[Medical check-up for the early recognition of testicular tumors].
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Biomedical subjects
Publications and source records attributed to G Staehler.
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The resistance of 2,314 bacterial strains from 1968 to 1972 was investigated drawing on case histories from the Munich University Urological Clinic. Using the disc-diffusion method 12,160 sensitivity tests were conducted with these strains against gentamicin, co-trimoxazole, ampicillin, tetracycline and chloramphenicol. The material was compiled from 35,000 individual data by means of modern electronic data processing and evaluated according to variable criteria. As expected the incidence of resistance in hospital-acquired pathogens was considerably higher than that in community-acquired pathogens; however, the resistance pattern of hosptial-acquired pathogens remained essentially unchanged from 1968 to 1972, whereas a significant increase of resistance in community-acquired infections was recorded. It can thus be concluded that the methods used in this clinic for combatting hospital infection and a more critical attitude towards anti-bacterial therapy have had positive results. An express warning is issued against unspecific antibacterial therapy which is often administered outside the clinic on the pretext of long-term therapy. In the light of the resistance situation of urinary tract pathogens, antibiotics should be used sparingly, keeping in mind the acidification of urine and the wash-out principle by means of high fluid intake.
For the first time cystoscopic argon and neodymium-YAG laser irradiation of the bladder wall using a flexible quartz fiber light guide (as described by Nath) was studied morphologically and histologically. It was seen that it is possible to control the depth of tissue removal without the risk of perforation of the bladder wall. Therefore endoscopic surgery of bladder tumors by laser radiation seems to be possible. Hydronephrosis could not be observed even after direct laser irradiation of the orifices.
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Experience in the treatment of 167 testicular tumors is reported in 164 patients who were hospitalized during the last 15 years. Seminoma patients were irradiated postoperatibely, teratoma patients since 1965 have been subjected to radical lymphadenectomy and also irradiated postoperatively if there was confirmed evidence of metastases. The total survival rate was 58.6 percent. Cytostatic therapy was used in only a few cases: convincing remission could not be observed. The favorable results so far obtained with lymphadenectomy justify the continuation of surgical treatment.
70 nonselcted patients with prostatic carcinoma underwent coagulation analysis. Sxi had typical evidence of diffuse intravascular coagulation and in 8 cases such a disorder was highly probable. In 3 patients coagulation alterations appeared only after estrogen treatment, 17 patients (24.3%) thus showed evidence of intravascular coagulation. The hemostatic distrubance was silent in all but 3 cases where bleeding occurred. Coagulation disorders were found mainly in advanced stages and poorly differentiated carcinomas. There was a much higher content of thromboplastic activity in prostatic carcinoma than in normal prostatic tissue. Heparin plays a predominant role in the treatment of the coagulation disorder. In addition to therapy of clinically maifest consuption coagulopathy heparin can be used in prophylaxis against bleeding and thrombosis in cases with clinically silent intravascular coagulation and also in estrogen treatment.
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