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Biomedical subjects

G Rutishauser

Publications and source records attributed to G Rutishauser.

At least 73 records · Page 4Linked to original sources

Absorption of oxalic acid in rats by means of a 14C method.

13 rats received a daily dose of 0.5 ml of a 1% solution of 14C-marked sodium oxalate (specific activity 29 nCi/ml) administered in one application with a throat probe. Feces and urine were collected every 24 h and the amount of 14C-oxalate was determined by liquid scintillation counting. The average distribution for 13 rats during 7 days showed 25.2% of 14C-oxalate in the urine and 73.4% in the feces. The rate of absorption is considerably higher than values given in literature (2.6--12% urine). These results indicate that in the pathogenesis of calcium oxalate stone formation some possible significance must be attributed to the exogenic oxalate.

Absorption↗

[Long-term observations on different methods of nephropexy].

In 29 patients with nephroptosis two different methods of nephropexy were compared; nephropexy using sutures passing through the parenchyma (n = 16) and nephropexy using tissue adhesives (n = 13). The first group was mobilized 3.5 days after operation, whereas the second group was mobilized one day after operation. On later follow-up 79% of the patients had no or minor complaints. Those patients who had the same disturbances as preoperatively had all been treated by nephropexy using sutures passing through the parenchyma. In 56% of this group radiological recurrence was seen, whereas in the group using tissue adhesives there was only 8% radiological recurrence. We think therefore that the nephroxepy using tissue adhesive is the simplest and least traumatic method.

Adult↗

Experimental approach to the correlation of hemodynamic changes with increases in urinary lactate dehydrogenase as a new parameter reflecting serious renal tissue damages.

From previous investigations with nephroptotic patients increased urinary LDH was assumed to be a reliable marker indicating a renal tissue defect due to the organs descent in erect position. Animal experiments now allowed correlation of this enzymatic activity with controlled changes of anatomical and physiological parameters. Changes of the renal hemodynamics or urinary flow induced in acute experiments in dogs simulated kidney displacement in nephroptotic patients. Both ureters were cannulated for separate urine collection and one kidney was manipulated. The renal arterial or venous flow was reduced or the ureter was occluded under electromagnetic blood-flow control. Arterial constriction alone (30%/15 min) selectively caused a drastic decrease (approximately 80%) of Xenon wash-out (= nutrient-flow) in the renal cortex. Under the same conditions radio-labeled microspheres injected intracardially showed a centralization of the renal capillary blood flow from the outer cortex to the juxtamedullary zone. Urinary LDH activities increased up to 800% immediately after arterial constriction. In accordance with total LDH activity the percentage distribution of isoenzymes changed: LDH-I increased and the LDH-V decreased. Neither constriction of the renal vein nor ureteral occlusion had similar effects. In long-term experiments backward fixation of one kidney in rats would reflect the effects of kidney displacement over years in nephroptotic patients: animals were unilaterally nephrectomized and the remaining kidney was dislocated backwards (approximately 2,5 vertebrae) and fixed to the lateral pelvic wall. "Ptotic" rats showed during the following examinations a constant increase of urinary LDH up to 50% by 26 weeks postoperatively. In accordance with increased LDH the isotope nephrogram was pathological and arteriographies showed a stretched and narrowed renal artery. In a number of rats "ptotic" fixation was not effective enough. All these animals showed normal LDH, isotope nephrograms and arteriographies. Both animal experiments documented that reduced flow/hypoxia is essentially responsible for the tissue damage in the kidney manifested by increased release of urinary LDH.

Animals↗

Diagnostic relevance of urinary lactate dehydrogenase determination in nephroptosis and for the indication to nephropexy.

Previously reported experiments with animals suggested that reduced renal arterial flow might be the actual cause for the pathogenicity of nephroptosis. Clinical studies now give evidence that measurements of urinary LDH may be a criterion equal to the isotope nephrogram (ING) in considering this disease. Patients with a "mobile" kidney verified by i.v. pyelography were examined by an ING and a 1-day test for urinary LDH. In accordance with periodic kidney displacement total urinary LDH activities were measured in a 8-h urine volume in the supine position and a 8-h urine volume in the erect position of the patients. Evaluations were all expressed as percentage increase of LDH activity of the patient in the erect versus supine position and correlated with his ING-pattern. Among 45 nephroptotic individuals 34 showed, in accordance with a pathological ING, a mean LDH increase of more than a 100%. Eleven individuals had normal INGs and less than 20% increase equal to a group of 16 normal controls. We postulated a 30% increase as the upper limit between normal and pathological urinary LDH. The percentage distribution of isoenzymes was also altered within the pathological LDH range: LDH-I, which increases in normal controls, now decreased in nephroptotic patients. LDH-IV and V, which decrease in controls, now increased. Homomeric isoenzymes obviously show reciprocal behavior. The degree of kidney descent in cm does not correlate with percentage increase of urinary LDH, i.e. it is not a criterion for pathogenicity. Biopsies taken during nephropexy revealed that from an anamnestic duration of 50 weeks onwards the kidney is significantly affected and tissue damages become evident. If patients were re-investigated after nephropexy they showed normal i.v. pyelograms and normal LDH and no longer had clinical symptoms.

