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Biomedical subjects

M Marberger

Publications and source records attributed to M Marberger.

At least 199 records · Page 11Linked to original sources
PubMed1988

Experimental testicular torsion: effect on endocrine and exocrine function and contralateral testicular histology.

In order to investigate whether unilateral testicular torsion exerts a negative influence on the previously undisturbed contralateral side, exocrine and endocrine testicular function were evaluated before and two months after torsion. A rat model with 6 hours', 12 hours' or permanent extravaginal 540 degrees torsion of the right testis was used; a sham operated group of animals served as controls. Ejaculates were collected by electrostimulation; LH, FSH and testosterone serum levels were determined by radioimmunoassays. Eight weeks after torsion sperm output had decreased by half in the experimental groups, and LH levels increased significantly, whereas the other hormone levels, as well as the controls, remained unchanged. Morphometry of the contralateral testis revealed no alterations except a significant increase of the Leydig cells and interstitial cells in some subgroups. All observed changes correlate with the functional loss of one testis; definite evidence for contralateral damage was not observed.

Animals↗
PubMed1988

Intracavernous injection of prostaglandin E1 in impotent men.

Intracavernous injection of prostaglandin E1 was used in 210 men as a screening test for the differential diagnosis of vasculogenic impotence. Of these 210 patients 112 entered an autoinjection protocol for treatment of erectile dysfunction. Prostaglandin E1 appears to be effective in the diagnosis and treatment of nonvasculogenic impotence because it is a physiological agent that is metabolized locally within the cavernous tissue. Additionally, in our series neither systemic reactions nor priapism occurred, nor was fibrosis of cavernous tissue or scar formation observed after up to 90 injections.

Alprostadil↗
PubMed1988

Painless piezoelectric extracorporeal lithotripsy.

A total of 693 stones in 438 renoureteral units from 426 patients 4 months to 84 years old was treated with a mobile piezoelectric lithotriptor using ultrasound stone localization. Of the units 37 per cent had solitary stones smaller than 1.5 cm. in diameter, (group 1), 32 per cent had multiple stones up to this size (group 2), 21 per cent had stones 1.6 to 2.5 cm. in diameter (group 3) and 10 per cent had calculi larger than 2.5 cm. in diameter (group 4). No sedation or analgesics were necessary in 96.2 per cent of the treatments. Of all stones 97.2 per cent were disintegrated, with 39 per cent of the units requiring repeat treatments usually on an outpatient basis. Of the patients 82 per cent had transient hematuria, 6 per cent had fever and 28 per cent temporarily took some type of analgesics within the first 3 months after treatment. Nine per cent of the patients required postoperative ancillary interventions. After 3 months 92 per cent of the renoureteral units in group 1, 73 per cent in group 2, 74 per cent in group 3 and 50 per cent in group 4 were free of stones. Piezoelectric extracorporeal lithotripsy proved to be as efficient as spark-gap lithotripsy, yet it was essentially painless. Ultrasound localization permits treatment of all renal stones but it restricts lithotripsy of ureteral stones to the most proximal and distal fourths of the ureter.

Equipment Design↗
PubMed1987

Hemodynamic effects of experimental testicular torsion.

Experimental testicular torsion must be used for certain studies of clinical relevance, but most experimental models either do not provide hemodynamic alteration comparable to the clinical situation or cannot guarantee reproducibility. Using a rat model arterial perfusion and hemorrhagic infarction were correlated to the degree of both intra- and extravaginal testicular torsion. Arterial inflow was measured sequentially with radiolabelled microspheres, hemorrhagic infarction was judged by the increase of testicular weight. Maximal hemorrhagic infarction and reproducible values were found when the spermatic cord was twisted together with the tunica vaginalis for 360 degrees-540 degrees.

Animals↗
PubMed1987

Testicular cancer: prognostic implications of vascular invasion.

