[The "Pisse-Prophet" or the "English fortune-teller from urine". A critical book on uroscopy bei Thomas Brian]. / Der "Pisse-Prophet" oder "der englische Wahrsager aus dem Urin". Ein kritisches Buch zur Harnschau von Thomas Brian.

In the middle ages, uroscopy was the main nosological principle in medicine. It lead to quackery. One of the critics of uroscopy, who demanded a medicine mainly oriented on the patient, was Thomas Brian in 1637.

Soluble p185(HER-2) in patients with malignant bone tumours.

BACKGROUND: This study was initiated to test the hypothesis that soluble p185(HER-2) could be of value as a diagnostic or predictive marker for patients with malignant bone tumours. PROCEDURE: Sera of 35 patients with high-grade malignant osteosarcoma (n = 27) and Ewing Sarcoma (n = 8) were tested at the time of diagnosis by ELISA and compared with sera of controls (n = 38) and clinical data. RESULTS: In patients with osteosarcoma and Ewing Sarcoma, levels of sp185(HER-2) did not differ significantly from levels in controls. These results were irrespective of the type of tumour, survival chemotherapy or other clinical variables. CONCLUSION: p185(HER-2) serum levels do not appear to be of diagnostic or predictive value for differentiation of high-grade osteosarcoma and Ewing Sarcoma.

Pamidronate increases bone mineral density in women with postmenopausal or steroid-induced osteoporosis.

INTRODUCTION: We aimed to determine the efficacy and safety of a cyclic intravenous therapy with pamidronate in patients with postmenopausal or glucocorticoid-induced osteoporosis. METHODS: We enrolled 86 Austrian female patients with postmenopausal (n = 69, mean age 68.13 +/- 1.14) or glucocorticoid-induced (n = 17, mean age 66.89 +/- 2.03) osteoporosis defined as a T-score of < -2.5 for bone mineral density (BMD) of the lumbar spine L1-L4. Patients received a single intravenous dose of 30 mg pamidronate at 3 months intervals. The per cent change in BMD was primary, whereas the safety and the biological response were secondary endpoints. RESULTS: Seventy-six female patients (88%) completed study. Sixty patients received pamidronate therapy for the treatment of late postmenopausal osteoporosis and 16 patients received the same treatment for glucocorticoid-induced osteoporosis. At the end of the trial, lumbar spine (L1-L4) BMD increased significantly in patients with postmenopausal osteoporosis (P = 0.000067), whereas in patients with glucocorticoid-induced osteoporosis no significant change was observed (P = 0.724). The increase in the Ward's triangle BMD did not reach significance level in postmenopausal women receiving pamidronate (P = 0.0740). However, pamidronate treatment for glucocorticoid-induced osteoporosis resulted in a significant increase in Ward's triangle BMD (P = 0.0029). The efficacy of pamidronate treatment for postmenopausal osteoporosis was also reflected in a decrease in circulating biochemical markers for bone formation, including alkaline phosphatase and osteocalcin. In addition, pamidronate was well tolerated with no incidence of severe gastrointestinal events. CONCLUSION: Cyclic intravenous administration of pamidronate is well-tolerated therapy in postmenopausal osteoporosis, and increases spinal BMD. Randomized controlled studies with adequate number of patients are needed to test the efficacy of the compound in the treatment of glucocorticoid-induced osteoporosis.

Suprascapular nerve entrapment. A meta-analysis.

We performed a review of the literature between 1959 and 2001. We found 88 cases of suprascapular nerve entrapment, which fulfilled our inclusion criteria. Suprascapular nerve entrapment is rare and mainly occurs in patients under 40 years of age. Males are more likely to suffer from a ganglion compressing the nerve than females. If the patient's history reveals a trauma, it is more likely that the ligament is compromising the nerve. Ganglions usually cause isolated infraspinatus atrophy, whereas a combined atrophy of the supra- and infraspinatus muscles is more common in cases in which the nerve is compressed by the ligament.

Subcutaneous low-dose epoetin beta for the avoidance of transfusion in patients scheduled for elective surgery not eligible for autologous blood donation.

This randomized, multicentre, parallel-group study assessed the efficacy of epoetin beta in reducing the transfusion frequency in patients ineligible for autologous blood donation prior to surgery. The patients (n = 194) received either epoetin beta (125 or 250 IU/kg, once weekly) or no therapy for 3-4 weeks before surgery. The pre-operation haemoglobin levels were markedly increased in the epoetin beta groups (125 IU/kg: +1.1 g/dl; 250 IU/kg: +1.6 g/dl), but not in the control group. The transfusion frequency was significantly reduced in both epoetin groups as compared with the control group (p = 0.046). Epoetin beta was well tolerated, and no serious adverse events were observed. Low-dose administration of epoetin beta before elective surgery reduces the transfusion frequencies in patients not eligible for autologous blood donation.

