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Biomedical subjects

M Rauchenwald

Publications and source records attributed to M Rauchenwald.

18 recordsLinked to original sources
PubMed2006

Vascular risk factors and erectile dysfunction in a cohort of healthy men.

To determine the impact of vascular risk factors in the genesis of erectile dysfunction (ED) in a cohort of healthy men. Participants of a health-screening project were carefully selected as men without known vascular disease. Erectile dysfunction was quantified via the IIEF5-questionnaire. All men underwent a detailed health examination including determination of blood pressure, blood lipid profile and fasting serum glucose. In total 1519 men (42.9+/-7.9 years) were analysed. Age (P < 0.01), elevated levels of total cholesterol (P = 0.04) and low-density lipoproteins (LDL) (P = 0.02) were associated with moderately to severely impaired erectile function (IIEF5: <12). Men with total cholesterol >240 mg/dl had a 2.7 (1.5-4.9)-fold increased risk for moderate to severe ED, the respective figure for LDL >160 mg/dl was 2.6 (1.4-4.9). In this well characterized, healthy population, elevated serum lipids are the most important risk factors for the development of ED.

Adult↗
PubMed2003

Triple incision to treat phimosis in children: an alternative to circumcision?

OBJECTIVE: To evaluate the functional and cosmetic results and patient satisfaction after triple incision plasty for phimosis in children. PATIENTS AND METHODS: The study included 197 boys who had a triple incision for phimosis (mean age 5.8 years, range 0.25-18). The indications for preputial surgery were recurrent balanoposthitis, ballooning during micturition and severe phimotic stenosis. The results after surgery were assessed using a questionnaire about the child's/parent's satisfaction, and an outpatient follow-up examination for functional and cosmetic preputial appearance. RESULTS: Of 128 parents/children responding, 108 (84%) were satisfied with the function and 102 (80%) reported a good cosmetic outcome. Triple incision as preputioplasty would be recommended to other parents by 119 (93%) respondents. Ninety-one (71%) of the parents feared disadvantages in their son's later life if the child had been circumcised. The outpatient examination showed an excellent functional and cosmetic outcome in 71 (77%) of the children. CONCLUSION: Triple incision is a simple, fast and safe technique for preputial relief, with good functional and cosmetic results, and was well accepted by the patients.

Child↗
PubMed1996

Characterization of laterality of innervation of the rat bladder.

Retrograde axonal tracers were used to assess the laterality of bladder innervation which is unknown. Fluoro-Gold and Fast Blue were injected into the left and right bladder walls, respectively of male Wistar rats. The major pelvic (MPG), pelvic accessory (PAG), and dorsal root (DRG) ganglia were then removed and analyzed. 59% and 33% of the total labelled MPG cells were found in the ipsilateral and contralateral MPG (efferents), respectively. 65% and 31% of the total labelled PAG cells were found in the ipsilateral and contralateral PAG (efferents) respectively. The L1/L2 and L6/S1 DRG each received similar amount of ipsilateral innervation (45-52%) based on total labelled cells at each DRG level. 8%, 4%, and 4% of labelled cells in the MPG, PAG and DRG, respectively, contained both Fluoro-Gold and Fast Blue consistent with bilateral input originating from a single neuron. Immunohistochemistry showed that 40% of retrogradely labelled PAG cells were positive for tyrosine hydroxylase, far exceeding what has been shown for the MPG. Thus, assuming limited diffusion of tracers, the bladder receives a substantial crossed innervation especially in bladder afferents. This redundancy and bilateral neural input may contribute to preservation of bladder function and sensation even after extensive pelvic surgery.

Amidines↗
PubMed1995

Efferent innervation of the rat testis.

Previous assessments of the autonomic nerve supply of the male genital tract concluded that the testis received sympathetic input primarily from paraaortic ganglia, particularly the spermatic ganglion. We challenged this consensus by using retrograde axonal tracing to examine the source and distribution of efferent fibers reaching the testis of adult rats. We also used immunohistochemical methods to assess putative neurotransmitters in testicular neurons of the abdominal and pelvic ganglia. The results indicate the majority of retrogradely labeled cell profiles were localized within the major pelvic (38%) and pelvic accessory ganglia (37%), and only a few labeled cell profiles were present in the paraaortic and spermatic ganglia. Injection of FluoroGold and Fast Blue dyes into the respective right and left testis demonstrated that 17% of the neurons in pelvic ganglia were labeled when tracers were microinjected beneath the capsule of the contralateral testis. About 8% of the neurons were labeled both with FluoroGold and Fast Blue, suggesting that certain neurons can provide simultaneous input to the left and right testicles. Immunohistochemical results showed that tyrosine hydroxylase, a marker for noradrenergic fibers, was present in over 33% of the cell profiles labeled with either FluoroGold or Fast Blue. Some 27% of the fluorescent-labeled cell profiles were positive for neuropeptide Y, while 22% were immunoreactive for vasoactive intestinal polypeptide. No evidence for vasoactive intestinal polypeptide immunoreactivity was detected within the testis, but neuropeptide Y-immunoreactive fibers were present in the tunica albuginea and testicular vasculature. Catecholamine fluorescent fibers were distributed sparsely throughout the periphery of the testis in association with the capsule, vasculature, and interstitium.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

