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D Ackermann

Publications and source records attributed to D Ackermann.

69 records · Page 4Linked to original sources
PubMed1987

Urothelial carcinogenesis and portocaval anastomosis in the rat.

Portacaval anastomoses were performed in the rat to study urothelial carcinogenesis in this model and the promoting effect of dietary tryptophan. We were unable to produce any urothelial cancers or premalignant changes; some animals formed uric acid stones and developed papillary hyperplasia in the bladder. We conclude that the initiating carcinogen is likely to be exogenous and may be dietary in those experiments that have produced urothelial cancers.

Animals↗
PubMed1987

Bilateral testicular germ cell tumors: a report of 20 cases.

Of 412 patients with unilateral testicular cancer 20 (4.3 per cent) suffered a second primary germ cell tumor: 1 had a simultaneous bilateral tumor and in the remaining 19 the second tumor was diagnosed after an interval of 2 months to 32 years. Patients with clinical stages III and IV disease were found only in the group with a second tumor. In 5 patients known risk factors for the development of testicular tumors were found and in 2 prior testicular biopsies showed carcinoma in situ. Effective chemotherapy was used more often in the treatment of the second primary tumor. Of the 20 patients 18 (90 per cent) are free of disease after a mean observation of 5.7 years. A long followup of testicular cancer patients with sonographic evaluation of the remaining testis as well as periodic self-examination by the patient is required.

Adult↗
PubMed1987

Urethral reconstruction in females.

The report of 4 female patients operated on for severe functional impairment of the urethra gives rise to a historical review of the development of bladder flap procedures. Two patients had urethral reconstruction with a rotary bladder flap and 2 patients had urethral lengthening according to Leadbetter. Indications, mechanisms of continence and technical aspects of both procedures are discussed.

Adult↗
PubMed1986

Preoperative preparation of the bowel for urological surgery: a review.

The risk of postoperative complications following opening of the intestine can be reduced by lowering the intraluminal bacterial count. The latter is achieved principally by decreasing the mass of the gut content and by antibiotic prophylaxis. Macroscopically satisfactory decontamination of the gut can be attained with laxatives, enemas, elementary diet or orthograde lavage. We prefer oral lavage with Golytely solution since it allows rapid preparation of the gut and is well tolerated. The value of antibiotic prophylaxis in association with operations on the colon or rectum is undisputed and a number of regimes have been shown to be effective. In view of its effectiveness and lack of side effects. 24-hour perioperative parenteral prophylaxis with metronidazole can be recommended.

Digestive System↗
PubMed1986

[Treatment of superficial tumors of the bladder with bacillus Calmette-Guérin].

In a prospective study 21 patients with superficial bladder tumors were treated with BCG and examined as to compatibility and effectiveness. The BCG treatment was according to Morales with 6 intravesical applications in weekly intervals, 120 mg BCG each, and skin scarification with 5 mg on the thigh at the same time. A BCG viable vaccine of the Pasteur Paris strain (immune BCG PasteurFR) was used. 15/21 patients (71%) complained of dysuria and frequency, 10/21 (48%) reported fever. No patient stopped the treatment because of side effects, no tuberculostatic medication was needed. Within 3 months 12/16 patients (75%) with carcinoma in situ were endoscopically and cytologically free of tumors, no recurrencies were observed during the median follow-up time of 11 months. In only one of the 5 patients with papillary tumors did a complete remission occur. The 4 patients with treatment failure had multifocal papillary tumors. The intravesical application of BCG can be recommended for the treatment of carcinoma in situ. The results obtained with papillary tumors are not satisfactory, the transurethral resection remains the preferred treatment for this disease.

Ambulatory Care↗
PubMed1984

[Practical experiences with antegrade local chemolysis of struvite/apatite, uric acid and cystine calculi in the kidney].

In 18 patients (20 kidneys) with struvite/apatite-, uric acid- and cystine stones antegrade local chemolysis was performed via percutaneous or operative nephrostomy. Complete stone dissolution was achieved in 11 kidneys, while in six kidneys partial dissolution of stones was performed. In these six cases added instrumental manipulations shortened the time of therapy. In three cases chemolysis was unsuccessful. Average irrigation time was 21 days per renal unit. Only minor complications like dysuria and skin rashes were seen. Due to long time of irrigation we recommend chemolitholysis mainly as an additional form of therapy in case of residual stones after operative or percutaneous nephrolithotomy.

Acetylcysteine↗
PubMed1984

[Reconstruction of the urethra in women using a bladder flap].

Three patients have been successfully operated with bladder flap procedures for severe functional impairment of the urethra. In two cases total urethral reconstruction was established with a rotary flap (= inverse Boari flap). The third case with recurrent incontinence and instable pelvis was cured by lengthening the urethra analogous the Leadbetter technique. Using a rotary bladder flap tube the whole urethra can be reconstructed. Continence is achieved without suspension procedure of the urethrovesical junction. The neomeatus urethrae internus should be placed as low as possible without injury to the bladder plate. Care must be taken to the blood supply because of the risk of flap necrosis. In case of good blood supply the one-stage urethral reconstruction is recommended.

Adult↗
PubMed1983

Obstructive uropathy: frusemide test and analysis of renographic curve patterns.

