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Biomedical subjects

H Sommerkamp

Publications and source records attributed to H Sommerkamp.

At least 19 recordsLinked to original sources
PubMed2003

[Proven and unproven hygiene measures in urology].

In urology, catheter-associated urinary tract infections are most common, and postoperative wound infections the second most common nosocomial infections. This article gives an overview of standard hygiene measures, but focuses on proven and unproven hygiene measures for preventing catheter-associated urinary tract infections and postoperative wound infections. Consistent implementation of these measures contributes to minimizing infection rates and to establishing a quality standard, whereby surveillance of nosocomial infections contributes substantially to internal quality assurance.

Antibiotic Prophylaxis↗
PubMed1999

A modified corporoplasty for treating congenital penile curvature and reducing the incidence of palpable indurations.

OBJECTIVE: To reduce the incidence of postoperative palpable induration after treating congenital penile curvature, using a modified corporoplasty technique. PATIENTS AND METHODS: In a retrospective unrandomized clinical trial, 105 patients with a congenital penile angulation of >30 degrees and for whom coitus was therefore difficult or impossible, underwent surgical correction. Of the 105 patients, 55 underwent the Nesbit-Kelâmi technique, whereby a diamond-shaped section of the tunica albuginea is excised and the defect closed with an interrupted suture. The remaining 50 patients underwent the modified corporoplasty, the edges of the tunica albuginea being brought together with a continuous, blood-tight, intratunical suture, and the end knots buried. RESULTS: The early results (<6 months) were comparable in both groups, with correction of the curvature in 94% and 95%, and postoperative complications in 14% and 15%. There were fewer postoperative haematomas in those undergoing modified corporoplasty (6% vs 18%). The late results (>6 months) also showed that these patients developed fewer palpable indurations (16% vs 44%). CONCLUSION: The modified corporoplasty reduced the incidence of postoperative haematoma and late complications (e.g. palpable indurations) after the surgical correction of congenital penile curvature.

Adolescent↗
PubMed1998

[Hemorrhagic cystitis after high dose chemotherapy. An interdisciplinary problem].

Hemorrhagic cystitis is a well known toxic and often life-threatening complication from high-dose chemotherapy with cyclophosphamide. The incidence is particularly high after allogeneic bone marrow transplantation. The morphologic bladder wall changes are associated with gross hematuria, clot formation in the bladder and problems to control the bleeding in up to 70% without preventive measures. Prevention is routinely done and can reduce but not obviate the incidence of hemorrhagic cystitis. Treatment is initiated by forced diuresis and continuous bladder irrigation. When necessary endoscopic cauterisation of bleeding mucosal areas is combined with the instillation of hemostyptic agents. Embolisation of the pelvic vessels or open surgery to control the bleeding is indicated in selected cases in a life-threatening situation.

Antineoplastic Agents, Alkylating↗
PubMed1998

Transurethral resection of cystic and non-cystic ejaculatory duct obstructions.

Ejaculatory duct obstructions are diagnosed in approximately 5% of azoospermic men and can be treated by transurethral resection (TURED) or incision of the ducts. Eight patients with azoospermia and ejaculatory duct obstructions were treated by TURED after clinical examination, semen analysis, biochemical analysis of seminal plasma, endocrine analysis, transrectal ultrasonography and testicular biopsy. In 3/3 cases of cystic and in 3/5 cases of non-cystic obstruction. TURED of the stenosis was possible. During a follow-up of 12 months there was an increase in semen volume and sperm count in 3/3 and 3/5 patients, respectively. No pregnancy was achieved during the period up to 12 months. Clinical symptoms such as haemospermia and pain disappeared in all cases. In our cases and another 98 cases of ejaculatory duct obstructions documented in the literature, men of semen quality improved in 38-60% with a pregnancy rate of men 22-31% after TURED. We conclude that there is a correlation between the aetiology of ejaculatory duct obstructions and success rate of TURED.

Constriction, Pathologic↗
PubMed1998

Anastomotic stricture after radical prostatectomy. Incidence, findings and treatment.

