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Biomedical subjects

S Engel

Publications and source records attributed to S Engel.

At least 91 records · Page 5Linked to original sources

Conversion reaction presenting as acute spinal cord injury.

A conversion reaction, presenting as an acute spinal-cord injury, was diagnosed in 9.8% of new patients admitted to a spinal injury unit during the period from November 1982 to November 1983. There were eight men and one woman (mean age, 23 +/- 8 years). A history of previous episodes of conversion reaction was common in this group. Some patients had evidence of previous vertebral damage. Diagnosis of this condition is difficult, even for those who are familiar with patterns of spinal-cord injuries. All patients were walking independently and had no sensory deficits at the time of discharge from hospital.

Acute Disease↗

Regional and global left ventricular function during intra-aortic balloon counterpulsation in patients with acute myocardial infarction shock.

We evaluated the improvement in hemodynamic and left ventricular (LV) function in 15 patients with acute myocardial infarction and cardiogenic shock, who were treated with intraaortic balloon counterpulsation (IABP). They were studied by flow-directed right heart catheterization and nuclear angiography. IABP decreased LV end-diastolic volume from 134 to 114 ml and LV end-systolic volume from 100 to 72 ml. LV stroke volume increased from 34 to 42 ml and cardiac output from 3.0 to 3.6 L/min. Global LV ejection fraction increased from 27.6% to 36.1%, and this was due to improvement in regional ejection fraction in ischemic areas. Pulmonary capillary wedge pressure and pulmonary blood volume decreased. Right ventricular ejection fraction also increased significantly. IABP improved LV function in acute myocardial infarction.

Adult↗

Odontoid fractures, systemic disease and conservative care.

Patients admitted to the Prince Henry Hospital Spinal Unit between January 1982 and January 1983 with a diagnosis of fracture of the odontoid process of the axis were reviewed. There were nine patients representing 20% of all new cervical fractures. The mean age was 64.5 +/- 19.3 years. Alcoholism, brain damage following head injury, osteo-arthritis, cervical spondylosis, rheumatoid arthritis and osteoporosis may be complicating factors in the management of odontoid fractures. A fracture of the odontoid in an elderly patient with a history of minimal trauma suggests osteoporosis. Early mobilization in a custom-moulded orthosis with frequent radiological monitoring prevents the complications of prolonged bed rest.

Aged↗

[Results of ligature of the upper testicular vein in idiopathic varicocele and subfertility].

The results of a total of 102 varicocele operations, 83 of which were performed because of subfertility and a desire to have children, are presented. In 3% of the cases a recidive operation was necessary because of persistent varicocele. 55 patients with limited fertility were subsequently examined for volume, density and form of sperm, total motility and propulsive motility. Whereas the volume of sperm and the total motility remained unchanged, the density and form of sperm and the propulsive motility had improved significantly 9 months after the operation. Among the men followed up the conception rate was 20%.

Adult↗

Detection of ostium secundum atrial septal defects by transoesophageal cross-sectional echocardiography.

Transoesophageal cross-sectional echocardiography has special advantages when investigating the interatrial septum which is imaged perpendicularly without echo dropouts from an oesophageal transducer position. The technique was successfully used in 19 out of 20 patients (95%) with an ostium secundum atrial septal defect and in 30 control subjects. In all of the latter the interatrial septum was visualised as a continuous echo structure separating the atria, whereas a distinct discontinuity representing the septal defect was apparent in all patients with atrial septal defect. Echocardiographic measurement of the defect size correlated well with surgical findings in 11 patients who underwent open heart surgery in the course of this study. In a comparative transthoracic examination, adequate recordings were obtained in 18 of the 20 patients and in 26 of the 30 control subjects. Direct subcostal visualisation of the defect was reliable in 10 of 18 patients. Peripheral venous contrast studies were also performed with the transoesophageal as well as the transthoracic technique. Echo contrast remained confined to the right heart in the control subjects. Left sided contrast appearance diagnostic of an interatrial communication was shown in the patients using the transoesophageal technique (100% sensitivity), with an additional right atrial negative contrast apparent in seven patients. The transthoracic approach, on the other hand, showed left sided echo contrast in 14 of 18 patients and an additional negative contrast effect in two of the 14. It is concluded that transoesophageal is superior to transthoracic cross-sectional echocardiography as a highly sensitive method for the detection and evaluation of ostium secundum atrial septal defects.

Adolescent↗

Transoesophageal cross-sectional echocardiography with a phased array transducer system. Technique and initial clinical results.

Cardiac imaging by transthoracic two dimensional echocardiography is impaired in patients with chronic lung disease, those with obesity, and those with abnormal chest wall configuration. In order to overcome these limitations, a miniature phased array ultrasound transducer fitted to the tip of a commercially available gastroscope was developed. Transducer position and orientation can be adjusted completely by external control of vertical displacement inside the oesophagus, rotation, and angulation. Introduction and operation of the transducer gastroscope system are usually well tolerated by the patients, since no mechanical vibrations are generated and there is no need for an oil bag to secure oesophageal wall contact. Cardiac images of high quality are obtained even from structures and regions that are poorly or not at all imaged from external transducer positions.

Adult↗

[Diagnosis and therapy of obstructive azoospermia--model of interdisciplinary cooperation in andrology].

An interdisciplinary diagnostic and therapeutic program for treatment of male infertility dueto obstructive azoospermia is presented. Important diagnostic methods are testicular biopsy and vesiculo-deferento-epididymography. The most important and successful operative techniques are discussed and the advantage of microsurgical dissection and reconstruction of the obstructed ductus deferens and epididymis reviewed.

Humans↗

Persistent serum immune complexes in syphilis.

Serum immune complexes were estimated by a polyethylene glycol precipitation method in 51 patients with early syphilis. The immune complexes were increased in 41% of patients before treatment and decreased to normal limits in only 56% during treatment. The results of the specific antireponemal tests using dissolved immune complexes show that antibodies from the immune complexes are specific antibodies.

Adolescent↗