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Biomedical subjects

W Werner

Publications and source records attributed to W Werner.

At least 19 recordsLinked to original sources
PubMed1999

[Immunotesting--a conditio sine qua non for therapeutic BCG instillation in bladder neck carcinoma?].

The intravesical instillation of BCG (Bacillus Calmette-Guérin) in cases of relapsed superficial bladder cancer is an acknowledged kind of prophylaxis. It is uncertainly up to now whether a verification of the immune systems competence is necessary. The recommendations in this problem are very different. In conclusion to the recent literature we think that a verification of the immune system before BCG installation in the urinary bladder has not a prognostic value. Additionally, the legal obligingness of this immunotest is doubtful.

Administration, Intravesical↗
PubMed1999

[An unusual case of genital tuberculosis. A case report].

We represent and discuss etiology, diagnosis as well as differential diagnoses of tuberculous orchtitis referring to an actual case of this rare disease. In the least of all cases one can conclude from the clinical symptoms on the tuberculous origin of the disease. Other differential diagnoses will set more frequently due to rarity of this disease. Quite a lot of cases a bacterial superinfection veils the sterile leucocyturia as main characteristic of genitourinary tuberculosis. Imaging diagnostics frequently fails to give indications of tuberculous origin of the lesion. As before the evidence of Mycobacteria tuberculosis is the most important parameter to proof a tuberculosis. Despite required microbiological cultivation to make a resistogram the polymerase chain reaction is a high sensitive and comparable fast method for detection of Mycobacteria even from tissue. In such dubious cases we recommend to perform an operative denudation due to frequently difficult delimitation from malignant testicular tumours.

Antitubercular Agents↗
PubMed1999

[Strategy for informed consent before a planned live kidney donation].

It has been observed an increasing discrepancy between the supply and demand of cadaveric organs for transplantation for a few years, particularly in renal transplantation. For this living organ donation will occupy an lasting place also in Germany. The new regulation organ donation and transplantation in Germany provides a legal protection and prohibits all forms of organ trading. First of all the transplant team have to take into consideration medical and psychological aspects of donor and recipient but a detailed enlightenment of the pair concerning risks, complications and long term outcome is important as well. In this paper is introduced the enlightenment procedure and the common declaration of donor and recipient of the transplant center Jena. The authors conclude, that living organ donation is not a problem after intensive preparation and enlightenment of donor and recipient with the new Transplant Law in the background.

Documentation↗
PubMed1999

[Image properties of spherical as aspheric intraocular lenses].

BACKGROUND: One reason for the problems that pseudophakic patients have with their mesopic vision is the spherical aberration of the implanted intraocular lens (IOL). Therefore we developed an aspheric IOL that will minimize this aberration. Starting with a 22 diopter lens we checked whether it is possible to keep the aspheric surface of the lens constant while changing the second radius to cover a larger range of needed refractive power. Afterwards we also checked whether the theoretical results correspond to the practically tested image quality. METHODS: We analyzed the image quality of the aspheric lenses theoretically by calculating the optimal defocused geometrical spot size. For the ray tracing we used the Gullstrand schematic eye model with an aspheric cornea. The calculated spot sizes were compared to those of a spherical IOL. Subsequently we compared the quality of both lenses by imaging an USAF-test target through a model eye. RESULTS: We were able to design an aspherical IOL to improve the optical performance up to the limit of diffraction. When the second radius was changed, the spot size enlarged as we expected, but it was considerable smaller than that of the respective spherical IOL. The image quality that we tested with the model eye was considerably better with the aspherical lens than with the spherical lens. CONCLUSIONS: It is possible to improve the optical performance of intraocular lenses by aspherization. The production procedure can be kept simple by aspherizing only one side of the lens. The refractive power can be changed by varying the radius of the spherical side. In our opinion aspheric IOL's should be used especially for cataract patients with a pupil size of 5 mm and more.

Adolescent↗
PubMed1999

Interphase cytogenetic diagnosis of bladder cancer on cells from urine and bladder washing.

