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DerUnfallchirurg.91020791.eng.abstr
|
DerUnfallchirurg.91020791.eng.abstr
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[
{
"id": "DerUnfallchirurg.91020791.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The purpose of the study is to establish data on the stability of an ACL replacement . In 40 human cadaver knees , either a mid patellar ligament third with a trapezoid bone block on one side was fixed on the femoral side in a 2-diameter drill hole , or a conventional interference screw fixation was applied . Average primary stability amounted to 570 N ( +/- 100 N ) for the bone-blocking technique , and to 402 N ( +/- 79 N ) for the interference screw fixation . When statistically tested by variance analysis , stability was significantly higher for the bone blocking technique than with interference screw fixation ( p 0.05 ) . Thus , when using a mid-patellar ligament third for ACL reconstruction , the new implant-free technique described here appears to be a practical and reliable method for femoral graft fixation ."
],
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0,
827
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]
}
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[] |
[] |
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DerUnfallchirurg.91020805.eng.abstr
|
DerUnfallchirurg.91020805.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020805.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Despite the many benefits of prone positioning in critically ill patients with respiratory failure and ARDS in the ICU , its technical problems have not yet been adequately resolved . Different approaches with special beds for prone positioning do exist , but these devices are difficult to handle , often not available and involve high costs . With this in mind , we developed an easy handling prone positioning system ( MBS ) that requires no special beds and runs at low cost . The MBS is a cost-effective device , yielding many benefits for prone positioning in critically ill patients with severe athelectasis and ARDS ."
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}
] |
[] |
[] |
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}
] |
DerUnfallchirurg.91020808.eng.abstr
|
DerUnfallchirurg.91020808.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020808.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We report on a posttraumatic aneurysm of the brachiocephalic trunk , something which is rather rare . The injury was caused by blunt chest trauma following a car accident . Computed tomography could not find the brachiocephalic lesion . In patients with fractures of the upper ribs after blunt chest trauma , angiography should be done to exclude severe injuries of the aorta and brachiocephalic vessels ."
],
"offsets": [
[
0,
405
]
]
}
] |
[
{
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37
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{
"id": "DerUnfallchirurg.91020808.eng.abstr-s1-t2",
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},
{
"id": "DerUnfallchirurg.91020808.eng.abstr-s2-t1",
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},
{
"id": "DerUnfallchirurg.91020808.eng.abstr-s2-t2",
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},
{
"id": "DerUnfallchirurg.91020808.eng.abstr-s2-t3",
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},
{
"id": "DerUnfallchirurg.91020808.eng.abstr-s2-t4",
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{
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{
"id": "DerUnfallchirurg.91020808.eng.abstr-s3-t2",
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"id": "DerUnfallchirurg.91020808.eng.abstr-s4-t2",
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{
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"id": "DerUnfallchirurg.91020808.eng.abstr-s4-t4",
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},
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"id": "DerUnfallchirurg.91020808.eng.abstr-s4-t6",
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},
{
"id": "DerUnfallchirurg.91020808.eng.abstr-s4-t8",
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"aorta"
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{
"id": "DerUnfallchirurg.91020808.eng.abstr-s4-t9",
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{
"id": "DerUnfallchirurg.91020808.eng.abstr-s4-t10",
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]
}
] |
[] |
[] |
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DerUnfallchirurg.91020811.eng.abstr
|
DerUnfallchirurg.91020811.eng.abstr
|
[
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"The different treatments for femoral fracture after total knee arthroplasty are discussed . A new method with the LIS system ( Synthes ) is described and first clinical results presented ."
],
"offsets": [
[
0,
188
]
]
}
] |
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},
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"id": "DerUnfallchirurg.91020811.eng.abstr-s1-t2",
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]
}
] |
[] |
[] |
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DerUnfallchirurg.91020824.eng.abstr
|
DerUnfallchirurg.91020824.eng.abstr
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{
"id": "DerUnfallchirurg.91020824.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This article reviews the surgical treatment of chronic posterior knee instability . The treatment rationale includes exact definition of the instability pattern ( \" envelope-of-motion \" of the tibia ) by clinical examination , arthrometry and stress radiography . Exact evaluation of the osseous anatomy is mandatory to identify an eventual varus morphotype . This osseous variant in combination with posterior/posterolateral instability should be treated by an osteotomy in every case . The technique of additive osteotomy to correct varus and increase the sagittal tilt of the proximal tibia is described . Ligament reconstruction in chronic posterior knee instability must address the posterior cruciate ligament and the lateral/posterolateral structures in many cases . Patellar tendon grafts , quadriceps tendon grafts or hamstrings can be used for posterior cruciate ligament replacement . Arthroscopic or mini-open techniques may be used for graft placement , direct posterior fixation of the graft via a posterior incision is an option for patellar tendon grafts . Bousquet's biceps plasty or Clancy's biceps tenodesis may be used for posterolateral stabilization ; a biceps tendon strip can also be used for lateral collateral ligament reconstruction . Results of surgery are still moderate . In the author's series of chronic posterior/posterolateral instability , 26 cases were treated with posterior cruciate ligament reconstruction and biceps tenodesis . Follow-up at 18 months demonstrated increased stability ( mean residual posterior drawer 8 mm at 70 ° and 20 lb force ) and improved knee function ( 33 % IKDC B , 67 % IKDC C ) . Presently , surgical treatment of chronic posterior knee instability should be restricted to centers devoted to this problem ."
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[] |
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] |
DerUnfallchirurg.91020839.eng.abstr
|
DerUnfallchirurg.91020839.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020839.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Extracorporal shock wave therapy ( ESWT ) has been postulated as an additional therapeutic option in nonunion after fracture treatment . We have reexamined patients with nonunions treated at our institution to evaluate the efficacy of the method . In a prospective nonrandomized study patients were investigated with a minimum duration of nonunion of 6 months . Following 2 cycles of ESWT with 2000 impulses/18 kV , the reevaluation was performed at 1 , 3 and 6 months after treatment . A total of 27 pseudarthroses was reevaluated , in 11 one or more reosteosyntheses had been performed prior to ESWT . Following ESWT we found a success rate of 41 % ( n = 11 ) . The clinical evidence of subjective , clinical improvement was found in 5 of these patients within 1 month , in all of these patients within a period of 3 months . Radiologic evidence of improvement occurred in none of these patients within 1 month , in all of these patients within 6 months . ESWT appears to represent an additional treatment option in patients with longstanding nonunion . If no improvement occurs , the maximum delay of reosteosynthesis is three months ."
],
"offsets": [
[
0,
1138
]
]
}
] |
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[] |
[] |
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DerUnfallchirurg.91020848.eng.abstr
|
DerUnfallchirurg.91020848.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020848.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Between 1986 and 1996 , 21 patients had a tibiocalcanear arthrodesis . Indications for surgery were in all cases either osteomyelitis or avascular necrosis of the talus . External stabilisation was used in 17 patients due to severe soft tissue damage or extensive infection of the talus , internal screw fixation was used in four patients . There were eight complications in seven patients , one patient had a below the knee amputation . The leg length discrepancies after resection of the talus was equalised in four cases with callus distraction using an Ilisarov ring fixator . Follow up evaluation was available in 18 patients after an average of 38 months ( 12-86 mo . ) . There were no infectious recurrenies during the follow up period and a solid fusion was achieved in all patients that were followed . According to a modified Kitaoka score , results were excellent and good in 12 of the 18patients . External stabilisation , especially the Ilisarov ring fixator is the primary method of treatment in cases with severe infection or soft tissue damage ."
],
"offsets": [
[
0,
1061
]
]
}
] |
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] |
[] |
[] |
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DerUnfallchirurg.91020855.eng.abstr
|
DerUnfallchirurg.91020855.eng.abstr
|
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"The treatment of deep cartilage defects is a challenge for every orthopeadic surgeon . The potention for regeneration of cartilage tissue is minimal and leads to mechanically inferior fibrous tissue . The established techniques induce the growth of fibrous tissue but fail to prevent arthrosis . Autologous chondrocyte transplantation seems to be the most promising therapy concept with clinical relevance to reserves a full thickness cartilage defekt with hyaline-like cartilage . Outcome studies with a follow up from 2-10 years show in up to 90 % good and excellent results for defects on the femoral condyle and 70 % for the patella . Mechanical testing of the regenerated cartilage showed almost simular stiffness as nearly normal hyaline cartilage . The available data justify the acceptance of autologous chondrocyte transplantation as a standard procedure for limited indications and well-trained surgeons . Result of already inaugurated studies will show the potential of chondrocyte transplantation to prevent osteoarthritis ."
],
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[
0,
1036
]
]
}
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[] |
[] |
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] |
DerUnfallchirurg.91020893.eng.abstr
|
DerUnfallchirurg.91020893.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020893.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The usual treatment for operative repair of diaphragmatic injuries is laparotomy or thoracotomy . We report on a 26-year-old patient , who was treated by laparocopic surgery for a rupture on both sides of the diaphragm . The operation was without complications and the advantages of minimally invasive laparoscopic surgery were clearly evident . There was much less strain on the patient and the postoperative recovery period was short . In addition , for unclear findings there is a high diagnostic potential in laparoscopy . The rupture on the right side of the diaphragm was not diagnosed until laparoscopy , although our patient underwent extensive diagnostics prior to the intervention ."
],
"offsets": [
[
0,
692
]
]
}
] |
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},
{
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{
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] |
[] |
[] |
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] |
DerUnfallchirurg.91020897.eng.abstr
|
DerUnfallchirurg.91020897.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020897.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The case of an 39-year-old man is presented , who sustained a bilateral locked fracture dislocation of the shoulders occurring during an epileptic seizure . Radiographs demostrated a compression-fracture of the anteromedial aspect of the humeral head bilaterally ( reversed Hill-Sachs-lesions ) . Additionally , fractures of the lesser and greater tuberosity were diagnosed at the right site . Open reduction and internal fixation was performed in both shoulders within 12 hours . 6 months later the patient has no complaints with a free range of motion . Diagnostics , treatment and result are discussed in context with the literature ."
],
"offsets": [
[
0,
637
]
]
}
] |
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27,
30
]
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"db_id": "C0025266"
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}
]
},
{
"id": "DerUnfallchirurg.91020897.eng.abstr-s1-t2",
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"fracture"
],
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79,
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"dislocation"
],
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]
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},
{
"id": "DerUnfallchirurg.91020897.eng.abstr-s1-t4",
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"shoulders"
],
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116
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],
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{
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147,
154
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},
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"id": "DerUnfallchirurg.91020897.eng.abstr-s2-t1",
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},
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"id": "DerUnfallchirurg.91020897.eng.abstr-s2-t2",
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},
{
"id": "DerUnfallchirurg.91020897.eng.abstr-s3-t1",
"type": "umlsterm",
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386
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{
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],
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462
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],
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"id": "DerUnfallchirurg.91020897.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"motion"
],
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},
{
"id": "DerUnfallchirurg.91020897.eng.abstr-s5-t3",
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{
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DerUnfallchirurg.91020918.eng.abstr
|
DerUnfallchirurg.91020918.eng.abstr
|
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"The causes of residual deformity with posttraumatic painful arthritis after tarsometatarsal ( Lisfranc ) fracture-dislocation with the need for correctional arthrodesis are in our experience ( 22 cases over 5 years ) overseen injuries in one third , closed reduction and immobilisation or inadequate fixation technique with K-wires in another two thirds of cases . Foot malalignment and residual instability is assessed with weight-bearing radiographs of both feet , adduction/abduction stress films and CT scans for complex deformity . Correction is carried out via two longitudinal dorsal incisions , strict epiperiosteal preparation and debridement of the Lisfranc joint of all remaining cartilage , sclerosis and fibrous tissue . Reorientation begins , in the same manner as primary open reduction , with anatomical alignment of the second metatarsal base to the second cuneiform . Defects are filled with autologous bone grafting , stable fusion can be achieved with 3.5 mm cancellous compression screws . Full weight bearing is allowed in a modelled plaster shoe for 6 to 8 weeks . The functional medium-term results are convincing with 15 of 17 patients seen after 13 months of follow-up working full time . The Maryland Foot Score improved from 38.9 to 76.8 points in these patients ."
