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Biomedical subjects

W Mathisen

Publications and source records attributed to W Mathisen.

At least 19 recordsLinked to original sources

Endocrine tumors of the pancreas.

A review of 33 patients operated on between 1951 and 1978 for endocrine tumors of the pancreas is presented. The series consists of 25 patients with hyperinsulinism, 6 with the Zollinger-Ellison syndrome, and 2 with the WDHA syndrome. Clinical features and diagnostic problems are discussed. A noticeable feature is that the average time lapse between onset of symptoms and final diagnosis in insulinoma patients has not been significantly reduced during the years covered by this review. This is in spite of the progress made in testing procedures and laboratory methods designed to diagnose hyperinsulinism. Resection of the tumor has been the preferred treatment in insulinoma patients, of whom 22 are still alive. Insulinomas were associated with other endocrinopathies in 3 cases. Patients with the Zollinger-Ellison syndrome had raised serum gastrin levels and increased basal acid output. Four patients are still alive. Two patients had other endocrinopathies. Both patients with the WDHA syndrome died shortly after the operation. One had biochemical evidence of multiple endocrinopathies.

Achlorhydria

Probable endometrial carcinoma of the prostate, crossed renal ectopia and dermatomyositis in a 32-year-old man.

An unusual type of prostatic carcinoma associated with crossed renal ectopia and dermatomyositis is reported in a young man. Infiltration by an epithelial tumor filled the enlarged prostate with soft papillary masses. Cystoprostatectomy and removal of a single large pelvic lymph node metastasis were done. Histologically, the tumor resembled endometrial carcinoma and may have arisen from paramesonephric tissue in the prostate. Large amounts of immunoglobulins were found in the tumor tissue. The patient has survived for more than 5 years, although a slow growing urethral recurrence has been noted.

Adenocarcinoma

Air cystometry at different flow rates.

Air cystometry was performed with 3 different flow rates in patients suffering from different bladder diseases. To demonstrate neurogenic bladder disorder a flow rate of 75 ml/min was recommended.

Humans

Metabolism of testosterone in the human prostate and seminal vesicles.

Tissue from the normal, hyperplastic and the cancerous human prostate as well as tissue from the human seminal vesicles are capable of metabolizing testosterone in vitro. By incubating minced tissue with 3H-testosterone for 2 hours at 37 degrees C the following radioactive metabolites were identified: testosterone (17 beta-hydroxyl-4-androsten-3-one), androstenedione (4-androstene-3,17-dione), androstanedione (5alpha-androstane-3,17-dione), 5alpha-dihydrostestosterone (17 beta-hydroxy-5alpha-androstane-3-one, DHT), 3alpha-androstanediol (5alpha-androstane-3alpha,17beta-diol), 3beta-androstanediol (5alpha-androstane-3beta-17beta-diol) and androsterone (3alpha-hydroxy-5alpha-androstane-17-one). When normal human prostatic tissue was incubated with 3H-testosterone approximately 40% of the hormone was metabolized and 30-35% of the metabolites were identified as DHT. There were apparently no differences in testosterone metabolism between the dorsal and lateral prostatic lobes. A much lower conversion of 3H-testosterone was observed in the seminal vesicles (24%). The same metabolites were formed by prostatic carcinoma tissue, although distinctive quantitative differences from the normal prostate were observed. Thus, only 23% of the testosterone was metabolized by cancerous tissue of which 15% was present as DHT. The formation of 17-keto metabolites and androstanediols in the prostatic carcinoma tissue was approximately the same as in the normal prostatic tissue. The most extensive metabolism of testosterone was found by incubation of tissue from benign nodular prostatic hyperplasia. About 65% of the testosterone was metabolized, and 40% of the metabolites were identified as DHT. Hyperplastic prostatic tissue also showed a significantly higher formation of 5alpha-androstanedoils and the other tissues examined. The high formation of DHT and 5alpha-androstanediols in benign nodular prostatic hyperplasia in comparison with normal and cancerous prostatic tissue and seminal vesicle tissue might indicate that these metabolites should be studied more closely as possible aetiological factors for prostatic hyperplasia. The very low metabolism of testosterone in prostatic carcinoma tissue should be examined further in relation to tumour differentiation and clinical effect of endocrine therapy.

Adenocarcinoma

Total replacement of ureter with a segment of ileum.

Replacement of ureter with a segment of ileum was successfully performed in two patients. One had ureteral cancer and the other recurrent calculi due to cystinuria. The first patient had only one kidney. In the second both ureters were replaced with ileum. Formation of a papilla at the distal end of the ileal segment in the bladder may reduce the risk of vesico-ileal reflux.

Adult

Duplication of the male urethra treated by septotomy. A case report.

In a case of incomplete duplication of the male urethra the interurethral septum was divided by scissors. After this simple operative procedure, the patient was relieved of his obstructive symptoms. Postoperative urethrography revealed considerable improvement of the calibre of the urethral lumen, and uroflowmetry showed almost normalized flow values. This technique is recommended as treatment in similar cases.

Humans

Uretero-vaginal fistula.

Six cases of uretero-vaginal fistula are presented. Five patients developed this complication after gynaecological surgery and one after Caesarian section. Constant urinary incontinence combined with normal voiding is typical of this lesion. Excretory urography revealed a stricture in the distal part of the ureter in 5 cases, while in one patient the urographic findings were normal. Accumulation of contrast medium in the vagina was seen on urography in 2 patients. Surgical correction is the treatment of choice, and all patients were successfully treated by resection of the distal part of the ureter with reimplantation of the ureter into the bladder.

Adult