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Biomedical subjects

H E Wegner

Publications and source records attributed to H E Wegner.

34 records · Page 2Linked to original sources
PubMed1995

Laparoscopic pelvic lymphadenectomy in prostatic cancer: an analysis of seventy consecutive cases.

From July 1992 to April 1994, 70 patients with prostatic cancer underwent laparoscopic pelvic lymph-node dissection (LPLD) before retropubic radical prostatectomy or afterloading therapy in our clinic. After an initial learning phase, the accuracy of LPLD was excellent, with only 3.0% residual nodes and no false-negative results due to LPLD. The rate of severe complications was 5.7% (4/70). No transfusions were required due to LPLD. If patients with positive nodes (D1) were excluded from local therapy, the benefits of LPLD were estimated as 12 patients with positive nodes avoiding open surgery (17.1%); 15 patients undergoing afterloading therapy and avoiding open surgery (21.4%); 1 patient with high preoperative prostate-specific antigen having a chance of surgical cure (1.4%) - a total of 28 of 70 patients (40.0%). We conclude that, depending on the therapeutic concept applied, LPLD is beneficial for patients with prostatic cancer, it opens the door for other curative procedures like after-loading therapy, and reappraisal of perineal prostatectomy.

Adult↗
PubMed1995

Treatment of Peyronie's disease with local interferon-alpha 2b.

Peyronie's disease is an illdefined condition that often leads to severe penile deformity. Various conservative treatments have failed to have any impact, and surgery remains the mainstay of therapy in advanced cases. Recent reports of successful treatment of related diseases, notably keloid formation, with interferons (INF) have prompted us to use this biologic response modifier to alter the behavior of the myofibroblast, the cell most likely responsible for the development of Peyronie's disease. From December 1992 to July 1994, 25 patients suffering from Peyronie's disease were treated with five local injections of 1 million units of INF-alpha 2b each into a single designated and ultrasonographically measured plaque. The interval between the injections was 1 week. The patients were assessed clinically and ultrasonographically 1 and 6 months after the last injection. The condition improved clinically in only 1 case, but progressed in none. The measured plaque size decreased in 7 no or mildly calcified cases, remained stable in 12 cases, and increased in 6 patients, (solely calcified plaques). Side effects (myalgia, fever) occurred in 4 patients; of these 2 patients withdrew from treatment. INF-alpha 2b given according to our regimen is at best usefull for the treatment of Peyronie's disease in the early, noncalcified stage during which it displays verifiable impact on the plaque treated and also helps alleviate the plaque-associated pain; but further dose-finding studies will have to be performed to identify clinically relevant treatment regimens.

Adult↗
PubMed1995

Efficacy of linsidomine chlorhydrate, a direct nitric oxide donor, in the treatment of human erectile dysfunction: results of a double-blind cross over trial.

Recent experimental work has demonstrated that nitric oxide (NO) is the neurotransmitter responsible for cavernous smooth muscle relaxation. Different studies on the performance of the direct NO-donor SIN-1 (linsidomine chlorhydrate) in patients with erectile dysfunction have come to conflicting results. We have performed a double-blind cross over trial in 40 patients with erectile dysfunction of mixed etiology comparing SIN-1, SIN-1 plus the alpha-blocker Urapidil, and prostaglandin E1 (PGE1) in order to determine the effectiveness of SIN-1. PGE1 achieved the best response, the combination of SIN-1 and Urapidil performed slightly, statistically insignificantly poorer with significantly increased side effects. SIN-1 alone performed statistically significantly (p < 0.0068) worse. SIN-1 is not a useful alternative to PGE1. The combination of SIN-1 and Urapidil performs equally as good as PGE1 but cannot be recommended due to intolerable side effects.

Adult↗
PubMed1994

Ileal conduit urinary diversion 16 months before renal transplantation in a case of non-functioning lower urinary tract.

The case history of a cadaveric kidney graft recipient with complete non-functioning of the lower urinary tract is reported. An ileal conduit was formed 16 months prior to transplantation. The graft ureter was implanted into the conduit without any problems, graft functioning was excellent, and no surgical, metabolic, or infectious complications occurred during the 18-month follow-up period.

Adult↗
PubMed1994

Bladder cancer following prostate cancer--an analysis of risk factors.

Between 1969 and 1988, 1421 men had been treated for primary adenocarcinoma of the prostate. In 14 cases subsequent primary bladder cancer was observed, as compared to 5.98 cases to be expected, thus constituting a relative risk of 2.34. Seven of these cases developed synchronously (within 6 months), with a range of up to 10 years. Aetiologically, cigarette smoking was detected as the single most important denominator, whereas family history was positive for malignancy in only two cases.

Adenocarcinoma↗
PubMed1994

Paratesticular epidermoid cyst and ipsilateral spermatic cord dermoid cyst: case report and discussion of pathogenesis, diagnosis and treatment.

We report a case of a paratesticular epidermoid cyst with a concurrent dermoid cyst of the ipsilateral spermatic cord at the internal inguinal ring. The patient presented for evaluation of a presumed testicular neoplasm. Epidermoid and dermoid cysts were confirmed histologically after local excision. To our knowledge concomitant occurrence of these lesions has not been reported previously. We discuss the pathogenesis, diagnosis and treatment.

Adult↗
PubMed1994

Mesenteric desmoid tumor 19 years after radiation therapy for testicular seminoma.

This is the first report of a desmoid tumor 19 years after radiation therapy for seminoma of the testis at the age of 40. It stresses the need to include the desmoid tumor in the differential diagnosis of an intra-abdominal tumor after treatment of testicular cancer as well as the possible radiation induction of desmoid tumor.

