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DerUrologeA.90380060.eng.abstr
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DerUrologeA.90380060.eng.abstr
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"We represent and discuss etiology , diagnosis as well as differential diagnoses of tuberculous orchtitis referring to an actual case of this rare disease . In the least of all cases one can conclude from the clinical symptoms on the tuberculous origin of the disease . Other differential diagnoses will set more frequently due to rarity of this disease . Quite a lot of cases a bacterial superinfection veils the sterile leucocyturia as main characteristic of genitourinary tuberculosis . Imaging diagnostics frequently fails to give indications of tuberculous origin of the lesion . As before the evidence of Mycobacteria tuberculosis is the most important parameter to proof a tuberculosis . Despite required microbiological cultivation to make a resistogram the polymerase chain reaction is a high sensitive and comparable fast method for detection of Mycobacteria even from tissue . In such dubious cases we recommend to perform an operative denudation due to frequently difficult delimitation from malignant testicular tumours ."
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DerUrologeA.90380065.eng.abstr
|
DerUrologeA.90380065.eng.abstr
|
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"The primary renal angiosarcoma is a rarely seen highly malignant tumor . Making a diagnosis based on histology may prove difficult . Because of hematogenous formation of metastases and bad prognosis in most cases we recommend that the surgical intervention be followed by the well tolerated systemic chemotherapy with Doxorubicin and Ifosfamid ."
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DerUrologeA.90380114.eng.abstr
|
DerUrologeA.90380114.eng.abstr
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"To compare the efficacy of digital rectal examination ( DRE ) and serum prostate specific antigen ( PSA ) in early detection of prostate cancer , we initiated a prospective multicenter screening trial . In 12 542 men choosen at random with a mean age of 62 ( +/- 7.5 ) a suspect DRE or a PSA level > 4.0 ng/ml was found in 2343 ( 20 % ) . Of the presently performed 744 biopsies , 157 revealed diagnosis of prostate cancer . Although further biopsies as well as the follow up of the 12 542 men are still missing , combination of DRE and PSA value > 4.0 ng/ml appears to be superior to DRE alone with a positive predictive value of 50 % versus 19 % in early detection of prostate cancer ."
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[] |
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DerUrologeA.90380128.eng.abstr
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DerUrologeA.90380128.eng.abstr
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"We were interested in the effectivity and morbidity of URS as an auxiliary treatment in patients who underwent ESWL for ureteral ( n = 71 ) and kidney stones ( n = 31 ) . Between 1991 and 1995 , 102 URS were performed for treatment of ureteral fragments . 28 ( 27.5 % ) were located in the proximal , 24 ( 23.5 % ) in the middle and 50 ( 49 % ) in the distal ureter . In 25 cases , fragmentes were found as \" Steinstrasse \" . In the same period of time , 2554 patients with ureteral stones were treated with ESWL alone , therefore the overall rate of URS was low ( 4 % ) . URS alone had a stonefree success rate of 58.9 % . The success rate depended on the location of the ureteral stone : proximal 25 % , middle 50 % and distal 82 % . URS combined with ESWL showed an overall success rate of 97.9 % . Finally , only 2 patients ( 2,1 % ) required an open surgery . 29.3 % of the stones were treated by extraction only . The extraction of stone was the most frequent procedure to remove the fragments after ESWL . The rate of complications were 6.9 % . None of the patients suffered from late complications like stricture of the ureter . The URS for the treatment of stone fragments after ESWL has been shown to be an effective and safe procedure with a low rate of complications ."
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"We were interested in the efficacy and morbidity of the ureteroscopy ( URS ) in the treatment of \" steinstrasse \" after ESWL . From 1991 to 1996 , 27 patients with \" steinstrasse \" were treated with a total of 32 ureteroscopic procedures . The URS alone had a stonefree success rate of 43.7 % ( n = 14 ) . URS combined with ESWL was effective in 43.7 % ( n = 14 ) , leading to an overall success rate of 87.4 % . In 4 cases ( 12.6 % ) a second therapy was necessary ( in 3 cases a second URS + ESWL and in one patient a nephrectomy due to septic pyonephrosis ) . The overall rate of auxiliary ESWL after URS was 53.1 % . Mean operating time was 72 minutes ( 20-180 min ) . The rate of complications was 21.8 % ( n = 7 ) and mainly due to ureteral perforations or postoperative fever but none suffered from late complications like ureteral stricture . All treated patients received a double-J-stent and antibiotics . The treatment of \" steinstrasse \" in the middle portion of the ureter proved to be more difficult due to the anatomical position of the ureter and lasted in a longer operating time as the upper or distal \" steinstrasse \" . The stone extraction and the lithoclast-lithotripsy alone or in combination were the most frequent used ureteroscopic procedures to eliminate stone fragments . The URS alone or in combination with the ESWL for the treatment of \" steinstrasse \" is a highly effective and safe approach ."
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DerUrologeA.90380138.eng.abstr
|
DerUrologeA.90380138.eng.abstr
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"The disadvantages of high flexible endoureteral stents ( DJ ) in case of tumorinduced extrinsic ureteral compression are due to an insufficient vertical stability of the used stents leading to stent-compression and consecutive hydro- or pyonephrosis . The new developed tumor-stent used in case of tumor-induced ureteral compression is available from 6 to 8 French in diameter and 24 to 32 cm in length . The corpus consists of a combination of high-stability plastics but is of sufficient elasticity in length . Both ends consist of extremely elastic J-parts guaranteeing an exact fixation . As against common DJ's with the same outside-diameter the new stent has a comparable interior diameter and compared to used \" old \" tumor stents promises a higher interior flow in case of extrinsic diseases . The application can be undertaken in well-known technique , needs no special instrumentation and no learning-curve . To date 52 stents at our urologic departments were placed without any problems , the latest remaining for 15 months . Tumor-induced compression or a higher rate of encrustation could not be seen . All patients tolerated these stents well . In our opinion the new stabilized endoureteral stent can be seen as a better solution instead of percutaneous nephrostomy or frequent stent changing in patients with tumor induced extrinsic ureteral compression ."
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[] |
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DerUrologeA.90380150.eng.abstr
|
DerUrologeA.90380150.eng.abstr
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"We present our experiences with the approach of placing 2 parallel ureteral Double-J stents simultaneously in extrinsically obstructed ureters . In all 5 reported patients therapy with single ureteral stents had failed despite correct stent position . With the increased stiffness of 2 parallel ureteral silicon 7F Double-J stents ureteral kinking and luminal compression could be reduced leading to sufficient reduction of hydronephrosis . This approach with potential space between the stents preserves urinary flow through as well as around the stents which is considered to be the most important mechanism in stented ureters ."
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[] |
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DerUrologeA.90380156.eng.abstr
|
DerUrologeA.90380156.eng.abstr
|
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{
"id": "DerUrologeA.90380156.eng.abstr-passage-0",
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"After the initial enthusiasm subsided lasercoagulation of the prostate has been criticized because the extent of tissue destruction cannot be controlled and many patients may be expected to have significant postoperative obstructive as well as irritative voiding symptoms which may last for weeks . Thanks to new laservaporization techniques these disadvantages have been largely eliminated . With the Holmium laser a real resection of prostatic tissue is possible allowing the surgeon to see the prostatectomy defect immediately and to assess tissue destruction during the operation ( \" what you see is what you get \" ) . The postoperative voiding disturbances are diminished and comparable to those after TUR-P ."
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[] |
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DerUrologeA.90380162.eng.abstr
|
DerUrologeA.90380162.eng.abstr
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"Even complex diagnostic tests may not establish aetiology and degree of erectile dysfunction ( ED ) in many patients . Therefore , we evaluated a self-report method with a restrictive focus to quality of erections which may yield information sufficient to make an aetiologic diagnosis . We studied 74 patients 25 to 75 years of age with untreated ED . Sexually stimulated erections were quantified and compared to duplexsonographically and clinically evaluated data from pharmacostimulated erections . Patients reported that there was a marked decrease in ability to penetrate the partner , to sustain an erection and of penile rigidity ( p 0.001 ) . Parameters from duplexsonography and clinically assessed response to pharmacostimulation correlated ( r = 0.72 ) . Direct comparison of these data with quantified history showed no relation ( r = 0.05 ) . Using change in penile volume due to erection as a basis to compare with , showed significant correlation with quantified data from history ( r = 0.26-0.34; p 0.03 ) and measured parameters from pharmacostimulated erections ( r = 0.44-0.55; p 0.0001 ) . Sexually- and pharmacostimulated erections are proportional to change in penile volume . Although there is a relation between erections emerging from both stimulations , quantifying history on sexually stimulated erections does not qualify to make an aetiologic diagnosis without using complex tests ."
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[] |
[] |
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DerUrologeA.90380168.eng.abstr
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DerUrologeA.90380168.eng.abstr
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"id": "DerUrologeA.90380168.eng.abstr-passage-0",
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"Purpose of our study was to develop a reliable model to define clinical stage I nonseminomatous germ cell tumors ( NSGCT ) being at low risk and at high risk for occult retroperitoneal metastases based on pathohistological and immunohistochemical parameters in order to stratify the therapeutic approach . 3-5 paraffin-embedded formalin fixed tissue blocks of 149 clinical stage I NSGCT were available from all patients and were analyzed for histopathological features associated with pathological stage : presence/absence of vascular invasion , presence/absence of tunical invasion , percentage of each histological cell type present in the primary tumor . Immunohistochemical expression of MIB-1, p53, bcl-2, cathepsin D and e-cadherin was evaluated using a semiquantitative scoring ystem . Statistical analysis was performed by univariate and multivariate logistic regression models . Percentage of embryonal carcinoma [ %EC ( p 0.001 ) ] and presence of vascular invasion [ VI ( p 0.0001 ) ] were the most significant independent risk factors associated with pathological stage II disease . Combination of %EC and VI allowed correct prediction of final pathological stage in 88 % of patients . Cut-off values including both variables identified correct pathological stage in 131/149 patients ( 88 % ) . Less than 45 % EC and absence of VI correctly identified pathological stage I disease in 91.5 % ; more than 80 % EC and presence of VI correctly predicted pathological stage II in 88 % of the patients . %EC and presence/absence of VI appear to be reliable prognosticators to identify both patients at high risk and at low risk for occult retroperitoneal disease . P53, bcl-2, MIB-1, cathepsin D and e-cadherin did not appear to be of prognostic value in clinical stage I NSGCT ."