OBJECTIVES: Stricture of the vesico-urethral anastomosis is a well-known complication after radical prostatectomy. Dilatation, stricture incision or resection have been proposed for endoscopic treatment. METHODS: In a retrospective study of 340 patients with prostatic cancer who underwent a radical retropubic prostatectomy from 1988 until 1996, we looked at the incidence of anastomotic strictures. RESULTS: An anastomotic stricture was found in 24 cases (7%) requiring endoscopic treatment. Based on prospective X-ray studies, we were able to show that the site of stricture is located below the bladder neck musculature in most cases well above the distal urethral sphincter and pelvic floor. No continence problems were encountered following structure resection in a follow-up of 12-72 months determined by a questionnaire and pad test. CONCLUSION: The transurethral resection of anastomotic stricture allows for a rather generous tissue resection, which is preferable to incision or dilatation in our hands.

Adenocarcinoma↗
PubMed1997

Endoscopic treatment of reflux by subureteric collagen injection: critical review of 5 years' experience.

In the past decade, subureteric endoscopic injection of Teflon or collagen has been propagated as a safe and successful treatment for vesicoureteral reflux. In our center, from 1990 through 1995, 118 children and 5 adults with reflux and recurrent urinary tract infections were injected with cross-linked bovine collagen in an open, prospective study. Efficacy and safety were assessed 6 and 12 months after injection, and long-term (> or =3 years) results were available in 78 cases. The overall success rate was 58% (64% of ureteral units) free from reflux at 12 months and 54% (58%) after 3 years. Analysis of anatomic, urodynamic, and technical features showed the grade of reflux to be the best predictor of success or failure. When only primary low- and middle-grade reflux, without concomitant anatomic disorders, is considered, the long-term success rate rose to 69% (74% of ureteral units). In conclusion, subureteric collagen injection cannot ultimately replace the highly effective surgical reimplantation. However, the procedure offers a minimally invasive alternative in selected cases of mild reflux when conservative management is inadequate.

Adolescent↗
PubMed1997

Processing of tumor tissues for vaccination with autologous tumor cells.

Vaccination with gene-transfected tumor cells has recently been proposed as a new strategy in the immunotherapy of cancer. Since autologous tumor cells provide an optimal antigen profile, the possibility of generating single cell suspensions from renal cell carcinoma (RCC), malignant melanoma (MM), colon carcinoma (CC), and non-small-cell lung cancer (NSCLC) biopsies was investigated. One hundred and seventy-four tumor biopsies were processed by mechanic and enzymatic dissociation, yielding 1-2 x 10(6) cells/g tumor (median), irrespective of tumor type. Primary tumor cell cultures (PTCC) of > or = 10(7) cells were established from 29 of 86 (34%) RCC, 14 of 38 (37%) MM, 11 of 23 (48%) NSCLC and 4 of 27 (15%) CC specimens. The amount of non-tumor cells, as assessed by morphology and immunocytology, was generally low (< 30%) in RCC (35 of 41) and MM (11 of 17), while it exceeded 60% in 8 of 11 PTCC from NSCLC and 3 of 11 CC. A high tumor cell yield was obtained in biopsies with a high degree of vascularization and in the virtual absence of necrosis. Thus, PTCC > or = 10(7) cells were obtained in 73% of MM with a high degree of vascularization and in 22% of MM with a low degree of vascularization (p < 0.007). Long-term tumor cell cultures exceeding 20 passages were established in 24 of 86 (18%) RCC, 7 of 38 (18%) MM and 3 of 27 (11%) CC, while successful implantation in nude mice was achieved in 8 of 20 RCC and 5 of 10 MM. Thus, under the conditions described, > or = 10(7) primary tumor cells of high purity could be generated from about one third of RCC and MM biopsies, while the success rate increased to > 50 and > 70%, respectively, in samples with a high degree of vascularization generated by an optimized biopsy technique excluding necrotic parts.

Animals↗
PubMed1997

Ureteral xanthine calculus and aberrant umbilical artery causing ureteral obstruction.

A 30-month-old girl presented with gastrointestinal symptoms and a febrile urinary tract infection. Sonographic and radiographic imaging demonstrated left hydronephrosis due to a radiolucent ureteral stone. Surgical exploration identified an aberrant, patent left umbilical artery causing ureteral obstruction. Stone and urine analyses revealed hereditary xanthinuria that had not previously been recognized in this child and her family.

