E Becht

Universität des Saarlandes, Saarbrücken, Saarland, Germany

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Publications (39)119.83 Total impact

  • E Becht, S Alloussi, M Ziegler
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    ABSTRACT: Ileum neobladder after cystectomy is mainly reserved for male patients. Female patients are normally excluded from this kind of urinary diversion for fear of incontinence following orthotopic bladder substitution. In addition as in the male, the question of urethral recurrence of urothelial carcinoma is still not settled. We report on seven cases of successful orthotopic bladder reconstruction in females by means of an ileum neobladder according to Hautmann with follow up of up to 4.5 years. One of these patients had a complicated bladder-vaginal fistula and almost complete loss of bladder function because of a shrunken bladder after radiation therapy for a cervical carcinoma and the other six had undergone radical cystectomy because of bladder carcinoma. The ileum neobladder is anastomosed with the preserved urethral stump. The original method of ileum neobladder is extended by a colposuspension plasty according to Marshall-Marchetti, which is the means of achieving continence. The first results are encouraging and open further possibilities for bladder reconstruction in the female.
    Der Urologe 06/1995; 34(3):243-7. · 0.46 Impact Factor
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    ABSTRACT: The increased sympathetic neurotransmission in benign prostatic hyperplasia (BPH) results in a alpha 1C-adrenoceptor-mediated increase in prostatic smooth muscle tone which seems to be responsible for the dynamic infravesical obstruction occurring in BPH. The prostatic smooth muscle contractions evoked by norepinephrine can be efficiently blocked by alpha 1-adrenoceptor blockers. Moreover, an impressive number of clinical trials illustrated the beneficial results of alpha 1-adrenoceptor blockers in the treatment of BPH. However, despite knowledge of alpha 1-adrenergic neurotransmission and the clinical application of its blockade by selective alpha 1-adrenoceptor antagonists, very little is known about the intracellular pathways involved in the regulation of prostatic smooth muscle contractility. To study the intracellular mechanism of the alpha 1C-adrenoceptor-induced prostatic smooth muscle contraction, the patch-clamp technique in the whole-cell configuration mode combined with the Fura-II fluorescence technique was used in human, enzymatically isolated smooth muscle cells obtained from patients undergoing transurethral resection of the prostate because of symptomatic BPH. Furthermore changes in prostatic smooth muscle contractility were registered in organ bath experiments. Application of the selective alpha 1-adrenoceptor agonist phenylephrine (PE) increased the L-type Ca(2+)-channel current (ICa) dose dependently from 8 up to 18.5 microA/cm2, simultaneously elevating the free cytoplasmic Ca2+ concentration ([Ca2+]i) up to 1.9 microM. Pretreating the myocytes with pertussis toxin, an exotoxin of Bordetella pertussis which inactivates GTP-binding proteins (G proteins) of the Gi and G(o) family by ADP ribosylation, reduced the PE-induced ICa stimulation by 71.5 +/- 5.6% (n = 21). Dialysis of the cytosol with the second messenger inositol-1,4,5-trisphosphate (IP3), which releases Ca2+ from intracellular non-mitochondrial, IP3-sensitive Ca2+ pools, imitated the PE-evoked responses. Pretreating the myocytes with the Ca(2+)-release blockers ryanodine (10-100 microM, n = 8), thapsigargin (0.1 microM, n = 11) or low-molecular weight heparin (n = 14) largely attenuated the PE-evoked responses. The experimental results suggest a coupling of alpha 1-adrenoceptors to phospholipase C-converting phosphoinositol-4,5-bisphosphate into diacylglycerol, an endogenous activator of the protein kinase C and IP3 which releases Ca2+ from intracellular stores stimulating ICa via Ca(2+)-calmodulin-dependent protein kinase induced phosphorylation of voltage-dependent Ca2+ channels. This knowledge could be of interest for conservative treatment in symptomatic BPH.
    Urologia Internationalis 02/1995; 54(1):6-21. · 1.07 Impact Factor
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    ABSTRACT: A man in whom urinary diversion (colon conduit) was performed after 2 unsuccessful implantations of artificial urethral sphincters for treatment of iatrogenic incontinence became continent again after implantation of an alloplastic sling. Three months later the patient underwent urinary undiversion with augmentation cystoplasty. After 3 years ureteroneocystostomy was necessary due to distal ureteral stenoses. At 7-year followup the patient is continent. He has good bladder capacity, bladder emptying and a normal upper urinary tract.
    The Journal of Urology 11/1994; 152(4):1203-5. · 3.70 Impact Factor