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[] |
[] |
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DerUrologeA.90380179.eng.abstr
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DerUrologeA.90380179.eng.abstr
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"Partial priapism is a rare condition which has been previously reported in the literature only in eight cases . Unlike the typical case of priapism , patial priapism generally shows erection only of the proximal corpora cavernosa . In most of the cases a well defined membrane separated the proximal erected and the distal flaccid part of the corpus . The origin of the fibrous membrane is not clear . Usually a painful segmental thrombosis of the corpora cavernosa was found proximal the membrane . Until 1985 diagnosis and therapy of this entity have principially involved invasiv methods . Later computed tomography ( CT ) and magnetic resonance ( MR ) were used for noninvasive imaging and conservative management was elected . We report a case of partial priapism and review the diagnostic and therapeutic procedure in the previous literature ."
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DerUrologeA.90380242.eng.abstr
|
DerUrologeA.90380242.eng.abstr
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DerUrologeA.90380246.eng.abstr
|
DerUrologeA.90380246.eng.abstr
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"In correction of the ureterovesical junction , the pathology can be corrected using an extravesical or intravesical technique . We performed an extravesical antireflux procedure with the dismembered or non-dismembered technique in 117 ureters between March 1991 and March 1996 at our Department of Pediatric Urology . The success rate was 94.9 % ( 111 renal units ) . Postoperative morbidity and complications were minimal , hematuria and bladder spasms were not seen . Associated pathology like paraostial diverticula , megaureter with the necessity for modeling and ureter duplex do not compromise the success rate ."
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DerUrologeA.90380252.eng.abstr
|
DerUrologeA.90380252.eng.abstr
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"id": "DerUrologeA.90380252.eng.abstr-passage-0",
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"In the last years the incidence of renal cell carcinoma diagnosis increased about 15-20 % . The main aim of this study was to analyse the reason of the increase of incidence . In the present autopsy series comprising 23.801 autopsies the percentage of patients who died of renal cell carcinoma is 1,77 % in Jena and 1,55 % in Koeniggraetz ( 200.000 inhabitants each ) . Over this time the incidence of renal cell carcinoma in autopsies has increased ."
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DerUrologeA.90380258.eng.abstr
|
DerUrologeA.90380258.eng.abstr
|
[
{
"id": "DerUrologeA.90380258.eng.abstr-passage-0",
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"text": [
"Colony-stimulating factors ( CSF ) are frequently used in cases of cytostatic therapy of patients with testicular cancer assuming that they support hematopoietic recovery and , thus , shorten duration of neutropenia as well as reduce infections . Currently , G-CSF and GM-CSF are clinically used . In the present study efficacy and toxicity of these two drugs were investigated and compared in patients with testicular cancer treated by standard chemotherapy . Studying 83 chemotherapy cycles applied to 31 patients with advanced germ cell tumors the effectivity and the side effects of the two CSF were examined by questioning , clinical evaluation , and blood chemistry studies . G-CSF ( 480 µg subcutaneously ( sc ) ) were used in 55 and GM-CSF ( 400 µg sc ) in 28 chemotherapeutic cycles . The indications consisted in the treatment of leukocytopenia on the one hand and in the prophylaxis in subsequent cycles on the other hand . No difference between the two CSF could be found either with regard to postponement of the next cycle ( G-CSF : 6.8 vs. GM-CSF : 7.3 days ) , or to the number of injections per cycle ( G-CSF : 8 vs. GM-CSF : 12.5 ) , or to the leukocyte ( G-CSF : 2.1 vs. GM-CSF : 1.6 x 103/µl) or platelet nadir ( G-CSF : 0.5 vs. GM-CSF : 0.5 x 105/µl; mean values of all cycles , respectively ) . Both CSF did not seem to influence the production of platelets . However , a difference between the two CSF was demonstrated with respect to the toxicity . Frequency ( G-CSF : 38.5 % vs. GM-CSF : 69.3 % ) as well as intensity of side effects causing a change of the drug ( G-CSF : n = 1 vs. GM-CSF : n = 7 ) were lower in the case of G-CSF . In conclusion , these data demonstrate no difference was seen between G-CSF and GM-CSF with respect to the efficacy in patients with testicular cancer treated by standard chemotherapy . However , the use of G-CSF seems to be associated with lower toxicity ."
],
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DerUrologeA.90380270.eng.abstr
|
DerUrologeA.90380270.eng.abstr
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"The intramuscular ( i . m . ) administration of Decapeptyl Depot has been approved in Germany for the treatment of advanced hormone dependent prostate cancer since July 1990. In this study a reformulated Decapeptyl Depot , administered as a first-line endocrine therapy , was injected intramuscularly ( i . m . ) or subcutaneously ( s. c . ) every 28 days for 6 months . At 12 different hospitals , 52 prostate cancer patients were treated , whereby 25 patients received a s. c . injection and 27 patients a i . m . injection . Testosterone was measured as the main parameter : after 28 days , both the s. c . and the i . m . application form of Decapeptyl Depot successfully reduced initial testosterone levels of at least 2.3 ng/ml to steady-state castration levels below 1.2 ng/ml , maintaining this complete suppression for the entire length of the trial ( 168 days ) . Decapeptyl Depot was well tolerated and very acceptable to the patients in both groups . Side effects were few and predictable , being largely associated with decreased testosterone concentrations . No cumulation in triptorelin serum levels was observed within the 6 months of treatment . Decapeptyl Depot , administered subcutaneously or intramuscularly was effective and safe in the treatment of patients with advanced prostate cancer ."
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DerUrologeA.90380276.eng.abstr
|
DerUrologeA.90380276.eng.abstr
|
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"text": [
"Bilateral emphysematous pyelonephritis is an extremely rare , rapidly progressive and life-threatening intrarenal and perirenal infection . It is associated with diabetes mellitus , obstruction of the upper urinary tract and the presence of gas-forming coliform bacteria . As it presents as a severe acute pyelonephritis , a high index of suspicion and computer-tomographic imaging are essential to make the diagnosis . Only immediate combined medical and ( bilateral ) surgical therapy can reduce the high patient mortality . Postoperatively , computer-tomographic monitoring is recommended to follow the response to therapy ."
],
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}
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]
}
] |
[] |
[] |
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] |
DerUrologeA.90380279.eng.abstr
|
DerUrologeA.90380279.eng.abstr
|
[
{
"id": "DerUrologeA.90380279.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Metastatic cancer to the testis is a rare phenomenon of prostate carcinoma with only 80 cases reported in the literature . Most of these secundary testicular tumors were diagnosed on routine pathohistological examination of testicular tissue after plastic orchiectomy . In none of these cases metachronous development of these metastases has been described . For the first time we report on a 75-year old patient who developed a prostate carcinoma metastatis to the right testicle three years after undergoing subcapsular orchiectomy . This case shows that the urologist has to think about a metastatic cancer when he sees a testicular tumor also after plastic orchiectomy ."
],
"offsets": [
[
0,
674
]
]
}
] |
[
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],
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0,
10
]
],
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},
{
"id": "DerUrologeA.90380279.eng.abstr-s1-t2",
"type": "umlsterm",
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},
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"id": "DerUrologeA.90380279.eng.abstr-s1-t3",
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"db_id": "C0021358"
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]
},
{
"id": "DerUrologeA.90380279.eng.abstr-s1-t4",
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"text": [
"prostate"
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"id": "DerUrologeA.90380279.eng.abstr-s1-t5",
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"id": "DerUrologeA.90380279.eng.abstr-s1-t6",
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"id": "DerUrologeA.90380279.eng.abstr-s2-t1",
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"id": "DerUrologeA.90380279.eng.abstr-s2-t2",
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"tissue"
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"id": "DerUrologeA.90380279.eng.abstr-s2-t4",
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"id": "DerUrologeA.90380279.eng.abstr-s2-t5",
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"id": "DerUrologeA.90380279.eng.abstr-s3-t1",
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"id": "DerUrologeA.90380279.eng.abstr-s3-t2",
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"id": "DerUrologeA.90380279.eng.abstr-s4-t1",
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"id": "DerUrologeA.90380279.eng.abstr-s4-t4",
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},
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"id": "DerUrologeA.90380279.eng.abstr-s4-t5",
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"id": "DerUrologeA.90380279.eng.abstr-s4-t7",
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"id": "DerUrologeA.90380279.eng.abstr-s4-t8",
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DerUrologeA.90380282.eng.abstr
|
DerUrologeA.90380282.eng.abstr
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[
{
"id": "DerUrologeA.90380282.eng.abstr-passage-0",
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"text": [
"Bilateral testicular tumors account for approximately 3,5 % of all testicular malignancies and to our knowlegde about 800 cases are reported in the literature . An even more seldom event is the appearance of a testicular germ cell tumor with a contralateral benign non-germ cell tumor . We report the 6th case of such a coincidence . The dignity of a contralateral tumor should be assured by frozen section and in case of benign histology organ preserving therapy is indicated . Even in cases of bilateral testis cancer tumor enucleation may be considered , if the strict conditions for resection and follow-up are respected ."
],
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}
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DerUrologeA.90380332.eng.abstr
|
DerUrologeA.90380332.eng.abstr
|
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{
"id": "DerUrologeA.90380332.eng.abstr-passage-0",
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"text": [
"Carcinoma of the penis is a malignant epithelial tumor of ominous prognosis if not adequately treated . To a large extent the probability of positive lymph nodes is determined by the grade of the primary lesion . In turn the number of positive nodes greatly influences the survival . In the past the complications of radical ilioinguinal lymphadenectomy have decreased their timely indication . If delayed lymphadenectomy is performed , the survival rate is reduced by approximately 50 % as compared to the results of immediate lymphadenectomy . The modified inguinal lymphadenectomy described by Catalona leads to less complications . If performed without delay it should lead to improved survival in patients with higher stage and high grade penile cancer . Recently suggested employment of adjuvant and neoadjuvant chemotherpy may further enhance the survival ."
],
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0,
864
]
]
}
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DerUrologeA.90380337.eng.abstr
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"At the present time , lymph node metastases may be nomographically predicted or histologically proven . As a rule , this indicates a systemic disease . Unimodal local therapy ( radical prostatectomy/irradiation ) does not alter the outcome . Occasionally , this appeared to be the case , if lymph nodes were diagnosed in a very early stage ( diagnostic lead-time ) . This phenomenon disappears , when the follow-up time is long . A comparable situation is encountered , if one relies on the bimodal local therapy , i . e . radical prostatectomy plus adjuvant irradiation . Similarly , there is a diagnostic lead-time effective . However , patients with minimal lymph node metastases ( also known as pN1.1) may probably not need immediate endocrine therapy . The combination of tele- and brachy-therapy in the presence of positive nodes appears to be not useful . Unimodal systemic therapy following radical prostatectomy has never been tested in a phase III-trial . If one weighs the arguments pro immediate versus delayed hormone therapy , the following trends can be found : The time-to-progression is prolonged , however , that does not translate in a longer cause-specific survival . In the results of a phase III-trial of irradiation plus primary versus delayed androgen deprivation in stage N1/pN1 prostate cancer the above trends were noticed . Neoadjuvant hormone therapy in N1 prostate cancer has not been tested in a phase III-trial , however , it is very unlikely that patients benefit more than from a similar treatment in the presence of locally advanced , but node-negative prostate cancer . An interesting concept in these potentially long surviving patients is the intermittent hormone therapy , among the benefits is the reduced number of side-effects ."