],
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}
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DerUnfallchirurg.91020924.eng.abstr
|
DerUnfallchirurg.91020924.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020924.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The authors report on a prospective multicenter study with regard to the operative treatment of fractures and dislocations of the thoracolumbar spine . 18 traumatologic centers in Germany and Austria , forming the working group \" spine \" of the German Society of Trauma Surgery , are participating in this continuing study . Between September 1994 and December 1996 682 patients ( 64 % male ) with an average age of 391/2 ( 7-83 ) years were entered . The entry criteria included all patients with acute and operatively treated ( within 3 weeks after trauma ) fractures and dislocations of the thoracolumbar spine ( Th 10-L 2 ) . Part 1 of this publication outlines the protocol and epidemiologic data . The incidence of fractures and dislocations of the thoracolumbar spine and associated injuries were recorded according to a standardized protocol , as well as the different operative methods and complications , duration of hospital stay , rehabilitation and incapacity . The analysis of the clinical social and radiological course was a second focus . The most frequent mechanism of injury was a fall ( 50 % ) or traffic accident ( 22 % ) . Most of the fractures occured at the L 1 level ( 49 % ) . All injuries were classified according to the ASIF ( AO ) classification . 65 % sustained an A-type fracture ( compression fracture ) . Associated injuries were observed in 35 % and 6 % were polytraumatized . Extremities and thorax were most frequently affected . Younger age and traffic accidents lead more often to C-type fracture ( fracture dislocation ) and polytrauma . An increased number of multisegmental or multilevel lesions were observed in polytraumatized patients . There were 16 % with incomplete paraplegia ( Frankel/ASIA B-D ) and 5 % with complete paraplegia ( Frankel/ASIA A ) . The rate of patients with initial neurologic deficits significantly increased with the severity of spinal injury according to the Magerl classification . Until discharge a neurologic improvement ( at least 1 Frankel/ASIA grade ) was observed in 32 % of the partially paralyzed ( Frankel/ASIA B-D ) and in 12 % of the patients with complete paraplegia ( Frankel/ASIA A ) . A neurologic deterioration occured in 3 patients ( 0.4 % ) . As a base for further follow-up and late results the individual starting point was determined by collecting relevant data of the patients ' history : 277 ( 40.6 % ) patients suffered from simultaneous diseases , one half was spine related . At the time of injury 559 ( 82.0 % ) patients were employed ; 429 ( 62.9 % ) doing manual work . 369 ( 54.1 % ) patients stated sportive activities before the injury and 561 ( 82.3 % ) designated their \" back function \" as normal . For the time before injury the patients scored an average of 93.4 points in the Hannover Spine Score ( 0-100 points concerning complaints and function of the back/spine ) ."
],
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0,
2878
]
]
}
] |
[
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],
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]
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{
"id": "DerUnfallchirurg.91020924.eng.abstr-s1-t2",
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],
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],
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DerUnfallchirurg.91020942.eng.abstr
|
DerUnfallchirurg.91020942.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020942.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The diagnostic accuracy of magnetic resonance imaging ( MRI ) for traumatic discoligamentous instabilities of the lower cervical spine was evaluated . MRI findings were correlated with the intraoperative findings . Fifteen patients were included in the study ( 11 males , 4 females , 33 years old on average ) . Indication for surgery was established with dynamic a. p . instability under fluoroscopy . In the operation , all patients showed complete traumatic rupture of the intervertebral disc . In contrast , MRI sequences revealed only eight mild and four severe disc lesions . Intraoperatively ruptures of the anterior and posterior longitudinal ligaments were verified in 7 patients each . MRI studies depicted only five ruptures of the anterior and three ruptures of the posterior longitudinal ligaments . In three cases MRI demonstrated no pathological findings ( 3 of 15 false-negative results ) . MRI and intraoperative findings showed no statistical correlation . MRI is of only limited value in diagnosing traumatic discoligamentous instabilities of the lower cervical spine ."
],
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[
0,
1088
]
]
}
] |
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DerUnfallchirurg.91020949.eng.abstr
|
DerUnfallchirurg.91020949.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020949.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The objective of this prospective study was to determine clinical and radiological results 2 years after ankle fractures and to compare them with preoperative arthroscopic findings . Of 135 consecutive patients undergoing osteosynthetic treatment , 128 ( type A , 2 ; type B , 97 ; type C , 29 ) were reviewed 2 years later . The Kitaokascore for functional and clinical rating and the Kannusscore for radiological rating were used . Initial cartilaginous lesions localized on the medial malleolus led to poor clinical ratings ( P 0.01 ) and cartilaginous lesions of the pilon tibiale and talus caused poor radiological results ( P 0.032 and P 0.046 ) . After rupture of the deltoid ligament , more pain was observed ( P 0.038 ) . Rupture of the syndesmosis , however , did not affect the outcome . Clinical outcome was poor among the 30- to 65-year-old patients . The clinical and radiological outcome of women was poorer ( P 0.018 and P 0.046 ) than for men . The older the patients , the more radiological signs of arthritis were found . The outcome of ankle fracture seems to correlate significantly with the nature , dimension and localization of fracture-associated cartilaginous and ligament lesions . Age and sex also seem to play a significant role in the outcome ."
],
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[
0,
1274
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}
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] |
[] |
[] |
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DerUnfallchirurg.91020967.eng.abstr
|
DerUnfallchirurg.91020967.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020967.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Secondary haematogenous joint involvement is seen in less than 1 % of patients with Salmonella infections . These atypical infections are frequently encouraged by pre-existing local or systemic disease . We present a case of a patient with known alcohol abuse who developed a septic infection of her right hip requiring resection of the femoral head . Histologic analysis showed signs of pre-existing osteonecrosis probably induced by alcohol intake . Cartilage and bone were invaded and destructed by an aggressive granulation tissue . Initially , a biopsy evaluated without knowledge of the positive bacteriological result had been interpreted as indicative of a tumour . The onset , clinical course , diagnosis and therapy of joint involvement by Salmonella are discussed with regard to our case and the relevant literature . This case illustrates the necessity for clinicians to share all their information about the patient with the pathologist ."
],
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0,
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]
]
}
] |
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] |
[] |
[] |
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DerUnfallchirurg.91020972.eng.abstr
|
DerUnfallchirurg.91020972.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020972.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Up to the present only few cases of spontaneous healing of juvenile bone cysts after pathological fractures were published . Most authors will not accept the possibility of a \" healing fracture \" in bone cysts because of missing documentation . In our clinic we could observe spontaneous healing of a juvenile bone cyst of the tibia after a pathological fracture in a ten-year old boy . Therefore healing of bone cysts after fracture is proven . On the other hand healing of bone cysts following conservative treatment after a fracture is not sure . Conservative treatment depends on the localization and type of the fracture . We recommend nonoperative treatment of first pathological fractures in small-sized bone cysts . This kind of treatment can be especially advised for young patients up to the tenth year because there are only few complications in fracture healing and a relatively high recurrence rate following operative treatment . In case of a refracture there are better conditions for fracture healing after surgery ."
],
"offsets": [
[
0,
1032
]
]
}
] |
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"arg2_id": "DerUnfallchirurg.91020972.eng.abstr-s9-t1",
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},
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"id": "DerUnfallchirurg.91020972.eng.abstr-s8-r8-t5.1-t3.1",
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},
{
"id": "DerUnfallchirurg.91020972.eng.abstr-s8-r9-t6.1-t3.1",
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{
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},
{
"id": "DerUnfallchirurg.91020972.eng.abstr-s9-r2-t1.1-t2.1",
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},
{
"id": "DerUnfallchirurg.91020972.eng.abstr-s9-r4-t2.2-t1.1",
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}
] |
DerUnfallchirurg.91020975.eng.abstr
|
DerUnfallchirurg.91020975.eng.abstr
|
[
{
"id": "DerUnfallchirurg.91020975.eng.abstr-passage-0",
"type": "abstract",
"text": [
"By using UTN in the treatment of very distal tibia fractures delayed fracture-healing and pseudarthrosis with breakage of the nail are described . The removal of the distal solid part of the nail shows a special difficulty . We report about two cases of broken UTN in 1997. A simple extraction device to remove the distal part of the broken nail is demonstrated ."
],
"offsets": [
[
0,
363
]
]
}
] |
[
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-t1",
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"treatment"
],
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20,
29
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{
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"db_id": "C0039798"
}
]
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-t2",
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"text": [
"tibia"
],
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45,
50
]
],
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"db_id": "C0040184"
}
]
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"pseudarthrosis"
],
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90,
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}
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},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-t4",
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"nail"
],
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126,
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"db_id": "C0027342"
}
]
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-t5",
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"tibia fractures"
],
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45,
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}
]
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s2-t1",
"type": "umlsterm",
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"nail"
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191,
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]
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"db_id": "C0027342"
}
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},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"device"
],
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[
294,
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}
]
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s3-t2",
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"text": [
"nail"
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341,
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]
],
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{
"db_name": "UMLS",
"db_id": "C0027342"
}
]
}
] |
[] |
[] |
[
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r1-t1.1-t3.1",
"type": "location_of",
"arg1_id": "DerUnfallchirurg.91020975.eng.abstr-s3-t1",
"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t3",
"normalized": []
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r2-t4.1-t1.1",
"type": "connected_to",
"arg1_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t4",
"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r3-t1.1-t5.1",
"type": "location_of",
"arg1_id": "DerUnfallchirurg.91020975.eng.abstr-s3-t1",
"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t5",
"normalized": []
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r4-t3.1-t1.1",
"type": "associated_with",
"arg1_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t3",
"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s3-t1",
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},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r5-t5.1-t3.1",
"type": "result_of",
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"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t3",
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},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r6-t1.1-t5.1",
"type": "associated_with",
"arg1_id": "DerUnfallchirurg.91020975.eng.abstr-s3-t1",
"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t5",
"normalized": []
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r7-t4.1-t5.1",
"type": "causes",
"arg1_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t4",
"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t5",
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},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r8-t3.1-t4.1",
"type": "produces",
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"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t4",
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},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r9-t5.1-t1.1",
"type": "disrupts",
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},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r10-t1.1-t3.1",
"type": "associated_with",
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"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t3",
"normalized": []
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r11-t5.1-t1.1",
"type": "associated_with",
"arg1_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t5",
"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r12-t1.1-t4.1",
"type": "connected_to",
"arg1_id": "DerUnfallchirurg.91020975.eng.abstr-s3-t1",
"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t4",
"normalized": []
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r13-t3.1-t5.1",
"type": "result_of",
"arg1_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t3",
"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t5",
"normalized": []
},
{
"id": "DerUnfallchirurg.91020975.eng.abstr-s1-r14-t4.1-t3.1",
"type": "causes",
"arg1_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t4",
"arg2_id": "DerUnfallchirurg.91020975.eng.abstr-s1-t3",
"normalized": []
}
] |
DerUrologeA.00390022.eng.abstr
|
DerUrologeA.00390022.eng.abstr
|
[
{
"id": "DerUrologeA.00390022.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract Prevention of prostate cancer up to now is not possible , advanced stages of prostate cancer are not curable . About 13 000 men a year die of prostate cancer in Germany . PSA-based screening has been shown to be effective in detecting prostate cancer at an early , potentially curable stage ; however , this tumor marker is limited by appreciable false-positive and false-negative results . Several PSA-related indexes may improve the power of PSA in early detection : As PSA density , age-adjusted PSA , and percent free PSA . These indexes can improve positive predictive value of PSA-testing , but are not able to differentiate carcinoma from benign hyperplasia on an individual basis . Men presenting for early detection have to be informed about possible overtreatment before undergoing biopsy to further investigate increased PSA above 4.0 ng/ml or suspect findings in digital rectal examination ."
