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Biomedical subjects

A Pfau

Publications and source records attributed to A Pfau.

At least 37 records · Page 2Linked to original sources

Nd:YAG laser hyperthermia in the treatment of recalcitrant verrucae vulgares (Regensburg's technique).

Heat therapy of cutaneous diseases has been used for decades. During the last years several kinds of energy sources, including electromagnetic energy from radiofrequency, microwaves and sonic energy from ultrasound, have been used to produce local hyperthermia. The general principle of this treatment is based on the fact that disease tissue which is being treated is more sensitive to the effects of elevated temperature than normal tissue and thus less able to recover after heat exposure. We report the case of a 54-year-old female patient with recalcitrant verrucae vulgares on the little finger of her right hand and on her left sole, who was treated with Nd:YAG laser hyperthermia. Laser energy was applied twice with an interval of 6 weeks. Laser output power was 10 W, spot size 8 mm and irradiation time up to 20 s. By this technique it was possible to receive a surface temperature of about 40 degrees C for 30 s. After hyperthermia no skin changes like whitish discoloration, blistering or crusting were observed. After the patient had completed the second course a total remission took place. No recurrence was seen in a follow-up period of 3 months. This method could be used in the treatment of recalcitrant warts on the fingers and hands, periungual and other parts of the body including plantar surfaces.

Female↗

UV-A-provoked localized bullous pemphigoid.

A 71-year-old woman had noticed the development of blisters on her forehead 4 months before she was referred to our department. Treatment with oral corticosteroids resulted in complete healing, but new blisters subsequently developed on the face, neck and backs of the hands. After the possibility of phototoxic and photoallergic reactions, as well as an abnormal porphyrin profile, had been excluded, the diagnosis of bullous pemphigoid was made by histological and direct immunofluorescent examination. UV-A provocation on the upper arm produced lesions histologically and immunohistochemically typical of bullous pemphigoid. Of particular importance was the fact that the blisters were limited strictly to light-exposed skin areas.

Aged↗

Single dose quinolone treatment in acute uncomplicated urinary tract infection in women.

A total of 125 ambulatory women (85 premenopausal and 40 postmenopausal) who experienced 174 acute urinary tract infections with mainly gram-negative bacteria (99%) was randomized to receive a single dose, 2-tablet treatment with either ofloxacin (400 mg.), norfloxacin (800 mg.) or ciprofloxacin (500 mg.). Cure was achieved in 163 of the 174 acute episodes (94%). More specifically, the cure rates were 97% (57 of 59 infections) with ofloxacin, 96.5% (56 of 58) with ciprofloxacin and 88% (50 of 57) with norfloxacin. While the initial cure rate of the acute urinary tract infections was 96% (112 of 117) in the premenopausal group, it reached only 90% (51 of 57) in the postmenopausal group. The 17 urinary tract infections that followed the initial 2-tablet quinolone treatment were cured by either an additional single dose, 2-tablet treatment with a different quinolone in 6 cases, a 1-day treatment with other adequate antibacterials in 9 and a 7-day treatment in 2. The 2-tablet quinolone treatment proved to be an effective, easy and cost-effective treatment for acute urinary tract infections in premenopausal and postmenopausal women.

Acute Disease↗

[Prostatic specific antigen for detection and monitoring of prostatic cancer].

