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Biomedical subjects

R Hauser

Publications and source records attributed to R Hauser.

At least 91 records · Page 5Linked to original sources
PubMed1995

Fertility in cases of hypergonadotropic azoospermia.

OBJECTIVE: To review the outcome of reconstructive microsurgery in men with hypergonadotropic azoospermia. DESIGN: A retrospective study on patients with hypergonadotropic azoospermia who underwent scrotal exploration and bypass microsurgery. SETTING: Male infertility microsurgery clinic affiliated with a tertiary university hospital. PATIENTS: Thirty-one hypergonadotropic azoospermic men with evidence of spermatogenesis on testicular biopsy. INTERVENTIONS: Microsurgical exploration of the testes, operative sperm aspiration, and bypass procedures: vasoepididymostomy or vasovasostomy. MAIN OUTCOME MEASURES: Intraoperative aspirated sperm, postoperative ejaculated sperm, proof of fertilizing ability (fertilizations), and pregnancies. RESULTS: Sperm were aspirated intraoperatively in all cases and were detected in postoperative ejaculations in 87%. Of the 14 patients with long-term follow-up data, 6 achieved pregnancies (8 children), and 3 more demonstrated the capacity for fertilization at IVF. CONCLUSIONS: The observation of a high serum FSH in men with azoospermia does not rule out the possibility of obstruction and the capacity for fertility. Caution should be exercised particularly if unilateral testicular atrophy is present. A testicular biopsy should be performed to detect possible spermatogenesis and, if present, then a microsurgical bypass can lead to a successful pregnancy.

Adult↗
PubMed1995

Le(a) and Le(b) tissue glycosphingolipids.

BACKGROUND: The Le(a) and Le(b) antigens are synthesized by cells making exocrine secretions, but it is not well-defined where plasma and red cell Le(a) and Le(b) antigens are made. STUDY DESIGN AND METHODS: This study uses chromatographic and immunochemical methods to extract Le(a) and Le(b) glycolipids from human tissues. RESULTS: Le(a) and Le(b) antigens may be synthesized by both epithelial and mesodermal tissues. Expression of Lewis transferase activity was demonstrated in various tissues, confirming the epistatic interaction by Le and H genes to form the Leb antigen. CONCLUSION: The Le(a) and Le(b) substances found in plasma might originate from the epithelial cells of the digestive tract.

Epithelium↗
PubMed1995

[Effect of contralateral noise exposure on otoacoustic distortion product emissions in man].

The influence of contralateral white noise with levels of 50 and 60 dBnHL on the amplitude of distortion-product otoacoustic emissions (DPOAE) was measured. Thirty ears of normally hearing adults (17 women, 13 men, mean age 26.5 +/- 5.3 years) were examined. Two representative DPOAE frequencies 2f1-f2 = 1342 Hz and 6341 Hz were compared. The lower DPOAE frequency was placed in the frequency region where middle-ear pressure has a strong influence on DPOAE amplitudes, the higher DPOAE frequency respectively in the region where lesser influence is exerted by middle-ear pressure. During the application of contralateral white noise a statistically significant total of 85% of DPOAE amplitudes was reduced, although there was some variation in the individual behaviour of DPOAE amplitudes. In general the higher DPOAE frequency (6341 Hz) was reduced distinctly less than the lower DPOAE frequency (1342 Hz). The reaction of DPOAE amplitude depended closely on the time course of the contralateral stimulus and amplitude reductions were present over 10 minutes without adaptation or fatigue. It is not possible to differentiate between middle-ear or inner-ear mediate effects but the middle ear is at least involved. Based on the presence of those DPOAE amplitude reductions over ten minutes without adaptation or fatigue and the fact that lower frequencies are influenced much more than higher frequencies a synergistic effect--middle-ear and efferent mediated--is suggested.

Adult↗
PubMed1995

Pregnancies after microsurgical correction of partial epididymal and vasal obstruction.

