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  • 1
    Electronic Resource
    Electronic Resource
    Influence of an extracellular volume expansion (ECVE) on renal amino acid- and sodium handling in patients with autosomal dominant polycystic kidney disease (ADPKD) (1997)
    Springer
    Amino acids 13 (1997), S. 311-322 
    Details
    ISSN: 1438-2199
    Keywords: Amino acids ; ADPKD ; Renal failure ; Renal amino acid-/sodium handling ; Hypertension ; Nitric oxide ; Cyclic GMP ; Na+/K+-ATPase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Although ADPKD is one of the first kidney diseases to be understood from the gene to the pathogenesis of clinical abnormalities, there were no data concerning the renal handling of amino acids and possible disorders of amino acid (AA) pattern in these patients. Therefore, in 9 patients suffering from ADPKD and in 8 healthy normal persons (NP) renal amino acid excretion was measured before and after extracellular volume expansion (ECVE) (21 of physiological electrolyte solution). Renal function was stable in both groups (serum creatinine: ADPKD: 85.1 ± 18.4 vs. NP 84.4 ± 13.5 μmol/l; GFR: 93.8 ± 16.4 vs. 104.4 ± 9.4 ml/min/1.73 m2). Mean blood pressure was higher in ADPKD patients than in NP (99.4 ± 2.6 vs. 85.5 ± 2.4 mmHg), but did not change after ECVE. After ECVE in both groups, urine volume increased distinctly, whereas GFR was only slightly enhanced. The plasma concentrations of leucine, glycine, valine, threonine, glutamine, and alanine were significantly higher in controls than in ADPKD patients. The amino acid reabsorption capacity was reduced in ADPKD patients in 12 of 21 amino acids before ECVE. After ECVE, the fractional excretion of amino acids (FEAA) increased only in NP. In parallel with changes in amino acid handling, the FENa (%) after ECVE increased both in ADPKD patients and in NP (before ECVE - ADPKD: 1.22 ± 0.23 vs. NP: 1.53 ± 0.23; after ECVE: 3.17 ± 0.25 (ADPKD) vs. 2.74 ± 0.22/NP; (ADPKD p ≤ 0.01, NP p ≤ 0.02) whereas FELi (%) increased significantly only in ADPKD (p ≤ 0.045) range (before ECVE - ADPKD: 25.8 ± 8.9 vs. NP: 20.5 ± 4.0; after ECVE: 41.4 ±15.4 vs. 25.2 ± 3.9). Furthermore, concentrations of cGMP (pmol/ml) in plasma increased after ECVE (before ECVE - ADPKD: 5.31 ± 0.56 vs. NP: 6.65 ±0.79; after ECVE: 11.31 ± 1.66 vs. 11.30 ± 1.91; p ≤ 0.05). Na+-dependent and, perhaps, NO-mediated processes in the reabsorption of AA in the proximal tubule seem to be different in ADPKD and may be related to different distributions of receptors and ATP-dependent transport systems with pathogenetic impact on abnormal transtubular fluid transport in ADPKD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01372595
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  • 2
    Electronic Resource
    Electronic Resource
    Erektile Dysfunktion – Problem gelöst mit Sildenafil (VIAGRA®)? (1998)
    Springer
    Der Internist 39 (1998), S. 1232-1236 
    Details
    ISSN: 1432-1289
    Keywords: Schlüsselwörter Sildenafil ; erektile Dysfunktion ; erektile Dysfunktion ; Sildenafil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zum Thema Wohl selten hat die Neuentwicklung eines Medikaments ein derart breites Interesse des Laienpublikums erregt und eine vergleichbare Beachtung in den Nachrichtenmedien gefunden wie das in den USA entwickelte und vor kurzer Zeit auf den Markt gekommene Sildenafil. Wie ebenfalls kaum verwunderlich ist, werden nicht minder tatsächliche oder vermeintliche Nebenwirkungen diskutiert. Um die Größenordnung potientieller Anwender aufzuzeigen: hierzulande geht man hochgerechnet von ca. 4–6 Millionen Männern mit unterschiedlich ausgeprägter erektiler Dysfunktion aus. Grundsätzliche Erwägungen und befürchtete gravierende Auswirkungen auf die Kostenentwicklung im Gesundheitswesen haben dazu geführt, daß die gesetzlichen Krankenkassen die Kostenübernahme für Sildenafil jedenfalls vorerst ablehnen. Ärztliche Information scheint dringend geboten, um die Männer zu selektieren, die von einer Sildenafiltherapie profitieren könnten und um die auszuschließen, bei denen Sildenafil wegen Kontraindikationen nicht angewendet werden sollte. In dieser Übersicht werden Wirkungsmechanismus, Pharmakokinetik, Dosierung, Anwendungsrichtlinien, Neben- und Wechselwirkungen sowie Ergebnisse klinischer Studien bezüglich Sildenafil dargestellt und diskutiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080050295
