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Biomedical subjects

M Sohn

Publications and source records attributed to M Sohn.

At least 19 recordsLinked to original sources

[Nephropexy in the course of time. Aspects of an historical surgical technique].

The first successful nephropexy was performed in the year 1881. From this time, surgical therapy of nephroptosis has always been a subject of discussion. A partly uncritical acceptance led to nephropexy being the most performed urological operation at the beginning of the 20th century, with up to 200 different surgical variations. As early as the 15th century, a first description of ren mobilis was made by Alessius de Pedemontanus. The first surgical intervention for the treatment of nephroptosis was performed by Gilmore in 1870. In 1877, the American Dowell from New Orleans tried a fixation of the kidney through a seton, however, this operation failed. Eventually in 1881, Eugen Hahn from Berlin was able to perform the first successful nephropexy, he named this method "nephroraphy". In 1882, the first modification was made by Bassini with sutures through the renal capsule. Finally, the gynaecologist George Edebohl led nephropexy into a great popularity and secured the method through numerous technical innovations. By 1936, approximately 170 different surgical methods existed for fixation of the kidney. An accurate diagnosis is imperative before performing nephropexy. There were times in which this operation was carried out much too often and, therefore, had a bad reputation. However, it is not correct to drop nephropexy altogether as some would prefer. The statement by Professor Voelcker from Halle in the year 1911 that for all those who have a urinary obstruction and those with a beginning dilation, nephropexy is still justified and may - when correctly performed provide many blessings". Nothing needs to be added to this.

Europe↗

[Surgical therapy of erectile dysfunction. Current status].

In the light of the current domination of oral pharmacotherapy for the treatment of erectile dysfunction, the aim of this paper is to give a critical and up-to-date overview of the possibilities of surgical therapy. We evaluate possible therapy options such as penile vein surgery, arterial revascularisation surgery and penile prosthetics surgery. Today, vein surgery has faded into total insignificance due to the efficiency of oral and intracavernous therapeutics, and as a result of the pathomechanism of cavernoveinous insufficiency and the disappointing long-term results published in the literature. A similar fate has been met by penile revascularisation surgery, which today is performed only in a very limited number patients with strict selection criteria such as age and exclusion of diabetes mellitus. Thus, aside from pharmacotherapy, penile prosthetics is the only surgical therapy option maintaining its significance as a cure for erectile dysfunction. There are convincing long-term results with a high degree of patient and partner satisfaction, high patient acceptance and a good functional durability of the mostly three-part hydraulic implants.

Erectile Dysfunction↗

Cloning of BNIP3h, a member of proapoptotic BNIP3 family genes.

Apoptosis is regulated by interaction of antiapoptotic Bcl-2 family proteins with various proapoptotic proteins, several of which are also members of the Bcl-2 family. BNIP3 (formerly NIP3) is a proapoptotic mitochondrial protein classified in the Bcl-2 family based on limited sequence homology-3 (BH3) domain and COOH-terminal transmembrane domain. Sequence comparison of BNIP3 has indicated that there are several BNIP3 human homologs of this protein, like BNIP3L, Nix and BNIP3. We have cloned a new member of BNIP3 family from the cDNA library prepared from human dermal papilla cells and designated as BNIP3h. BNIP3h shows substantial homology with other BNIP3 family proteins. BNIP3h induced apoptosis from 24 hours after transfection in MCF7 cell lines and its apoptosis inducing activity is extended until 72 hours after transfection.

Amino Acid Sequence↗

Idiopathic hypertrophic spinal pachymeningitis: a case report.

Idiopathic hypertrophic pachymeningitis (IHP) is a rare, chronic nonspecific and granulomatous inflammatory disorder of the dura with unknown etiology. The diagnosis can be established by open biopsy and exclusion of all other specific granulomatous and infectious diseases. We report a typical case of spinal IHP occurring in a long segment of cervical and thoracic dura from C6 to T8. The patient was 56-yr-old female, who had been suffered from pain on her upper back and both arms for 3 months and recent onset motor weakness of both legs. During the 9 months of follow-up period, she experienced the improvement of her neurologic symptoms with combined therapy of partial excision and corticosteroid medication. Since early surgical intervention and subsequent pulse steroid therapy are mandatory for this disease to avoid irreversible damage of nervous system, the identification of this unique disease entity is essential on frozen diagnosis. A few cases have been reported in Korean literature.