Adult↗
PubMed1994

Prostaglandin E1 versus linsidomine chlorhydrate in erectile dysfunction.

Recent experimental work has demonstrated that nitric oxide (NO) is the neurotransmitter responsible for cavernous smooth muscle relaxation. Different studies on the performance of the direct NO donor linsidomine chlorhydrate (SIN-1) in patients with erectile dysfunction have had conflicting results. We performed a single-blind cross-over trial in 20 patients with erectile dysfunction of mixed etiology comparing prostaglandin E1 (PGE1) to SIN-1 at two different dosages (1 and 2 mg, respectively) in order to determine the effectiveness of SIN-1. PGE1 always achieved the best response, SIN-1 performed statistically significantly poorer irrespective of the dosage used. There were only a few side effects with no significant difference. SIN-1 is not a useful alternative to PGE1 in the treatment of erectile dysfunction.

Adult↗
PubMed1994

Granulomatous orchitis--an analysis of clinical presentation, pathological anatomic features and possible etiologic factors.

Granulomatous orchitis is an inflammatory change of the testis, rarely bilaterally, which cannot be distinguished from testis cancer with clinical modalities and therefore the diagnosis is usually made after orchiectomy. We reviewed our experience with 5 cases of granulomatous orchitis all treated with orchiectomy for suspected testicular cancer. Patients' age ranged from 52 to 69 years; three times the right side was affected, histologically intratubular and interstitial type were identified as well as complete testicular destruction. Testicular intraepithelial neoplasia was not detected in any of the specimens.

Diagnosis, Differential↗
PubMed1994

[Mixed gonadal dysgenesis--a rare cause of primary infertility. Report of 2 cases and review of the literature].

We report on two cases of primary male infertility attributable to mixed gonadal dysgenesis. In one case the diagnosis was made when the patient was 30 years old; in the other, the 44-year-old patient had been evaluated 4 years before for erectile dysfunction, which had been treated with a penile prosthesis without the diagnosis being made. These two cases are life following exceptional in that the diagnosis was made in adult-life following an uncomplicated male adolescence.

Adult↗
PubMed1993

Effect of nitric oxide-donor, linsidomine chlorhydrate, in treatment of human erectile dysfunction caused by venous leakage.

Recent experimental work has demonstrated that nitric oxide (NO) is the neurotransmitter responsible for cavernous smooth muscle relaxation. We studied the effect of a direct NO-donor, linsidomine chlorhydrate (SIN-1), in 30 patients with venous leakage confirmed by dynamic pharmacocavernosography and pharmacocavernosometry that was refractory to prostaglandin E1 (PGE1) under the assumption that the more physiologic approach might give better results. In all 30 patients, response to SIN-1 was no better, and in 22 cases it was less than the response to PGE1. No systemic or local side effects of SIN-1 were observed. SIN-1 is not superior to PGE1 in the treatment of erectile dysfunction caused by venous leakage, and failure of NO-mediated smooth muscle relaxation does not play a part in the entity, "venous leakage."

Adult↗
PubMed1993

Renal cell cancer and concomitant transitional cell cancer of the renal pelvis and ureter in the same kidney--report of 4 cases and review of the literature.

Three patients (1 man, 81 years old; 2 women, 56 and 61 years old) had renal cell cancer and transitional cell cancer in the same kidney, and another patient (female, 77 years old) had renal cell cancer and transitional cell cancer in the ipsilateral ureter. Simultaneous occurrence of renal cell cancer and transitional cell cancer is an extremely rare entity with only 15 cases having been reported.

Aged↗
PubMed1992

Multiple primary cancers in urologic patients. Audit of 19-year experience in Berlin and review of the literature.

During the period 1969-1988, 4,353 patients were treated for urologic cancers in the Department of Urology, Klinikum Steglitz, University Hospital of The Free University Berlin. In 144 cases (3.3%) a second primary neoplasm occurred, and in 88 cases (2.0%) the urologic cancer was the first primary tumor. The relative risk of development of a secondary primary neoplasm after the urologic primary tumor was calculated. No overall increased risk was found. In relation to certain cancer associations (bladder and prostate, kidney and prostate) the risk was increased by factor 2. In 43 percent of the cases the second primary tumor developed within half a year; the overall time span was twenty-five years.

Berlin↗
PubMedDate not supplied

Multiple primary neoplasms in patients with testicular germ cell tumor.

The study of multiple primary neoplasms may provide more insight into the pathogenesis of specific cancers and, secondly, it addresses the issue of treatment-related induction of second tumors. 584 consecutive patients with testicular germ cell tumors treated during 1969-1992 in Berlin were retrospectively analyzed for the prevalence of multiple primary neoplasms. 23 patients (16 pure seminoma, 7 nonseminoma) developing nontesticular malignancies in addition to testis cancer were identified (3.9%, 95 confidence intervals +/- 1.6%). The mean age at the time of the testis cancer was 42.8 years, and mean age at the time of nontesticular malignancy was 50.2 years. In 4 cases, the nontesticular malignancy preceded testis cancer, in 3 patients both neoplasms occurred simultaneously, and in 16, nontesticular malignancies developed subsequently to testis cancer. In 4 patients, triple malignancies were observed. Bladder carcinoma and bronchogenic cancer with each 3 cases were the most frequent second neoplasms seen in these patients. 9 consecutive cancers developed within radiation fields, the median latency period in these cases was 12 years. None of the subsequent cancers developed after chemotherapy. It is concluded that genetic predisposition and radiation effects are the most important factors contributing to the occurrence of multiple primary neoplasms in patients with testicular germ cell cancer. The high rate of multiple primary neoplasms in these patients lends further evidence to the theory of genetic anticipation of germ cell cancer.

Adult↗