[Indications and results of ex-vivo surgery of the kidney].

394 renal transplantations have been performed in our unit between 1974 and 1995. In all instances extra-corporal surgical procedures on the graft, its vessels and, in rare instances, on the collecting system were necessary. The surgical procedures, which took up to 90 minutes on the work-bench, ranged from repair of minor iatrogenic vascular injuries to major vascular reconstructions, in order to facilitate the subsequent implantation of the graft. During the same period work-bench surgical procedures with subsequent autotransplantation were performed in 8 patients. The indication for such a procedure was a renal cell carcinoma in 2 patients with a solitary kidney and bilateral renal cell carcinoma in 1 patient, as well as renovascular disease (renal artery stenosis, aneurysm of the renal artery) in the remaining 5 cases.

Adolescent↗
PubMed1995

[Prenatal diagnosis of abnormalities of the urinary tract].

During the period January 1983 to December 1993 malformations of the urinary tract were suspected in 166 cases prenatally and confirmed after birth. Boys dominated (72% of cases); in 66% of the cases the malformation was unilateral. The most frequent diagnosis was ureteropelvic obstruction in 74 infants (45%). 73 out of 166 infants (44%) required surgical intervention. Altogether 124 operations were performed (68% temporary diversions; 32% definitive corrections). The high number of required interventions already during the first month of life highlights the importance of prenatal screening for the early detection of urinary tract malformations, especially obstructive uropathy and multicystic-dysplastic kidney. On the other hand, vesicouretal reflux is usually detected only postnatally on investigation of a urinary tract infection.

Diagnostic Imaging↗
PubMed1994

Serum immunosuppressive acid protein predicts lymph node metastases in patients with renal cell carcinoma.

OBJECTIVE: To evaluate the usefulness of serum immunosuppressive acid protein (IAP) as a marker for lymph node metastases in patients with renal cell carcinoma. PATIENTS AND METHODS: Serum IAP levels were studied in 73 patients with renal cell carcinoma, prior to therapy. Serum IAP levels were correlated with the clinical and the post-operative histopathological stage. A threshold value of 800 micrograms/ml was applied. RESULTS: Statistical analysis revealed a better correlation between IAP concentration and disease than with any other variable. Sensitivity and specificity were 94% and 84%, respectively, thus providing good positive (65%) and negative (98%) predictive values regarding lymph node involvement. CONCLUSION: Measuring serum IAP levels can be a valuable contribution to lymph node staging in patients with renal cell cancer. The choice of cut-off value of 800 micrograms/ml has yet to be supported by a larger series.

Adult↗
PubMed1994

Laparoscopic procedure for varicocelectomy.

OBJECTIVE: To report the results of laparoscopic varicocelectomy, a new surgical technique which presents minimal risks and provides an effective management of clinical varicoceles. PATIENTS AND METHODS: Between July 1991 and November 1992, 45 laparoscopic varicocelectomies were performed in 44 patients whose ages ranged from 11 to 41 years. Endoscopic ligation, carried out according to the technique described by Palomo, was performed in 14 patients. In the remaining 30 patients ligation of 31 spermatic veins was performed according to Bernardi's procedure. RESULTS: On post-operative follow-up symptoms disappeared in all the patients treated. Two of the patients showed persistent venous reflux on colour Doppler ultrasound examination. CONCLUSIONS: The excellent identification of the anatomical structures, the minimal surgical trauma, the decrease in post-operative morbidity and the quick convalescence of the patients have made this new technique a viable alternative to routine open high ligation.

Adolescent↗
PubMed1994

[Laparoscopic ligation of spermatic vessels in varicocele].

