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Biomedical subjects

G Zoeller

Publications and source records attributed to G Zoeller.

10 recordsLinked to original sources
PubMed1999

Outcome after repair of congenital penile malformations.

Penile malformations seen and treated during childhood may result in voiding disorders and sexual malfunction in adults. Preputial synechia and phimosis will seldom be the reason for these problems, although some men do seek treatment to correct radical circumcision. Little is known about the satisfaction of men with neonatal or childhood circumcision. Congenital penile curvature is seen in 0.4-0.6% of men. Slight bends do not need any operative treatment and young men should be given advice and counselling accordingly. If treatment is needed, a standard Nesbit procedure or one of its modifications is used in order to avoid urethral manipulation. A hypospadiac position of the urethral meatus together with a more or less prominent ventral bending of the penis is seen in another 0.3-0.5% of boys. Reports on more than 200 operations to correct this deformity have been published. Between 5 and 25% of early complications such as fistula formation, stenosis of the neourethra and skin problems result from hypospadias repair. Long-term follow-up studies have shown that adulthood satisfaction with respect to voiding and sexual function is achieved in 2/3 and some degree of dissatisfaction in 1/3 of cases. Epispadias repair is a much more complicated procedure and long-term results are seldom reported. Nevertheless, quite good results with respect to continence (approximately 80%) and sexual function may be achieved.

Adolescent↗
PubMed1997

Dual-phase helical CT of the kidney: value of the corticomedullary and nephrographic phase for evaluation of renal lesions and preoperative staging of renal cell carcinoma.

OBJECTIVE: Our objective was to evaluate early-phase unenhanced and late-phase contrast-enhanced helical CT in revealing renal lesions and staging renal cell carcinomas. SUBJECTS AND METHODS: Contrast-enhanced helical CT of the kidneys was performed in 145 patients who also underwent unenhanced CT. Contrast-enhanced CT was performed in the corticomedullary phase (CMP) and nephrographic phase (NP). A total of 173 lesions in 96 patients were proven histologically or cytologically. The performance of helical CT in the three study groups was compared: unenhanced and CMP enhancement, group 1; unenhanced and NP enhancement, group 2; unenhanced, CMP enhancement, and NP enhancement, group 3. Among the parameters evaluated were the sensitivity for helical CT of all 173 renal lesions and the sensitivity and specificity for the 90 malignant tumors. Also, the preoperative CT staging of the 76 renal cell carcinomas was correlated with the pathologic specimens. RESULTS: The sensitivity for detection of all renal lesions in group 1 (84%) was significantly less than in groups 2 and 3 (97% and 100%). The specificity and accuracy of helical CT in revealing renal cell carcinomas were significantly higher (p < .05) in group 3 (95% and 95%, respectively) than in groups 1 (93% and 92%, respectively) and 2 (89% and 91%, respectively). Two renal cell carcinomas were overlooked by the interpreters of the helical scans in group 1. The accuracy of preoperative CT staging of renal cell carcinomas was significantly better (p < .05) in group 3 (91%) than in groups 1 (82%) and 2 (86%). CONCLUSION: When patients underwent unenhanced helical CT, CMP helical CT, and NP helical CT, we achieved a better rate of detection and characterization of renal lesions and better preoperative staging of renal cell carcinomas than when we used either CMP helical CT or NP helical CT alone.

Adult↗
PubMed1995

Staging problems in the pre-operative chemotherapy of Wilms' tumour.

