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D Schultz-Lampel

Publications and source records attributed to D Schultz-Lampel.

14 recordsLinked to original sources
PubMed1999

[Pilot study on early diagnosis of renal cell carcinoma by sonography].

UNLABELLED: The goal of this study was to investigate the practicability and effectiveness of a systematic screening for renal cell carcinoma by ultrasound in the course of the established German Health Ministry screening programs. METHODS: In two centers (Mainz and Wuppertal) a screening program for renal cell carcinoma for all citizens (age > 40 years) was established. The screening was divided into two phases (time period 1 year): (1) All citizens over 40 years could attend voluntarily a cost-free ultrasound investigation. (2) A follow-up investigation for the entire screening population was provided. RESULTS: Ten thousand volunteers attended the screening program. Mean age was 60 years. Thirteen renal cell carcinomas were detected. The incidence of other findings was 15%; none of those required further treatment. CONCLUSION: Systematic screening for renal cell carcinoma by ultrasound is cost-effective and showed high acceptance and practicability in a German population. The rate of detection of renal cell carcinoma was higher than initially statistically calculated.

Aged↗
PubMed1999

[Pathophysiology and diagnosis of functional disorders of micturition].

Voiding dysfunctions secondary to failure of adequate relaxation of the striated urinary sphincter or the smooth bladder neck should be considered in children with urinary day time incontinence and/or enuresis and recurrent urinary tract infections. The urodynamic findings resemble to those obtained in neuropathic bladders, but only a minority of the children suffer from neurologic disorders or anatomical obstruction. In the majority of cases a developmental delay of the central nervous system responsible for urinary control is assumed. Behavioural disturbances play another important etiological role. Therapy is based on behavioural modification.

Child↗
PubMed1999

Neo-adjuvant and adjuvant treatment of locally invasive bladder cancer.

Since Sternberg et al. in 1985 first published preliminary results of polychemotherapy in patients with metastatic bladder cancer, it became apparent that transitional carcinoma of the bladder is highly responsive to chemotherapy. Response rates up to 70% with combination therapy regimens like methotrexate, vinblastine, doxorubicin or adriamycin and cisplatin promised that transitional carcinoma might be able to cure even in advanced stages. Chemotherapy has either been applied prior to the local treatment (such as radical cystectomy or radiotherapy) in a neo-adjuvant regimen, or after local therapy in an adjuvant regimen. Although a large number of studies have been published in the past 20 years, the role of the different chemotherapeutic approaches has not been clearly defined. Therefore, neither neo-adjuvant nor adjuvant chemotherapy can be recommended as 'gold standard' treatment for advanced bladder cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Experimental results on mechanisms of action of electrical neuromodulation in chronic urinary retention.

Sacral foramen neuromodulation--initially applied for the treatment of urinary incontinence--has proved to be effective in patients with chronic urinary retention. Thus far, the underlying neurophysiological mechanisms have not been elucidated. In an experimental study on the neurophysiological basis of sacral neurostimulation, one objective was to investigate the mechanisms responsible for initiation of micturition in chronic urinary retention. In ten female cats anesthetized with alpha-chloralose the clinical situation of sacral foramen stimulation was experimentally reproduced by isolated S2 nerve stimulation after L6-S3 laminectomy. Stimulation responses were recorded from the bladder, peripheral nerves, and striated muscles of the foot and pelvic floor. The effect of sudden cessation of prolonged S2 stimulation, during which the bladder was completely inhibited, was evaluated in 70 stimulation sequences in 5 cats. Sacral nerve stimulation induced excitatory and inhibitory effects on the bladder, depending on the frequency and intensity of stimulation. With unilateral S2 stimulation, bladder excitation was best at frequencies of 2-5 Hz and at intensities ranging between 0.8 and 1.4 times the threshold for the M-response of the foot muscle. Inhibition was the dominating effect at frequencies of 7-10 Hz and at intensities exceeding 1.4 times the threshold. Prolonged S2 stimulation above the threshold produced complete bladder inhibition during stimulation but induced strong bladder contractions after sudden interruption of stimulation, with amplitudes being significantly higher than that of spontaneous contractions preceding the stimulation. These results confirm the hypothesis of a "rebound" phenomenon as the mechanism of action for induction of spontaneous voiding in patients with chronic urinary retention.

Animals↗
PubMed1998

Bilateral chronic sacral neuromodulation for treatment of lower urinary tract dysfunction.

