Biomedical subjects
Publications and source records attributed to M Hermanns.
Involvement of the male genitalia by langerhans cell histiocytosis ist very rare. It has been reported in only three cases yet. We present a patient with recurrent disease of the skin of the penis and by proliferation involvement of the distal urethra and the corpus cavernosum. An overview of the disease and its therapy is given.
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.
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Markedly T2-weighted MR images of the pelvis can be obtained with TSE sequences using short acquisition times. In order to determine whether TSE sequences at 0.5 Tesla produce diagnostically valuable images, 9 normals and 53 patients with suspected gynaecological tumours were examined with TSE and SE sequences. Visual comparison showed a considerable superiority of the TSE sequences in most respects. The quality of the TSE images was regarded as very good in 82% and good in 18% (SE sequences: 27% very good, 55% good, 18% moderate), delineation of anatomical structures 81% very good and 19% good (SE sequence: 31% very good, 53% good, 16% moderate). TSE sequences were also superior in the detection of pathological changes (87% very good, 13% good) compared with SE sequences (56% very good, 37% good, 7% moderate). Venous plexuses in the parametrium were better demonstrated by SE sequences. There were significantly higher signal to noise ratios (SNR) with TSE sequences for fat, bone marrow (each p < 0.001), and urine (p < 0.05). Using muscle as reference tissue, there were significantly higher signal-difference to noise ratios (SDR) for fat (p < 0.001), and bone marrow (p < 0.0001), the other pelvic organs and tumours showed no significant differences between the SNR and SDR. TSE sequences are well suited to replace SE sequences in the MR diagnosis of gynaecological tumours.
In the early stages of chronic renal failure in childhood renal osteodystrophy is a therapeutic challenge, since in childhood it is mainly growth that is affected. The clinical appearance, pathophysiology and therapy are discussed with reference to an actual case of reflux nephropathy in a child.
It was the objective of our study to find a simple and reliable method for the electroneurographic examination of the sural nerve of patients suffering from polyneuropathy. As a first step, the normal values of persons not affected by this disease were taken by orthodromic technique and surface electrodes. The results were as follows: nerve conduction velocity: 59,44 m/s +/- 5,05; amplitude of the nerve action potential: 6,58 microV +/- 3,05; duration of the amplitude: 2,08 ms +/- 2,7; prolongation of latency after double stimulation: 3,37% +/- 0,77. Then potentials were stimulated by surface- and needle electrodes on the patients affected by polyneuropathy and recorded. Comparing the results gained by the different methods, we found that they correlated in a highly significant way, which means that all the methods are equally applicable. The stimulation and recording by surface electrodes, however, has apart from its reliability the additional advantage of being a simple, quick, and gentle method of examination. There is little objection to applying it repeatedly to the same patient. Further information about polyneuropathy can be obtained by the examination of the relative refractory period.
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