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  • 3
    Electronic Resource
    Electronic Resource
    Was erwartet und erhofft der Urologe vom Pathologen in der Diagnostik des Prostatakarzinoms? (1998)
    Springer
    Der Pathologe 19 (1998), S. 59-62 
    Details
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Prostatakarzinom ; Staging ; Grading ; Key words Prostate cancer ; Staging ; Grading
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Prostate cancer has become the most common cancer in males in Western countries. In the United States 317000 men were newly diagnosed with this disease in 1996. Screening efforts will identify increasing numbers of men who will be scheduled for prostate biopsy. Since the progression of prostate cancer varies widely from rapid tumor growth with early distant metastases to slow growth with good prognosis, it is of utmost importance that prognostic parameters be identified which allow the course of the disease to be predicted. Thus, the correct pathohistological staging, the evaluation of different grading systems, and the biological impact of positive surgical margins after radical prostatectomy requires collaboration between urologists and pathologists.
    Notes: Zusammenfassung Das Prostatakarzinom ist mittlerweile der häufigste Tumor des Mannes in den westlichen Industrieländern. In den USA wurde im Jahr 1996 ein solches Karzinom bei 317000 Männern diagnostiziert. Durch intensivierte Screeningbemühungen werden immer mehr Männer einer Prostatabiopsie zugeführt. Die Progression des Prostatakarzinoms reicht von einem schnellen Tumorwachstum mit frühzeitiger Metastasierung bis hin zu einem langsamen Wachstum mit guter Prognose. Aus diesem Grund ist es von großer Bedeutung, prognostische Parameter zu identifizieren, die eine Aussage zum Krankheitsverlauf ermöglichen. Neben der Identifizierung von Prognosefaktoren erfordert die korrekte pathohistologische Klassifizierung, die Evaluation von Gradingsystemen und die Beurteilung der biologischen Bedeutung positiver Absetzungsränder nach radikaler Prostatektomie die enge Kooperation zwischen Urologen und Pathologen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002920050255
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  • 4
    Electronic Resource
    Electronic Resource
    Biomodulation of 5-Fu cytotoxicity by folinic acid and its stereoisomers: in vitro experiments with different cell lines of prostatic cancer (1995)
    Springer
    Urological research 23 (1995), S. 163-167 
    Details
    ISSN: 1434-0879
    Keywords: Prostate cancer ; Chemotherapy ; 5-Fluorouracil ; Folinic acid ; Cell culture ; Tumor spheroids
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The results of cytotoxic chemotherapy for advanced, hormone-escaped prostate cancer have been disappointing. Evaluation of the effect of new drugs or new combinations with already known ones is required. The antimetabolite 5-fluorouracil (5-FU) has been shown to be active in prostate cancer, acting via inhibition of thymidylate synthase, an essential enzyme in DNA de novo synthesis. Experiments with cell lines of different tumors have shown that 5-FU activity can be modulated by addition of the coenzyme tetrahydrofolic acid (folinic acid). We investigated the effect of folinic acid and its stereoisomers on 5-FU action in different cell lines of prostate cancer. It was found that addition of non-toxic folinic acid led to a two- to fourfold better antiproliferative effect of 5-FU. The unnatural 6R isomer, which is a compound of chemically synthesized folinic acid, inhibited the modulatory effect of the natural 6S isomer. Our results indicated that a combination of folinic acid and 5-FU may result in a better response of patients with hormone-resistant prostate cancer than of patients treated with 5-FU alone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00389568
