T. Reineke - Academia.edu (original) (raw)
Papers by T. Reineke
Urology, 2005
Objectives. To assess, in a prospective study, the incidence of fecal incontinence after radical ... more Objectives. To assess, in a prospective study, the incidence of fecal incontinence after radical perineal prostatectomy. Methods. Bowel symptoms were evaluated with questionnaires mailed to 132 patients preoperatively and 6 months postoperatively, and annually thereafter. All patients had undergone extrafascial perineal prostatectomy for Stage cT1-cT3N0M0 prostate cancer. The data of 116 patients (88%), who answered at least the preoperative and 12-month questionnaires, were analyzed. Reduced sensibility, reduced discrimination, urgency, or stool smearing were symptoms indicative of fecal incontinence. Patients with one symptom of fecal incontinence were evaluated further with a structured telephone interview. Results. Daily stool smearing was reported preoperatively by 4% of the patients. Two symptoms related to fecal incontinence were present preoperatively in 6% of the patients. At 12 months postoperatively, 15 patients (13%) reported at least two symptoms of fecal incontinence. The structured telephone interview revealed that 6 of these 15 patients had symptoms of fecal incontinence that were related to the perineal prostatectomy; 9 patients had newly developed symptoms not related to surgery or symptoms due to tumor recurrence or radiotherapy. Patients with the presence of at least one symptom of fecal incontinence before surgery had an almost fourfold increased risk of developing at least two symptoms of fecal incontinence postoperatively compared with patients without any symptom of fecal incontinence. Conclusions. Significant fecal incontinence after radical extrafascial perineal prostatectomy is a rare event.
Urologia Internationalis, 2006
To evaluate the potency in patients after radical perineal prostatectomy with wide excision of bo... more To evaluate the potency in patients after radical perineal prostatectomy with wide excision of both neurovascular bundles. In this prospective study, a quality-of-life questionnaire was completed by 128 patients at the preoperative stage, and 6 and 12 months postoperatively. Ten questions concerning the patient's sexuality were included on the pre- and both postoperative questionnaires. In addition, 6 patients who recorded some erectile function were sent a separate questionnaire containing eight more detailed questions. Preoperatively, 74/128 (57.8%) patients reported erections sufficient for sexual intercourse, and of these 74, 6 (8.1%) described having spontaneous erections 1 year postoperatively. These spontaneous erections occurred 1-5 times per week. The reply to the separate mailing made clear that the reported erections were insufficient for intercourse. Patients undergoing standardized radical prostatectomy with wide excision of the neurovascular bundle have a very small chance of spontaneous erections sufficient for intercourse postoperatively.
Current Urology, 2009
Objective: Bothersome persistent urgency is often underestimated and can be early and late sequel... more Objective: Bothersome persistent urgency is often underestimated and can be early and late sequela following therapy for localized prostate cancer. Does urodynamic investigation help to detect those who are at risk? Do patients with similar urodynamic findings perform better after radical prostatectomy and thus should be advised against brachytherapy? Patients and Methods: Sixty-nine patients who received brachytherapy for clinically localized
BJU International, 2004
Extraprostatic tumours were found in 18% of specimens taken during RP, and bilateral tumours in 6... more Extraprostatic tumours were found in 18% of specimens taken during RP, and bilateral tumours in 63% of patients. After a mean follow-up of 27 months, there was PSA relapse in two of the 80 patients in the RP and RP + NS groups, and six of the 52 patients in the BT group; a significant difference, with a hazard ratio of 5.2. The acute morbidity was low in all groups. At 1 year, more than two incontinence pads were used by 5% of patients after RP and by 4% after BT. Similarly, at 1 year 15% of patients after RP and 13% after BT were bothered by urinary incontinence. Newlydeveloped fecal soiling was reported by 4%, 5% and 11% of the RP, RP + NS and BT groups respectively; none of the patients after RP and 4% after BT were bothered by this symptom. The duration and stiffness of erection was assessed after 1 year and reported to be equal or slightly decreased by a third after RP + NS and 38% after BT. Taking a 5-10 point difference as clinically relevant, role, emotional and social functioning were improved considerably after RP + NS than after BT, but sexual activity was impaired significantly after RP + NS than after BT.