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    ABSTRACT: Renal clear cell carcinomas and the corresponding ipsilateral control tissues were investigated for protein kinase CK2 activity and subunit ratio. The average protein kinase CK2 activity from 21 different kidney samples was 318 U/mg and that from the corresponding tumors 610 U/mg. The subunit ratio of protein kinase CK2 alpha in tumors/normal tissue (T/N) was 1.58 and that of the protein kinase CK2 beta (T/N) was 2.65. The data suggest that the generally described increase in protein kinase CK2 activity in tumor cells may to some extent result from a deregulation in subunit biosynthesis or degradation. This at least partly owing to the presence of excess enzymatically active protein kinase alpha-subunit but also to a significantly higher presence of the non-catalytic beta-subunit.
    Biochemical and Biophysical Research Communications 08/1994; 202(1):141-7. · 2.41 Impact Factor
  • Aktuelle Urologie - AKTUEL UROL. 01/1994; 25(04):200-207.
  • J Steffens, E Becht, M Ziegler
    DMW - Deutsche Medizinische Wochenschrift 12/1993; 118(46):1689-93. · 0.65 Impact Factor
  • V Moll, E Becht, M Ziegler
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    ABSTRACT: Between 1975 and 1991, 142 patients with renal cell carcinoma and 10 with oncocytoma underwent a total of 164 kidney preserving operations. The indication for surgery was imperative (group 1, 47 patients) among those with a solitary kidney (9), renal insufficiency (17) or bilateral tumors (21). Of the patients with small or peripheral tumors and a healthy contralateral kidney 105 were selected for elective surgery (group 2). Most procedures were done either without ischemia (24%) or with warm ischemia (69%). In some patients from the imperative indication group hypothermia was achieved by in situ perfusion (5%) or ex vivo work bench surgery and autotransplantation (2%). Complication rates were 15% for group 1 and 9.5% for group 2. In group 1, 3 patients died of cancer, 5 lived with metastases and 2 had local tumor recurrence. No patient in group 2 had recurrences or metastases. The tumor-specific survival rate of patients with kidney preservation for renal cell carcinoma was comparable to that of a control group undergoing radical nephrectomy. Due to the high reliability and efficacy, kidney preserving surgery for renal cell carcinoma should be done more often, even in patients with a normally functioning contralateral kidney.
    The Journal of Urology 09/1993; 150(2 Pt 1):319-23. · 3.70 Impact Factor
  • Aktuelle Urologie - AKTUEL UROL. 01/1993; 24(06):365-367.
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    ABSTRACT: The purpose of the present study was to compare the effectiveness of MRI, CT and radioimmunoscintigraphy in the staging and detection of bladder cancers in 28 patients. We distinguish two groups: Group I included the tumour stages CIS-T3A and the second group the deep infiltrative tumours T3B-T4. MRI was slightly superior to CT in respect of tumour staging (75% correct results as compared to 63%). No understaging occurred with MRI, whereas in 22% of the cases the stage of the tumour was underestimated using CT diagnostics. Overstaging occurred in 25% of the MRI and 15% of the CT-diagnostics, respectively. RIS cannot distinguish the tumour groups, and hence this method is useful only for the detection of the primary tumour and metastases. In 77% of cases the tumour was detected and in 15% the tumour could be safely excluded.
    RöFo - Fortschritte auf dem Gebiet der R 11/1992; 157(4):349-54. · 2.76 Impact Factor
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    ABSTRACT: Magnetic resonance tomography is a method which is sufficiently precise to demonstrate morphological changes for tumor staging of carcinoma of the urinary bladder. The stage of the tumor was correct in 68 resp. 86% of the patients. The RIS shows organ and lymph node metastases and has the capability to differentiating between scar and tumor after transurethral resection. The local spread, especially the infiltration depth of the tumor, is not visible. In 90% of the patients a primary tumor was detected, only in 5 cases a false-negative and in 2 cases a false-positive finding was made.
    Nuklearmedizin 07/1992; 31(3):74-9. · 1.67 Impact Factor
  • Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren - ROFO-FORTSCHR RONTGENSTRAHL. 01/1992; 157(10):349-354.
  • Aktuelle Urologie - AKTUEL UROL. 01/1992; 23(06):267-275.
  • E Becht, H Derouet, M Ziegler
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    ABSTRACT: Operative ureteral replacement with the patient's own body tissue or by reconstructive ureteral surgery is indicated relatively often. The operative methods applied vary: they include pelvic flap pyeloplasty, caudal transposition of the kidney, interposition of the small intestine, trans-ureterostomy, calico-ureterostomy, of bladder flap transplantation and autotransplantation of the kidney. When the indications are correctly observed with reference to the kind and location of the ureteral lesion all these methods are successful. The methods of alloplastic replacement of the ureter, in contrast, have lost clinical importance and should be performed only in rare, isolated cases, mainly as a short-term solution. Possible indications are a poor general condition in patients for whom alloplastic ureteral replacement is the only alternative to permanent nephrostomy and malignant tumours requiring immediate irradiation, which cannot be postponed until definitive wound healing has taken place following a plastic operation. It is important that problems of biocompatibility have now been largely overcome. Segmental ureteral replacement with alloplastic materials is not possible, however, and the functional difficulties with urinary transport have not been solved in the long term, even in models with pumps and reflux-preventing mechanisms.