],
"offsets": [
[
0,
912
]
]
}
] |
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{
"id": "DerUrologeA.00390022.eng.abstr-s1-t1",
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"text": [
"Abstract"
],
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[
0,
8
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],
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]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s1-t2",
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"text": [
"Prevention"
],
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9,
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},
{
"id": "DerUrologeA.00390022.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"prostate"
],
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[
23,
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]
],
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"db_name": "UMLS",
"db_id": "C0033575"
},
{
"db_name": "UMLS",
"db_id": "C0033572"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"cancer"
],
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[
32,
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]
],
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{
"db_name": "UMLS",
"db_id": "C0006826"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"stages"
],
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[
76,
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]
],
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{
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"db_id": "C0027646"
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{
"id": "DerUrologeA.00390022.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"prostate"
],
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86,
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]
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"db_name": "UMLS",
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}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"cancer"
],
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[
95,
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}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s1-t8",
"type": "umlsterm",
"text": [
"prostate cancer"
],
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23,
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"db_name": "UMLS",
"db_id": "C0376358"
}
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},
{
"id": "DerUrologeA.00390022.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"prostate cancer"
],
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[
86,
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]
],
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{
"db_name": "UMLS",
"db_id": "C0376358"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"men"
],
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[
133,
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]
],
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{
"db_name": "UMLS",
"db_id": "C0025266"
},
{
"db_name": "UMLS",
"db_id": "C0024554"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"prostate"
],
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[
151,
159
]
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"db_name": "UMLS",
"db_id": "C0033575"
},
{
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"db_id": "C0033572"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"cancer"
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160,
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},
{
"id": "DerUrologeA.00390022.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"Germany"
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],
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{
"id": "DerUrologeA.00390022.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"prostate cancer"
],
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151,
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]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"screening"
],
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],
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"db_id": "C0220909"
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},
{
"id": "DerUrologeA.00390022.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"prostate"
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]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s3-t3",
"type": "umlsterm",
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},
{
"id": "DerUrologeA.00390022.eng.abstr-s3-t4",
"type": "umlsterm",
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"stage"
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},
{
"id": "DerUrologeA.00390022.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"tumor"
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},
{
"id": "DerUrologeA.00390022.eng.abstr-s3-t6",
"type": "umlsterm",
"text": [
"marker"
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323,
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},
{
"id": "DerUrologeA.00390022.eng.abstr-s3-t7",
"type": "umlsterm",
"text": [
"prostate cancer"
],
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[
244,
259
]
],
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{
"db_name": "UMLS",
"db_id": "C0376358"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s3-t8",
"type": "umlsterm",
"text": [
"tumor marker"
],
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[
317,
329
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0041365"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"indexes"
],
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[
420,
427
]
],
"normalized": [
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"db_name": "UMLS",
"db_id": "C0021200"
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{
"db_name": "UMLS",
"db_id": "C0918012"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"power"
],
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[
444,
449
]
],
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{
"db_name": "UMLS",
"db_id": "C0032863"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"PSA"
],
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[
453,
456
]
],
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"db_id": "C0138741"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"PSA"
],
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[
481,
484
]
],
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{
"db_name": "UMLS",
"db_id": "C0138741"
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]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"PSA"
],
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[
508,
511
]
],
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{
"db_name": "UMLS",
"db_id": "C0138741"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s4-t6",
"type": "umlsterm",
"text": [
"PSA"
],
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531,
534
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],
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{
"db_name": "UMLS",
"db_id": "C0138741"
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]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"indexes"
],
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[
543,
550
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"db_name": "UMLS",
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{
"db_name": "UMLS",
"db_id": "C0918012"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"value"
],
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[
583,
588
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042295"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"carcinoma"
],
"offsets": [
[
640,
649
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007097"
}
]
},
{
"id": "DerUrologeA.00390022.eng.abstr-s5-t4",
"type": "umlsterm",
"text": [
"hyperplasia"
],
"offsets": [
[
662,
673
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DerUrologeA.00390027.eng.abstr
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DerUrologeA.00390027.eng.abstr
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"According to the representative data of the Tumor Registry Munich , 38.1 % of prostate cancer patients received a primary androgen deprivation , whereas 20.5 % had an adjuvant hormonal treatment . Following surgical castration being the most common form of androgen deprivation , 5 -dihydrotestosterone is still present in prostate cancer tissue . Therefore , a maximal androgen blockade ( MAB ) consisting of a chemical or surgical castration plus a pure or antigonadotropic antiandrogen , has been proposed . Indeed , MAB lowers the dihydrotestosterone-androgen-receptor complex and suppresses the growth-factor dominated signal transduction . This leads to a measurable increase of apoptosis . New is the finding that LHRH as well as LH ( for example following surgical castration ) are bound by receptors located at the prostate cancer cell . In 30 phase-III trials , MAB has been tested against monotherapy and a cancer-specific survival advantage of 3 to 6 months and a approximately 6-month delay of progression was demonstrated . The most effective form of MAB is the combination of a LHRH agonist - in contrast to surgical castration - with a well-tolerated pure antiandrogen . The quality of life during MAB is low , if a pure antiandrogen such as flutamide is used which leads to rather serious side-effects . At the present time , special indications for MAB are patients with minimal metastases , bone pain at the time of diagnosis , a neoadjuvant or adjuvant application in combination with a radical prostatectomy or radiotherapy and particularly intermittent androgen deprivation which is tested at the present time in at least 5 international studies . An endocrine withdrawal syndrome is observed in approximately 30 % of patients , if , following a PSA-relaps , the antiandrogen is discontinued . Little notice has been given to the use of prognosticators for the decision , whether a MAB is useful or not . Patients with good prognostic factors as defined by Sylvester have a clear advantage , if MAB is compared to monotherapy , whereas patients with a pure prognosis did not benefit . In addition to these prognostic factors up-front , the PSA dynamics under an initial MAB may be employed for the decision , if this form of androgen deprivation is to be continued or not . In essence , in contrast to a general use of MAB a more differential application based on quality-of-life issues and prognosis should be preferred ."
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] |
[] |
[] |
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DerUrologeA.00390036.eng.abstr
|
DerUrologeA.00390036.eng.abstr
|
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"id": "DerUrologeA.00390036.eng.abstr-passage-0",
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"text": [
"To evaluate whether MRI is usefull in staging renal cell carcinomas with caval thrombus the accuracy of computed tomography ( CT ) and magnetic resonance imaging ( MRI ) in staging renal tumors with caval thrombus were preoperatively examined . Tumor staging by CT and MR imaging were correlated with histopathological tumor stadium . In MRI 4 out of 7 thrombi were correctly diagnosed with high accuracy , in CT none . In advanced renal carcinoma MRI with Gadolinium was superior to CT imaging , especially in diagnosing tumor thrombus . Consequently the extent of tumor thrombus may be assessed by MRI which therefore may replace conventional cavography ."
],
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0,
657
]
]
}
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DerUrologeA.00390041.eng.abstr
|
DerUrologeA.00390041.eng.abstr
|
[
{
"id": "DerUrologeA.00390041.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The benefits of epidural analgesia are well known , but it is not well understood which types of urologic surgery benefit most from epidural analgesia . In this study , the effects and side effects of prolonged epidural analgesia are prospectively examined and analysed on 172 adult patients in three different operation groups . An epidural infusion of local anaesthetic combined with an opioid and adrenaline was given for a period of 5-7 days . There was no difference between the groups with respect to the effectiveness of the analgesia and patients ' perception of the treatment . Mobilization differed , as expected , between the groups , however even after the most major surgery ( e . g . cystectomy with bladder substitution ) , mobilization was impressively unproblematic . Retarded return of regular intestinal function after the transperitoneal operation and partly after lumbotomy compared with the extraperitoneal operation depended on which operation was performed and the amount of analgesia given . The side effects such as sedation , nausea and pruritis were conditional partly on the opiate and partly on the intervention . Up to 11 % showed slight muscular weakness of the lower limbs as a specific side effect of the local anaesthetic . Complications : One patient died of cerebral hypoxy due to an initially undetected subdural catheter placement complicated by severe pre-existent carotid stenosis . In four patients , the epidural analgesia had to be stopped because of catheter migration . There was no clinical evidence of hematoma , abscess or permanent neurological damage . Epidural analgesia works well in terms of analgesia , mobilization and patient satisfaction , bearing in mind the potential side effects and complications . It can be recommended for lumbotomy and long transperitoneal operations however not for extraperitoneal interventions in the lower abdomen such as radical prostatectomy ."
],
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0,
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}
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DerUrologeA.00390048.eng.abstr
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"The most common causes of an ' acute scrotum ' in childhood are testicular torsion , torsion of an appendix testis , epididymoorchitis , idiopathic edema , and hematoma . In rare cases a scrotal hematoma can originate from an extra- or intraperitoneal adrenal bleeding . 12 such cases have been described in the literature , yet . We report on 3 further cases , that occured in our institution between 1992 and 1997. In the first case we performed a scrotal exploration due to a suspected testicular torsion , but only a normal testicle and liquid hematoma were seen . Postoperatively we discovered an ipsilateral adrenal hemorrhage by sonography . In the latter two cases the adrenal bleeding was recognized primarily as causal for the scrotal mass and operation remained undone . In newborns adrenal hemorrhage is mostly due to birth-trauma , large birth-weight , hypoxia , and asphyxia . This was present as well with our 3 children . If the clinical situation of the child is stable , complete restitution under conservative therapy can be expected ."
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DerUrologeA.00390052.eng.abstr
|
DerUrologeA.00390052.eng.abstr
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{
"id": "DerUrologeA.00390052.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Metastases to the bladder from renal cell carcinoma are extremely rare . The prognosis is poor and seems not related to the type of treatment . Most patients die within 1 year of diagnosis . The treatment should be therefore as conservative as possible . We report a case of solitary , synchronous bladder metastasis treated by transurethral resection . At 24 months the patient is free of recurrence ."
],
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}
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[] |
[] |
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DerUrologeA.00390120.eng.abstr
|
DerUrologeA.00390120.eng.abstr
|
[
{
"id": "DerUrologeA.00390120.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Radiotherapy of patients with prostate cancer offers an alternative to radical prostatectomy in early stages ( T1-T2). In locally advanced prostate cancer a high dose or combined radiotherapy is more effective than radical surgery with concurrent lower morbidity and mortality . Recent developments in linear accellerator technique , the progress in dose calculation and planning techniques provide the means to apply higher doses to a given tumor volume while effectively protecting the surrounding normal tissue at the same time . These improvements may possibly reduce the rate of therapy related side effects or complications significantly . The combination of external beam radiotherapy and interstitial brachytherapy as well as the combination of hormone therapy and external beam radiotherapy are most likely more effective than percutaneous irradiation alone . In special cases with a very low risk of recurrent tumor an interstitial permanent brachytherapy alone is indicated . Future developments ( i . e . intensity modulated radiotherapy - IMRT , combined thermo-radiotherapy , proton- or neutrontherapy ) may further increase the rate of curative treatments in patients with prostate cancer ."
],
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[
0,
1205
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]
}
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DerUrologeA.00390126.eng.abstr
|
DerUrologeA.00390126.eng.abstr
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"Radiotherapy unequivocally has to be regarded as standard therapy in stage I and IIA/B testicular seminoma . Using low dose abdominal irradiation tumour control rates of 95-98 % in stage I disease and 80-95 % in stage IIA/B can be achieved . Disease specific survival reaches 100 % . Likewise , radiotherapy is treatment of first choice in case of testicular intraepithelial neoplasia ( TIN ) in a solitary testis or in case of a double-sided TIN yielding safe eradication of the in-situ carcinoma of the testis . Objectives of further clinical research in radiotherapy of testicular malignancies aim at reduction of treatment intensity in order to minimize acute and late side effects of irradiation without compromising tumour control rates ."
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DerUrologeA.00390141.eng.abstr
|
DerUrologeA.00390141.eng.abstr
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[
{
"id": "DerUrologeA.00390141.eng.abstr-passage-0",
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"text": [
"Retroperitoneal fibrosis ( RPF ) is an uncommon inflammatory disease of the retroperitoneum leading to extensive fibrosis with consecutive obstruction of adjacent organs , namely the ureters . Since no consensus on the standard therapy exists , aim of the current study was to evaluate the outcome of 39 patients with RPF . Between 1986 and 1997 39 cases of RPF were diagnosed : 21 cases had primary RPF and 18 patients had secondary RPF after aortofemoral graft ( n = 13 ) , radiation ( n = 2 ) , or prior retroperitoneal surgery ( n = 2 ) . 21 patients demonstrated unilateral and 16 cases had bilateral hydronephrosis , in 2 patients no dilatation was observed . In 28 cases ( n = 12 primary RPF , n = 16 secondary RPF ) intial management consisted of DJ-stent placement , whereas in 11 cases ( n = 9 primary RPF , n = 2 secondary RPF ) percutaneous nephrostomy had to be placed . All patients received oral immunosuppressive agents ( prednisolone 1 mg/kg , azathioprine 1 mg/kg/day ) for 3 months before reevaluation was performed . In case of complete remission , immunosuppressive medication was continued for another 3 months , in case of stable disease or progression surgery was performed . In 26 cases ( n = 15 primary RPF , n = 11 secondary RPF ) ureterolysis with intraperitoneal displacement and omental wrapping was performed . 3 patients demonstrated complete remission after oral prednisolone/azathioprine ; in 2 cases RPF presented as pelvic mass and was resected followed by immunsuppressive therapy , in another 2 cases bilateral ileal replacement of the ureters had to be performed and 4 cases remained on DJ-stents and nephrostomy , resp. Postoperatively , all patients with primary RPF were continued on immunsuppressive medication for another 3 months . After a follow-up of 6 to 120 months only 3 patients developed a retroperitoneal recurrence and were treated by unilateral nephrectomy or DJ stent placement ( n = 2 ) . Our data suggest that the combination of both immunosuppressive medication and surgical management results in an excellent longterm outcome in idiopathic retroperitoneal fibrosis with a recurrence rate of only 8 % . Combination therapy should be considered as therapeutic option early in the course of the disease . Primary reconstructive surgery appears to be the most promising approach in secondary retroperitoneal fibrosis with a recurrence rate of only 5 % ; short external compression of the ureter might be managed by endoluminal balloon dilatation ."
],
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}
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"186 cases of nephrectomy for renal cell cancer are studied retrospectively . The overall 5-year survival rate was 77,2 % . According to the 4th edition of the \" TNM \" classification system of UICC the survival rates of patients with T2- ( n = 97 ) , T3 a ( n = 58 ) and T3b-tumors ( n = 25 ) were 80,9 % , 79,3 % and 65,6 % , respectively . No patient with a stage T4 tumor ( n = 6 ) survived longer than 20 months . The 5-year survival rate of patients with N1-lymph node metastases was 83,3 % ( n = 8 ) ; without lymph node metastases 78,3 % ( n = 152 ) , respectively . There was no survival longer than 20 months in case of N2-lymph node metastases ( n = 13 ) . According to the grading survival rates of 95,4 % ( G1, n = 46 ) , 71,2 % ( G2, n = 130 ) and 71,4 % ( G3, n = 8 ) resulted ."
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"Purpose : The pontine micturition center plays a central role in regulating the micturition reflex , but the precise neural mechanisms are unclear . The cerebral cortex is involved in coordinating micturition but there is little knowledge on specific evolutionary higher brain regions . The present study aimed to investigate whether cortical activation during micturition can be demonstrated by EEG power spectra patterns and to explore whether specific cortical regions involved in the interaction of inhibition and release during the micturition reflex can be discerned . We also aimed to test whether intravesical electrostimulation ( IVES ) therapy in patients with micturition disorders has an effect on patterns of cortical activity ."