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DerUrologeA.90380344.eng.abstr
|
DerUrologeA.90380344.eng.abstr
|
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"text": [
"Lymph node positive carcinoma of the prostate ( stage pN + /D1) is generally considered to be systemic disease that cannot be cured by radical prostatectomy . Treatment options in these minimally metastasized tumors are the wait and watch stategy , hormonal therapy , radiotherapy and radical prostatectomy alone or in combination . At present , there are no prospective randomized trials available regarding the value of these treatment modalities . In retrospective studies , the results of radical prostatectomy seem to be superior to conservative management . In several studies comparing radical prostatectomy vs. pelvic lymphadenectomy alone , a higher tumor burden in the lymphadenectomy alone groups is present . In general , radical prostatectomy reduces local complications of prostate carcinoma and improves quality of life . In conclusion , patients with single or low volume lymph node metastases as well as patients with low tumor grade or favorable Gleason score and diploid tumors seem to benefit from radical prostatectomy . However , the definitive role for radical prostatectomy has to be stated as uncertain ."
],
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DerUrologeA.90380349.eng.abstr
|
DerUrologeA.90380349.eng.abstr
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"The role of radiotherapy of the pelvic lymphatic pathways in patients with node positive prostate cancer remains uncertain . Interpretation of the few prospective studies ( RTOG 75-06 and 77-06 ) is hampered by severe flaws in the study design . Extension of the radiation to the paraaortal region shows no advantage over radiation of the pelvic lymphatics alone and is not warranted . Data on longterm side-effects are only available from older studies with outdated radiation techniques . According to more recent studies short term side effects are considerably higher with radiation of the pelvic lymphatics when compared with radiation of the prostate alone . In summary radiation of the lymphatic pathways in lymph node positive prostate cancer cannot currently be considered as standard treatment and should be carried out within clinical studies ."
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DerUrologeA.90380358.eng.abstr
|
DerUrologeA.90380358.eng.abstr
|
[
{
"id": "DerUrologeA.90380358.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Aim of this case-control study , performed on 412 male bladder cancer cases and 414 controls with benign prostatic hyperplasia in a former area of coal , iron and steel industries in Germany , was to identify occupations with an increased bladder cancer risk . In bladder cancer cases , smokers were overrepresented ( 58.3 % ) compared to controls ( 35.2 % ) . The percentage of patients who had stopped smoking for at least 10 years did not differ in cases ( 10.2 % ) and controls ( 9.7 % ) . Significantly elevated smoking-adjusted bladder cancer odds ratios ( MH ) were observed in painters and lacquers ( MH 2.24 , 95 % CI 1.07-5.13), chemistry-related occupations ( MH 2.44 , 95 % CI 1.05-5.67), coke plant workers ( MH 2.89 , 95 % CI 1.16-7.16) and hard coal miners ( MH 2.33 , 95 % CI 1.52-3.58). Significantly decreased smoking-adjusted bladder cancer odds ratios ( MH ) were observed in businessmen ( MH 0.64 , 95 % CI 0.45-0.92) and office personnel ( MH 0.58 , 95 % CI 0.41-0.81). In these two groups a relevant exposure to occupational bladder carcinogens is not likely ."
],
"offsets": [
[
0,
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]
]
}
] |
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},
{
"id": "DerUrologeA.90380358.eng.abstr-s1-t2",
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{
"id": "DerUrologeA.90380358.eng.abstr-s1-t3",
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{
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{
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DerUrologeA.90380364.eng.abstr
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DerUrologeA.90380370.eng.abstr
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DerUrologeA.90380370.eng.abstr
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"A 74-years old patient is admitted to the hospital with a over a period of 4 years growing , scrotal , ulcerated tumor . There is no connection to the testicle or the epididymis palpable . All laboratory findings including the tumorparameters are normal . The scrotal sonography shows a solid tumor , that is filled with vessels in the Doppler sonography . The complete tumor resection with histological examination leads to the diagnosis of a scrotal leiomyoma . This rare , benign tumor is a differential diagnosis to paratesticular or non-germinal tumors ."
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[] |
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DerUrologeA.90380425.eng.abstr
|
DerUrologeA.90380425.eng.abstr
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{
"id": "DerUrologeA.90380425.eng.abstr-passage-0",
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"The recent new morphological classification of epithelial renal tumors has overcome the former unspecified adenoma and carcinoma classification by introducing a specific subtyping . Today we divide in oncocytic and metanephrogenic renal cell adenomas , clear cell- , papillary- , chromophobe- , and collecting duct associated renal cell carcinomas , and transitional cell- and neuroendocrine renal carcinomas . These entities are characterized by a definite immunohistological marker spectrum and differing histogenetic pathways . New cytogenetic data have proven specific chromosomal aberrations for the different tumor types and have confirmed the morphological classification . Certain genetic changes are correlated to specific pathological phenotypes especially in oncocytic tumors . It is possible now to propose an in part hypothetical kidney tumor model which describes the development and progression of adenomas and carcinomas of the kidney in an adenoma-carcinoma sequence ."
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DerUrologeA.90380433.eng.abstr
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DerUrologeA.90380433.eng.abstr
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"Abstract Renal cell tumors display notoriously an intra- and intertumoral morphological heterogeneity making a reproducible cytomorphological diagnosis impossible . To overcome the cytological heterogeneity , the \" Heidelberg Classification of Renal Cell Tumours \" is soundly based on the genetic lesions that underlie the formation of distinct tumors . Allelic loss of chromosome 3 p and mutation of the VHL gene specify conventional renal cell carcinoma . In addition duplication of chromosome 5 q as well as allelic losses of prognostic value at chromosomes 6 q , 8 p , 9 p and 14 q characterize conventional renal cell carcinomas . Papillary renal cell tumors , which display an adenoma-carcinoma sequence , are marked by trisomies of chromosomes 3 q , 7 , 8 p , 12 q , 16 q , 17 q und 20 as well as loss of the Y chromosome in males . Chromophobe renal cell carcinoma shows a low chromosome number due to monosomy of chromosomes 1 , 2 , 6 , 10 , 13 , 17 , and 21. Benign tumors , such as renal oncocytoma and metanephric adenoma , can also be diagnosed by genetic means . The distinct types of tumors have different biological behaviour and therefore , an accurate classification is considered clinically important . We worked out a quick and reproducible fluorescent microsatellite assay for detecting allelic changes . This technique is useful for postoperative and retrospective diagnosis as well as for preoperative analysis of fine needle aspiration specimens ."
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DerUrologeA.90380442.eng.abstr
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DerUrologeA.90380442.eng.abstr
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"Abstract The observation of extremely variable clinical courses for patients with renal cell carcinomas of an identical pathological stage as well as a comparable histological differentiation resp. growth pattern strongly indicates the existence of tumors harboring different biological aggressiveness . Currently available histopathological classification systems do not predict the biological behaviour of renal cell cancer as sufficiently as the establishment of a therapeutical strategy adjusted to the individual patient would require . The need for a more refined characterization of the biological potential of the indidual tumor results from the introduction of modified operative strategies as organ-preserving surgery , for example , as well as from the recently suggested application of an adjuvant systemic therapy adapted to the individual risk for tumor recurrence resp. the development of progressive disease . Therefore , the clinically orientated basic scientist and the basic scientifically orientated clinician intensively try to determine prognostically important biological variables which would allow to better predict the biological aggressiveness of a single tumor in addition to \" classical \" prognostic parameters ( T-stage , histological grading , growth patterns ) . In this context , several biological parameters including the identification of alterations on the DNA- , RNA- and protein level have been discussed as possible biological prognostic markers for renal cell cancer . The present review tries to reflect currently available biological characteristics of RCC which might gain clinical importance with regard to an individualized therapy in the near future ."
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DerUrologeA.90380452.eng.abstr
|
DerUrologeA.90380452.eng.abstr
|
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"Renal cell carcinoma accounts about three percent of all adult neoplasms . This review provides a current status about the surgical management of renal cell carcinoma . In localised carcinomas radical nephrectomy is still the standard treatment and provides 5 Year survival rates up to 98 % . As nephron-sparing surgery in mandatory indications can achieve similar survival doubt can be expressed whether lymphadenectomy or adrenalectomy are necessary in every case . Nephron-sparing surgery is associated with a higher rate of operative complications up to 40 % and probably with a higher risk of local recurrence . However , parenchymal-sparing surgery in elective indications is possible for small tumors , if long term follow up is guaranteed . But there is no convincing advantage of nephron-sparing surgery to recommend this procedure as a general approach in patients with a normal contralateral kidney . Radical surgery in renal carcinomas invading to the vena cava still remains a challenging surgical intervention . Nevertheless , in selected patients surgery can realise long term survival in over a third of cases . Palliative nephrectomy in metastatic renal carcinomas is only justified in real palliative indications ( bleeding , pain ) or in clinical trials investigating cytoreductive surgery before immunotherapy . In highly selected patients with metastatic renal carcinoma a radical surgical approach including nephrectomy and complete metastasectomy can achieve long term survival ."
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DerUrologeA.90380460.eng.abstr
|
DerUrologeA.90380460.eng.abstr
|
[
{
"id": "DerUrologeA.90380460.eng.abstr-passage-0",
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"text": [
"In approximately 4-10 % of patients presenting with renal cell cancer the transluminal propagation of a tumor thrombus into the vena cava inferior or the right atrium comes to diagnosis . Recent investigations have indicated that the presence of neoplastic extension into the venous system does not reveal independent prognostic value regarding the clinical course of the disease . Although the complete surgical removal of vena cava thrombosis in patients without simultaneously occurring regional lymph node or distant metastases has become a well established treatment modality , several questions concerning this surgical strategy still remain the subject of ongoing discussions . In the present investigation that included 92 patients with renal cell cancer and intracaval neoplastic extension it was clearly demonstrated that the use of cardiopulmonary bypass , deep hypothermia and circulatory arrest preferably during the removal of intracaval thrombosis extending into the right atrium does not result in a substantially increased treatment-related intra- or postoperative mortality . However , in contrast to a previously reported observation this treatment option did not reveal any substantial impact on the long-term survival of the patients following surgical therapy . Accordingly , the cranial extension of intracaval thrombosis was not identified as a biological variable of any prognostic importance for renal cell cancer patients ."
