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Biomedical subjects

T C Gasser

Publications and source records attributed to T C Gasser.

At least 91 records · Page 5Linked to original sources
PubMed1993

Risk of bacteraemia during extracorporeal shock wave lithotripsy.

Extracorporeal shock wave lithotripsy (ESWL) is widely used to treat urinary calculi. With increasing numbers of ESWL, more patients prone to infectious complications will be treated. However, little is known about the infectious risks of ESWL. To provide a basis for the rational use of antimicrobial prophylaxis, we studied the incidence of bacteraemia during ESWL. A total of 23 patients with urinary calculi were treated. Blood cultures (4-7 per patient) were taken before, during and immediately after ESWL, adding up to a total of 154 cultures. In 22 of these patients no bacteraemia was detected. In 1 patient small numbers of 2 different micro-organisms were found in 2 blood samples only. This finding, and the circumstances of blood collection, suggested contamination rather than bacteraemia. It was concluded that the risk of bacteraemia during ESWL is very low.

Adult↗
PubMed1993

Retroperitoneal fibrosis and chronic periaortitis: a new hypothesis.

The etiology of retroperitoneal fibrosis (Ormond's disease) has still not been clarified. A new hypothesis postulates chronic fibrosing periaortitis. Atherosclerosis of the abdominal aorta and plaque rupture lead to the liberation of oxidized lipoproteins through the adventitia into the periaortic fatty tissue. This results in a chronic inflammatory process. In support of the periaortitis hypothesis is our finding that 9 of 14 consecutively studied patients with retroperitoneal fibrosis had either proven atherosclerosis of the abdominal aorta or a high probability of this in view of multiple vascular risk factors. No patients had received previous methysergide medication.

Adult↗
PubMed1993

[Urethral strictures after extracorporeal bypass: suprapubic or transurethral catheter?].

Patients undergoing open heart surgery with the use of extracorporeal circulation (ECC) are at increased risk of developing a urethral stricture. Possible etiologic factors are ischemia and local pressure of an indwelling catheter during ECC. In a retrospective analysis, we compared 152 patients who have been treated with an indwelling urethral catheter during ECC with 148 patients who have been treated with suprapubic urinary drainage. 10 (6.6%) of the patients in the indwelling catheter group developed a urethral stricture as compared to none in the suprapubic group. It is concluded that the risk of developing a urethral stricture following operation with the use of ECC is significantly reduced with a suprapubic urinary drainage.

Catheters, Indwelling↗
PubMed1993

[Approval process of "medical devices" exemplified by the penile prosthesis].

The penile prosthesis AMS Hydroflex was successfully introduced in 1985, yet only 5 years later was withdrawn from the market. The approval process of medical devices in the USA and Switzerland is critically analyzed. While the American Food and Drug Administration (FDA) is responsible for approving the marketing of medical devices in the USA no such office exists in Switzerland. In Switzerland the physician takes full responsibility when using a device. It is, however, intended to introduce similar to the USA three regulatory control categories depending upon the degree of regulation necessary to assure safety and effectiveness of each device.

Adult↗
PubMed1992

[Malignant mesothelioma of the tunica vaginalis testis].

Malignant mesothelioma of the tunica vaginalis testis is an extremely rare tumor, with only 37 cases previously described in the literature. Treatment consists of inguinal orchiectomy with close follow-up [1]. Asbestos exposure, trauma and hydrocele have been implicated as risk factors. We describe a patient's history and the pathological findings as well as the management according to preceding reports in the literature.

Aged↗
PubMed1992

[Kaposi's sarcoma of the urinary bladder after kidney transplantation].

In 1872 the Viennese dermatologist Moritz Kaposi first described a pigment sarcoma of the skin. A modification of the epidemiology and the follow-up results in the accumulation of reports about the Kaposi-sarcoma after organ transplantation in the sixties and in the beginning of the eighties frequently Kaposi-sarcomas by the immunodefect syndrome AIDS were noticed. The incidence of Kaposi-sarcomas after kidney transplantations is estimated to be 0.3 to 1.8 per thousand. We report about a patient developing a Kaposi-sarcoma of the bladder during an immunosuppression therapy with Imurec and Sandimmun.

Adult↗
PubMed1992

[Marfan syndrome and cystic kidneys of the adult type].

For the first time Bernhard Marfan described the Marfan-Syndrome in 1896; it is a meso- and ectodermed variety with the conducting symptom of "arachnodactyly". Marfan-Syndrome is an autosomal dominant hereditary disorder with high penetrance and variable expressivity. In our opinion this case of a 41-year-old patient with kidney cysts and aneurysma dissecans of the arteria ascendens by Marfan-Syndrome was described in the literature only twice. The casuistics of this Marfan-Syndrome patient shows a particular rare associated organ-change--the kidney cysts--and illustrate the frequency of this hereditary disease.

Adult↗
PubMed1991

[Perioperative antimicrobial preventive treatment in urology].