Female↗

Systemic and cavernous plasma levels of endothelin 1 in healthy males during different functional conditions of the penis.

The role of the sympathetic adrenergic nerves in mediating the constant tone of penile flaccidity and returning the erect penis to its flaccid state is fairly well established. However, it is not yet known whether additional nonadrenergic transmitters might be involved in this process. Endothelin 1 (ET-1), a 21-amino-acid peptide with potent and long-lasting vasoconstrictor activity, may be one of the factors contributing to such control. The present study was undertaken to determine whether plasma levels of ET-1 changed during flaccidity, tumescence, rigidity, and detumescence. We determined plasma levels of ET-1 in the peripheral and cavernosal blood of 32 potent adult male volunteers, in whom penile tumescence and erection were elicited by exposure to visual and tactile erotic stimuli. Whole blood was aspirated from the corpus cavernosum and the cubital vein, and ET-1 was quantified in plasma aliquots obtained from the blood samples. Using the organ bath technique, we evaluated the contractile effects of ET-1 and norepinephrine (NE) on isolated human corpus cavernosum musculature. No significant change in ET-1 levels was observed in the peripheral or cavernosal blood in the process of developing erection, rigidity, or detumescence. The mean plasma level of ET-1 was 0.2-0.7 fmol/ml. In the organ bath, ET-1 elicited concentration-dependent contractions of isolated human corpus cavernosum, which were much more pronounced than those evoked by the adrenergic agonist NE. Our data indicate that despite the in vitro efficacy of ET-1 in stimulating contractile activity in isolated human cavernous smooth muscle, the peptide may not be of ultimate importance for the mechanism of flaccidity and detumescence in healthy males. Nevertheless, the exact role of ETs in the control of penile smooth muscle tone remains to be established.

Adult↗

Peptide-derived broad-reacting antisera against tospovirus NSs-protein.

Sequence alignments of tospovirus species of serogroup I to IV revealed a stretch of 24 amino acids at the C terminus of the non-structural protein NSs with a highly conserved sequence. Based on this sequence the 24 amino acids peptide YFLSKTLEVLPKNLQTMSYLDSIQC was synthesized and used to raise antisera in two rabbits. The specificity of the antisera against NSs from infected plants was confirmed with Western blots and by immunogold labelling and electron microscopy. These antisera detected tospovirus isolates of serogroup I to III in antigen-coated plate ELISA and Western blots but failed to detect isolates of serogroup IV. Epitope scanning using overlapping octopeptides composing the peptide suggested that the antisera contained antibodies against two different epitopes. Strongly reacting peptides were found at the C-terminus of the original peptide sequence when probing with one of the antisera. In this part the sequence was homologous to serogroup I, II and III, with all deviations from serogroup IV located here. Additional octopeptides, based on this region, synthesized with sequence modifications back to the serogroup IV sequence in all possible combinations, had low reactivity. However two of the modified peptides with partly restored serogroup IV sequences revealed promising reactivity and could be suitable to raise an antiserum with broader reactivity, including serogroup IV.

Amino Acid Sequence↗

AIDS-related perceptions and condom use of prostitutes in Korea.

The purpose of this study was to assess the impact of AIDS-related knowledge and attitudes of prostitutes on condom use from diverse 'sex markers' in Korea. The data were collected by interviewers at five different 'sex markets'. During March 1993, research assistants at the Institute of Health Services Research interviewed 371 prostitutes visiting sexually transmitted disease (STD) clinics. Multiple regression method was used in identifying the determinants of condom use. The level of condom use was regressed on personal characteristics of prostitutes, AIDS-related perceptions, and market type. Prostitutes' level of condom use turned out to be different across the markets featuring diverse types of services and fees. Neither perceived vulnerability nor perceived seriousness of AIDS had significant effects on condom use. Our findings suggested that the many AIDS-preventive educational efforts by STD clinics are ineffective. Hence, individual STD clinics need to develop AIDS-preventive education programs which are suitable for the unique circumstances of their respective 'sex markets'.

Acquired Immunodeficiency Syndrome↗

Establishment and characterization of cell lines constitutively expressing hepatitis B virus X-protein.

