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Biomedical subjects

G Zöller

Publications and source records attributed to G Zöller.

32 records · Page 2Linked to original sources
PubMed1995

Distribution of neurofilament-positive nerve fibres and sensory endings in the human anterior cruciate ligament.

The present immunocytochemical study describes the distribution of neurofilament-containing nerve fibres and corpuscular-like endings in the human anterior cruciate ligament. The entire anterior cruciate ligament of a non-injured knee joint from a child was cut into serial 15-microns-thick frozen sections, which were processed for immunofluorescence staining with a monoclonal antibody against the 68-kDa neurofilament subunit. Numerous neurofilament-positive fibres were found in bundles. These bundles were mostly located near blood vessels in the subsynovial layer and in interfascicular gaps. Only a few single nerve fibres were found independent of blood vessels in interfascicular gaps and between collagen bundles. Neurofilament-containing nerve fibres were preferentially located near the bony attachments of the anterior cruciate ligament. Two types of corpuscular-like endings were found, i.e. "spiral-like" (type I) and "spray-like" (type II) endings. Similarly to nerve fibres, both types of corpuscular-like endings were found mainly near the tibial and femoral attachment sites (15 of 17), whereas only two were found in the middle third of the ligament. Most likely, the type I and type II corpuscular-like endings serve a mechanoreceptive function involved in the sensory control of normal movements and in stress protection.

Anterior Cruciate Ligament↗
PubMed1994

A modified technique for nerve-sparing retroperitoneal lymph node dissection in stage II nonseminomatous germ cell tumors using intraoperative measurement of bladder neck pressure alterations following sympathetic nerve fiber electrostimulation.

We present a simplified method for nerve-sparing retroperitoneal lymph node dissection in patients with nonseminomatous testicular cancer. The sympathetic fibers involved in antegrade ejaculation are identified by intraoperative electrostimulation, resulting in an increase of bladder neck closure pressure. This increase is demonstrated by intraoperative monitoring of both the intravesical pressure and the pressure within the bladder neck by a two-channel microtip measuring catheter. 4 patients with stage I and 6 patients with stage II nonseminomatous testicular cancer were operated on with this modified technique. Ejaculation was preserved in all cases. Semen volume ranged from 2.2 to 4.0 ml. Sperm cell count ranged from 2 to 22 x 10(6)/ml with 20-50% motile spermatozoa, except for 2 of the 3 patients who initially presented with preoperative azoospermia following chemotherapy. In 1 of these 3 patients, postoperative semen analyses revealed a recovery of germ cell function demonstrated by oligoasthenozoospermia.

Adrenergic Fibers↗
PubMed1993

[Follow-up of tissue acidosis, lactic acid production and morphologic changes in testicular tissue in ischemia and the effect of cooling].

More than 90% of the patients with a testicular torsion are loosing their testis by orchiectomy or by following ischemic atrophy. The critical time of irreversible changes of the testis is according to literature 4-6 hours. The aim of our study was to measure the tissue acidification (pH) in the testis at different temperatures and to estimate the cooling effect on pH, lactate accumulation and morphological changes. We have measured in 36 human testis (orchiectomy in patients with metastatic prostate cancer) the tissue acidification (pH), the tissue lactate level and the morphology changes at a temperature of 35, 25, 15 and 5 C. In 12 testis of young dogs we have measured the same parameters. Starting with a normal testis temperature of 35 C the pH is falling to 6.0 within 1 hour of ischemia. By colling to 15 C this time can be prolonged to 6 hours. The tissue lactate level rises from 25 mumol/gdw to nearly 200 mumol/gdw at 35 C. The morphology of semi-thick slices of the testis shows a swelling of the intratubular tissue (spermatogenesis) by loss of the interstitial space. By reducing temperature also a slowdown of the changes can be observed. The critical pH value of the testis for irreversible changes is not known. A ph of less than 6.0 is probably a value, which may result in such changes.

Acid-Base Equilibrium↗
PubMed1993

[Course of tissue acidosis, lactic acid production and morphologic changes in testicular tissue during ischemia. Effect of hypothermic measures].

