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Biomedical subjects

J Steffens

Publications and source records attributed to J Steffens.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Renal oncocytoma. Diagnosis and its therapeutic consequences].

The angiographic findings (hypovascularity, spokewheel phenomenon, lucent rim, linear course of vessels) and CT features (central scar, hyperdense without contrast medium) of 20 patients with renal oncocytomas were analyzed. Simultaneously seven patients with renal cell carcinoma preoperatively misdiagnosed as oncocytoma were compared and critically discussed. Preoperatively, reliable differentiation of renal oncocytoma and renal carcinoma is not possible. Nevertheless, in the presence of features typical for oncocytoma the operative strategy should be "kidney-preserving surgery".

Adenoma, Oxyphilic↗
PubMed1993

[Nuclear magnetic resonance tomography for improving the differential diagnosis of pathologic changes in the scrotal contents].

A total of 75 patients with scrotal pathology were examined using magnetic resonance imaging (MRI). The diagnostic results were compared with operative and histological findings and with the sonographic results available. Compared with sonography, MRI showed diagnostic advantages in the detection and characterization of malignant tumors and in the exclusion of non-tumorous testicular pathology (old torsions, periorchitis, old hematomas). No false-negative results were found by MRI. False-positive results were found in 2 out of 75 MRI examinations. The possibility of showing tunica albuginea, of imaging testes in various planes and its diagnostic accuracy of about 88% as well as the lack of ionizing irradiation make MRI the most reliable form of diagnostic imaging in the classification of scrotal pathology. Sonography (51/75) showed high sensitivity in detecting testicular disease (90%), but its specificity (55%) was disappointing and could not be quantified with regards to the differentiation of testicular cancer.

Adolescent↗
PubMed1992

Renin-producing renal cell carcinomas--clinical and experimental investigations on a special form of renal hypertension.

The pathogenetic relationship between tumour and hypertension was investigated in 129 patients with renal cell carcinoma, of whom 41 (31.8%) were hypertensive. Of these 41 patients with renal tumours and hypertension, 6 (14.6%) were found to have primary reninism. In these patients the plasma renin activity in blood from the renal veins showed a tumour kidney to contralateral kidney ratio of between 4 and 7, and 2 patients also had secondary hyperaldosteronism. In the same 6 cases the renin content in the renal tumour tissue was significantly higher than that in tissue from the adjacent tumour-free renal cortex of the ipsilateral kidney. Immunohistochemical demonstration of renin in the tumour was only possible in these 6 cases. In 5 of these patients blood pressure returned to normal following nephrectomy; in the 6th case there was a drop in blood pressure after nephrectomy. In 3 renin-positive tumours examined, autonomous renin production was demonstrated in cell culture. Renin-producing renal cell carcinomas are an uncommon cause of renal hypertension. The differential diagnosis of hypertension should therefore also include renal tumour.

Captopril↗
PubMed1992

[Varicocele in childhood. Treatment indications and value of sclerotherapy].

Varicocele is the most common surgically correctable cause of male subfertility. The incidence of varicocele is about the same in adolescents as in men (16.3%). Percutaneous transfemoral sclerotherapy has been performed in 42 of the authors' own cases; it is an alternative to surgical ligation of the varicocele and should be recommended whenever a varicocele is found, to prevent gonadotoxic damage.

Adolescent↗
PubMed1992

[Idiopathic left-sided varicocele. An ontogenetic abnormality?].

Phlebograms for sclerotherapy of varicoceles were performed in 659 patients. In 484 cases no valves of the left spermatic vein could be demonstrated. However, 172 patients showed sufficient valves or absent insertions of the spermatic veins at typical point with retrograde flow through collaterals (persistent intercardinal anastomoses). The value of nutcracker phenomena I and II is discussed. Ontogenetic disorders in the development of the secondary abdominal venous system are responsible for the occurrence of the idiopathic left-sided varicocele.

Adolescent↗
PubMed1992

[Carcinoma of the kidney with production of renin. A special form of hypertension].