Child, Preschool↗
PubMed1995

Digitization and postprocessing of plain-film radiographs for assessment of stone fragmentation after extracorporeal shockwave lithotripsy.

In 50 patients treated for urolithiasis by extracorporeal shockwave lithotripsy (ESWL++), the radiographs taken before and 1 day afterward were initially assessed by conventional radiography and subsequently after standardized digitization and postprocessing. Clinical outcome and passage of stone fragments were reevaluated 3 weeks after ESWL. Using specially developed software routines, new disintegration parameters could be obtained by detecting the number of relevant minima in light-intensity distribution along the length axis of the concrement in digitized images. Comparing the digitized images before with those after ESWL, the concremental surface and axial length in digitized images on average showed no statistically significant difference. However, the number of visually and automatically detected light-intensity minima of the concrement region in digitized images obtained 1 day after ESWL was significantly higher than prior to ESWL and correlated significantly with the number of fissure lines in the conventional images. These new features in digitized images showed a high sensitivity in predicting later passage of stone fragments. Moreover, in six of the seven patients without detectable fissure lines in the early conventional radiographs but obvious signs of concretemental disintegration 3 weeks after ESWL, there was an increase in the number of light-intensity minima in the digitized images 1 day after ESWL. Our findings indicate that this method of digitization and post-processing of radiographs may improve the assessment of ESWL effectiveness by improving standardization in the analysis of all surveyed parameters and by offering new relevant disintegration measures.

Adult↗
PubMed1994

Intravesical idarubicin--a phase-I study.

In the scope of a pharmacokinetic and dose-finding study 33 patients received instillations of idarubicin in 11 different doses 1 h before scheduled transurethral resection of bladder cancer. The dose was increased continuously from 5 to 30 mg and the concentration from 0.25-1.5 mg/ml. Idarubicin uptake into tissue was measured along with the serum level. The results showed a clear correlation of the tissue levels with dose and concentration. A significantly higher concentration of idarubicin was measured in the tumor in comparison with the mucosa. Absorption into the muscle was minimal and serum levels were low. Systemic toxicity was not observed, but there were signs of local toxicity in 50% of the subjects. Cytotoxic concentrations in the mucosa were reached at doses of over 15 mg and concentrations of over 0.5 mg/ml. A phase-II study is in preparation.

Administration, Intravesical↗
PubMed1991

[The combined radiation and hormonal therapy of prostatic carcinoma: a conceptual analysis].

The concept of a combination of radiotherapy and hormonal therapy for the treatment of locally advanced carcinoma of the prostate was evaluated in view of an improved success rate compared to radiotherapy alone. At present, however, radiotherapy still remains the central mode of therapy in the treatment of the local tumor. The time sequence in a combination with hormonal therapy is of importance. Antecedent hormonal treatment can reduce tumor size, thus improving local conditions for percutaneous--and especially interstitial--radiotherapy; it is indicated in patients with voiding problems. An improvement in survival rates has so far not been achieved, however, local tumor remission rates are better. With concomitant hormonal therapy, compared to radiotherapy alone, tumor progression rates are lower. It remains to be seen, whether these results can be improved by using newer pharmacological ways of androgen blockade. The application of androgen withdrawal as a secondary measure with local tumor persistence or progression after radiotherapy remains a palliative treatment of limited efficacy. Due to the heterogeneity of the available study reports and the concurrent lack of controlled, randomized trials, a conclusive evaluation of the concept of combined radio- and hormonal therapy of prostatic cancer is as yet not possible.

Combined Modality Therapy↗
PubMed1990

Side-effects of extracorporeal piezoelectric shock wave lithotripsy (EPL).

