[Causes, prevention and treatment of complications of lymphadenectomy in testicular tumor patients]. / Ursachen, Prävention und Behandlung von Komplikationen der Lymphadenektomie beim Hodentumorpatienten.

In our clinic 483 lymphnode dissections were performed during the last 17 years. Different complications were found under operation in 2.7% and postoperatively in 9.9%. The mortality rate was 0.8%. Three years ago we started a different technique for lymph node dissection. The lowest incidence of complications during this period was found in the modified unilateral resection technique (8.9%), far higher after the bilateral (radical) (24%), the second-look lymphadenectomy (33%) and the so-called "salvage-lymphadenectomy" (42.9%). Causes of complications, therapy and prevention are discussed.

Urinary cytology in workmen engaged in the petrochemical industry with reference to non-industrial risk factors.

Urine cytology was evaluated in 8,406 male workers of 8 petrochemical factories in western and northern Germany during the routine medical check-up performed by the department of industrial medicine of the respective factory. All relevant data referring to possible private and occupational risk factors were registered and evaluated. Four percent (n = 358) of the 8,406 workers examined exhibited Pap 3/4 cytology. Urological examination did not reveal any bladder tumor in those workers with either a single Pap 4 or a repeated Pap 3 finding on cytology. Our study showed that deterioration of cell differentiation correlated significantly with age and cigarette smoking. Furthermore, a risk group (males above 40 years of age exposed to occupational chemicals, smokers, and coffee drinkers) differed from a non-risk group. Age and cigarette smoking seemed to be the determinant factors. No correlation could be adduced between any kind of industrial exposure and urine cytology.

Epidemiology, Pathogenesis and diagnosis of calcium oxalate urolithiasis.

In the German Federal Republic, the incidence of urolithiasis is 0.54% and the prevalence is 4%. Calcium oxalate stones are to be expected in over 60% of the cases. Pathogenetic factors are discussed. It is demonstrated that the overconsumption of chocolate, rhubarb and spinach brings about risk situations for stone formation, while asparagus and tomatoes present no risk. The increased animal protein and alcohol intake may be the most important reasons for the accumulations of calcium oxalate stones. Beside the minimum investigation programme it is demonstrated by examples that recurrent stone formers need an extended investigation to find out more about the pathogenesis, in order to determine an effective treatment or to prevent recurrences.

Incidence, Prevalence and mortality of urolithiasis in the German Federal Republic.

Two nationwide surveys were conducted in the German Federal Republic. An incidence of 0.54% and a prevalence of 4% were registered. The ratio of men to women for incidence was 2:1 and for prevalence 1:1. Stone prevalence increased from 1.28% to 6.79% with increasing age. The occupational groups mostly affected were pensioners (34.3%), housewives (23.5%) and employees (16.9%). In cities the prevalence rate was higher than in rural areas. In recent years the mortality rate had decreased.

Circadian rhythm of lithogenic substances in the urine.

After determination of the lithogenic and inhibitory substances in serum and urine of 18 healthy control subjects and 20 patients with calcium oxalate urolithiasis on an uncontrolled diet, the alteration of the parameters while taking a standard diet was investigated. After attainment of a steady state, the investigations were performed over 48 h on 3-h aliquots of urine. Typical circadian rhythms were detected for all lithogenic parameters in the urine and normal ranges were established. This special investigation permits detection of "peaks" in the excretion of lithogenic substances which were masked in investigation of 24-h urine samples alone.