PURPOSE: Chronic sacral neuromodulation aims at functional restoration of selected forms of nonneurogenic and neurogenic bladder dysfunction. The original technique, as described by Tanagho and Schmidt, provides unilateral sacral nerve stimulation via an implanted stimulator powering an electrode inserted into a sacral foramen. Its drawback was that the implant failed unpredictably in some patients despite previous successful percutaneous test stimulation. Therefore, we modified the stimulation technique to improve the efficacy of chronic sacral neuromodulation. MATERIALS AND METHODS: Guarded bipolar electrodes powered by an implantable neurostimulator were attached bilaterally directly to the S3 nerves through a sacral laminectomy in 9 women and 2 men (mean age 43.4 years). Of the patients 5 had urinary incontinence due to detrusor hyperactivity and 6 had urinary retention from detrusor hypocontractility. Mean followup with repeated urodynamics was 13 months (range 9 to 28). RESULTS: Four significant complications were encountered in 4 patients. In 10 patients the urological sequelae of the neurological disorder were alleviated significantly (50% or more), including 5 who experienced complete relief of symptoms. CONCLUSIONS: The efficacy of chronic sacral neuromodulation can be improved by bilateral attachment of electrodes directly to the sacral nerves.

Adult↗
PubMed1997

[Enuresis].

Explore the source record for details and available documents.

Adolescent↗
PubMed1997

[Extracorporeal shockwave lithotripsy in childhood].

In general, the criteria for treatment of urolithiasis in children are the same as those for adults. Today, extracorporeal shock wave lithotripsy (ESWL) is the method of choice for treatment of most pediatric urinary stones. Stone-free rates between 57% and 97% at short-term follow-up and 57%-92% at long-term follow-up have proven the efficacy of ESWL treatment in children. So far, there is no evidence of negative side effects of ESWL treatment in children in the long-term, confirming the safety of ESWL treatment seen in the short-term results. In particular, neither induction of hypertension nor deterioration of renal function have been detected in children when limitation of shock wave energy and shock wave numbers have been carefully observed.

Adolescent↗
PubMed1996

Continent diversion with the Mainz pouch.

From 1983 until July 1994, 561 patients in 2 urology departments (Mainz and Wuppertal) underwent a Mainz pouch 1 procedure. The Mainz pouch 1 was used for bladder augmentation in 60 patients, for orthotopic bladder substitution in 61 patients, and for continent cutaneous urinary diversion in 440 patients. In the group of continent cutaneous urinary diversion, the continence mechanism applied was an ileal intussusception nipple in 270 patients, an appendix stoma in 146 patients, a submucosal seromuscular bowel-flap tube in 14 patients, and a submucosal full-thickness bowel-flap tube in 10 patients. Indications for urinary diversion were bladder cancer in 339 patients, anatomical or functional loss of bladder capacity in 179 patients, and other primary or secondary malignancies of the bladder or true pelvis in 43 patients. After a mean follow-up period of 57 months (range, 3-127 months), early and late complications were encountered in 12% and 37% of the patients, respectively. In the bladder-augmentation group, 93% of the patients are completely continent day and night. All but three patients, who empty their reservoir by intermittent self-catheterization (CIC), void spontaneously by abdominal straining. In the orthotopic bladder-substitution group, 95% of the patients are continent during the daytime. To prevent urinary leakage, 13% have to empty their reservoirs regularly at 4-h intervals and 13% have to perform CIC to avoid residual urine. Among the patients treated with continent cutaneous urinary diversion, stoma failure occurred in 11%, stoma stenosis was encountered in 13% and required open revision in 2%, endoscopical incision in 10%, and conservative treatment (dilation) in 1% of cases.

Cecum↗
PubMed1996

Urolithiasis in horseshoe kidneys: therapeutic management.

OBJECTIVES: We sought to compare the results of different therapeutic strategies in patients with horseshoe kidneys and urolithiasis. METHODS: The records of 47 patients (28 male, 19 female; mean age, 42 years) with horseshoe kidney treated for urolithiasis from 1983 to 1994 were reviewed retrospectively and follow-up studies of 38 of 47 patients were obtained after 7 to 122 months (mean, 79). RESULTS: Open surgery was performed in 6 patients with ureteropelvic junction obstruction; 1 required nephrectomy of a nonfunctioning right kidney and the other 5 are stone free. Percutaneous nephrolithotomy (PNL) was performed in 4 patients with normal drainage and a moderate to large stone burden; 3 became stone free and the other required extracorporeal shock-wave lithotripsy (ESWL) secondarily. In the remaining 37 patients with normal drainage and a small to moderate stone burden, ESWL achieved a 100% disintegration rate and a 76% stone-free rate. CONCLUSIONS: The presence of anatomic obstruction will necessitate open surgery for urolithiasis in patients with horseshoe kidney; however, in patients with normal urinary drainage PNL or ESWL can be considered, either singly or as a part of combination therapy. When management is tailored to the individual patient's needs, results of stone treatment can be equivalent to those in normal kidneys.