In the Department of Urology, University of Freiburg, West Germany extracorporeal piezoelectric shock wave lithotripsy (EPL) has been used in the treatment of urinary and biliary stones since November 1987. The first 85 treatments (in 71 patients) for renal stones were evaluated with regard to complications and side effects. There was no need for any anesthesia. Urinary obstruction was observed in 12% of the cases. Aside from the urinary obstruction and urosepsis (2%) no serious complications were seen. Endourological auxiliary measures were applied in 32% (27% prophylactically). The temporary glomerular damage which appeared in some patients vanished within 6 days after treatment. Because of possible asymptomatic ureteral obstruction a close follow up by ultrasound is recommended. EPL was found to be a useful method of treatment for renal calculi with few side effects.

Female↗
PubMed1990

Intracavernous drug delivery system: an alternative to intracavernous injection in the treatment of impotence?

In 6 monkeys, the feasibility of chronic intracavernous drug application via a permanent intracavernous catheter was examined. In 4 monkeys, a combination of papaverine (15 mg/ml) and phentolamine (0.5 mg/ml) was injected via the drug delivery system; in 2 monkeys each, 30 or 100 injections were done. As a control, saline was injected in 2 monkeys. The dose of the papaverine-phentolamine mixture to induce full erection had to be increased by a mean of 240%, comparing the 1st to the 30th injection. The dose then remained stable. After 100 injections, penile histology showed a thin fibrotic layer around the implantation site of the catheter. Beside slight smooth muscle hypertrophy in the papaverine-phentolamine group, there were no abnormal findings in the proximal and medical part of the cavernous bodies. The distal part of the cavernous bodies showed extensive fibrosis due to mechanical irritation by the tip of the intracavernous catheter. Given appropriate selection and indication, implantation of an intracavernous drug delivery system may be an alternative to chronic intracavernous injection in the treatment of impotence.

Animals↗
PubMed1990

[Incidence of hemorrhage following suprapubic Cystofix puncture using a new trocar-cannula combination--a randomized, prospective comparative study].

In this study a new trocar-cannula-unit(10 French) is introduced, which was used in a prospective randomised comparative study in 74 patients for suprapubic bladder punction. Another 75 patients served as controls receiving a suprapubic punction with the standard Cystofix (French 10)-system. In the control-group 9 cases (12%) of macrohematuria occurred. On the other hand we found that the incidence of macrohematuria was reduced to 5 cases (6.8%), when using the new trocar-cannula-unit, which had been developed in our hospitals.

Adult↗
PubMed1989

Intra-individual comparative study of dynamic and pharmacocavernography.

A series of 65 consecutive patients with suspected venous leakage as a cause of their erectile dysfunction underwent dynamic and pharmacocavernometry/cavernography. This comparison of methods for diagnosing venous leakage produced divergent findings in 25/65 patients (38.5%). Because of its theoretical advantages, pharmacocavernometry/cavernography is recommended for the diagnosis of venous leakage.

Blood Flow Velocity↗
PubMed1989

[Limited therapy of prostatic cancer].

When considering treatment options for localized prostatic carcinoma without surgical excision of the tumor, the following aspects have to be considered: tumor stage, age of the patient, surgical risk and personal attitude of the patient towards the suggested treatment plan. The function of the prostate as an exocrine gland can not be conserved by any method aimed at cure. Predominant goal is the eradication of the tumor, and in metastatic disease delaying the tumor progression. Inadequate local tumor control is associated with a poor prognosis. Refined radiotherapeutic techniques are expected to improve local results. Radical surgery is not organ-conserving, but offers immediate information on the completeness of the tumor excision. In principle, the method which yields a higher success rate in tumor control disregarding aims at organ conservation should be preferred.

Brachytherapy↗
PubMed1989

Therapy and prognosis of carcinoma of the renal pelvis.

Forty-eight patients with carcinoma of the renal pelvis were treated between 1976 and 1986. 77% (n = 37) underwent nephrectomy; 4% (n = 2) open biopsy; 8% (n = 4) organ-preserving surgery, and 11% (n = 5) were treated conservatively. Major complications associated with the nephrectomies included: hemorrhage (11%); pulmonary embolism (5%); abscess (5%); ileus (5%), and pneumonia (5%). There was no postoperative mortality. Grade-III carcinoma, advanced tumor stage (T4N+M1), and generalized urothelial cancer worsened the prognosis. Such patients might benefit from adjuvant therapy.

Adult↗