We prepared human hepatoma cell lines, which expressed the human hepatitis B virus-X gene product. The plasmid pMAMneo-X, containing an HBV-X gene promoter, an enhancer and a structural gene was constructed. Transfected HBV-X gene integration and expression were detected by Southern and Northern blotting, as well as by chloramphenicol acetylase transferase (CAT) assay using various kinds of promoter-CAT reporter systems. HBV-X protein expression in stable transfectants was confirmed by immunofluorescence microscopy. Transfected cell lines showed permanent expression of HBV-X proteins. The HBV-X transfectant activated its target promoters in promoter-CAT constructs as reporters. The HBV-X transfectant enhanced AP-1 transcription factor binding to its target DNA. Therefore, X-transfectants are not only stable, but also have specific biological functions. Cell cycle analysis by flow cytometry showed that the majority of the transfectant cells are arrested in the G1 or G2 phase of the cell cycle. These cell lines may be useful in analyzing the biological functions of HBV-X and its functional role in the formation of hepatocellular carcinomas.

Carcinoma, Hepatocellular↗

A path analysis on prisoners' health behavior and medical utilization.

In this thesis, Korean prisoners' health behavior and the characteristics of their medical utilization were surveyed and analysed. Because prisoners are inclined to be mediators of communicable diseases or unhealthy behaviors between prison institution and the outside world, health care for prisoners is directly related to the national population. Data were collected through a self-administered survey of 5 Korean prisons out of a total of 38 correctional facilities and analysed in accordance with a causal model based on a path frame, by serial multiple regressions on health behavior, health status, and medical utilization, etc. According to the survey analysis, while prisoners were generally concerned with their health much more than they were before imprisonment, they perceived that their health status had deteriorated after imprisonment, and that their need for health services was increasing gradually during their time in prison. In the path analysis on the causal relations among variables related to the prisoners' health status and medical utilization, the prisoners' characteristics affected their health concern and health behavior, and subsequently affected their health status and medical utilization, respectively. To sum up these exploratory studies on prisoners' health behavior and health service utilization, some efforts to organize a health care system embracing the correctional institution and health care administration should be made on the level of establishing a health care delivery system for special social groups like prisoners.

Adult↗

Inflammatory pseudotumor of the epididymis.

We report the case of a 73-year-old patient who presented clinically with a palpable left scrotal mass after a 3-month history of therapy-resistant epidiymitis. He underwent epidiymectomy, and the following histopathologic and immunohistochemical evaluation revealed an inflammatory pseudotumor. We present the second case of an inflammatory pseudotumor of the epididymis being reported in the literature and give a brief review of the literature concerning this very rare neoplastic entity.

Aged↗

Traumatic seromuscular rupture of intestine: the acute and chronic forms.

BACKGROUND: Traumatic seromuscular rupture of intestine in the acute form is recognized by surgeons and pathologists and has received mention in the medical literature. The authors encountered two cases of this lesion presenting in the chronic form, in one case initially going unrecognized, both in battered children. To our knowledge, the chronic form of the injury has not been previously described in the literature. Three lesions in the acute stage were used to analyze the evolutionary stages of the chronic presentation. METHODS: The two chronic cases are described, together with gross and microscopic photographs. Three acute lesions are also described, with illustrations, two in battered children and one in a pedestrian/vehicle fatality. RESULTS: The three acute cases illustrate the pathogenesis and gradation of the injury that, in the absence of surgical therapy, will develop into the chronic lesion. The two chronic case descriptions illustrate the gross and microscopic pathology and the pathognomonic features. CONCLUSION: Seromuscular rupture of the intestine, when left untreated, develops in time into a lesion that may appear cryptogenic to the surgeon or the pathologist. This paper defines that lesion and its pathogenesis.

Adult↗

Hydrodynamic thrombectomy of haemodialysis grafts and fistulae: results of 51 procedures.

PURPOSE: To describe efficacy of hydrodynamic thrombectomy for occluded dialysis native and graft fistulae in 51 instances. MATERIALS AND METHODS: Fifty-one hydrodynamic thrombectomies of 34 native and graft a-v fistulae were performed. There were 32 thrombectomies in PTFE grafts and 19 procedures in native Brescia-Cimino fistulae. Multiple thrombectomies were performed in 11 of 34 fistulae. The estimated occlusion time was 36.4+/-22 h. The length of the occluded segment ranged from 2 to 50 cm (mean 28.8 cm). In all cases, a 7 F hydrodynamic thrombectomy catheter was used. Double-cannulation technique was used for graft fistulae, single-cannulation for native fistulae. Additionally, balloon dilatation was performed in all 51 cases, stenting in six, and aspiration thrombectomy in two cases. RESULTS: Arterialized flow was re-established by hydrodynamic thrombectomy and PTA in 43 of 51 cases (84%). By additional use of other techniques, technical success improved to 46 of 51 procedures (90%). Early re-thrombosis occurred in six cases within 24 h of thrombectomy (11%). Clinical success was achieved in 39 of 46 technically successful cases (85%). Cumulative patency was calculated at 63% after 1 week, 57% after 1 month, 48% after 3 months, 37% after 6 months, and 32% after 12 months. Patency of native fistulae after thrombectomy was better than patency of grafts. CONCLUSIONS: Hydrodynamic thrombectomy is an effective percutaneous technique for declotting haemodialysis fistulae and grafts recently thrombosed.