Prostatic specific antigen (PSA) can be detected in normal and benign hypertrophic prostates, as well as in prostatic cancer and its metastases. Since it appears in the serum, this glycoprotein has become an established marker for the detection and monitoring of prostate cancer. Using a radioimmunoassay (CIS--Biointernational, France), we found serum PSA levels higher than 4 ng/ml in 55 of 58 patients with prostatic cancer. The concentrations were proportional to tumor stage: significantly higher in stages C and D than in stages A and B (p less than 0.002). In all 6 cases with occult prostatic carcinoma (stage A), levels were higher than 15 ng/ml. PSA was found to be a good indicator of response to therapy, as well as a marker of tumor progression during follow-up. After radical prostatectomy serum PSA levels decreased to below 1 ng/ml. Following radiotherapy levels returned to normal within 1-6 months in 8 of 11 patients. In 21 of 23 with metastases serum PSA decreased during hormonal treatment. In 3 who responded initially to hormonal therapy, levels increased before clinical manifestation of tumor progression. We conclude that PSA is a sensitive serum marker for the diagnosis of prostatic cancer in cases of metastatic disease of unknown origin, as well as for monitoring the response to treatment of prostatic carcinoma. The use of PSA serum levels for screening for prostatic cancer is still controversial.

Antigens, Neoplasm↗

Effective prophylaxis for recurrent urinary tract infections during pregnancy.

Effective prevention of recurrent urinary tract infections (UTIs) and possible acute pyelonephritis is of major importance during pregnancy. During 39 pregnancies, 33 women with a history of recurrent UTIs (and, in some instances, pyelonephritis) received postcoital prophylaxis consisting of a single oral dose of either cephalexin (250 mg) or nitrofurantoin macrocrystals (50 mg). While 130 UTIs occurred during a mean observation period of 7 months before prophylaxis, only a single UTI occurred during pregnancy after prophylaxis; this difference was highly significant. Thus the use of one of these effective regimens is strongly recommended for any pregnant woman with a history of recurrent UTIs. The treatment's effectiveness can be explained by two features of the two antibacterial agents involved: both reach high bactericidal concentrations in the urinary tract and induce no (or minimal) resistance in the introital gram-negative bacterial flora.

Acute Disease↗

[Extracorporeal shock wave lithotripsy for cystine urolithiasis].

We present 31 patients with cystine urolithiasis referred to our extracorporeal shock wave lithotripsy (ESWL) center since 1985. This group differed statistically from the other 3000 patients treated by us for urolithiasis with regard to age, stone burden, number of previous operations, and known duration of urolithiasis. The average known duration in those with cystine stones was 15 years. Of 26 patients with such a history, 22 had an average of 2 operations each. At referral, 14 had bilateral stones and among the others there were 5 nonfunctioning kidneys. Of 26 referred with a diagnosis of cystine nephrolithiasis, only 11 were being treated medically. At presentation, 31 had no stones and 1 was being treated medically. In the other 29 patients, 44 renal-ureteral units had urolithiasis. During follow-up 2 ureteral stones were discharged spontaneously and the other units were treated by ESWL, surgery and/or ureteroscopy, and percutaneous irrigation. 36/42 units were free of significant stone residue, but in 4 there were large gravel remains; 1 kidney was removed primarily and 1 kidney lost its function following prolonged obstruction after ESWL. During follow-up, of 11 patients unable to tolerate D-penicillamine and treated by urinary alkalinization alone, 3 have already formed new stones.

Cystine↗

The treatment of chronic bacterial prostatitis.

Chronic bacterial prostatitis, the most common cause of recurrent urinary tract infections in the male patient, is a clinical entity accurately defined by two essential features: (1) recurrent urinary tract infections and (2) persistence of gram-negative bacteria in the prostatic secretion. Chronic bacterial prostatitis is mainly a bacteriologic diagnosis and, therefore, sequential bacteriologic localization cultures are the only way to correct diagnosis. Thirty-five of 39 patients (90%) with chronic bacterial prostatitis were cured of their disease either by a short-term (14-day) intramuscular kanamycin treatment or a long-term (average of five months) oral co-trimoxazole, pure trimethoprim or ciprofloxacin treatment; selected patients suffering from chronic bacterial prostatitis with an associated pathology such as benign enlargement of the prostate, associated occasionally with infected prostatic calculi, who did not respond to medical therapy alone, were cured by a combined adequate antibacterial and surgical (a modified retropubic prostatectomy) treatment. All the patients were followed up for at least one year and most patients several years following treatment.

