Biomedical subjects

K Kressel

Publications and source records attributed to K Kressel.

9 recordsLinked to original sources

PubMed1993

[Diagnosis and therapy of non-germ cell testicular tumors. Organ preservation or orchiectomy?].

Between 1980 and 1990, 670 testicular examinations were performed. Testicular palpation and ultrasonography were carried out. A total of 588 patients (87.8%) had malignant testicular tumors; 82 patients (12.2%) were found to have nongerminal testicular and paratesticular tumors. Intraoperative frozen section histology and tumor size determined the subsequent procedure. In cases of epidermal cysts, adenomatoid tumors and fibrous pseudotumors, the testicle was preserved in the majority of cases. Leydig's cell tumor, Sertoli's cell tumor and dermoid cysts were removed together with the testicle because it was not clear if they were benign. During the postoperative follow-up period, there was no evidence of local recurrence or metastases in any of the patients.

Biomarkers, Tumor↗

PubMed1992

Long-term experience with transurethral rigid ureteroscopy as a complementary method to extracorporeal shockwave lithotripsy.

Between May 1985 and September 1990, 291 ureteroscopies were performed either for primary or secondary stone therapy or for diagnostic purposes. Rigid ureteroscopes (12.5 or 9.5 French) were used without dilation of the ureteral orifice. 83% of the stones could be removed either by direct extraction or electrohydraulic or ultrasound lithotripsy. The highest failure rates (25.6%) occurred in stones located in the upper ureter, the lowest failure rate (9.6%) resulted from treatment of lower ureteral stones. 3.4% complications were observed such as perforation, leakage, stenosis and septicemia. After an average follow-up of 4.5 months, 1 in 70 patients revealed an ureteropelvic stricture which was treated with open surgery. The ureterorenoscopy represents an effective and low-risk primary and secondary method for treatment of ureteral stones in stone centers using extracorporeal lithotriptors which are exclusively equipped with ultrasound detection devices.

Combined Modality Therapy↗

PubMed1991

[Beta-HCG positive seminoma--incidence with special reference to tumor marker concentration in testicular venous blood].

The treatment of so-called "marker-positive" pure seminoma is still a controversial subject. We report on 32 cases of seminoma treated within 2 years. In these we measured beta-HCG and AFP in a cubital vein and in the spermatic cord veins. While 78% of the patients affected had elevated beta-HCG levels in the spermatic cord, in only 25% elevated beta-HCG levels were found in a cubital vein. This shows the markedly higher sensitivity of marker evaluation in spermatic cord veins. Furthermore, we conclude that seminoma generally produces beta-HCG and that therefore no change of the usual principles of therapy is required.

Adult↗

PubMed1989

[Surgical therapy of epididymitis].

Five hundred and seventy-five patients with acute epididymitis were hospitalized between 1979 and 1987, and 149 of them (25.9%) underwent surgery to the epididymis or the testis. For removal of the morphological alterations responsible for the inflammation, secondary operations were required in 157 cases (27.3%). We divided the patients into four age groups (under 15 years, 15-30 years, 31-60 years and more than 60 years), because the operative treatment indicated depends partly on the patient's age. For every age group the value of different follow-up examinations was checked. Prepubertal children have to be considered separately.

Adolescent↗

PubMed1988

Benign testicular tumors: a case for testis preservation?

Between June 1980 and June 1986, 345 inguinal explorations for intrascrotal space-occupying lesions were performed. In 47 patients benign testicular tumors were diagnosed (13.5%). In 32 of the 47 tumors (68%), the testis could be preserved by excision or enucleation of the tumor. In the remaining 15 patients a high semicastration was carried out: in 12 cases macroscopic examination or frozen section revealed doubtful benignity (6 Leydig cells tumors, 5 dermoid cysts and 1 epidermoid cyst), in 3 patients because of extensive involvement of the testis. In a follow-up period of 1-7 years none of the patients has shown evidence of tumor recurrence or metastasis. Changing the concept of not incising the parietal tunica of the testis and regarding clear-cut macroscopic and histological criteria of benignity on frozen section will safely lower the testicular loss rate from up to 80% to about 30% when benign tumors are encountered.

