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Biomedical subjects

H Frohmüller

Publications and source records attributed to H Frohmüller.

At least 55 records · Page 3Linked to original sources
PubMed1984

[Current analysis of pathogen spectrum and resistance in bacterial urinary tract infections. Bacteriologic urine findings of hospitalized urologic patients].

We analysed the bacteriological urinary findings of all inpatients of the urological department on admission, during hospitalization and on discharge, over a period of one year. The percentage of urological patients with florid urinary tract infections was less than 10%. The most commonly found pathogen was E. coli, followed by Proteus, enterococci, Pseudomonas and Klebsiella. Any change in the bacterial spectrum was not associated with individual diseases or their treatment. Mixed infections were rarely seen. The nosocomial urinary tract infection rate was an overall 1.5%. Since the clinical findings on admission often require the immediate administration of antibiotics, the results of urine culture cannot always be awaited. Given the present situation with respect to resistance, the use of antibiotics with a sensitivity of only 50% does not appear to make good sense. Prior to receiving the bacteriological report, cephalosporins of the second and third generation are to be recommended to treat complicated urinary tract infections in hospitalized urological patients.

Anti-Bacterial Agents↗
PubMed1983

[Report of experiences with therapy of blunt kidney injuries].

Blunt renal injuries are classified into 4 groups, namely contusions (grade I), lacerations (grade II), severe fractures (grade III) and pedicle injuries (grade IV). A group of 71 patients with closed renal trauma is reported being classified into 46 grade I, 20 grade II, 3 grade III and 2 grade IV cases. Only the 5 patients with grade III and IV injuries needed surgical intervention resulting in nephrectomy in all 5 cases. Late complications occurred in 4 of the 20 patients of group II, namely contracted kidneys in 2 and hypertension in another 2 instances. The appropriate treatment should be chosen on an individual basis. In grade III and IV renal trauma, surgical intervention is generally required resulting in most instances in nephrectomy. In grade I lesions expectant management is considered the rule. Controversy exists regarding the optimal therapy of grade II injuries. Statistics demonstrate that surgical intervention in these cases will result in greater renal tissue loss as compared with expectant management.

Adult↗
PubMed1981

[Present status of transurethral laser technique in the treatment of urethral strictures (author's transl)].

The main difference between the conventional methods of urethrotomy and the laser method is that the scar tissue of the urethral stricture is not cut but removed by evaporisation. At present only neodymium: YAG and argon ion lasers are available for clinical endoscopic use. For the purpose of removing tissue neodymium: YAG lasers need irrigation with a gas in contrast to argon ion lasers that can be utilized with the well known water irrigation. Certain considerations and experiences suggest the carbon dioxide lasers to be the best ones for evaporating stricture tissue since they cause very limited zones of necrosis with immediate sealing of the wound edges. Transurethral carbon dioxide laser application, however, is still at an experimental stage, since convenient light transmission systems are not available for clinical use at the present time.

Argon↗
PubMed1979

[Recent advances in the treatment of nephrolithiasis (author's transl)].

The treatment of nephrolithiasis depends mainly on the type of stone present. Uric acid calculi can be dissolved by oral medication producing alkalinization of the urine. Cystin stones can only rarely be dissolved by oral administration of D-penicillamine. The best and least expensive prophylaxis is a high and constant fluid intake of 600 ml every 4 hours. This way the pathologically increased cystin excretion can be kept soluble. Calcium containing calculi and so-called "infection stones" need surgical intervention. Because of the high recurrence rate of renal stones every indication for an operative procedure has to be considered very carefully. For lasting results elimination of urinary obstruction is necessary. The treatment of choice of patients with staghorn calculus disease is surgical, even in the solitary kidney and in geriatric patients. As recent advances in the operative treatment of nephrolithiasis coagulum pyelolithotomy, intraoperative pyeloscopy, hypothermia and "bench surgery" (extra-corporeal renal surgery) are reviewed. Attempts to dissolve renal calculi by percutaneous nephrostomy as well as extraction of pelvic stones by the same procedure are mentioned. Finally, the importance of postoperative prophylaxis and the progress made in the medical treatment of calcium stones are pointed out.

Calcium↗
PubMed1978

[Transurethral prostatic resection by cold punch technique. Indication and results (author's transl)].

