 own cases the problems of the operative treatment of vesicovaginal fistulae and defects are explained. In particular it is referred to those criteria which are of importance for the success of the corrective operations.

Adult

[Surgery for hypospadias using a penile and scrotal skin flap].

It is reported on a penoscrotal operation method, where the penile urethra is formed by a skin stripe of penis and scrotum. 35 cases operated by means of this method, the operation technique of which is described in detail, operated cases had altogether good functional and cosmetic results with a completely complicationless postoperative course.

Humans

Experiences with our surgical technic of partial resection of the kidney.

On the basis of 305 partial resections of the kidneys is reported on experiences with an own operation technique. By applying a chromium cat-gut supporting suture a secure and pboblem-free care of the resection wound is possible, which guarantees an as far as possible uncomplicated postoperative course. The operation technique is described and in general the problems of postoperative early and late complications are discussed.

Adolescent

[Our experiences with urate I in bladder stones].

It is reported on the experiences with the electrohydraulic lithotripsy in 122 patients. The indications, contraindications and regulations for the intervention are shown and it is referred to their significance for a successful and dangerousless operation. This fact is emphasized by two own cases with intraoperative complications. In the opinion of the authors the electrohydraulic lithotripsy is the method of choice in the treatment of vesicular calculi in an adequate indication and in the department of the authors it has fully restricted the mechanical lithotripsy.

Aged

[Unitemporary surgical procedure by Michalowski for strictures of perineal and bulbar urethra].

Initially the authors briefly deal with the genesis of strictures of the urethra in the perineal and bulbar region of the urethra and the experiences and results of the authors with the unitemporary method of operation after Michalowski for these strictures of the urethra are reported. The technique of the plastic-surgical intervention is demonstrated and here important details are explained which, as the authors think, are decisive for the success. The results are shown with the help of the own clinical material.

Humans

[Contribution on the surgical correction of penile and penoscrotal hypospadias (author's transl)].

The authors present a modification of the penoscrotal method of operation for the treatment of penile and penoscrotal hypospadias. The operating technique employed by the authors differs from the original method in that the urethra is formed from a strip of skin from the penis and scrotum. The so far good results are shown, and the importance of careful pre- and postoperative treatment for the success of the operation is pointed out.

Humans