OBJECTIVE: To determine the effect of the International Society of Paediatric Oncology (SIOP) Wilms' tumour protocols (pre-operative chemotherapy based on clinical and radiological findings, with no prior tumour verification by open or needle biopsy) on subsequent intra-operative tumour diagnosis and staging. PATIENTS AND METHODS: The diagnosis and staging of possible Wilms' tumour by clinical, ultrasonographic and radiological assessment were compared with the intra-operative findings in 14 consecutive children (1-12 years of age) treated between 1989 and 1994. RESULTS: A diagnosis of Wilms' tumour was histologically verified in 11 of 14 children. In two children, verification was not possible due to complete necrosis of the tumour following pre-operative chemotherapy. In a 12-year-old boy with an estimated stage IV disease due to a solitary lung metastasis, a renal cell carcinoma was revealed in the nephrectomy specimen while subsequent thoracotomy revealed dysmorphic but not malignant tissue. The estimated tumour stage was correct with regard to localized or metastatic disease in nine of 11 children with histologically confirmed Wilms' tumour, while in two children with an estimated stage II tumour, liver metastases were found intra-operatively and the tumour was upstaged to IV. CONCLUSION: Exact tumour diagnosis and staging was difficult in these patients. Although the accuracy of tumour staging depends on the sensitivity of radiological and ultrasonographic examinations, difficulties in tumour diagnosis may be overcome by biopsies of the primary tumour. The justification of upstaging a low-stage I/II tumour to stage III, provoking a more intense post-operative treatment, should be proven by prospective randomized studies. The decision to perform a primary tumour biopsy would be facilitated if possible subsequent deterioration of outcome could be excluded.

Child↗
PubMed1994

Wilms tumor: the problem of diagnostic accuracy in children undergoing preoperative chemotherapy without histological tumor verification.

From 1989 to 1992, 9 consecutive children with a tentative diagnosis of Wilms tumor underwent therapy planned according to the International Society of Pediatric Oncology (SIOP)-9 Wilms tumor protocol, including preoperative chemotherapy. Because tumor biopsy is not recommended in this SIOP-9 protocol due to a possible tumor spread from open or needle biopsy, diagnostic accuracy is mandatory. We present our problems in diagnostic accuracy resulting in withdrawal of 2 children from preoperative chemotherapy, understaging the tumor in 2 and missing exact tumor histology due to complete tumor necrosis in 2. In addition, preoperative chemotherapy was applied in 1 child who later was found to have renal cell carcinoma. Although the SIOP-9 protocol of Wilms tumor treatment may be effective with regard to reducing the intensity of therapy, staging problems may be a major drawback in this therapeutic strategy based on preoperative chemotherapy.

Child↗
PubMed1994

Bone marrow immunoscintigraphy versus conventional bone scintigraphy in the diagnosis of skeletal metastases in urogenital malignancies.

Bone marrow immunoscintigraphy using a 99mTc-labelled anti-NCA-95 monoclonal antibody and conventional bone scintigraphy with 99mTc-methylene-diphosphonate were compared in the diagnosis of skeletal metastases in 58 patients with urogenital tumours. In 13 patients with metastatic disease, bone marrow immunoscintigraphy proved to be superior to bone scintigraphy, detecting 431 metastatic lesions on immunoscans as compared to 261 lesions on bone scans. However, on a patient-by-patient basis bone marrow immunoscintigraphy did not demonstrate a clinical advantage over conventional bone scanning, as in this study no patient was identified with metastatic disease still confined to the marrow space, with bone scintigraphy and bone X-ray being normal.

Adult↗
PubMed1992

Digital radiography in urologic imaging: radiation dose reduction on urethrocystography.

Digital luminescent radiography (DLR) is a new form of digital radiographic technology which can be used as an alternative to conventional radiologic systems; it replaces conventional screen-film systems by photostimulable phosphorus. Due to the linear dynamic range of photostimulable phosphorus, x-ray examinations can be performed with significantly lower radiation exposure. In this study radiation dose was reduced by about 90% using DLR for urethrocystography.

Humans↗
PubMed1991

Color-coded duplex sonography for diagnosis of testicular torsion.

By color-coded duplex sonography moving structures are visualized as red or blue colors within a normal gray-scale B-mode ultrasound image. Thus, blood flow even within small vessels can be visualized clearly. Color-coded duplex sonographic examination was performed in 11 patients who presented with scrotal pain. This method proved to be reliable to differentiate between testicular torsion and testicular inflammation. By clearly demonstrating a lack of intratesticular blood flow in testicular torsion, while avoiding flow in scrotal skin vessels being misinterpreted as intratesticular blood flow, this method significantly decreases the number of patients in whom surgical evaluation is necessary to exclude testicular torsion.

Color↗