49 patients with clinically proven uropathy and 14 others suffering from nephropathy underwent quantitative 131I-OIHA renography, combined with a frusemide provocation test. In significant obstruction, diuresis reaction was typically less than 5% (predictive value of a positive test 76%). The renographic curves, derived from the renal cortex and from the pyelon were diverging, with the pelvic curve showing a continuous rise (predictive value of a positive test for the curve pattern analysis 92%). Non-obstructive dilatation of the urinary system was characterized by a high diuresis index (greater than 15%) (predictive value 82%). The curve pattern was plateau-like before and showed a converging course of cortical and pelvic activity spontaneously, at least after diuresis provocation (predictive value 75%). Nephropathy alone could exceptionally mimick both significant obstruction and non-obstructive dilatation. Qualitative renographic curve analysis combined with diuresis provocation renders a higher diagnostic yield regarding the dynamic state of questionable uropathy than either test alone.

Adolescent↗
PubMed1980

[Management of liver cell adenoma and focal nodular hyperplasia].

Since 1975 six cases with hepatic adenoma (5 females, 1 male) and five cases with focal nodular hyperplasia (3 females, 2 males) have been treated at our hospital. Four of the five women with hepatic adenoma took oral contraceptive pills before the diagnosis was made, only one patient took the pills in the group with focal nodular hyperplasia. Hepatic adenomas were resected electively in three patients; one patient underwent operation because of ruptureed adenoma with intraabdominal hemorrhage. In the other two cases with hepatic adenoma resections were not possible, but both tumors have regressed after the cessation of oral contraceptives. One patient in the group with focal nodular hyperplasia underwent liver resection because of intratumoral hemorrhage with recurrent pain; in the other four cases no treatment was done as symptoms were absent. We recommend elective resection for hepatic adenoma because of the high risk of spontaneous ruptur. Embolization or ligation of the hepatic artery are alternative procedures when resection is not possible and tumors do not regress after the cessation of oral contraceptives. On the other hand a more conservative attitude is suggested for focal nodular hyperplasia because those patients do not frequently bleed; resection is indicated in case of symptoms or growth of tumor.

Adult↗
PubMed1979

[Renal hypothermia in situ. Comparison between surface and perfusion cooling concerning renal function in pigs (author's transl)].

There are 2 competing methods for cooling the kidney in situ during surgical ischemia: from without by applying ice to the renal surface and from within by perfusing the renal artery. The latter procedure is said to be superior in protecting renal function. Herein the protective effect on renal function of both methods are compared. Pigs of 15--25 kg weight underwent nephrectomy on one side. The remaining kidney was subjected to cold ischemia during 90 minutes while perfusion- or surface cooling was performed. For perfusion cooling the aorta was punctured and the catheter introduced into the renal artery. The perfusing liquid consisted of a physiologic electrolyt solution (Ringer-Lactate) with heparin kept at a temperature of 3--5 degrees C. The initial perfusion lasted 10 minutes and resulted in a median renal core temperature of 23 degrees C. Then the kidney was put on a cooling pad and every 15 minutes again perfused for one minute. For surface cooling sterile melting ice made of glucose solution 5% was applied directly to the kidney. The renal core temperature could be kept at 15--20 degrees C. The two methods of hypothermia were judged by comparing the serum creatinine levels and the I131-hippuran clearances one month after surgery. There was no difference whatever as analysed by the t-test. Hypothermia by applying ice to the renal surface therefore proved to be equivalent to hypothermia by perfusion. Moreover it is much simpler.

Animals↗
PubMed1979

[Turning-point of the bowel preparation?].

The whole-gut irrigation more and more carries through to be a favourite method for preoperative large bowel preparation. In 1975 it was used only by 3 hospitals in Switzerland, which resulted from our investigations about large bowel preparation. This new procedure brings advantages such as complete cleaning of the gastrointestinal tract, shortening of the preoperative hospitalisation time, retarded beginning of postoperative bowel function, no catabolic situation of patients' metabolism at operation-day, good compatibility and simple handling, according to our experience with 75 cases. There are not any disorders of the fluid and electrolyte balance except a small intake of water without clinical importance. The indication for whole-gut irrigation is given in all patients, who are subjected to an operation on the colon and rectum except the emergencies. Ileus, toxic megacolon and perforation of the large bowel are considered absolute contraindications. Severe large bowel stenosis, cardiac and renal insufficiency are relative contraindications only.

Humans↗
PubMedDate not supplied

Respiratory function in chronic hemiplegia.

Dynamic spirometry was examined in 23 non-smoking hemiplegic patients after the acute phase. The decrease of slow inspiratory forced capacity is related to motor impairment and does not vary with time. The forced inspiratory and expiratory vital capacities are similar to the slow inspiratory vital capacity in the first 6 months of the disease, but significantly decrease later independent of the motor impairment. The peak expiratory flow is highly variable but is clearly decreased, and is related to motor impairment. These results point to a restrictive respiratory syndrome due to mechanical limitation of thorax excursions caused by weakness, hypotonicity, and incoordination of the trunk musculature. The importance of long-term physiotherapy of the trunk is emphasized.

Adult↗