[Clinical aspects of hydatid torsion. Diagnosis and therapy in 104 consecutive patients]. / Die Klinik der Hydatidentorsion. Diagnostik und Therapie bei 104 konsekutiven Patienten.

At the department of the urology of the university hospital in Giessen we observed 104 hydatid torsions with acute scrotal pain between 1977 and 1998. The average age of the affected patients showed a peak in boys with 12 years of age. 33.7% of the patients underwent primary conservative treatment and 66.3% were operated primarily. We only recommend conservative treatment after careful clinical evaluation and definitive detection of testicular perfusion. Scrotal ultrasound and color duplex sonography hereby serve as decisive tools.

Varicocele--a historical perspective.

Varicocele is an essential part of andrological urology. Due to its frequency and to the problems connected with it, varicocele became a subject of interest at an early stage in the history of medicine. Questions arose as to how the changes and the consequences resulting from this condition should be treated. Even today, some questions regarding the etiopathology and therapy of varicocele remain unanswered.

Historical milestones regarding torsion of the scrotal organs.

PURPOSE: The clinical syndrome of the acute scrotum, whereby the spermatic cord or appendix testis becomes twisted, commonly affects young men. Our knowledge of this condition, however, is of relatively recent origin. MATERIALS AND METHODS: We performed an historical survey of torsion of the scrotal organs dating back to 1703. In Bologna in 1703 Morgagni observed the first hydatid on the caput epididymis. He described 10 hydatid cases of the testis and epididymis producing, in his opinion, the fluid of hydroceles. The first illustration of appendix testis dates from Cooper 1841. Later these testicular appendages, or hydatids, were shown to be vestigial remnants of either the müllerian duct or the wolffian structures, depending on location. Actual torsion of the appendix testis was mentioned by Ombrédanne in 1913 but the first case report was published in 1922 by Colt. Appendix testis torsion was first schematically illustrated in 1923 by Mouchet and was characterized by Dix in 1931 in a manner that is still valid today. Interestingly, the great majority of case reports since 1932 have originated from America. In 1810 Hunter described a typical case of testicular torsion, and in 1840 Delasiauve presented the first case of surgically treated testicular torsion. A schematic and original illustration of a contorted undescended testis was published in 1894 by Lauenstein. RESULTS: Testicular torsion was, and still is, a true urological emergency but the historical survival rate of the testis was extremely low. Searching for improvement in clinical diagnosis, physicians have noted helpful specific signs, 1 of which is that the period of ischemia determines loss of the testis. CONCLUSIONS: The historical development of diagnosis of torsion of the appendix testis and spermatic cord highlights the ever present need for careful examination, a high index of suspicion and timely therapy.

Transurethral laser urethrotomy with argon laser: experience with 900 urethrotomies in 450 patients from 1978 to 1993.

From April 1978 to September 1993, the Department of Urology of Giessen Medical School used laser urethrotomy as standard endoscopic treatment in benign urethral strictures. In this period, 900 urethrotomies were performed in 450 patients. The majority of strictures treated were iatrogenic (65%), located in the posterior urethra (62.8%) and classified as short (< or = 1 cm) (71%). Argon laser urethrotomy was carried out in the 12 degrees position according to the technique of internal optical urethrotomy. An indwelling transurethral catheter was left for 48 h after urethrotomy. Uroflowmetry after argon laser urethrotomy revealed the efficacy of the method. A retrospective analysis of the operations was performed. Analysis showed that recurrence appeared on average after 15.2 months (range 1-39) in up to 70.1%. Nearly 50% of recurrence was evident within 1 year following surgery. Recurrence was independent of location, length and etiology of the stricture. We conclude according to our data that argon laser urethrotomy is technically feasible. Due to the high recurrence rate the method offers no advantage over conventional internal optical urethrotomy.

[Experience with argon laser in urological diseases (author's transl)]. / Erfahrungen mit der Argon-Laserapplikation bei urologischen Erkrankungen.

