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Biomedical subjects

H Gall

Publications and source records attributed to H Gall.

At least 91 records · Page 5Linked to original sources
PubMed1988

Erectile dysfunction due to ectopic penile vein.

A total of 86/260 patients with erectile dysfunction had venous leakage as (joint) etiology. In 5 of 86 patients cavernosography showed pathologic cavernosal drainage only via an ectopic penile vein into the femoral vein. After ligation of this pathologic draining vessel, 4 of 5 patients regained spontaneous erectability. One patient with pathologic bulbocavernosus reflex latencies needed intracavernosal injection of vasoactive drugs for full rigidity.

Adult↗
PubMed1988

Mid-term results of autoinjection therapy for erectile dysfunction.

Of over 300 patients with erectile dysfunction, 186 were selected for intracavernosal autoinjection therapy with a standardized papaverine-phentolamine mixture. A total of 156 patients performed 4,813 protocol autoinjections with a minimum of 10 and a maximum of 230 per patient. The dose that induced a full erection at the hospital could be reduced under home conditions by a mean of 35 per cent. Systemic side effects were not observed. The most inconvenient local side effects were prolonged erections in 24 patients in diagnostic use and in 3 patients in therapeutic use. There were treated easily without further consequences.

Dose-Response Relationship, Drug↗
PubMed1988

Functional evaluation of penile hemodynamics.

A multidisciplinary study was performed on 200 consecutive patients with erectile dysfunction more than 1 year in duration, which included a standardized intracavernous injection of a vasoactive substance mixture (15 mg. per ml. papaverine plus 0.5 mg. per ml. phentolamine). The multidisciplinary findings correlated well with the intracavernous dose needed for full erection. The group without pathological hemodynamic findings (36 patients) needed an average of 0.67 ml. and the group with pathological inflow (107) needed an average of 1.07 ml. In the venous insufficiency group (57 patients) only 18 achieved full erections with an average of 2.1 ml. (39 achieved tumescence only to 3 ml.). The results show that standardized intracavernous injection of a vasoactive substance mixture is a useful method to evaluate penile hemodynamics. This pharmacological test appears to be effective in the differential diagnosis of nonvascular and vascular erectile dysfunction.

Adult↗
PubMed1988

Late results after sclerotherapy of varicocele.

Percutaneous sclerotherapy is technically feasible in about 80% of patients with idiopathic varicocele. Persistence must be reckoned with in 3-5% of the cases. Sclerotherapy is a low-risk technique which can be applied on an outpatient basis in the vast majority of cases. In about 40% of the cases, an improvement of the fertility can be attained by raising the spermatozoal density; the total motility and morphology of the spermatozoa can only be slightly improved by this therapy. Percutaneous sclerotherapy is to be recommended as an alternative to surgery since it provides equally good results, is cheaper and causes hardly any complications.

Adult↗
PubMed1988

Pharmacokinetics and metabolism of epidoxorubicin and doxorubicin in humans.

Pharmacokinetics of doxorubicin (DOX), epidoxorubicin (EPI), and their metabolites in plasma have been performed in eight patients receiving 40 to 56 mg/m2 of both anthracyclines as a bolus injection in two sequential cycles. Terminal half-life and volume of distribution appeared to be smaller in case of EPI, whereas plasma clearance and cumulative urinary excretion was larger in comparison to DOX. The major metabolite of DOX was doxorubicinol (Aol) followed by 7-deoxy-doxorubicinol (7d-Aolon). Metabolism to glucuronides was found in case of EPI only. The area under the curves (AUC) of the metabolites of EPI decreased in the order of the glucoronides E-glu greater than Eol-glu, 7d-Aolon greater than epirubicinol (Eol). The AUC of Eol was half of the value in its counterpart Aol. In the case of EPI, the AUC of 7d-Aolon was twice the level of that of the corresponding metabolite of DOX. The terminal half-lives of the cytostatic metabolites Aol and Eol were similar, but longer than the corresponding values of their parent drugs. Half-lives of the glucuronides (E-glu, Eol-glu) were similar to the half-life of their parent drug. 7d-Aolon had a somewhat shorter half-life in comparison to both DOX and EPI. Approximately 6.2% of EPI and 5.9% of DOX were excreted by the kidney during the initial 48 hours. Aol was found in the urine of patients treated with DOX, whereas Eol, E-glu, and Eol-glu were detected in urine of patients treated with EPI. The cumulative urinary excretion appeared to be 10.5% for EPI and its metabolites, and 6.9% for DOX and its metabolite. The plasma concentration v time curves of (7d)-aglycones showed a second peak between two and 12 hours after injection, suggesting an enterohepatic circulation for metabolites lacking the daunosamine sugar moiety. The plasma concentrations of the glucuronides were maximal at 1.2 hours for E-glu and 1.9 hours for Eol-glu. All other compounds reached their maximum plasma concentration during the first minutes after the administration of DOX and EPI. Deviating plasma kinetics were observed in one patient, probably due to prior drug administration.