In a retrospective study the primary tumors of 33 patients with seminomas and 53 with nonseminomatous germ cell tumors were re-evaluated for vascular invasion. The significance of vascular invasion was analyzed in respect to the appearance of visceral metastases and the effect of adjuvant chemotherapy. Vascular invasion was demonstrated in 27 per cent of the patients with seminomas and 53 per cent with nonseminomatous germ cell testis tumors, while visceral metastases appeared in 9 and 32 per cent, respectively. Without adjuvant chemotherapy all 13 patients with nonseminomatous germ cell testis tumors and vascular invasion had metastases, compared to only 3 of 13 without vascular invasion (p less than 0.0005). Of 9 patients with seminoma and vascular invasion 3 had tumor progression, compared to 1 of 24 without vascular invasion (p greater than 0.05). With adjuvant chemotherapy only 1 of 15 patients (7 per cent) with nonseminomatous germ cell testis tumors and vascular invasion had metastases, compared to 100 per cent of 13 without this treatment. No significant correlation was noted between pT stage versus vascular invasion and pT stage versus tumor progression. The results demonstrate the importance of vascular invasion in the staging of and choice of treatment for early nonseminomatous germ cell testis tumors.

Adolescent↗
PubMed1986

Late sequelae of the management of ureteral calculi with the ureterorenoscope.

We examined 42 patients 19 to 20 months after ureteral calculi had been removed with the ureterorenoscope. All 42 patients were asymptomatic and showed no evidence of an increased rate of urinary tract infection or hypertension. An excretory urogram in 38 patients demonstrated no abnormality related to the procedure, in particular no ureteral stenosis and renal scarring. Renal sonography in the remaining 4 patients likewise was normal. Reflux cystography revealed low grade (sterile) vesicoureteral reflux in 2 patients. In view of a 92 per cent success rate in 236 renoureteral units, with serious complications in only 2 per cent, the technique can be considered safe and effective.

Adult↗
PubMed1985

Late sequelae of ultrasonic lithotripsy of renal calculi.

We examined 82 patients 12 to 43 (mean 22) months after renal calculi had been removed by ultrasonic lithotripsy. Recurrence was noted in 2 patients but this correlated to the previous stone-forming rate. Smaller fragments that had remained in 9 patients were passed in 2, removed percutaneously in 2 and unchanged in the remainder. There was no evidence of hypertension or urinary tract infection related to the procedure. There were 62 patients available for computerized tomography and 11 per cent of the kidneys showed minute calcifications not visible on plain films. Barely visible scarring was noted on the fibrous capsule posterior to the lower pole in 22 per cent of the cases and on the abdominal wall along the former nephrostomy tract in 46 per cent. However, a cortical scar was noted in only 1 kidney and no arteriovenous fistulas were found. On dimercapto-succinic acid scans it was impossible to localize the puncture site and serial 131iodine-hippurate renograms available in 18 patients showed a 7.6 plus or minus 2.8 per cent (mean plus or minus standard error of mean) increase in function. We conclude that percutaneous nephrolithotripsy with ultrasound is a safe and effective procedure with minimal late morbidity.

Adolescent↗
PubMed1985

Percutaneous coagulum nephrolithotripsy: a new approach.

Intrarenal scatter of stone fragments during percutaneous nephrolithotripsy is a complication which may predispose to post-operative pain and further stone formation. The use of a coagulum to prevent such a complication has proved difficult when introduced percutaneously. This experimental study describes a new gelatine (Lithogel) which is introduced through the nephroscope to coat the renal calculus; it allows easy disintegration of the calculus within the gel, is safe to use and effectively prevents the scatter of fragments into inaccessible calices.

Animals↗
PubMed1985

[Tissue damage during percutaneous ultrasonic lithotripsy].

The ultrasound lithotripsy for the percutaneous desintegration of renal calculi does not cause any irreversible injuries. The intensity of the ultrasound lithotriptor is clearly below the cavitation threshold. By aspiration the ultrasound probe injures the mucous membrane. A superficial oedema and submucous haemorrhages appear. Despite an amplitude of 50 mu no perforation could be obtained at the urinary bladder of the rabbit. In irrigation of the ultrasound probe with more than 20 ml disinfectant per minute a tissue-injuring heat development is prevented. In the Sister-chromatide-exchange test no mutagenic effect by influence of the ultrasound could be proved. Metal splinters are excreted with the urine. Infolded into the wall of the urinary bladder they are unchangedly to be proved after nine weeks, in contrast to the suture the histological reaction is, however, minimal.

Animals↗
PubMed1984

Late sequelae of percutaneous nephrostomy. Work in progress.