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DerUrologeA.00390166.eng.abstr
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"A calculation model was developed for the cost of stone therapy and metaphylaxis in Germany based on estimates of stone incidence , types and recurrence rates , actual costs for stone removal and metaphylaxis ( based on data from a district of the social health care system ) . There are 200,000 stone recurrences per year in Germany . Cost for treatment of these stones amount to $ 687,000 , 000. Stone metaphylaxis reduces the recurrence rate by some 40 % . The annual cost for stone removal could be lowered by $ 275,300 , 000. Metabolic evaluation/metaphylaxis amount to $ 70,100 , 000 per year , resulting in an net saving of $ 205,200 , 000. In 1997 , there were 96 days off-work per stone patient resulting in 5,800 , 000 days off-work in Germany per year . Metaphylaxis in stone formers can lower health care cost significantly . Although health care conditions may vary from country to country , in principle this calculation model is applicable also to other countries ."
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DerUrologeA.00390171.eng.abstr
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"Glans penis leiomyomas are uncommon as primary nonepithelial tumors of the urogenital tract . Only 4 cases are described until today . We saw an other case of an 12 years old boy with a leiomyoma of the glans penis . Clinically the lesion presented as a yellow induration with no symptoms as pain , pruritus or bleeding . The biopsy revealed histological a leiomyoma in the subcutis of the glans penis with no symptoms of malignancy . Because of suspected functional and cosmetic deficiency a total resection was not performed . None of the cases described in the literature showed in the follow up malignancy or recurrency . 18 months postoperatively our patient is furthermore well and without symptoms . Nevertheless the leiomyoma of that localization is rare , this tumor should be included in the differential diagnosis of the neoplasms of the glans penis ."
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DerUrologeA.00390174.eng.abstr
|
DerUrologeA.00390174.eng.abstr
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"We report a case of mixed squamous-cell carcinoma with adenocarcinoma of the female urethra . A 37 year old women who presented with a 3-month ' history of obstructive voiding symptoms . Clinical investigation showed a urethra tumor of 2,5 x 3,5 cm . Needle biopsy revealed a grade 3 carcinoma . Staging resulted in local cancer disease , a 2,5 x 3,5 cm tumor surrounding the whole urethra with protruding the trigonum . We performed urethrectomy with resection of the bladderneck and cystoneostomy . During bladderneck resection we performed regional staging lymphadenectomy of the obturator lymph nodes . Histological investigation revealed a mixed squamous-cell carcinoma with adenocarcinoma and undifferentiated carcinoma of the urethra . Periurethral tissue showed lymphangiosis carcinomatosa with negativ lymphnodes . To exclude involvement of regional superficial lymphnodes we subsequently performed modified inguinal lymphadenectomy without evidence of advanced cancer disease ."
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DerUrologeA.00390214.eng.abstr
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"During the past decade , the molecular mechanisms in the process of tumor progression , including metastasis and angiogenesis , have become better understood . Cancer metastasis consists of multiple , complex interacting steps . Each of these steps is crucial and limiting , since a failure to complete any one prevents the tumor cell from producing a metastasis . Detachment from the solid tumor by loosening the intercellular junctions and proteolysis of the extracellular matrix enables tumor cells to enter blood- and lymph vessels . The intravasation into the circulation is supported by the secretion of angiogenic factors , which induce degradation of the basal membran in blood vessels . Adhesion to endothelial cells , extravasation from the circulation , and induction of angiogenesis are further essential steps for completing the metastatic process . Furthermore , it is well known that once a tumor cell has entered circulation , it will survive only by evasion of the immune system . The systematic identification of tumor antigens opens up new possibilities for immunotherapeutic approaches ."
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DerUrologeA.00390235.eng.abstr
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"text": [
"Experimental studies revealed that the contractile response of the urinary bladder to sacral anterior root stimulation depends on the actual bladder volume . Furthermore , no clinical relevant technique is available for continuous monitoring of the bladder wall distension respectively bladder volume in paraplegic patients . The presented study investigates the reliability of especially developed implantable ultrasound sensors as a sensoric system for continuous monitoring of the bladder volume . In six anaesthesized pigs two ultrasound sensors , one transmitter and one receiver , were implanted on the bladder wall at different locations ( latero-lateral , dorsal-ventral , rostral-caudal ) . After closing the abdominal wall , the bladder was filled in 50 ml steps up to 250 ml . After each filling step the running time of the ultrasound signal was measured . In all experiments reproducible results and a high correlation of the measured running times with bladder volume were observed . The latero-lateral configuration of the sensors seemed to be most confidental . The presented study indicates that bladder volumetry with implantable ultrasound sensors is possible with minimal technical prerequisites . This promising technique for continuous bladder volumetry could play an important role in the development of an intelligent and autoadaptive neurostimulator of the urinary bladder in paraplegic patients ."
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DerUrologeA.00390240.eng.abstr
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DerUrologeA.00390240.eng.abstr
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"VVS represents the standard procedure of choice for the treatment of obstructive azoospermia following vasectomy . However , recently ICSI has been suggested by some to represent the solution for all cases of male factor infertility regardless of its etiology based on its success rates . Therefore , we compared VVS to MESA/TESE and ICSI in terms of pregnancy , complications , and costs . Between 1/93 and 6/98 157 VVS was performed microsurgically using the 2-layer technique in 157 patients following prior vasectomy . Between 9/94 and 9/97 69 couples underwent MESA/ICSI for epididymal obstruction not amenable to microsurgical reconstruction such as postinflammatory obstruction and congenital absence of the vas deferens ; in the same time period 42 couples underwent TESE/ICSI for azoospermia of testicular origin due to cryptorchidism , testicular atrophy , obstruction of the rete testis . In most ases MESA or TESE and ICSI were performed metachronously . Mean interval of vasal obstruction was 7.6 ( 0.5-18) years ; patency after VVS was 77% , pregnancy rate was 52% . Local complication rate was 4.7% , no maior complications were observed . Costs per life birth after VVS were as high as 5.447 , - DM or 2.800 Euro . Pregnancy rates after MESA/TESE and ICSI were 22.5% and 19.5% , respectively with 16 singletons , 3 twins and 3 abortions ; local complications occured in 3.9% of the men . Multiple birth were noticed in 15.8% following ICSI , but only in 0.7% following VVS . 5.7% and 1.4% of the femal partners experienced serious complications as a mild or severe ovarian hyperstimulation-syndrome , respectively . Costs per life birth after MESA/TESE cycle were as high as 28.804 , - DM or 14.100 Euro . Even in the era of ICSI microsurgical vasovasostomy represents the standard approach for obstructive azoospermia following vasectomy . Based on a cost-benefit analysis VVS is more successful in terms of pregnancy rates ( 52% vs. 22.5% ) . We conclude that MESA/ICSI should be reserved for patients not amenable for microsurgical reconstruction ."
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DerUrologeA.00390251.eng.abstr
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DerUrologeA.00390251.eng.abstr
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[] |
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DerUrologeA.00390254.eng.abstr
|
DerUrologeA.00390254.eng.abstr
|
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"In a time of scarce resources , the demand for a rational therapy is important in the present discussion to reform the health system . This article describes rational therapy and introduces practical approaches like drug therapy , evidence-based medicine , and clinical practice guidelines . The development of efficient cost-benefit relations may lead to more rationalization in the health sector . It is important to attain acceptance also among the patients that rationing in the health system is a necessary measure in diagnosis and therapy ."
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DerUrologeA.00390304.eng.abstr
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DerUrologeA.00390304.eng.abstr
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DerUrologeA.00390324.eng.abstr
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DerUrologeA.00390334.eng.abstr
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DerUrologeA.00390334.eng.abstr
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DerUrologeA.00390341.eng.abstr
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"As a result of the enhanced clinical application of prostate specific antigen ( PSA ) , an increasing number of men are becoming candidates for prostate cancer work-up . A high PSA value over 20 ng/ml is a good indicator of the presence of prostate cancer , but within the range of 4-10 ng/ml , it is rather unreliable . Even more alarming is the fact that prostate cancer has been found in 12-37% of patients with a \" normal \" PSA value of under 4 ng/ml ( Hybritech ) . While PSA is capable of indicating a statistical risk of prostate cancer in a defined patient population , it is not able to localize cancer within the prostate gland or guide a biopsy needle to a suspicious area . This necessitates an additional effective diagnostic technique that is able to localize or rule out a malignant growth within the prostate . The methods available for the detection of these prostate cancers are digital rectal examination ( DRE ) and Transrectal ultasound ( TRUS ) . DRE is not suitable for early detection , as about 70% of the palpable malignancies have already spread beyond the prostate . The classic problem of visual interpretation of TRUS images is that hypoechoic areas suspicious for cancer may be either normal or cancerous histologically . Moreover , about 25% of all cancers have been found to be isoechoic and therefore not distinguishable from normal-appearing areas . None of the current biobsy or imaging techniques are able to cope with this dilemma . Artificial neural networks ( ANN ) are complex nonlinear computational models , designed much like the neuronal organization of a brain . These networks are able to model complicated biologic relationships without making assumptions based on conventional statistical distributions . Applications in Medicine and Urology have been promising . One example of such an application will be discussed in detail : A new method of Artificial Neural Network Analysis ( ANNA ) was employed in an attempt to obtain existing subvisual information , other than the gray scale , from conventional TRUS and to improve the accuracy of prostate cancer identification ."
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DerUrologeA.00390348.eng.abstr
|
DerUrologeA.00390348.eng.abstr
|
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{
"id": "DerUrologeA.00390348.eng.abstr-passage-0",
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"text": [
"The ileal conduit is a simple and safe supravesical urinary diversion with few postoperative complications . In patients with liver disease with portal hypertension , however , the risk of recurrent , peracute conduit bleeding is increased . While the diagnosis is simple , several therapeutic options are available . In most cases the bleeding comes from stomal varices , that can be controlled with local sclerotherapy with 3% Ethoxyscerol or ligation of the bleeding vessel . The resection of the part of the conduit carrying the varices is an option if bleeding is life threatening or the source cannot be localised . If bleeding recurs excision of the conduit should be considered . Malignant disease must be excluded as a bleeding source ."
],
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0,
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]
}
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[] |
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DerUrologeA.00390356.eng.abstr
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DerUrologeA.00390362.eng.abstr
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"Renal cell carcinomas ( RCC ) are endowed with impressive metastatic potential . Patients with RCC who present with apparently solitary metastatic lesions represent a small cohort . Due to the different long-term results achieved with surgical resection of metastatic RCC lesions , a generally accepted judgement about this treatment modality is not possible . Several studies suggest that aggressive surgical management can provide an effective treatment , especially in patients with solitary pulmonary metastases . Most noteworthy is the fact that because of the organ distribution of RCC metastases , surgical therapy is dominated by general and thoracic surgeons , neurosurgeons , and orthopaedic surgeons . Therefore , an interdisciplinary approach is one of the most important key points for a successful outcome in these patients ."
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DerUrologeA.00390407.eng.abstr
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DerUrologeA.00390407.eng.abstr
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DerUrologeA.00390411.eng.abstr
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"There are no direct associations between testosterone levels and sexual function in the aging male . A study of 169 patients focusing on the relations of hormone levels and sexual dysfunction did not reveal associations between testosterone levels and the risk of altered sexual functions . In volunteers , in whom a hypogonadism was generated by the application of GnRH , no alteration in sexual reactions occurred . It is possible that other testosterone fractions are more meaningful than the total testosterone . However , all the known fractions correlate closely . The significance of a normal testosterone level for a normal erection has been rarely considered up to now . In an animal experiment , the intracavernous pressure , the density of -receptors , and the PDES activity depended on normal testosterone levels . It is not known whether different testosterone levels influence the effectiveness of treatment procedures for erectile dysfunction in humans ."
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DerUrologeA.00390414.eng.abstr
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DerUrologeA.00390414.eng.abstr
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"Age-related changes in men resemble symptoms of hypogonadism . Although the average levels of testosterone decrease with age , correlations between complaints and testosterone levels are inconsistent and low in aging men . This is related to methodological limitations of studies , the high interindividual variability of testosterone in the aging male , ambiguities of normal values , and numerous determinants ( e . g . , health status , health behavior ) on the level of testosterone ."
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DerUrologeA.00390421.eng.abstr
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DerUrologeA.00390421.eng.abstr
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DerUrologeA.00390425.eng.abstr
|
DerUrologeA.00390425.eng.abstr
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"Renal lesions are frequently encountered in blunt pediatric abdominal trauma . In this retrospective study , we analyzed the incidence of renal trauma in these trauma patients to determine which diagnostic and therapeutic approaches were most predictive . From 1976 to 1996 , 308 children sustaining blunt abdominal trauma were admitted to our department . Patients were evaluated using abdominal paracentesis , ultrasonography , and urinary analysis . In specific cases , IV urography , CT scan , and/or angiography were applied . We used the Organ Injury Scale ( OIS ) for classification of renal trauma into five grades ."
