[Ultrasonic tomography for documenting pregnancy-related changes in the kidney].
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Dilatation, Pathologic↗
Biomedical subjects
L Hoffmann
Publications and source records attributed to L Hoffmann.
[Treatment of tumor pain].
The management of pain in cancer patients requires experience and a therapy-protocol. Analgesics should be given orally and on a fixed schedule. Necessary is a cascade which allows a stepwise escalation. Patients should be treated with mild analgesics first and continuous infusions of narcotics may be used in the final stage of cancer. The combination of analgesic and psychopharmacological agents augments the analgesic effect. Quite often the side effects of analgesic therapy require an individual schedule.
Analgesics↗
[Histomorphologic studies of prostate biopsies, prostatectomy preparations and lymph node metastases in prostatic cancer].
Histomorphological studies on 40 prostatectomy and 122 lymphadenectomy preparations from patients with carcinoma of the prostate revealed the limits of prostate biopsy in assessing the volume of the tumour preoperatively, of capsule infiltration and of tumour histology in general. Multiple foci, the exclusion of dedifferentiated portions of a tumour and the lack of correlation between the histology of primary tumours and the degree of lymphogenous metastasis are limiting factors in the individual use of the histology of primary tumours for grading purposes. Our studies furthermore revealed the necessity for differentiated consideration of the category T3 and for intraoperative microscopic examination of resection margins in total prostatavesiculectomy.
Adenocarcinoma↗
[Radical prostatovesiculectomy in the treatment of prostate cancer. Indications, operative technic and personal results].
Cancer of the prostate is the most common form of carcinoma in males of advanced age. If treated at an early stage, it can be healed by prostatovesiculectomy. Rectal prophylactic examination of all males aged 45 years or more should therefore be performed on a larger scale in order to detect these carcinomas as early as possible. Radical operation is indicated in males younger than 70 years old from stage T1 up to stages T3 and M0. Criteria vary in regard of the N-categories. The surgical technique practiced in the perineal and retropubic approach to prostatovesiculectomy is described, advantages and disadvantages are dealt with. No complete urinary incontinence could be observed in the 20 patients who underwent this operation at our hospital. Only 1 patient suffers from severe stress-induced incontinence, all others experiencing no difficulty in this respect. In 2 cases rectal lesions occurred during the operation. Postsurgical strictures occurring in the region of the urethra-bladder anastomosis in 2 other patients could be eliminated by internal urethrotomy. Impotence is the most common complication following this operation.
Adult↗
[Pain treatment of tumor patients].
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Analgesics↗
[Squamous epithelial carcinoma of the mouth cavity].
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Alcohol Drinking↗
[Indications and contraindications for epididymo-deferens vesiculography from a current viewpoint].
69 years after the introduction of x-ray examination of the seminal duct, the indication and contraindication are reviewed according to current interdisciplinary aspects, basing on 31 cases studied over a period of two years. The procedure followed in the roentgenological visualization of carcinoma of the prostate is generally recognized, whereas controversial opinions are held with regard to patients with occlusive azoospermia. The possibility of lesions and damage caused by some contrast media is an established fact. Differences in the lumen of the ductus epididymidis prevented complete visualization of the epididymis when using the previous, highly concentrated, sticky contrast media which were insoluble in water. These drawbacks have been eliminated by Amipaque. Today epididymograms are no longer considered necessary, although there are exceptions. Experience and a sophisticated technique are mandatory. If refertilization is envisaged, it is permissible during operation only to effect a descending x-ray for the purpose of clarifying the outflow conditions.
Epididymis↗
[Methodologic studies on protein metabolism and bioenergetics of protein deposition in growing animals. 4. Energy metabolism in chickens in connection with measurement of parameters of protein metabolism].