Fortschritte der Kiefer- und Gesichts-Chirurgie, 1996
A clinical, radiographic and computer-assisted axiographic follow-up was carried out on 60 patien... more A clinical, radiographic and computer-assisted axiographic follow-up was carried out on 60 patients who had been treated for unilateral subcondylar fractures. These were patients of the Department of oral, maxillofacial and facial plastic surgery of the Medical Faculty of the University of Technology in Aachen, Germany. After surgical reduction of the condyle with fixation by osteosynthesis where results were positive, 27 patients exhibited a shortening of the condyle paths on the side operated on by up to 16.4%. Although conservative therapy produced slighter straightening of the condyle with more or less strongly marked condylar deformations in two-thirds of the cases, functionally more positive results were obtained by markedly slighter limitation of the condyle paths on the traumatized side. These results would appear to indicate operative therapy of unilateral subcondylar fractures in the case of luxation fractures, condylar dislocation in excess of 50 degrees, and in those cas...
TumorDiagnostik & Therapie, 2002
Geburtshilfe und Frauenheilkunde, 2013
Background: Aim of the study was a critical assessment of the clinical validity of the prenatal d... more Background: Aim of the study was a critical assessment of the clinical validity of the prenatal determination of sFlt-1/PlGF for preeclampsia (PE), pregnancy-induced hypertension (PIH), and proteinuria. Our analysis was based on a specificity of 95 % and a sensitivity of 82 % for the prediction of preeclampsia, as described by Elecsys (Roche). Methods: In this retrospective study the ratio of the prenatal antiangiogenic factor sFlt-1 (soluble fms-like tyrosine kinase-1) to the proangiogenic factor PIGF (placental growth factor) was analyzed using the electrochemiluminescence immunoassay of Elecsys (Roche Diagnostics, Mannheim, Germany) in 173 pregnant women. Sixty-three women with PE, 34 women with PIH and 6 women with proteinuria were compared to 72 controls. On average, the sFlt-1/PlGF ratio was determined 8 (controls), 2.4 (PE), 3.2 (PIH) and 4.1 (proteinuria) weeks before delivery. The PE and PIH cases were further subdivided into early (< 34 weeks of gestation) and late (≥ 34 weeks of gestation) onset groups. Statistical data analysis was done using the usual descriptive statistics and logistic regression analysis. ROC curves were calculated, and the sensitivity, specificity, and negative and positive predictive value (NPV, PPV) were estimated for a threshold of 85. Results: Although the specificity of the sFlt-1/PlGF ratio was high for PE, the sensitivity was low (only 59.4 %), thus giving unsatisfying results for PE. The sensitivity only increased to 62.5 % for the early-onset PE group. Intriguingly, a high ratio was detected for the combination of IUGR (intrauterine growth restriction) and PE in the early-onset PE group (8 cases). In the control group, 4 cases exceeded the cut-off value of 85 but showed no clinical signs of PE and the birth was unremarkable. In summary, we found that the sFlt-1/PIGF ratio could not be used as a predictive test for preeclampsia but rather as an indicator for the development and estimation of the severity of PE. Thus, the test is less suitable for the reliable exclusion of PE in routine clinical practice. Recommendation: The determination of the sFlT-1/PlGF ratio is only one element for PE diagnosis in addition to the measurement of blood pressure, proteinuria, ultrasound and Doppler.
Geburtshilfe und Frauenheilkunde, 2011
Zeitschrift für Geburtshilfe und Neonatologie, 2009
European Urology Supplements, 2005
Zeitschrift für Kardiologie, 1997
In transesophageal echocardiography several methods have been used to grade mitral regurgitation.... more In transesophageal echocardiography several methods have been used to grade mitral regurgitation. For a direct comparison of these techniques, 36 patients (60 +/- 13 years) with native mitral regurgitation underwent multiplane transesophageal echocardiography and angiography within 5 days. We compared the following measurements: 1) The maximal color jet area of mitral regurgitation, 2) the ratio of maximal systolic to diastolic pulmonary venous flow velocity in the left upper pulmonary vein, 3) the proximal jet width of mitral regurgitation, 4) the maximal regurgitant flow rate Qmax, measured by the proximal convergence method, 5) the regurgitant office area Areg, calculated by dividing Qmax by maximal regurgitant velocity obtained by continuous wave Doppler. The correlation between color jet area (r = 0.4; p < 0.05) or pulmonary venous flow (r = -0.3; p = n.s.) with angiographic severity of mitral regurgitation is low. The sensitivity of the retrospective best cut-off values is ...
