PubMed Health⌕ Search

Biomedical subjects

Keith Hansen

Publications and source records attributed to Keith Hansen.

10 recordsLinked to original sources
PubMed2006

Delayed diagnosis of partially obstructed longitudinal vaginal septa.

OBJECTIVE: To report delayed diagnosis in two cases because of subtle manifestations of partially obstructive müllerian anomalies. DESIGN: Case report. SETTING: Academic medical center. PATIENT(S): The first case is a 30-year-old woman who was seen initially with irregular vaginal bleeding, dysmenorrhea, and dyspareunia. On physical examination she was noted to have an anterior vaginal mass with a fistulous tract adjacent to the cervix. Blood and mucus issued from the fistulous tract when the anterior blade of the speculum compressed the vaginal mass. In case 2 a 40-year-old nulligravida was seen with infertility and mild dysmenorrhea. Her history was significant for a Strassman's metroplasty. On examination she was noted to have a bulging at the apex of the vagina adjacent to the cervix. INTERVENTION(S): Transvaginal ultrasound, fistulogram, hysterosalpingogram, resection of the longitudinal vaginal septa, and cycle day 3 FSH. MAIN OUTCOME MEASURE(S): Symptoms. RESULT(S): In case 1 the subject had resolution of irregular vaginal bleeding, dysmenorrhea, and dyspareunia. In case 2 the patient declined to pursue further therapy. CONCLUSION(S): Common gynecologic symptoms resulted from partially obstructed vaginal septa. These cases demonstrate the importance of a high index of suspicion in subjects who do not respond to standard therapies.

Abnormalities, Multiple↗
PubMed2006

Assisted reproductive technologies in South Dakota: the first ten years.

One in six couples experience infertility. New assisted reproductive technologies such as in vitro fertilization (IVF) have helped thousands of couples worldwide to have a family. IVF has been available in South Dakota for the past ten years. Improvements in the clinic and laboratory have led to better live birth rates and lower incidences of multiple pregnancies. Advances in technology will help even more people overcome fertility problems in the near future.

Embryo Transfer↗
PubMed2005

Kimura's disease: case report and review of the literature.

Kimura's disease is a rare, chronic inflammatory disease characterized by subcutaneous nodules in the head and neck regions associated with regional cervical lymphadenopathy. Following its recognition as a pathologic entity, numerous reports have been published detailing the pathogenesis, radiologic manifestations, and treatment modalities. An extensive review of the literature did not reveal any cases of diffuse thoraco-abdominal lymphadenopathy described in relation to Kimura's disease. Hence, the interest in the case discussed here.

Angiolymphoid Hyperplasia with Eosinophilia↗
PubMed2004

Palifermin for oral mucositis after intensive therapy for hematologic cancers.

BACKGROUND: Oral mucositis is a complication of intensive chemotherapy and radiotherapy with no effective treatment. We tested the ability of palifermin (recombinant human keratinocyte growth factor) to decrease oral mucosal injury induced by cytotoxic therapy. METHODS: This double-blind study compared the effect of palifermin with that of a placebo on the development of oral mucositis in 212 patients with hematologic cancers; 106 patients received palifermin (60 microg per kilogram of body weight per day) and 106 received a placebo intravenously for three consecutive days immediately before the initiation of conditioning therapy (fractionated total-body irradiation plus high-dose chemotherapy) and after autologous hematopoietic stem-cell transplantation. Oral mucositis was evaluated daily for 28 days after transplantation. RESULTS: The incidence of oral mucositis of World Health Organization (WHO) grade 3 or 4 was 63 percent in the palifermin group and 98 percent in the placebo group (P<0.001). Among patients with this degree of mucositis, the median duration of mucositis was 6 days (range, 1 to 22) in the palifermin group and 9 days (range, 1 to 27) in the placebo group. Among all patients, regardless of the occurrence of mucositis, the median duration of oral mucositis of WHO grade 3 or 4 was 3 days (range, 0 to 22) in the palifermin group and 9 days (range, 0 to 27) in the placebo group (P<0.001). As compared with placebo, palifermin was associated with significant reductions in the incidence of grade 4 oral mucositis (20 percent vs. 62 percent, P<0.001), patient-reported soreness of the mouth and throat (area-under-the-curve score, 29.0 [range, 0 to 98] vs. 46.8 [range, 0 to 110]; P<0.001), the use of opioid analgesics (median, 212 mg of morphine equivalents [range, 0 to 9418] vs. 535 mg of morphine equivalents [range, 0 to 9418], P<0.001), and the incidence of use of total parenteral nutrition (31 percent vs. 55 percent, P<0.001). Adverse events, mainly rash, pruritus, erythema, mouth and tongue disorders, and taste alteration, were mild to moderate in severity and were transient. CONCLUSIONS: Palifermin reduced the duration and severity of oral mucositis after intensive chemotherapy and radiotherapy for hematologic cancers.