The application of the Argon laser in urology has proved to be effective in resecting recurrent, exophytic urothelial tumors of the bladder up to the size of a raspberry. In cases of wide spread bladder tumors we only perform a radiation of the resected area as local recurrence prophylaxis following transurethral resection. The urethroscopic Argon laser irradiation makes laser urethrotomy and evaporisation of urethral strictures possible. Furthermore, a curative and conservative treatment of urethral tumors is possible in combination with chemotherapy. The same applies for the penis carcinoma. Urethral ruptures are also successfully treated by urethroscopic laser recanalization. A determination of the ureteral submucosal course, which may allow a prognosis about the probable maturation, is possible in cases of cystoureteral reflux with the help of laser diaphanoscopy.

[Treatment of hospital-acquired urinary infections with amikacin (author's transl)]. / Amikacin bei Harnweginfektionen durch Problemkeime in der Urologie.

The efficacy of amikacin was evaluated in 32 patients with urinary infections due to hospital-acquired rods. Treatment with amikacin was successful in all cases of acute urinary infection by gentamicin-resistent gram-negative strains. Amikacin shares with other aminoglycosides the risk of nephrotoxicity and ototoxicity. Follow-up studies are preferable to patients already suffering from damage of hearing. Lesions of n. vestibularis were relatively infrequent.

[Results of quantitative radionucleid investigations in acute testicular disease (author's transl)]. / Ergebnisse einer quantitativen Radionukliddiagnostik bei akuten Hodenerkrankungen.

All publications dealing with tortion of the testis stress the difficulty of diagnosis and the frequency of errors. This has suggested to us the need to develop a radio-isotope testiculogram corresponding to the radioisotope nephrogram used for renal functional diagnosis. The substance for the timeactivity curve is 99mTc pertechnitate which is taken up by the tubular epithelium of the testis and epididymis. A scan at 20 minutes proved highly diagnostic and produced a small amount of radiation only. Six quantitative parameters described the shape of the curve. These have been determined for the normal and related to age and point of measurement. It is then possible to differentiate partial and total tortion from acute epididymoorchitis. It is no longer necessary to subject every patient with acute testicular disease to surgery. With partial tortion, a conservative operation with fixation of the testis can be recommended instead of semicastration.

[Contact- and suture-free hemostasis on the kidney parenchyma by means of a new infrared radiation instrument (MICOR)]. / Berührungs- und nahtlose Blutstillung am Nierenparenchym mit einem neuartigen Infrarot-Strahler (MICOR)

A new industrial instrument named MICOR (prototype), which means "Melting with Infrared Concentrated Radiation", is used on the dog kidney. We compare haemosytpiss after partial resection by scalpell using convential sutures (16 dogs) and MICOR (17 dogs);the dog kidneys are single organs. The results show, that MICOR--without touching kidney--is very effective and as effective as parenchym--sutures. Comparing examinations of morphology and kidney function show no essential difference between both methods. By renal clearance techniques an advantage MICOR could be shown. We expect better results by imporvement of the MICOR and hope for a helpful use in human surgery.

[Renal parenchyma resection--development, technique, problems (author's transl)]. / Die Nierenparenchymresektion--Entwicklung, Technik, Probleme

Organ preservation by renal surgery is the principal and most pressing task of urology, according to Bischoff. In clinical practice at the present time, resection of the renal parenchyma is the principal aim and is to a large extent achieved. Sacrificing a localised diseased portion of the parenchyma (organ amputation) contributes to the survival of the rest of the organ (preservation of the organ). The additional inevitable loss of functional tissue must be kept as small as possible (sparing the organ). Decisive syndromes are nephrolithiasis, renal tumors and to a decreasing extent, tuberculosis of the urinary system. The operation, which usually takes the form of resection of the pole of the kidney, but which must sometimes be extended to heminephrectomy and even more, repeatedly underlies attempts at improvement both in animal experiments and in the clinical sphere.

[Behavior of fat constitutents during refining. 8. Determination of polymeric fatty acids in rape seed oil and their behavior during refining]. / Studien über das Verhalten von Fettinhaltsstoffen bei der Raffination. 8. [Mitt.] Zur Bestimmung polymerer Fettsäuren in Rapsöl und deren Verhalten bei der Raffination

1. Studies on rape-seed oil have shown that the determination of oxypolymers by means of the method according to Rost (determination of fatty acids insoluble in petroleum ether) yields unsatisfactory results. By way of contrast, the gravimetric determination (after isolation of the polymers via the non-urea adduct fatty acid methyl esters and thin-layer chromatographic separation), as proposed by the authors, permits to obtain results of good reproducibility and to determine thermopolymers and oxypolymers separately. 2. During the refining of rape-seed oil, it was observed that its polymer content decreased considerably on bleaching, and increased on deodorizing.