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Biomedical subjects

R Günther

Publications and source records attributed to R Günther.

At least 181 records · Page 10Linked to original sources
PubMed1979

Percutaneous nephropyelostomy using a fine-needle puncture set.

The authors describe an improved method of percutaneous nephropyelostomy using a long, fine, flexible needle combined with a wider and shorter cannula. The needle facilitates atraumatic puncture of the renal collecting system and antegrade pyelography and subsequently serves as a guide over which the nephrostomy cannula is inserted. This technique was successful in 105 of 115 procedures (93 patients) over a period of 15 months and has replaced operative nephrostomy in the author's hospital.

Humans↗
PubMed1979

Transrenal ureteral embolization.

Transrenal closure of the ureter with butyl-2-cyanoacrylate using adjuvant balloon catheter occlusion was successfully performed for the palliative management of inoperable vesicovaginal and vesicosacral fistulas in 3 patients. Unilateral percutaneous nephrostomy provided supravesical urinary diversion as well as access for permanent embolization of the ureter. The contralateral kidney was nonfunctional in 2 patients. In the third, in addition to unilateral ureteral occlusion, the contralateral kidney was defunctionalized by embolization of the renal artery ("radiological nephrectomy") to avoid the need for bilateral nephrostomy drainage.

Adult↗
PubMed1979

[History and course of pregnancy in a group of cerclage patients. A comparative study (I) (author's transl)].

The previous history and course of pregnancy in 357 women with variable births, in whom cerclage had been performed during 1966-1976 at the Freiburg University Gynaecological Hospital, were compared with a group of 380 women without cerclage, the age, parity and period during which birth had occurred, being identical. The high average of the patients with cerclage (29.3 years), the low percentage of primigravidae (17.1%), the threefold increased rate of abortions and early births (28.4%) as well as the high perinatal mortality (21.5%) during the preceding pregnancies, confirmed these women as a "risk" group. After cerclage, births before the 38th week were reduced from 41.1% to 24.6% (p less than 0.001.) 52.3% of the premature births occurred between the 36th and completed 37th week. Perinatal mortality dropped to 5.6% (p less than 0.00l.). A clinically relevant gestosis was less frequent (0.8%;p less than 0.00l.). The fact that the rate of premature births in the cerclage group (p less than 0.001) continued to be elevated, is mainly attributed to the frequency of rupture of the amnion before the 38th week (21.0%).

Abortion, Spontaneous↗
PubMed1979

[Labor and delivery, fetal and maternal risk following cerclage. A comparative study (author's transl)].

In a comparative study of the course of pregnancy and delivery of 357 patients who delivered live infants between 1966-1976 following cerclage operation were compared to a control group of 380 without cerclage who were matched in age, parity and delivery time to the group under study. The high prematurity rate in the pregnancies preceeding the cerclage of 28.4% decreased following the cerclage to 16.8% (p less than 0.001). The perinatal mortality was reduced from 21.5% to 5.6% (p less than 0.001). This effect was especially achieved by the lower incidence of deliveries of infants with a birth weight of less than 1500 grams (p less than 0.05). The difference to the controls regarding prematurity (8.2%) and perinatal mortality (1.6%) remained significant (p less than 0.001). An increased rate of malformations in the cerclage children was not noticed. The maternal risk is low and consists mainly of a increase of cervical lacerations (4.9%) and problems of wound healing (2.2%). The duration of labor and type of delivery, the type of third stage of labor, and the post-partum course were not different from the control group.

Birth Weight↗
PubMed1978

Transcatheter embolization of the kidney with butyl-2-cyanoacrylate: experimental and clinical results.

The technique and efficacy of therapeutic catheter embolization of the kidney with butyl-2-cyanoacrylate (Histoacryl) were studied in 80 rabbits (including control groups) and in 10 dogs. A mixture of butyl-2-cyanoacrylate, 50% glucose, and tantalum powder was used for the embolization. Complete and permanent vascular occlusion was found in nearly all cases. The main complication observed was a reflux of embolizing material into the lumbar arteries, which occurred in seven rabbits. Clinically therapeutic embolization was performed in six patients with hypernephroma. The indication for embolization in these patients, as well as in two others with iatrogenic lesions, was pronounced hematuria. Cessation of bleeding was achieved in all cases. For embolization the coaxial catheter technique is recommended; in special cases with extensive arteriovenous shunts, adjunctive balloon occlusion would be advisable.

Adenocarcinoma↗
PubMed1978

[Uptake of 2-C14 urate by erythrocytes in hyperuricemia and in gout (author's transl)].

The uptake of 2-C14 urate by erythrocytes was measured in 19 patients with primary hyperuricemia, 6 patients with secondary hyperuricemia, 17 patients with primary gout and 30 controls. The uptake of urate in patients with primary gout was significantly lower than in the controls. In contrast no such difference could be observed in patients with primary and secondary hyperuricemia. The uptake of labeled urate by erythrocytes from gouty patients is especially diminished in the early phase of the uptake kinetics. The possible relevance of this finding for the pathogenesis of urate precipitation in gout is discussed. Further, we consider the application of the tracer urate uptake by erythrocytes as an aid in the early diagnosis of gout.

Erythrocytes↗
PubMed1978

The impact of in-situ balloon occlusion of the renal artery and hypothermic perfusion on renal blood flow.

Unilateral renal blood flow was evaluated in-situ in 13 dogs by cineangiodensitometry and microsphere distribution studies before and after intermittent balloon occlusion with and without hypothermic perfusion of one kidney. The contralateral kidney served as control. No significant difference in renal blood flow and vascular resistance was noted before, and 5, 30 and 60 minutes after unilateral intra-arterial manipulation. Compartmental flow distribution studies in 5 dogs revealed no evidence of alteration of intra-renal haemodynamics. In a clinical pilot study, unilateral renal blood flow measured by cineangiodensitometry showed no change of clinical significance 5 and 60 minutes after intraluminal balloon occlusion of the renal artery for 60 seconds.

