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Biomedical subjects

J E Altwein

Publications and source records attributed to J E Altwein.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Selective arteriography of the internal pudendal artery in posttraumatic erectile dysfunction].

102 patients with erectile dysfunction were evaluated by a multidisciplinary approach including measurement of the bulbocavernous reflex (BCR)-latency, cystometry, dynamic cavernosography and bilateral selective arteriography of the pudendal arteries. Seven patients had a posttraumatic source of their erectile failure. Three patients showed a mixed neurogenic-arteriogenic aetiology of erectile dysfunction, two patients had evidence of isolated arterial damage, one patient had a venous and one an isolated neurogenic cause of erectile dysfunction. The passage of pudendal-penile vessels and nerves through the urogenital diaphragm is the most vulnerable portion of its way through the pelvis. Ruptures of the prostatomembranous urethra are frequently accompanied by injury to the pudendal-penile vessels and nerves, thus causing erectile dysfunction.

Accidents, Traffic↗
PubMed1985

[Parameters of incurability in urinary bladder cancer].

Curative treatment of bladder cancer is limited to superficial tumors (Ta-T2). Advanced stages (T3a + T3b) can be treated only palliatively even when confined to the bladder (N0, M0). Nevertheless the differentiation between curable and incurable tumors is difficult. The classification of patients into the two different categories is usually done on the basis of tumor infiltration and lymph node involvement. In this retrospective study all available data of patients with bladder cancer were evaluated for their prognostic reliability in order to obtain a safe basis for further therapeutic approaches. The principal aim was to define parameters of reliable prognostic significance to prevent under- or overtreatment during the entire course of the disease.

Adenocarcinoma↗
PubMed1985

Congenital and acquired penile curvatures: diagnosis and outcome with the Nesbit procedure.

A surgical correction according to Nesbit [1] was performed in 9 patients with congenital penile curvature as well as in 5 patients with acquired penile curvature in the context of Peyronie's disease and in 1 case after an old penile fracture. Dynamic cavernosography with simultaneous passive erection and photographic documentation of the curvature in two planes served as basic preoperative diagnostic methods. Besides the recording of a local report, the postoperative results were evaluated by means of a detailed questionnaire in all patients. 8 patients in the group of congenital curvatures as well as 3 patients of the group with acquired penile curvatures were shown to be completely satisfied with the functional result of the surgical correction. With the knowledge of the result of the operation, 13 out of 14 patients would indeed agree to the operation if asked again. This experience indicates that treatment according to Nesbit is justified in the therapy of both congenital and acquired penile curvatures.

Adolescent↗
PubMed1985

Bulky germinal tumors: comparison of different induction regimens and significance of residual disease.

In order to study the efficacy of three different chemotherapy regimens and the prognostic significance of residual disease after chemotherapy, we analyzed 84 patients with bulky germinal tumors. Chemotherapy, consisting of vinblastine, bleomycin/adriamycin, cisplatin (VB/AP) was administered sequentially to 37 patients. 19 patients were treated with the cisplatin, vinblastine, bleomycin (PVB) regimen and 17 patients with cisplatin, vinblastine, bleomycin, ifosfamide (PVBI). The initial complete remission (iCR) was 71% (52 of 73) with a relapse rate of 29% (15 of 52). 10 of 73 (14%) patients achieved partial response and 11 of 73 (15%) showed progression due to multidrug resistance. There was no statistically significant difference in iCR, continuous complete remission (cCR), relapse and survival between the PVB, PVBI and VB/AP regimens. In 50 patients, the residual tumor after chemotherapy was examined histologically. cCR was achieved in 75% (15 of 20) of patients with necrosis or fibrosis, in 50% (5 of 10) with adult teratoma and in 25% (5 of 20) with malignant tumor. Comparison of survival curves according to residual histology revealed statistically significant differences (p = 0.02). Our findings suggest that in patients with germinal bulk disease PVBI-regimen and VB/AD-therapy are not superior to the standard regimen. Residual disease seems to be an important prognosticator.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

[Masked obstructive uropathy of the upper urinary tract in childhood].

Congenital ureteropelvic junction obstruction is the most common site of urinary tract obstruction in children. In infants an abdominal mass, in older children loin or abdominal pain, especially after fluid intake, are commonly the presenting features. In some cases the only symptom is posttraumatic hematuria. Appropriate diagnostic procedures are suggested.

Child↗
PubMed1985

[Pathophysiology and methods of treatment in renal hypertension in renal artery aneurysms].