],
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DerUrologeA.90380466.eng.abstr
|
DerUrologeA.90380466.eng.abstr
|
[
{
"id": "DerUrologeA.90380466.eng.abstr-passage-0",
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"text": [
"Systemic immunotherapy , notably with interleukin-2 ( IL-2) and interferon- ( IFN ) , has yielded a response rate of 10 % to 30 % in metastic renal cell carcinoma . However , systemic immunotherapy is limited by severe side effects , and long-lasting response is rare . Tumor palliation and quality-of-life are important end points for evaluating the clinical benefits of immunotherapy . Experimental and clinical treatment models have proved that local IL-2 application is less toxic than systemic treatment and is therapeutically effective . Here we report long-term experience with inhalation IL-2 therapy in 188 patients who had progressive pulmonary metastatic renal cell carcinoma . High-dose inhalation of IL-2 was used with low-dose systemic IL-2 or IFN . Maximal toxicity over the total treatment time was mild , and the low incidence of WHO grade 3 toxicity ( 24 % ) allowed social activities and peformance of social roles . Comedication for systemic side effects was required only in half of the patients . Inhaled IL-2 prevented progress of pulmonary metastases in 68 % of patients for a median period of 9.8 months . Median survival was 12.4 months compared with the expected 5.3 months and quality-of-life did not differ substantially from pretreatment status . Local treatment can be applied alone or in combination with systemic therapy and can increase therapeutic efficacy ."
],
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DerUrologeA.90380479.eng.abstr
|
DerUrologeA.90380479.eng.abstr
|
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{
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"text": [
"The indication for elective organ-preserving surgery in renal cell carcinoma is under discussion . The statements about the maximum tumor size , which could be considered for this surgical procedure , differ in the literature . In a serie of 281 consecutive radical tumornephrectomies we compaired the results of preoperative ultrasound and computerized tomography regarding to tumor size and multifocality with the results of the postoperative systematically section of the removed kidneys . Further we analysed the results of 14.793 autopsies regarding to tumor size and multifocality . Serial section of the 281 nephrectomy specimens revealed a total of 64 multifocal tumors in 48 kidneys ( = 17,1 % ) . The correlation between tumor size and multifocality showed only in tumors up to 20 mm no additional lesions , whereas in the higher tumor categories the incidence was up to 23 % . These clinical investigations were confirmed by the results of the autopsies . In summery of the results we conclude , that the elective organ-preserving surgery of renal cell carcinoma is only indicated in tumors with a maximum diameter of 20 mm ."
],
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DerUrologeA.90380486.eng.abstr
|
DerUrologeA.90380486.eng.abstr
|
[
{
"id": "DerUrologeA.90380486.eng.abstr-passage-0",
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"text": [
"In this study we describe 22 cases of retrograde ureteral stent placement in pregnant women with therapy-resistant flank pain due to hydronephrosis . Eleven were primiparous and one patient expected twins . Eight of 22 patients presented symptoms of pyelonephritis . In 21 cases the hydronephrosis was located on the right and in 4 cases it was bilateral . Maximal lower calix diameter was 12 mm ( range 9-22 mm ) . With the exception of two cases , sonographically controlled stent placement was performed under local anesthesia without sedation . All patients were painfree within 6 days and were given prophylactic low dosis of antibiotic until the day of delivery . Renal function remained within the normal limits . Double-J stent displacement occured in 3 patients - of which one underwent nephrostomy . Postnatal examination demonstrated urolithiasis in 4 of 19 patients . This study provides evidence for effectiveness of retrograde ureteral Double-J stent placement as a therapeutic option in cases of severe symptomatic hydronephrosis during pregnancy with a low morbidity rate ."
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DerUrologeA.90380569.eng.abstr
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DerUrologeA.90380569.eng.abstr
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"Since the first child was born after in-vitro fertilization in 1978 , different techniques of ovarian stimulation , oocyte retrieval and embryo culture have improved significantly . The development of microinjection techniques was a mile stone in reproductive medicine . Even in cases of severe impairment of semen quality , using the Intracytoplasmic Sperm Injection ( ICSI ) , pregnancy rates of approximately 20 % per treatment cycle can be achieved . However for using artificial reproductive techniques ( ART ) the female age is a major limiting factor as well as the development of premature ovarian failure ( POF ) . Crucial for the male is the question whether or not sperm cells can be retrieved . Today an interdisciplinary approach is recommended to take care of the afflicted couple in order to address the complex problem of infertility . There is evidence that children born after microinjection techniques bare a higher risk for chromosomal aberrations compared to the normal population . However rates of major malformations seem to be identical in both groups . An evaluation of the potential risks and efforts and an extensive counseling of the infertile couple has to be taken before initiating invasive ART ."
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DerUrologeA.90380575.eng.abstr
|
DerUrologeA.90380575.eng.abstr
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"Treatment of severe male subfertility has become available since the intracytoplasmic injection of a single sperm into an oocyte was successfully applied for the first time in 1992. Moreover , also with the use of testicular spermatozoa for this procedure fertilization and pregnancies could be accomplished . This review addresses the development of these techniques and discusses achievements and problems as well as future aspects of the feasability of early spermatid injection are stressed . Futhermore it includes the basic elements of spermatogenesis and the major concerns regarding the underlying genetic reasons for spermatogenic failure ."
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DerUrologeA.90380586.eng.abstr
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DerUrologeA.90380586.eng.abstr
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"Abstract Amifostine is an organic thiophsophate which protecvts normal cells from the effects of chemotherapy with reduced nadir and duration of cyclophosphmamid induced neutropenia , reduced cisplatin derived renal and neurological complications being described . However , no data are available for urological malignancies treated with cisplatin-based chemotherapy . Aim of the study was to assess the efficacy of pretreatment with amifostine in terms of prevention of renal , hematopoetic and neurologic toxicity . 17 patients ( mean age : 62.6 [ 45-74 ] ) with advanced transitional cell carcinoma of the urinary bladder received inductive or adjuvant cisplatin based chemotherapy ( 1-6 cycles ) with a cisplatin dose of 70 mg/m2. Amifostine ( 740-910 mg/m2) was administered intravenously 30 minutes prior to chemotherapy . For all patients creatinine clearance , serum creatinine and electrolytes including magnesium , and blood cell count were determined prior to and after each cycle . A group of 12 patients ( mean age : 61.9 [ 51-67 ] ) did undergo MVEC chemotherapy ( 1-4 cycles ) without receiving amifostine and served as control group . Amifostine was well tolerated and only 1 patient suffered from gastrointestinal discomfort , blood pressure remained unchanged in all patients . Amifostine prevented a significant reduction of creatinine clearance even in the 2 patients with known renal insufficiency : mean creatinine clearance was 125 +/- 20 ml/min prior to and 115 +/- 25 ml/min after chemotherapy . In the control group , however , creatinine clearance dropped from 121 +/- 30 ml/min to 85 +/- 20 ml/min after completion of MVEC chemotherapy . Serum creatinine levels did not increase significantly ( 1.1 mg/dl prior to and 1.2 mg/dl after chemotherapy ) , magnesium levels did not decrease significantly and normalized at the end of chemotherapy . Significant neutropenia and thrombocytopenia developed in 29 % and 12 % of the patients in the amifostine group and in 67 % and 33 % of the patients in the control group . Amifostine was shown to have a protective effect against cisplatin induced nephrotoxicity in the elderly patient undergoing systemic chemotherapy . Based on our data amifostine should be applied in the supportive management to prevent chemotherapy induced complications ."
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DerUrologeA.90380592.eng.abstr
|
DerUrologeA.90380592.eng.abstr
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"In spite of the high and lasting efficiency of transurethral prostatectomy , intraoperative blood loss results in increased morbidity in this procedure . This led to the development of many alternative treatment modalities in the last years . To minimize the risk of bleeding , we improved the high-frequency technology in several steps . To achieve this , the output signals of commercially available high-frequency generators were modulated to the effect that each cut results in an efficient coagulation zone in the tissue at excellent cutting quality . Laboratory and in vitro studies using porcine kidneys as well as clinical trials showed good cutting characteristics accompanied by a significant reduction of bleeding . As a result , blood transfusions were less necessary , the transurethral catheter could be removed earlier in the postoperative period , and hospitalization time was significantly reduced . In conclusion , the improved high-frequency technology in form of the \" coagulating intermittent cutting \" results in a blood-sparing tissue resection with a consecutive reduction of morbidity ."
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[] |
[] |
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DerUrologeA.90380599.eng.abstr
|
DerUrologeA.90380599.eng.abstr
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"The case of a spontaneous kidney rupture due to an urothelial carcinoma one week after delivery is presented . Diagnosis was made during operation . In comparison to the carcinoma , which is diagnosed and treated in time , the prognosis is poor . The patient deserved continous gynecological follow-up and showed the classic symptoms of an urothelial carcinoma for six months . In spite of regular sonographic controls during pregnancy the tumor was not diagnosed . Diagnosis and management of renal carcinomas during pregnancy are discussed ."
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EthikInDerMedizin.00120002.eng.abstr
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EthikInDerMedizin.00120002.eng.abstr
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"id": "EthikInDerMedizin.00120002.eng.abstr-passage-0",
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"Abstract . Definition of the problem : In parallel with public and philosophical discussions , there is an ongoing debate about euthanasia in theological ethics . In this situation it is helpful to provide a systematic overview of the different arguments and judgements . Arguments : A short introduction is followed by a first part dealing with the definition of terms . The second and major part concerning normative arguments is subdivided into three steps : the level of principles , the more concrete level of actions and finally the level of social consequences . The third part presents some reflections following the eudaimonistic ethical tradition ( the ethics of a good life and death ) focusing on the central question : how to find meaning in life when faced with suffering . Conclusion : It would be fruitful to intensify the ethical reflection both on the problems concerning the foundations of social life , especially the meaning of dignity , autonomy and inviolability of human life , and social consequences of a liberal practice of euthanasia . In this context ethicists are challenged to reflect on the different approaches to what is or can be a good life and a human death ."