Renal scans of 36 patients were obtained with and without the use of contrast material, and a dynamic CT study was performed at least three years after percutaneous nephrostomy (PNS) to evaluate the late effects of that procedure on kidney morphology and function. Only one kidney showed a cortical scar (1 X 1 X 1 cm in size) at the puncture site, and there were no signs of a loss of renal function or of alterations of the collecting system. Eight kidneys demonstrated slight capsular fibrosis at the puncture site, three were displaced posteriorly, and ten had some slight perirenal scarring around the lower pole. Overall, the morphological alterations were minimal and considerably less than those associated with open surgery. Coupled with the minimal complication rate associated with the initial PNS procedure, these findings indicate that PNS may be considered safe.

Adult↗
PubMed1984

[Endoscopic treatment of ureteral calculi].

At least 4/5 of all ureteric calculi, which until recently required open ureterolithotomy, can today be managed successfully with endoscopic techniques, in particular ureterorenoscopy and percutaneous nephrolithotripsy. Using these techniques in 131 reno-ureteral units of 128 patients a success rate of 84% was achieved, which was not influenced by the position of the stone within the ureter or the sex of the patient. With minimal morbidity and a mean postoperative hospitalization of 4.5 days only 2 patients experienced complications requiring a surgical intervention. The routine insertion of an internal double-J-ureteric stent after ureteroscopy significantly reduced hospitalization.

Endoscopes↗
PubMed1984

[Staging of adenocarcinoma of the kidney--CT largely replaces catheter angiography].

In renal adenocarcinoma (hypernephroma) CT as a rule provides the same information as angiography. Our experience is based on a collection of 61 tumour cases, divided in stages according to the TNM system. In retrospect, 39 of our own cases were investigated by CT as well as by angiography; the accuracy of both methods was tested on 33 operative findings. Prospectively 22 cases were examined by CT only and results controlled via 20 operative findings. CT is superior in the T and N stages. Usually demonstration of vein invasion is as good in CT as in catheter angiography. Metastases in the adrenals and the liver are vasible in CT. Seen from the point of view of a "non-touch procedure" (particularly to be demanded with a tumour metastasising as early as this!) the non-invasive method of CT proves especially suitable. We use CT primarily in all cases of suspicion. In singular cases CT is supplemented by further angiographic investigations, e.g. cavography. Exceptions to the topical proceedings mentioned above are a suspected tumour in a solitary kidney, and bilateral tumours. Such cases should be investigated by catheter angiography following i.v. urography and/or sonography.

Adenocarcinoma↗
PubMed1983

[The renal pelvic tumor in the sonogram].

A prospective study evaluates screening investigations of the kidneys of 2350 patients. Sonographic criteria of the renal pelvic tumour are established. So-called "indirect signs" are only recognized by the compound scanner. By these ultrasonic symptoms a pelvic tumor could be detected with 15 patients which is a frequency of 6,5%. Part of the patients were preselected. The possibility of false-negative findings remains unconsidered. The study proves the great relevancy of ultrasonography in this disease. When operations of renal pelvic carcinomas were retrospectively checked our diagnostic results were underlined.

Humans↗
PubMed1983

Is the solitary kidney a privileged kidney?

In rabbits the renal function of solitary kidneys subjected to ischaemic damage was compared with that of kidneys damaged identically in the presence of a normal contralateral organ. In spite of compensatory hypertrophy of the solitary kidney, no improvement in its tolerance to ischaemia was observed. The solitary kidney is thus not a privileged kidney.

Animals↗
PubMed1983

Renal blood flow alterations after temporary ischemia. An experimental model in the rabbit.

In an effort to investigate the efficiency of various pharmacological agents in protecting the kidney against normothermic ischemia, an animal model was developed and the post-ischemic hemodynamics in the renal cortex of rabbit kidneys were studied. Renal cortical blood flow was evaluated 5-30 min after 60 min of normothermic ischemia of the left kidney using 141Ce-, 51Cr-, and 85Sr-labelled microspheres. Control groups were subjected to sham operation. The right kidneys served as individual controls. Ischemic kidneys showed a significant weight increase independent of reperfusion. Furthermore, a transient highly significant increase of cortical blood flow was found with an absolute maximum about 10 min after termination of ischemia. This increase in cortical blood flow was paralleled by a highly significant decrease of vascular resistance.

Animals↗