Infectious complications following urologic surgery include bacteriuria, bacteremia, sepsis, acute pyelonephritis, and wound infection. Antimicrobial prophylaxis reduces the risk of some of these complications and is recommended in transrectal core biopsy of the prostate, transurethral surgery, open prostatectomy, and stone surgery. Prophylaxis does not appear to be beneficial in patients undergoing transrectal needle or transperineal core biopsy of the prostate, cystoscopy, orchiectomy, hydrocelectomy, and simple nephrectomy. Patients with urinary tract infection preoperatively should receive antimicrobial treatment prior to surgery.

Anti-Bacterial Agents↗
PubMed1990

Radical prostatectomy versus expectant primary treatment in stages I and II prostatic cancer. A fifteen-year follow-up.

A fifteen-year follow-up of a prospective, randomized study comparing placebo with radical prostatectomy as the primary treatment of early prostatic cancer is presented. A total of 111 patients with clinical Stage I or II prostatic cancer, normal acid phosphatase levels, and negative findings on skeletal x-ray film were evaluable. Thirty Stage I patients and 20 Stage II patients received placebo only; 31 Stage I and 30 Stage II patients underwent radical prostatectomy. The survival status for 95 patients (86%) was established at the fifteen-year follow-up. No significant differences in crude survival occurred in either stage or in both stages combined. Moreover, the survival curves closely followed reference curves based on expected U.S. mortality for men of comparable ages and races. A statistically significant association between a high Gleason histologic score and poor survival was established. In this study, initial treatment with radical prostatectomy did not yield longer survival than initial placebo treatment alone. However, the findings should be interpreted with caution, since sample size was small and staging procedure was simplified.

Adenocarcinoma↗
PubMed1989

Bladder neck suspension material investigated in a rabbit model.

Different principles for providing stable and durable suspension of the bladder neck and proximal urethral tissue are employed in endoscopic bladder neck suspension for female stress urinary incontinence. Six different anchor materials, some of which are currently used as tissue bolsters (anchors) for endoscopic bladder neck suspension, were implanted in the abdominal wall muscle of 45 rabbits. Tension on the anchors was measured and maintained by springs positioned between pairs of anchors. At two months evaluation, vascular graft and loops of suture retained 40% of the starting tension, while two sizes of screw anchors lost all tension. Silicone pads and kink free silicone tubing rapidly pulled through the tissue in 83% and 100% of the cases, respectively. Local tissue reaction with scar formation, physical characteristics of the anchor material (silicone, stainless steel, dacron or polypropolene) and cross sectional area of the anchor were identified as the important factors for anchor stabilization of tissue which has been repositioned under tension.

Abdominal Muscles↗
PubMed1988

Intracavernous self-injection for impotence: a long-term therapeutic option? Experience in 78 patients.

A total of 78 patients 17 to 84 years old reported their experience via questionnaire with the papaverine-phentolamine injection technique for impotence. The mean number of injections used was 30.7. Penile induration occurred in 13 patients (16 per cent) and it was generally of limited extent. A higher incidence of induration was observed in those with vasculogenic impotence. Prolonged erection was reported by 23 per cent of the patients, 8 per cent of whom experienced erection for more than 12 hours. Priapism occurred exclusively in diabetic patients and patients with a neurological etiology of impotence. A total of 22 per cent of the patients reported moderate to severe pain with injection, 35 per cent indicated decreased quality of erection with time in response to the vasoactive agents and 28 per cent believed this therapy to be unsatisfactory. Among those who discontinued the injections 5 cited variability of erectile response (duration or quality) as the reason for discontinuation. A decrease in the effectiveness of the injections with time may be anticipated among some patients. For patients who face a penile implant without other options penile self-injection with vasoactive drugs is a reasonable alternative in that complications do not prevent successful prosthetic implantation.

Consumer Behavior↗
PubMed1987

Amoxicillin/clavulanate in urinary tract infection.

A new beta-lactamase-stable oral antibiotic (Augmentin) has been found to be effective in the treatment of urinary tract infections (uncomplicated and complicated, recurrent, and nosocomial) and bacteriuria. The literature is reviewed.

Amoxicillin↗
PubMed1987

Penile prosthesis reimplantation.

Occasionally, penile prostheses are removed following erosion, infection or malfunction and they are not replaced immediately. Patients may present later for reimplantation of a penile prosthesis after an interval free of a device. However, no information is available as to the outcome and difficulties of such a procedure. We reviewed the charts of all 305 patients undergoing implantation of a penile prosthesis at our institution and contacted all 8 who had undergone reimplantation. Bilateral prostheses were placed in 4 patients. Unilateral prostheses only could not be implanted in either side because of extensive fibrosis. Of the 8 patients 4 are able to have intercourse (1 with difficulty) and reimplantation of the prosthesis often was difficult or impossible. We conclude that reimplantation of a penile prosthesis is beneficial for some patients but they should be informed of the possibility of unsatisfactory results.

Adult↗