In connection with the measuring of parameters of the protein metabolism in parallel experiments, the energy metabolism of 6 chickens (origin Tetra B) in the live weight range between approximately 100 and 1,800 g was determined under conditions of restricted energy supply. 3 animals each received a feed mixture containing 20% (animal group 1) and 38% (animal group 2) crude protein. The amount of feed was daily increased by 1.5 g DM. The digestibility of energy and nitrogen was independent of the age. 66.3 +/- 3.3% and 64.0 +/- 5.0% resp. of the metabolisable energy were utilised for protein and fat retention. The energy maintenance requirement, determined at a live weight of 2,000 g, was independent of protein supply and averaged in the two animal groups 434 +/- 40 kJ metabolisable energy/kg live weight 0.75 . d. The result of multiple regression was, for the growth period investigated, an energy maintenance requirement of 403 +/- 32 kJ metabolisable energy/kg live weight 0.75 . d. 1.77 and 1.38 J metabolisable energy resp. were required for 1 J protein or fat retention. The energy requirement for protein retention was independent of the degree of protein supply. The results from the measuring of energy metabolism are discussed in connection with the kinetic parameters of protein metabolism ascertained in parallel experiments.
Animals↗
[Successful therapy of uncontrollable macrohematuria caused by the cyclophosphamide-injured bladder].
An uncontrollable bleeding of the urinary bladder was successfully treated using a 4% formalin strip tamponade with vesico-ureteral reflux and supportive therapy with thrombocyte concentrates and transfusions of fresh blood. Non-toxic side-effects of oxazaphosphorin derivates and modern methods of prophylaxis using a uroprotectic are presented. Previously the use of formalin together with vesicoureteral reflux was contraindicated; in this case it was successfully applied for the first time via the suprapubic route using a strip tamponade.
Adult↗
[Detection of carbonic anhydrase in the human kidney from the viewpoint of acid-base regulation (an immunohistochemical study in urolithiasis patients)].
The enzyme carbonic anhydrase was detected with an indirect immunoperoxidase method in 22 kidney exploratory excisions of patients with urolithiasis, ren mobilis or stenosis of ureteral pelvic junction. The reactivity of carbonic anhydrase was related to disturbances in acid-base equilibrium. Carbonic anhydrase was detected in the convoluted parts of the distal tubules, connecting tubules and cortical collecting ducts. The distribution corresponds vastly with the localization of intercalated cells. The reaction was increased in three cases with acid rigidity and was strongly reduced in one case of renal tubular acidosis.
Acid-Base Equilibrium↗
[Results of the determination of enteral calcium absorption and calcium kinetics with 47Ca in patients with chronic recurring urolithiasis].
In the context of the classification of hypercalciuria in urolithiasis, the measurement of enteral calcium absorption is very important. A precise method is that of oral load with 47Ca and measurement of its activity by means of a human body counter; 47Ca activity in serum, urine and stools in simultaneously measured. To date 47 patients with chronically recidive calcium lithiasis (with between 3 and over 100 stone episodes) and an average age of 43.2 years have been examined. Calcium absorption lay between 42.7% and 90.0% of the dose, the average was 59.3% with a standard deviation of +/- 12.9. This is higher than in persons with healthy kidneys, but not significantly so. Calcium absorption is significantly lower in patients with renal insufficiency. The studies on calcium kinetics revealed turnover rates and pool sizes within the normal range.
Adult↗
[Urinary calculi and the single kidney].
The problems and interactions of urolithiasis and monorenality are presented in a survey covering four essential parameters: --Urolithiasis as an indication for nephrectomy: One nephrectomy in four is performed because of urolithiasis. This rate of nephrectomy has not changed in the last 50 years. --Recidive urolithiasis in the residual kidney: Around 37% of all monorenal persons have a diseased single or residual kidney. On average one in four cases of residual kidney disease is caused by urolithiasis. This recidive calculus quota has also not significantly changed in recent decades. --Lethality of operations on the residual kidney: Urolithiasis is becoming almost the only indication for operating on a residual kidney; due to postrenal anuria, uraemia and urosepsis a large percentage of such operations are emergency operations under extremely unfavourable initial conditions. Despite the use of modern methods of medical treatment the lethality rate is for this reason still relatively high (7-15%). --Life expectancy of monorenals with urolithiasis: The life expectancy of monorenals with urolithiasis is clearly limited due to further complications (chronic pyelonephritis, hypertonia, urinary stasis and uraemia). It is therefore absolutely necessary for monorenal persons with urolithiasis to have intensive observation and urological treatment.