Adult↗
PubMed1988

Cell culture studies on neurofibromatosis (von Recklinghausen). VI. No increased stimulation of cell proliferation by sera from neurofibromatosis patients.

The growth-stimulating activity of sera from 10 patients with von Recklinghausen neurofibromatosis (NF-1) was compared with that of sera from 10 age- and sex-matched healthy donors. Cell cultures derived from peripheral neurofibromas and from skin biopsies of healthy persons were used as indicator cells. Stimulation of 3H-thymidine incorporation increased with the clotting time of the blood samples, reaching a plateau at about 35 h with no decline of activity during the following 48 h. There was no difference between the stimulating activity of sera from the NF-1 patients and that of sera from the healthy donors with either type of indicator cells. This held true when the indicator cells were stimulated during the exponential growth phase or when serum-starved confluent cells were exposed to the various sera. Three NF-1 strains used as indicator cells during this investigation showed a significantly less vigorous response to both types of human sera and to fetal calf serum than the respective control strains. All human sera collected after 42 h clotting time were superior to fetal calf serum with both types of indicator cells.

Blood Proteins↗
PubMed1987

[Erectile dysfunction: a multidisciplinary approach].

In 1985, a multidisciplinary investigation was carried out on 134 patients suffering from erectile dysfunction (mean age 37.5 years). The study comprised medical and sexual history, physical examination, laboratory tests, psychological interview and psychometrics, nocturnal penile-tumescence (NPT) measurements, bulbocavernosus-reflex (BCR) latency, and penile Doppler sonography. If indicated, we performed additional autoinjection of the corpus cavernosum (CCAT) with vasoactive agents, dynamic cavernosography, and bilateral selective pudendal arteriography. Thus we found an organic cause in 85% of the cases, revealing a vascular disease in 76%.

Adult↗
PubMed1987

Stop-type and shunt-type varicoceles: venographic findings.

Forty-four patients with a left-sided idiopathic varicocele were examined with bidirectional Doppler ultrasound (US), physical examination, and percutaneous retrograde venography. On the basis of the Doppler findings, the varicoceles were classified as either stop type or shunt type. On venography, the stop-type varicoceles showed only retrograde blood flow (reflux) in the testicular (internal spermatic) vein, whereas each shunt-type varicocele showed both retrograde and orthograde (i.e., physiologic) venous blood flow: First, reflux appeared in the testicular vein, then orthograde flow occurred in the deferential vein, cremasteric vein, or both. The shunt-type varicocele therefore represented a kind of venous bypass. Thus, the existence of two hemodynamically different types of varicocele as suggested initially by Doppler US is confirmed by percutaneous retrograde venography. The shunting of venous blood appears to be a precondition for medium and large varicoceles and might have some prognostic significance for subfertility associated with varicoceles.

Humans↗
PubMed1987

Idiopathic varicoceles: feasibility of percutaneous sclerotherapy.

Percutaneous retrograde venography was performed in 717 patients with a left-sided idiopathic varicocele. In 674 (94.0%), testicular (internal spermatic) vein insufficiency was proved by contrast medium reflux from the left renal vein into the testicular vein, down to the pampiniform plexus. The different venographic patterns of the testicular veins were classified into seven basic types. Five of these, comprising 624 patients, had incompetent or missing valves all along the trunk of the testicular vein. In 554 of the 624 (88.8%), sclerotherapy was performed, but such treatment was possible in only three of 50 patients with a competent orifice valve bypassed by an insufficient collateral (type IVb). In 43 of the 717 patients (6.0%), no insufficient vein could be found at all (type 0). The mean fluoroscopy time was 4.4 minutes. There were no serious complications associated with venography or sclerotherapy, and the initial recurrence rate was 9.8%. Percutaneous sclerotherapy is therefore a simple, safe, and effective treatment of testicular vein insufficiency and is suitable for almost 80% of patients with varicoceles.