Adolescent↗
PubMed1995

In situ tunneled bowel flap tubes: 2 new techniques of a continent outlet for Mainz pouch cutaneous diversion.

In Mainz pouch continent cutaneous urinary diversion, introduction of the in situ tunneled appendix as the continent outlet in 1990 has simplified the surgical technique and greatly increased the acceptance of the procedure. Based on the results of long-term animal studies, 2 new techniques of a continent outlet were randomly used with a Mainz pouch 1 procedure (ileocecal pouch) in 17 patients in whom the appendix was not available or usable for construction of a continent outlet. According to the flap valve principle of the tunneled appendix, in 17 patients a small caliber conduit was created from large bowel wall at the lower pole of the cecum and was tunneled in situ under the mucosa. In technique 1 (seromuscular bowel flap tube), a tube lined by serosa was created from a pedicled island flap of large bowel wall in 11 patients. In technique 2 (full thickness bowel flap tube), a tube lined by mucosa was created from a pedicled flap of large bowel wall in 6 patients. After a mean followup of 8 months (range 2 to 17) 16 of 17 patients catheterize the reservoir at intervals of 4 to more than 6 hours using 14 to 16F catheters and are continent day and night without leakage. The only major complication in this series was incontinence in 1 patient with a seromuscular bowel flap tube who died of metastatic tumor 6 months postoperatively.

Dermatologic Surgical Procedures↗
PubMed1992

Tumor in the horseshoe kidney: clinical implications and review of embryogenesis.

We report on 3 patients with tumor in a horseshoe kidney, 1 of whom had bilateral tumor (renal cell cancer on the right side and urothelial cancer on the left side). Tumors that arise predominantly in the bridge of a horseshoe kidney can mimic the symptoms of an intra-abdominal disease process. Besides routine diagnostic procedures, angiography is essential to plan the surgical approach, which in principle should be organ-sparing. The literature of the embryology of the horseshoe kidney was reviewed for a relationship between the abnormal renal development and the site of tumorigenesis, and for development of a key for the wide variation of blood supply. Recently reported data suggest that the theory of a mechanical fusion is valid only for horseshoe kidneys with a fibrous isthmus but that an abnormal migration of the posterior nephrogenic area causes the majority of horseshoe kidneys in which the isthmus consists of parenchyma. Development of the isthmus through abnormal migration could predispose this location for renal cell cancer and would explain the varying forms of blood supply. Additionally, this hypothesis supports the previously raised assumption that horseshoe kidneys may be the result of teratogenic factors, which also may be responsible for the known increased incidence of related congenital anomalies and of nephroblastoma.

Adult↗
PubMed1991

MRI for evaluation of scrotal pathology.

Since 1986, 205 patients, age 2-84 years, mean age 33 years, with scrotal pathology were examined by magnetic resonance imaging (MRI). A 1.5-T Siemens Magnetom and specially designed external coils were used for obtaining T1- and T2-weighted images. Of these, 88 patients underwent MRI studies for suspicion of testicular cancer, and 117 for a variety of benign scrotal lesions. MRI studies yielded excellent diagnostic information of scrotal pathology: predictive value for diagnosing testicular cancer was 100% with 62% of correct differentiation between seminoma and non-seminomatous tumors. In future, the incidence of diagnostic surgical explorations of scrotal pathology can be reduced by MRI studies.

Adult↗
PubMed1991

The nutcracker syndrome: new aspects of pathophysiology, diagnosis and treatment.

Magnetic resonance imaging (MRI) was used to study vascular anatomy in 3 patients with the nutcracker syndrome and in 10 healthy volunteers. From these studies an abnormal branching of the superior mesenteric artery from the aorta was identified as being the cause of the nutcracker syndrome. Consequently, surgical transposition of the left renal vein to achieve an unobstructed renal venous backflow was performed successfully in 2 patients, while 1 underwent nephrectomy. In 1 patient adjuvant ureteral instrumentation became necessary to aid occlusion of persisting shunts between peripelvic venous varicosities and the urinary tract. Awareness of the pathophysiology of the nutcracker syndrome ensures an early diagnosis, which should be confirmed by a combination of diagnostic procedures, including MRI.

Adult↗