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Biomedical subjects

S Kessler

Publications and source records attributed to S Kessler.

At least 109 records · Page 6Linked to original sources
PubMed1989

Endoscopic microsurgical dissection of the esophagus. Results in an animal model.

Blunt dissection of the esophagus is considered the least invasive technique in the treatment of either benign or malignant diseases of the esophagus. Its disadvantage is that it has to be carried out blindly. The results may be uncontrollable hemorrhage, unrecognized injuries to the trachea, and damage to the recurrent laryngeal nerve. In order to reduce the degree of invasiveness a new endoscopic microsurgical technique for the dissection of the esophagus has been developed and tried out in animals. This paper presents the operative technique. Our new endoscopic microsurgical technique obviates a thoracotomy, while direct endoscopic vision results in improved dissection. The magnified endoscopic view permits selective exposure of blood vessels and prevents injury to the adjacent organs.

Animals↗
PubMed1989

Social system responses to Huntington disease.

Huntington disease (HD) is an adultonset, genetic disorder with major psychosocial implications. Although many of the psychiatric symptoms of the disorder have been attributed to the HD gene, systems factors may also account for the disorder's manifestations. Three illustrative issues--patient preselection, the denial of symptom onset, and suicide induction--are discussed from the vantage point of family systems thinking. Recently developed capacity for presymptomatic testing of HD despite the current absence of treatment or cure makes it likely that family therapists increasingly will be involved in clinical work with individuals and families in which HD occurs.

Adaptation, Psychological↗
PubMed1988

Invited essay on the psychological aspects of genetic counseling. V. Preselection: a family coping strategy in Huntington disease.

Preselection refers to the "sick"-role assignment given to an asymptomatic individual in a family in which a genetic or other disorder with multiple uncertainties occurs. The selection process is made, often when the preselected person is still a child, without knowledge of who eventually will be affected. The process requires the collusion of the family members for its initiation and maintenance and serves as a major coping strategy to reduce or bind the stresses and anxieties engendered by uncertainty. Preselection is seen often in families in which Huntington disease occurs and is promoted by the delayed age of onset of the disorder and the uncertain gene status of the person at risk.

Adaptation, Psychological↗
PubMed1988

Spindle cell squamous carcinoma of the tongue in the first decade of life.

A case of spindle cell squamous cell carcinoma of the tongue in a 4-year-old boy is presented. The diagnosis is supported by immunohistochemical demonstration of cytokeratins within the tumor cells. The authors believe this report represents the first case of "nonkeratinizing" spindle cell squamous carcinoma of the tongue in the first decade of life.

Carcinoma, Squamous Cell↗
PubMed1988

Malignant nerve sheath tumors of the head and neck.

Malignant nerve sheath tumors comprise approximately 5% of all soft tissue sarcomas; only 8% to 15% of these tumors arise in the head and neck. Most tumors appear as a rapidly expanding nonpainful mass in the face or lateral neck. Reported association with Von Recklinghausen's disease varies from 26% to 70%. Wide surgical excision is generally the recommended primary treatment. Recently, there has been a trend to include postoperative radiation therapy as a primary modality.

Adult↗
PubMed1987

Attitudes of persons at risk for Huntington disease toward predictive testing.

Attitudes of 69 persons at risk for Huntington disease (HD) were obtained by means of semistructured interviews and questionnaires. About 79% of the individuals said that they would use a presymptomatic predictive test if it were available. All believed that the test should be made available even though there was no cure for HD. Nearly 2/3 of subjects would use the test for prenatal diagnosis, and of these 71% would terminate a pregnancy if the fetus was found to carry the HD gene. Most subjects believed that pretest counseling should be mandatory and many said that testing should be withheld from persons who were psychologically unstable or were threatening self-harm. The data suggest that about 2-6% of persons at risk for HD may have severe psychiatric or suicidal responses to a positive outcome of predictive testing. This underscores the need for adequate pretest counseling and the availability of professional and community resources to deal with the impact of predictive testing on individuals and their relatives.