Urology, 2005
Objectives. To assess, in a prospective study, the incidence of fecal incontinence after radical ... more Objectives. To assess, in a prospective study, the incidence of fecal incontinence after radical perineal prostatectomy. Methods. Bowel symptoms were evaluated with questionnaires mailed to 132 patients preoperatively and 6 months postoperatively, and annually thereafter. All patients had undergone extrafascial perineal prostatectomy for Stage cT1-cT3N0M0 prostate cancer. The data of 116 patients (88%), who answered at least the preoperative and 12-month questionnaires, were analyzed. Reduced sensibility, reduced discrimination, urgency, or stool smearing were symptoms indicative of fecal incontinence. Patients with one symptom of fecal incontinence were evaluated further with a structured telephone interview. Results. Daily stool smearing was reported preoperatively by 4% of the patients. Two symptoms related to fecal incontinence were present preoperatively in 6% of the patients. At 12 months postoperatively, 15 patients (13%) reported at least two symptoms of fecal incontinence. The structured telephone interview revealed that 6 of these 15 patients had symptoms of fecal incontinence that were related to the perineal prostatectomy; 9 patients had newly developed symptoms not related to surgery or symptoms due to tumor recurrence or radiotherapy. Patients with the presence of at least one symptom of fecal incontinence before surgery had an almost fourfold increased risk of developing at least two symptoms of fecal incontinence postoperatively compared with patients without any symptom of fecal incontinence. Conclusions. Significant fecal incontinence after radical extrafascial perineal prostatectomy is a rare event.
Journal of the American Society of Echocardiography, 1998
Doppler evaluation of mitral regurgitation remains difficult; thus, a head-to-head comparison of ... more Doppler evaluation of mitral regurgitation remains difficult; thus, a head-to-head comparison of the diagnostic accuracy of Doppler methods was undertaken. Fifty patients with native mitral regurgitation underwent multiplane transesophageal echocardiography within 5 days of catheterization. Angiographic grade of mitral regurgitation and, in 20 patients with grade II-IV regurgitation, invasively determined regurgitant stroke volume were compared with color Doppler area, regurgitant jet diameter, ratio of systolic to diastolic peak pulmonary venous flow velocities, and (based on the proximal convergence zone) maximal regurgitant flow rate and regurgitant orifice area. Rank correlation coefficients of angiographic grade with Doppler parameters were 0.61 for color jet area, -0.61 for pulmonary venous flow velocity ratio, 0.69 for color jet diameter, 0.79 for maximal regurgitant flow rate, and 0.78 for regurgitant orifice area (all P &amp;amp;amp;lt; .01). Convergence zone-based parameters also correlated best (r=0.73) with invasively determined regurgitant stroke volume. Receiver operating characteristic curve analysis confirmed higher diagnostic accuracy for proximal jet width and proximal convergence zone parameters than for color jet area or pulmonary venous flow velocity ratio. Proximal convergence zone parameters and proximal color jet diameter best distinguished severe from mild forms of mitral regurgitation.
European Heart Journal, 1996
Background Biplane angiographic and transthoracic echocardiographic volume calculations have show... more Background Biplane angiographic and transthoracic echocardiographic volume calculations have shown to be sufficiently reliable in symmetric hearts; however, they are unreliable in the presence of aneurysmatic distortions. Multiplane transoesophageal echocardiography offers unobstructed cross-sectional views of the heart from one stable transducer position with the potential of imaging irregular cavity forms more accurately. It was the purpose of this in vitro study to compare the precision of multiplanar transoesophageal echocardiography to that of biplane angiography in determining left ventricular volumes, especially in aneurysmatic models.
European Archives of Oto-Rhino-Laryngology, 2001
Objective: Test of dose-response relationship for Ginkgo biloba extract EGb 761 (oral) in outpati... more Objective: Test of dose-response relationship for Ginkgo biloba extract EGb 761 (oral) in outpatients with acute idiopathic sudden sensorineural hearing loss (ISSHL) of at least 15 dB at one frequency within the speech range occurring less than 10 days before study inclusion. Design: Multicentre, randomized, double-blind phase III study comparing dosages of 120 mg twice daily and 12 mg twice daily over 8 weeks. Main endpoint: Recovery (in dB) of the auditory threshold from the initial measurement to the value on the last day of treatment, averaged over those frequencies from 0.25, 0.5, 1, 2, and 3 kHz for which the initial hearing loss amounted to 15 dB or more compared to the level on the opposite side. Patients: 106 patients with an average age of 44 ± 16 years and with hearing loss at affected frequencies 26 dB ± 9 dB included between December 1995 and July 1997. Results: Large majorities of both treatment groups recovered completely. In exploratory analyses of the 96 patients included according to the protocol, patients given the higher dose had less risk of not recovering well (≤10 dB residual hearing loss) (one-sided Fisher test: P = 0.0061), especially if they had no tinnitus (n = 44, P = 0.00702). Conclusion: A higher dosage of EGb 761 (oral) appears to speed up and secure the recovery of ISSHL patients, with a good chance that they will recover completely, even with little treatment. This was already observed after one week of treatment. We find it justified to treat patients who have unilateral ISSHL of less than 75 dB and neither tinnitus nor vertigo with 120 mg oral EGb 761 twice daily.
