Biomedical subjects
Publications and source records attributed to H J Heinrichs.
The influence of different factors on the immediate function of the transplant was investigated retrospectively in 172 patients. The immediate function of the transplanted kidney was influenced negatively by dehydration of the patient, by intraoperative decrease in blood pressure above 30 mmHg, by an prolonged cold ischemia time, and by the "handling time".
The early urological complications of 200 patients receiving a kidney allograft between 1985 and 1987 were analyzed retrospectively. In the first 4 weeks after transplantation urological, complications were found in 25 cases (12.5%), with a portion of 74.1% ureteral fistulas. The treatment was conservatively in 4 cases and operatively in 21 patients (84%), in 3 cases a recurrent operation was necessary. After an urological complication the graft prognosis was diminished markedly and the letality was higher in comparison with uncomplicated cases.
In September 1985 in our kidney transplantation centre for the first time ciclosporin A was used. Up to now altogether 50 patients received this new form of immunosuppression. During the sand immune application no essential side effects occurred. The success of the change of the therapy was independent of the degree of the serum creatinine level at the time of conversion. In the period of observation we performed altogether 106 kidney transplantations. With 88% of grafts functioning normally at the discharge under application of ciclosporin A we achieved a clear improvement of the results of transplantation in comparison with the classical immunosuppression (53.6%) in the period of observation.
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The effect of the iodine not bound to the nuclear drug 131I hippurate on nuclear medical renal diagnosis by means of whole body clearance has been investigated. The results show that whatever clearance method is used, the tubular secretion performance decreases with increasing free iodine. This results in considerable error if the free iodine in the nuclear drug is not taken into account in the clearance calculation.
From the epicritical comparison of 85 histologically ascertained carcinomas of the prostate in the 10-year interval and 105 cases in the 5-year interval in the own clinic result survival times of on an average 2.7 years or absolutely of 19.5%. References to the improvement of the prognosis in early recognition, radical operation and chemotherapeutic treatment are given.
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After the historical description of transplantations in Europe since 1966 the essential new facts and constant data in donnor conditioning, transplantation and after-treatment are discussed on the basis of special literature. 63 own courses are evaluated with complications.
A survey of the at present possible vascular accesses and their valency for acute and chronic haemodialyses depending on age and body weight is followed by a comparison of the two most essential possibilities of access Scribner-shunt and fistula Brescia-Cimino. Thei main complications thombosis and infection are discussed and therapeutic directives are shown.
On the basis of special literature presence and frequency of autochthonic melanomas in the uro-region are described. It is referred to 1 own case. The sequels of metastasizing are given in the chapter "secondary localisation" with the comprehensive reason for the decision, again to remove again an already functioning renal graft, when it becomes known, that a metastasising melanocytoma was present in the donor of the organ.
It is reported on our first experiences with the cryotherapy in 15 patients with adenomas of the neck of the bladder and carcinoma of the prostate who all on account of high quantities of residual urine underwent a permannt catheterisation and in whom an open operation of Tur were contraindicated due to severe concurring secondary diseases. 2/3 of the patients we could free from the permanent catheter, in 1/3 an undisturbed miction free from residual urine was possible In 1/3, however, the catheter had to be kept also after the end of the treatment.
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Coagulation disturbances were discussed which appeared after operative removal of a hypernephroid carcinoma and teratocarcinoma. Despite taking into consideration preoperative coagulation tests after operation secondary haemorrhages appeared which could at first not be explained and which must be seen in the connection with the tumour metabolism changing the coagulation. Diagnostic and therapeutic propositions follow.
With 23 years an embryonal teratoma of the testicles and with 29 years a seminoma was treated by semicastration and post-irradiation or applications of cytostatics. In the two cases 10 or 12 years later seminomas of the other side appeared. Problems of the double-side simultaneous and successive affection are discussed, therapeutic consequences derived and the prognosis is entered. Apart from this the clinical and morphological signs of bilateral metastases of the testicles by a bronchial carcinoma are explained and discussed.
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