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  • 1
    Electronic Resource
    Electronic Resource
    Klinischer Verlauf und Narbenentwicklung beim operierten vesico-renalen Reflux in einer Langzeitbeobachtung (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 920-926 
    Details
    ISSN: 1432-1440
    Keywords: Vesico-renal reflux ; Renal parenchymal scar ; Urinary tract infection ; Asymptomatic bacteriuria ; Uroepithelial cell ; Vesico-renaler Reflux ; Nierenparenchymnarbe ; Harnwegsinfektion ; Asymptomatische Bakteriurie ; Uroepithelzelle
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung 62 Patienten (14 Knaben, 48 Mädchen), bei denen an insgesamt 85 Niereneinheiten ein vesico-renaler Reflux (Grad 2–4) erfolgreich operiert worden war, wurden im Durchschnitt 9,3 Jahre postoperativ auf das Auftreten von Harnwegsinfektionen (HWI) und von neuen Nierenparenchymnarben (NN) verfolgt. Bei den männlichen Patienten traten postoperativ bis auf einen Knaben keine HWI bzw. NN auf. Ähnliches galt auch für etwa 45% der Mädchen. Beide Gruppen von Patienten wiesen vor Operation hohe Refluxgrade auf. Bei den übrigen Mädchen, deren präoperative Reflux-Grade im Durchschnitt relativ niedrig lagen, traten jedoch postoperativ über Jahre noch HWI auf. NN entwickelten sich vorwiegend in dieser Zeit. Untersuchungen der Fähigkeit von Uroepithelzellen (UEZ), das Bakterienwachstum zu hemmen, zeigten, daß die UEZ dieser Patienten das Bakterienwachstum nicht supprimieren konnten. Somit entsprachen diese Mädchen bezüglich ihrer UEZ-Funktion Patientinnen mit asymptomatischer Bakteriurie. HWI und NN bei Reflux scheinen somit durch unterschiedliche Ursachen ausgelöst zu werden.
    Notes: Summary 62 patients (14 boys, 48 girls) representing 85 refluxive renal units (Grade 2–4) were investigated after successful operation for the development of further urinary tract infections (UTI) and renal scars (RS). The mean follow-up was 9.3 years. With the exception of one boy, none of the male patients developed any UTI or new RS. A similar result was obtained for about 45% of the girls. These two groups of patients presented with high-grade reflux before surgery. The remaining female patients (about 55%), however, presenting with lower-grade reflux before surgical treatment, developed further UTI as well as new RS despite surgical correction of their reflux. Investigations on the capacity of uroepithelial cells (UEC) to suppress bacterial growth revealed a deficient antibacterial effect of UEC in these patients. Such an UEC defect has also been shown in patients with asymptomatic bacteriuria. In conclusion, different reasons seem to be responsible for recurrent UTI and the development of RS in patients with reflux.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01738146
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  • 2
    Electronic Resource
    Electronic Resource
    Alterations of peripheral testosterone metabolism after induced hypoprolactinemia in patients with prostatic carcinoma (1979)
    Springer
    Journal of molecular medicine 57 (1979), S. 49-51 
    Details
    ISSN: 1432-1440
    Keywords: Bromocriptin ; Prostatakarzinom ; Prolaktin ; Androgene ; Testosteron ; Bromocriptine ; Prostatic Carcinoma ; Prolactin ; Androgens ; Testosterone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In 12 patients with advanced prostatic carcinoma the effect of bromocriptine-induced hypoprolactinemia on the peripheral androgen metabolism was investigated after3H-testosterone injection under conditions that each individual served as his own control. After a 5-day significant prolactin suppression, the elimination of3H-label 1 h after testosterone injection was about 45% and equal to pre-bromocriptine values. The recovery of dihydrotestosterone separated by silica gel T.L.C., however, was significantly augmented, resulting in a marked decrease of the testosterone/dihydrotestosterone ratio from 12.2 to 6.3. This induced 5α-reductase activity after prolactin suppression is in accordance with our earlier findings on prostatic carcinoma tissue, matches well with observations of Magrini et al. on induced hyperprolactinemia and may be a new approach to the understanding of androgen dependent disorders.