A group of 16 infertile patients suspected of having a partial epididymal obstruction on the basis of severe oligozoospermia, normal-sized testes and a normal serum follicle-stimulating hormone, underwent scrotal exploration. Evidence of partial obstruction of the epididymis was found in 13 cases and of the vas deferens in one case, and was supported by finding normal spermatogenesis on testicular biopsy. Vasoepididymostomy or vasovasostomy were performed, resulting in a significant improvement of semen analysis in 50% of cases and in six pregnancies in two patients. The diagnosis of partial epididymal obstruction should be considered when the above criteria are met. If pregnancies do not result when intracytoplasmic sperm injection (ICSI) is used with the ejaculated spermatozoa, a testicular biopsy followed by a microsurgical by-pass procedure should be considered whenever normal spermatogenesis is diagnosed. In all cases, the epididymal spermatozoa should be aspirated during the operation and either used immediately for insemination or stored frozen. The remarkable results of the new artificial reproduction technologies and in particular ICSI, question the indication for microsurgical correction in cases of partial epididymal obstruction.

Adult↗
PubMed1995

Pheochromocytoma in pregnancy: case report and review of the literature.

Pheochromocytoma is a rare disease that may occur during pregnancy. Only a few hundred cases have been published in the literature. Manifestations include hypertension with various clinical presentations, possibly resembling those of pregnancy-induced hypertension, or pre-eclamptic toxemia. Differentiation of these conditions is not always feasible, thus creating a serious risk, because fetal and maternal morbidity and mortality are far higher with pheochromocytoma. Biochemical measurements of catecholamines and their metabolites are apparently a convenient way to establish diagnosis during pregnancy, inasmuch as interpretation of radiological evaluation is complicated by the gravid uterus, and might even be potentially dangerous due to the use of ionizing radiation. More sophisticated methods for evaluation are not always practical during pregnancy. Medical treatment aims at controlling symptoms, mandating the use of alpha- and beta-receptors blockade medication. Surgical intervention is the only possible curative method available, but the critical issue is probably to identify the exact timing during the course of pregnancy for such intervention, or the ability to control symptoms until delivery. Although malignant transformation of pheochromocytoma have been reported, it is extremely uncommon. The overall prognosis is mainly affected by early diagnosis, and multidisciplinarian management.

Adrenal Gland Neoplasms↗
PubMed1995

Upper airway response in workers exposed to fuel oil ash: nasal lavage analysis.

OBJECTIVES: Among other constituents, fuel oil ash contains vanadium pentoxide, a known respiratory irritant. Exposure to ambient vanadium pentoxide dust has been shown to produce irritation of the eyes, nose, and throat. The usefulness of nasal lavage in detecting an inflammatory response to exposure to fuel oil ash among 37 boilermakers and utility workers was investigated. METHODS: A baseline lavage was performed on the morning of the first day back to work after an average of 114 days away from work (range 36 hours to 1737 days). A lavage was performed after exposure on the morning three days after the baseline lavage. Exposure to respirable particulate matter of diameter < or = 10 microns (PM10) and respirable vanadium dust were estimated with daily work diaries and a personal sampling device for respirable particulates. These estimates were made for each subject on each workday during the three days between lavages. For each subject, the adjusted change in polymorphonuclear cells was calculated by dividing the change in polymorphonuclear cell counts by the average of the counts before and after exposure. The association between the adjusted polymorphonuclear cell counts and exposure was assessed with multiple linear regression, adjusted for age and current smoking. RESULTS: Personal sampling (one to 10 hour time weighted average) showed a range of PM10 concentrations of 50 to 4510 micrograms/m3, and respirable vanadium dust concentration of 0.10 to 139 micrograms/m3. In smokers the adjusted polymorphonuclear cell count was not significantly different from zero (-0.1%, P > 0.5), but in nonsmokers it was significantly greater than zero (+50%, P < 0.05). In both non-smokers and smokers, there was considerable variability in adjusted polymorphonuclear cell counts and a dose-response relation between these adjusted cell counts and either PM10 or respirable vanadium dust exposure could not be found. CONCLUSION: A significant increase in polymorphonuclear cells in non-smokers but not smokers was found. This suggests that in non-smokers, exposure to fuel oil ash is associated with upper airway inflammation manifested as increased polymorphonuclear cell counts. The lack of an increase in polymorphonuclear cells in smokers may reflect either a diminished inflammatory response or may indicate that smoking masks the effect of exposure to fuel oil ash.