Humans↗

[Normocalcemic nephrolithiasis and primary hyperparathyroidism].

In normocalciuric and in hypercalciuric renal stone formers tubular calcium reabsorption (TRCa) was studied before and during an intravenous calcium infusion. In addition two patients with proven primary hyperparathyroidism (pHPT) were studied. TRCa was decreased in hypercalciuric stone formers whereas an increase was noted both in pHPT and in normocalciuric subjects. It is concluded that normocalciuric nephrolithiasis may be a manifestation of mild and/or early pHPT.

Absorption↗

Rectal bladder with dorsolateral, intrasphincteric submucosal pul through of the sigmoid colon in adult bladder cancer patients. Five years later.

Report on 12 adult bladder tumor patients with cystectomy, rectal bladder and dorsolateral, intrasphincteric pull through of the sigmoid and anal colostomy (Nédélec type). Voluntary control of feces and urine was found satisfactory by most patients although urinary continence at night was not perfect. The long-term prognosis with this form of urinary diversion in patients with bladder cancer was far from satisfactory: 4 patients died of recurrent carcinoma with terminal symptoms of sepsis, but 5 patients died from primary sepsis (and not cancer) from 3 months to 4 years after diversion. It seems that this bad prognosis was due to insufficient separation of urinary and fecal passage in a group of patients, where the upper urinary tract has often already suffered as the result of earlier tumor treatment. Fewer complications might be expected with an intersphincteric pull through and perineal colostomy (Gersuny type).

Aged↗

[Prevention of thromboembolic complications in transurethral resection of the prostate (author's transl)].

1. The effect of 2 X 500 ml Dextran 70 i.v. for prevention of postoperative deep vein thrombosis in patients with transurethral resection of the prostate was investigated in a controlled, prospective and randomized study. The diagnosis of deep vein thrombosis was made by means of the 125I-fibrinogen test. 2. A total of 86 patients were studied. Two out of 47 in the control group developed deep vein thrombosis and 3 out of 39 in the dextran group. The total number of all thromboembolic complications in the control group is 19.2% as compared to 7.7% in the dextran group. This difference is statistically seen not significant. 3. Dextran prophylaxis showed no side effects. 4. A search of the literature on thromboembolic complications in urology shows the following. The incidence of deep vein thrombosis is general urology is about the same as in general surgery, i.e. every third patient develops deep vein thrombosis. There are no studies which would show that the number of fatal pulmonary emboli can be significantly reduced by any sort of preventive method in urologic patients. 5. The incidence of deep vein thrombosis in open prostatectomies is around 50%. In transurethral resection, however, this figure is between 5 and 10%. But nevertheless there are fatal pulmonary emboli. There exist no studies showing a significant reduction in the incidence of deep vein thrombosis after prostatectomy by any form of prevention. In order to avoid the postthrombotic syndrom and fatal complications, a prevention of thromboembolism seems reasonable, if this form of prevention has minimal side effects.

Adult↗

[Urogenital-tuberculosis: pathogenesis, diagnostic approach, roentgenologic pathology, staging and remarks for differential diagnosis (author's transl)].

The diagnostic tactics in the clarification of urogenital tuberculosis are referred to the changes for the individual examinations mentioned. Some tables show the results of radiological investigations on 200 patients with proved renal tuberculosis, the extend of the triple staging proposed by us being specified. In addition to expositions on the radiopathology of urogenital tuberculosis, the differential diagnosis is indicated, its focus lying in the comparsion of 118 patients with clinical-bacteriological and/or histologically confirmed non-specific chronic pyelonephritis. The comparison of patients from two 3-year groups 1959-1961 and 1971-1973 as well as between natives and foreigners shows a change in the clinical radiological picture of renal tuberculosis.

Diagnosis, Differential↗