Biomedical subjects
Publications and source records attributed to W Weidner.
A second Doppler examination after intracavernous injection of papaverine provides more objective data in cases with questionable penile Doppler results and vascular impotence.
In this study, 20 men suffering from acute nongonococcal epididymitis were treated with ofloxacin 200mg bid given orally for 2 weeks. Patients were re-examined after 2, 6, and 12 weeks. The outcome was assessed both clinically and microbiologically. Two weeks after start of therapy, the causative agent (Chlamydia trachomatis) was still present in only 1 patient, although local painful swelling of the epididymis persisted in 14 men. During the follow-up period, local signs of epididymitis decreased. After 12 weeks, an eradication of the causative micro-organisms was found in 16 of 20 cases. In 4 men, infection by the primary pathogen persisted: Escherichia coli (2); Pseudomonas aeruginosa (1) and C. trachomatis (1). Local pain and swelling was still detected in 6 of 20 men.
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Two groups of 30 patients each suffering from gonococcal urethritis were treated either with minocyclin for 7 days or with a single administration of penicillin or spectinomycin, respectively. 30% of them revealed an additional infection with C. trachomatis or U. urealyticum. On the 8th day, we observed remaining symptoms in only 20% of the patients treated with minocyclin, but in 40% of the group treated with penicillin/spectinomycin.
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Two experimental methods for collecting cord blood for acid-base analysis using green top vacutainer tubes were compared with a standard method using heparinized syringes. Paired samples from 30 newborn infants were collected using one of the vacutainer methods and the standard heparinized syringe method. No significant differences in pH, pCO2, base deficit, or pO2 were noted when comparing the two vacutainer methods with the standard syringe method. Both vacutainer methods were substantially easier to use than the heparinized syringe method. A green top vacutainer may be used to obtain an accurate cord blood sample for assessment of an infant's acid-base status at birth, and to aid the neonatologist as an indicator of intrapartum asphyxia.
A total of 123 men with the symptoms of chronic prostatitis, who had been classified as suffering from either prostatitis or prostatodynia on the basis of infection diagnosis, were asked to complete two psychological test forms: the Giessen Symptom Check List (GSCL) and a prostatitis questionnaire. The most striking result was that in the GSCL both groups, in comparison with the test standardization sample, showed a relatively high degree of symptoms (subjective discomfort), particularly in the scales "Tendency to Fatigue" and "Pain in Limbs." The symptoms in the prostatitis questionnaire could be grouped into 4 scales, whereby the main finding was that the patients with prostatitis complained of greater discomfort on the scale "Vegetative Genital Complaints" than those with prostatodynia.
Seven patients (five male and two female, age range from 50 to 88) with angiographic proven abdominal aortic aneurysms were evaluated with magnetic resonance (MR) imaging (1.5-kG system) of the abdomen. Images were obtained in transverse, coronal, and saggital planes with three radiofrequency pulse sequences [saturation recovery (SR), inversion recovery (IR), and spin echo (SE)]. All of the aneurysms were identified as to site and relative size with MR images. The lumen in which there was rapidly flowing blood was always dark (low intensity), whereas the aneurysmal area which contained presumed clot or slow flowing blood was brighter (high intensity) on SR images. Although the size, location, and relationship to other blood vessels was best demonstrated on aortography, MR images provided similar information in all cases. MR images correctly demonstrated thrombus in six cases. In conclusion, MR imaging provides a clear delineation of the anatomy of abdominal aortic aneurysms. In addition, it can provide information concerning tissue type, i.e., it distinguished clot from moving blood. It may be possible in the future to further characterize atherosclerotic and other pathological changes in vessel architecture by using various pulse sequences and timing parameters to provide in vivo histological typing.
Ureaplasma urealyticum is considered an etiologic agent in urogenital tract infections, especially prostatitis. Using the 'four-specimen technique', diagnosis can be based upon significant numbers of these microorganisms. In ejaculate, the critical number seems to be 10(3) cfu/ml of semen to discriminate between real infection and contamination during urethral passage. In our study, 46 of 412 samples (11.2%) exceeded this critical number. Most but not all patients suffering from ureaplasma-associated prostatitis established by the 'four-specimen technique' revealed significantly high ejaculate numbers, whereas all samples from patients with prostatodynia and healthy controls had lower numbers. In these cases, numbers of round cells in semen, i.e. all leukocytes and spermatides, were significantly increased as compared to prostatodynia. A significantly negative correlation was detected between the numbers of ureaplasmas and zinc concentration in semen, and an almost identically negative correlation to the content of fructose, thus indicating secretory dysfunction of the accessory glands in ureaplasmal infections of the prostate.
Two cases of leukemic priapism are described. Both patients underwent a combined oncological (antileukemic chemotherapy, cell depletion by leukapheresis) and urological (transglandular cavernosum-spongiosum shunt, heparin lavage of the corpora cavernosa) therapy. Cytologically necrobiotic tumor cells could be identified in the corpus cavernosum aspirates causing blood stasis in the corpora cavernosa initiating priapism. Only sufficient venous outflow by additional transglandular cavernosum-spongiosum shunt completed therapy, effected a rapid detumescence and led to subsequent ability of erection and coitus. This suggests the necessity of additive surgical treatment in every patient suffering from leukemia and priapism, if spontaneous detumescence under chemotherapy is not obvious.