    Notes: Zusammenfassung Beeinflussung des peripheren Testosteronstoffwechsels durch induzierte Hypoprolaktinämie bei Patienten mit Prostatakarzinom. Der Effekt einer Bromocriptin-induzierten Hypoprolaktinämie auf den peripheren Androgenstoffwechsel wurde bei 12 Patienten mit fortgeschrittenem Prostatakarzinom nach Injektion von3H-Testosteron in der Weise untersucht, daß jeder Patient als seine eigene Kontrolle galt. Nach einer fünftägigen Hypoprolaktinämie betrug die Elimination androgengebundener Radioaktivität 1 Stunde nach Testosteroninjektion 45% und entsprach dem Wert vor Bromocriptinbehandlung. Die durch Silica Gel-Dünnschichtchromatographie analysierte Recovery von Dihydrotestosteron war allerdings signifikant erhöht. Daraus ergab sich eine deutliche Verminderung des Verhältnisses Testosteron/Dihydrotestosteron von 12.2 auf 6.3. Diese induzierte Kapazität der 5α-Reduktase nach peripherer Prolaktin-Suppression steht in Übereinstimmung mit unseren früheren Ergebnissen an Prostatakarzinomgewebe, wird unterstützt durch Beobachtungen von Magrini et al. bei induzierter Hyperprolaktinämie und könnte wichtige Rückschlüsse für das Verständnis androgenabhängiger Krankheitsbilder liefern.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01476982
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  • 3
    Electronic Resource
    Electronic Resource
    Diagnostik und operative Therapie beim vesiko-renalen Reflux (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 912-919 
    Details
    ISSN: 1432-1440
    Keywords: Vesico-renal reflux ; Classification of reflux ; Diagnostic procedures ; Surgical techniques ; Vesiko-renaler Reflux ; Refluxklassifizierung ; Diagnostische Verfahren ; Operationstechniken
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Für die Abklärung und Klassifizierung des vesiko-renalen Refluxes stehen eine Reihe diagnostischer Maßnahmen zur Verfügung, deren Aussagekraft nicht unumstritten ist. Aus diesen Gründen müssen therapeutische Entscheidungen bei der Refluxerkrankung häufig vom klinischen Verlauf abhängig gemacht werden. Durch die operative Refluxkorrektur kann mit hoher Zuverlässigkeit und geringer Komplikationsrate der vesiko-renale Reflux unabhängig vom präoperativ nachgewiesenen Refluxgrad beseitigt werden.
    Notes: Summary Detection and accurate grading of vesico-renal reflux is rendered difficult by the limited realiability of the different diagnostic procedures. Therapeutic decisions are therefore to a large extent influenced by the clinical situation. Properly performed antireflux surgery combines a high cure rate with a low complication rate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01738145
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  • 4
    Electronic Resource
    Electronic Resource
    Social integration, sexual behaviour and fertility in patients with bladder exstrophy —a long-term follow up (1996)
    Springer
    European journal of pediatrics 155 (1996), S. 678-683 
    Details
    ISSN: 1432-1076
    Keywords: Bladder exstrophy ; Interpersonal relations ; Sexual behaviour ; Fertility and education
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract After primary bladder closure or urinary diversion, other factors apart from the reconstruction itself gain importance for individuals with the exstrophy-epispadias complex: social integration and, after reaching puberty, sexuality and fertility. Between 1968 and July 1994 115 patients with bladder exstrophy or incontinent epispadias underwent surgery at our institution. A total of 104 patients could be followed, 2 of whom died in the meantime. Of the remaining 102 patients 48 attend school, 4 are in college, 40 have completed or are currently undergoing vocational training, 3 are unemployed, 1 lives in a therapeutic centre and 6 are younger than 6 years of age. A total of 95% of the patients with continent urinary diversion are continent day and night, whereas only three of five patients with a sling plasty (incontinent epispadias) or with primary bladder closure followed by a Young-Dees procedure are continent. None of the patients showed deterioration of renal function. In 25 females the external genitalia were reconstructed. Fixation of the uterus was done in 13 to correct or prevent uterine prolapse. Of the 17 women older than 18 years of age with genital reconstruction, 16 are satisfied with the cosmetic result. All adults engage in sexual intercourse. Five women have delivered seven children by Caesarean section. Of the 35 male adults 32 underwent reconstruction of the external genitalia and 34 males achieve erection. One developed necrosis of the penis early in life following primary bladder closure performed at an outside hospital. Penile deviation was present in 11 of the 32 patients with genital reconstruction, which is distressing in only 2. Thirty patients are satisfied with the cosmetic result. After genital reconstruction 9 males developed epididymitis, necessitating two orchiectomies and three vasectomies. No patient with reconstruction of the external genitalia can ejaculate normally or has fathered children, whereas ejaculation was normal in the three men who did not undergo genital reconstruction and in two patients prior to post-pubertal reconstruction. Furthermore, two of these three men have fathered four children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01957152