Germany, East↗
[Energy maintenance requirements and energy requirement for protein retention in growing rats and broilers. 1. Energy maintenance requirements of growing rats].
In 4 experiments with 3 times 3 male Wistar rats each, which received rations with different protein contents (10; 25 and 40% crude protein in the dry matter), in the growth range between approximately 65 and 180 g live weight and with an environmental temperature of 30 degrees C, a total of 226 measurings of the total metabolism were carried out on the energy level maintenance, partly also with the insertion of a fasting day. The most important results were: On the energy level maintenance with the simultaneous catabolisation of body fat there was considerable protein energy retention, which amounted to between 30 and 40% of the retention achieved in the growth periods. The energy maintenance requirement can be determined with good reproducibility (standard mean deviation: +/-6%). The average energy requirement directly measured at the feeding level maintenance of 437 kJ metabolizable energy (ME)/kg live weight 0,75.d (n=224) differs insignificantly from the average value obtained by means of multiple regression analysis from experiment periods with feeding for growth 423 kJ ME/kg live weight 0,75.d (n=437). Consequently it is not necessary to differentiate between energy requirement for maintenance and energy requirement connected correlatively with the live weight (metabolic weight of the body) under conditions of growth. Energy maintenance requirement proved to be insignificantly dependent on the amount of protein in the feed. The relative values of protein quotas of 10, 25 and 40% in the feed were 100, 101 and 103%; the expected values (derived from the efficiency of ATP synthesis in the oxidation of carbohydrates and protein) amount of 100, 104 and 109%. The problem of the thermogenous effect of protein, which is also of great importance to human nutrition urgently requires further experimental investigation. For growing rats the best adaptation of the energy maintenance over the investigated period of development is achieved if the 2/3 potence of the live weight is chosen as the expression of the metabolic body weight. With high probability this can also be transferred to the characterisation of protein metabolisation.
Animals↗
[Energy maintenance requirement and energy requirement for protein retention in growing rats and broilers. 3. Energy requirement for protein retention in rats].
In 4 experiments with 3 X 3 male Wistar rats each, which received rations with different protein content on 3 levels (10-40%), a total of 240 measurings of the total metabolism with the purpose of ascertaining the energy requirement for protein retention were carried out under the conditions of ad libitum feeding in the growth range between approximately 65 and 200 g live weight at a temperature of the environment of 30 degrees C. With 25% crude protein (caseine supplemented with methionine) in the feed mixture, with an energy content of the ration between 18 and 20 kJ/kg dry matter, the N-retention capacity of the animals was largely exhausted. When 150 g live weight were exceeded, the N-retention capacity of the animals decreased considerably. Energy retention in % of gross energy depended on the protein level of the feed rations; in all 4 experiments the rats achieved the highest energy retention with 10% crude protein in the feed. The level of energy utilisation decreased with the increasing protein content of the feed mixture. Requirement values of metabolisable energy per 1 J protein energy retention of 1.69; 1.93; 1.81 and 1.74 J were derived by means of multiple regression analysis for all 4 experiments, assuming the exponent 0.75 for the variable metabolic body size. The application of multiple regression analysis to the values of energy retention measuring in all 4 experiments results in the mean energy requirement of 1.67 J/J protein retention, which completely coincides with previous investigations. When the exponent 0.67 was assumed for the variable metabolic body size, the energy requirement data for the individual experiments resp. after the joint evaluation of all 4 experiments were 1.56; 1.75; 1.68 and 1.56; 1.53 J/J resp. The significant influence of the live weight, the consumption quota of digested nitrogen (protein level of feeding) and the protein retention quota on the value of protein requirement for protein retention was proved. This evidence is discussed with respect to further research for the factorial assessment of the bioenergetic of protein retention.
Animals↗
[Energy maintenance requirement and energy requirement for protein retention in growing rats and broilers. 4. Energy requirement for protein retention in broilers].