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In 233 patients suffering from chronic prostatitis, increased granulocyte counts in prostatic secretions revealed real inflammation in 111 patients (47,6%): four patients (1,7%) suffered from specific and 22 (9,4%) from chronic bacterial prostatitis. In 85 men (36,5%) "non-bacterial" prostatitis was evident, whereby in 22 (9,4%) ureaplasma-associated prostatitis was obvious. 26 men (11,2%) showed increased granulocyte counts in prostatic secretions, in these cases the mere microbiological finding was C. trachomatis. In 28 cases (15,9%) concomitant inflammatory urethral reactions were the only clinical finding.
A standardized clinical and microbiological diagnostic examination was conducted on 137 patients with acute or chronic epididymitis (cardinal symptom: painful swelling of the epididymis). Patients with spontaneous secretion from the urethra were examined according to the methods of urethritis diagnosis, patients without it with the four-glass test. Gram-negative bacteria and enterococci were responsible for 27.7% of the infections. Additional tests for Chlamydia trachomatis and mycoplasmas increased the microbiological rate of diagnosis to 65.7%. Demonstration of Ureaplasma urealyticum in significant numbers was always associated with urethritis or prostatitis. Chlamydia trachomatis was demonstrated especially in younger, sexually active men with epididymitis but without accompanying urethritis or prostatitis. The most striking clinical finding was a disturbance in bladder emptying in about one third of all patients with epididymitis, regardless of age.
To determine whether ciprofloxacin might be efficacious in therapy for chronic bacterial prostatitis, its diffusion into prostatic fluid was studied in ten healthy volunteers. One hour after administering 500 mg ciprofloxacin, the concentration of ciprofloxacin was measured by the agar diffusion method and bioassay. Serum levels were twice as high as in seminal fluid; however, 12 and 24 hours later concentration in seminal fluid was tenfold higher than in serum. Split ejaculates were examined to determine the secretory pattern of ciprofloxacin into seminal fluid. The two fractions also showed tenfold concentration. Ciprofloxacin concentration in expressed prostatic secretion ranged from 15 to 0.9 mg/l, thus indicating pronounced diffusion of ciprofloxacin into the prostatic fluid.
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106 outpatients, visiting our department because of sexual disturbances, underwent a standardized examination program. The following anamnestic data and clinical and laboratory findings were recorded: Details of the vita sexualis, evidences for genital and vascular diseases, endocrine abnormalities including diabetes mellitus, drug consumption. Genital organs were judged by clinical examination, blood-pressure, oscillography and penis-flow-index were measured, hormones, sugar and lipids in blood serum were determined, with respect to a special indication, cavernosography and pelvic angiography were performed, and prostatic inflammation was excluded. None of the anamnestic data differ in its frequency from that of the total population. Mean blood pressure, oscillographic indices, hormone levels, and lipids were found within the normal range. Only a high rate of diabetes mellitus (6%) in all patients and a high rate of pathologic penis-flow-index in men between 40 and 60 years of age were found. We conclude from our results, that medical history and laboratory findings in general will indicate no pathogenetic mechanism in impotence. Just the recording of penile blood flow will give positive correlations.
The infectious male urethritis is characterized by the urethral discharge, which is clear or purulent due to the number of leucocytes. Infection occurs mostly in sexual intercourse. Neisseria gonorrhoeae today causes only about 20-30% of the infections. Gramnegative bacteria are demonstrable by microscopic examination of the urethral discharge, otherwise by cultivation. Ureaplasma and chlamydia trachomatis, an intracellular growing bacterium, are the most frequent agents in infectious urethritis. They are often found together, the cultivation requires special laboratory conditions. They are common saprophytis bacteria within the urethra (u. urealyticum in up to 50%), their number of colony forming units of urethritis, like yeasts, viruses, trichomonas are rare. The treatment of gonorrhoic urethritis is done by penicillin or spectinomycin. Infections by u. urealyticum and c. trachomatis are treated with tetracyclin. Although spontaneous healing is not uncommon, therapy should be performed with respect to the high risk of following prostatitis and epididymitis.
It has definitely been demonstrated that Ureaplasma urealyticum is one etiologic agent of nongonococcal urethritis, a sexually transmitted disease. For this reason it seemed possible that the organisms might cause ascending inflammatory reactions of the prostate. Quantitative determinations of ureaplasmas and Mycoplasma hominis, together with localization studies, were therefore performed to elucidate the importance of these microorganisms in patients with chronic prostatitis. U. urealyticum was found in high numbers in expressed prostatic secretions and urine voided after prostatic massage from 82 (13.7%) of 597 patients with chronic prostatitis. Because numbers of ureaplasmas in first-voided urine and midstream urine were significantly lower, the source of the organisms in these patients was assumed to be the prostate. These data and the results of tetracycline treatment provide sufficient evidence for the etiologic importance of ureaplasmas in chronic prostatitis.