Adult↗

[Interdisciplinary concepts of surgical sex transformation in transsexual patients].

From the introduction of the law on recognition of transsexuals (TSG) in 1980, over 1400 decisions were made by German regional district judges up to 1990. In over 90% of the cases the desired gender was accepted and attested officially. In the near future, a growing number of requests has to be expected. Generally, transsexual patients desire surgery to achieve a complete sex change. Since the foundation of an interdisciplinary gender dysphoria identity committee at our institution in 1989, we have developed criteria on indications, operative techniques and follow-up, which would overtax a urology department, but which can be managed by an interdisciplinary team. Operative techniques may be regarded as well standardized in male-to-female transsexuals and may be performed by the urologist alone; in female-to-male transsexuals sex transformation remains complex interdisciplinary challenge to urologists and plastic surgeons, mainly due to urethral complications. Continuous psychiatric guidance and endocrinological monitoring of the patients facilitates indications for surgery and perioperative management.

Adult↗

[Value of registering nocturnal REM phase related erections in diagnosis of erectile impotence].

A recently published field study from Boston, USA, showed an incidence of complete erectile dysfunction of 9.6% in 1290 men between 40 to 70 years. The invasive diagnostic schedule based on intracavernous pharmacon injection since 1982, continues to be dependent on the individual adrenergic tonus of the patient influenced by stress and fear. False-positive results are often found and consequently lead to strictly somatic therapeutic approaches like microsurgical vascular procedures or prosthetic implants. Computerized registration of nocturnal REM-phase correlated erections (NPTR-measurements) enables the examiner to evaluate the principal erectile capacity of intracavernous erectile tissue independently from psychic disturbances, if well standardized evaluation criteria are used.

Diagnosis, Differential↗

Nucleus pulposus pulmonary embolism. A case report.

STUDY DESIGN: This postmortem case report describes nucleus pulposus pulmonary embolism occurring in a human. OBJECTIVES: Clinical, pathologic, and pathogenetic features of the case are discussed. Reference is made to warnings in the literature stressing the importance of avoiding, during radiologic procedures, any possibility of intrathecal ingress of iodinated, ionic, hyperosmolar contrast material. SUMMARY OF BACKGROUND DATA: Various tissues have been implicated as pulmonary emboli in humans. Nucleus pulposus has been reported to embolize to spinal cord vessels in animals and humans and to embolize to the lungs in two animal species. This is the first report of nucleus pulposus pulmonary embolism in a human. METHODS: A patient with refractory low back pain was admitted for lumbar discography using diatrizoate meglumine, 52%, and diatrizoate sodium, 8%. Afterward, an ultimately fatal systemic reaction began, among the symptoms of which were spasmodic extensions of the lower back and legs. Postmortem examination was performed. RESULTS: Nucleus pulposus pulmonary emboli were seen microscopically on random lung sections. The lumbar vertebral column grossly featured acute herniations of disc material into vertebral marrow spaces; nucleus pulposus was identified microscopically in these areas. CONCLUSIONS: We speculate that the spasmodic back extensions imposed compressive forces on vertebrae, causing nucleus pulposus to be extruded into vertebral marrow sinusoids (thus creating emboli) and possibly causing these emboli to flow anteriorly into the anterior external vertebral plexus, which resulted in pulmonary emboli exclusively with no spinal cord emboli.

Anaphylaxis↗

[Percutaneous treatment possibilities in thrombotic occlusion of Brescia-Cimino dialysis shunts].