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[] |
[] |
[] |
EthikInDerMedizin.00120030.eng.abstr
|
EthikInDerMedizin.00120030.eng.abstr
|
[
{
"id": "EthikInDerMedizin.00120030.eng.abstr-passage-0",
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"Abstract . Definition of the problem : The medical progress made in human reproduction and prenatal diagnosis is having an increasing effect on the responsibility of doctors concerning reproduction and birth . A faulty diagnosis or professional error is causing lawyers to be confronted with difficulties in which ethical views are involved . It is becoming clear that there will be difficulties if the courts have to rule on the question whether the doctor is under an obligation to pay maintenance following the birth of an unwanted child or a child with genetic defects . Arguments and conclusion : First , the controversy about parental claims on maintenance as a result of an unwanted child ( \" wrongful birth \" ) is presented , and the ethical arguments against physician liability are critically discussed . Subsequently , the claims of a genetically defective child against the doctor ( \" wrongful life \" ) are dealt with . It should be stressed that it is unjust for the court to reject physician liability in this case . The intention is to point out that ethical judgements are improper and inadequate in both cases ."
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] |
[] |
[] |
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EthikInDerMedizin.00120075.eng.abstr
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"Abstract . Definition of the problem : Is it the brain that makes a human being a person ? This anthropological question has been raised because of the findings of modern human brain research , and there are severe ethical consequences anew : If the appropriate anthropological answer is yes , then all invasive research would be problematic , because one would touch the basis of human essence . The problem is that the two major philosophical paradigms that offer an answer to the anthropological question , dualism and monism , have opposing concepts . Arguments : This paper argues that the error of these two paradigms is that they understand the human body and the human mind as ' res ' - as things . The explanation of the human being as an interactive unit of body and mind is impossible in both paradigms . A third anthropological view that tries to make that understandable is the anthropology of the Hebrew Bible . It does assume the category ' thing ' while speaking about humans , it presumes the category ' aspect ' . There is no Hebrew word for ' mind ' in contrast to ' body ' or vice versa . The biblical language only knows terms for the unity of human beings seen under a certain aspect . Conclusion : Here , the body and thus the brain are important and necessary condition for human essence , but this is not a sufficient explanation for the human personality . Invasive research on the human brain is here neither generally forbidden nor tolerated - one has to demonstrate in every single case whether the planned operation touches regions that are crucial for the personality of the human subject ."
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] |
[] |
[] |
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EthikInDerMedizin.00120088.eng.abstr
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EthikInDerMedizin.00120088.eng.abstr
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"Abstract . Definition of the problem : This article describes the communication structure concerning the problems of genetic engineering , in-vitro fertilization and the current debate about \" genetic advisory \" . Arguments : Proceeding from the social systems theory , two observation types are discriminated : 1st and 2nd orders , which occur here as critical and affirmative positions . The first term refers to specific operations of the social system of medicine , the second to communication of social movements . Neither perspective can deliver total rationality or unity , and the two positions cannot be put together as one rational model . They have to be put into debate structures in order to learn from each other by reciprocal observations . Conclusion : Every kind of observation , taken in a communicative frame like this one , delivers a limited , but necessary contribution to the debate . System rationality will be possible only by coupling asymmetrical observations . This goal will , however , can only be reached , if the communication proceeds in a controversy based mode . This way , the difference between critical and affirmative positions cannot be \" solved \" but it can be used for further recognition ."
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[] |
[] |
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EthikInDerMedizin.00120122.eng.abstr
|
EthikInDerMedizin.00120122.eng.abstr
|
[
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"Abstract . A narrative analysis of a sequence from a documentary on the withholding of treatment in persistent vegetative state allows the discernment of several characteristics of the approach of the media to medical ethical problems : ( 1 ) The arrangement of the story units in the film sequence corresponds to established patterns of movie dramaturgy . ( 2 ) The documentary \" hollywoodizes \" morality ; it interprets the arena of the problem in the realm of the movie theatre and not in the realm of ethical discourse . ( 3 ) The moral decision occurs in the return to mythical narrative structures which show a tendency to confirm perceived established world interpretation . ( 4 ) Morality is reduced to black and white characterizations . ( 5 ) The ethical conflict is transmitted through the plane of personal action which tends to blot out complex interdependencies . ( 6 ) Private happiness forms the basis for an essential set of criteria for all actions and decisions . The rational weighing of criterion is not easily transmittable by television ; instead , television , due to its audiovisual sensory nature , has a great potential to awaken insight into and understanding of specific situations and personal experience . Thus television can supplement the philosophical discipline of hermeneutical bioethics in generating sympathy and deeper understanding ."
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[] |
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EthikInDerMedizin.00120139.eng.abstr
|
EthikInDerMedizin.00120139.eng.abstr
|
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"text": [
"Abstract . Movies tell stories . Thrilling are especially those situations , when people have to make ethical decisions . Issues of medical ethics crop up not only in hospital series , but often in genres where this subject is hardly to be supposed : comedies , westerns , love stories and gangster movies . Enacting these conflicts means offering a solution , and in doing so films refer to moral values and - at the same time - function as seismographs for the social relevance of bioethical topics . But it is possible that ethical principles of good decision-making fall victims to the drama of the story . Analysis of the portrayed conflict is similar to a case discussion in bioethics and represents a helpful adjunct to the procurement of analytical and communicative competences ."
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788
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[] |
[] |
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] |
EthikInDerMedizin.00120154.eng.abstr
|
EthikInDerMedizin.00120154.eng.abstr
|
[
{
"id": "EthikInDerMedizin.00120154.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Definition of the problem : Television has developed various forms for the presentation of issues on medical ethics . Our inquiry focuses on the textual , visual and musical elements that are used in two short television features on preimplantation genetic diagnosis . Arguments : We used the method of question-stimulated group discussion to reconstruct how an audience of persons interested in medical ethics perceives which moral problems are presented in the films and how the audience grounds its perceptions on determinate elements of the films . Conclusion : In the enactment of ethical questions in the two selected features there is a salient tendency - pointed out by spontaneous and subjective impressions of the audience - ( 1 ) to juxtapose rather than to mediate the presentation of medico-technical progress and the presentation of those who are concerned , ( 2 ) to present conflicts in a personally close-up manner that invites identification , ( 3 ) to inform about moral problems only by emphasising undesirable consequences . All these observations are connected with specific textual elements , pictures and music and , as a first step of analysis , described with regard to their effect on the viewers ."
],
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[
0,
1236
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]
}
] |
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] |
[] |
[] |
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EthikInDerMedizin.80100005.eng.abstr
|
EthikInDerMedizin.80100005.eng.abstr
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[] |
[] |
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EthikInDerMedizin.80100012.eng.abstr
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EthikInDerMedizin.80100012.eng.abstr
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"Abstract . Definition of the problem : The Dutch policy regarding euthanasia has been causing amazement in other countries over and over again : Although euthanasia is illegal in the Netherlands , there are cases of euthanasia in which no criminal prosecution follows . The latter are regulated actively and in public by the Dutch authorities . In other countries certain cases of euthanasia are sometimes tolerated as well , however , there it is in most cases merely tacitly consented to . In contrast to these countries , in the Netherlands it is declared in advance under which conditions physicians do not need to fear criminal prosecution of their illegal actions . How can this peculiar Dutch policy be explained ?"
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[] |
[] |
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EthikInDerMedizin.80100026.eng.abstr
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EthikInDerMedizin.80100026.eng.abstr
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"Abstract . Definition of the problem : In health care institutions caregivers from different cultures treat patients who themselves may come from different cultural backgrounds . The ethical impact of this issue is how in spite of these cultural differences mutual understanding can be achieved . Modern health care systems must react to this multicultural challenge explaining : what does universality of the medical task mean , what are the consequences of demographic change , how to deal with the multicultural work force of the modern health care facilities , and how one must differentiate between universal and variable elements of the health care delivery . The following questions are discussed : 1. Which aspects of medicine require consideration of the multicultural structures ? 2. Which medical fields must especially integrate multicultural perspectives ? 3. How the patient's cultural context can be taken into account ."
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] |
[] |
[] |
[
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EthikInDerMedizin.80100091.eng.abstr
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EthikInDerMedizin.80100091.eng.abstr
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[] |
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EthikInDerMedizin.80100128.eng.abstr
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EthikInDerMedizin.80100128.eng.abstr
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"Abstract . Definition of the problem : The development of molecular genetics has provided tools not only for the diagnosis of genetic diseases and disease dispositions in affected individuals , but also for the detection of healthy carriers of recessive hereditary traits . The resulting , ethically controversial option of genetic population screening used to be restricted to a small number of rather rare diseases by methodological limitations which are now about to be overcome ."
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[] |
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EthikInDerMedizin.80100138.eng.abstr
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EthikInDerMedizin.80100138.eng.abstr
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[] |
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EthikInDerMedizin.80100152.eng.abstr
|
EthikInDerMedizin.80100152.eng.abstr
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[
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"Abstract . Definition of the problem : The report supplies the national part of a European survey in which doctors that are involved in the treatment of patients in `Persistent Vegetative State ' ( PVS ) are being interviewed . The questions concern decision-situations the doctors are frequently confronted with in the treatment of PVS-patients . The questionnaire is designed as a decisiontree in order to bring about the exact delineations that govern the decisions . Therefore the result of the survey only portrays which delineations are in fact being accepted ( and does not allow any conclusion concerning which norms should guide the decisions ) . Whether these factual delineations correspond to ethical-normative criteria that derive from guiding principles - such as human dignity - is being discussed in the part reflecting on the survey . It is crucial to an adequate interpretation of the survey results to keep in mind that the doctors were not being asked about what they actually did in the situations described ; the survey was designed to bring about what the doctors ' basic attitudes towards the problems are ."
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EthikInDerMedizin.80100206.eng.abstr
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EthikInDerMedizin.80100206.eng.abstr
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[] |
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EthikInDerMedizin.80100227.eng.abstr
|
EthikInDerMedizin.80100227.eng.abstr
|
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{
"id": "EthikInDerMedizin.80100227.eng.abstr-passage-0",
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"text": [
"Abstract . Definition of the problem : The rapid pace of medical progress has drawn renewed attention to the various possible ways of treating dead or brain-dead pregnant women since the 1980 ' s. The discussion today revolves around medical , social , legal and economic aspects . The historical areas of conflict which surrounded deliveries carried out on dead mothers ( usually by means of a Sectio in mortua , nowadays known as a perimortem Caesarean section ) and their significance in today's debate are , for the most part , regarded as being of little relevance ."