In order to determine the value of fluorescence in situ hybridization (FISH) in the diagnosis and follow-up of bladder cancer interphase cytogenetics was performed on cells from urine and bladder washings. 50 ml of urine or bladder washings were collected. FISH was carried out using centromere probes for chromosomes 7, 8, 9 and 12 according to standard protocols. In each case 100 cell nuclei were analysed. Fifty-four samples from urine and 67 samples from bladder washing were analysed by FISH in comparison with results obtained by conventional cytology. Sensitivity of detection of tumor cells by FISH was 68.5% in urine and 63% in bladder washings regardless of tumor stage and grade. Sensitivity obtained by conventional cytology was 50% in urine and 77.3% in bladder washings. FISH on cells from urine samples is an effective complement to the standard urine cytology. Using centromere probes this approach is characterized by high specificity and sensitivity in tumors with T-category higher than pTa and grade higher than G1.

Carcinoma, Transitional Cell↗
PubMed1999

The principle of toxicopy and its integration into the administrative proceedings in Austria.

Toxicopy can be understood as an analogon to placebo but within any setting. Placebo is state-of-the-art since decades with relevant consequences: Only those effects may be considered as being pharmacon-specific, that go beyond non-pharmacological ("Placebo") effects. Placebo--theory is a limitation for the applicability of Morgans Canon (4), which is/was accepted within medicine like an axiom: When searching for the causes of disease physiological causes need to be ruled out, before other especially psychological etiologies can be taken into consideration. Toxicopy principle could be confirmed in different settings all over the world, in old and young, male and female, rich and poor and in different cultures. Therefore Morgans Cannon is falsified. Toxicopy principle is accepted as state-of-the-art and part of stand court rulings of the Austrian administrative tribunal. The plant law in Austria--and in Germany--provides for the protection of citizens against health hazards caused by plants, regardless of their etiologies. Therefore, non-toxicological threats must also be considered in plant approval proceedings in future.

Age Factors↗
PubMed1998

[The VATER syndrome from the urologic viewpoint].

Duplications of the bladder is uncommon and rarely occurs as isolate anomaly. Two cases of complex malformations from the VACTERL-association are reported. The study of urogenital duplications in cases from the literature are described.

Abnormalities, Multiple↗
PubMed1998

The major late promoter and bipartite leader sequence of fowl adenovirus.

The region of the fowl adenovirus serotype 10 (FAV-10) genome containing the major late promoter (MLP) and leader sequences was determined and appropriate genomic fragments were cloned and sequenced. A TATA box was identified and the location of the putative transcription start site was determined. By using synthetic primers from the transcription start site in conjunction with oligonucleotides from the coding regions of the penton base and hexon genes, cDNA was produced from late mRNA isolated from cell cultures infected with FAV-10 at 24 h post-infection. The resulting cDNA was cloned and sequenced and the leader sequences thus identified. It was found that the FAV-10 MLP utilized only two leader sequences (a bipartite leader). By comparison with human adenoviruses (HAVs) it appeared that the second leader in HAVs was absent from the FAV-10. The second leader sequences of FAV-10 was larger than either the second or third leaders of HAVs, but was 29 basepairs shorter than the combined size of the leader sequences 2 and 3 from HAV-2. To confirm the transcription start site and leader sequences, single stranded cDNA was produced from mRNA using the primers from within the coding sequence for the penton base or hexon. A tail of dGTP's was added and cDNA synthesis was completed using an oligonucleotide from within the hexon or penton base coding sequence and a second poly-dCTP oligonucleotide. Sequencing of the resultant G-tailed DNA confirmed the location of the transcription start site as an adenosine residue 24 basepairs upstream from the 3-prime (3') end of the TATA box. Sequencing 5' of the TATA box failed to reveal any sequence similarity with the human adenovirus upstream stimulatory factor (USF). Various plasmids were constructed which placed the determined sequences of the MLP, leader, and the region upstream of the TATA box linked to the co-acetyl acid transferase (CAT) gene. These expression plasmids in transient expression assays of CAT activity in primary chicken kidney cell culture with or without FAV-10 co-infection were determined. These experiments showed that the cassette containing sequences 5' of the TATA box expressed CAT to a much greater level than cassettes not containing this upstream region and that the presence of virus significantly increased the activity of the promoter following the onset of viral DNA replication. Without the 5' region, cassettes failed to express above background levels. These results suggest that the basic structure of the fowl adenovirus MLP is similar to that of the human adenovirus although it utilizes a bipartite rather than a tripartite leader sequence.

