Biomedical subjects
Publications and source records attributed to T Zwergel.
Although prostatic cancer is the most common malignant disease in men in western countries, only limited data on chromosomal changes are available. We report on our cytogenetic findings in cell cultures from four primary prostatic carcinomas indicating the existence of intratumoral focal heterogeneity concerning chromosomal anomalies in prostatic cancer.
Explore the source record for details and available documents.
Prostaglandin synthetase inhibitors are used for the treatment of ureteric colic. However, there is controversy regarding the mechanism of action of these drugs. In this study, differential prostaglandin synthesis in the human renal pelvis, ureter and bladder was measured using specific radioimmunoassays and gas chromatography/mass spectrometry. There was a significant quantitative predominance of the smooth muscle constrictor eicosanoids, PGF2 alpha and TXA2 over the dilatory PGE2 in tissue from all sites--renal pelvis, ureter and bladder. The results indicate that prostaglandins play a direct role in smooth muscle activity of the upper urinary tract and the inhibition of this activity with indomethacin indicates a further mode of its action in pain relief in ureteric colic.
An intact canine model was developed to study the effects of prostaglandins (PG) and prostaglandin synthetase inhibitors on acutely obstructed kidneys. Totally implanted nephrostomy tubes were placed to measure renal pelvic pressure. Complete ureteral obstruction was obtained with a Fogarty balloon catheter inflated in the distal ureter; by this method renal pelvic pressure reached 40-50 mm Hg. Renal pelvic pressure was reduced after intravenous indomethacin and dipyrone administration, whereas blood pressure showed no major changes. Exogenous prostaglandins had both immediate and contrary effects: PGE2 caused a significant decrease, whereas PGF2 alpha caused a significant increase in renal pelvic and blood pressure. The reduced rise in renal pelvic pressure appears to be the main reason for the analgesic effects of prostaglandin synthetase inhibitors. The efficiency of these drugs in the treatment of renal colic is supported by this study, that of prostaglandins cannot be proved.
Word processing is currently the most frequent application for personal computers, and a wide variety of standard software is available. The capabilities of modern word-processing software includes the convenient typing and correction of all routine correspondence, as well as the professional layout of scientific manuscripts. The decision to purchase a certain word-processing programm should be made according to local needs and prerequisities. Three to six months may be necessary to fully adapt the organization of a clinic or private practice to the new technology.
CT examination of the testes was carried out in 49 patients for the investigation of testicular tumours. Hypodensity and inhomogeneity were typical of teratomas and hyperdensity and relative homogeneity of seminomas. Granulomatous orchitis and lymphomas showed the same characteristics as seminomas. Three testes in the abdomen could be localised and classified. One non-palpable primary tumour was found as well as an old partially calcified tumour, three old torsions and one lipo-sarcoma. In about 10% it was not possible to distinguish between tumour and inflammatory lesions. Compared with sonography, CT has advantages, particularly in the diagnosis of old torsion.
The Piezolith 2200 as an extracorporeal shock wave lithotripter uses piezoelectrically generated, high-energy sonic impulses for treatment of urinary calculi; the shock wave generator is self-focussing. Localization of concrements is performed by means of ultrasound imaging. Treatment with the Piezolith 2200 is painless for the patient and thus possible without anesthesia and analgesia. We report on 806 cases of treatment involving a total of 572 kidneys in 567 patients (561 adults, 6 children) suffering from calculi of various sizes in the renal pelvis (n = 126), calculi in the calyces (n = 384), partial (n = 24) or full (n = 19) staghorn calculi, as well as calculi in the upper part of the ureter (n = 19). In 88% of these cases the concrements could be removed completely. Since cardiac activity is not influenced by piezoelectrically generated high-energy impulses, this procedure is particularly suited to the treatment of patients with heart problems.
Explore the source record for details and available documents.