Adolescent↗
PubMed1987

[2 years' experiences with cavernosal autoinjection therapy].

Between February 1985 and January 1987, 186 patients with erectile dysfunction were selected for cavernosal autoinjection therapy (CAT). After more than 4800 protocolled autoinjections and 10-230 CAT/pt., no cavernous fibrosis, penile deviation or cavernitis occurred. The only serious side effects were prolonged erections in about 10% during diagnostic and less than 1% during therapeutic use. These prolonged erections could be easily treated by puncture and aspiration of corpora cavernosa or intracavernosal injection of Metaraminol.

Drug Therapy, Combination↗
PubMed1987

[Venous insufficiency of the corpora cavernosa as (additional) cause of erectile dysfunction].

In 25-30% of the patients with erectile dysfunction, venous insufficiency is the (additional) reason for the erectile failure. Surgical procedures and prognosis depend largely on the precise localisation of the pathological drainage. The venous leakage is proven and exactly localized by a multiprojectional cavernosography, measurement of the maintainance flow and intracavernous pressure monitoring. The most reliable screening test for venous erectile dysfunction is the intracavernous application of a standardised vasoactive drug combination.

Erectile Dysfunction↗
PubMed1987

[Diagnosis of varicocele with bidirectional Doppler sonography. A contribution to the pathogenesis of varicocele].

A total of 375 patients with varicocele were examined by bidirectional Doppler sonography. Venous reflux was classified as one of two Doppler grades: spontaneous reflux and Valsalva-induced reflux. The Doppler grades were compared with clinical aspects (e.g. size) of the varicocele. Using bidirectional recording, it is possible to describe two hemodynamically different types of varicoceles (the pressure type and the shunt type). On the basis of the Doppler results the pathogenesis of varicocele can be determined. Spontaneous reflux causes the shunt type and the medium-sized and large varicocele, while Valsalva-induced reflux causes the pressure type or the stop type and the small and subclinical varicocele.

Blood Flow Velocity↗
PubMed1987

[Diagnosis of vascular impotence: comparison of Doppler sonography and arteriography].

The use of Doppler ultrasonography to examine penile arteries represents an important step in the multidisciplinary evaluation of erectile dysfunction. This noninvasive method for demonstrating the presence of arterial lesions was found to have a sensitivity of 92.6% and an accuracy of 90% when compared with selective arteriography. The necessity of performing selective arteriography can be markedly reduced in cases of erectile dysfunction by investigations using Doppler ultrasonography.

Adult↗
PubMed1987

[Intravascular pressure measurements and phlebography of the renal vein: a contribution to the etiology of varicocele].

Phlebography of the left renal vein was performed in 80 patients with left-sided varicocele demonstrating the nutcracker phenomenon. In 39 cases we could prove a compression of the left renal vein. In 10 varicocele patients additional intravascular pressure measurements were studied in both renal veins in the supine and erect position. We found no significant difference between the pressure in the left and right renal vein in the supine position: values varied with respiration. Changing from the supine to the erect position one can note a significantly elevated pressure, higher on the left side than on the right side due to the longer excursion of the left kidney. Urine investigations were done in 153 patients before and in 191 after sclerotherapy to detect protein or blood. Only in 4 patients we found proteinuria but no microhematuria. The results suggest that the aetiology of the varicocele formation is not the nutcracker phenomenon or renal vein hypertension; the predominant cause is a congenital incompetence of the valves in the left testicular vein. The driving force for the retrograde blood flow from the left renal vein into the testicular vein was the increase in pressure: in the supine position caused by respiration, the continuous reflux in the erect position caused by the hydrostatic pressure. The varicocele does not cause a congested kidney with hematuria and proteinuria.

Humans↗