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Biomedical subjects

E Kreutzer

Publications and source records attributed to E Kreutzer.

18 recordsLinked to original sources
PubMed1998

Early endoscopic realignment as primary therapy for complete posterior urethral disruptions.

We assessed the outcome of early endoscopic realignment of posterior urethral disruptions. We evaluated six patients who underwent early or delayed endoscopic realignment for the disrupted posterior urethra over a 3-year period. C-Arm fluoroscopy guidance and orientation in two planes were used as necessary. Potency, restructure rates, and continence were assessed in addition to hospital length of stay, intraoperative blood loss, and uroflow. The collective results of ten publications were also reviewed. In the present study, all of the six patients were continent. One had diminished erectile capability, and four required subsequent internal urethrotomies. Evaluation of the cumulative data (including the present study) showed an overall 9% incontinence rate, 60% potency rate, and 54% restricture rate. Endoscopic realignment of the disrupted posterior urethra is a minimally invasive procedure with results comparable to those of open delayed urethroplasty. Early and delayed repairs have been applied with similar results, the former being advocated in patients who are medically and orthopedically stable. Hospital stay, loss of work, morbidity, and related complications are also markedly decreased with early endoscopic realignment.

Adolescent↗
PubMed1993

CT and MR evaluation of pericardial constriction: a new diagnostic and therapeutic concept.

Eighty patients with pericardial constriction confirmed by catheter data were studied by CT (n = 79), MR imaging (n = 24), or both. To determine the validity of these imaging methods for subsequent treatment, 30 patients' studies were evaluated retrospectively (1980-1984) and 50 (1985-1991) prospectively. Twenty patients from the first group and 30 patients from the second group underwent pericardiectomy. By systematic analysis of CT scans and MR images it was possible to characterize the morphology of pericardial constriction (n = 80); to identify global (n = 27), right-sided (n = 46), left-sided (n = 2), annular (n = 2), effusive (n = 2), and epicardial (n = 1) forms of pericardial constriction; and to define parameters of myocardial atrophy and fibrosis (n = 17). Seventeen patients had myocardial atrophy, fibrosis, or both. Seven of them underwent pericardiectomy; all died of acute myocardial failure (100%). Four (9.3%) of 43 patients without myocardial atrophy or fibrosis died as a consequence of other complications. The method of thoracotomy and periepicardiectomy was continuously adjusted to the preoperative CT and MR findings. Thus, the clinical use of CT and MR imaging in patients with known or suspected pericardial constriction is based on (a) exclusion of patients with restrictive hemodynamics from diagnostic thoracotomy, (b) preoperative determination of the method of thoracotomy and extent of pericardiectomy, and (c) exclusion of patients with myocardial atrophy or fibrosis from pericardiectomy.

Adult↗
PubMed1990

Surgical treatment of brain metastases from renal cell carcinoma.

Between January 1976 and December 1986, 22 patients with renal cell carcinoma underwent surgical resection of brain metastases at Memorial Sloan-Kettering Cancer Center. Ten of the patients had metastases limited to the brain and 12 also had extracranial metastases. Twenty patients received external radiotherapy. Five had craniotomy after failing radiation therapy and 15 had adjuvant radiotherapy. Two patients died within thirty days following craniotomy; the median survival of the remaining 20 patients was 20.9 +/- 6.8 months calculated according to a Weibull survival model. Variables examined in relation to survival included absence or presence of extracranial metastases at time of craniotomy, time interval between nephrectomy and diagnosis of cerebral metastases, neurologic status prior to craniotomy, location of the brain tumor, and patient age. None of the variables was significant at the 10 percent level by the Weibull analysis. However, three favorable prognostic factors, namely metachronous brain metastasis more than one year after nephrectomy, minimal or no neurologic deficit at time of craniotomy, and infratentorial lesions show a trend toward improved survival with p less than 0.20. The data suggest that surgical resection of a single and occasionally multiple brain metastases is warranted in selected patients with renal cell carcinoma.

Adrenal Gland Neoplasms↗
PubMed1978

[Skincycle of a new spontaneous mutant (Nackig) with abnormal hair keratinization in the mouse (author's transl)].

The pathomorphological and pathophysiological reactions of the first skincycle of the mutant (Ng) were histologically investigated. 1. During the hair growth disturbances as the result of imperfect keratinisation changes of the morphology and function of different skin areas could be observed. 2. The developments of abnormal thinner hair growth were correlated to hyperorthokeratotic, inter-respectively intrafollicular hyperplasia of the epidermis and to infraseboglandular hypoplasia of the follicles. 3. The hyper- and hypoplasia of the epidermis corresponded with a functional pseudohypo- and pseudohypertrophy of the cutis. 4. During the skincycle the perifollicular epithelium ranged from the inter- to intrafollicular skin areas. The inter- and intrafollicular epidermal sections varied simultaneously. 5. These results are important for the understanding of some pathomorphological and pathophysiological reactions of skin compartments of man.

