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Biomedical subjects

R B Kurzel

Publications and source records attributed to R B Kurzel.

35 records · Page 2Linked to original sources
PubMed1988

'Delivery' of an anal angiofibroma.

A case is presented of an anal angiofibroma. This is the first report of this tumour in a pregnant patient. The tumour appeared to grow in size during the pregnancy.

Adult↗
PubMed1988

Repair of symptomatic diaphragmatic hernia during pregnancy.

Congenital diaphragmatic hernia complicating pregnancy is a rarity, accounting for only six out of 17 cases of diaphragmatic hernia reported in the English literature. This case report describes the first successful repair of an acutely symptomatic foramen of Bochdalek hernia during pregnancy, with maternal and fetal survival. In the asymptomatic patient, surgery should be performed promptly on an elective basis in the first and second trimesters. During the third trimester, an asymptomatic defect should be repaired at the time of elective cesarean section. Active labor should be avoided. If symptoms of obstruction arise, this lesion represents a true surgical emergency, and immediate operative intervention should be undertaken regardless of the stage of pregnancy. Delay can result in both fetal and maternal mortality in up to half of cases. Tube gastrostomy may be performed at the time of repair to avert a potential prolonged gastric ileus and gastric volvulus.

Adult↗
PubMed1981

Retroperitoneal fibrosis: a two decade experience and gynecologic manifestations.

A 20-year experience with idiopathic retroperitoneal fibrosis (RPF) is presented (6 cases). Its gynecologic manifestations with the simulation of pelvic malignancy is discussed. Three of the patients presented with pelvic masses, one of these a para-vaginal mass. In one patient, RPF followed or was concurrent with invasive squamous cell carcinoma of the cervix, of which this is the first reported case. The subject of RPF is reviewed with the modes of management and evidence for an autoimmune etiology. Thrombocytopenia, a previously unreported finding with RPF, was noted in three of the six patients. The reversal of the A/G ratio in these patients is discussed, correlating this finding with the progression of azotemia.

Adult↗
PubMed1981

Management of a vaginal foreign body.

A case is presented of a vaginal foreign body. A drinking glass was inserted in the vagina of an intoxicated patient by her irate lover. Infection followed. The emergency care is described, including the method of extraction of the object, along with discussion of the principles involved and associated complications.

Female↗
PubMed1981

Hypercalcemia and idiopathic hypertrophic subaortis stenosis.

A patient presenting with hypercalcemia was found to have idiopathic hypertrophic subaortic stenosis and phenotypic Turner's syndrome. She has 3 daughters with phenotypic Turner's syndrome. 1 with a thickened interventricular septum and a son with asymmetric septal hypertrophy without obstruction and also possibly with hypercalcemia. Chromosome-banding studies revealed a normal 46,XX karyotype with no structural defects noted. The need for further studies of the incidence of hypercalcemia in idiopathic hypertrophic subaortic stenosis and in all the aortic outflow obstruction syndromes is suggested along with parathyroid function studies.

Aged↗
PubMed1980

Genital prolapse during pregnancy.

A case is presented of genital prolapse occurring during pregnancy in a patient with multiple congenital urogenital defects. The etiologies are hypothesized to be a congenitally defective pelvis and hormonally mediated connective tissue changes in pregnancy. The procidentia was treated with a vaginal hysterectomy, anterior and posterior colporrhaphy and sarcrospinous fixation. Pudendal nerve injury as a rare complication of sacrospinous fixation is discussed.

Adult↗
PubMed1978

Orbital involvement of an extramedullary plasmacytoma.

A patient presenting with left-sided proptosis was found to have an EMP primary to the maxillary antrum with extenion into the orbital floor. The patient was in stage II, and myeloma protein was detectable. This protein was found to be the lambda-chain of IgG.

Aged↗
PubMed1978

Venous stasis retinopathy after long-standing menorrhagia.

It is uncommon for visual symptoms to be the initial presentation after long-standing menorrhagia. In this case, menorrhagia secondary to leiomyomata gave rise to a severe iron deficiency anemia. A VSR followed that resolved quickly after transfusion. A hysterectomy was performed for definitive treatment.

Adult↗
PubMed1976

On the presence of bilirubin in the ocular humors of premature infants.

The yellow pigments observed in the ocular humors of premature infants were identified as the plasma pigments bilirubin and oxyhemoglobin. The blood/vitreous humor barrier to bilirubin was estimated to be (1/0.11) for total bilirubin and (1/0.25) for direct-acting bilirubin. Hall method histochemical staining for bilirubin in sections of premature infant eyes was highly positive for the vitreous humor, and suggestive of uptake of bilirubin by the neural-retinal cells.

Adult↗
PubMedDate not supplied

Cervical dysplasia in pregnancy: progression versus regression post-partum.

OBJECTIVE: To assess the natural history of cervical dysplasia during pregnancy and determine the rates for progression or regression post-partum by the severity of the lesion. METHOD: This was a retrospective study of 100 patients screened by PAP smear. Lesions were graded by colposcopy and biopsy, and followed post-partum. RESULTS: Lesions were graded as ASCUS, LGSIL, and HGSIL. The majority of lesions showed a tendency to regress post-partum (approximately 64%), a trend that was statistically significant (P < .003). A substantial minority (approximately 34%) showed no change in severity of the lesion. The tendency for lesions to progress in severity was very low (approximately 3%). No patient had microinvasive disease. Of patients who had CIS, persistence of this lesion post-partum was present in 67%. CONCLUSION: Patients with cervical dysplasia in pregnancy may be followed conservatively with colposcopy and biopsy.

Adolescent↗
PubMedDate not supplied

Serum creatine kinase is not a reliable indicator of ectopic pregnancy.

OBJECTIVE: It has been reported that elevation in creatine kinase may be used as an indicator of ectopic pregnancy as a consequence of trophoblast invasion of the smooth muscle layer of the Fallopian tube. In this study, we attempt to verify this observation and establish the sensitivity and positive predictive value of the test. METHODS: Serum creatine kinase (MM-fraction) was obtained from patients presenting with possible ectopic pregnancy prior to surgical intervention. Ectopic pregnancies were confirmed by laparoscopy. Noted was whether the gestation was ruptured or unruptured, its location in the tube, and estimated cross-sectional tubal distention. Controls consisted of patients with first-trimester pregnancies simulating ectopic pregnancy, i.e., patients having a positive pregnancy test, complicated by vaginal bleeding and/or abdominal pain. RESULTS: The distribution of creatine kinase values for both patients with ectopics versus control are positively skewed, with a mode of 10-19 U/L. The mean creatine kinase for ectopic pregnancies was 62.3 U/L, S.D. = 63.1 U/L. For controls, the mean creatine kinase = 40.8 U/L, S.D. = 30.1 U/L. The difference in these means is significant (p = 0.04), but weakly so. In addition, for ectopic gestations there was no significant difference in creatine kinase values with regard to degree of tubal distention, gestation location, or whether rupture had occurred, thereby limiting the clinical value of this test. CONCLUSIONS: Although the mean value of serum creatine kinase is statistically significantly higher in ectopic pregnancy relative to controls, the distribution curve for creatine kinase values for ectopics is broad, with much overlap with the control curve. Hence, the sensitivity and positive predictive value for this test is poor.

Biomarkers↗