Adolescent↗
PubMed2004

Site of action of acute alcohol administration in stimulating the rat hypothalamic-pituitary-adrenal axis: comparison between the effect of systemic and intracerebroventricular injection of this drug on pituitary and hypothalamic responses.

The peripheral injection of alcohol stimulates the activity of the hypothalamic-pituitary-adrenal (HPA) axis, but the ready penetration of this drug in most bodily compartments has made it difficult to identify its specific sites of action. Here we determined whether alcohol can directly influence the corticotropes. We first determined whether alcohol acted within the brain to stimulate neurons in the paraventricular nucleus (PVN) of the hypothalamus, which synthesizes corticotropin-releasing factor (CRF) and vasopressin (VP). To test this hypothesis, we injected alcohol intracerebroventricularly (icv; 5 microl of 200-proof; 86 micromol) and compared these results with those obtained after its ip administration (3.0 g/kg). Although not causing neuronal damage and not leading to detectable levels of the drug in the general circulation, icv alcohol significantly up-regulated PVN CRF heteronuclear RNA levels and increased plasma ACTH levels, a change comparable to the one observed in the ip model. To determine whether alcohol stimulated the corticotropes independently of CRF and/or VP, we injected the drug ip or icv and measured changes in anterior pituitary proopiomelanocortin (POMC) transcripts and ACTH release in the presence or absence of endogenous CRF and/or VP. Intracerebroventricular and ip alcohol significantly increased POMC primary transcript levels, measured by ribonuclease protection assay, over a time-course that corresponded to ACTH release. Both the POMC and the ACTH responses were completely abolished by removal of CRF and VP. Collectively, these results indicate that alcohol-induced activation of the corticotropes does not represent a direct influence of the drug on the pituitary but requires CRF and VP.

Adrenocorticotropic Hormone↗
PubMed2003

Recurrent, purulent vaginal discharge associated with longstanding presence of a foreign body and vaginal stenosis.

A 13-year-old presented with malodorous, purulent, vaginal discharge following each menses for the last three months since menarche. This discharge resolved following antibiotic therapy but recurred with each menses. On exam, the patient was found to have a blind ending vagina with a small, midline perforation. Ultrasound and MRI examinations done prior to surgery did not identify the vaginal foreign body. She was taken to the operating room for examination under anesthesia and vaginoscopy. During surgery this area was found to be comprised of dense adhesions which nearly obliterated the distal vagina. The vaginal adhesions were lysed and a plastic foreign body was discovered in the upper vagina. After removing the foreign body the superior vagina was undermined, pulled down, and sutured to normal inferior vagina. A Mentor mold was placed in the vagina to maintain patency.

Adolescent↗
PubMed2003

Loxapine versus olanzapine in the treatment of delirium following traumatic brain injury.

The use of typical neuroleptics has always been the mainstay of treatment for delirium following traumatic brain injury (TBI). Given the recent application of atypical neuroleptics to various psychiatric conditions formerly treated with typical neuroleptics, one questions whether this new class of drugs is superior to its predecessor in treating delirium post-TBI. We present a case of one patient with TBI-induced delirium where in fact the use of the typical mid-potency neuroleptic, loxapine, appeared to have a better clinical effect over the atypical neuroleptic, olanzapine.

Adult↗
PubMedDate not supplied

An unusual complication of ureteroneocystostomy discovered at laparoscopy.

BACKGROUND: Laparoscopy is an important surgical technique, and an understanding of normal and altered anatomy is crucial for successful surgery. We describe herein a patient in whom the left ureter follows an anomalous course due to previous surgery. METHODS: This is the case report of a 28-year-old female with a history of ureteral reimplantation evaluated with laparoscopy for dysmenorrhea and infertility. RESULTS: The left ureter followed an anomalous, transperitoneal course, lateral to the fallopian tube, starting at the infundibulopelivc ligament down to its insertion in the bladder. During its transperitoneal course, the ureter perforated the ileum. CONCLUSION: This case describes an anomalous course of the ureter presumed to be due to previous childhood surgery. As more individuals with a history of ureteral reimplantation reach adulthood, an increasing number will require abdominal, surgical procedures. An understanding of potential anatomic abnormalities will reduce the risk of inadvertent visceral damage at surgery.

Adult↗