The Piezolith 2200 allows not only a qualitatively identical treatment of urolithiasis like the HM-Dornier systems or the Siemens Lithostar, but the application of lithotriptable urinary calculi could be extended to cardiac risk patients, to patients with skeletal deformities and to those with unusual body height and weight. As the piezolithotripsy does not cause pain, treatment is possible without anaesthesia or analgesia. Combined with internal ureteral stenting by self-retaining double-J-ureteral catheter also calculi with larger stone masses can be treated advantageously by exclusive piezolithotripsy as monotherapy. Multiple treatments by the piezolithotriptor are possible because of good focussing of the shock waves and the smaller parenchymal alteration. Lithotripsy of ureteral calculi is performed in the upper and lower part of the ureter. In small calculi the retrograde introduction of an ureteral catheter armed with an "ultrasound mirror" is necessary.
The development, present status and future trends in the use of computers in urology in the Federal Republic of Germany are reviewed. The hardware, software required for hospital and private practice and the staff needed are discussed. Proposals are given for the installation and stepwise upgrading of computer systems, from simple text processing units to complex hospital communication systems. Finally new technologies that might considerably change the use of computers in urology are presented.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
An analysis of 3,180 prostatectomies (between 1966 and 1982) reveals an increasing number to sixfold from 1966 to the end of the 70s. The preoperative preparation of the patients often suffering from several cardiovascular and especially respiratory diseases (about 40%) is improved by an early cooperation of all medical disciplines involved. Important complications such as the fluid absorption toxicity could be reduced; the excessive absorption of irrigation fluid (i.e., the TUR-P syndrome) was found in about 1.0% of the cases. Postoperative complications such as epididymitis or urethral strictures can be diminished by special surgical treatment methods.
In each case the primary treatment of tuberculosis is a medicamentous therapy. Using the modern basis medication of isoniazid, rifampicin, ethambutol and streptomycin at present for the normal case the short-term therapy of maximally 12 months made its way. The operative treatment of the urogenital tuberculosis is only a part of the total therapy plan. Among 715 patients nearly half of them had to undergo at least one surgical intervention from 1966 to 1983. The nephrectomy rate of 22.3% is to be classified as high and is conditioned by progressing and extended changes of the kidneys, which are in most cases recognized too late. In 69 patients partial resections of the kidney were performed. Since 1976 the indication for this intervention was in 13 cases made only intraoperatively and at the same this the planned nephropyeloplasty was performed on account of disturbance of the urine flow. Good postoperative results encourage to perform plastic reconstructive measures also in changes of the kidneys of stage III.
Injuries of the urethra confront traumatologists and urologists with common diagnostic and therapeutic problems. By an early interdisciplinary cooperation life-threatening early complications such as urosepsis, and late complications which are difficult to be corrected such as strictures of the urethra may be prevented and reduced, respectively. The accidental mechanisms and the diagnostic possibilities in injuries of the urethra are explained in detail. In 24 patients with anterior ruptures of the urethra and in 66 patients with posterior injuries of the urethra with the exception of 12 immediate operative reconstructions primarily a suprapubic and transurethral micturition was chosen. The posttraumatic results concerning the rate of stricture, the kind of removal of the stricture, the frequency of incontinence of urine and erectile impotence are analysed.
The surgical therapy of genitourinary tuberculosis is important as adjuvant treatment besides an appropriate anti-tuberculous drug therapy. During the years 1966-1983 surgical treatment was necessary in 46.1% (330 cases) of 715 patients. Cases, not treated properly for a long time, still have a high incidence of nephrectomy. Since 1976 more reconstructive operations and partial kidney resections have been carried out, resulting in a 5,6% rate of secondary nephrectomy. In up to 92.3% of the patients with these operations, renal function was not reduced or had improved. In cases with progressive tuberculosis of the upper urinary tract reconstructive surgical treatment is also recommended with good late results.
Following criteria decide on the further life of patients with acute severe trauma: how fast injuries and their severity are recognized and following therapies are managed; prior conditions for a sufficient treatment of the acute trauma patient consist in a perfect organization and a good cooperation of all specialists. Important details of the therapeutic concept, divided in 5 or 6 phases are given. Furthermore special urological aspects in cases of multiple injuries are discussed.