],
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[
0,
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]
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}
] |
[] |
[] |
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}
] |
DerUrologeA.00390432.eng.abstr
|
DerUrologeA.00390432.eng.abstr
|
[
{
"id": "DerUrologeA.00390432.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Nosocomial urinary tract infections ( UTI ) are frequent complications after transurethral prostatectomy . The resection itself , postoperative catheterization and the prostate are possible causes of these infections . In this prospective study we investigated the influence of bacterial prostatic colonization on the incidence of postoperative urinary tract infections and inflammatory complications . In 78 patients we observed in 42 cases ( 53,8% ) a bacterial prostatitis . In 14 patients ( 17,9% ) we found nosocomial UTI's and in 12 patients ( 15,4% ) inflammatory complications . The incidence of postoperative UTI's increase significantly in patients with positive prostate-cultures . On the other hand we only found corresponding prostate- and postoperative urine-cultures in less than 50% . The presented data are not sufficient to conclude the kind of relevance of bacterial prostatic colonization for postoperative UTI's in transurethral prostatectomy . Under consideration of the significant increase of nosocomial UTI's in patients with positive prostate cultures a perioperative antibiotic prophylaxis seems to be required in general ."
],
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[
0,
1150
]
]
}
] |
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{
"id": "DerUrologeA.00390432.eng.abstr-s1-t2",
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{
"id": "DerUrologeA.00390432.eng.abstr-s1-t3",
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"id": "DerUrologeA.00390432.eng.abstr-s1-t5",
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"id": "DerUrologeA.00390432.eng.abstr-s1-t7",
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"id": "DerUrologeA.00390432.eng.abstr-s2-t2",
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},
{
"id": "DerUrologeA.00390432.eng.abstr-s2-t3",
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"id": "DerUrologeA.00390432.eng.abstr-s2-t5",
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"id": "DerUrologeA.00390432.eng.abstr-s3-t1",
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DerUrologeA.00390436.eng.abstr
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DerUrologeA.00390446.eng.abstr
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DerUrologeA.00390446.eng.abstr
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"Asymptomatic microhematuria is a common reason for a urological consultation . Uncertainty prevails as to how meticulous the work-up must be , to not miss relevant or even life-threatening underlying diseases . To date , the Urological Associations have not released any guidelines to which extent patients need to be examined for asymptomatic microhematuria , which therefore is managed individually by each urologist . There are various potential examinations that can be applied , ranging from a clinical examination to a kidney biopsy ."
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[] |
[] |
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DerUrologeA.00390455.eng.abstr
|
DerUrologeA.00390455.eng.abstr
|
[
{
"id": "DerUrologeA.00390455.eng.abstr-passage-0",
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"text": [
"One hundred and twenty-five consecutive patients with prostate cancer underwent an extended , radical perineal prostatectomy according to the technique described by VE Weldon . This technique was modified by an initial complete mobilization of the posterior aspect of the prostate and seminal vesicles from the rectum and pelvic wall , incision of the endopelvic fascia , and partial resection of the dorsal vein complex after suture ligature . The perioperative morbidity was low ."
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[] |
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DerUrologeA.00390463.eng.abstr
|
DerUrologeA.00390463.eng.abstr
|
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},
{
"id": "DerUrologeA.00390463.eng.abstr-s6-r2-t1.1-t3.1",
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{
"id": "DerUrologeA.00390463.eng.abstr-s6-r3-t3.1-t2.1",
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}
] |
DerUrologeA.00390520.eng.abstr
|
DerUrologeA.00390520.eng.abstr
|
[
{
"id": "DerUrologeA.00390520.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Pathogenic aspects of interstitial cystitis ( IC ) are reviewed on the basis of the current literature applying the criteria of evidence-based medicine ( EBM ) . Three hundred forty-six peer-reviewed publications of the past 30 years were retrieved via MEDLINE employing the key words \" interstitial cystitis and pathogenesis or etiology \" and classified according to EBM criteria and subject categories . The papers were then reviewed and summarized and are discussed considering the theory of acute and chronic inflammatory responses ."
],
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[
0,
537
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]
}
] |
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{
"id": "DerUrologeA.00390520.eng.abstr-s1-t1",
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"cystitis"
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43
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},
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"id": "DerUrologeA.00390520.eng.abstr-s1-t5",
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0,
18
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{
"id": "DerUrologeA.00390520.eng.abstr-s1-t6",
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]
},
{
"id": "DerUrologeA.00390520.eng.abstr-s1-t7",
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253,
260
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"id": "DerUrologeA.00390520.eng.abstr-s2-t3",
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"id": "DerUrologeA.00390520.eng.abstr-s2-t7",
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},
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"id": "DerUrologeA.00390520.eng.abstr-s3-t1",
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410,
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}
] |
[] |
[] |
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},
{
"id": "DerUrologeA.00390520.eng.abstr-s1-r7-t3.1-t7.1",
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{
"id": "DerUrologeA.00390520.eng.abstr-s1-r8-t2.1-t3.1",
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{
"id": "DerUrologeA.00390520.eng.abstr-s1-r9-t5.1-t7.1",
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{
"id": "DerUrologeA.00390520.eng.abstr-s1-r10-t4.2-t3.1",
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"id": "DerUrologeA.00390520.eng.abstr-s2-r1-t1.1-t6.1",
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"id": "DerUrologeA.00390520.eng.abstr-s2-r3-t1.1-t7.1",
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},
{
"id": "DerUrologeA.00390520.eng.abstr-s2-r4-t6.1-t4.1",
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}
] |
DerUrologeA.00390530.eng.abstr
|
DerUrologeA.00390530.eng.abstr
|
[
{
"id": "DerUrologeA.00390530.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Interstitial cystitis ( IC ) represents a rare and complex inflammatory bladder condition in which diagnostics can be challenging . Strict NIH criteria for its diagnosis were designed for research purposes . Their routine application would miss large proportions of IC patients . When IC is suspected , history and physical exam are followed by an evaluation of long-term voiding diaries . Large voided volumes ( functional capacity > 250 cc ) or longer micturition intervals ( > 2 h . ) , absence of nocturia or symptom-free periods reduce the likelihood of IC . Further exclusion diagnostics include urine tests ( infection ) , cytology ( in-situ carcinoma ) , ultrasound ( calculi , bulks , anomalies ) and urodynamics in selected cases . Bladder capacity measurements under sedoanalgesia are of limited value , since functional low-volume bladders can be mechanically extendable . Cystoscopy under general anesthesia represents the diagnostic standard procedure for IC during which 90% of IC-patients present with characteristic mucosal glomerulations after bladder distension . Biopsies are recommended for exclusion of malignancy . Potassium-leak testing plays no relevant role in routine diagnostics due to its poor sensitivity . Similarly , complex determinations of novel IC markers ( histamine , tryptase , cytokines , growth factors , substance P , nitric oxide ) are of no relevance in clinical settings and should be restricted to research projects ."
],
"offsets": [
[
0,
1463
]
]
}
] |
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"id": "DerUrologeA.00390530.eng.abstr-s1-t1",
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13,
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},
{
"id": "DerUrologeA.00390530.eng.abstr-s1-t2",
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"bladder"
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72,
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]
},
{
"id": "DerUrologeA.00390530.eng.abstr-s1-t3",
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0,
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"id": "DerUrologeA.00390530.eng.abstr-s4-t3",
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"id": "DerUrologeA.00390530.eng.abstr-s6-t2",
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"id": "DerUrologeA.00390530.eng.abstr-s7-t1",
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"id": "DerUrologeA.00390530.eng.abstr-s7-t3",
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DerUrologeA.00390535.eng.abstr
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DerUrologeA.00390535.eng.abstr
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DerUrologeA.00390539.eng.abstr
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DerUrologeA.00390539.eng.abstr
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DerUrologeA.00390545.eng.abstr
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DerUrologeA.00390545.eng.abstr
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DerUrologeA.00390551.eng.abstr
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DerUrologeA.00390551.eng.abstr
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[] |
[] |
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DerUrologeA.00390554.eng.abstr
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DerUrologeA.00390554.eng.abstr
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[
{
"id": "DerUrologeA.00390554.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Tumor cell metabolism is characterized by a high rate of aerobic glycolysis . The metabolic differences require changes in glycolytic enzyme activities and isoenzyme patterns . The inactive form of the M2 pyruvate kinase ( Tu M2-PK) is specifically expressed in tumor cells and has been detected immunohistochemically in tumor tissue but also in peripheral blood of patients with different malignant tumors . In this study , Tu M2-PK in the plasma of patients with renal cell carcinoma ( RCC ) was compared with healthy volunteers . Tu M2-PK was quantified with a commercially available enzyme linked immunosorbent assay ( ELISA ) kit . Using the ELISA kit , plasma probes of 57 healthy individuals were compared to 63 patients with RCC ( 51 patients with non-metastatic RCC , 12 patients with metastatic RCC ) . Statistical analysis was performed with the non-parametric ANOVA test according to Kruskal-Wallis . In patients with renal cell carcinoma , Tu M2-PK was significantly higher than in healthy volunteers . For organ-defined , non-metastatic tumors , sensitivity was only 27.5% , if the 95% reference values of the control group were used for discrimination . The differences were more pronounced in patients with metastatic disease . Tu M2-PK was significantly enhanced compared to healthy controls , but also to the group with non-metastatic disease , the sensitivity was 66.7% . Our data show that Tu M2-PK has no impact as an unspecific marker for the diagnosis of renal cell carcinoma . This is especially relevant to organ-defined , non-metastatic RCC . In advanced metastatic disease , a potential importance as a parameter for treatment control in palliative therapeutic approaches can be assumed , and warrants further investigations ."
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DerUrologeA.00390557.eng.abstr
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DerUrologeA.00390557.eng.abstr
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"With the objective of developing a biodegradable ureteric stent , various polylactides were analyzed and grafted with a clinically adapted surface . Stent moulding was performed by CESP technology ( Controlled Expansion of Saturated Polymers ) , which is not based on high temperature but gas-loading under high pressure which induces a foamy bulk structure . The hydrolytically biodegradable , synthetic homo- and copolymers poly ( D , L-lactide ) ( PDLLA ) , poly ( D , L-lactide-co-trimethylene-carbonate ) ( PDLLA-co-TMC ) , poly ( D , L-lactide-co-glycolide ) ( PDLLA-co-Gly ) as derivatives of lactic acid or glycolic acid and surface modifications with hydroxyethylene-methacrylate ( HEMA ) and oligoethyleneoxidemonomethacrylate ( OEOMA ) were analyzed with regard to cytotoxicity and cell adhesion . Methacrylates have minimized protein and cell adhesion and degradation of non-toxic products . All polymers exhibited a high degree of biocompatibility and cell adhesion was markedly reduced following HEMA grafting . A 3 cm and 7 Charrière prototype of the stent was moulded from PDLLA-co-TMC by CESP-technology , and grafted with HEMA by means of plasma-induced polymerization . Finally , the stents were implanted into female sheep , following unilateral ureterotomy . Regular blood and urine analysis as well as ultrasound and the final autopsy revealed no pathological findings . Histopathological analysis exhibited a regular epithelium without any changes being determined by contact to the stent , and a good regeneration of all layers in the area of anastomosis ."
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DerUrologeA.00390572.eng.abstr
|
DerUrologeA.00390572.eng.abstr
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"text": [
"We report on a 44-year-old man with the rare case of a mucin-positive carcinoma of the urachus . We performed extended partial cystectomy with regional staging lymphadenectomy of the obturator lymph nodes . Histological investigation revealed a mucin-positive carcinoma of the urachus with negative lymph nodes . For this case , we present symptoms , a plan for diagnosis , and treatment of these tumors ."
],
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]
}
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DerUrologeA.60350357.eng.abstr
|
DerUrologeA.60350357.eng.abstr
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[
{
"id": "DerUrologeA.60350357.eng.abstr-passage-0",
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"text": [
"Physiologically , angiogenesis in adults is a controlled process which plays a role , for example , in wound healing . Pathological angiogenesis is observed in tumor formation and represents a multifactorial process , in which specific angiogenic factors , as well as growth factors , extracellular matrix proteins and cell adhesion molecules are involved . Tumor growth is characterized by an imbalance in favor of angiogenic over angiogenesis-inhibiting factors . Some of the most frequently examined angiogenic factors are vascular endothelial growth factor , acidic/basic fibroblast growth factors and the platelet-derived endothelial cell growth factor . The most important angiogenesis inhibitors are angiostatin and thrombospondin . To date , the clinical relevance of tumor angiogenesis has been shown for several human tumors . For most urological tumors , the grade of tumor vessel formation , measured as microvessel density , has been associated with metastases , tumor growth and clinical course . The prognostic value of this feature of malignant growth seems to be higher than that of most of the classical and newer prognostic factors . Systematic investigations of tumor angiogenesis are becoming increasingly relevant for diagnostic and therapeutic strategies and offer opportunities for the development of new specific therapeutic approaches in clinical oncology ."
],
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DerUrologeA.60350363.eng.abstr
|
DerUrologeA.60350363.eng.abstr
|
[
{
"id": "DerUrologeA.60350363.eng.abstr-passage-0",
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"text": [
"Adhesion molecules play an important role in organogenesis , wound healing , inflammation , and progression of malignant tumors . Three major classes of adhesion molecules may be discriminated by function : ( a ) calcium-dependent homotypic adhesion molecules ( e . g . cadherins ) , ( b ) substrate adhesion molecules ( e . g . integrins ) and ( c ) heterotypic adhesion molecules ( e . g . ICAM-1). Molecules of each of the three classes have been identified in urologic tumors . Results of research on substrate adhesion molecules and heterotypic adhesion molecules have not yet led to new clinical concepts . In contrast , loss of E-cadherin in tumors of the bladder and prostate has been clearly associated with de-differentiation of tumors and diminished survival of patients . Loss of another adhesion molecule , C-CAM , has been observed in prostate cancer . This has led to new therapeutic approaches , which are in an experimental stage at present . It may be expected that , in the future , new therapeutic concepts will be based on research on adhesion molecules in urologic tumors ."