The results of measurings of the total metabolism from experiments with 6 male broilers (origin: Tetra B) each, which mainly served the ascertainment of energy maintenance requirement (cf. 2) in the growth range between 100 and 2,000 g with alternating experiment phases on the maintenance and growth level, have also undergone interpretation for the further characterisation of the energy requirement for protein retention. Caused by the sequence of periods chosen, there were compensatory growth effects. Energy retention in % of gross energy varied between the experiments in the limits of 24 and 39%, and concerning energy retention per animal and day there were differences up to 100% between the experiments. The share of protein energy retention in energy retention on average amounted to 38% after a medium-high protein supply and 54% after a high protein supply. The utilisation of metabolisable energy for energy retention was significantly lower from rations of a high protein level (40% crude protein) than from those of a medium-high protein level (20% crude protein). Assuming an energy requirement for fat retention of 1.2 J metabolisable energy per J retention, a requirement of metabolisable energy for 1 J protein retention of 1.68; 1.66 and 1.86 was ascertained in the 3 experiments by means of regression analysis. An energy requirement for maintenance of 423 (30 degrees C), 511 (25 degrees C) and 432 kJ metabolisable energy/kg live weight 0 75 X d (30 degrees C) correlated with these requirement values. Energy requirement for protein retention increased significantly with N-intake and decreased significantly with the daily protein retention rate. There was no dependence on the live weight of the broilers.
Animals↗
[Loading urography with furesis in ureteral stenosis and its value for the indication of surgery].
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Adult↗
[Energy requirement of growing bulls].
The series of experiments concerning the utilisation of feed energy by growing bulls (482 total metabolism periods) as described in this periodical in four articles (Schiemann and others 1976; Jentsch and Schiemann 1976; Jentsch and others, 1976; Hoffmann and others, 1977), has undergone further statistical processing in order to test possibilities of factorial analysis for the derivation of values for the energy requirement of growing bulls. Square equations for the characterisation of the maintenance requirement of metabolisable energy and net-energy-fat in kJ/kg live weight 0.75 and day were derived for the live weight range between 50 and 335 kg (see equations (2) and (4)). Beyond this live weight range the maintenance requirement of growing bulls-- related to the metabolic body weight -- corresponds to that of fullgrown oxen (410--420 kJ metabolisable energy/kg live weight 0,75 and day). The analysis of the energy content for the live weight increase in dependence on the live weight resulted in the statistical generalisation characterised by equation (5) for live weights above 200 kg. Up to 200 kg live weight the energy content of the live weight gain is between 8 and 10 MJ/kg live weight gain. Above that, equations for the characterisation of the energy requirement of fattening bulls in ad libitum feeding were derived for the live weight ranges between 200 and 335 kg as well as 335 and 550 kg (cf. equations (2) and (3)). The significance of the factorial analysis of the energy metabolism of growing animals is discussed comparatively to previous assessments.
Aging↗
[Problems of assessment and occupational rehabilitation of patients with malignant urogenital neoplasm].
The expert opinion and the rehabilitation of patients with urogenital tumours often render great problems and tasks for the urologist. A schematic invalidisation of these patients is to be refused. The leading idea of an expert opinion should be the rehabilitation. This demands from the expert a judgment of the function with evaluation of the oncological prognosis quoad vitam and a judgment of the remaining functions of the treated organism as well as a recommendation for the further professional activity based on this judgment. A close cooperation with industrial institutions, the factory public health, the medical advisory commissions and the rehabilitation commissions is necessary for rehabilitation. The notion of rehabilitation--professional as well as social--is to be extended to the not unconsiderable number of patients at pensioner's age. The resumption of a suitable work effects in a patient sith successfully treated tumour disease the improvement of the general physico-psychic resistance, increases the will to recovery and activity and furthers the acclimatization and adaptation to remaining disturbances. Thus expert opinion in the sense of rehabilitation is also a therapy. The results of modern tumour therapy should not be measured only at the survival rates, but also at the degree of the social and professional rehabilitation of the patients.
Disability Evaluation↗