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  • 5
    Electronic Resource
    Electronic Resource
    Coagulating intermittent cutting. Improved high-frequency surgery in transurethral prostatectomy (1999)
    Springer
    Der Urologe 38 (1999), S. 592-598 
    Details
    ISSN: 1433-0563
    Keywords: Key words BPH • TURP • High-frequency surgery ; Schlüsselwörter BPH • TURP • Hochfrequenz-Chirurgie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei unbestritten hoher Effektivität kann die transurethrale Elektroresektion der Prostata (TURP) durch möglichen intraoperativen Blutverlust eine erhöhte Morbidität aufweisen. Dies ist eine Tatsache, die in den letzten Jahren zur Entwicklung zahlreicher alternativer Behandlungsmethoden geführt hat. Zur Minderung des Blutungsrisikos haben wir in mehreren Stufen eine Verbesserung der Hochfrequenztechnik entwickelt. Hierbei wurden durch geeignete Modifizierung der Elektronik handelsüblicher Hochfrequenz-Generatoren die ausgehenden Spannungs- und Stromsignale derartig moduliert, daß während jedes einzelnen Schnittes bei weiter bestehender guter Schneidequalität eine in das Gewebe hineinreichende effiziente Koagulationszone entsteht. Sowohl Laborexperimente und In-vitro-Versuche an Schweinenieren wie auch die durchgeführten klinischen Studien ergaben bei guten Schneideeigenschaften eine deutliche Reduktion der Blutungsbereitschaft und damit des Blutverlustes. So konnten Fremdblutgaben reduziert und die Gesamtmorbidität mit kürzerer Katheterverweildauer bei ebenso gekürztem stationärem Aufenthalt deutlich gesenkt werden.
    Notes: Summary In spite of the high and lasting efficiency of transurethral prostatectomy, intraoperative blood loss results in increased morbidity in this procedure. This led to the development of many alternative treatment modalities in the last years. To minimize the risk of bleeding, we improved the high-frequency technology in several steps. To achieve this, the output signals of commercially available high-frequency generators were modulated to the effect that each cut results in an efficient coagulation zone in the tissue at excellent cutting quality. Laboratory and in vitro studies using porcine kidneys as well as clinical trials showed good cutting characteristics accompanied by a significant reduction of bleeding. As a result, blood transfusions were less necessary, the transurethral catheter could be removed earlier in the postoperative period, and hospitalization time was significantly reduced. In conclusion, the improved high-frequency technology in form of the “coagulating intermittent cutting” results in a blood-sparing tissue resection with a consecutive reduction of morbidity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001200050333
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  • 6
    Electronic Resource
    Electronic Resource
    Nebenmilz des Samenstrangs (1997)
    Springer
    Der Urologe 36 (1997), S. 262-264 
    Details
    ISSN: 1433-0563
    Keywords: Schlüsselwörter Samenstrangtumor • Nebenmilz ; Key words Spermatic cord neoplasms • Accessory spleen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A 40-year-old man who presented with a tumor of the left spermatic cord was found to have an ectopic accessory spleen located within the left spermatic cord.
