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Biomedical subjects

M Sohn

Publications and source records attributed to M Sohn.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Reflectory stimulation of the pudendal nerve in dynamic pharmaco-cavernosometry].

A prospective study was performed in 20 patients to assess the impact of vibratory glans stimulation on the course and results of dynamic pharmaco-cavernosography and cavernosometry. An intracorporeal pressure rise was achieved with lower amounts of saline when stimulation was applied and in some cases could not be provoked by saline infusion without glans stimulation. False-positive diagnoses of diffuse venous leakage could thus be eliminated. The data presented in this paper confirm the need for stimulation of the pudendal reflex arch to achieve physiological conditions. The simplicity of the procedure and the minimal time requirement suggest its clinical routine application of vibratory glans stimulation during cavernosography and cavernosometry.

Erectile Dysfunction↗
PubMed1990

Signet ring cell carcinoma in adenomatous polyp at site of ureterosigmoidostomy 16 years after conversion to ileal conduit.

The case of a signet ring cell carcinoma of the colon arising in an adenoma at the site of ureterosigmoidostomy after conversion to an ileal conduit is reported. Urine exposure to the colonic mucosa was present only for a short period before development of an adenoma with subsequent signet ring cell carcinoma transformation more than 15 years later. In the face of recent reports on adenocarcinoma in cases of bladder substitution or augmentation without any possible promoting influence of the fecal stream, the well known risk of neoplasia after sigmoidostomy remains unclear in its etiology.

Adenocarcinoma, Mucinous↗
PubMed1990

[Imaging of penile vascular anastomoses using color-coded Doppler ultrasound: comparison with CW Doppler ultrasound and clinical aspects].

In fourteen patients undergoing surgical revascularization (11 with Hauri's, three with Virag's anastomosis) because of erectile dysfunction, the patency of vascular anastomosis was evaluated and visualized by color-coded-Doppler sonography (CCDS). Results were compared with continuous-wave Doppler (CWD) and clinical data. CCDS proved to be superior to CWD with regard to assessment of flow in the penile vessels and to applicability. Strength and direction of flow can be judged visually. Therefore, the nature of the imaged vessel (artery or vein, deep or dorsal artery) can be differentiated. There is a good correlation of CCDS and CWD in their evaluation of the patency of the anastomosis. CCDS showed higher accuracy in detecting deep cavernosal arteries.

Adult↗
PubMed1990

Gadolinium-enhanced magnetic resonance imaging in the staging of urinary bladder neoplasms.

Magnetic resonance imaging (MRI) proved to be an important diagnostic tool in the correct staging of bladder neoplasms. The advantage of multiplane imaging and high soft-tissue contrast may be extended by the use of MRI contrast media such as the gadoliniumdiethylene-triaminepentaacetic acid complex. In 60 patients with suspected or proved bladder tumors, the results of preoperative gadolinium-enhanced MRI were correlated with the histopathologic findings. The staging accuracy of infiltrating tumors was 83% and sensitivity and specificity 86% and 83%, respectively. Three tumors could only be localized after administration of gadolinium. All active tumors demonstrated significant contrast enhancement after intravenously injected gadolinium. Small papillary tumors or carcinoma in situ remain problematic to preoperative staging procedures. The advantages of gadolinium-enhanced MRI will best be employed in the exact pretherapeutic staging of infiltrative bladder neoplasms or in restaging procedures after chemotherapy and radiotherapy.

Adenocarcinoma↗
PubMed1990

Pelvic fractures and traumatic lesions of the posterior urethra.

We report on the retrospective analysis of 61 traumatic lesions of the posterior urethra in a fractured pelvis. In collaboration with the orthopedic surgeons, 44 cases could be classified with regard to the nature and mechanism of the pelvic fracture. No direct relationship between the structural integrity of the dorsal ring segment and the urological pathology could be established. However, the mechanism of injury in 35/44 cases with pelvic girdle injuries and urethral pathology appears to be a predominantly lateral compression force. Ten of the 44 patients received a surgical stabilization of the fracture and open splinting of the urethra at the same time. An infection in the area of surgery developed in only one of these patients; however, this cleared up completely under antibiotic therapy and closed suction irrigation. The primarily conservative treatment of urethral lesions (27/61) is compared with primary open splinting or reanastomosis (34/61), which we prefer, with regard to the number of reoperations and late results. The joint conclusion of urologists and orthopedic surgeons concerns a primary simultaneous surgical treatment both of the urethral lesion and the pelvic fracture.

Fracture Fixation↗
PubMed1990

Recurrent pneumothorax in AIDS patients with Pneumocystis pneumonia. A clinicopathologic report of three cases and review of the literature.