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  • 5
    Electronic Resource
    Electronic Resource
    Fetal rhabdomyomatous nephroblastoma (1980)
    Springer
    European journal of pediatrics 133 (1980), S. 167-172 
    Details
    ISSN: 1432-1076
    Keywords: Nephroblastoma ; Wilms' tumor ; Nodular renal blastema ; Rhabdomyosarcoma ; Fetal rhabdomyoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fetal rhabdomyomatous nephroblastoma is a very rare variant of Wilms' tumor. The special clinical and histologic features of this variant are presented on the basis of a case seen in a boy who was 13 months old at nephrectomy 8 months ago and has remained healthy since then. The tumor chiefly consists of fetal striated muscle; it occurs predominantly in infancy and early childhood and is often bilateral. Angiography shows a relative paucity of vessels. The volume of the tumor (determined by ultrasonography) decreases only slightly after preoperative radio- and chemotherapy because of a predominance of mesenchymal structures. The finding of nodular renal blastema in renal parenchyma with an apparently normal gross appearance is an argument in favor of classifying this type of tumor in the group of nephroblastomas and may explain the tendency of fetal rhabdomyomatous nephroblastoma to occur bilaterally.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00441587
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  • 6
    Electronic Resource
    Electronic Resource
    Social integration, sexual behaviour and fertility in patients with bladder exstrophy – a long-term follow up (1996)
    Springer
    European journal of pediatrics 155 (1996), S. 678-683 
    Details
    ISSN: 1432-1076
    Keywords: Key words Bladder exstrophy ; Interpersonal relations ; Sexual ; behaviour ; Fertility and education
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract After primary bladder closure or urinary diversion, other factors apart from the reconstruction itself gain importance for individuals with the exstrophy-epispadias complex: social integration and, after reaching puberty, sexuality and fertility. Between 1968 and July 1994 115 patients with bladder exstrophy or incontinent epispadias underwent surgery at our institution. A total of 104 patients could be followed, 2 of whom died in the meantime. Of the remaining 102 patients 48 attend school, 4 are in college, 40 have completed or are currently undergoing vocational training, 3 are unemployed, 1 lives in a therapeutic centre and 6 are younger than 6 years of age. A total of 95% of the patients with continent urinary diversion are continent day and night, whereas only three of five patients with a sling plasty (incontinent epispadias) or with primary bladder closure followed by a Young-Dees procedure are continent. None of the patients showed deterioration of renal function. In 25 females the external genitalia were reconstructed. Fixation of the uterus was done in 13 to correct or prevent uterine prolapse. Of the 17 women older than 18 years of age with genital reconstruction, 16 are satisfied with the cosmetic result. All adults engage in sexual intercourse. Five women have delivered seven children by Caesarean section. Of the 35 male adults 32 underwent reconstruction of the external genitalia and 34 males achieve erection. One developed necrosis of the penis early in life following primary bladder closure performed at an outside hospital. Penile deviation was present in 11 of the 32 patients with genital reconstruction, which is distressing in only 2. Thirty patients are satisfied with the cosmetic result. After genital reconstruction 9 males developed epididymitis, necessitating two orchiectomies and three vasectomies. No patient with reconstruction of the external genitalia can ejaculate normally or has fathered children, whereas ejaculation was normal in the three men who did not undergo genital reconstruction and in two patients prior to post-pubertal reconstruction. Furthermore, two