],
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}
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"id": "EthikInDerMedizin.80100227.eng.abstr-s2-t2",
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"attention"
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"brain-dead"
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"women"
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"id": "EthikInDerMedizin.80100227.eng.abstr-s2-t6",
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"id": "EthikInDerMedizin.80100227.eng.abstr-s3-t2",
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"id": "EthikInDerMedizin.80100227.eng.abstr-s3-t3",
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}
] |
[] |
[] |
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EthikInDerMedizin.8010s058.eng.abstr
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EthikInDerMedizin.8010s058.eng.abstr
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[] |
[] |
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EthikInDerMedizin.8010s077.eng.abstr
|
EthikInDerMedizin.8010s077.eng.abstr
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[] |
[] |
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EthikInDerMedizin.8010s104.eng.abstr
|
EthikInDerMedizin.8010s104.eng.abstr
|
[
{
"id": "EthikInDerMedizin.8010s104.eng.abstr-passage-0",
"type": "abstract",
"text": [
"With the German law \" Sozialgesetzbuch 5 \" and its §137 coming into force , hospitals are obliged in taking part in quality assurance programs in Germany . In the last ten years the requirements of quality management are to be defined and implemented by the clinical directors and executives . Controlling in medical affairs was formerly ruled by law as far as technical and laboratory procedures were concerned . Quality assuring measures are aimed to improve structural processes , treatment methods and medical outcomes . Continuing quality improvement is meant to describe the dynamic character that is needed when starting quality assurance programs and planning follow-up measures . This will result in improvement of quality of life for the patients , more efficient clinical structures , costs reduction in the health care system and even in having more time for education of the medical personnel . Besides these modern aspects of physicians ' treatment the ancestors had rules for medical measures , too . In the past the ancient cultures developed more and more rules about technical , medical and ethical questions to beware the patient from mistreatment and to avoid adverse events and even to punish the charlatan ."
],
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[
0,
1229
]
]
}
] |
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] |
[] |
[] |
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EthikInDerMedizin.90110079.eng.abstr
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EthikInDerMedizin.90110079.eng.abstr
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[] |
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] |
EthikInDerMedizin.90110089.eng.abstr
|
EthikInDerMedizin.90110089.eng.abstr
|
[
{
"id": "EthikInDerMedizin.90110089.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Abstract . Definition of the problem : In 1997 , Percutaneous Transluminal Coronary Angioplasty ( PTCA ) was performed in 138.001 cases in Germany . The standard indications , single vessel disease and badly controlled angina , are more and more extended to multivessel disease with and without severe angina , unstable or preinfarction angina , and acute myocardial infarction ( AMI ) itself . Dilating asymptomatic stenoses of more than 70-80% is a widely used indication , intending prophylaxis of complete occlusion and AMI . Actually there is no generally accepted guideline for the different new indications , conservative versus invasive treatment schedule . It is difficult for the patient to get appropriate information before his decision between mechanical procedures and conservative methods ; authentic informed consent actually seems to be in a very bad position . In 1992 the working group called \" Arbeitsgemeinschaft leitender kardiologischer Krankenhausaerzte ( ALKK ) \" decided to start a registry of all PTCA procedures , in order to gain knowledge about the present status of PTCA in Germany . Up to March 1999 , 198.608 PTCA are logged ."
],
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[
0,
1159
]
]
}
] |
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}
] |
[] |
[] |
[
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{
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{
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{
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{
"id": "EthikInDerMedizin.90110089.eng.abstr-s3-r21-t8.1-t5.1",
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},
{
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},
{
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EthikInDerMedizin.90110146.eng.abstr
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EthikInDerMedizin.90110146.eng.abstr
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"Abstract . Definition of the problems : The physician-patient-relationship is influenced by economically driven decisions . This study explores the ethical consensus in explaining economical backgrounds of therapeutic and diagnostic interventions to patients , and the clinical practices of patient information ."
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[] |
[] |
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EthikInDerMedizin.90110162.eng.abstr
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EthikInDerMedizin.90110162.eng.abstr
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[] |
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EthikInDerMedizin.90110169.eng.abstr
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EthikInDerMedizin.90110169.eng.abstr
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"Abstract . Definition of the problem : In Germany , the dissection rate of the deceased is distinctly lower than in many other European countries . Although critics of autopsies use to put forward ethical objections and religious scruples , neither the Christian church nor piety stand opposite to the practise of autopsies ."
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[] |
[] |
[] |
EthikInDerMedizin.90110222.eng.abstr
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EthikInDerMedizin.90110222.eng.abstr
|
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[] |
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EthikInDerMedizin.90110233.eng.abstr
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EthikInDerMedizin.90110249.eng.abstr
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EthikInDerMedizin.90110249.eng.abstr
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"Abstract . Definition of the problem : In Germany , clinical ethics is still in the state of development . Ethics consultation is very new and rare in the clinical setting in German university hospitals . Therefore this paper describes the clinical ethics activities at the Medical Center of Philipps University , Marburg , regard to ethics consultation in a case report . Clinical ethics rounds at the Surgical Intensive Care Unit are organized according to the theory and practice of the ethics consultation service at the Medical Center of the University of Virginia , established by J.C. Fletcher , F.G. Miller and J.J. Fins ."
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[] |
[] |
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"id": "EthikInDerMedizin.90110249.eng.abstr-s5-r16-t2.1-t1.1",
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] |
ForumDerPsychoanalyse.00160001.eng.abstr
|
ForumDerPsychoanalyse.00160001.eng.abstr
|
[
{
"id": "ForumDerPsychoanalyse.00160001.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The concept \" the patient's psychic reality \" delineates a fundamental epistemological and clinical position regarding the notion of reality . Two distinctions are implied : the patient's psychic reality as opposed to that of someone else ( e.g. the analyst ) ; and psychic vs. objective reality . These delineations are repeatedly obscured . While blurring the boundaries between the patient's and the analyst's vantage points , we fail to distinguish between hypothesis and evidence , bypassing nuances of clinical data that do not fit into the course we seemingly have found . Reflecting more rigorously on the question of how to arrive at what we believe to know may help us to find our way to more profound pathways , heretofore unconscious ."
],
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[
0,
747
]
]
}
] |
[
{
"id": "ForumDerPsychoanalyse.00160001.eng.abstr-s2-t1",
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"text": [
"objective"
],
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278,
287
]
],
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"db_id": "C0018017"
}
]
},
{
"id": "ForumDerPsychoanalyse.00160001.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"analyst's"
],
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[
403,
412
]
],
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"db_name": "UMLS",
"db_id": "C0605770"
}
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{
"id": "ForumDerPsychoanalyse.00160001.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"unconscious"
],
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[
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]
],
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"db_id": "C0041657"
},
{
"db_name": "UMLS",
"db_id": "C0041654"
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]
}
] |
[] |
[] |
[] |
ForumDerPsychoanalyse.00160045.eng.abstr
|
ForumDerPsychoanalyse.00160045.eng.abstr
|
[
{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The personality organisation and the process of therapy of drug-addicted patients are examined by the comparative analysis of 15 single cases . The antisocial tendency is emphasised as the main clinical feature . It is related to specific genetic traumata and the externalisation of parts of the superego . During the therapeutical process , the antisocial tendency destroys the therapeutical relation . If it is possible to continue therapy beyond this point , the patients can now enter into a process , in which new identifications and the integration of parts of the superego are involved . Approaching the end of the therapy , patients , again , tend to destroy the results of therapy if one does not consider specific problems of the separation process ."
],
"offsets": [
[
0,
760
]
]
}
] |
[
{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"personality"
],
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4,
15
]
],
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}
]
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"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s1-t2",
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"text": [
"therapy"
],
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48,
55
]
],
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"db_id": "C0087111"
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"db_id": "C0039798"
}
]
},
{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"patients"
],
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[
73,
81
]
],
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{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s1-t4",
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"text": [
"analysis"
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114,
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]
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{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s1-t5",
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"text": [
"single"
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129,
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}
]
},
{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"traumata"
],
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]
],
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}
]
},
{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"superego"
],
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],
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"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s5-t1",
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"db_id": "C0039798"
}
]
},
{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"patients"
],
"offsets": [
[
466,
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]
],
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"db_name": "UMLS",
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}
]
},
{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"identifications"
],
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},
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"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s5-t4",
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},
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"db_id": "C0039798"
}
]
},
{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s6-t4",
"type": "umlsterm",
"text": [
"separation"
],
"offsets": [
[
740,
750
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0237868"
}
]
}
] |
[] |
[] |
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},
{
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},
{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s1-r9-t4.1-t1.1",
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},
{
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},
{
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{
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"normalized": []
},
{
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{
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},
{
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},
{
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},
{
"id": "ForumDerPsychoanalyse.00160045.eng.abstr-s6-r1-t3.1-t1.1",
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},
{
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{
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] |
ForumDerPsychoanalyse.00160059.eng.abstr
|
ForumDerPsychoanalyse.00160059.eng.abstr
|
[
{
"id": "ForumDerPsychoanalyse.00160059.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The confusion of scientific , economic , juridical and professional contexts is the reason for the present uneasiness within therapeutic culture . The author pleads for autonomy of these contexts to defend the profession reasonably against powerful overdetermination by other contexts . The debate about EST ( \" empirically supported therapy \" ) is being drawn upon to show that the list of criteria for differentiation of effective and ineffective therapies is not warranted . Scientific or economic dominance claims might have deteriorating effects in the professional fields , as well-known researchers meanwhile fear . In economic contexts the aim is efficiency , in professional contexts it is quality . To develop own quality measures has the aim to promote the profession as a learning organization . Proposals are made . This could help to rise professionals ' self-confidence ."
],
"offsets": [
[
0,
886
]
]
}
] |
[
{
"id": "ForumDerPsychoanalyse.00160059.eng.abstr-s1-t1",
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"text": [
"confusion"
],
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4,
13
]
],
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},
{
"id": "ForumDerPsychoanalyse.00160059.eng.abstr-s1-t2",
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"economic"
],
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[
30,
38
]
],
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}
]
},
{
"id": "ForumDerPsychoanalyse.00160059.eng.abstr-s1-t3",
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"text": [
"therapeutic"
],
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[
125,
136
]
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[] |
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ForumDerPsychoanalyse.00160099.eng.abstr
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ForumDerPsychoanalyse.00160099.eng.abstr
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[] |
[] |
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ForumDerPsychoanalyse.00160116.eng.abstr
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ForumDerPsychoanalyse.00160116.eng.abstr
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ForumDerPsychoanalyse.00160123.eng.abstr
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ForumDerPsychoanalyse.00160123.eng.abstr
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"This presentation of a short therapy as it occurs in everyday practice intends to show that such a short therapy can be carried out psychoanalytically ( in the sense of working with resistance , transference , and countertransference ) even if a focus is not specifically worked out at its beginning but the therapist follows the mise en scène of a conflict on the basis of his/her countertransference instead , after having interactionally determined grounds for treatment . Countertransference offers not only an effective access to the perception of the interaction but it also drives on the process as such . The unconscious dialogue between patient and analyst as well as the conflict management within the therapist in addition to his/her abstinent non-intervention and explicit interpretation play an important role . If the process gets underway the relevant data emerge as it were ' on their own ' , supporting , supplementing , and correcting the respective therapeutic hypothesis and in this way putting it on increasingly firmer ground . The time-limit catalyses and intersifies especially the separative aspects of the emerging conflicts . As cognition and relationship develop reciprocally a therapeutic relationship is being established which is capable of sustaining the strains of intensification on the basis of growing insight ."