],
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DerUrologeA.60350370.eng.abstr
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DerUrologeA.60350370.eng.abstr
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DerUrologeA.60350378.eng.abstr
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DerUrologeA.60350378.eng.abstr
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"The rapid development of recombinant DNA technology and our enhanced understanding of the genetic basis of human disease has facilitated the development of new molecular therapeutic modalities , termed gene therapy . Gene therapy involves the transfer of functional genes into somatic cells and their expression in target tissues in order to replace absent genes , correct defective genes , or induce antitumoral activity in the tumor-bearing host . Currently , an increasing number of gene therapy strategies are being investigated in experimental and clinical trials . Despite substantial progress , a number of technical and logistical hurdles must still be overcome before gene therapy can be safely and effectively applied in the human patient . Since gene therapy involves complex cell processing and can be time consuming and costly , simplifications or even alternative approaches will be necessary in order to establish this therapy as suitable for clinical use . This report reviews various gene therapy stategies and gene delivery techniques currently under clinical or experimental investigation . Special emphasis is given to cytokine gene therapy using gene-modified tumor vaccines for cancer treatment ."
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[] |
[] |
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DerUrologeA.60350390.eng.abstr
|
DerUrologeA.60350390.eng.abstr
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"id": "DerUrologeA.60350390.eng.abstr-passage-0",
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"Apoptosis , or programmed cell death , plays an essential role in specific cell deletion during normal embryonal and adult development . Apoptotic cells are characterized by fragmentation of nuclear DNA and formation of apoptotic bodies . Molecular genetic analysis has revealed the involvement of several deaths and survival genes that are regulated by extracellular and intracellular factors . There are multiple inducers and inhibitors which interact with target cellspecific receptors and transduce signals involved in cellular proliferation , cell cycle progression and programmed cell death . The elimination of tumor cell populations by applying lethal doses of chemotherapeutic agents or radiation is a well-established strategy in cancer therapy . Although improved cytotoxic chemo- and radiotherapy regimens are available , the efficacy of these strategies is still disappointing with regard to many solid tumors . Better understanding of the molecular mechanism of apoptosis , including death genes , death signals , receptors and signal transduction pathways , will provide new approaches in the development of strategies to regulate malignant cell survival and death . Recent discoveries in the field of apoptotic cell death promise to have a significant impact on antitumor therapies . Apoptosis is known to be an active process which can be artificially manipulated by several molecular pathways . This information concerning the regulation and induction of programmed cell death might lead among otherthings , to the development of new powerful means to eliminate malignant cell populations of otherwise resistant genitourinary tumors such as prostate cancer ."
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DerUrologeA.60350408.eng.abstr
|
DerUrologeA.60350408.eng.abstr
|
[
{
"id": "DerUrologeA.60350408.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The different subgroups of hypercalciuria cannot be separated clearly by the Pak calcium-load test . To improve the diagnosis and therapy we examined all relevant parameters of calcium metabolism in 32 patients with calcium urolithiasis and hypercalciuria ( > 6.25 mmol/day ) . We also conducted bone mineral density measurements as well as the Pak calcium-load test . In most cases the pathophysiological constellations which Pak takes as the basis for his classification of hypercalciuria could not be shown . To date , diagnostics only insufficiently explains the genesis of hypercalciuria ( except pHPT ) . As a consequence , a therapeutic problem arises : a low-calcium diet should not be generally recommended , since some patients may develop osteopenia . From our investigation the following diagnostic and therapeutic conclusions can be drawn : ( 1 ) Hypercalciuria in primary hyperparathyroidism should be treated by surgical removal of the adenoma . ( 2 ) The parathormone-independent osteogenic form should be treated with thiazides . ( 3 ) Hypercalciuria with increased 1,25-dihydroxyvitamin D should be treated by low-calcium diet ."
],
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}
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] |
[] |
[] |
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DerUrologeA.60350413.eng.abstr
|
DerUrologeA.60350413.eng.abstr
|
[
{
"id": "DerUrologeA.60350413.eng.abstr-passage-0",
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"text": [
"Laparoscopic pelvic lymph node dissection was performed in 120 patients scheduled to undergo either radical perineal prostatectomy or radiation therapy . On average 13 lymph nodes were resected in each patient , and 21 patients were found to have metastatic disease in 1-9 lymph nodes . After an initial learning curve , mean operative time was reduced significantly , allowing laparoscopic lymph node dissection and radical prostatectomy to be performed as a one-stage procedure . The overall complication rate was 10 % ; open revisions were necessary in only 2 of 120 patients . Postoperative hospital stay was 2 days in patients undergoing laparoscopic lymph node dissection only . This minimally invasive procedure is particularly beneficial to patients with lymph node metastases not undergoing radical prostatectomy , as well as to patients planned to be treated by radiation therapy . The combination of laparoscopic lymph node dissection and radical perineal prostatectomy avoids an abdominal incision and thus shortens both the hospital stay and the period of convalescence ."
],
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]
}
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DerUrologeA.60350443.eng.abstr
|
DerUrologeA.60350443.eng.abstr
|
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"In a retrospective study 6890 patients with prostate cancer from the North Swedish Cancer Register were analyzed according to cancer specific survival . Prostate cancer mortality was 40 % in patients with well differentiated cancers , 54 % in patients with moderate differentiated prostate cancer and 72 % in men with low differentiated prostate cancer . Prostate cancer mortality was 80 % in men younger than 60 years , 63 % in men 60-69 years old , 53 % in men 70-79 years old and 49 % in men older than 80 years ."
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[] |
[] |
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DerUrologeA.60350446.eng.abstr
|
DerUrologeA.60350446.eng.abstr
|
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"In a population-based study , disease progression and survival were evaluated in primary untreated patients with newly diagnosed cancer of the prostate without distant metastases . Complete follow-up was achieved in 223 eligible patients with localized disease . These patients were treated with hormones if they had symptoms of tumor progression . After a medium observation time of 14 years , 73 patients experienced local tumor progression and 27 ( 13 % ) had metastases . Seventy-four percent of the patients had died , but only 11 % of prostate cancer . The estimated overall and disease-specific survival after 15 years was 20.7 % ( 95 % , confidence interval 14.1-27.3 % ) and 80.9 ( 72.4-89.4 % ) , respectively . In a multivariate analysis , tumor grade turned out to be a strong predictor of progression and death due to prostate cancer . The low disease-specific mortality rate , especially in patients with highly and moderately differentiated tumors , means that any therapy intended for patients with early prostate cancer must be evaluated in clinical trials with untreated controls for comparison ."
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[] |
[] |
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DerUrologeA.60350449.eng.abstr
|
DerUrologeA.60350449.eng.abstr
|
[
{
"id": "DerUrologeA.60350449.eng.abstr-passage-0",
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"text": [
"The long-term outcome in patients with prostate cancer treated with palliative intent was examined in two populations from Goeteborg , Sweden . The results showed a prostate-cancer-related mortality of 62 % . The cumulative mortality increased over time , indicating that prostate cancer may be a slow-growing tumour , but that patients were at considerable risk for disease progression and eventual death . Dying from prostate cancer was associated with a long hospital stay and frequent demands for palliative treatments such as TURP , radiation and procedures due to upper-urinary-tract obstruction . In a subpopulation of patients who survived for more than 10 years , the cancer-related mortality was suprisingly high , 62 % after noncurative treatment . Even if the patients were diagnosed before the PSA era , the above findings should be taken into account when advising patients with prostate cancer about therapy if they have a long life expectancy ."
],
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0,
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]
}
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DerUrologeA.60350454.eng.abstr
|
DerUrologeA.60350454.eng.abstr
|
[
{
"id": "DerUrologeA.60350454.eng.abstr-passage-0",
"type": "abstract",
"text": [
"From 1978 to 1982 , 172 patients with T1-3, Nx , M0 prostate cancer were included in a surveillance protocol with deferred treatment on symptomatic progression . The median age at diagnosis was 68 ( 38-89 ) years . The disease-specific survival at 10 years was 80 % for the total series , 84 % for the subgroup with T1-2 tumors , and 92 % for patients with T1-2 tumors diagnosed when the patients were old less than 70 years . For the subgroup with T3 tumors , the disease-specific survival at 9 years was 70 % . In all subgroups the competing mortality was higher than the prostate cancer mortality . Deferred treatment appears to be an acceptable treatment option for patients with a tumor clinically confined to the prostate with a life expectancy of 10 years or less ."
],
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0,
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]
]
}
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[] |
[] |
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DerUrologeA.60350456.eng.abstr
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DerUrologeA.60350456.eng.abstr
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[
{
"id": "DerUrologeA.60350456.eng.abstr-passage-0",
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"text": [
"Erectile dysfunction has taken on increasing importance in urologic practice . Still open is the question of which tests are mandatory for adequate clinical assessment of erectile dysfunction . One accepted standard modality is the intracavernous pharmacotest with vasoactive agents . In contrast , color duplex sonography is not considered mandatory although it reveals detailed information about penile vessels and functional implications . The question remains whether the information gained by color duplex sonography is relevant for therapy , making it an indispensable standard procedure . Patients with erectile dysfunction were evaluated , without preselection , by extensive history , clinical evaluation , laboratory tests , tumescence and rigidity measurements , intracavernous administration of vasoactive drugs and color duplex sonography . Seventy-nine patients were available for final analysis . Color duplex sonography revealed 39 normal tests , 16 arterial impairments , 19 venous leakages and 5 arteriovenous fistulae . Intracavernous vasoactive agents ( pharmacotest ) revealed 44 reactions sufficient for intercourse and 35 insufficient responses . In 89 % of patients , the diagnoses on color duplex sonography and intracavernous pharmacotesting were similar . The accuracy of the two methods in diagnosing erectile dysfunction was not statistically different ( McNemar's test ) . In contrast to intracavernous pharmaco-testing , color duplex sonography permitted further etiologic subdivision into arterial disease , venous leakage , arteriovenous fistula and normal result . This was made possible by measuring significantly ( P 0.01 ) different arterial peak flow velocities , end-diastolic velocities and calculated resistance index . These data did not imply direct clinical consequences . Color duplex sonography and intracavernous pharmacotesting reveal comparable results concerning the diagnosis of an erectile dysfunction . In contrast to pharmacotesting , color duplex sonography reveals details of the nature of the erectile dysfunction . Because this information has no profound implications for the choice of therapeutic procedure , color duplex sonography can not be recommended as a standard procedure in the evaluation of erectile dysfunction ."
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DerUrologeA.60350463.eng.abstr
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DerUrologeA.60350463.eng.abstr
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"id": "DerUrologeA.60350463.eng.abstr-passage-0",
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"The vascular organization of human spermatic cord was analyzed by means of injection and by casting preparation of the testicular artery and veins of the pampiniform plexus after orchiectomy . After leaving the human testis , the testicular veins are organized in two main groups and form two vein plexus . One of these vein groups forms a tight plexus around the testicular artery . Computer-aided 3-D reconstructions based on the paraffin serial sections of the human spermatic cord allowed us to demonstrate the relation between the blood vessels and the other tissue structures of the spermatic cord . The results obtained allowed us to subdivide the human spermatic cord into three compartments . The dorsomedial compartment contains the vas deferens and its blood vessels . The middle compartment contains the testicular artery and the vein group which forms a tight plexus around this artery . The ventrolateral compartment contains a vein group which shows no topographic relation to the testicular artery . This vein group is embedded in a large , macroscopically visible volume of fatty tissue . To be sure of sparing the testicular artery during antegrade sclerotherapy this vein group should be prepared ."
],
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DerUrologeA.60350468.eng.abstr
|
DerUrologeA.60350468.eng.abstr
|
[
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"id": "DerUrologeA.60350468.eng.abstr-passage-0",
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"Leydig cell tumors are the most common tumors of the gonadal stroma . They account for 3 % of all testicular tumors . Whereas in 10 % of adult cases malignancy occurs , the clinical course in children is benign . During childhood the tumor presents with precocious pseudopuberty , in adults with testicular swelling and gynecomastia . We report on 17 cases of Leydig cell tumor , paying special attention to clinical and morphological aspects ."
],
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[
0,
444
]
]
}
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[] |
[] |
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DerUrologeA.60350478.eng.abstr
|
DerUrologeA.60350478.eng.abstr
|
[
{
"id": "DerUrologeA.60350478.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In this study a modified experimental kidney xenograft model was developed , which reproduced , in a reliable way , the course of hyperacute rejection . In this model guinea-pig kidneys were transplanted to rats using end-to-side anastomoses with recipient aorta and vena cava , respectively , and ureter drainage for diuresis monitoring . The aim of this study was to investigate the protective effects of complement modulation by soluble complement receptor 1 ( sCR1) on the xenografts . Twenty-four xenotransplantations were performed and recipients randomized for treatment either by 3 ml saline or 50 mg/kg sCR1 as a 3-ml bolus . It was found that sCR1 was highly efficient in delaying hyperacute rejection from 10.5 +/- 2.1 min in the control group to at least 2 h in the therapy group and in prolongation of graft function . The complement activity was significantly reduced in the sCR1-treated rats , even at the time of rejection , as a result of complement modulation in this group of xenograft recipients . Xenografts from saline-treated animals showed necroses , interstitial haemorrhages and platelet aggregates occluding the vessels as soon as 10 min after the reperfusion started . No such changes could be seen even after 120 min in the xenografted kidneys of sCR1-treated rats . Also C3 deposits in the glomeruli and interstitium were markedly reduced ."