Animals↗
PubMed1998

Fowl adenovirus recombinant expressing VP2 of infectious bursal disease virus induces protective immunity against bursal disease.

The right hand end Nde I fragment 3 (90.8-100 map units) of the fowl adenovirus serotype 10 (FAV-10) was characterised so as to allow the location of an insertion site for recombinant vector construction. Infectious bursal disease virus (IBDV) VP2 gene from the Australian classical strain 002/73, under the control of the FAV-10 major late promoter/leader sequence (MLP/LS) was inserted into a unique Not I site that was generated at 99.5 map units. This recombinant virus was produced without deletion of any portion of the FAV-10 genome. When administered to specific pathogen free (SPF) chickens intravenously, intraperitoneally, subcutaneously or intramuscularly, it was shown that the FAV-10/VP2 recombinant induced a serum VP2 antibody response and protected chickens against challenge with IBDV V877, an intermediate virulent classical strain. Birds were not protected when the recombinant was delivered via the conjunctival sac.

Animals↗
PubMed1998

A de novo translocation 46,X,t(X;15) causing haemophilia B in a girl: a case report.

Haemophilia B is an X-linked recessive bleeding disorder caused by mutations in the factor IX gene with an incidence of 1:25000-30000. Usually female carriers are clinically normal, and severe phenotypic expression of the disease in females is extremely rare. In this report we describe a girl with a clinically severe course of haemophilia B who had no signs of Turner syndrome or any other dysmorphic features. Cytogenetic and molecular studies in the patient and her parents showed a de novo translocation 46,X,t(X;15)(q27.1;p11.2) in the patient, indicating a possible break near the factor IX gene. The structurally normal X chromosome was late replicating and inactivated in all metaphases as shown by high-resolution R-banding. By fluorescence in situ hybridization (FISH) with YAC and cosmid probes we could further characterize the breakpoint region on the X chromosome and the involvement of the factor IX gene.

Adult↗
PubMed1998

31P-magnetic resonance spectroscopy (31P-MRS) of human allografts after renal transplantation.

BACKGROUND: 31P-Magnetic resonance spectroscopy (31P-MRS) can be used as a non-invasive tool for measuring the relative intracellular concentrations of several phosphorus metabolites in different organs. Various pathological conditions are characterized by different metabolic patterns. We studied the value of 31P-MRS after renal transplantation with both an uneventful and a clinically complicated course. METHODS: We determined the relative concentrations of phosphate-containing metabolites in renal allografts of humans with 31P-MRS (1.5 Tesla) in the first few weeks after transplantation; 18 patients with an uneventful clinical course and 10 patients who required dialysis after transplantation were examined. Six patients with a stable allograft function 2-3 months after transplantation served as controls. RESULTS: In patients with primary allograft function, we found a significant correlation between the phosphomonoester/phosphodiester-ratio (PME/PDE) (r = 0.66, r < 0.01) and the time after transplantation, but no correlation between the nucleoside triphosphate (beta-NTP)-concentration (r = -0.11) and the time course. In the patients with primary or early allograft dysfunction caused by histologically proven rejection (n=5), we found a low beta-NTP compared to patients with an uncomplicated clinical course (0.09+/-0.01 vs 0.15+/-0.03), but no differences in the PME/PDE ratio (0.73+/-0.21 vs 0.80+/-0.21). In contrast, the PME/PDE ratio was lowered in three patients with delayed graft function caused by acute tubular necrosis (0.45+/-0.07 vs 0.80+/-0.21), but the beta-NTP concentration was not reduced (0.15+/-0.003 vs 0.15+/-0.03). The 31P-MR spectrum of two patients with cyclosporin A damage was not altered compared to the controls. CONCLUSIONS: 31P-MRS can be used in patients in the early period after renal transplantation. A significant correlation between the PME/PDE ratio and the time course but no change in the beta-NTP concentration was found in patients with primary allograft function in the first 4 weeks after renal transplantation. Different patterns of 31P-MR spectra were observed depending on the different causes of primary and early transplant dysfunction.