Aneurysms of the renal artery occur infrequently and remain mostly asymptomatic. A review of the pertinant literature reveals approximately 300 reports. Hypertension is the predominant sign and affects two thirds of all patients, particularly in aneurysms complicated by stenosis or thromboembolism of renal artery, which is caused by the renin-angiotensin-mechanism. A solitary renal aneurysm causes no renal hypertension; 66% of all diagnosed renal artery aneurysms require no treatment. Resection of the aneurysm and direct suture was done in half of all operated patients. Only in 27 cases operative treatment consisted of extirpation and patch-plastic (autologic or alloplastic). Two additional cases in our own hospital with resection and patch-plastic are described. By using those techniques it is possible to normalize renal artery blood flow as well as blood pressure. Other well-known surgical procedures are nephrectomy, aorto-renalbypass and several others.

Adult↗
PubMed1985

[Testicular and epididymal metastasis of prostate cancer].

Metastatic testicular carcinoma is unusual. A case of carcinoma of the prostate with metastases to the testis and epididymis is reported. Routes of metastatic spread of neoplasm to the testis are discussed. Easily removable cancer may remain in the scrotum when using the socalled subcapsular orchiectomy without complete removal of the scrotal contents.

Adenocarcinoma↗
PubMed1984

Percutaneous sclerotherapy of varicoceles--an alternative to conventional surgical methods.

Between May 1981 and October 1982, 259 varicoceles were identified by phlebography. It was possible to occlude 217 with Varicocid using a percutaneous Seldinger catheterisation technique under local anaesthesia. This method is an alternative to standard surgical techniques and has several advantages. It is cheap, it can be carried out on an out-patient basis, it lacks the risks associated with general anaesthesia and there are few complications.

Adult↗
PubMed1984

[The risk of cancer in neuropathic bladders].

Neuropathic bladder is on number six in a list of predisposing factors for bladder cancer. The incidence is reported to be between 0.25 and 9.7%. For these patients mortality is about twenty times higher than in patients with normal bladder function. Chronic infection of the urinary tract and long-term indwelling catheter increase the risk of cancer. Pure squamous cell and squamous cell carcinoma with elements of transitional cell carcinoma is noticed to be surprisingly frequent. In comparison, carcinoma in defunctionalized bladder is rare. For prophylaxis, instead of using a long-term catheter, intermittent catheterization is supposed to be applied as well as consequent cystoscopic examination once a year and 'mapping' of a neuropathic bladder which exists longer than 10 years.

Adult↗
PubMed1984

[Value of computed tomography and lymphography for the demonstration of pelvic lymph node metastases in prostatic cancer].

Between 1977 and 1982 74 patients with cancer of the prostate underwent a pelvic lymphadenectomy. 17 had a preceding lymphangiography and 25 computerized tomography; the sensitivity of the former was 50%, the specificity 56% and the accuracy 53%, whereas the latter produced rates of 25, 100 and 76%, respectively. These percentages are in keeping with the literature. In addition, 61 of the 74 patients had during the lymphadenectomy a frozen section, which was in 87% accurate, but yielded a false negative ratio of 32%. The efficiency is within the figures given in the literature.

Evaluation Studies as Topic↗
PubMed1984

[Therapy of stress incontinence recurrence: comparison of fascia sling-plasty and Zoedler band in 117 patients].

We report on 117 patients with urinary stress incontinence, 44 with previous attempts at surgical correction. The inguinovaginal fascial sling operation as modified by Narik and Palmrich was used in 33 women and had an early success rate of 91%. The Zoedler method used in 84 women was successful in 87%. 52% of women with fascial sling procedure (mean duration of follow-up 1.1 year) and 45% with Zoedler method (mean duration of follow-up 5.7 years) stayed completely continent. The most common reasons for failure are discussed.

Adolescent↗
PubMed1984

Germinal testicular tumors in childhood. Report of observations and literature review.

1,124 case observations, published from 1955 to 1981, and 45 of our own cases of childhood testicular tumor are evaluated. The age distribution, histology (WHO classification), stage and prognosis are compared to 1,062 adult cases. Diagnostic procedures are itemized. Priorities in the therapeutic approach and the effectiveness of various methods, depending on stage and histology, and toxic side effects and other complications are documented. In children, 29% of childhood testicular tumors are non-germinal, as compared to 8% in adults. 49% are yolk sac tumors. The age distribution differs depending on histology. Metastases occur less frequently (9%) than in adults (61%). Dissemination is predominantly hematogenic. Prognosis is best in teratoma which is cured by orchiectomy. Yolk sac tumor limited to the testicle, in infants less than 2 years old, is sufficiently treated with orchiectomy alone. Older children require adjuvant chemotherapy. Overall, chemotherapy was indicated in 15% of the evaluated cases of childhood testicular malignoma.

Adolescent↗