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[] |
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ForumDerPsychoanalyse.00160148.eng.abstr
|
ForumDerPsychoanalyse.00160148.eng.abstr
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[
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"The purpose of Psy-BaDo is to serve as a useful concept for quality assurance for everybody and every form of psychotherapy and to link psychotherapy to the medical development as an \" evidence based medicine \" . In its foundations it is aimed at \" structural quality \" in the sense of standard therapy and standard therapist , at \" process quality \" in the sense of a standard documentation of diagnostic and therapeutic measures and at \" result quality \" , which is orientated at the medical concepts of illness , of the role of the physician and of therapy . Economy , efficiency and practicability should be assured via quality management by a central controlling institute supported by all professional groups . The criticism of the Psy-BaDo aims at its underlying reductionist scientific perceptions , at the discharge of basic psychoanalytic views , and at the integrative application of methods without any justification through the theory of therapy following the pattern of medical application of drugs . The \" practical quality assurance \" of the Psy-BaDo involves no clinically and scientifically necessary psychodynamic-systemic diagnostics at all , which is , however , a pre-conditon for any reasonable psychotherapy . With Psy-BaDo the psychotherapeutic treatment becomes simply a disease-management which defines its quality assurance by criteria of normalisation and thus follows the medical model of transformation disease into health . Medical psychotherapy as an integrated standard treatment offers itself to society as a monopolistic health supply agency . Psy-BaDo intends to adapt psychotherapeutic medicine to somato-psychiatric standards , ignores the differentiated level of knowledge and perception in psychotherapy for the sake of a legitimation as the most-favoured psychotherapy within the health care system ."
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ForumDerPsychoanalyse.00160204.eng.abstr
|
ForumDerPsychoanalyse.00160204.eng.abstr
|
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"Evidence from development psychology is reported that suggests that the ability to inpute mental states to others and to share emotions with them is part of the biological endowment of the newborn . A proper development of these capacities requires , however , within a specific range of fixed parameters , a fitting pattern of interactions between mother and baby . The emotional development of the infant critically depends on whether highly specific requirements for a successful emotional synchronisation and fitting have been fulfilled . From a psychoanalytic perspective corresponding results and insights from developmental psychology are of immediate relevance for a therapeutic understanding and treatment of even very severe forms of psychopathology . In a case study implications for the unfolding of the therapeutic process are illustrated ."
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ForumDerPsychoanalyse.00160231.eng.abstr
|
ForumDerPsychoanalyse.00160231.eng.abstr
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"In recent years female psychoanalysts provided fertile approaches to an understanding of the mother-daughter-relationship with the conceptions of the ' lesbian complex ' ( Poluda-Korte ) , the ' symbiotic illusion ' ( Halberstadt-Freud ) , the ' higher permeability of the ego-boundaries' ( Rohde-Dachser ) , and the ' conflict of separation-individuation which has to be resolved again and again throughout life ' ( Berger ) . In the light of these conceptions it is hypothesized that in analyses with both participants being of equal gender ( female-female psychoanalyses ) a specific intensity and quality of female aggression may manifest itself when certain threshold situations of the pre-oedipal mother-daughter-relationship are revided . Case vignettes and a literary example illustrate the risks as well as possible resolutions engendered by these early relationship dynamics , as these are reactivated in the here and now of the analyst's relationship towards her patient ."
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ForumDerPsychoanalyse.00160247.eng.abstr
|
ForumDerPsychoanalyse.00160247.eng.abstr
|
[
{
"id": "ForumDerPsychoanalyse.00160247.eng.abstr-passage-0",
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"text": [
"By means of personal experiences of the analytic situation and several case descriptions the concept of the evently suspended attention of Freud is compared with the concept of reverie of Bion in relation to their different position in the analytic process . The different process characteristics will be identified . Reverie is not identical with evenly suspended attention , as it is treated usually in the analytic literature . Reverie in the sense of Bion refers to qualitative different , deeper , more restrictive and fragmentary transference dimensions than the evenly suspended attention in the sense of Freud which is more related to an elaborated concept of transference and countertransference processes ."
],
"offsets": [
[
0,
716
]
]
}
] |
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ForumDerPsychoanalyse.00160261.eng.abstr
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ForumDerPsychoanalyse.00160261.eng.abstr
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"Object relationships developed in the treatment of patients with psychosomatic disorders require specific measures in handling the analyst's countertransference . Frequently feelings of tedium and emptiness as defence against either helplessness and futility may be experienced or , on the other hand , fantasies of omnipotence or magical healing powers . Comprehending one's repressed emotional responses contributes to a beneficial analytical process , in the course of which the analyst is appropriated as a Siamese self-object . The specific quality of this object relationship adds intrinsic significance beyond the normal scope of analytical work on the patient's relationships with his family . On the basis of the dynamics of the self-object relationship insight into the processes of transference and countertransference and therapeutic consequences are developed ."
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ForumDerPsychoanalyse.80140001.eng.abstr
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ForumDerPsychoanalyse.80140001.eng.abstr
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"The ability of empathy includes different competences : being infected by emotions , the adoption of another person's perspective and the capability to understand the social context . All three competences have to be learned through social experiences . A theory of the empathic process has to describe , how it is possible to experience emotions and phantasies of another person in the self as one's own and to recognize them as belonging to the other . The theoretically founded attempt to differentiate between self-perception and the perception of the other proves necessarily to reach an impass . A constructivistic hypothesis seems to be more appropriate here , that conceives empathy as a personal draft . This draft is directed by one's own inner objects and by concrete experiences with the other as well . In the psychoanalytic dialogue both participants , patient and analyst , develop their empathic drafts and try to reach through them an understanding ."
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ForumDerPsychoanalyse.80140018.eng.abstr
|
ForumDerPsychoanalyse.80140018.eng.abstr
|
[
{
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"The author investigates the relationships between the concept of functional pleasure as defined by Fenichel and some other psychoanalytic concepts . It is argued that in the realization of formations of repressed genital-sexual drive-wishes the erogenic pleasure which is intended changes into a functional pleasure in which successful defense can be subjectively experienced . At the beginning of a sexual interaction there is an anxiety whether it is possible to keep the repressed wishes with their substitutes out of consciousness . The pleasure-unpleasure-principle as defined by Freud is read as an unpleasure-functional pleasure-principle which is only valid for the realization of substitutes of the repressed . Furthermore the reasons for a solution of the oedipus complex as put forward by Freud are rejected and sublimations are understood as the result of different defense mechanisms which lead to substitutes of the repressed which are in accordance with society and the ego of an individual ."
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ForumDerPsychoanalyse.80140034.eng.abstr
|
ForumDerPsychoanalyse.80140034.eng.abstr
|
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ForumDerPsychoanalyse.80140066.eng.abstr
|
ForumDerPsychoanalyse.80140066.eng.abstr
|
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"Acting within the context of the therapeutic process is often equated with acting-out . Subtile behaviour , too , as a part of the \" complex system of sending and receiving unconscious signals \" ( Sandler ) which serve for the patient to induce behavior of the transference object in the analyst or fulfilling his unconscious wishes is seen as acting-out or microacting-out ( Treuniet ) . However , this delicate acting has no meaning , it is not symbolic or communicative action . It is aimed at inducing effects and interactions . It appears both on the side of the analyst and of the patient and is part of the unconscious communication in the therapeutic process . Diverse interactive means and ways will be demonstrated , how the analyst is moved to unnoticed acting and to handling the patient in an unnoticed manner in a certain way . The acting-reactions of the analyst may have the character of interpretations , by which he unintentionally demonstrates , in what a way he understands the patient ."
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ForumDerPsychoanalyse.80140095.eng.abstr
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ForumDerPsychoanalyse.80140095.eng.abstr
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"Since Freud's Dream Interpretation and his additional writings on the analysis of dreams , technique of handling a dream report within the analytic session has nearly been unchanged . It is characterized by dream centered associations and their interpretation in regard to dream contents and to transference . This approach constitutes an alien element within contemporary interactional psychoanalytic technique and tends to provoke resistances in the analytic dialogue . This article stresses the function of reporting of dreams during the session in respect to the interactional process . It comes to the conclusion that sufficient attention should be drawn to interactional analysis of dream reporting following the questions : Why does the patient at this point of the process tell a dream , and why does he tell this very dream instead of another ?"
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[] |
[] |
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ForumDerPsychoanalyse.80140111.eng.abstr
|
ForumDerPsychoanalyse.80140111.eng.abstr
|
[
{
"id": "ForumDerPsychoanalyse.80140111.eng.abstr-passage-0",
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"In this paper the question is considered to what extent the patient's and analyst's perception and tolerance of both aggressive and destructive elements of the analytic relationship can be increased . Successful interpretation enables the patient to feel , enact and comprehend animosity in the transference and experience that the relationship can continue . The concept of primary aggression developed in Freud's speculation on death instinct is discussed in its clinical function of relief . The metapsychological concept of primary aggression facilitates work on aggressive and especially destructive developments of the relationship . Freud's and subsequently Eissler's examination of the reciprocity of destructiveness and narcissism opened plausible clinical avenues to explain the compensation of defence mechanisms against mankind's vulnerability in the face of mortality . The concept of primary aggression is obviously of greater relevance than frustration/aggression models since the former does not view the patient as mere victim of his biography , but as a subject with the potential to enact his own destructiveness . Since aggressiveness is often concomitant with fear and suppressed guilt , interpretation plays a decisive role in relieving the superego strain ; more confrontation may involve the analyst in the role of the persecutor . Sudden and violent feelings of hate towards the analyst require careful treatment of the patient's irritation . Interpretation of genetic causes of animosity often prove to be countertransference resistance ; interpretation in transference , however , is viewed as profitable . Finally , those dangerous and destructive phases of treatments are discussed , which compel the analyst to protect the setting ."