PURPOSE: Acute thrombotic occlusion of Brescia-Cimino forearm fistulae is a severe complication. Aspects of percutaneous therapy include balloon dilatation, thrombolysis and mechanical thrombectomy. We report on 21 cases with obstructed shunts. Clinical evaluation and palpation helped to select each shunt for an individual therapeutic approach. PATIENTS AND METHODS: One patient presented with a proximal arterial occlusion, three patients with a small occluding thrombus, 4 patients with a severe stenosis but only a small amount of thrombus and 13 patients with an extended amount of clot material. RESULTS: 7 patients underwent balloon dilatation alone, three patients thrombolysis with rtPA and 11 patients hydrodynamic thrombectomy. Arterialized shunt flow was reestablished in 20 of 21 cases. The shunt was reused for dialysis in 17 cases. Reobstruction within two weeks after intervention occurred in two cases. CONCLUSIONS: With regard to the individual clot size, different percutaneous methods are available for successful shunt recanalisation.

Acute Disease↗

Quantification of androgen receptor and follicle-stimulating hormone receptor mRNA levels in human and monkey testes by a ribonuclease-protection assay.

A sensitive, solution-hybridization ribonuclease-protection assay (RPA) was established to quantify the expression of mRNA for the androgen receptor (AR) and follicle-stimulating hormone receptor (FSHR) in total RNA samples isolated from tissues of the cynomolgous monkey, human testes obtained from elderly patients undergoing orchidectomy because of prostatic carcinoma or from transsexual men undergoing gender reassignment as well as human cell lines DU 145, REP and RVP. Sensitivity experiments revealed that, in the human and monkey, 1-2 micrograms of total RNA were sufficient to achieve quantifiable signals of the different receptor mRNA species. Quantification of AR and FSHR mRNA levels showed a 1.7-fold higher expression of AR mRNA and a 2.4-fold higher expression of FSHR mRNA in the monkey testes compared to human testes from patients with prostatic carcinoma. Normal spermatogenesis in both human and monkey testes indicated no relationship between spermatogenic status and receptor expression. The significantly lower expression of AR and FSHR mRNA in humans than in monkeys might therefore be either age- or species-related. Quantification of mRNA for AR and FSHR in the testis of the transsexual patients undergoing oestrogen and antiandrogen treatment displayed a drastic increase (4.5-fold) in mRNA for the AR, whereas mRNA for the FSHR was barely detectable. Due to its high sensitivity, reproducibility and its ability to quantify mRNA transcripts, the RPA is a useful tool for investigating expression of low abundant receptor genes and their regulation when only very small amounts of tissue are available. Furthermore, it is suitable for use in clinical and experimental studies in which accurate quantification of transcripts is necessary.

Aged↗

Objective measurement of the effectiveness, therapeutic success and dynamic mechanisms of the vacuum device.

OBJECTIVES: To determine the efficacy and possible beneficial effects of the Catalyst vacuum device (VD) in the treatment of impotence, the ischaemic state of the penis after application of a constriction ring and the origin of the blood in the corpus cavernosum after application of the VD. PATIENTS AND METHODS: Thirty men (mean age 62 years; range 46-76) suffering from erectile dysfunction were selected for the trial after using the VD for 2 weeks at home. Changes in penile tumescence and rigidity before, during and after the VD were assessed using the Rigiscan monitor. Blood gas analysis (BGA) was performed in selected patients whilst using the VD, allowing calculation of the proportional contribution of venous and arterial blood to the increase in penile volume. The efficacy of the VD was also assessed by questionnaires completed before treatment and at the 6 month follow-up. RESULTS: Four patients were lost to follow-up but the 26 impotent men who used the VD for 6 months were able to have sexual intercourse after using the VD. The average rigidity measured at the base and tip of the penis after application of the VD was > 80%. The duration and extent of nocturnal penile tumescence and rigidity at the start and the end of the study improved, although only one variable increased significantly. Patients reporting spontaneous morning erections showed significant improvements in total erection-time, erection-phase and plateau-phase duration, effective rigidity and tumescence increase. BGA determined 30 min after applying a constriction ring showed ischaemia of the penile blood and the mean contribution of arterial and venous blood to penile blood volume was by 58 and 42%, respectively. CONCLUSION: The efficacy of the Catalyst vacuum device was objectively determined and the quality of the nocturnal erections improved in some patients. After application of a constriction ring an ischaemia of the penis developed. In contrast to previous reports, the increased penis volume during the application of the VD is caused not only by arterial inflow but also by venous backflow.

Aged↗