    Notes: Zusammenfassung Ein 40 jähriger Mann stellte sich mit dem Verdacht eines linksseitigen Samenstrangtumors vor. Dabei ergab sich die Diagnose einer Nebenmilz des linken Samenstrangs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001200050102
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  • 7
    Electronic Resource
    Electronic Resource
    Pelvic floor activity patterns in urinary stress incontinent women: Evolutionary, neurophysiological and diagnostic considerations (1995)
    Springer
    International urogynecology journal 6 (1995), S. 175-179 
    Details
    ISSN: 1433-3023
    Keywords: Kinesiologic EMG evaluation ; Pelvic floor activity patterns ; Philogenetic considerations ; Symmetrical coordinated inhibition of activity ; Urinary stress incontinent parous women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Kinesiologic EMG measurements show that the pelvic floor muscles are capable of both continuing activity and brisk reactivity; although some variability in the amount and characteristics of motor unit activity and recruitment could be demonstrated from different sites in the pubococcygeus muscles, the activation or inhibition of firing of motor units in the pelvic floor muscles of healthy females was always found to be concordant bilaterally. In contrast, we have demonstrated significantly shorter maximal voluntary activation times, unilateral pubococcygeus activation disturbances, and even paradoxical unilateral inhibition of motor unit firing in the pelvic floor muscles of urinary incontinent women. As the particular human motor control patterns of the pelvic floor muscles — as they relate to the continence and excretory functions — are philogenetically rather recent, we postulate that they are therefore vulnerable and easily disturbed by even minor denervation injuries (as has been demonstrated in women after vaginal deliveries). We further postulate that such disturbances lead to deficient performance of the pelvic floor muscles, and contribute to the development of incontinence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01900583
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  • 8
    Electronic Resource
    Electronic Resource
    Treatment of progressive, local, advanced cancer of the prostate (1998)
    Springer
    Der Urologe 37 (1998), S. 145-148 
    Details
    ISSN: 1433-0563
    Keywords: Key words Prostate cancer • Local progression • Treatment options ; Schlüsselwörter Prostatakarzinom • Lokaler Progreß• Therapieoptionen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die eindeutige Zuordnung einer Behandlungsmodalität beim lokal fortgeschrittenen Prostatakarzinom ist aufgrund fehlender qualifizierter randomisierter und kontrollierter Studien schwierig. Die perkutane Bestrahlung ist die z. Z. am häufigsten angewandte Therapieform, an der andere Behandlungskonzepte verglichen werden müssen. Die radikale Prostatektomie als Monotherapie erbringt bei diesem Tumorstadium keine Überlebensvorteile. Die Kombination aus lokalen Therapieformen und neoadjuvanter Hormonmanipulation scheint ein erfolgversprechendes Therapiekonzept zu sein, das mit Hilfe prospektiver klinischer Studien weiter belegt werden sollte.
    Notes: Summary Due to the lack of randomized and controlled trials comparing treatment options for locally advanced prostate cancer no clear cut therapeutical advise can be given. Currently, external beam radiotherapy is the form of treatment most often applied to which other therapeutic modalities have to be compared. Radical prostatectomy alone does not improve survival at this stage. The combination of local treatment modalities with neoadjuvant androgen deprivation seems to be a promising approach which has to be evaluated in prospectiv clinical trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001200050162
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  • 9
    Electronic Resource
    Electronic Resource
    1996 Schönbein Medal of Honour awarded to Hans-Heinrich Möbius (1997)
    Springer
    Journal of solid state electrochemistry 1 (1997), S. 114-115 
    Details
    ISSN: 1433-0768
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100080050031
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  • 10
    Electronic Resource
    Electronic Resource
    Iridium 192 high-dose-rate brachytherapy —a useful alternative therapy for localized prostate cancer? (1997)
    Springer
    World journal of urology 15 (1997), S. 252-256 
    Details
    ISSN: 1433-8726
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report on a novel protocol involving iridium 192 high-dose-rate brachytherapy and follow-up of up to 130 months in patients with prostatic carcinoma. Using regional anesthesia, five to seven hollow needles are placed within the prostate by perineal puncture under ultrasound guidance. A 9-Gy prostate dose is applied followed by 30 min of hyperthermia (since 1991). This treatment is repeated once after 7 days; 2 weeks later, 18 × 2-Gy external beam radiation (small-field prostate) is added as percutaneous dose saturation. Since 1984 we have treated 40 patients with this protocol. Local tumor control was achieved by means of prostatic biopsy at 18 months after therapy and determination of prostate-specific antigen (PSA) values in bout 70% of the patients; after a mean follow-up period of more than 6 years (16–130 months), 80% of the patients show either no evidence of disease or stable disease. We therefore conclude that iridium 192 high-dose-rate brachytherapy is a useful alternative in the treatment of localized prostate cancer in patients who are not eligible for radical prostatectomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01367663
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