In men of advancing age benign prostatic hypertrophy is the most frequent cause of obstructive urinary symptoms. Transurethral prostatic resection has been demonstrated as a suitable method to lastingly cure patients with this disease, even if they belong to a high age group or to a so-called high risk group. This report is based on 1490 patients who were operated upon by transurethral prostatic resection utilizing the cold punch technique. The average age was 70.9 years. 5.7% of the patients were 80 years or older. In 38.1% the operative risk was increased. The indication for performing a transurethral prostatic resection is discussed and technical differences between the cold punch technique and the better known electroresection are pointed out. Early and late results as well as complications of the procedure are reported.

Aged↗
PubMed1976

[The treatment of locally confined prostatic carcinoma: radiotherapy versus total prostatectomy (author's transl)].

Recent data show that carcinoma of the prostate is not radioresistant. But not all prostatic cancers are radiosensitive. All information available in the literature on histologically proven local destruction of prostatic cancer tissue, all survival data and reported complications after radiation treatment are reviewed and discussed. The results of radical surgical treatment from various authors but mainly from the series of Belt and Schröder are used for comparison. From these data it is evident that total prostatectomy of stage B and C tumors is superior to radiation therapy as far as local eradication of tumor goes. Five- and ten-year actuarial survival rates are about identical for stage B disease but favor total prostatectomy in stage C patients. Sexual impotence, the most important lasting complication of total prostatectomy, is present in 23-47% of patients after radiotherapy. Urinary incontinence is not known after irradiation but reported after surgery. Long term damage of the lower urinary tract, the gastrointestinal system, or the lymphatics was reported in 2-24% of patients after radiotherapy. The indication for radiation treatment in stage D patients is very questionable. Exact surgical staging by iliac and obturator lymphadenectomy is desirable to rule out stage D disease in locally confined tumors. Radiation treatment is indicated in patients who are not willing to undergo surgery, who are unwilling to accept sexual impotence, or who are poor candidates for surgery from other reasons.

Cell Transformation, Neoplastic↗
PubMed1976

[On the size of the male urethra. Consequences of transurethral prostatic resection (author's transl)].

More recently it has been claimed by some authors that a disproportion between the size of the resectoscope and the lumen of the urethra is supposedly the cause of urethral strictures following transurethral prostatic resection. For this reason the use of resectoscopes no larger than 24 F in size has been urged. Reports in the literature as well as our own investigations in connection with the transurethral resection by cold punch technique cast some doubt on the wisdom of this statement as long as other causes, such as thermal damage during electroresection, are not definitely excluded.

Electrosurgery↗
PubMed1976

[Transurethral resection in patients with cardiac pacemakers (author's transl)].

Problems of transurethral resection in patients with cardiac pacemakers are discussed. Various complications caused by interference of cutting and coagulating currents with the pacemaker system and their possible prevention are pointed out. It is concluded that transurethral resection by cold punch technique has significant advantages over electroresection in patients with a cardiac pacemaker.

Aged↗
PubMed1975

[Etiology, diagnosis and treatment of spontaneous ruptures of the kidney (author's transl)].

Spontaneous ruptures of the kidney occur seldom. As a rule they are observed in impaired organs. According to the various underlying diseases the symptomatology can differ widely. Etiology and pathogenesis often become clear only after surgical exposure of the kidney. Our own observation of such a case lead us to review the causes as well as the diagnosis and treatment of spontaneous ruptures of the kidney. For clinical purposes we propose a classification into spontaneous ruptures of the kidney with perirenal hematoma and spontaneous ruptures of the pelviocalyceal system.

Aged↗
PubMed1975

Use of the Otis urethrotome in the treatment of urethral strictures and congenital urethral stenoses.

Internal urethrotomy using the Otis urethrotome is described in detail. Performing this procedure in 23 patients with urethral strictures, no further dilatations of the urethra were necessary in approximately 60%. If internal urethrotomy, which offers the advantages of having a very low rate of complications and which may be repeated, proves unsuccessful, a urethroplasty can still be carried out. As a preliminary procedure to transurethral resection of the prostate by cold punch technique, internal urethrotomy appears to be of great value in preventing urethral strictures - as demonstrated by follow-up studies in 351 patients.

Adult↗