Zeitschrift f�r Kardiologie, 1997
Mund-, Kiefer- und Gesichtschirurgie : MKG, 1998
A possible correlation between the thermal effects of the weather and the frequency of odontogeni... more A possible correlation between the thermal effects of the weather and the frequency of odontogenic soft-tissue infections was investigated with special regard to the so-called felt temperature (gT). Clinical data of 2111 patients of the years 1992-1996 in whom an incision was made because of an odontogenic soft-tissue infection were evaluated retrospectively and correlated to meteorological data for Aachen, collected or calculated by the "Deutsche Wetterdienst". In order to describe the thermal exchange between the human organism and the surroundings in a satisfactory way, the gT was chosen. The gT is a complexly calculated meteorological parameter which allows physiologically adequate estimation of the thermic surroundings of humans. Over the whole study time there was no impressive correlation between course and changing of the gT and the frequency of odontogenic soft-tissue infections. This result agrees with our finding that there was no seasonal accumulation of odonto...
Nephron, 1990
We carried out a retrospective investigation in 220 patients to assess the influence of various p... more We carried out a retrospective investigation in 220 patients to assess the influence of various parameters on the long-term course of membranoproliferative glomerulonephritis (MPGN) type I. 50 patients (23%) died during the follow-up period of 59 months on average, in another 57 (26%) end-stage renal failure developed. 54 patients (24%) suffered from chronic renal failure, stable renal function (creatinine below 1.3 mg/dl) was preserved in 59 patients (27%). 5 years after biopsy 49% of the patients had already died or needed regular dialysis treatment; after 10 years this proportion increased to 64%. Morphological findings: The outcome was--with the exception of focal crescent formations--not determined by the severity of glomerular changes; the survival rate, however, decreased significantly, if tubulointerstitial lesions were present as defined by acute renal failure, interstitial fibrosis or a combination of both. Clinical parameters: A progressive deterioration of renal function...
Zusammenfassung Anhand objektiver meteorologischer Parameter sollte überprüft werden, ob ein Zusa... more Zusammenfassung Anhand objektiver meteorologischer Parameter sollte überprüft werden, ob ein Zusammenhang zwischen thermischem Wirkungskomplex innerhalb des Wettergeschehens und der Häufigkeit odontogener Weichteilinfektionen besteht. Hierzu wurden die Daten von 2111 Patienten der Jahre von 1992-1996, bei denen wegen einer akuten odontogenen Weichteilinfektion eine Inzision durchgeführt worden war, retrospektiv ausgewertet und mit meteorologischen Daten für Aachen, die der Deutsche Wetterdienst ermittelt hatte,
Urologia Internationalis, 2006
To evaluate the potency in patients after radical perineal prostatectomy with wide excision of bo... more To evaluate the potency in patients after radical perineal prostatectomy with wide excision of both neurovascular bundles. In this prospective study, a quality-of-life questionnaire was completed by 128 patients at the preoperative stage, and 6 and 12 months postoperatively. Ten questions concerning the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sexuality were included on the pre- and both postoperative questionnaires. In addition, 6 patients who recorded some erectile function were sent a separate questionnaire containing eight more detailed questions. Preoperatively, 74/128 (57.8%) patients reported erections sufficient for sexual intercourse, and of these 74, 6 (8.1%) described having spontaneous erections 1 year postoperatively. These spontaneous erections occurred 1-5 times per week. The reply to the separate mailing made clear that the reported erections were insufficient for intercourse. Patients undergoing standardized radical prostatectomy with wide excision of the neurovascular bundle have a very small chance of spontaneous erections sufficient for intercourse postoperatively.
