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Biomedical subjects

H Melchior

Publications and source records attributed to H Melchior.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Ureter replacement operations].

Reviewing the recent literature and own clinical experiences, the possibilities of replacement of the ureter by isolated bowel segments, alloplastic prostheses and xenoplastic or autoplastic transplants are shown and evaluated. Although used only in single cases, the interposition of the appendix vermiformis into larger defects of the ureter seems to render the best results. The interposition of bowel segments in the urinary tract has been applied more often, the results, however, have been variable. Numerous modifications have been proposed. The use of alloplastic prostheses and free autologic transplants have--up to now--led to no satisfying long-term results. Only human deep frozen umbilical veins as xenotransplants seem to be suitable as ureter replacements.

Appendix↗
PubMed1987

[The physiology of penile erection. I. Hemodynamics of penile erection].

Arterial and venous flow and pressure studies of the corpora cavernosa were performed to elucidate the hemodynamics of canine penile erection. Being able to induce erection by electrical stimulation we were able to study the functionally relevant parameters at different stages of penile erection. From our results we conclude that penile erection can be subdivided in 5 phases: (1) latent-, (2) tumescence-, (3) erection-, (4) rigidity- and (5) detumescence phase. Furthermore, a differentiation of these subdivisions is made by observing at the mechanism of the 5 different stages: phase 1 to 4 is an active phenomenon, the detumescence phase is passive only.

Animals↗
PubMed1987

[The physiology of penile erection. II. Neurophysiology of penile erection].

Selective cavernous and pudendal nerve stimulation enabled us to study the neurophysiologic-/neurovascular mechanisms of penile erection in 6 monkeys. Corporeal pressure recordings during different neurostimulation patterns demonstrated that tumescence and erection are controlled by the autonomic nervous system (Nn. cavernosi) and has to be understood as the vascular phase of erection. However, rigidity is related to the muscle tone of the striated bulbospongiosus and ischiocavernosus muscles which are innervated by somatomotoric fibers of the pudendal nerve. This mechanism is defined as the muscular phase of penile erection.

Animals↗
PubMed1986

[Urinary retention in herpes zoster].

We report on 4 cases of transient neurogenic dysfunction of the urinary bladder caused by herpes zoster. All patients noticed a slow urinary stream leading to complete urinary retention and loss of sensation following the vesicular stage of herpes zoster, necessitating the insertion of a suprapubic tube. Urodynamic evaluations revealed a detrusor acontractility, cystoscopic findings included a unilateral cystitis. Symptoms and residual urine spontaneously disappeared after 2 to 3 weeks. The cause is a sacral meningo-radiculitis with herpes zoster virus leading to a transient neuromotoric paralysis of the urinary bladder.

Cystoscopy↗
PubMed1986

[Neurotherapy of the hyperactive bladder].

Results in the treatment of non-neurogenic bladder hyperactivity are unsatisfactory. However, the first promising results from neurostimulation and our own findings in the neuroanatomy and neurophysiology of the lower urinary tract have led us to consider peripheral neurostimulation of the S2 - dorsal root or dorsal nerve of the penis for treating patients with hyperactive bladder dysfunction. We report on the first 14 cases treated by peripheral neurostimulation and S2-dorsal root blockade with local anesthesia for bladder hyperactivity. The bladder function became normal, and the bladder capacity increased up to 400% under neurotherapy. The methods, results and complications are discussed.

Adult↗
PubMed1986

[Ileocystodynamics: urodynamic studies of the continent ileal bladder].

The continent ileal bladder represents a combination of the Kock-Pouch and enterocystoplasty (Couvelaire-Camey): a continent intestinal urinary reservoir with antirefluxive nipple-ureteroileostomy and continence providing ileourethrostomy. Urodynamic investigations demonstrate the time dependent increase of maximal capacity and compliance reaching "normal"-bladder values in comparison to corresponding age groups within 4 months. The continent ileal bladder meets all requirements for bladder substitution including low-pressure reservoir function with reflux prevention, maintained continence and controlled voiding per viam naturalem.

Compliance↗
PubMed1984

[Panurography -- a new method of combination excretory and micturitional urography].

To diagnose a vesicoureteral reflux, a new examination X-ray procedure was developed avoiding bladder catheterization: panurography. Panurography is a combination of excretion and micturition urography which for screening purposes can be performed in a single investigation without bladder catheterization. Recent advances in uroradiological imaging techniques with growing application of low-dose large-format image intensifier urography (14" image intensifier) not only reduce radiation exposure to less than 20% of that in conventional film-screen radiography, but also permit obtaining voiding cystograms which include the whole urinary tract from the kidneys to the urethra in children. Voiding conditions are improved by means of a comfortable micturition seat coupled with a uroflowmeter which automatically triggers exposures by a 10 cm-camera at preselected intervals as long as a measurable urine flow exists.

Adult↗
PubMed1983

[A urological x-ray study table with a 36-cm x-ray image intensifier].

The described urological table with 14" (36 cm) image intensifier represents a new concept. Instead of the conventional technique, i.e. fluoroscopy with a 9" (23 cm) image intensifier and radiography with film-screen combinations in a cassette, all X-ray diagnostic work is done with a 14" (36 cm) image intensifier and a 100 mm spot film camera. Field size of the X-ray image intensifier as well as spot film image quality are satisfactory to replace the conventional radiographic technique. The radiation exposure of patient and examiner is reduced significantly by the spot film technique. Omission of conventional radiographic technique allows reduction of table length to 100 cm instead of the conventional 140 cm. Furthermore, the new urological table facilities the anaesthesist's access to the patient.

Equipment Design↗
PubMed1983

[Drug therapy of detrusor dysfunction].

In a urodynamic study, the effect of carbachol, distigmine and prostaglandin-F2 alpha on neuropathic detrusor areflexia and on the non-contracting detrusor as well as the effect of scopolamine, emepronium bromide and flavoxate on the idiopathic unstable bladder and neuropathic detrusor hyperreflexia were examined. Carbachol and distigmine do not have any effect on detrusor contractility but reduce the bladder capacity by decreasing the detrusor compliance. The instillation therapy by prostaglandin-F2 alpha provokes detrusor contractions in some cases of non-contracting detrusor. Emepronium bromide and flavoxate therapy of the idiopathic unstable bladder and neuropathic detrusor hyperreflexia showed improvement of the subjective symptoms, but not of the urodynamic findings. The oral therapy of scopolamine has no effect on overactive detrusor function. Treatment of the idiopathic unstable bladder by prolonged detrusor distension with the aid of peridural anaesthesia showed satisfactory results in more than 50%.

Adult↗
PubMed1981

Three-dimensional intraoperative stone localization.

The technique of three-dimensional intraoperative stone localization is based on the geometrical laws of stereoscopic photography. While the horizontal stone position is determined conventionally from the situation of the stone images in relation to the X-ray markers, the vertical stone position can be calculated from the diameter of the kidney, the projection distance between the double images of the concrements and the projection distance between the double images of the marker. A new small X-ray unit with a collimator attached to a tripod with counterbalance guarantees optimal intraoperative handling as well as constant X-ray exposure data and easy focusing.

Humans↗