Adult↗
PubMed1987

Psychological aspects of genetic counseling. IV. The subjective assessment of probability.

Subjects asked to compare mathematically equal statements (or frames) of probability invariably perceived a difference in magnitude between percentages and equivalent proportions. Presented as unrelated to genetic risk, percentages tended to be chosen as having greater magnitude than their equivalent proportions. In justifying their choices subjects used a process of reasoning in which numbers were mentally compared, contrasted, or otherwise manipulated (numerical strategy). When framed as genetic risks, two types of reasoning were used to assess probabilities, the numerical strategy and one involving mental images of persons or parts of persons (person strategy). Subjects who used numerical reasoning tended to perceive percentages as having a greater risk magnitude than equivalent proportions whereas when person reasoning was used proportions with denominators of 10 or less tended to be perceived as having a greater risk magnitude than equivalent percentages. The implications of the findings for genetic counseling are discussed.

Adult↗
PubMed1986

The significance of vasitis nodosa.

Vasitis nodosa is an infrequently recognized, benign disorder that may be confused with malignancy of the vas deferens. A review of 30 patients with vasal masses removed during vasovasostomy revealed 20 men with vasitis nodosa. Of the patients 15 had vasal masses on physical examination, 1 of which was painful. Of the 20 patients with vasitis nodosa 14 had associated granulomatous inflammation. Vasitis nodosa is notably more common than has been reported previously and has been associated with spontaneous recanalization of the vas deferens following vasectomy.

Genital Diseases, Male↗
PubMed1984

Psychological aspects of genetic counseling. III. Management of guilt and shame.

Reactions of guilt and shame are conspicuous in the context of genetic counseling, and the relief of their distressing aspects is a widely held goal of genetic counselors. They are in a unique position to accomplish this; however, guidelines as to how one might proceed are not readily available. We have considered guilt and shame responses and have attempted to differentiate them, dynamically and developmentally, and have pointed out how each might be manifested in the course of genetic counseling. The major counseling tactics by means of which the alleviation or reduction of feelings of guilt and shame might be achieved are outlined and case illustrations are provided in which actual and potential counseling situations are explored and discussed.

Adult↗
PubMed1984

Evulsion of the optic nerve: a clinicopathological study.

Four patients with evulsion of the optic nerve caused by blunt trauma were clinically evaluated. The evulsion was complete in two of the patients and incomplete in the other two. The patients' visual acuity ranged from counting fingers to no light perception. In addition, two eyes were histopathologically studied. Several explanations of the exact cause and the extent of the evulsion are advanced within this report.

Adolescent↗
PubMed1983

Unusual and fatal complications of rhinoplasty.

Serious complications of cosmetic rhinoplasty are extremely rare. However, awareness of their existence is essential so that the surgeon can minimize the potential hazards of the procedure. This demands a careful preoperative examination, a meticulous intraoperative technique, and a careful postoperative monitoring of the patient. The complications of rhinoplasty have been classified into infectious, traumatic, hemorrhagic, systemic, and miscellaneous groups. The pertinent literature is reviewed, as well as cases of inclusion cyst formation, disturbance of eye closure, local activation of systemic disease, and fatalities from intracranial injury with brain laceration and pneumocephalus.

Adolescent↗
PubMed1983

Pulmonary caseating granulomas associated with Mycoplasma pneumoniae pneumonia.

Severe Mycoplasma pneumoniae pneumonia, complicated by autoimmune hemolytic anemia, monarticular arthritis, and persistent upper lobe consolidation, clinically simulating pulmonary tuberculosis, occurred in a young girl. A specimen taken at open lung biopsy grew Mycoplasma pneumoniae and microscopically showed caseating granulomas, a finding never previously associated with M pneumoniae infection. Although it is possible that another infectious or immunologic granulomatous lung disease may have been responsible for the unusual clinical, roentgenographic, and pathologic findings, no other etiologic agent was identified.

Caseins↗