Urology, 2005
Objectives. To assess, in a prospective study, the incidence of fecal incontinence after radical ... more Objectives. To assess, in a prospective study, the incidence of fecal incontinence after radical perineal prostatectomy. Methods. Bowel symptoms were evaluated with questionnaires mailed to 132 patients preoperatively and 6 months postoperatively, and annually thereafter. All patients had undergone extrafascial perineal prostatectomy for Stage cT1-cT3N0M0 prostate cancer. The data of 116 patients (88%), who answered at least the preoperative and 12-month questionnaires, were analyzed. Reduced sensibility, reduced discrimination, urgency, or stool smearing were symptoms indicative of fecal incontinence. Patients with one symptom of fecal incontinence were evaluated further with a structured telephone interview. Results. Daily stool smearing was reported preoperatively by 4% of the patients. Two symptoms related to fecal incontinence were present preoperatively in 6% of the patients. At 12 months postoperatively, 15 patients (13%) reported at least two symptoms of fecal incontinence. The structured telephone interview revealed that 6 of these 15 patients had symptoms of fecal incontinence that were related to the perineal prostatectomy; 9 patients had newly developed symptoms not related to surgery or symptoms due to tumor recurrence or radiotherapy. Patients with the presence of at least one symptom of fecal incontinence before surgery had an almost fourfold increased risk of developing at least two symptoms of fecal incontinence postoperatively compared with patients without any symptom of fecal incontinence. Conclusions. Significant fecal incontinence after radical extrafascial perineal prostatectomy is a rare event.
Urologia Internationalis, 2006
To evaluate the potency in patients after radical perineal prostatectomy with wide excision of bo... more To evaluate the potency in patients after radical perineal prostatectomy with wide excision of both neurovascular bundles. In this prospective study, a quality-of-life questionnaire was completed by 128 patients at the preoperative stage, and 6 and 12 months postoperatively. Ten questions concerning the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sexuality were included on the pre- and both postoperative questionnaires. In addition, 6 patients who recorded some erectile function were sent a separate questionnaire containing eight more detailed questions. Preoperatively, 74/128 (57.8%) patients reported erections sufficient for sexual intercourse, and of these 74, 6 (8.1%) described having spontaneous erections 1 year postoperatively. These spontaneous erections occurred 1-5 times per week. The reply to the separate mailing made clear that the reported erections were insufficient for intercourse. Patients undergoing standardized radical prostatectomy with wide excision of the neurovascular bundle have a very small chance of spontaneous erections sufficient for intercourse postoperatively.
Current Urology, 2009
Objective: Bothersome persistent urgency is often underestimated and can be early and late sequel... more Objective: Bothersome persistent urgency is often underestimated and can be early and late sequela following therapy for localized prostate cancer. Does urodynamic investigation help to detect those who are at risk? Do patients with similar urodynamic findings perform better after radical prostatectomy and thus should be advised against brachytherapy? Patients and Methods: Sixty-nine patients who received brachytherapy for clinically localized
BJU International, 2004
Extraprostatic tumours were found in 18% of specimens taken during RP, and bilateral tumours in 6... more Extraprostatic tumours were found in 18% of specimens taken during RP, and bilateral tumours in 63% of patients. After a mean follow-up of 27 months, there was PSA relapse in two of the 80 patients in the RP and RP + NS groups, and six of the 52 patients in the BT group; a significant difference, with a hazard ratio of 5.2. The acute morbidity was low in all groups. At 1 year, more than two incontinence pads were used by 5% of patients after RP and by 4% after BT. Similarly, at 1 year 15% of patients after RP and 13% after BT were bothered by urinary incontinence. Newlydeveloped fecal soiling was reported by 4%, 5% and 11% of the RP, RP + NS and BT groups respectively; none of the patients after RP and 4% after BT were bothered by this symptom. The duration and stiffness of erection was assessed after 1 year and reported to be equal or slightly decreased by a third after RP + NS and 38% after BT. Taking a 5-10 point difference as clinically relevant, role, emotional and social functioning were improved considerably after RP + NS than after BT, but sexual activity was impaired significantly after RP + NS than after BT.