More than 90% of patients with testicular torsion lose their testis, either because orchiectomy is necessary or because ischaemic atrophy develops. The critical time before irreversible changes to the testis have taken place is, according to literature, 4-6 h. The aim of our study was to measure the tissue acidification (pH) in the testis at different temperatures and to estimate the effect of cooling on pH, lactate accumulation and morphological changes. In 36 human testes (obtained by orchiectomy in patients with metastatic prostate cancer) we measured the tissue acidification (pH), the tissue lactate level and the morphological changes at temperatures of 35, 25, 15 and 5 degrees C. We also measured the same parameters in 12 testes taken from young dogs. At the normal testicular temperature of about 35 degrees C the pH falls to 6.0 within 1 h of ischaemia. Cooling to 15 degrees C can extend this time to 6 h. The tissue lactate level rises from 25 mumol/gdw to nearly 200 mumol/gdw at 35 degrees C. The morphology of semithin sections of the testis shows swelling of the intratubular tissue (spermatogenesis) with loss of the interstitial space. Reducing temperature can also slow-down these changes. The critical pH value of the testis beyond which irreversible changes take place is not known; a pH of less than 6.0 is thought to be the probable threshold.

Acid-Base Equilibrium↗
PubMed1992

[Imaging and functional parameters in diagnosis of obstructive nephropathy].

Obstruction of the kidney leads to terminal kidney failure within a few years. Therefore, early recognition of such obstruction is of importance. Non-invasive diagnostic ultrasound examination now allows intrauterine visualization of a suspected obstruction. However, the implications of such a dilated ureteral pelvic system are obscure. Whether there is obstruction or dilatation can only be evaluated postnatally by a nuclear technique. The aim of our study was to measure the recovery of kidney function. We investigated 13 kidneys of 9 newborns or small infants (up to 2 years). The follow-up was continuous for up to 29 days. The parameters were: urine output (24-h clearance), glomerular filtration rate, fractional excretion of sodium and potassium, free water clearance, total protein excretion, albumin and alpha 1 microglobulin excretion. The urine output fell from 0.3 to 0.12 ml/min within 14 days after relief of obstruction. The glomerular filtration rate rose from nearly 30 ml/min to about 50 ml/min within a week. The fractional excretion of sodium and potassium indicated recovery of the proximal tubli. The fractional sodium excretion fell below 1% within 4 days. The free water clearance reflects the concentrating ability of the kidney, and in kidneys from newborns it had only positive values, while in kidneys of children older than 6 months there were also negative values. The protein excretion and the albuminuria showed recovery of the glomerular as well as the tubular system.(ABSTRACT TRUNCATED AT 250 WORDS)

Alpha-Globulins↗
PubMed1992

[Wilm's tumor 1992. State of research and results of current therapeutic concepts].

Wilms' tumor is the most frequent and most important pediatric tumor in urologic oncology. In recent years the prognosis of Wilms' tumor has improved markedly and a cure rate of more than 80% can be achieved by means of standardized therapy protocols such as those established by the National Wilms' Tumor Study (NWTS), the Société Internationale d'Oncologie Pédiatrique (SIOP), and the German Society of Pediatric Oncology (GPO). However, since the number of long-term survivors is now expected to increase, serious long-term complications must be taken into account, especially after radiation therapy, and treatment modalities must be modified with due consideration for toxicity and late effects of treatment. Refinement of treatment protocols is therefore the main aim to two studies, SIOP-9/GPO and NWTS-4. In Germany, children with Wilms' tumor are now treated according to the SIOP-9/GPO protocol including preoperative chemotherapy. Preoperative chemotherapy can reduce tumor volume markedly, leading to a significantly higher proportion of children with stage I/II tumors at the time of surgery. Thus, postoperative chemotherapy can be reduced and radiation therapy avoided in children in whom stage III tumors would other wise have to be expected. Radiation therapy of pulmonary metastases can be restricted to children who have not responded to prior chemotherapy, whereas in others it seems tumor-free survival can be achieved by extirpation of the remaining pulmonary metastases alone following chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Chemotherapy, Adjuvant↗
PubMed1992

[Sex differentiation disorders from the andrologic viewpoint].

