Zeitschrift fur Urologie und Nephrologie最新文献

In an analysis of 302 cadaveric kidney transplantations performed from 1986 to 1988 the frequency of spontaneous kidney allograft ruptures could significantly reduced by introduction of cyclosporine therapy. Therefore, the importance of rejection in the etiology of allograft rupture is emphasized. In comparison with an earlier analysis the prognosis of rupture with respect to organ repair has been impaired (41 vs. 68%). The importance of intense and effective immunosuppressive therapy in the early period after kidney transplantation is emphasized.

It is reported on the results of measurements of the antitoxydative capacity (AC) in the serum of children suffering from chronic renal failure, during hemodialysis and after kidney Transplantation. The results show in comparison with healthy children (19.95 +/- 5.22 mm, n = 19) that children suffering from chronic renal failure may develop an increased AC (66.18 +/- 29.14 mm, n = 24). In dialyzed children different values are found previous and after hemodialysis (58.11 +/- 9.25 vs. 17 +/- 3.6 mm). Children show after transplantation the highest values (78.9 +/- 26.04 mm, n = 13). If the increase of the AC is a compensatory and regulatory mechanism or the result of accumulation of antioxydative substances should realized in further investigations. The measurements of vitamin-E-supplemented sera may show that an oral application of vitamin E increase the AC in vivo.

Urinary specimens of 156 patients were examined simultaneously by SDS electrophoresis and isoelectric focusing (IEF). Simultaneous separated protein test mixtures may help to a rapid orientation on the isoelectric points and molecular weights of the urinary proteins. The SDS electrophoresis as well as the IEF make possible a safe proteinuria typing, whereby both methods have specific advantages.

On the occasion of his 100th birthday the curriculum vitae and the scientific work of the surgeon Johannes Volkmann (1889-1982) are presented. The influence of his teacher Friedrich Voelcker (1872-1955) and the importance of Volkmann to the development of intravenous urography are emphasized.

Male fertility is indirectly evaluated by analysis of semen. Two questions must be answered in connection with an investigation program. 1. Which prerequisites must the spermatozoa fulfill to the fertilization of oocytes in vivo and to the induction of a normal embryogenesis? 2. Which laboratory tests can be taken as an in vitro model for the fertilization process? Fertilization consists of various steps which require different spermatozoal functions. Several methods were developed to test in vitro whether the semen sample is capable to realize the sequence of fertilization, whereas, it is supposed that there is a close connection between the laboratory test in vitro and the fertilization in vivo. The methods of sperm analysis are presented and their medical practice and predictive value is discussed.

The malondialdehyde equivalent (MDE) was measured by the thiobarbiturate method quantitatively in serum of healthy children, children suffering from chronic renal failure and after kidney transplantation. In the reference group (n = 19) a serum concentration of 3.98 +/- 0.84 nmol/ml was found. Elevated MDE serum concentrations were measured in all groups suffering from renal disease: groups with various degree of diminished renal function (7.05 +/- 2.12 nmol/ml; n = 24), children treated by chronic hemodialysis (6.38 +/- 0.98 nmol/ml; previous dialysis and 6.27 +/- 0.63 nmol/ml after dialysis, n = 9) and children after renal transplantation (6.59 +/- 1.14 nmol/ml; n = 13). In the hemodialysis group the MDE concentration was not affected by a single dialysis nor by sixth months dialysis course. A cell-damaging lipid peroxidation in children suffering from renal diseases is reflected by the investigations.

In recent years the true incidence of impotence due to organic diseases in comparison with psychogenic disorders could be verified. New diagnostic tools as penile Doppler ultrasonography, PBI estimation, NPT measurement, invasive SKIT's, neurophysiological methods, selective phalloarteriography, artificial erection and dynamic cavernosography are introduced and are the guide to therapeutic approach.

Retroperitoneal lymphadenectomy may produce in the majority of patients an irreversible loss of normal ejaculation due to lesion of presacral sympathetic nerve fibers. Libido and orgasm did remain unchanged. In 14.3% of the patients a retrograde ejaculations could evaluated. By application of alpha-sympathicomimetic drugs this could reversed to an antegrade ejaculation. However, fertility was altered strongly because of motility loss.

In 20 patients analyses of the coagulation potential were performed in order to test the heparin dosage during chronic hemodialysis. The activated PTT is the most suitable laboratory test. Because of the individually different heparin consumption the control of PTT should performed in every dialysis patient after 90 minutes during the first 2-3 dialysis treatments. Thereby a lasting dosage schedule for each patient could be obtained. The heparin consumption per dialysis unit was approximately 5,200 (3,000-9,000) IU.