Dermoid Cyst↗

PubMed1988

[Nongerminal, benign testicular tumors--report of experiences].

Between 1983 and 1986 179 inguinal testicular explorations were performed. Testicular palpation and sonograms were carried out. 163 patients (91%) had malignant testicular tumours. 16 patients (9%) were found to have benign, nongerminal testicular tumours. When intraoperative frozen section diagnosed epidermoid cysts, the majority of these were enucleated, while the dermoid cysts and Leydig cell tumours were removed together with the testicle. The postoperative follow-up on all patients showed no evidence of local recurrence or metastases.

Dermoid Cyst↗

PubMed1980

A typology of divorcing couples: implications for mediation and the divorce process.

An experimental mediation procedure for the negotiation of divorce settlement agreements was studied through the intensive analysis of nine completed mediation cases. The audio recordings of mediation sessions and postdivorce interviews with both of the former marital partners provided the material on which the analysis is based. Five additional couples, drawn from a similar population but who used the traditional adversarial system, provided a comparative perspective. High levels of prenegotiation conflict and nonmutuality of the decision to divorce were negatively related to attitudes toward mediation and behavior during negotiations. The report focuses on four distinctive patterns of divorce decision-making. The typology is based on three primary dimensions: degree of ambivalence; frequency and openness of communication; and level and overtness of conflict. Couples exhibiting the enmeshed and autistic patterns of divorce were the most difficult for mediators to work with and had the poorest postdivorce adjustment; couples exhibiting the direct and disengaged conflict patterns fared better, both in mediation and in the postdivorce period. The potential importance of intercouple differences for the divorce mediation process and postdivorce adjustment are considered.

Adult↗

PubMed1978

Difficulties in family therapy evaluation. I. A comparison of insight vs. problem-solving approaches. II. Design critique and recommendations.

In Part 1, an outcome study comparing two methods of family treatment, is reported. Families were randomly assigned to one of two forms of conjoint therapy: an Insight-oriented treatment (N = 10) or a Problem-Solving intervention (N = 10). The results on self-report measures of family functioning indicate that the Problem-Solving intervention produced more favorable changes after three months. Experienced therapists did better than inexperienced therapists in the Insight-treatment condition but level of experience did not make a difference in the Problem-Solving therapy. A group of eight families who dropped out of the Insight-treatment group provided data on correlates of premature termination. In Part II, the study is critically reviewed. The practical obstacles to implementing an experimental design in a clinic setting are considered. Special attention is given to issues involving the selection of treatment and control conditions: sampling and the measurement of outcome. Alternatives to experimental designs are considered.

Adolescent↗

PubMed1977

Divorce therapy: an in-depth survey of therapists' views.

In-depth interviews were conducted with 21 highly experienced therapists on the criteria of a constructive divorce, the obstacles to achieving such a divorce, and the strategies and tactics of divorce therapy. The primary criterion of a constructive divorce was the successful completion of the process of psychic separation and the protection of the welfare of minor children. Therapy may focus on the decision to get divorced and/or the negotiation of the terms of a divorce settlement. Three types of therapeutic strategies were identified: reflexive intervention by which the therapist orients himself to the marital problems and attempts to gain the trust and confidence of the partners; contextual interventions by which he tries to promote a climate conducive to decision-making; and substantive interventions intended to produce resolution on terms the therapist has come to believe are inevitable or necessary. The nascent state of divorce therapy as an area of therapeutic specialization is noted. The problem of diagnostic criteria for divorce, the relationship between therapists and lawyers, the nature and consequence of therapist impartiality, and the degree to which therapists should mediate the terms of divorce are considered central issues meriting further study.

Attitude of Health Personnel↗