Search PubMed⌕ Search

Biomedical subjects

S Schlossberg

Publications and source records attributed to S Schlossberg.

11 recordsLinked to original sources
PubMed2006

Bucket handle tears of the medial meniscus: meniscal intrusion rather than meniscal extrusion.

OBJECTIVE: To determine the frequency of medial meniscal extrusion (MME) versus "medial meniscal intrusion" in the setting of bucket handle tears. Images were evaluated for previously reported risk factors for MME, including: medial meniscal root tear, radial tear, degenerative joint disease and joint effusion. METHODS: Forty-one consecutive cases of bucket handle tear of the medial meniscus were reviewed by consensus by two musculoskeletal radiologists. Imaging was performed using a 1.5 GE Signa MR unit. Patient age, gender, medial meniscal root integrity, MME, medial meniscal intrusion, degenerative joint disease, effusion and anterior cruciate ligament (ACL) tear were recorded. RESULTS: Thirteen females and 27 males (age 12-62 years, median=30 years) were affected; one had bucket handle tear of each knee. Effusion was small in 13, moderate in 9 and large in 18. Degenerative joint disease was mild in three, moderate in two and severe in one. 26 ACL tears included three partial and three chronic. Medial meniscal root tear was complete in one case and partial thickness in two. None of the 40 cases with an intact or partially torn medial meniscal root demonstrated MME. MME of 3.1 mm was seen in the only full-thickness medial meniscal root tear, along with chronic ACL tear, moderate degenerative joint disease and large effusion. Medial meniscal intrusion of the central bucket handle fragment into the intercondylar notch was present in all 41 cases. CONCLUSION: Given an intact medial meniscal root in the setting of a "pure" bucket handle tear, there is no MME.

Adolescent↗
PubMed1995

Repair of obliterative vesicourethral stricture after radical prostatectomy: a technique for preservation of continence.

We present the open surgical repair of complete obstruction of the bladder neck unresponsive to endoscopic management. By combining abdominal and perineal dissection, partial pubectomy, and omental wrapping, repeat anastomosis is possible without the need for bladder tubularization. Two patients have been repaired successfully. Although both men presented with indwelling suprapubic tubes and a defect of greater than 1.5 cm, they are now voiding normally at 18 and 7 months post-operatively without the need for pads, medication, or instrumentation. Complete obliteration of the bladder neck after radical prostatectomy can be functionally reconstructed. Postoperative continence will depend on the function of the membranous urethra. If incontinence occurs, this can be managed in a reconstructed open urethra.

Humans↗
PubMed1993

Chromophore enhanced laser welding of canine ureters in vitro using a human protein solder: a preliminary step for laparoscopic tissue welding.

Laser welding of the genitourinary tract has the potential advantage of forming an immediate watertight seal. It may obviate the need for sutures, eliminate the inherent lithogenic reaction to suture, and potentially improve healing. In the current study we employed a KTP-532 laser in vitro to weld canine ureters. Ureters were transected over a stent and immediately repaired using the KTP-532 laser (power density 7.14 W/cm.2, spot size = 0.5 cm.) alone or in combination with different tissue solders. Solders consisted of 40% human albumin alone or with the addition of iron oxide or fluorescein as light absorbing dyes (chromophores). Following the repairs, intraluminal bursting strength and the total energy required to complete the repairs were measured. The KTP laser alone was not able to achieve a satisfactory repair. Successful ureteral repairs were achieved in all solder groups while maintaining ureteral continuity at supraphysiologic pressures.

Anastomosis, Surgical↗
PubMed1988

Men with congenital absence of the vas deferens often have seminal vesicles.

