0000000000266644

AUTHOR

U. Engelmann

Prognostische Parameter des Harnblasenkarzinoms

Anhand des Krankengutes der Urologischen Klinik und Poliklinik der Universitat Mainz von 1968 bis 1972 wurden prognostische Parameter erarbeitet, die im folgenden mit einer kurzen Literaturubersicht der letzten Jahre vorgestellt werden sollen.

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Die intravesikale Sonographie in der Stadieneinteilung des Harnblasenkarzinoms

Bei der Therapieplanung und Prognose des Blasenkarzinoms spielt die Tiefe der Tumorinfiltration eine wichtige Rolle. Mit der Computertomographie ist eine Differenzierung des Tiefenwachstums von Blasentumoren in der Blasenwand selbst nicht moglich. Die Treffsicherheit der transabdominellen Sonographie bei der Stadieneinteilung des Blasenkarzinoms wird in der Literatur mit 85% angegeben [1]. Die intravesikale Sonographie ist der suprapubischen Ultraschalluntersuchung uberlegen: Schaller und Mitarbeiter [2] klassifizierten 26 von 28 Tumoren, also uber 90%, korrekt.

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MAINZ-Pouch: Blasenaugmentation, Blasenersatz und kontinente Harnableitung

Operationsverfahren zur kontinenten Harnableitung, der Blasenaugmentation oder zum Blasenersatz haben in den letzten Jahren eine Renaissance erfahren. Vorteil der 1983 vorgestellten Technik des Mainz-Pouch [6] ist, das sie in standardisiertem Vorgehen fur alle drei genannten Indikationen geeignet ist. Seit 1983 wurden an der Universitatsklinik Mainz 79 Eingriffe zur kontinenten Harnableitung (n = 39), zur Blasenaugmentation (n = 28) und zum Blasenersatz (n = 12) durchgefuhrt. Bei der In dikation zur Operation standen ein funktioneller oder morphologischer Blasenverlust (n = 43) oder die Zystektomie wegen Blasenkarzinom (n = 31) im Vordergrund.

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Palliative Chemotherapie des metastasierenden Harnblasenkarzinoms

Von den an der Urologischen Universitatsklinik Bern vom Januar 1979 bis Dezember 1981 behandelten Patienten mit einem metastasierenden Harnblasenkarzinom wurden insgesamt 24 Patienten des Stadiums T3-4GII-IIIN+M0-1 ausgewertet.

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Influence of Perioperative cis-Platinum on Breaking Strength of Bowel Anastomoses in Rats

Adjuvant and perioperative chemotherapy is increasingly being used in the treatment of malignant disease. Therefore, the influence of cytostatic drugs is of interest and is being investigated experimentally. The influence of various drugs is well known and has been described elsewhere (Shamberger et al. 1981). Recently, cis-platinum, an inorganic complex that inhibits DNA synthesis by cross-linking DNA strands, has been introduced. In urology it has shown a surprisingly good effect on testicular tumors and has been used in bladder cancer for palliative treatment, being one of the most potent drugs for this purpose (Yagoda 1979). It is now being combined with cystectomy for curative therapy …

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Laser welded vascular anastomosis

A comparative study was undertaken to investigate the application of a specially adapted microsurgical Neodymium Yag Laser system with a wavelength of 1,319 microns and a CO2 laser system for laser assisted microvascular end-to-end anastomosis (LAMA) of the rat femoral artery. Conventionally sutured anastomoses served as controls. Postoperative investigations included patency tests, light microscopy and tensile strength measurements. Both laser systems seem to be equally suitable for LAMA: The patency rates do not differ from those of sutured anastomoses and formation of microscopically small aneurysms occurred predominantly in control animals and only once in laser groups. The clamp time n…

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Permeability of the rat bladder to Cisplatinum under different conditions: comparison with Mitomycin C and Adriamycin.

In 50 female Sprague-Dawley rats the absorption of Cisplatinum through the bladder wall was studied. Under different conditions, including cystitis and electrocoagulation of the bladder mucosa, the absorption was low and the measureable serum concentrations did not exceed 2.64 micrograms/ml. The influence of Tween 80--a non-ionic surfactant--on the absorption is investigated. The results are compared with those found for Adriamycin and Mitomycin C under identical conditions.

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Laser — Klinische Anwendung

Der Neodym-YAG-Laser mit einer Emissionswellenlange von 1,06 μm besitzt eine hohe Penetrationstiefe ins Gewebe von ca. 5 mm mit einem homogenen Koagulationssaum. Bereits 1973 wurden von Mussiggang u. Mitarb. [3] Hautschnitte und Resektionen an Nieren, Leber und Milz im Tierversuch durchgefuhrt, die jedoch offensichtlich wegen der damals zur Verfugung stehenden Laserleistung von nur ca. 50 Watt nicht uberzeugend verliefen. Nach dem nunmehr der Neodym-YAG-Laser in der Urologie (insbesondere in der Behandlung des Blasentumorleidens und bei pathologischen Veranderungen am auseren Genitale) und anderen Fachdisziplinen nach Verbesserung des Instrumentariums und einer hoheren Leistung bei zahlreic…

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Urolithiasis Following Portacaval Shunt in Rats

A reliable technique for a portacaval anastomosis (PCA) in rats was first published by Lee and Fisher 1961. Since then the biological and biochemical consequences have been studied extensively in numerous investigations. The occurrence of a urolithiasis following PCA was first reported by Herz et al. 1972. Disturbances of uric acid metabolism that were caused by the shunt were thought to be responsible. They should lead to an increased production of endogenous uric acid and thus to hyperuricosuria. Investigations that were published since then mainly focused on chemical stone analysis (Bichler et al. 1974; Rasenack et al. 1977; Wallace et al. 1984).

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Das Onkozytom der Niere

The angiographic findings in ten patients with renal oncocytoma are described. Characteristic features include: absence of encasement, vascular occlusions, arterio-venous shunts and contrast lakes (8/10). Spoke-wheel arrangement of tumor vessels (8/10). Homogeneous tumour contrast during the capillary phase (7/10). Sharp demarcation from the kidney and surroundings (9/10) and a peritumoral halo (4/10). If the suspicion of an oncocytoma is raised by CT examination of a space-occupying lesion (part I), angiography should be performed to confirm the diagnosis and help in planning surgical treatment.

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Development of Bladder Carcinoma Following Portacaval Shunt in Rats

Portacaval anastomosis (PCA) was first introduced by Eck (1877) and was investigated in a number of different animals. Lee et al. (1961; 1974) published a reliable method with low mortality in rats. The occurrence of urolithiasis in rats following portacaval anastomosis happened to be noticed by chance. It was published by Herz et al. (1972a, 1972b, 1973), who defined the portacaval shunt rat as an experimental model. Heine et al. (1979) described dysplastic and neoplastic changes of the bladder mucosa following portacaval anastomosis. His findings were confirmed by Duy et al. (1981); Grun et al. (1982), and Dubuisson et al. (1984). However, Wallace et al. (1984) found papillary hyperplasia…

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