    Der Urologe 10/1991; 30(5):299-301. · 0.46 Impact Factor
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    ABSTRACT: Since 1975 a total of 55 patients with vesicovaginal fistulas have undergone surgery at the Clinic of Urology, University of Saarland, Homburg/Saar. A majority (55%) of the cases were complicated. In 9 cases supravesical urinary diversion was necessary. Successful closure of the fistula was achieved in 45 patients (81.8%); only in one case is the fistula still present. In 5 patients with uncomplicated fistulas successful closure was accomplished by a vaginal approach. In the presence of complications, e.g., previous radiotherapy or accompanying lesions of the ureter or rectum, a transvesical/transabdominal approach was preferred; surgery was successful in 93.3% of such cases.
    Der Urologe 04/1991; 30(2):94-8. · 0.46 Impact Factor
  • E Becht, V Moll, G Mast, M Ziegler
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    ABSTRACT: From 1976 to 1989 in 90 patients (n = 98 tumors) with renal cell carcinoma organ-preserving surgery was performed (age 25-84 years, mean 58 years). Imperative indications for organ preservation (tumor removal by partial resection with or without clamping of the artery, autotransplantation) (n = 18) were chronic renal failure, benign pathology of contralateral kidney, functional or anatomical solitary kidney, and bilateral tumors. Elective organ-preserving surgery (n = 72) was done for small peripherally located lesions and in cases of uncertain preoperative tumor dignity. Tumors removed for imperative indications were 2-11 cm (mean 6.5 cm) in size. In the elective group tumor size ranged from 1 to 6 cm (mean 3.5 cm). Follow-up was 3 months to 13 years, 1 postoperative mortality was observed in the group with imperative indication. 15/90 patients are alive without tumor, 1 patient with metastasis, 1 patient died because of metastasis and 1 for unrelated reasons. All patients beside 1 in the group with elective indication are alive without metastasis. Renal cell carcinoma has changed its clinical feature. More and more tumors are detected by ultrasound without clinical symptoms. Though radical tumor nephrectomy still is the standard operation for renal cell cancer, in cases especially with small tumors the indication for organ-preserving operation with regard to these excellent results should be given more often.
    Urologia Internationalis 02/1991; 47 Suppl 1:143-6. · 1.07 Impact Factor
  • Aktuelle Urologie - AKTUEL UROL. 01/1991; 22(06):344-347.
  • E Becht, N Graf
    Der Urologe 10/1990; 29(5):W35-40. · 0.46 Impact Factor
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    ABSTRACT: Long-term results among 46 children with ureterosigmoidostomy are presented. The indication for ureterosigmoidostomy had been bladder exstrophy in 40 patients, incontinent epispadias in 5 and neurogenic bladder dysfunction in 1. Of the 40 patients with bladder exstrophy 8 had undergone ureterosigmoidostomy after failure of other types of urinary tract reconstruction (6 had upper tract dilatation before ureterosigmoidostomy). Three patients with previously damaged upper urinary tracts required early postoperative conversion because of severely increasing kidney dilatation. Three other patients required conversion after a mean of 10 years to preserve kidney function. One patient died after 16 years of a cause not related to ureterosigmoidostomy. The remaining 39 patients were alive with a functioning ureterosigmoidostomy after a mean followup of 14.7 years. The daytime continence rate was 97.4% (38 of 39 patients) and the complete continence rate was 92.3% (36 of 39). Except for 1 tubular adenoma that was removed successfully during routine colonoscopy, no bowel neoplasia has been observed. None of the 45 living patients has renal insufficiency.
    The Journal of Urology 05/1990; 143(4):770-4; discussion 774-5. · 3.70 Impact Factor
  • Aktuelle Urologie - AKTUEL UROL. 01/1990; 21(05):251-258.
  • M. Ziegler, G. Mast, E. Becht, V. Moll
    Aktuelle Urologie - AKTUEL UROL. 01/1990; 21:25-28.

Publication Stats

291 Citations
119.83 Total Impact Points

Institutions

  • 1990–1995
    • Universität des Saarlandes
      • Klinik für Neurologie
      Saarbrücken, Saarland, Germany
  • 1983–1990
    • Johannes Gutenberg-Universität Mainz
      • • Department of Urology
      • • III. Department of Medicine
      Mainz, Rhineland-Palatinate, Germany