Anti-Bacterial Agents↗

Measurements of 129I in human and bovine thyroids in Europe--transfer of 129I into the food chain.

Bovine thyroid glands from different countries in Europe and human thyroid glands from Lower Saxony (Federal Republic of Germany) show isotopic 129I/127I ratios of 2.1 X 10(-9) to 8.2 X 10(-8) for cattle and 2.1 X 10(-9) to 8 X 10(-8) in humans. These values give information about the concentration of fallout 129I in Europe since most of these glands were collected in areas without nuclear facilities. Some of the human thyroids were collected after the Chernobyl accident between May 1986 and February 1988. Results obtained from human thyroids taken in some locations of Lower Saxony show no significant increase of the 129I during this time. Higher concentrations of 129I were only found in cattle grazing in the vicinity of a reprocessing plant in Mol, Belgium. Samples of soil, vegetation, milk, and water from this area contained higher than normal concentrations of 129I. The long-term transfer of radioiodine from the soil to the plant and the translocation within the soil were studied using a soil monolith with a 129I-contaminated surface. During the 4 y of the experiment, the transfer factor plant/soil decreased from 0.3 to 2.2 X 10(-3). Soil samples taken in 5-cm steps to a depth of 30 cm then at 40 and 50 cm depths showed that the transport of radioiodine to lower layers proceeds very slowly. The top 5-cm layer contained about 80% of the total radioactivity 52 mo after contamination. In an in-vivo study with a dairy cow, the transfer of radioiodine from feed to milk to cow meat and to pig thyroid gland was followed for 53 d using 129I-labeled pasture grass contaminated via roots. A part of the milk obtained from the cow was fed to a pig as a substitute for humans. The mean value of the transfer factor milk/feed was 2.4 X 10(-3) d kg-1. The values of the transfer factor cow meat/feed obtained for different muscle cuts and organs (excluding thyroid) ranged between 3.0 X 10(-4) (kidney) and 5.4 X 10(-2) d kg-1 f.w. The transfer factors pig thyroid/milk (as pig feed) and pig thyroid/cow feed exhibited values of 1.2 and 8.7 X 10(-3) d kg-1 f.w., respectively.

Animal Feed↗

Long-term transfer of I-129 into the food chain.

To investigate the transfer of Iodine-129 along the feed-animal-milk-pig thyroid pathway under conditions of short- and long-term contamination, two feeding experiments with dairy cows were carried out. Pasture grass radiolabelled with I-129 via root uptake was used as labelled feed in both experiments. During the first experiment the transfer of I-129 from feed to milk and the effective removal half-life of I-129 in the milk were determined after constant doses of I-129 in the labelled grass had been administered for a period of 8 days. In the second experiment the long term transfer of I-129 from feed-to-milk-to-cow-meat and to pig thyroid gland was followed for a period of 53 days. The pig was used because of the physiological similarity between pigs and humans. The effective half-life for removal of I-129 from milk was found to be 1.6 days. The values for the transfer factor from feed-to-milk (in units of day kg-1) resulting from the 1st assay ranged between 1.0.10(-3) and 1.7.10(-3). The long term feeding experiment exhibited a middle value for the transfer factor of 2.4.10(-3). The transfer factors pig thyroid/milk (as pig feed) and pig thyroid/cow feed exhibited values of 1.2 and 8.7.10(-3) respectively.

Animal Feed↗

Effective prophylaxis of recurrent urinary tract infections in premenopausal women by postcoital administration of cephalexin.

