Biomedical subjects
Publications and source records attributed to W Hübner.
In 50 patients with benign prostatic hyperplasia the preoperative diagnostical value of ultrasonography was compared with urography. The results show the sufficient efficacy of both methods in the case of bland history and normal urinary findings. In the estimation of adenoma weight the rectal ultrasonography is superior to other techniques.
Fourier transform infrared spectroscopy has been used to characterize the carbonyl stretching vibration of DMPC, DMPE, DMPG, and DMPA, all labeled with 13C at the carbonyl group of the sn-2 chain. Due to the vibrational isotope effect, the 13C = O and the 12C = O vibrational bands are separated by ca. 40-43 cm-1. This frequency difference does not change when the labeling is reversed with the 13C = O group at the sn-1 chain. For lipids in organic solvents possible conformational differences between the sn-1 and sn-2 ester groups have no effect on the vibrational frequency of the C = O groups. In aqueous dispersion unlabeled phospholipids always show a superposition of two bands for the C = O vibration located at ca. 1740 and 1727 cm-1. These two bands have previously been assigned to the sn-1 and sn-2 C = O groups. FT-IR spectra of 13C-labeled phospholipids show that the vibrational bands of both, the sn-1 as well as the sn-2 C = O group, are clearly superpositions of at least two underlying components of different frequency and intensity. Band frequencies were determined by Fourier self-deconvolution and second-derivative spectroscopy. The difference between the component bands is ca. 11-17 cm-1. Again, the conformational effect as shown by reversed labeling is negligible with only 1-2 cm-1. The splitting of the C = O vibrational bands in H2O and D2O is caused by hydrogen bonding of water molecules to both C = O groups as shown by a comparison with spectra of model ester compounds in different solvents. To extract quantitative information about changes in hydration, band profiles were stimulated with Gaussian-Lorentzian functions. The chemical nature of the head group and its electronic charge have distinctive effects on the extent of hydration of the carbonyl groups. In the gel and liquid-crystalline phase of DMPC the sn-2 C = O group is more hydrated than the sn-1 C = O. This is accord with the conformation determined by X-ray analysis. In DMPG the sn-1 C = O group seems to be more accessible to water, indicating a different conformation of the glycerol backbone.
Renal cyst puncture under ultrasonic guidance has proved an excellent and safe method in the differential diagnosis of cystic renal masses. The use of ultrasound in the follow-up of patients with renal cyst puncture is mandatory for evaluation of complications and results. The therapeutic success of renal cyst puncture is poor and estimated at about 25%. New percutaneous techniques with resection of the cystic wall lead us to expect much better results than with open surgical management.
By means of new endourological techniques supravesical urinary drainage is possible with minimal invasiveness. In 10 patients suffering from hydronephroses caused by gynaecological malignancies a worthwhile prolongation of lifetime was achieved by palliative urinary drainage (mean follow-up: 9.1 months). Four cases with fistulas and consecutive incontinence were treated successfully by percutaneous ureteral occlusion (3x), inner stenting respectively (1x). The very low invasiveness of the methods described should encourage the decision towards palliative supravesical urinary drainage.
In this paper 151 patients treated for ureteric stones in our department (January 1982 to July 1986) are reviewed. Open ureterotomy was almost completely discontinued during this time. The success rates for the different methods are: ureterotomy: 100%, ESWL (78% in combination with endourology): 100%, endourology: 91%, "Zeiss-loop": 62%. In our department endourological procedures are still the most economical method of ureteric stone removal.
In 71 patients we performed second interventions after unsuccessful Cryosurgery of the prostate (56 X TUR-P, 9 X Cryosurgery, 6 X suprapubic adenomectomy). The average time between the two operations was 1.8 years. In 62% we achieved satisfactory spontaneous micturation. The results are analyzed and the value of second interventions after Cryosurgery of the prostate is discussed.
On the basis of our experience of 410 operations and constant contact with the most prominent exponents of this new method we feel able to draw the following conclusion; cryosurgery of prostate adenomas with good equipment is a palliative method with little danger which can be used to advantage in maximum-risk patients with indwelling catheters and large adenomas. The success rate is 70-80%, whereby this falls to 50% after 5 years. Since it is difficult to classify patients as "maximum-risk" from an internal point of view, we must reckon that the evaluation is too unfavourable in around 20%.
Report on the late results of 68 Boari plastic operations performed at least 4 years ago. Excellent results were achieved (normal urogramme, clinically free of pain) in 65% and satisfactory results (normal urogramme, subclinical infection of the urinary tract and/or vesicouteral reflux) in 8%. In 14 patients (27%) the results were not satisfactory. It appears that the Boari plastic operation continues to be a recommendable method for bridging major defects of the distal ureter.
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Home parenteral nutrition is indicated in the short bowel syndrome, chronic inflammatory bowel disease and as an adjunct to cancer therapy. For venous access the cannulation of a collateral of the subclavian vein and the central venous silastic catheter have proved helpful. Our own experience with 19 patients shows, that with careful supervision home parenteral nutrition can be performed with low risk.
Radioactivity was measured in the blood of normal and alloxan diabetic rats, after the oral administration of [U-14C]gluconate and [U-14C]glucono-delta-lactone, respectively. Radioactivity was also measured in the intestinal contents and feces 5 h after ingestion of the radioactive materials, It was concluded that the lactone is better absorbed from the intestine than the gluconate anion. According to this enhanced membrane permeation and the higher concentration reached in blood, the space of distribution of the lactone is larger than that of gluconate (50 and 41% of body weight, respectively); a higher retention in tissues and a greater loss in urine was also observed after administration of the lactone. Incorporation into liver glycogen is also higher from the lactone than from gluconate after oral administration, particularly in diabetic animals. The initial deficit in the oxidation of gluconate compared to that of the lactone, caused by a lag period of 7 and 4 h, respectively, is completely compensated during the following 8-9 h. The oxidative turnover of gluconolactone and of gluconate is significantly enhanced in diabetic animals. The better utilization in diabetic metabolism is in part explainable by a rise of glycolytic intermediates in the liver, which are decreased in starvation and diabetes. The limiting step of gluconate metabolism is the initial phosphorylation. Possibilities are discufor the dietetic use of gluconic acid in the form of an apolar derivative (lactone, ester).
Intra-aortic balloon counterpulsation (IABP) was used in 20 patients with acute myocardial infarction and cardiogenic shock, after four hours of drug treatment. In all instances the abnormal haemodynamic state had been demonstrated. Four patients were successfully treated and finally discharged home. In two with post-infarction ventricular septal defect and cardiogenic shock, IABP also successfully reversed the shock state, while in seven the shock state was reversed but they died 2-8 days after IABP had been stopped. IABP failed in seven patients who died during its application. In those in whom IABP failed there had been no significant fall in pulmonary-artery pressure and no significant increase in stroke volume. The post-mortem examinations demonstrated that cardiogenic shock was irreversible where more than 50% of the left ventricular myocardium had been infarcted.
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