Open surgical procedures and percutaneous transvenous radiological techniques are available for the treatment of varicoceles. With the advent of laparoscopic surgery another minimally invasive procedure has become available. In 39 patients with left unilateral and 1 with bilateral, clinically evident, varicocele laparoscopic ligation of the spermatic vessels was performed. In 17 cases both the spermatic veins and the artery were cut, whereas in 24 cases it was possible to spare the spermatic artery. In more than 90% of these cases the artery could be identified as a pulsatile vessel. No serious complications were encountered. All patients were discharged from the hospital on postoperative day 1 or 2. Out of 26 patients who could be followed clinically and by colour coded Duplex sonography, 1 showed signs of persistent and 1 of recurrent varicocele. The quick convalescence of the mostly young patients, the excellent identification of the anatomic structures, and the minimal surgical trauma are advantages of laparoscopic varicocelectomy.

Adolescent↗
PubMed1993

Primary vesicoureteral reflux in infants with a dilated fetal urinary tract.

Vesicoureteral reflux (VUR) was recognized neonatally by voiding cystography in 25 of 117 infants with a dilated fetal urinary tract. There was a male preponderance (76%) and a high percentage (40%) of associated urinary malformations. Thirty-nine refluxing units were studied. All grades of VUR were detected but gross dilating VUR dominated (59%). Spontaneous resolution was excellent in lower grades of VUR but was poor in gross VUR. Surgery was successfully performed in 13 renal units of nine patients with gross reflux, additional ipsilateral malformations, or pyelonephritis during antibiotic prophylaxis. Segmental renal scars developed in four kidneys after urinary infections, and a diffuse parenchymal lesion was noted in nine kidneys even at birth. One boy with duplication had a non-functioning refluxing system. Our results in a small number of infants show differences to children with VUR detected after urinary infections and seem to support the existence of a congenital reflux nephropathy.

Cystostomy↗
PubMed1993

A multivitamin infusion prevents lipid peroxidation and improves transplantation performance.

The objective of this study was to test the hypothesis that ischemia reperfusion damage in kidney transplantation is associated with lipid peroxidation and that inhibition of lipid peroxidation by antioxidants improves the function of the transplanted kidney. Lipid peroxidation was assessed by measuring the plasma malonaldehyde content (as thiobarbituric acid reaction product) with high-performance liquid chromatography. Kidney function was assessed by plasma creatinine and creatinine clearance. Thirty patients of an ongoing series were randomly selected into two groups, with 14 controls and 16 patients in the antioxidant therapy group. Therapy consisted of two ampoules of Omnibionta (which contains vitamins C, E, A and B complex) diluted in 500 ml physiological sodium chloride, which was infused intravenously prior to reperfusion onset. No significant differences existed for the age of the patients in the control (43.00 +/- 9.86 years) and the therapy group (41.56 +/- 14.14 years) nor in the kidney preservation time, which was 24.12 +/- 8.73 and 18.43 +/- 9.97 hours in the control and therapy group, respectively. The controls showed a transient increase of plasma lipid peroxides as measured by malonaldehyde with a peak one hour after onset of reperfusion. Compared to the baseline value of 0.74 +/- 0.26 (mean +/- SD) the one hour malonaldehyde value increased to 1.46 +/- 0.22 nmol/ml (P < 0.001). In the therapy group the plasma malonaldehyde level did not increase, but slightly decreased by about 20% compared to the baseline value. The difference of plasma malonaldehyde between the two groups one hour after reperfusion onset was highly significant (P > 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

In situ extracorporeal shock wave lithotripsy of ureteral calculi with the MPL-9000X lithotriptor.

Within the wide armamentarium of urinary stone treatment modalities extracorporeal shock wave lithotripsy (ESWL) has been established as the first line procedure. With the Dornier MPL-9000X lithotriptor one has the choice of ultrasound or fluoroscopic localization of calculi throughout the entire urinary tract. Except for the kidney, ultrasound guidance is preferred for calculi in the distal ureter, while fluoroscopy is generally used on the proximal two-thirds of the ureter. Between January and December 1990, 123 ESWL treatments were performed on 83 patients suffering from ureteral calculi with an average stone size of 9.3 x 6 mm. Median treatment parameters were 1,597 shock waves at 19.3 kv. for 43 minutes. For stones in the upper two-thirds of the ureter sedation analgesia was given, while ESWL on the pelvic ureter did not create intolerable pain. Of the treatments 69% were done on an outpatient basis. In situ ESWL treatment of urinary calculi was successful in 72 patients (86.7%), and 20 patients (24.1%) were treated with multiple treatment sessions. ESWL therapy for 47 stones in the distal ureter showed better results than for 33 stones plus 2 steinstrasse in the proximal part (95.5% versus 80% stone-free rate). Of 4 patients with mid ureteral calculi 2 could be rendered stone-free by ESWL alone. Auxiliary procedures, such as percutaneous nephrostomy or ureteral splints, had to be performed in 15.7%. Final endoscopic stone extraction was done in 7 cases and open surgery in 4, constituting a 13.3% failure rate for ESWL therapy. The results prove that the MPL-9000X lithotriptor is effective for primary noninvasive stone treatment.