],
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0,
1370
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]
}
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DerUrologeA.60350490.eng.abstr
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DerUrologeA.60350490.eng.abstr
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{
"id": "DerUrologeA.60350490.eng.abstr-passage-0",
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"text": [
"The seminal vesicle cyst is a congenital malformation of the male urogenital tract , which seems to be more frequent than originally presumed . It is usually combined with an ipsilateral renal agenesis and an ectopic ureter . Two relevant cases are reported and embryology , major presenting symptoms , diagnostic procedures , differential diagnosis and therapy are extensively discussed ."
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}
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DerUrologeA.70360003.eng.abstr
|
DerUrologeA.70360003.eng.abstr
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"Although human benign prostatic hyperplasia ( BPH ) is the most common tumor in men , its etiology is still unclear . At present , it is only widely accepted that BPH is under the endocrine control of the testes and strongly associated with aging . Therefore , in the human prostate we describe the impact of aging on the activity of various androgen metabolizing enzymes as well as on the endogenous androgen and estrogen levels . Moreover , the inhibition of 5-reductase by finasteride ( Proscar ) will be reported . Among all androgen metabolizing enzymes , within the human prostate 5-reductase is the most powerful one . Most of the androgen metabolizing enzymes undergo a significant age-dependent alteration . For distinct enzymes , the correlation with age is either negative ( e . g . 5-reductase ) , or positive . Despite a complex pattern of age-dependent alterations , the dominance of 5-reductase among all androgen metabolizing enzymes is always maintained . This is underlined by a strong accordance between the age-dependent 5-reductase activity and the corresponding age-dependent endogenous DHT level . In epithelium , both the 5-reductase activity and the DHT level decrease with age , whereas in stroma not only the 5-reductase activity is rather constant over the whole age range but the DHT level as well . In contrast to the relatively unaltered DHT content in the stroma of the human prostate , the estrogen content follows an age-dependent increase . On the other side , in epithelium such a positive correlation between the estrogen level and age is not found . Thus , the age-dependent decrease of the DHT accumulation in epithelium and the concomitant increase of the estrogen accumulation in stroma will lead to a tremendous increase with age of the estrogen/androgen ratio in the human prostate . This could be of pathogenetic importance for BPH development if in fact a balanced androgen/estrogen synergism is necessary for the integrity of the normal human prostate . Finally , it is remarkable that the inhibition of 5- reductase activity by finasteride ( Proscar ) is significantly stronger in epithelium than in stroma . Therefore , it is conceivable that the global size-reduction of BPH under finasteride treatment is primarily due to the regression of BPH epithelium ."
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DerUrologeA.70360010.eng.abstr
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DerUrologeA.70360010.eng.abstr
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"Phytopharmaceutical agents have been used for a long time in the treatment of symptomatic benign prostatic hyperplasia ( BPH ) . However , until recently , it has been questioned whether phytotherapy is superior to a placebo treatment . In this article , the most widely used phytopharmaceutical agents , such as saw palmetto berry extracts , Radix urticae extracts , pumpkin seeds , pollen extracts and different phytosterols , are described . In addition , both in vitro and in vivo studies are discussed in an attempt to explain a possible mechanism of action . There are several new clinical studies which demonstrate a significant benefit compared with placebo treatment . Based on these results , the use of phytopharmaceutical agents for the treatment of mild to moderate symptomatic BPH seems to be well justified . So far , no significant inhibition of further prostate growth has been demonstrated . For this , a careful follow-up of the patients is necessary so as not to miss a deterioration and perhaps the need for an operation ."
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DerUrologeA.70360018.eng.abstr
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DerUrologeA.70360018.eng.abstr
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"id": "DerUrologeA.70360018.eng.abstr-passage-0",
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"The International Consensus Committee recommends -adrenoceptor antagonists for medical therapy of benign prostatic hyperplasia ( BPH ) . This review evaluates 52 randomized , placebo-controlled , double-blind studies , including 10 399 patients and , moreover , 40 clinical studies including 33 600 patients undergoing treatment with -adrenoceptor antagonists because of BPH . The therapeutic efficacy of all -adrenoceptor antagonists is more or less the same . There is an average improvement of symptom scores of about 35 % and a mean increase in maximum flow rate of between 1.8 and 2.5 ml/s . Studies investigating long-term efficacy and quality of life tend to show a long-term benefit . The introduction of selective 1-adrenoceptor antagonists led to a significant reduction of side effects . These side effects are primarily caused by the vasodilatatory qualities of -blockers . The development of so-called uroselective 1A-adrenoceptor antagonists in the treatment of BPH possibly leads to further reduction of side effects related to vasodilatation . Medical therapy by 1-adrenoceptor antagonists seems to be superior to phytotherapy or treatment with 5-reductase inhibitors , as shown in a few studies . So far , it is not clear whether there is any advantage of combination therapy . The application of 1-adrenoceptor antagonists is indicated in all cases of symptomatic BPH , excluding patients who need TUR-P ( e . g . , middle lobe ) or prostatectomy . If patients are either willing or eligible to have surgical treatment , therapy by 1-adrenoceptor antagonists is a rational choice . Comparative clinical trials have to be conducted to provide additional information and to clarify which -blocker may be recommended as the first choice . Until then , those 1-adrenoceptor antagonists should be used for which safety and efficacy are well documented and which can be prescribed at reasonable costs ."
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DerUrologeA.70360035.eng.abstr
|
DerUrologeA.70360035.eng.abstr
|
[
{
"id": "DerUrologeA.70360035.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Medical therapy in the treatment of symptomatic benign prostatic hyperplasia has changed very much during the last few years . Finasteride is a 5-alpha-reductase inhibitor , which inhibits the predominant intraprostatic isoenzyme II of 5-alpha-reductase and therefore DHT , which is - among other factors - essential for the physiological growth of the prostate . However , it also has an important influence on developing BPH . It was shown in several studies that finasteride can increase urinary flow rates , decrease the prostate volume , and improve the symptom score and PSA value . The objective improvement in urinary flow rates was only moderate , but better results were obtained in the improvement of patient symptoms . Large multicenter studies will be conducted to see if the efficacy of treatment can be improved by combination therapy with alpha-1-blockers."
],
"offsets": [
[
0,
872
]
]
}
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DerUrologeA.70360040.eng.abstr
|
DerUrologeA.70360040.eng.abstr
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{
"id": "DerUrologeA.70360040.eng.abstr-passage-0",
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"Nineteen men with post-prostatectomy urinary incontinence grade II and III ( mean follow-up 12.7 months ) underwent periurethral injections of collagen . In all , 37 procedures were performed ; 58 % of the patients underwent the procedure at least twice . A mean of 16 ml collagen was injected . The results were successful directly after injections , leaving all patients continent ; however , after 3 months the treatment failed and all patients returned to their incontinence status as seen preoperatively . No perioperative complications were noted . Despite the simple and safe nature of this procedure , men with severe postoperative stress incontinence do not benefit from periurethral collagen injections ."
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DerUrologeA.70360045.eng.abstr
|
DerUrologeA.70360045.eng.abstr
|
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"id": "DerUrologeA.70360045.eng.abstr-passage-0",
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"Interleukin-2 ( IL-2) and interferon- ( IFN- ) were both administered subcutaneously ( SC ) in combination with intravenously ( IV ) applied 5-fluorouracil ( 5-FU ) for the treatment of patients with metastasized renal cell carcinoma ( RCC ) . The therapy protocol consisted of a treatment cycle of 8 weeks , which could be carried out in an outpatient regimen . The IFN- was given in each of the 8 weeks ( 6-9 MU/m2 once to three times weekly SC ) combined sequentially with IL-2 ( 5-20 MU/m2 three times weekly SC for 4 weeks ) and 5-FU ( 750 mg/m2 IV weekly for 4 weeks ) . Among the 30 consecutive patients treated , in 2 cases a complete , and in 9 cases a partial , remission was achieved in patients with mostly lung and skeletal metastases , with an overall objective response rate of 37 % . Mean response duration was 8 months ( range 3-18 months ) . A stable state of the disease lasting 3-18 months was observed in 10 cases . The side effects were only slight and corresponded to toxicity grade I ( n = 2 ) , grade II ( n = 22 ) and grade III ( n = 6 ) , according to the WHO classification . In conclusion , this triple-drug biochemotherapy demonstrated significant clinical effectiveness comparable with that of an aggressive IL-2 treatment regimen ( applied IV ) , but without its high toxicity ."
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[] |
[] |
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DerUrologeA.70360050.eng.abstr
|
DerUrologeA.70360050.eng.abstr
|
[
{
"id": "DerUrologeA.70360050.eng.abstr-passage-0",
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"text": [
"A verrucous carcinoma of the urinary bladder ( pT4N0M0, G1) developed in a 66-year-old woman who had been suffering from interstitial cystitis with Hunner's ulcer for 10 years . Up to now , only 7 cases of verrucous carcinoma of the urinary bladder unassociated with bilharzial cystitis have been reported . Although the development of a verrucous carcinoma as a complication of interstitial cystitis has not been reported so far , the authors regard the chronic irritation of the bladder to be the most important etiologic factor for the malignant transformation . After conservative management had failed , a radical cystectomy with supravesical urinary diversion was performed . The characteristics of interstitial cystitis , verrucous carcinoma and surgical management are discussed ."
],
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DerUrologeA.70360068.eng.abstr
|
DerUrologeA.70360068.eng.abstr
|
[
{
"id": "DerUrologeA.70360068.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In 180 children ( 87 children belonging to a control group , 68 with fever of non-renal origin , and 25 with pyelonephritis ) albumin and immunoglobulin G ( markers for glomerular dysfunction ) , -1-microglobulin and -NAG ( markers for proximal tubular dysfunction ) and apolipoprotein A1 ( marker of ' postrenal ' dysfunction ) were measured in second-voided morning urine . In children with fever of non-renal origin , glomerular dysfunction was encountered in 8.8 % , tubular dysfunction in 17.6 % and mixed glomerular-tubular dysfunction in 14.7 % of cases . Among children with pyelonephritis , 28 % revealed glomerular dysfunction and 44 % mixed glomerular-tubular dysfunction . No case of solitary proximal tubular dysfunction was observed in children with pyelonephritis . There were highly significant differences in presence and expression of glomerular dysfunction between children with fever of non-renal origin and children with pyelonephritis ( P 0.0001 ) , whereas with regard to proximal tubular dysfunction , the differences were only moderately significant ( -NAG : P 0.01 ) or of low significance ( -1-microglobulin: P 0.05 ) . This may indicate that morphologic changes occur during interstitial pyelonephritis due to inflammation of glomeruli , resulting in glomerular dysfunction , while proximal tubular dysfunction may additionally be due to fever-associated function processes ."
],
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0,
1403
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]
}
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DerUrologeA.70360077.eng.abstr
|
DerUrologeA.70360077.eng.abstr
|
[
{
"id": "DerUrologeA.70360077.eng.abstr-passage-0",
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"text": [
"Persistent remnants of the caudal muellerian ducts can manifest in several forms and are often associated with other urogenital disorders , especially hypospadias . Inadequate activity of the muellerian inhibiting factor , in addition to fetal testosterone deficiency , is responsible for this syndrome . The etiology , diagnosis and management of muellerian duct remnants are discussed . A complex case of penile-scrotal hypospadia , hypoplastic prostate gland , testicular ectopia and retrovesical cyst is presented ."
],
"offsets": [
[
0,
519
]
]
}
] |
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[] |
[] |
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DerUrologeA.70360081.eng.abstr
|
DerUrologeA.70360081.eng.abstr
|
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"id": "DerUrologeA.70360081.eng.abstr-passage-0",
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"text": [
"This case report deals with the clinical history of a 52-year-old woman who suffered from delayed graft function and ischaemic pain after a technically successful renal transplantation . The past history of the patient revealed that coronary catheters had repeatedly been used for investigation and treatment of myocardial infarctions . The clinical investigation reported here revealed a typical auscultatory result with an arteriovenous ( AV ) fistula in the right upper limb . After performing a digital arterial angiography , an AV fistula between the femoral artery and vein was demonstrated . Operative occlusion of the fistula increased the perfusion of the kidney graft and the right limb . The patient recovered without wound infection and could leave the hospital with the transplanted kidney functioning well . This case report demonstrates that persistence of AV fistulas after angiographic investigations is rare . Operative occlusion of these lesions should be performed before kidney transplantation to avoid steal phenomena and disturbed would healing ."