Adult↗
PubMed1995

Airway obstruction in boilermakers exposed to fuel oil ash. A prospective investigation.

We prospectively investigated the lower airway response in boilermakers overhauling an oil-powered boiler. We studied 26 male boilermakers with a mean age (SD) of 43.3 (8.6) yr. Pre-exposure spirometry and methacholine challenge tests were performed before beginning the boiler overhaul; postexposure tests were performed after approximately 4 wk of work on the boiler. Exposure to particulates with an aerodynamic diameter of 10 microns and smaller (PM10) and respirable vanadium dust were estimated using daily work diaries and a personal sampling device for respirable particles. Using these estimates, we calculated average and peak exposure between pre- and postexposure tests for each subject. The average PM10 concentration ranged from 1.44 to 6.69 mg/m3, with a mean (SD) of 3.22 (1.42) mg/m3; the average vanadium concentration ranged from 2.2 to 31.3, with a mean (SD) of 12.2 (9.1) micrograms/m3. The mean postexposure fall in FEV1 was 140 +/- 160 ml (p < 0.01); 24 of 26 subjects had a drop in FEV1. For each subject, the adjusted change in FEV1 (delta FEV1.adj) was calculated by dividing the change in FEV1 by the average of the pre- and postexposure FEV1 values. The delta FEV1.adj was regressed, controlling age and current smoking status, on average and peak exposure to both PM10 and vanadium. There was a dose-response relationship between average and peak PM10 exposure and delta FEV1.adj: beta = -0.91% per mg/m3, p = 0.08 and beta = -1.03% per mg/m3, p = 0.03, respectively. However, there was no relationship between delta FEV1.adj and respirable vanadium dust concentration. Furthermore, there was no postexposure change in nonspecific airway responsiveness. In summary, we found a significant fall in FEV1 and a dose-response relationship between delta FEV1.adj and average and peak PM10 exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Fibrovascular polyps of the esophagus].

Fibrovascular polyps of the esophagus account for 0.5-1% of all esophageal tumors. These are usually pedunculated lesions that originate below the upper esophageal sphincter. Etiology is unknown. Histological examination typically shows a fibrovascular stroma, which is covered by non-keratinizing squamous epithelium. Seventy-five percent of all patients are male, and are usually between 40 and 70 years of age. Most fibrovascular polyps cause few but non-specific symptoms. Occasionally they are regurgitated into the oral cavity and may then give rise to choking episodes and even fatal aspiration. Fibrovascular polyps are best diagnosed by endoscopy and/or radiography. Differential diagnosis includes carcinoma and intramural myoma. Once diagnosis is made, surgical removal, is indicated by either transoral or lateral cervical approaches. With adequate treatment prognosis is excellent.

Actins↗
PubMed1995

[Evaluation of bone marrow grafts and hemopoietic chimerism using PCR hypervariable sequencing with variable number tandem repeat sequences].

PCR amplification of highly polymorphic variable number of tandem repeat (VNTR) sequences could be particularly useful in documentation of engraftment and characterization of chimerism following allogeneic bone marrow transplantation (BMT). We have monitored a 31-year old male patient treated with allogeneic BMT for chronic myeloid leukaemia. The recipient's DNA samples were obtained before the transplant and on day 28, 100 and 150 after BMT. The donor's DNA (patient's sister) was also obtained as a reference. ACT B2 locus on chromosome 6 was chosen for the analysis. In addition a deletion polymorphism locus within the pseudoautosomal region of chromosome X and Y (amelogenin gene) was also analysed. On day 28 after BMT both donor and recipient specific alleles were detected in the recipient's sample. However, on day 100 and 150 the recipient specific alleles were no longer detectable. The aforementioned pattern was observed for both markers analysed. The disappearance of recipient specific alleles correlated with clinical symptoms of chronic graft-versus host disease.