Adult↗
PubMed1998

Nephron sparing surgery for renal cell carcinoma 4 cm. or less in diameter: indicated or under treated?

PURPOSE: Although radical nephrectomy is the standard treatment for localized unilateral renal cell carcinoma with a normal contralateral kidney, there is ongoing interest in the use of nephron sparing surgery or partial nephrectomy in such cases. The extent of radical surgery in such cases has also been reconsidered in view of the uncertainty regarding the malignant or benign nature. MATERIALS AND METHODS: Of 14,793 autopsies in Jena from 1985 until 1995 there were 260 renal cell carcinomas. Of the 260 renal cell carcinomas the diameter was 40 mm. or less in 104. These 104 tumors were divided into group 1-20 mm. or less (33 cases), group 2-21 to 30 mm. (28) and group 3-31 to 40 mm. (43). RESULTS: Grade 1 renal cell carcinomas decreased in frequency with increasing tumor diameter, while an opposite result was noted for grade 3. Lymph node and distant metastases were well correlated with tumor size. With an increase in tumor size the frequency of venous involvement increased as well. Significantly more multifocal malignant renal cell carcinomas were seen in tumors between 21 and 40 mm. compared to those 20 mm. or less in diameter. CONCLUSIONS: The metastatic potential and biology of these small nodules are not yet known. To lower the risk of local recurrence the results of our study suggest that nephron sparing surgery might be advisable in patients with renal cell carcinoma 20 mm. or less in diameter.

Adult↗
PubMed1998

Coincidence of induratio penis plastica and erectile dysfunction.

There are still diverse management options in Peyronie's disease and diverse opinions about the coincidence of Peyronie's disease and erectile dysfunction (ED) as well. The connection between Peyronie's disease and ED has been proved by some articles, but on the other hand authors have refused this fact. We found ED in about 30% of our patients suffering from Peyronie's disease. We have investigated 61 patients with Peyronie's disease. A diagnostic pattern for evaluation of angulation and ED are proposed. The tunica albuginea plication technique was used in 35 patients with good results. In our investigation we cannot find any coincidence of Peyronie's disease with ED.

Adult↗
PubMed1998

[Does treatment with thrombocyte aggregation inhibitors modify kidney transplantation surgery?].

The influence of aspirin treatment on haemostasis is still under debate. There are doubts in emergency operations, especially in transplant patients, concerning dosage and change in medication. Our results are based on an analysis of the therapeutic approaches in German transplantation centres. The question of transplant suitability, dosage and haemostatic effects are discussed with respect to the literature. Some 92.11% of the transplantation centres perform the operation even though the patient has been treated with aspirin. In these cases an increased bleeding tendency is tolerated and observed in 34.2% of the centres. An increased mortality has not been reported. Most of the transplantation centres accept a dosage of 100 mg aspirin daily. Only 7.89% of the transplantation centres refuse to operate on aspirin-treated patients. Correctly indicated aspirin treatment (for cardiac arrhythmia, embolism, or thrombosis, for example) does not contraindicate renal transplantation (daily dosage up to 100 mg). In elective surgery, however, a preoperative change in medication is recommended, e.g., the heparin instead of aspirin.

Aspirin↗
PubMed1998

[Urologic complications after kidney transplantation (II)].

Urological complications after renal transplantation are often responsible for postoperative morbidity and mortality in spite of a decrease in incidence and severity of such complications in the last decades. It is of particular interest to detect this complications early and to treat them in an adequate manner especially in regard to the increasing lack of human organs for transplantation. The number of transplanted patients in the population is still increasing and they are treated not only in transplant centers but also by general practitioners, nephrologists and urologists in private consultings. This necessitates a survey about the most important complications including diagnostics and therapeutic options. Measures of prevention and early detection are taken into account. Questions concerning impotence and incontinence are discussed in detail. Attention must be paid to the fact of immunosuppression and its peculiarities in transplanted patients. In this way the outcome of patients and transplants can be prolonged.

Female↗