[The bladder catheter]. / Der Blasenkatheter.

The benefit of the transurethral catheter to protect or measure renal function is well accepted. Urethral stricture and infection of the lower urinary tract as the complications should lead to a cautious use of catheters. A careful placement, the choice of the best material and a correct management help to avoid complications. Alternatives are discussed.

[Kaposi sarcoma of the glans penis with meatal obstruction. Case report and literature review]. / Kaposi-Sarkom der Glans penis mit Meatusobstruktion. Fallbeschreibung mit Literaturübersicht.

Kaposi sarcoma was first described by Moritz Kaposi 1872. It is a disease of the reticuloendothelial system. Preferred manifestations are mainly skin, mucosa and gastrointestinal tract. Location of penile glans with meatal obstruction has been mentioned to date in 4 cases. We report a patient with acquired immune deficiency syndrome who presented a meatal obstruction caused by Kaposi-sarcoma. In this patient with a survival time of 8 months meatotomy and locoregional radiotherapy was an adequate therapy.

Contrast-enhanced endorectal coil MRI in local staging of prostate carcinoma.

OBJECTIVE: Our goal was to evaluate contrast-enhanced MRI using an endorectal coil in detecting and staging prostate carcinoma. MATERIALS AND METHODS: Sixty patients with clinically suspected prostate carcinoma were examined by T1-weighted contrast-enhanced endorectal coil MRI at 1.5 T. Results were compared with T2-weighted images in all cases and with histologic findings following radical prostatectomy in 28 patients. RESULTS: Prostate carcinomas showed no consistent pattern of contrast enhancement. In 27 patients, the tumor enhanced less than the surrounding prostatic tissue; in 10 patients, enhancement was heterogeneous; and in 23 cases, the lesion was hyperintense compared with normal glandular tissue. With respect to tumor delineation, contrast-enhanced sequences were superior to T2-weighted images in 1 case only; in 24 patients, the tumor could not be delineated at all. However, contrast-enhanced sequences provided a higher diagnostic confidence in delineating the seminal vesicles, prostate capsule, and neurovascular bundle in nine, six, and three cases, respectively. In the operated patients, accuracy, sensitivity, and specificity for staging advanced disease were comparable for both sequences. CONCLUSION: The T2-weighted sequences remain mandatory for delineation of prostate carcinoma. Contrast-enhanced T1-weighted sequences do not improve overall staging accuracy and therefore are not warranted routinely, but should be considered in cases requiring clearer delineation of the prostate capsule and/or seminal vesicles.

[Spontaneous recanalization after vasectomy]. / Spontane Rekanalisation nach Vasektomie.

Two cases of spontaneous recanalisation could be reoperated. The recanalisation was proved histologically. The reasons were analysed. The own technique is presented: resection of at least two centimeters of the vas, ligature, electrocoagulation, proximally turning-up fixation of the end, distally immersing the end in a tobacco-pouch.

[Infectious complications after transurethral resection]. / Infektiöse Komplikationen nach transurethralen Resektionen (TUR).

300 consecutive TUR were prospectively examined bacteriologically. We used, lacking contraindications, Co-Trimoxazol as antibiotic prophylaxis, when urine at admittance was sterile, otherwise we treated the urinary infection. The antibiotics were applied from the beginning of the intervention until the catheter was removed. Of the 49 patients with a indwelling catheter 28 (57%) had an urinary infection. All but one were cured. 2 of 64 (3%) patients undergoing resection of a bladder tumour acquired asymptomatic nosocomial infection. 198 patients underwent TUR of the prostate with initially sterile urine. 7 patients suffered from fever in the postoperative course, in 6 cases the origin remained unclear. 3 patients showed an asymptomatic nosocomial infection. Overall, with antibiotic prophylaxis we found an infection rate of 2-5% for the TUR of the prostate and of 3% for the TUR of bladder. Primarily infected urine, in this study, did not elevate the risk for infectious complications.

[Transient normalization of the thrombocyte count in chronic idiopathic thrombocytopenia during pneumonia]. / Transiente Normalisierung der Thrombozytenzahl bei chronischer idiopathischer Thrombozytopenie während einer Pneumonie.

A patient is described with severe chronic idiopathic thrombocytopenic purpura. The platelet count was constantly below 20 X 10(9) Tc/L. Therapy with steroids, immunoglobulin-infusion with and without steroids, vincristine and danazol produced no improvement of the thrombocytopenia. During acute pneumonia a transient remission of the platelet count was observed. Antibodies against thrombocytes and immune complexes were not detected. The level of platelet-associated IgG was increased before and after infection but was only slightly elevated when platelet count was normal. An attempt to imitate the infection by vaccinating the patient with pneumovac with a view to later splenectomy did not change the platelet count. This observation confirms the hypothesis that elevation of platelet count during infection is due to decreased production of platelet autoantibody. Even severe forms of ITP are potentially reversible.

Immunohistochemical localization of alcohol dehydrogenase in the human gastrointestinal tract.

To elucidate the possible role of alcohol dehydrogenase in the generation of damages caused by alcohol abuse, it is important to know the exact localization of this enzyme. Anti-alcohol dehydrogenase antibodies were used to localize the enzyme in human gastrointestinal tissues. Alcohol dehydrogenase was detectable in the mucosa of all parts of the gastrointestinal tract. There is a notable decrease in the amount of alcohol dehydrogenase with increasing distance from the stomach. In the stomach, the reaction for alcohol dehydrogenase was strongest in the mucus-producing cells, moderate in the parietal cells, and weak in the chief cells. Throughout the gut, alcohol dehydrogenase was present in cells exposed to the lumen in amounts comparable to that of the parietal cells. Crypt cells and goblet cells were negative. The results strongly indicate that alcohol dehydrogenase is an intrinsic component of gastrointestinal epithelial cells.

Immunohistochemical evidence for cell surface and Golgi localization of galactosyltransferase in human stomach, jejunum, liver and pancreas.

Immunohistochemical localization of galactosyltransferase (UDP-galactose: 2-acetamido-2-deoxy beta-D-glucopyranose beta (1-4) transferase) in human tissue specimens of gastric and jejunal mucosa, exocrine pancreas, and liver was carried out at the light microscopic level using affinity purified rabbit anti-human milk galactosyltransferase antibodies. Intracellular localization of galactosyltransferase in epithelial cells appeared as a triangular compact structure close to the apical pole of the nucleus. In hepatocytes, the enzyme was found in discrete spots in the cytoplasm between the nuclei and the bile canaliculi. In addition to the intracellular, juxtanuclear location an intense reaction at the luminal part of the cell surface was found in the lining epithelium of the stomach, in enterocytes of the jejunal villus tips, and in ductular cells of the pancreas. Enterocytes located in the middle portion along the cryptvillus gradient exhibited cytoplasmic staining adjacent to the brush borders. Basolateral membranes appeared negative. Little or no enzyme could be demonstrated in cells belonging to the connective tissue. These results show that secretory cells contain a Golgi apparatus which can be visualized at the light microscopic level by virtue of its content in galactosyltransferase. Presence of galactosyltransferase antigen on the surface of certain cells supports the assumption that ectoglycosyltransferases do exist, at sites, however, apparently not involved in cell contact and adhesion.