PubMed Health⌕ Search

Biomedical subjects

S Lenk

Publications and source records attributed to S Lenk.

At least 19 recordsLinked to original sources
PubMed2003

[European Association of Urology guidelines on urinary and male genital tract infections].

Today, the classical bacteria that cause venereal diseases, e.g. gonorrhea, syphilis, chancroid and inguinal granuloma, only account for a small proportion of all known sexually transmitted diseases (STDs). Other bacteria and viruses as well as yeasts, protozoa and epizoa must also be regarded as causative organisms of STD. Taken together, all sexually transmitted infections comprise more than 30 relevant STD pathogens. However, not all pathogens that can be sexually transmitted manifest diseases in the genitals and not all infections of the genitals are exclusively sexually transmitted. Concise information and tables summarising the diagnostic and therapeutic management of STDs in the field of urology allow a synoptic overview, and are in agreement with the recent international guidelines of other specialist areas. Special considerations (i.e. HIV infection, pregnancy, infants, allergy) and recommended regimens are presented.

Disease Notification↗
PubMed2001

[Diagnosis of chronic prostatitis].

The new classification of prostatitis syndromes by the National Institutes of Health clearly defines the diagnostic criteria for categorization according to the clinical symptoms. In addition to the validated symptom scores, the four-glass test demonstrating increased numbers of leukocytes and/or bacteria serves for differentiating between the symptoms. Increased levels of leukocytes and/or increased bacterial count in expressed prostatic excretion (EPS) are typical of prostatitis, although there is a high degree of correspondence with the VB3 fraction (urine voided after prostatic massage). The detection of peroxidase cells (granulocytes) and of an increased concentration of polymorphonuclear (PMN) leukocyte elastase in the ejaculate are indicative of uroadnexitis. Nonbacterial forms of prostatitis (NIH III) and increased PSA levels require intensive clinical diagnosis.

Bacterial Infections↗
PubMed2001

Genitourinary tuberculosis.

The worldwide prevalence of tuberculosis is still high and has remained almost unchanged over the past century as a result of increasing incidence in countries of the Third World. Twenty per cent of patients with tuberculosis will develop an extrapulmonary manifestation over time, the most common site being the genitourinary tract. The patient's history can lead to the sometimes difficult diagnosis. Radiological imaging helps in depicting genitourinary tuberculosis. However, the diagnosis of genitourinary tuberculosis is made on the basis of culture studies and is supported by polymerase chain reaction. The latter has impressive sensitivity and specificity, but lacks the ability to determine biological activity. The combination of three or four anti-tuberculosis drugs over a course of 6 to 9 months remains the treatment of choice. Drug resistance is increasing and necessitates tight therapy control. Tuberculosis of the male seminal duct may be an important cause of male infertility as a result of multiple epididymidal scarring. In these cases testicular sperm extraction is the method of choice for sperm retrieval. The outcome of sperm retrieval followed by intracytoplasmatic sperm injection is not affected.

Humans↗
PubMed2000

Relationship between semen quality and the seminal plasma components carnitine, alpha-glucosidase, fructose, citrate and granulocyte elastase in infertile men compared with a normal population.

The seminal plasma components neutral alpha-glucosidase, carnitine, fructose, citrate, and polymorphonuclear granulocyte (PMN) elastase in 253 men were determined. The seminal plasma of 221 infertile men, a control group with proved fertility and 13 patients after vasectomy were investigated. The concentrations of free carnitine (212 versus 521 micromol/l, n = 219, P < 0.001), total carnitine (437 versus 743 micromol/l, n = 219, P < 0.001), and the activity of neutral alpha-glucosidase (15.1 versus 23.4 IU/l, n = 236, P < 0.05) were significantly reduced in the infertile patient group as compared to the fertile control group, the concentration of PMN elastase (102 versus 48 microg/l, n = 234, P < 0.05) being significantly increased in the infertile patients. In the patients after vasectomy the activity of neutral alpha-glucosidase was the only epididymal marker that was significantly reduced (4.3 versus 9. 8 IU/l, n = 35, P = 0.002) in comparison with the patients with testicular azoospermia. At a limit of 6 IU/l the sensitivity of the method was 92% and the specificity was 72%. Altogether, the epididymal markers were reduced in subfertile patients compared with the control group. For the differential diagnosis of azoospermia only the determination of the neutral alpha-glucosidase activity is useful.