Animals↗
PubMed1978

The influence of some prostaglandins on DNA synthesis and DNA excision repair in mouse spleen cells in vitro.

In vitro experiments were performed on mouse spleen cells to establish possible influences of some naturally occurring prostaglandins on DNA synthesis and DNA excision repair. The prostaglandins A1, B1, E1, E2 and F2alpha were tested in concentrations of lopg, 5ng and 2.5microgram per ml cell suspension. DNA synthesis was significantly increased by PgF2alpha in all the three concentrations tested, while the other tested prostaglandins were essentially ineffective. DNA excision repair was significantly inhibited by PgE1 and PgE2 at 5ng/ml and at 2.5microgram/ml but increased by PgF2alpha in the two lower concentrations. The rejoining of DNA-strand breaks after gamma-irradiation was slightly reduced by PgE1, PgE2 and PgF2alpha at 2.5microgram/ml.

Animals↗
PubMed1978

[Retrograde pancreatic phlebography with simultaneous balloon occlusion of portal and arterial flow. An experimental study (author's transl)].

The possibility of demonstrating the venous system of the entire pancreas by retrograde portal contrast injection with simultaneous balloon occlusion of the portal vein, coeliac axis and superior mesenteric artery was investigated in 12 dogs. In seven cases good filling of the larger pancreatic veins was obtained. Portal and arterial pressure relationships altered considerably during various experimental conditions. A rise in serum transaminases was observed only once when there was thrombosis of the portal vein and branches of the hepatic veins. Apart from this, there was no rise in transaminases or alphaamylase. Histologically there were only minor changes in the liver after total occlusion of 40 minutes, the occlusion having been performed over periods of six minutes with two to five minutes of flow alternating. The application of this method to man is discussed.

Animals↗
PubMed1978

[Percutaneous nephro-pyelostomy applications and results (author's transl)].

The use of percutaneous nephro-pyelostomy with a fine needle is described after 90 examination in 70 patients. Fine needle pyelography is used for antegrade demonstration of suspected ureteric obstruction when there is no renal excretion. Percutaneous nephro-pyelostomy can be used to assess the recovery of renal function after decompression, as well as for pressure measurements pre-operatively before carrying out plastic operations (Whitaker). Percutaneous nephropyelostomy offers the possibility of temporary or permanent urinary diversion in the presence of obstruction. In our own experience, the percutaneous method has almost totally replaced operative nephrostomy whenever supravesical drainage is necessary. In addition, it can be used for treating fistulas, antegrade splinting of the ureter or percutaneous removal of stones. Complications of renal puncture consisted of two small perirenal haematomas and two patients with short-lived haematuria, as well as one case of septicaemia with rapid recovery.

Adolescent↗
PubMed1978

The phlebographic diagnosis of phaeochromocytomas.

The diagnosis of phaeochromocytomas is based on the clinical features and on the hormone findings in the peripheral blood. Localisation, however, depends on radiological methods. Pneumoperitoneum was abandoned, because of its low accuracy, in favour of arteriography; lately, suprarenal phlebography has been available for the localisation of phaeochromocytomas. Our experience in nine patients with operatively confirmed phaeochromocytomas is described. Together with venous sampling from the caval system and the suprarenal veins for catecholamine estimations, it was possible to localise all tumours correctly. One tumour lying in the sympathetic chain in the thorax was correctly localised by hormone estimation. Our experience suggests that suprarenal phlebography represents a reliable method for localising phaeochromocytomas which carries a low risk and is to be preferred to arteriography.

Adrenal Gland Neoplasms↗
PubMed1978

[Percutaneous antegrade papillotomy. Preliminary experimental results and potential clinical use (author's transl)].

The possibility of percutaneous antegrade papillotomy under image intensifier control was investigated in eight dogs. It was successful in five animals. Successful papillotomy can be recognised radiologically and also by the feel of the catheter. The effect of papillotomy can be demonstrated by a fall of the pressure gradient existing between common bile duct and duodenum. The use of this method in patients is discussed.

Ampulla of Vater↗
PubMed1978

[Personal method for the surgical treatment of recessed gingiva].

The authors report their experience with a personal technique for the surgical treatment of gingival recessions. Their experience is based on operations upon 35 teeth. To avoid recurrences, the authors perform, on principle, the necessary vestibuloplasty, covering the wound surface with a full-thickness skin graft taken from the cheek, three weeks after the first intervention. The good results obtained permit to recommend this method.

Gingival Diseases↗
PubMed1978

[Peripheral arteriographies under intraarterial analgesia (author's transl)].

45% contrast medium, to which lignocaine had been added in a concentration of 0.1%, was injected for 44 translumbar aortograms, 26 femoral arteriograms and 4 brachial arteriograms under premedication with pethidine-promethazine. Few patients described their sensations spontaneously; most patients graded their pain as minimal and described only the sensation of heat. When the contrast medium was injected, first without and then with lignocaine, the pain was markedly reduced by lignocaine. No patient showed signs of CNS-toxicity. After the injection of the mixture of contrast medium and lignocaine, the heart rate rose slightly, the arterial blood pressure fell slightly, both not more than after injection of the contrast medium only. The ECG showed no anomalies. The addition of lignocaine to a contrast medium in low concentration represents a simple and, for the patient, acceptable method of analgesia as well as a safe alternative to general, spinal or epidural anesthesia.

Anesthesia, Local↗