Fortschritte der Kiefer- und Gesichts-Chirurgie, 1996
A clinical, radiographic and computer-assisted axiographic follow-up was carried out on 60 patien... more A clinical, radiographic and computer-assisted axiographic follow-up was carried out on 60 patients who had been treated for unilateral subcondylar fractures. These were patients of the Department of oral, maxillofacial and facial plastic surgery of the Medical Faculty of the University of Technology in Aachen, Germany. After surgical reduction of the condyle with fixation by osteosynthesis where results were positive, 27 patients exhibited a shortening of the condyle paths on the side operated on by up to 16.4%. Although conservative therapy produced slighter straightening of the condyle with more or less strongly marked condylar deformations in two-thirds of the cases, functionally more positive results were obtained by markedly slighter limitation of the condyle paths on the traumatized side. These results would appear to indicate operative therapy of unilateral subcondylar fractures in the case of luxation fractures, condylar dislocation in excess of 50 degrees, and in those cas...
TumorDiagnostik & Therapie, 2002
Geburtshilfe und Frauenheilkunde, 2013
Background: Aim of the study was a critical assessment of the clinical validity of the prenatal d... more Background: Aim of the study was a critical assessment of the clinical validity of the prenatal determination of sFlt-1/PlGF for preeclampsia (PE), pregnancy-induced hypertension (PIH), and proteinuria. Our analysis was based on a specificity of 95 % and a sensitivity of 82 % for the prediction of preeclampsia, as described by Elecsys (Roche). Methods: In this retrospective study the ratio of the prenatal antiangiogenic factor sFlt-1 (soluble fms-like tyrosine kinase-1) to the proangiogenic factor PIGF (placental growth factor) was analyzed using the electrochemiluminescence immunoassay of Elecsys (Roche Diagnostics, Mannheim, Germany) in 173 pregnant women. Sixty-three women with PE, 34 women with PIH and 6 women with proteinuria were compared to 72 controls. On average, the sFlt-1/PlGF ratio was determined 8 (controls), 2.4 (PE), 3.2 (PIH) and 4.1 (proteinuria) weeks before delivery. The PE and PIH cases were further subdivided into early (&amp;amp;amp;lt; 34 weeks of gestation) and late (≥ 34 weeks of gestation) onset groups. Statistical data analysis was done using the usual descriptive statistics and logistic regression analysis. ROC curves were calculated, and the sensitivity, specificity, and negative and positive predictive value (NPV, PPV) were estimated for a threshold of 85. Results: Although the specificity of the sFlt-1/PlGF ratio was high for PE, the sensitivity was low (only 59.4 %), thus giving unsatisfying results for PE. The sensitivity only increased to 62.5 % for the early-onset PE group. Intriguingly, a high ratio was detected for the combination of IUGR (intrauterine growth restriction) and PE in the early-onset PE group (8 cases). In the control group, 4 cases exceeded the cut-off value of 85 but showed no clinical signs of PE and the birth was unremarkable. In summary, we found that the sFlt-1/PIGF ratio could not be used as a predictive test for preeclampsia but rather as an indicator for the development and estimation of the severity of PE. Thus, the test is less suitable for the reliable exclusion of PE in routine clinical practice. Recommendation: The determination of the sFlT-1/PlGF ratio is only one element for PE diagnosis in addition to the measurement of blood pressure, proteinuria, ultrasound and Doppler.
Geburtshilfe und Frauenheilkunde, 2011
Zeitschrift für Geburtshilfe und Neonatologie, 2009
European Urology Supplements, 2005
Zeitschrift für Kardiologie, 1997
In transesophageal echocardiography several methods have been used to grade mitral regurgitation.... more In transesophageal echocardiography several methods have been used to grade mitral regurgitation. For a direct comparison of these techniques, 36 patients (60 +/- 13 years) with native mitral regurgitation underwent multiplane transesophageal echocardiography and angiography within 5 days. We compared the following measurements: 1) The maximal color jet area of mitral regurgitation, 2) the ratio of maximal systolic to diastolic pulmonary venous flow velocity in the left upper pulmonary vein, 3) the proximal jet width of mitral regurgitation, 4) the maximal regurgitant flow rate Qmax, measured by the proximal convergence method, 5) the regurgitant office area Areg, calculated by dividing Qmax by maximal regurgitant velocity obtained by continuous wave Doppler. The correlation between color jet area (r = 0.4; p < 0.05) or pulmonary venous flow (r = -0.3; p = n.s.) with angiographic severity of mitral regurgitation is low. The sensitivity of the retrospective best cut-off values is ...