],
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DerUrologeA.70360084.eng.abstr
|
DerUrologeA.70360084.eng.abstr
|
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"text": [
"In the diagnosis and treatment of acute scrotal pain and swelling it is important to differentiate between testicular torsion and epididymo-orchitis . A special case of a thirty-eight-year-old male asylant from Nepal was presented in the urological service with acute scrotal pain . To exclude testicular torsion , a diagnostic exploration of the scrotum was done with the findings of an acute funiculitis with abscess formation . Under surgical drainage of abscess together with medical treatment the acute inflammation disappeared . The diagnosis of filarial funiculitis was made after identifying the microfilariae in a blood vessel and in the peripheral blood smear . A filaricide medication with diethylcarbamacine citran was administered with good symptomatic relief ."
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DerUrologeA.70360103.eng.abstr
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DerUrologeA.70360103.eng.abstr
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"id": "DerUrologeA.70360103.eng.abstr-passage-0",
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"Nephron-sparing surgery in renal cell carcinoma is an accepted approach in patients with bilateral carcinomas , solitary kidneys and in patients with chronic renal failure in whom radical nephrectomy would necessitate immediate renal replacement therapy ( mandatory indications ) . Because of the improvement of operative techniques - like renal perfusion in hypothermia or work-bench surgery - over 95 % of patients can spared dialysis even if multiple tumors or locally advanced renal cancer is present . Based on the excellent outcome of nephron-sparing surgery in mandatory indications ( 5-year survival rates over 80 % ) , several centers advocate extending the use of partial nephrectomy to selected patients with a normal opposite kidney ( elective indications ) . Several reports on nephron-sparing surgery in elective indications with a median follow-up time of 40 months document similar survival rates compared to radical nephrectomy . Nevertheless , due to the low incidence of bilateral renal carcinomas ( under 2 % ) , only 2 of 100 patients would benefit from this approach . Furthermore , local recurrence after nephron-sparing surgery occurs mostly after 4 years ( late recurrence ) ; therefore , it seems doubtful whether the short follow-up times really reveal the the true recurrence rate . The prognosis after development of a local recurrence is poor ."
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DerUrologeA.70360109.eng.abstr
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DerUrologeA.70360109.eng.abstr
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"The elaboration of new operative procedures established in the last decade has led to an improved prognosis in patients with renal cell carcinoma with vena caval extension . We report on our personal operative experience in over 100 patients and present the current analysis of 76 patients with renal carcinoma with vena caval extension seen in our institution between 1985 and 1996. Sixty-six patients underwent nephrectomy and removal of vena caval tumor thrombi . Actuarial 5-year survival for patients without metastasis was 38 % . For patients with tumor stages between I and III , 5-year survival was between 40 and 50 % and was not significantly related to the rostral extent of the tumor thrombus . The relatively poor outcome for patients with tumor thrombi invading the right atrium was caused by a high perioperative mortality ( 50 % ) . For patients with distant metastases , medium survival time was 10.5 months , implying that radical surgery is useless in cases of distant metastases ."
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DerUrologeA.70360117.eng.abstr
|
DerUrologeA.70360117.eng.abstr
|
[
{
"id": "DerUrologeA.70360117.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Brain metastases develop as a late manifestation of renal cell cancer ( RCC ) and pose an increasing challenge to urologists as a result of the more frequent prolonged survival of patients with advanced RCC . Therapeutic options , including surgical resection and radiotherapy , were analyzed retrospectively to assess survival and to identify factors influencing prognosis in a group of 90 patients treated either by brain metastasectomy ( n = 64 ) or radiotherapy ( n = 26 ) . The analysis confirmed that the overall median survival was a disappointing 461 days and the 1-year survival rate was 31 % for patients treated by surgical resection and 310 days and 15 % respectively for patients treated by radiotherapy . However , a subgroup of patients who benefitted significantly from aggressive treatment of metastases could be defined . The following favorable prognostic factors showed a trend toward improved survival : ( 1 ) metachronous appearance of brain metastases more than 1 year after nephrectomy ( P 0.0001 ) , ( 2 ) good patient performance ( Karnofsky > 70 ) ( P 0.0002 ) , ( 3 ) patient's age under 50 years ( P 0.05 ) , ( 4 ) solitary lesions ( P 0.05 ) , ( 5 ) minimal or no neurological deficit ( P 0.05 ) , and ( 6 ) the absence of/or minimal extracranial metastases ( P 0.05 ) . No influence of lesion size and localization ( infratentorial vs supratentorial ) on survival was detected . Surgical treatment of recurrent brain tumors ( n = 17 ) yielded an additional median survival advantage of 8 months as compared to untreated patients ( n = 16 ) . Our results suggest that , especially in patients with good prognostic criteria , a radical metastasectomy plus vigorous surgery of local recurrences and , if required , subsequent systemic immuno- or chemoimmunotherapy should be performed . In patients with poor prognosis , stereotactic radiosurgery is recommended for palliation and survival prolongation ."
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"id": "DerUrologeA.70360117.eng.abstr-s9-r11-t5.1-t4.1",
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] |
DerUrologeA.70360126.eng.abstr
|
DerUrologeA.70360126.eng.abstr
|
[
{
"id": "DerUrologeA.70360126.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The clinical relevance of de novo Renal Cell Cancer was compared in chronic hemodialysis patients and renal allograft recipients . Clinical course of these patients was followed for 15 years . 21 of 788 patients who underwent radical nephrectomy were suffering from renal insufficiency at the time of surgery . Evaluated data included clinical symptoms , tumor histology and clinical course . 19 patients received chronic hemodialysis treatment . 7 patients demonstrated stable function of the allograft . 92 % of patients receiving hemodialysis treatment did not show metastasis and none died of renal cell carcinoma . On the contrary , 71 % of patients who underwent renal transplantation showed advanced tumor disease or metastasis . 3 patients have died of RCC . Aggressive tumor growth of RCC requieres close follow up in patients who received a renal allograft ."
],
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0,
868
]
]
}
] |
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] |
[] |
[] |
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DerUrologeA.70360130.eng.abstr
|
DerUrologeA.70360130.eng.abstr
|
[
{
"id": "DerUrologeA.70360130.eng.abstr-passage-0",
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"text": [
"The immunogenic potential of renal cell carcinoma and the resistance of its metastases against chemotherapy , radiation and hormonal treatment have led to the development of a great number and variety of different strategies , summarized under the term immunotherapy . Objective remissions can be expected in about 20-40 % of patients . Another 30-40 % show stable disease for a limited time , only occasionally for longer . Most results are from uncontrolled phase II studies . A cancer cure can usually not be expected , long-term remissions are rare ( 5 % ) , and high remission rates are only observed in studies with strong patient selection . Some authors have reported a higher survival rate in patients treated with IL-2 or IFN . Survival of patients with objective remissions is significantly improved . A standard therapy cannot be defined . Even presuming an increased survival rate , the toxicity , which can lead to a dramatic reduction in quality of life , and the high costs have to be considered carefully . We think that in view of the lack of therapeutic alternatives , the improving efficacy , the potential survival benefit , the reduction of toxicity and the perspectives , immunotherapy is essential in the treatment of metastatic renal cell carcinoma . Its use should be confined to clinical studies ."
],
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DerUrologeA.70360151.eng.abstr
|
DerUrologeA.70360151.eng.abstr
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[
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"The implantation of a Wallstent prosthesis is a minimally invasive alternative to conventional TUR-P for the treatment of infravesical obstruction owing to benign prostatic hyperplasia . We report on the long-term follow-up of 37 patients with a high-risk status for TUR-P who have been implanted since May 1990. The ASA status was : ASA I : 0 , ASA II : 2 , ASA III : 17 and ASA IV : 18 patients . The median follow-up is now 38.5 months . Directly after implantation , a medium increase in the maximum flow-rate from 7.5 ml/s to 16.9 ml/s was documented . Residual urine was reduced from 120 to 24.2 ml on average . After 12 , 18 , 24 and 36 months , average maximum flow rates of 16.1 , 16.7 , 12.0 and 11.6 ml/s were evaluated . The corresponding residual urine was 50.3 , 121.1 , 56.8 and 65 ml , respectively . Also , micturition frequency decreased from 12.4 preoperatively to 8.3 , 7.6 , 8.0 , and 8.4 per day on average . Nearly all patients reported perineal discomfort in the 1st weeks after implantation . For this reason , the stent had to be removed in 1 patient on the 45th postoperative day . In addition , a dislocated stent had to be replaced in 2 patients . Six of 15 retention patients presented with persisting detrusor dysfunction after implantation and were therefore discharged with a suprapubic tube . Endoscopic controls showed complete urothelial coverage in 78 % of our patients after 6 months . After 18 months all stents were completely covered . Long-term follow-up showed reobstruction in 6 of 37 patients ( 16.7 % ) and signs of incontinence in 4 of 37 ( 10.8 % ) . The late complication rate is therefore calculated at 27.5 % . Stent-related deaths could not be found . We conclude that Wallstent implantation into the prostatic urethra is an alternative to TUR-P for patients at high risk from surgery . The good postoperative results also remain stable during long-term follow-up ."
],
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DerUrologeA.70360157.eng.abstr
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DerUrologeA.70360157.eng.abstr
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"Since squamous cell carinoma of the penis is rare , prospective trials do not exist . Therefore , new treatment strategies have to be developed . Based on our experience with the treatment of 22 patients with penile squamous cell carcinoma , we describe our therapeutic approaches . Ten patients with superficial disease ( T1-2N0M0) were treated with partial penectomy . The 3-year survival rate amounted to 90 % . In patients with extensive disease ( T3-4 or N1-3) a partial or total penectomy was performed . After initial antibiotic therapy for 4 weeks , patients underwent inguinal lymph-node dissection and if the nodes were positive , additional pelvic lymph-node dissection . In patients with ulcerous inguinal lymph-node metastases surgical resection was performed , covering the wound with a musculocutaneous flap ( tensor fascia lata flap n = 2 ; rectus abdominis flap n = 1 ) . The 3-year survival rate of patients with T1-2N1 tumours ( n = 4 ) was 67 % and with T3-4N1-3 ( n = 8 ) 25 % . Patients with distant metastases received inductive systemic chemotherapy with cisplatin , methotrexate and bleomycin . Objective responses occurred in 22 % ( 1 CR , 1 PR ) of 9 patients . These results suggest that immediate radical surgery with lymph-node dissection is the best treatment for squamous cell carcinoma of the penis ."
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s10-t3",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s10-r19-t3.2-t2.1",
"type": "diagnoses",
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t2",
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},
{
"id": "DerUrologeA.70360157.eng.abstr-s11-r1-t2.1-t1.1",
"type": "uses",
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r2-t7.2-t8.1",
"type": "location_of",
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t8",
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},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r3-t4.1-t1.1",
"type": "issue_in",
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r4-t1.2-t6.1",
"type": "causes",
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t6",
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},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r5-t3.1-t8.1",
"type": "associated_with",
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{
"id": "DerUrologeA.70360157.eng.abstr-s12-r7-t4.1-t8.1",
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{
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
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{
"id": "DerUrologeA.70360157.eng.abstr-s12-r9-t3.1-t6.1",
"type": "associated_with",
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t6",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r10-t7.2-t6.1",
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t6",
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},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r11-t1.2-t7.2",
"type": "causes",
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r12-t4.1-t7.1",
"type": "location_of",
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
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{
"id": "DerUrologeA.70360157.eng.abstr-s12-r13-t4.1-t8.1",
"type": "associated_with",
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t8",
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},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r14-t4.1-t6.1",
"type": "location_of",
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"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t6",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r15-t4.1-t7.1",
"type": "associated_with",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t4",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r16-t4.1-t6.1",
"type": "associated_with",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t4",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t6",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r17-t7.2-t4.1",
"type": "adjacent_to",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t4",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r18-t7.1-t1.2",
"type": "produces",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r19-t7.2-t4.1",
"type": "location_of",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t4",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r21-t1.2-t7.1",
"type": "causes",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r22-t4.1-t1.1",
"type": "method_of",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t4",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r23-t7.2-t3.1",
"type": "location_of",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t3",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r24-t7.1-t8.1",
"type": "degree_of",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t8",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r25-t4.1-t7.2",
"type": "adjacent_to",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t4",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r26-t3.1-t7.2",
"type": "associated_with",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t3",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r27-t4.1-t3.1",
"type": "location_of",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t4",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t3",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r28-t4.1-t7.2",
"type": "location_of",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t4",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r29-t1.2-t7.2",
"type": "connected_to",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r30-t4.1-t1.2",
"type": "produces",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t4",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r31-t1.2-t8.1",
"type": "causes",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t8",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r32-t4.1-t7.2",
"type": "associated_with",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t4",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r33-t7.1-t1.1",
"type": "issue_in",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r34-t7.1-t6.1",
"type": "degree_of",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t6",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r35-t7.2-t1.1",
"type": "issue_in",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r36-t3.1-t1.1",
"type": "method_of",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t3",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r37-t7.2-t1.2",
"type": "connected_to",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t1",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r38-t7.1-t4.1",
"type": "associated_with",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t4",
"normalized": []
},
{
"id": "DerUrologeA.70360157.eng.abstr-s12-r39-t7.1-t3.1",
"type": "associated_with",
"arg1_id": "DerUrologeA.70360157.eng.abstr-s12-t7",
"arg2_id": "DerUrologeA.70360157.eng.abstr-s12-t3",
"normalized": []
}
] |
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