A correlation between the tumour and hypertension was investigated in 129 patients with renal cancer. Forty-one patients (31.8%) suffered from hypertension. Primary increased renin secretion was detected in 6 of these patients (14.6%). The renin activity quotient measured in the renal veins between the renal tumour and the contralateral kidney was between 4 and 7. Secondary hyperaldosteronism was detected in only 2 of the patients with a significantly different renin activity in the renal veins. The renin level detected in the tumour itself of these 6 patients was significantly higher than the level detected in the parenchyma of the same kidney. Renin was demonstrated immunohistochemically in the tumours of these patients. The blood pressure returned to normal after nephrectomy in 5 patients and a marked fall in blood pressure was observed in the 6th patient. Cell cultures of 3 tumours revealed autonomous renin production. Renin-secreting renal carcinomas represent a rare form of renal hypertension, which is why the possibility of renal cancer should also be considered when investigating a case of hypertension.

Aldosterone↗
PubMed1991

Segmental renal hypoplasia of vascular origin causing renal hypertension in a 3-year-old girl.

A rare case of renal hypertension in a 3-year-old girl caused by segmental renal hypoplasia of vascular origin is presented. Resection of the hypoplastic segment of the kidney permitted successful treatment of the high blood pressure with preservation of renal function. Elevated plasma renin activity in the renal vein of the affected side and biochemical investigations demonstrated that the resected segment of the renal cortex was the source of the renin leading to hypertension by activation of the renin-angiotensin-aldosterone system.

Child, Preschool↗
PubMed1991

[Observations on the formation of the secondary venous system of the abdominal cavity with special reference to idiopathic left-sided varicocele].

Based on 1,778 radiologic investigations of vena cava inferior, left renal vein and left spermatic vein the anomalies due to incorrect transformations from the first to the second abdominal venous system are presented. A persistent vena cardinalis posterior could be demonstrated in two cases. Varicoceles were seen with and without insufficient valves of the spermatic vein and venous outflow obstruction of the renal vein, respectively. Based on the demonstrated phlebographies disorders of ontogenesis seem to be the cause of the idiopathic left-sided varicoceles.

Abdomen↗
PubMed1991

[Magnetic resonance tomography in the differential diagnosis of pathologic changes in scrotal contents--a comparison with computed tomography].

48 patients with scrotal pathology were examined by magnetic resonance tomography (MRI) and computed tomography (CT). The diagnostic results were compared to surgical and histological findings. The correct diagnosis could be detected in 81% by CT and in 85% by MR. Another 27 patients were examined only by MR with positive results in 88%. Demonstration of tunica albuginea, imaging of testes in various planes and diagnostic accuracy in about 88% with missing ionising irradiation make MRI the most reliable diagnostic imaging in the classification of scrotal pathology. False negative results were found in 1/48 by CT and none by MRI. False positive results could be found in 2/75 of MRI examinations but none in CT.

Abscess↗
PubMed1990

Out-patient sclerotherapy of idiopathic left-sided varicocele in children and adults.

Between 1983 and 1989, 334 patients with idiopathic left-sided varicocele were referred for transfemoral sclerotherapy; 323 were adults and 11 were children. The standard site of injection of the sclerosing solution (Varicocid-Natriummorrhuat 55 mg, Benzylalkohol 20 mg) was the mid-portion of the spermatic vein. The upper third was injected only in cases where the catheter could not be negotiated further (e.g. abnormalities in the course of the spermatic vein or its drainage into the intrarenal veins). The amount of sclerosing material was predetermined fluoroscopically using contrast material. Occasionally, in cases of high catheter positioning, the Varicocid was injected fractionally. The amount injected was always between 1 and 3 ml. Of 80 patients studied 1 year later, varicoceles were still present in 3 (4%). The best results were achieved in patients with small varicoceles (Grade I), normal testicular volume and normal FSH levels; 29% showed an improvement in sperm count and 27% an increase in sperm motility, while sperm morphology improved in only 7%. The conception rate was 11%.

Adolescent↗
PubMed1990

Renin-producing renal cell carcinoma.