Adolescent↗
PubMed1999

Rapid detection of elevated prostate-specific antigen levels in blood: performance of various membrane strip tests compared.

OBJECTIVES: To compare the ability of four commercially available membrane strip tests to detect increased (4 microg/L or more) concentrations of prostate-specific antigen (PSA) in blood. METHODS: Serum samples with PSA concentrations less than 4 microg/L (n = 67) and from greater than 4 microg/L to 20 microg/L (n = 32) were independently examined by two observers using the PSA membrane strip tests from Chembio, Medpro, Seratec, and Syntron. The positive and negative results of each membrane strip test were classified as either true positive or negative and false negative or positive by comparing them with the quantitative PSA assay of Immulite DPC using the conventional threshold value of 4 microg/L. RESULTS: The interobserver variations of the tests were between 93% and 97%. The color stability of the Seratec and Chembio tests did not show significant differences between test results read within 10 to 20 minutes of the reaction time; however, the results of the other two tests were especially affected by variations in the reading time. The sensitivity and specificity of the tests in relation to the threshold of 4 microg/L were 67% to 93% and 87% to 97%, respectively. CONCLUSIONS: The Syntron test and, within certain limitations, the Seratec test fulfill the concept of a rapid and convenient PSA determination to detect PSA concentrations greater than 4 microg/L. Methodologic optimization of the tests by a grading of the PSA measuring ranges (eg, between 0 and 2, 3 and 4, 4 and 6, and 7 and 10 microg/L) should be taken into account for future development.

Aged↗
PubMed1998

[Pneumocysts juxta-articular to the ilial bone and the sacral bone].

PURPOSE: The purpose of the study was to detect and safely diagnose pneumatocysts by means of computed tomography. METHODS: From September 1995 to May 1996 computed tomography of the pelvis was performed in six patients for various indications. A slice thickness of 8 mm was employed for all studies. One patient had undergone surgery for hyperparathyroidism nine years previously. Attenuation values within the coincidentally diagnosed pneumatocysts were obtained. RESULTS: We found a total of 14 pneumatocysts juxtaarticular to the sacroiliac joint. Three patients demonstrated a bilateral intraarticular vacuum phenomenon, yet a joint communication was not found. The lesions did not coincide with inflammation, tumour or trauma. CONCLUSION: Pneumatocysts are benign bone lesions associated with arthrotic changes of the sacroiliac joint. Computed tomography is the modality of choice for the diagnosis of pneumatocysts.

Aged↗
PubMed1994

Renal autotransplantation for idiopathic retroperitoneal fibrosis.

Extensive loss of the ureter is a potential complication of surgery performed to relieve ureteral obstruction caused by retroperitoneal fibrosis. The authors describe the twelfth case managed successfully by renal auto-transplantation and review the literature.

Humans↗
PubMed1994

Diagnosis and treatment of obstructive azoospermia.

Obstructive azoospermia is an important reason for male infertility. The obstruction can be caused by congenital, postinflammatory or iatrogenic factors (herniotomy, orchidopexy, vasectomy). Diagnosis includes anamnesis, physical examination, determination of hormone levels (FSH, LH, testosterone), semen analysis and biopsy from both tests. 37 patients with suspected obstructive azoospermia and 19 patients after previous vasectomy underwent scrotal exploration. Following an intraoperative semen analysis, vasoepididymostomy was performed in 12 patients, vasovasostomy in 19 patients. After vasoepididymostomy, patency was stated in 42%, and pregnancy followed in 17%. The patency after vasectomy reversal was 85%. The success of treatment of obstructive azoospermia depends on the duration of obstruction, on the location and on the microsurgical technique applied.