Spontaneous pneumothorax associated with Pneumocystis carinii pneumonia (PCP) in AIDS patients has been reported with increasing frequency; however, little is known about the causative histopathology. In the past year, we treated three patients with documented PCP subsequently complicated by multiple spontaneous pneumothoraces. All patients underwent open surgical repair. In contrast to traditional pathologic findings of PCP in AIDS, histologic sections of lung from each patient consistently demonstrated an extensive interstitial inflammatory process with destruction of lung tissue primarily involving the periphery of the lung. Subpleural necrosis with bleb formation as well as bullous changes persisted even in the absence of an alveolar filling process. We conclude that the mechanism for pneumothorax in PCP is spontaneous rupture of necrotic lung tissue occurring in a subgroup of AIDS patients in which the interstitial inflammatory response to Pneumocystis has been accelerated.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Intraluminal fibrosis induced unilaterally by lobar instillation of CdCl2 into the rat lung.

Lung injury induced by intratracheal instillation of cadmium chloride (CdCl2) into the rat lung may serve as a model of human interstitial lung disease. In this study, CdCl2 solutions were instilled through a lobar bronchus into the left lung of the rat. Two doses (400 micrograms or 50 micrograms of CdCl2, each in 400 microliters of neutral saline) were used and the morphologic changes occurring during the first 7 days after a single exposure were documented by light and electron microscopy. With the higher dose, inflammatory cells appeared in the alveolar interstitium 1 day after CdCl2 administration. Edema and thickening of the alveolar walls were evident, as were damaged type I epithelial cells and denuded basement membranes. Fibrin was found in the air spaces. Within 2 days, inflammatory cells were seen in large numbers and fibroblasts were observed passing through gaps in the alveolar basement membranes into the air spaces. By 4 and 7 days after CdCl2, various forms of intraluminal fibrosis, including intrabronchiolar budding, mural incorporation, and obliterative changes, were observed. The contralateral lungs had normal-appearing architecture for all the time points investigated. In the lower dose exposure, gradients of alveolar damage were observed in which normal lung, interstitial fibrosis, and/or intraluminal fibrosis were seen within treated lungs. In the mildly damaged regions, interstitial fibrosis predominated, while in the more severely damaged regions, mural incorporation of the convoluted basement membranes was observed. The pulmonary fibrosis that developed appeared to be similar to some human interstitial lung diseases and may offer a system in which to study the regulation of collagen deposition and fibrosis development in these pathologic conditions.

Animals↗
PubMed1990

[Strategy of the interdisciplinary early intervention in unstable pelvic injuries and concomitant urogenital lesions].

Among our polytrauma patients, 36.3% suffered combination injuries of the pelvic ring and the urogenital tract, and 8 of the patients with this type of lesion underwent orthopedic and urological surgery in a single session on the day of the accident. One patient died of multiple organ failure, but otherwise we did not observe any complications; in particular, no infections occurred. By an average of 11 months after the operation, all patients were continent for urine and had normal urethrocystograms. In 3 cases the pelvic ring lesion was treated by plate fixation and in a further 3 cases by plate fixation with additional temporary external fixation. Definitive stabilization was achieved in all cases by an average of 2 weeks postoperatively.

Bone Plates↗
PubMed1989

[Microsurgical treatment for erectile impotence].

Using strict selection criteria, peripheral microsurgical revascularization was performed in 23 of 180 patients with erectile dysfunction (seen between February 1987 and December 1988). Average age of the 23 men was 51.8 (44-59) years. In 14 patients, the epigastric artery was transposed end-to-side to a side-to-side anastomosis between the dorsal artery and vein of the penis, while in two a piece of inferior epigastric vein was interposed. In the other seven patients an end-to-side anastomosis was constructed between the inferior epigastric artery and the deep dorsal vein of the penis. After three months, 19 of 20 patients who were followed-up had regular intercourse without intracavernous administration of drugs, after six months 15 of 17, after one year 11 of 14. In two patients irreversible thromboses of the anastomoses occurred when anticoagulant administration, required postoperatively, had been discontinued. The results indicate that with careful selection microsurgical treatment can achieve good results.

Anastomosis, Surgical↗
PubMed1989

Fournier's gangrene in hypersensitivity vasculitis.

Fournier's gangrene in IgE positive hypersensitivity vasculitis demands concurrent high dose immunosuppression, radical surgery and intensive treatment of septic sequelae. Even extended autologous skin grafting is possible with immunosuppression. A case of fulminant necrotizing infection of the genitalia, perineum and abdominal wall during the acute generalization phase of IgE positive hypersensitivity vasculitis is described. Apart from the radical surgical approach, medical treatment demands a different strategy than in classical Fournier's gangrene. The favorable outcome in a 21-year-old man after several months of intensive care could be realized only by close cooperation of internal specialists, urologists and plastic surgeons.

Adult↗
PubMed1989

Urinary bladder neoplasms: evaluation with contrast-enhanced MR imaging.