Combined Modality Therapy↗
PubMed1992

[Combined ultrasound-urodynamic study in paraplegic patients].

Over a period of 2 years (1989-1991), combined urodynamic and ultrasonic investigations of the lower urinary tract were performed in 80 patients with spinal cord injuries. The main advantage of this procedure proved to be the lack of irradiation to both patient and investigator. Besides the real-time image of the bladder, bladder neck, prostate, pelvic floor and urethra, functional conclusions were possible, especially when urodynamic pressure curves were also considered.

Adult↗
PubMed1991

Ultrasonography of urinary tract and micturition as an alternative to radiologic investigations in the spinal-cord-injured patient.

Over a period of 1.5 years (July 1989-Jan. 1991), a total of 504 patients, 442 of them suffering from spinal cord injuries with subsequent voiding disorders, were investigated by ultrasonography of the genitourinary tract. Ultrasonography of the upper urinary tract as well as the bladder and prostate provided and accurate image of the pathomorphological changes which go along with this kind of malfunction of the lower urinary tract in this group of patients. The application of rectal ultrasonography using a linear array rectal transducer was able to provide equal or even better images of the micturition process than micturition cystourethrography (MCU). An adequate and accurate real time image of the bladderneck, the prostatic urethra and the external rhabdosphincter could be obtained in all instances. Combined micturition cytourethrosonography (MCUS) with urodynamic evaluation has also been performed, which made the observation and judgement of the bladder outlet as well as the position of the catheter possible throughout the procedure without the interference of X-rays.

Adult↗
PubMed1990

Results after organ-preserving surgery for renal cell carcinoma. An Austrian multicenter study.

Data from 120 patients diagnosed as having renal cell carcinoma (RCC), and treated in an organ-preserving surgical manner were analyzed from 11 participating Austrian urological centers. The male to female ratio was 66:54. The subjects age ranged from 27 to 75 years with mean age of 59 years. The indication for conservative tissue-saving surgery was a solitary kidney in 48 instances, a bilateral RCC in 18 cases and, in 2 patients, a horseshoe kidney tumor. In 52 cases the indication for conservative surgery was a peripheral, easily resectable, low-stage tumor (elective indication). Results were comparable to radical nephrectomy of low-stage tumors especially relating to survival rates. Ninety-nine patients survived and were tumor free at the point of check up (December 1988). Thirteen patients had either local tumor recurrence and/or metastases and 5 patients died from the disease. The operative mortality and the morbidity rate was very low.

Adult↗
PubMedDate not supplied

Relationship between testosterone serum levels and lifestyle in aging men.

OBJECTIVE: The aim of this study was to evaluate the association between serum levels of testosterone and free testosterone to lifestyle in aging males. METHODS: Men between 45 and 85 years were assessed regarding body mass index (BMI), nicotine and alcohol consumption, stress level, physical and social activity, and sleeping quality by a self-administered questionnaire. In parallel, serum levels of testosterone (T), free testosterone (fT), LH, FSH, DHEA-S, E2 and SHBG were obtained. RESULTS: In total, 375 men with a mean age of 59.9 years (9.2 +/- SD) entered this study; 25.4% and 27.4% had hypogonadal testosterone or free testosterone serum levels, respectively. Nicotine consumption (smokers had higher levels of T and fT; p < 0.01), BMI (negative correlation to T; p < 0.01) and age (negative correlation to fT; p < 0.001) correlated with serum levels of testosterone or free testosterone. Physical and social activity, nicotine and alcohol consumption, stress level and sleep quality did not show a significant association with serum androgen levels. CONCLUSION: This prospective study of 375 men aged 45 to 85 years confirms the correlation between age, BMI and smoking with serum levels of testosterone and free testosterone, whereas the investigated variety of lifestyle factors did not show a significant association to serum androgen levels.

Age Factors↗