Urology, 2005
Objectives. To assess, in a prospective study, the incidence of fecal incontinence after radical ... more Objectives. To assess, in a prospective study, the incidence of fecal incontinence after radical perineal prostatectomy. Methods. Bowel symptoms were evaluated with questionnaires mailed to 132 patients preoperatively and 6 months postoperatively, and annually thereafter. All patients had undergone extrafascial perineal prostatectomy for Stage cT1-cT3N0M0 prostate cancer. The data of 116 patients (88%), who answered at least the preoperative and 12-month questionnaires, were analyzed. Reduced sensibility, reduced discrimination, urgency, or stool smearing were symptoms indicative of fecal incontinence. Patients with one symptom of fecal incontinence were evaluated further with a structured telephone interview. Results. Daily stool smearing was reported preoperatively by 4% of the patients. Two symptoms related to fecal incontinence were present preoperatively in 6% of the patients. At 12 months postoperatively, 15 patients (13%) reported at least two symptoms of fecal incontinence. The structured telephone interview revealed that 6 of these 15 patients had symptoms of fecal incontinence that were related to the perineal prostatectomy; 9 patients had newly developed symptoms not related to surgery or symptoms due to tumor recurrence or radiotherapy. Patients with the presence of at least one symptom of fecal incontinence before surgery had an almost fourfold increased risk of developing at least two symptoms of fecal incontinence postoperatively compared with patients without any symptom of fecal incontinence. Conclusions. Significant fecal incontinence after radical extrafascial perineal prostatectomy is a rare event.
Journal of the American Society of Echocardiography, 1998
Doppler evaluation of mitral regurgitation remains difficult; thus, a head-to-head comparison of ... more Doppler evaluation of mitral regurgitation remains difficult; thus, a head-to-head comparison of the diagnostic accuracy of Doppler methods was undertaken. Fifty patients with native mitral regurgitation underwent multiplane transesophageal echocardiography within 5 days of catheterization. Angiographic grade of mitral regurgitation and, in 20 patients with grade II-IV regurgitation, invasively determined regurgitant stroke volume were compared with color Doppler area, regurgitant jet diameter, ratio of systolic to diastolic peak pulmonary venous flow velocities, and (based on the proximal convergence zone) maximal regurgitant flow rate and regurgitant orifice area. Rank correlation coefficients of angiographic grade with Doppler parameters were 0.61 for color jet area, -0.61 for pulmonary venous flow velocity ratio, 0.69 for color jet diameter, 0.79 for maximal regurgitant flow rate, and 0.78 for regurgitant orifice area (all P &amp;amp;amp;lt; .01). Convergence zone-based parameters also correlated best (r=0.73) with invasively determined regurgitant stroke volume. Receiver operating characteristic curve analysis confirmed higher diagnostic accuracy for proximal jet width and proximal convergence zone parameters than for color jet area or pulmonary venous flow velocity ratio. Proximal convergence zone parameters and proximal color jet diameter best distinguished severe from mild forms of mitral regurgitation.
European Heart Journal, 1996
Background Biplane angiographic and transthoracic echocardiographic volume calculations have show... more Background Biplane angiographic and transthoracic echocardiographic volume calculations have shown to be sufficiently reliable in symmetric hearts; however, they are unreliable in the presence of aneurysmatic distortions. Multiplane transoesophageal echocardiography offers unobstructed cross-sectional views of the heart from one stable transducer position with the potential of imaging irregular cavity forms more accurately. It was the purpose of this in vitro study to compare the precision of multiplanar transoesophageal echocardiography to that of biplane angiography in determining left ventricular volumes, especially in aneurysmatic models.
European Archives of Oto-Rhino-Laryngology, 2001
Objective: Test of dose-response relationship for Ginkgo biloba extract EGb 761 (oral) in outpati... more Objective: Test of dose-response relationship for Ginkgo biloba extract EGb 761 (oral) in outpatients with acute idiopathic sudden sensorineural hearing loss (ISSHL) of at least 15 dB at one frequency within the speech range occurring less than 10 days before study inclusion. Design: Multicentre, randomized, double-blind phase III study comparing dosages of 120 mg twice daily and 12 mg twice daily over 8 weeks. Main endpoint: Recovery (in dB) of the auditory threshold from the initial measurement to the value on the last day of treatment, averaged over those frequencies from 0.25, 0.5, 1, 2, and 3 kHz for which the initial hearing loss amounted to 15 dB or more compared to the level on the opposite side. Patients: 106 patients with an average age of 44 ± 16 years and with hearing loss at affected frequencies 26 dB ± 9 dB included between December 1995 and July 1997. Results: Large majorities of both treatment groups recovered completely. In exploratory analyses of the 96 patients included according to the protocol, patients given the higher dose had less risk of not recovering well (≤10 dB residual hearing loss) (one-sided Fisher test: P = 0.0061), especially if they had no tinnitus (n = 44, P = 0.00702). Conclusion: A higher dosage of EGb 761 (oral) appears to speed up and secure the recovery of ISSHL patients, with a good chance that they will recover completely, even with little treatment. This was already observed after one week of treatment. We find it justified to treat patients who have unilateral ISSHL of less than 75 dB and neither tinnitus nor vertigo with 120 mg oral EGb 761 twice daily.