A total of 31 sexually active premenopausal women, prone to have recurrent urinary tract infections but who otherwise were healthy, underwent postcoital prophylaxis consisting of a single oral dose of 250 mg. cephalexin. While 127 urinary tract infections occurred in these patients during a mean of 6 months before treatment, only 1 occurred during a mean of 12 months after postcoital cephalexin prophylaxis. This difference was statistically highly significant. Each of these patients ingested approximately 120 cephalexin tablets per year of postcoital prophylaxis. Postcoital oral cephalexin prophylaxis is highly effective in the prevention of recurrent urinary tract infection in the nonpregnant as well as pregnant premenopausal women because of easy compliance, the high urine concentration achieved and the minimal induction of resistance to cephalexin in the introital gram-negative bacterial flora. Postcoital cephalexin prophylaxis achieves identical results to daily cephalexin prophylaxis but uses only a third of the tablets required in the daily regimens. Finally, cephalexin represents an additional valuable antibacterial drug in postcoital prophylaxis along with cotrimoxazole, nitrofurantoin and cinoxacin.

Adult↗

Can extracorporeal shock wave lithotripsy eradicate persistent urinary infection associated with infected stones?

Infected renal stones can be treated by extracorporeal shock wave lithotripsy but it still is not clear whether successful stone fragmentation and the disappearance of all macroscopic stone fragments guarantee eradication of the infection. Therefore, a prospective study was done in 135 patients with renal or upper ureteral stones associated with persistent urinary tract infection. The urinary infection was localized in each patient by bilateral ureteral catheterization. Upper tract infection in the kidney containing the stone was found in 75.6 per cent of the cases. A total of 94 patients completed treatment with extracorporeal shock wave lithotripsy and were followed for 3 to 16 months (mean followup 6.4 months). A marked correlation between the incidence of residual macroscopic stone fragments and the presence of persistent infection was noted. Of the 51 patients who became free of stones 48 (94 per cent) had sterile urine. Only 3 of the 51 patients had persistent infection in the treated kidney despite complete disappearance of the stones. In 45 of the 59 patients with stones smaller than 2 cm. (76 per cent) the infection was eradicated, whereas of the 35 with larger stones the urine became sterile in only 13 (37 per cent). We conclude that extracorporeal shock wave lithotripsy can be endorsed for treatment of small infected stones but it is inadequate for treatment of stones larger than 2 cm. unless combined with percutaneous nephrolithotripsy or chemical dissolution of the residual infected fragments.

Adult↗

Prevention of recurrent urinary tract infections in premenopausal women by post-coital administration of cinoxacin.

A total of 21 sexually active premenopausal women, prone to recurrent urinary tract infections but who otherwise were healthy, underwent post-coital prophylaxis consisting of bladder voiding and a single 250 mg. tablet of cinoxacin. While 94 urinary tract infections occurred during a mean of 7.5 months before treatment, only 8 occurred during a mean of 12.5 months after prophylaxis. This difference was statistically highly significant. A mean of 106 cinoxacin tablets per patient were administered during post-coital prophylaxis. Cinoxacin represents an additional valuable and effective antibacterial in post-coital prophylaxis of recurrent urinary tract infection in otherwise healthy premenopausal women, although it is slightly less effective than cotrimoxazole or nitrofurantoin. Effective post-coital prophylaxis requires the use of much smaller quantities of antibacterial agents than the daily use of a single tablet and in women with a high incidence of recurrent urinary tract infections it is superior to intermittent self-administered antibacterial therapy.

Adult↗

Use of internal polyethylene ureteral stents in extracorporeal shock-wave lithotripsy of staghorn calculi.

Ureteral stenting during extracorporeal shock-wave lithotripsy (ESWL) of complete staghorn calculi, using an internal polyethylene pigtail catheter, was found to be an efficient prophylactic measure against the high rate of complications in these cases. In the presence of a ureteral stent the stone fragments passed more easily into the bladder, accumulation of obstructing stone streets was prevented, and internal drainage of the urine was guaranteed. The need for auxiliary measures such as percutaneous nephrostomy, ureteroscopy or ureteral meatotomy was prevented in most cases. This prophylactic measure may turn ESWL to become the primary treatment of large staghorn calculi.

Catheters, Indwelling↗