Animals↗
PubMed1977

Chagasic cardiopathy. Immunopathologic and morphologic studies in myocardial biopsies.

Immunopathologic and morphologic studies at the light and transmission electron microscope levels were carried out in myocardial biopsies of 4 chagasic individuals with circulating antibodies reacting with plasma membrane of striated muscle and endothelial cells (EVI antibody). Two cases did not present clinical evidences of heart involvement, and 2 cases showed chronic heart disease. In viv deposits of immunoglobulins were found at the plasma membrane of working myocardial cells and endothelial cells. The cytologic location of the in vivo bound gamma-globulin was coincident with the specificity of the EVI antibody. Ultrastructural studies showed intracellular alterations compatible with hypoxia of the fibers; these lesions, although they were more severe in the 2 cases with heart disease, were also present in the asymptomatic individuals. These results are congruent with a possible pathogenic effect of the EVI antibody. In 2 patients with Chagas' heart disease, foci of mononuclear infiltrates were examined by transmission electron microscopy. At that level, a close relationship between lymphoctes and muscle cells was observed, with imbrication of the plasma membranes and disappearance of the basal laminae. In the neighborhood of the lymphocytes, definite muscle cell abnormalities were found. These observations are also congruent with the recently suggested possibility that a lymphocyte-mediated immune response against heart tissue may participate in some of the pathogenetic mechanisms of chronic chagasic cardiopathy.

Adult↗
PubMed1977

Anatomic correction of transposition of the great arteries.

Complete anatomic correction of transposition of the great arteries (TGA) and ventricular septal defect (VSD) was performed on 2 infants with high pulmonary arterial resistance. Both patients were operated upon under deep surface-induced hypothermia and limited cardiopulmonary bypass. Direct repair of the anomaly was accomplished by switching the aorta and the pulmonary artery with reattachment of the coronary arteries. The clinical result in the first patient was satisfactory. The postoperative cardiac catheterization and angiogram demonstrated no gradient across either outflow tracts and normal arrangement of the great vessels. The second patient died in the operating room, probably owing to compression or kinking of the left coronary artery.

Angiocardiography↗
PubMed1975

Cephalic mechanism for social control of fissioning in planarians: III. Central nervous system centers of facilitation and inhibition.

Previous studies have indicated that asexual reproduction (fissioning) in the planarian Dugesia dorotocephala is socially controlled through a cephalic mechanism: Isolation releases fissioning; grouping inhibits it; decapitation, at the level of the auricles, releases it even in grouped subjects. The brain is not necessary for programming the actual events of fissioning; these are orchestrated by the segmental plexus fissioning (SPF) system. Various surgical cuts were made to ablate selected portions of the central nervous system of isolated and grouped planarians in order to ascertain the inhibitory or facilitatory effects of these in the physiological mediation of such control on the SPF system. These results were synthesized into a model of this control system; the anterior lobes and optic regions of the brain inhibit the SPF system, and the anterior and caudal segmental plexuses facilitate it. These influences are partially tonic and partially contingent upon social stimulation.

Animals↗
PubMed1975

Immunopathologic and morphologic studies of skeletal muscle in Chagas' disease.

Skeletal muscle biopsies from 21 individuals infected with Trypanosoma cruzi were studied my means of immunofluorescence, ultrastructural immunochemical, light and electron microscopic, and histochemical procedures. In 12 cases, definite morphologic alterations were found. These alterations were coincident with the presence of circulating antibodies against the plasma membrane of striated muscle fibers and endothelial cells (EVI antibodies). In almost all cases the lesions also presented autologous immunoglobulins bound to the plasma membrane of muscle fibers and endothelial cells. Interstitial inflammatory exudate was not observed in the diseased muscle. On the basis of these observations, it is suggested that the EVI antibody is related to some of the pathogenetic mechanism of skeletal muscle damage in Chagas' disease.

Adenosine Triphosphatases↗
PubMedDate not supplied

Superimposed traumatic and gonococcal proctitis: report of two cases.

Two men sought treatment at an emergency room with apparent gonococcal proctitis. Further evaluation after failure of antibiotic therapy in both patients revealed that rectal damage resulting from the patients' sexual habits had resulted in a severe traumatic proctitis. The discovery of several organisms, including Neisseria gonorrhoeae and two nonpathogenic amebas, was probably only incidental. Two points are emphasized: the importance of obtaining a complete sexual history for every patient treated for venereal disease, and the inherent complications associated with anorectal manipulation.

Adult↗