Forty-eight patients with urinary bladder neoplasms were examined with magnetic resonance imaging before and after intravenous administration of gadolinium diethylene-triaminepentaacetic acid (DTPA). Spin-echo sequences with short repetition and echo times were used in all patients; in 20 a gradient-echo technique was used to perform sequential imaging. In 31 patients ratios of tumor signal intensity to that of fat, muscle, and bone marrow were calculated before and after Gd-DTPA enhancement on T1-weighted spin-echo images. Increases in tumor signal intensity on T1-weighted spin-echo images were statistically significant after contrast enhancement (alpha = 1%, P less than .0001). The average rise in relative signal intensity after contrast enhancement was 120% for the tumor-fat ratio (tumor-marrow ratio, 105%; tumor-muscle ratio, 85%). Tumor signal intensity peaked within 120 seconds and remained on a plateau for up to 45 minutes. Necrotic tissue within the tumor, seen in three cases, was detectable only on contrast-enhanced images.

Adult↗
PubMed1989

The value of magnetic resonance imaging at 1.5 T in the evaluation of the scrotal content.

50 patients with a broad variety of scrotal disorders were evaluated in form of a prospective study by high-resolution scrotal sonography and magnetic resonance imaging at 1.5 T with high-resolution surface coils. Basic anatomic correlations to normal structures of the scrotum were studied in 4 fresh cadaver testicles without pathology. Magnetic resonance imaging is sensitive and specific, but time-consuming and expensive.

Genital Diseases, Male↗
PubMed1989

Mucinous cystadenoma: pitfalls of differential diagnosis.

Cystic neoplasms of the pancreas often are difficult to differentiate from pseudocysts. It has been proposed that a history of clinical pancreatitis, elevated serum pancreatic enzymes, elevated cyst fluid amylase, and a communication with the pancreatic duct suggest the diagnosis of a pseudocyst. We report the case of a young woman who presented with a cystic mass in the pancreas and was thought to have a pseudocyst because of the above; at surgery, a mucinous cystadenoma was documented. The pitfalls of differentiating neoplastic cysts of the pancreas from pseudocysts are discussed.

Amylases↗
PubMed1988

Necrotizing sialometaplasia masquerading as residual cancer of the lip.

Necrotizing sialometaplasia is a benign disorder that histologically can mimic carcinoma. It is thought to develop as a result of ischemia or adjacent tissue injury. A patient is described who underwent a Mohs' micrographical fresh-tissue excision of one-third of the upper lip for basal cell carcinoma. By the time she was ready for reconstruction, a marked eczematous reaction developed to a polymyxin neomycin preparation (Neosporin ointment) at the wound edges. Reexcision of the wound margins before a flap reconstruction revealed necrotizing sialometaplasia on histopathological examination. This incidental finding fortunately was not mistaken for residual tumor. To prevent over-diagnosis and over-treatment of presumed malignancies, an awareness of necrotizing sialometaplasia is essential for all surgeons operating on mucosal surfaces in the head and neck.

Aged↗
PubMed1988

[Selective microsurgical therapy in vascular-induced erectile impotence].

Patients with erectile dysfunction should be subjected to a complex and complete diagnostic procedure, including selective pharmaco-phalloangiography and dynamic pharmacocavernosonography only when SKAT has failed and after the exclusion of neurological disorders. Patients being offered these invasive procedures should be highly motivated and willing to undergo surgical correction of the vascular origin of their erectile impotence. If peripheral vascular occlusive disease is found affecting the pelvic arteries, the best operative technique must be selected. In our opinion, this decision should be made intraoperatively after visualization of the dissected dorsal penile vessels. Use of the Doppler probe can be extremely helpful during the operation. Intraoperative findings on the degree of arteriosclerosis and arterial flow can differ from those allowed by preoperative diagnostic procedures. Penile erectile function was restored in seven of nine patients after penile revascularization performed under microsurgical conditions. We used the operative methods described by Virag and Hauri, applying our own modification of the Hauri procedure in two patients. With careful selection of patients and methods it should be possible to resolve individual patients' problems with peripheral occlusion, even though the exact hemodynamic pathology remains obscure.

Adult↗
PubMed1986

[Indications and results of Politano-Leadbetter antireflux-plasty in 565 cases of ureterorenal surgery].

The Politano-Leadbetter antireflux procedure is a standardized and safe method for the treatment of primary and secondary reflux persisting after successful therapy of infravesical obstruction. Indications for antireflux surgery depend on reflux classification, age, urethral calibration and evaluation of position and shape of the ureteral orifice, associated malformations and successful antimicrobial therapy. Reflux was cured in 90.4 per cent of 565 ureterorenal units in 361 children and 103 adults. A persisting reflux occurred in 5.1 per cent and a stenosis of the terminal ureter requiring reimplantation occurred in 0.7 per cent. The overall rate of reinterventions was 8.1 per cent. This low complication rate makes surgical correction advisable if urinary tract infection and primary reflux cannot be eradicated by continuous antimicrobial therapy.

Adolescent↗