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ForumDerPsychoanalyse.80140139.eng.abstr
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ForumDerPsychoanalyse.80140139.eng.abstr
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ForumDerPsychoanalyse.80140203.eng.abstr
|
ForumDerPsychoanalyse.80140203.eng.abstr
|
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ForumDerPsychoanalyse.80140241.eng.abstr
|
ForumDerPsychoanalyse.80140241.eng.abstr
|
[
{
"id": "ForumDerPsychoanalyse.80140241.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In the second half of life narcissistic problems are spread and of far-reaching meaning . This problems here are inquired with reference to the ego-ideal . After characterizing the ego-ideal in short terms , the hypothesis of a growing discrepancy of ego and ego-ideal in the second half of life is developed . Several dimensions of this conflict are inquired with reference to clinical problems in the treatment of elderly patients . At last forms of narcissistic transference are described and possibilities and goals of treatment are discussed ."
],
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0,
548
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]
}
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416,
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},
{
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]
}
] |
[] |
[] |
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ForumDerPsychoanalyse.80140258.eng.abstr
|
ForumDerPsychoanalyse.80140258.eng.abstr
|
[
{
"id": "ForumDerPsychoanalyse.80140258.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Up till now psychoanalytic psychotherapy confronted itself not very often with the challenges of quality assurance . Moreover , in the rare articles about this topic the specific characteristics of psychoanalytic therapy were not considered . The reasons for this strained relationship are on the one hand the difficulties between the conceptual guidelines of quality assurance and on the other hand the self-conception of psychoanalytic psychotherapy and inner conflicts of psycho-analytic psychotherapy revived through quality assurance . These problems lead to lack of interest and distance of the psychoanalytic therapy towards quality assur-ance . In case of unavoidable confrontation intense aggressive affects emerge , which impair the institutional self-assertion and the further conceptual development of psychoanalytic psychotherapy ."
],
"offsets": [
[
0,
844
]
]
}
] |
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}
] |
[] |
[] |
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] |
ForumDerPsychoanalyse.80140275.eng.abstr
|
ForumDerPsychoanalyse.80140275.eng.abstr
|
[
{
"id": "ForumDerPsychoanalyse.80140275.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Psychotherapists have the alternative , to design quality assurance within certain boundaries by themselves , or otherwise leave this important task to external instances . Those will apply their own criteria in developing a concept . This paper discusses the question , how far quality assurance in the field of analytic psychotherapy has to accept the definitions and concepts from other fields such as industry or somatic medicine , without changing or deteriorating the quality that in the end should be improved . Differentiation is necessary between the use of the Psy-BaDo for individual quality assurance of the individual psychotherapist and for quality- and psychotherapy-research . This paper points out new approaches to modifying the present concept of quality assurance for the purposes of analytic psychotherapy ."
],
"offsets": [
[
0,
828
]
]
}
] |
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{
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200,
208
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],
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{
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ForumDerPsychoanalyse.80140342.eng.abstr
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ForumDerPsychoanalyse.80140364.eng.abstr
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"Concerning the problem of violation of sexual abstinence in analysis the essay shows the dilemma between the call for the judge and the necessity of supervision and analysis of the analyst . The author sees one of the roots of the problem in the absence of a practicable psychoanalytic concept how to handle the erotic feelings in analysis appropriately so as to further development . Extending the idea of a \" transitional space \" Winnicott's the conception of an \" erotic-sexual full scope \" is developed that makes a form of abstinence possible , which cancels the contradiction between substitutive satisfaction and renunciation sexual gratification . Following this conception the connection between the neurotic treatment of sexuality in our society and violations of abstinence in analysis rooted in the disturbed relationship to ourselves as our body is shown . Further , the significance of the interdependence between the interest of society in a protected space of development and the elementary interest of psychoanalysis in the possibility and the existential conditions of this space is emphasized , for it is identical with the existential basis of psychoanalysis in society ."
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"type": "carries_out",
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"id": "ForumDerPsychoanalyse.80140364.eng.abstr-s5-r12-t2.1-t3.1",
"type": "issue_in",
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"id": "ForumDerPsychoanalyse.80140364.eng.abstr-s5-r13-t1.1-t4.1",
"type": "carries_out",
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},
{
"id": "ForumDerPsychoanalyse.80140364.eng.abstr-s5-r14-t4.1-t3.1",
"type": "method_of",
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"arg2_id": "ForumDerPsychoanalyse.80140364.eng.abstr-s5-t3",
"normalized": []
}
] |
ForumDerPsychoanalyse.90150001.eng.abstr
|
ForumDerPsychoanalyse.90150001.eng.abstr
|
[
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We live in an epoch that could be designated as the post-Gutenberg-era . Writing is no longer the dominant sign system . It is replaced by electronic signs . We consider approximately the year 1950 as the turning-point between these two epochs , because by then , in the years after the 2nd World War the American households were saturated with televisions . Thereby , the new sign system asserted itself . The topic of this article is the transformation of our sign system and thereby of our worlds of symbols , the leap from the world of written signs into the world of electronic signs , and the possibility born out of it to create electronic objects , which I prefer to call virtual objects . The manipulation of object-choice and object-relationships accompanying this change and the role assigned to analysts in this new world will be considered as well . These electronic signs developed quickly a life of their own . A totally new class of objects came into being , the class of virtual objects . These are electronically transformed , completed or wholly electronically produced objects . This procedure is accompanied by an industrialization of object-choice and object-relationships . The manipulated object-choice and object-relationship is born and , moreover , a displacement of natural objects through virtual ones . A change of the socio-cultural understanding is also a consequence of this process . New patterns of socio-cultural understanding develop , that could be described as industrial feudalism . The goal of this article is to describe the transformation of our world of signs and the connected industrialization of object relationships , and to interprete them according to our present possibilities ."
],
"offsets": [
[
0,
1729
]
]
}
] |
[
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"sign"
],
"offsets": [
[
107,
111
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0220912"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"electronic"
],
"offsets": [
[
139,
149
]
],
"normalized": [
{
"db_name": "UMLS",
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}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"signs"
],
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[
150,
155
]
],
"normalized": [
{
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}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"War"
],
"offsets": [
[
297,
300
]
],
"normalized": [
{
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"db_id": "C0043027"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"households"
],
"offsets": [
[
314,
324
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0020052"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"televisions"
],
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345,
356
]
],
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},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"sign"
],
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381
]
],
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},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"sign"
],
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466
]
],
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}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s6-t2",
"type": "umlsterm",
"text": [
"written"
],
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[
540,
547
]
],
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{
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"db_id": "C0043266"
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]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s6-t3",
"type": "umlsterm",
"text": [
"signs"
],
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[
548,
553
]
],
"normalized": [
{
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"db_id": "C0220912"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s6-t4",
"type": "umlsterm",
"text": [
"electronic"
],
"offsets": [
[
572,
582
]
],
"normalized": [
{
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"db_id": "C0013850"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s6-t5",
"type": "umlsterm",
"text": [
"signs"
],
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583,
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]
],
"normalized": [
{
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}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s6-t6",
"type": "umlsterm",
"text": [
"electronic"
],
"offsets": [
[
636,
646
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013850"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s7-t1",
"type": "umlsterm",
"text": [
"object-choice"
],
"offsets": [
[
718,
731
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0008300"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s7-t2",
"type": "umlsterm",
"text": [
"role"
],
"offsets": [
[
790,
794
]
],
"normalized": [
{
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"db_id": "C0035820"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s8-t1",
"type": "umlsterm",
"text": [
"electronic"
],
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869,
879
]
],
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}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s8-t2",
"type": "umlsterm",
"text": [
"signs"
],
"offsets": [
[
880,
885
]
],
"normalized": [
{
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"db_id": "C0220912"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s8-t3",
"type": "umlsterm",
"text": [
"life"
],
"offsets": [
[
906,
910
]
],
"normalized": [
{
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"db_id": "C0376558"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s11-t1",
"type": "umlsterm",
"text": [
"procedure"
],
"offsets": [
[
1104,
1113
]
],
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"db_id": "C0184661"
},
{
"db_name": "UMLS",
"db_id": "C0025664"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s11-t2",
"type": "umlsterm",
"text": [
"industrialization"
],
"offsets": [
[
1135,
1152
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021266"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s11-t3",
"type": "umlsterm",
"text": [
"object-choice"
],
"offsets": [
[
1156,
1169
]
],
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}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s12-t1",
"type": "umlsterm",
"text": [
"object-choice"
],
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[
1213,
1226
]
],
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}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s12-t2",
"type": "umlsterm",
"text": [
"displacement"
],
"offsets": [
[
1278,
1290
]
],
"normalized": [
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"db_id": "C0012725"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s13-t1",
"type": "umlsterm",
"text": [
"socio-cultural"
],
"offsets": [
[
1349,
1363
]
],
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}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s13-t2",
"type": "umlsterm",
"text": [
"understanding"
],
"offsets": [
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1364,
1377
]
],
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]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s14-t1",
"type": "umlsterm",
"text": [
"socio-cultural"
],
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1434,
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],
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},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s14-t2",
"type": "umlsterm",
"text": [
"understanding"
],
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1449,
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},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t1",
"type": "umlsterm",
"text": [
"goal"
],
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[
1527,
1531
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]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t2",
"type": "umlsterm",
"text": [
"signs"
],
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1598,
1603
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],
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]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t3",
"type": "umlsterm",
"text": [
"industrialization"
],
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[
1622,
1639
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],
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"db_id": "C0021266"
}
]
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t4",
"type": "umlsterm",
"text": [
"object relationships"
],
"offsets": [
[
1643,
1663
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0028758"
}
]
}
] |
[] |
[] |
[
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s4-r1-t2.1-t1.1",
"type": "performs",
"arg1_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t2",
"arg2_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t1",
"normalized": []
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s6-r1-t5.1-t1.1",
"type": "issue_in",
"arg1_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s6-t5",
"arg2_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t1",
"normalized": []
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s6-r2-t3.1-t1.1",
"type": "issue_in",
"arg1_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t3",
"arg2_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t1",
"normalized": []
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s7-r1-t1.1-t2.1",
"type": "affects",
"arg1_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t1",
"arg2_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t2",
"normalized": []
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s7-r2-t2.1-t1.1",
"type": "affects",
"arg1_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t2",
"arg2_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t1",
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},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s12-r1-t2.1-t1.1",
"type": "result_of",
"arg1_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t2",
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},
{
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"type": "result_of",
"arg1_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t1",
"arg2_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t2",
"normalized": []
},
{
"id": "ForumDerPsychoanalyse.90150001.eng.abstr-s13-r1-t1.1-t2.1",
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},
{
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"type": "result_of",
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"arg2_id": "ForumDerPsychoanalyse.90150001.eng.abstr-s15-t2",
"normalized": []
}
] |
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