Zeitschrift f�r Kardiologie, 1997
Mund-, Kiefer- und Gesichtschirurgie : MKG, 1998
A possible correlation between the thermal effects of the weather and the frequency of odontogeni... more A possible correlation between the thermal effects of the weather and the frequency of odontogenic soft-tissue infections was investigated with special regard to the so-called felt temperature (gT). Clinical data of 2111 patients of the years 1992-1996 in whom an incision was made because of an odontogenic soft-tissue infection were evaluated retrospectively and correlated to meteorological data for Aachen, collected or calculated by the "Deutsche Wetterdienst". In order to describe the thermal exchange between the human organism and the surroundings in a satisfactory way, the gT was chosen. The gT is a complexly calculated meteorological parameter which allows physiologically adequate estimation of the thermic surroundings of humans. Over the whole study time there was no impressive correlation between course and changing of the gT and the frequency of odontogenic soft-tissue infections. This result agrees with our finding that there was no seasonal accumulation of odonto...
Nephron, 1990
We carried out a retrospective investigation in 220 patients to assess the influence of various p... more We carried out a retrospective investigation in 220 patients to assess the influence of various parameters on the long-term course of membranoproliferative glomerulonephritis (MPGN) type I. 50 patients (23%) died during the follow-up period of 59 months on average, in another 57 (26%) end-stage renal failure developed. 54 patients (24%) suffered from chronic renal failure, stable renal function (creatinine below 1.3 mg/dl) was preserved in 59 patients (27%). 5 years after biopsy 49% of the patients had already died or needed regular dialysis treatment; after 10 years this proportion increased to 64%. Morphological findings: The outcome was--with the exception of focal crescent formations--not determined by the severity of glomerular changes; the survival rate, however, decreased significantly, if tubulointerstitial lesions were present as defined by acute renal failure, interstitial fibrosis or a combination of both. Clinical parameters: A progressive deterioration of renal function...
Zusammenfassung Anhand objektiver meteorologischer Parameter sollte überprüft werden, ob ein Zusa... more Zusammenfassung Anhand objektiver meteorologischer Parameter sollte überprüft werden, ob ein Zusammenhang zwischen thermischem Wirkungskomplex innerhalb des Wettergeschehens und der Häufigkeit odontogener Weichteilinfektionen besteht. Hierzu wurden die Daten von 2111 Patienten der Jahre von 1992-1996, bei denen wegen einer akuten odontogenen Weichteilinfektion eine Inzision durchgeführt worden war, retrospektiv ausgewertet und mit meteorologischen Daten für Aachen, die der Deutsche Wetterdienst ermittelt hatte,
Urologia Internationalis, 2006
To evaluate the potency in patients after radical perineal prostatectomy with wide excision of bo... more To evaluate the potency in patients after radical perineal prostatectomy with wide excision of both neurovascular bundles. In this prospective study, a quality-of-life questionnaire was completed by 128 patients at the preoperative stage, and 6 and 12 months postoperatively. Ten questions concerning the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s sexuality were included on the pre- and both postoperative questionnaires. In addition, 6 patients who recorded some erectile function were sent a separate questionnaire containing eight more detailed questions. Preoperatively, 74/128 (57.8%) patients reported erections sufficient for sexual intercourse, and of these 74, 6 (8.1%) described having spontaneous erections 1 year postoperatively. These spontaneous erections occurred 1-5 times per week. The reply to the separate mailing made clear that the reported erections were insufficient for intercourse. Patients undergoing standardized radical prostatectomy with wide excision of the neurovascular bundle have a very small chance of spontaneous erections sufficient for intercourse postoperatively.