The pathogenetic relationship between tumor and hypertension was investigated in 40 patients with renal cell carcinoma. 15 of 40 patients were hypertensive. Four of these 15 patients with renal tumors and hypertension (26.7%) were found to have primary reninism. In these patients the plasma renin activity in blood from the renal veins showed a tumor kidney to contralateral kidney ratio of between 6 and 7. In the same 4 cases the renin content in the renal tumor tissue was significantly higher than that in tissue from the adjacent tumor-free renal cortex of the ipsilateral kidney. Immunocytochemical demonstration of renin in the tumor was only possible in these 4 cases. In 3 of these patients blood pressure returned to normal following nephrectomy; in the 4th case there was a drop in blood pressure after nephrectomy. Renin-producing renal cell carcinomas are an uncommon cause of renal hypertension. The differential diagnosis of hypertension should therefore also include renal tumor.

Carcinoma, Renal Cell↗
PubMed1990

Nephrogenic adenoma of the bladder in a child--immunohistochemical and lectinhistochemical investigations.

A morphological study of a 6-year-old girl with a nephrogenic adenoma of the bladder is presented. The tumor developed 4 years after multiple reconstructive operations of the urinary tract. Immuno- and lectinhistochemically, the tubular structure of the lesion resembled that of a collecting tubule. A conservative approach was the treatment of choice in the absence of microscopically malignant changes.

Adenoma↗
PubMed1990

Value of selective reversible sacral nerve blockade in the diagnosis and treatment of the urge syndrome.

Interstitial cystitis, neurogenic disturbances of bladder emptying resulting from incomplete supranuclear lesions and idiopathic detrusor hyperreflexia are clinically always associated with frequency, nocturia, urgency or urgency incontinence (urge syndrome). These disturbances of bladder emptying are difficult to distinguish, even urodynamically. With selective sacral nerve blockade, it is possible to differentiate between forms urodynamically using a nerve-blocking anesthetic. Reversible selective sacral nerve blockade is also the treatment for idiopathic detrusor hyperreflexia.

Adult↗
PubMed1990

[The value of corpus cavernosum sonography following administration of vasoactive substances in the diagnosis of patients with erectile impotence].

In 70 Patients with erectile dysfunction, ultrasound examination of both corpora cavernosa after intracavernous injection of papaverine was done using B-scan, Duplex scan and Doppler color. B-scan can detect morphological disease in a penis profundis, the higher degrees of cavernous muscle myopathia, and disease of the tunica albuginea. For the analysis of pulse curve and the measurement of blood-flow velocity, the Duplex scan is necessary. Doppler color imaging enables ultra sonographic examination of a dorsalis and a penis profundis and can detect intracavernous vascular pathology. The results show that ultrasonography is an important diagnostic tool in patients with erectile dysfunction. A differentiated therapeutic strategy can be based on this examination, especially when revascularization procedures are being discussed. Additionally, better follow-up of patients under self-injection therapy is possible.

Adult↗
PubMed1990

[Super-selective embolization of a kidney angioma].

Superselective embolization of a centrally situated renal arteriovenous angioma in a 68-year-old woman is reported. The cardinal symptom was a recurrent painless gross hematuria, which disappeared after treatment. The embolization technique and the results of a 7-month follow-up examination are described.

Aged↗
PubMed1988

Tumours of the renal pelvis and ureter. Observations in 170 patients.

A study was made of 170 patients with renal pelvis or ureteric tumours, 160 of whom underwent surgery between 1948 and 1981. The most important aetiological factor was chronic phenacetin abuse: 21.7% of 83 patients with renal pelvis tumours and 11.4% of those with ureteric tumours gave a history of phenacetin abuse. The latency periods ranged from 24 to 26 years. This is the first report of a relationship between abuse of analgesics and urothelial tumours from the Federal Republic of Germany.

Adolescent↗
PubMed1988

Ureteral stone extraction with the Steffens lasso loop. A neglected procedure.

The main advantages of the Steffens lasso loop are its olive-tipped, 45 degrees-angled Tiemann guide, which allows easier and less traumatic passage above the ureteral stone, the tri-part lasso, which affords a better grasp of the stone, and the outlet for urine drainage. Between 1976 and 1986 we used this loop in 560 of 919 patients with distal ureteral stones. Immediate stone extraction was possible in 85.7% of the patients treated in 1986. Perforation of the ureter occurred in 2.3%, and 3% required ureterolithotomy. Our experience with this lasso loop has shown this instrument to be a valuable addition to other endourological methods.

Humans↗