PubMed Health⌕ Search

Biomedical subjects

O J Muensterer

Publications and source records attributed to O J Muensterer.

5 recordsLinked to original sources

Testosterone-producing adrenocortical neoplasm in a 6-year-old boy.

Adrenal tumours that predominantly secrete testosterone are virtually unknown in prepubertal male patients. We present the case of a 6-year-old boy with premature sexual development and markedly elevated serum testosterone, but normal urinary steroid levels. Diagnostic imaging demonstrated a spherical tumour of the left adrenal gland. Surgical excision led to normalisation of testosterone levels, and postoperative serial low hormone measurements ruled out tumour recurrence.Although extremely rare, this case illustrates that testosterone-producing adrenal adenomas may be encountered in boys without urinary steroid elevation. Surgical excision promises a definite cure. Testosterone is a useful tumour marker in these patients until the beginning of puberty.

Adrenal Cortex Neoplasms↗

Infant botulism.

Explore the source record for details and available documents.

Botulism↗

Computer-aided three dimensional assessment of knee-joint cartilage with magnetic resonance imaging.

OBJECTIVE: An MRI-based technique for non-invasive assessment of the quantitative distribution of articular cartilage in the knee-joint was to be developed, and its accuracy and reproducibility tested. DESIGN: Three cadaveric specimens and one patient were studied and MRI measurements compared with anatomical sections or arthroscopy. BACKGROUND: Data on articular cartilage thickness is needed for the design of computer models, determination of cartilage material properties from arthroscopy and staging of osteoarthrosis. METHODS: The knees were imaged using strongly T2-weighted spin-echo and FISP-3D sequences. After digital subtraction and automatic segmentation, three-dimensional reconstruction of the cartilages was performed. Surface areas, volumes and the mean cartilage thickness were calculated, and the regional distribution displayed after trigonometric correction. RESULTS: The difference between MRI volumes and those obtained from the sections ranged from 4 to 21% with a reproducibility of +/-4 to +/-12% after repositioning. The thickness maps obtained with MRI were very similar to those from the sections. In the patient, a full-thickness defect demonstrated with MRI was verified by arthroscopy. CONCLUSIONS: Using the technique presented, the quantitative distribution of knee-joint cartilage may be analysed non-invasively, accurately, and in a very time-effective manner, in cadavers and in living subjects. RELEVANCE: To date there exists no accepted method for the accurate, fast and non-invasive assessment of articular cartilage thickness. Such a technique is, however, very helpful for generating computer models of diarthrodial joints, determination of cartilage material properties during arthroscopy, staging of joint disease, and objective control of chondroprotective treatment.

Journal Article↗

Malignant peritoneal mesothelioma. Case-report demonstrating pitfalls of diagnostic laparoscopy.

Patients with peritoneal mesothelioma present with abdominal distension and clinical syndrome of debilitating ascites. Cytology of the peritoneal fluid obtained by laparocentesis often does not result in a diagnosis. Laparoscopy with biopsy of peritoneal nodules is a valuable method by which a histological diagnosis is established. However laparoscopy can greatly complicate the management of peritoneal mesothelioma by facilitating tumor dissemination to port sites. The patient presented was treated with cytoreductive surgery and perioperative intraperitoneal chemotherapy. Although palliation of intra-abdominal tumor and ascites was achieved, port sites-disease required extensive resection of the abdominal wall. Our experience with this patient suggests that if a malignant source of ascites is suspected and a diagnosis is not obtained by paracentesis, laparoscopy should be used to establish a diagnosis. However, trocars should only be placed along the midline of the abdominal wall so that port sites can be excised at the time of cytoreductive surgery. This diagnostic strategy is applicable to the majority of patients undergoing laparoscopy when there is known or suspected intraabdominal malignancy.

Ascites↗