Adult↗
PubMed1994

Penile deviation--our therapeutic concept.

Penile deviations can be congenital or acquired, e.g. Peyronie's disease, and--depending on the degree of curvature--can impede cohabitation or make it completely impossible. 53 patients (17 congenital, 36 acquired) with penile curvature were examined as to anamnesis, clinical state, autophotography or artificial erection with the help of vasoactive drugs or a vacuum device. A pharmacocavernosography was performed in patients with erectile problems. In cases of congenital deviation, surgical correction was carried out according to the Nesbit procedure, and in 2 patients with hypoplastic urethra after penile straightening a urethroplasty was performed. Twenty-eight patients with Peyronie's disease were treated with superoxide dismutase. Seven of them had to be operated on, and in 8 patients with severe deviation surgical therapy was primary. In conclusion, the management of penile deviation should be differentiated depending on the cause and degree of deviation as well as discomfort and erectile potency.

Adolescent↗
PubMed1993

Increased serum concentrations of procollagen type III peptide in severely injured patients: an indicator of fibrosing activity?

OBJECTIVES: To determine the serum concentrations of procollagen type III peptide in severely injured patients with different outcomes and to evaluate the relationship between serum procollagen type III peptide concentrations, sources of increased posttraumatic fibrotic activity (wounds, lung, liver, kidney), and decreased elimination of procollagen type III peptide (liver). DESIGN: Prospective study. SETTING: Surgical ICU, university hospital. PATIENTS: Fifty-seven patients (mean injury severity score: 38.5 points, range 13 to 75 points), between 16 and 70 yrs of age, treated in our institution within 6 hrs after the accident. MEASUREMENTS: Serial measurements were started on admission and continued on a 6-hr basis. After 48 hrs, the monitoring interval was extended to 24 hrs until recovery (but at least until day 14) or death. At each point of evaluation, pulmonary and circulatory function parameters and chest radiographs (once a day) were evaluated, the results were recorded, and blood samples were drawn to determine procollagen type III peptide, total bilirubin, creatinine, gamma-glutamyl transferase, polymorphonuclear elastase, and other parameters. Statistic evaluation was done with the Wilcoxon test, Spearman rank correlation, and a multiple regression model. RESULTS: Mean procollagen type III peptide serum concentrations (+/- SD) were significantly different in patients who died (8.0 +/- 3.8 U/mL) compared with those patients who survived with organ failure (2.7 +/- 1.3 U/mL) or without complications (1.4 +/- 0.5 U/mL), respectively. Significant correlations of procollagen type III peptide concentrations with the serum bilirubin concentrations (r = .7), days with need of mechanical ventilation (r = .64), PaO2/FIO2 ratio (r = -.6), polymorphonuclear elastase (r = .6), serum creatinine concentrations (r = .55), and injury severity score (r = .33) were observed. There was a tendency toward higher serum procollagen type III peptide concentrations in patients with severe skeletal injuries. CONCLUSIONS: Serum procollagen type III peptide concentrations in severely injured patients may be considerably increased in correlation with injury severity and outcome. Procollagen type III peptide serum concentrations seem to reflect the sum of increased collagen formation from wound healing and fibrogenesis of mediator-related organ damage (especially lung) and decreased procollagen type III peptide excretion due to impaired liver function. Further data are necessary to evaluate the role of hepatic elimination in these patients.

Adolescent↗
PubMed1992

Inflammatory mediators, infection, sepsis, and multiple organ failure after severe trauma.

