[Therapeutic local anesthesia in treatment of dental pulp diseases].
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Biomedical subjects
Publications and source records attributed to A Rost.
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The important role of immunological factors, HLA typing and pretransplant blood transfusion on improved kidney graft survival is well established. Additionally, graft survival depends on risk factors such as diabetes and age of the recipient. The effect of other clinical risk factors on graft survival was evaluated in 187 patients who received kidney transplants at our centre between 1970 and 1981. Graft survival according to the life table method and statistical analysis according to the logrank test revealed 4 main risk factors. Graft survival is significantly lower in type I diabetics and analgesic nephropathy, whereas it is better in hereditary and other renal diseases. Additional risk factors are coronary heart disease and repeated grafting. Time of dialysis before transplantation and age of the recipient showed no detrimental effect on graft survival.
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In this investigation, our own long-term results after kidney transplantation were compared with those in literature, and the influence of recent findings on the survival rate of patients and transplants was analyzed. In 217 kidney transplant patients, the 5 and 9-year-patient survival rate was calculated at 58% and 45% respectively. The 9-year-transplant function rate was 38%. Analogous results can be derived from collective international and European statistics. The long-term patient survival rate after successful transplantation shows better results than comparable statistics of hemodialysis treatment. Analysis of the results fractionated into the years 1970 to 1974, 1975 to 1977 and 1978 to 1981 shows a continuous improvement in the survival rate of patients and transplants. This improvement of results can be attributed to the reduction of surgical complications with increasing experience and particularly to knowledge recently gained in the field of transplantation immunology (compatibility in the HLA-A/B and -DR system, preoperative blood transfusions) and immunosuppression (reduction of steroid doses, supplementary ATG and cyclosporin A medication).
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Five patients with prostatic carcinoma (stages T3N0M0) were injected intramuscularly with 300 mg of cyproterone acetate (CPA) (Androcur-Depot) at weekly intervals. The concentrations of CPA, testosterone, LH, FSH, and prolactin in plasma after the first, third, and fifth injection were measured by specific radioimmunoassays. After five injections of Androcur-Depot, CPA levels were slightly higher than in previous determinations, suggesting that a balance between active substance release from the depot and excretion could be achieved after eight to twelve injections, with only slightly higher levels of active substance attained. Testosterone levels clearly were reduced after the first injection of CPA, but the lowest values were registered only after three injections. Plasma concentrations of FSH and LH were slightly diminished, whereas the prolactin level increased after CPA therapy.
In 70% of the patients with unilateral retentio testis the normal descended testicle shows damage in spermiogenesis too. The formation of auto-antibodies is considered as a possible cause. In rats with artificial uni- and bilateral cryptorchism, this mechanism was examined. The presence of auto-antibodies against spermatozoa could be proven by indirect immunofluorescence. After uni- and bilateral intra-abdominal displacement of the testicles, this phenomenon takes place after the 3rd month post-operatively, shows the maximum of titers after 6 months and decreases towards the 9th month post-operatively. An animal model is presented, suitable for the study of immunological processes in unilateral gonadal diseases.
A comparative analysis is presented of the results of adhesive urethrovesicopexy and the conventional suspension method according to Marshall, Marchetti and Krantz. It appears that the results are less favorable when compared to those mentioned in the literature, and no doubt attributable to the difficult differential diagnosis of stress and urge incontinence. The adhesive method supplies significantly less favorable results than the conventional method according to Marshall, Marchetti and Krantz.
As a result of successful recanalization of the vas deferens, a low pregnancy rate has been observed. The formation of auto-antibodies is considered as cause. In vasectomized and epididymectomized rats, the presence of auto-antibodies against spermatozoa was proven by indirect immunofluorescence. After uni- and/or bilateral obstruction of the vasa, the formation of antibodies against spermatozoa takes place which - after 2 months - proves to be permanent for 9 months, then showing a decreased titre. An animal model is presented suitable for the study of immunological processes in unilateral gonadal diseases.
82% of the male patients with healthy urogenital tract showed an isoelectric line in the stimulataneous EMG-derivation of the sphincter of the bladder under conditions of rest; in 18% of the males a moderate activity was present. In voluntary innervation at once an intensive electric activity of a spinle-shaped discontinuous pattern of the action potential developed in 76% of the patients. In the pressing trial in 83% of the cases a slight to moderately strong activity appeared. In contrast to the examined patients with healthy outlet of the vesicle the patients in whom an adenoma of the prostate gland or a carcinoma of the prostate gland, respectively, was present exhibited deviations from the normal pattern of the action potential, in which cases carriers of adenoma and carcinoma differed. Whether and to what extent the electromyography on the m. sphincter vesicae allows the possibility of the differentiation between adenoma of the prostate gland and carcinomaof the prostate gland in the early clinical stage shall be reserved for further examination.
On the basis of the case material of 1049 patients, the advantages and disadvantages of enucleation and the transurethral resection of the prostatic adenoma are compared. There are no significant differences in the lethality of the operation. Although at present preference is generally given to the transurethral resection, this procedure appears less favorable to us with regard to the intraoperative complications as well as late complications of urethral strictures, during long-term follow-up.
Untreated autologous compound skin (Rehn's skin flap) was used in three patients for partial replacement of the urinary bladder wall. The early postoperative results regarding the general tendency of the healing process, primary density, capacity, and functional voiding of the bladder correspond with an ideal replacement of the bladder wall. Observations of long-term controls will be reported later.
In 60 young, healthy volunteers the analgesic efficacy of 1-(m-methoxyphenyl)-2-(dimethylaminomethyl)-cyclohexan-1-ol (tramadol; Tramal), dextropropoxyphene and a commercial drug mixture (acetylsalicylic acid 200 mg; phenacetin 200 mg; codeine phosphor. 10 mg; caffeine anhydr. 50 mg; phenobarbital 25 mg) was investigated by determining the pain threshold in dental pulp. All three drugs increased the pain threshold considerably but there was no difference in the analgesic effect of the three drugs.
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Since 1967 we have been using preoperative radiation therapy for renal cell carcinoma as proposed by Riches. Radiation therapy, to include the para-aortic lymph nodes, is given in 250-rad increments four times weekly to a total dose of 3,000 rads. After an interval of three weeks following radiation therapy, we performed radical nephrectomy. The object of this preoperative treatment is devitalization of growing cells in the periphery of the tumor, thus preventing metastases and local recurrence, and and decreasing the size of the tumor and thereby facilitating surgery. In one third of the cases there is radiologically demonstrable decrease in the size of the tumor, probably secondary to obliteration of the dilated veins in the capsule. The delay of six weeks has had no adverse effect on the outcome of metastases.