Abnormal sex differentiation with ambiguous genitalia now leads to prompt and comprehensive diagnostic evaluation in the neonate. If necessary, phenotypic gender assignment is done very early and appropriate surgical correction is performed. Management at puberty and later is more difficult. Andrological guidance at this time covers problems of genital identification, sexuality and fertility. The different types of abnormal differentiation, i.e. genetic, gonadal and phenotypic alterations, may result in different andrological problems, e.g. hypogonadism including micropenis and undescended testes, lack of secondary sex characteristics and impotence. With respect to fertility the major problems are testicular azoospermia and/or congenital abnormalities of the male reproductive tract. Any proposals for treatment have to take account of all these different aspects of pathogenesis and the natural course of the disease. In each case, andrological guidance must be formulated with due consideration for the results of genital determination in childhood, including surgical correction.

Disorders of Sex Development↗
PubMed1991

Pre- and postoperative urodynamic findings in children with tethered spinal cord syndrome.

14 children with tethered spinal cord syndrome undergoing neurosurgical untethering were urodynamically evaluated in the pre- and postoperative period. The tethered spinal cord syndrome was mainly due to a previous surgical repair of meningomyeloceles. Preoperatively a neurogenic bladder dysfunction was found in 8 patients; postoperatively a transient amelioration could be demonstrated in 3 patients, whereas 2 children developed urinary retention, 1 of whom had never any complaint of bladder symptoms before. Thus, a high incidence of bladder dysfunction was revealed in children with tethered spinal cord syndrome, demonstrating substantial changes of the bladder function following neurosurgical intervention. With regard to these results a urodynamic evaluation should be part of the pre- and postoperative examinations in children with a tethered spinal cord syndrome.

Adolescent↗
PubMed1991

[Extracorporeal shockwave lithotripsy in the treatment of pediatric urolithiasis].

The 2nd generation lithotripter LITHOSTAR plus was used for extracorporeal shock wave lithotripsy of 9 kidney stones, 2 ureteral calculi and 2 bladder stones in 10 children 15 months to 17 years old. Ultrasonic stone localization was used in 2 children, x-ray guided stone localization in 8 children. General anesthesia was necessary in 6 children. A stone free rate of 60% was achieved after 1 treatment. Except for one 14-year old boy no adjuvant procedures like percutaneous nephrostomy or ureteral stents were applied. No major complications were encountered.

Adolescent↗
PubMed1990

[Radiologic diagnosis and treatment of Ormond's disease].

Retroperitoneal fibrosis is a rare entity of various causes. The clinical findings are not specific. In some cases the diagnosis is suggested by the characteristic appearance on urography. The purpose of this investigation is to evaluate the typical ultrasound and CT findings of patients with retroperitoneal fibrosis. A discussion of the current diagnostic procedure and treatment is presented.

Female↗
PubMed1990

[Extracorporeal shockwave lithotripsy with combined ultrasound and roentgenologic calculus localization. Initial clinical experiences with the Lithostar plus].

Since the introduction of extracorporeal shock wave lithotripsy for non-invasive treatment of renal and ureteral stones, lithotripter units have relied on either fluoroscopic or ultrasound stone localization. While ultrasound stone localization reduces X-ray exposure and facilitates treatment of radiolucent renal stones, fluoroscopic stone localization is superior in the detection of ureteral stones. Since April 1989 we have been using the Lithostar plus, a new lithotriptor system, which provides both fluoroscopic and ultrasound stone localization. After treatment of 108 patients, the initial data suggest that this system combines the advantages of both localization principles, while being as efficient as other second-generation lithotriptor units in bringing about the disintegration of renal and ureteral stones.

Equipment Design↗
PubMedDate not supplied

[Ektopic ureter - a not considered cause of persisting enuresis in girls].

BACKGROUND: Ectopic ureter - especially in a duplicated collecting renal system - is a specific cause of incontinence in young girls. Although the symptom of continuous dribbling of urine is characteristic for this malformation, diagnosis is often delayed, as the possibility of ectopic ureters is not considered in treating girls with delayed toilet training. CASE REPORT: We present the case of a young girl with a variety of unnecessary invasive diagnostic and therapeutic procedures due to a misunderstood "enuresis", before incontinence was cured by upper pole heminephrectomy. CONCLUSIONS: Girls, who never have been dry and who loose urine all the time do have an ectopic ureter, unless evidence to the contrary has been put forward. Only considering the possibility of ectopic ureters will avoid unnecessary diagnostic and therapeutic procedures in these girls.

Child↗