The relation of (multiple) organ failure (OF) to the release of inflammatory mediators and the incidence of infection and sepsis was studied prospectively in 100 patients with multiple trauma (injury severity score = 37). Sixteen patients died of OF, 47 patients survived OF, and 37 patients had no OF. Fifteen (24%) of the patients with OF showed no signs of infection. In patients with early onset of OF (n=45), infection followed with a lag of 2 or more days. In 16 (44%) of these patients, infection led to a deterioration in organ function. With late onset of OF (n=18), infection preceded OF in nine patients. Polymorphonuclear leukocyte-elastase, neopterin, C-reactive protein, lactate, antithrombin III, and phospholipase A discriminated significantly among the three outcome groups. Of all factors, only polymorphonuclear leukocyte-elastase showed a difference between patients with and without infection or sepsis, respectively. These data indicate that infection might not play a crucial role in the pathogenesis of posttraumatic OF in a substantial portion of patients with trauma. Early OF, especially, seems to be mainly influenced by the direct sequelae of tissue damage and shock (eg, the release of inflammatory mediators). Since infection and sepsis did not lead to an augmented release of mediators in patients with trauma, the role of both entities remains unclear.

Adult↗
PubMed1991

Laser surgery in superficial penile tumours.

The first results of laser surgery in superficial penile tumours are reported. In 2 patients with condylomata acuminata, 2 cases of giant condylomata Buschke-Löwenstein and in 2 patients suffering from early stage penile cancer diagnostic and/or therapeutic treatments using carbon dioxide or neodymium-YAG laser have been performed. In one patient with giant condyloma a recurrent tumour was found 5 weeks after the initial treatment and a second one using CO2 laser was done. All other patients are tumour-free with a follow up of 6-24 months and erectile function is normal. Therefore, in superficial penile tumours laser treatment is an excellent alternative therapeutic approach.

Condylomata Acuminata↗
PubMed1990

[Histologic changes after laser treatment of superficial penis tumors].

In the last years the excision of superficial benign and malignant penile tumors by laser surgery has been well established. Our first experience confirm the excellent cosmetic and functional results after laser surgery. Furthermore a decrease of recurrence rate was found due to laser vaporization of the adjacent tumor area. In spite of tissue damage by histological examination we were able to classify benign and malignant findings.

Adolescent↗
PubMed1990

[Corpus cavernosum injection treatment of erectile impotence].

Through the use of vasoactive substances an improvement of diagnosis and treatment of men suffering from erectile dysfunction was obtained. From June 1988 to December 1989 in 108 patients an intracavernous injection therapy trial was performed. The response rate 85% and in 69% of the patients an organic disorders was found. Five percent of the patients have had a prolonged erection after intracavernous papaverine phentolamine injection. All cases have been treated successfully by local use of the sympaticomimetics Noradrenaline. The use of vasoactive substances is the method of choice in diagnosis and treatment of erectile dysfunction.

Adult↗
PubMed1990

[Obstructive disorders of urine transport of the upper urinary tract--benign and malignant retroperitoneal fibrosis].

Our experience in diagnosis, treatment and follow-up course of patients suffering from benign and malignant retroperitoneal fibrosis are reported. Especially in idiopathic fibrosis the initial placement of percutaneous nephrostomy and long-term immunosuppression is the treatment of choice. In the follow-up ultrasonography and computerized tomography are valuable methods.

Humans↗
PubMed1989

[Surgical treatment of venous-induced erectile impotence in the male].

In 14 out of 94 patients with erectile dysfunction a venous insufficiency was suspected. Localization and securing of the venous leak were done by dynamic cavernosography. An insufficient penile blood supply could excluded by Doppler ultrasonography and measurement of the penile-brachial artery-pressure index. In 7 out of 13 patients treated by ligation of penile veins the erectile function was normalized after operation, in 4 cases an additional intracavernous injection therapy was necessary and in 2 patients the operation was unsuccessful. If impotence occurs once more due to venous collaterals the implantation of a penile prosthesis should considered.

Adult↗