of these three men have fathered four children. Conclusion Education, occupation and social development of patients with urinary diversion are uneventful. The cosmetic results achieved by genital reconstruction are satisfactory. In female patients, antefixation of the uterus should be performed before or together with an introitusplasty to prevent uterine prolapse. In male patients, however, surgery is performed at the expense of fertility. Detailed discussions with the patients and their parents should include not only the question of primary bladder closure versus urinary diversion, but also the pros and cons of correction of the external and – in females – the internal genitalia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01957152
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  • 7
    Electronic Resource
    Electronic Resource
    170. Alterations of peripheral testosterone metabolism after induced hypoprolactinemia in patients with prostatic carcinoma
    Amsterdam : Elsevier
    Journal of Steroid Biochemistry 9 (1978), S. 848 
    Details
    ISSN: 0022-4731
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0022-4731(78)90870-1
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  • 8
    Electronic Resource
    Electronic Resource
    Colonic conduit (1984)
    Springer
    World journal of urology 2 (1984), S. 159-165 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Urinary diversion is still an important therapeutic measure in the management of urological patients, despite recent advancements like clean intermittent self-catheterization or artificial sphincter implantation. Our current preoperative requirements, operative technique and postoperative management of the sigmoid and transverse colonic conduit operation is described herein, with special regard to different intraoperative situations. An alternative ureterointestinal implantation technique is mentioned, that can be used in cases of severely dilated ureters. Our results are briefly compared to other recently published findings.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00328098
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  • 9
    Electronic Resource
    Electronic Resource
    Active immunotherapy of stage IV renal cell cancer using autologous tumor cells (1986)
    Springer
    World journal of urology 3 (1986), S. 245-248 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A total of 53 patients with stage IV renal cell carcinoma were treated by vaccination with autologous tumor cells in Candida-antigen after palliative tumor nephrectomy. Follow-up has been up to 9 years. Complete remission within 48 months after nephrectomy was observed in 3 patients, while 6 showed partial remission and 18 are stable with disease. Of 26 patients with rapid progression, 17 died within 1 year after operation. The best response was seen in metastases to the liver and lung. CNS-lesions or bone metastases do not appear to respond to this treatment. We conclude that this mode of therapy is beneficiary to a certain group of patients and should be offered, as no severe side effects have been observed so far. Whether new perspectives of adoptive immunotherapy using tumor-specific monoclonal antibodies or recombinant interferons will prove effective remains to be seen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00632186
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  • 10
    Electronic Resource
    Electronic Resource
    Second generation shock wave lithotripsy: experience with the lithostar (1987)
    Springer
    World journal of urology 5 (1987), S. 225-228 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Extracorporeal shock wave lithotripsy (ESWL) has been in clinical use for more than 5 years. Several devices commonly designated “second generation” lithotriptors are now under experimental or clinical trials. A multifunctional lithotriptor unit developed in cooperation with the Siemens Company in Germany is described, which utilizes an electromagnetic mode of shock wave generation along with local coupling to the patient. The results of 795 treatments are presented. The prototype has been in operation since March 1986. Adjuvant endourological measures, all of which have been performed on the same table, include insertion of double-J stents and ureteral catheters prior to ESWL in 27% of all treatments. Shock wave lithotripsy alone has been performed successfully under local anesthesia or a combination of parenteral analgesia and sedation. Results of treatment have been uniformly satisfying.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00327225
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