Adult↗
PubMed1994

[Preoperative magnetic resonance tomography in chronic osteomyelitis of the extremities].

39 patients with bone and joint infections of the extremities were examined with magnetic resonance imaging (MRI) in view of an operative procedure. Patients with hip affections and patients with nonoperative treatment were excluded; therefore, 21 patients including 12 post-traumatic and 9 hematogenous cases of chronic osteomyelitis form the study group. MRI findings were verified at operation. Typical MRI findings were: intraosseous abscess (n = 15), extraosseous abscess (n = 9), communication of both (n = 7), edema of bone marrow (n = 9), soft tissues changes (n = 6) and fluid-surrounded sequestrum (n = 6). 83% of the post-traumatic cases had an intraosseous abscess, 67% of the hematogenous cases an edema of bone marrow. MRI improves preoperative planning considerably by sensitive depiction of pathological findings in three planes. To obtain information about activity of the process, scintigraphy is needed in addition. In some cases computer tomography (CT) is helpful to find small sequestra.

Adolescent↗
PubMed1994

[Lengthening, axial correction and segmental reconstruction of the extremities using the distraction method].

Between 1988 and 1992 lengthenings axial, corrections and reconstructions have been performed by distraction on lower arms, upper and lower legs in 25 patients because of deviations in length due to either congenital or acquired (multiple cartilaginous exostoses, posttraumatic conditions, congenital pseudarthrosis deformations or defects (fibula-defect, amnion-band-complex, amputation). On the average elongation amounted to 4 cm for an average installation time of the fixator system of 22 weeks and a mean duration of 25 weeks for the adaptation to full strength. Problems arose in the form of soft tissue infections at the rod perforation sites, the necessity for secondary interventions because of early fractures and for corrections of the fixator respectively. Complications compromising the expected goal of treatment did not occur. Consideration of the biological principle of distraction is essential whereas the type of fixator-system is of only minor importance.

Adolescent↗
PubMed1994

Sharing prosperity across the age distribution: a comparison of the United States and Germany in the 1980s.

Using six waves of data from the Panel Study of Income Dynamics and the German Socio-Economic Panel we compare the relative economic well-being of Americans and Germans in the 1980s. Economic growth during the 1980s substantially improved the economic well-being of the average person in the both the United States and Germany. But the rewards were disproportionately distributed across age and gender. In both countries, the family incomes of the very old, the very young and women were lower and grew more slowly than did the income of other families. Social security policy in Germany was more successful than American policy in providing income security in old age. But, despite massive social security programs in both countries, older women were still the most vulnerable members of society, in part because of a substantial drop in the level of social insurance they received following the death of their spouse.

Adolescent↗
PubMed1994

Retrograde ejaculation.

Retrograde ejaculation is an uncommon cause of male infertility. It should be suspected in any case of azoospermia, and might be congenital, acquired or idiopathic in origin. When pharmacological attempts to restore anterograde ejaculation fail, it is suggested that spermatozoa should be recovered from post-ejaculation urine to be applied in one of the modern techniques of assisted reproduction. The successful recovery of viable spermatozoa from the urine is dependent upon careful regulation of pH and osmolarity of the urine at the time of ejaculation. Careful handling of the retrieved spermatozoa enables isolation of sperm cells with good quality for insemination of ovulated oocytes (in vivo) or retrieved oocytes (in vitro).

Ejaculation↗
PubMed1994

Management of bilateral nonpalpable testes: laparoscopic diagnosis and orchidectomy.

Bilateral nonpalpable testes in the adult human are associated with testicular malignancy, infertility and other abnormalities. Investigation for localization of the testes is mandatory, and either orchidopexy or orchidectomy is indicated. Laparoscopy was performed in an azoospermic male with bilateral unpalpable testes. A diagnosis of intra-abdominal testes was made and bilateral orchidectomy was performed. Laparoscopy is recommended for diagnosis and precise localization, as well as for orchidectomy, thus avoiding open abdominal operation in cases of intra-abdominal testes.

Adult↗