The absence of semen fructose and low ejaculate volume in men with congenital absence of the vas deferens have been attributed to an associated agenesis of the seminal vesicles. Because vasography and retrograde seminal vesiculography cannot be performed in these men, this association has never been confirmed reliably. Therefore, we performed computerized tomographic scans of the seminal vesicles on 26 men with absence of the vas deferens. We found seminal vesicles bilaterally in 12 of these men, unilateral hypoplasia or absence in 8 and bilateral hypoplasia or absence in 6. Four men with normal seminal vesicles and 1 with unilateral hypoplasia underwent exploration in an attempt to find reconstructable vasa. We failed to identify a vas deferens in any of these men. These observations suggest that negative semen fructose and low ejaculate volume in men with absence of the vas deferens may be owing to agenesis or obstruction of the ejaculatory ducts rather than absent seminal vesicles.

Adult↗
PubMed1987

Investigations on urinary bladder reinnervation. Historical perspective and review.

Although nerve crossover surgery to bypass a spinal cord lesion and recentralize the decentralized bladder was first conceptualized in 1907, surprisingly few studies concerning this goal have been reported since. In addition to direct implantation of nerves into the detrusor, the studies reviewed have investigated the crossover of mixed roots (with and without nerve grafts), dorsal roots, ventral roots, pelvic, obturator and hypogastric nerves both in animal models, in human cadavers, and in human patients. Restoration of the micturition reflex through the use of nonsacral nerves has been achieved in cats. In addition, we have shown that the axons of a suprasacral mixed root (L7) when anastomosed to a sacral mixed root (S1) via a nerve graft can regenerate and recentralize the unilaterally decentralized bladder in the cat. The return of the micturition reflex after reconstruction of severed pelvic nerves has been documented, while the results of obstruction or hypogastric crossover have given diminished returns of bladder function. The direct implantation of nerves into the detrusor has not resulted in restoration of function. In addition, return of useful bladder function in humans after nerve crossover surgery has not been predictable. In part, present inability to achieve restoration of urinary bladder function may be a consequence of the complexity of micturition reflex organization and the inability to use techniques in humans that have given success in animals. Although, some of the technical aspects of nerve crossover surgery to bypass a spinal cord injury and restore functional micturition in those with neurogenic bladder dysfunction have been elucidated, further work is required to develop techniques that will enhance appropriate axonal regeneration to achieve reinnervation and return of useful function. Indeed, restoration of function may be limited by current microsurgical methodologies. Studies directed at understanding the neuropathophysiology of nerve injury and nerve surgery may be more fruitful in identifying factors than can be manipulated to achieve consistent return of useful function. In general, however, the results of the animal and human studies surveyed may be viewed with cautious optimism.

Animals↗
PubMed1987

Nerve crossover techniques for urinary bladder reinnervation: animal and human cadaver studies.

Interruption of spinal pathways integrating central and peripheral bladder control mechanisms will result in neurogenic bladder dysfunction. If central pathways could be restored to the decentralized bladder through a microneural reconstructive technique a return of useful function might be achieved. This anatomical study describes the nerve crossover techniques used in human cadaver dissections for connecting intercostal nerves to sacral roots intraspinally. The techniques were modified from and compared to similar procedures used in an animal model where adjacent extradural roots were connected through a nerve graft. We have shown previously that the unilaterally decentralized bladder of the cat can be recentralized after a nerve crossover procedure. If additional laboratory studies can document return of useful bladder function we anticipate that selected patients may benefit from similar nerve crossover techniques to bypass a spinal cord lesion to recentralize the bladder.

Animals↗
PubMed1984

Neurofibroma involving the penis in a child.

We report an unusual case of penile neurofibroma. These tumors of perineural and Schwann's cell origin can occur anywhere but have been reported to arise from the penis only 1 time previously.

Child↗
PubMed1983

The role of the epididymis in testicular descent.

In 54 patients with 70 undescended testes hospitalized for orchiopexy epididymal anatomy was examined intraoperatively. Of the testes 66 per cent had abnormal epididymides, which suggests a possibly significant role for the epididymis in the process of testicular descent.

Abnormalities, Multiple↗
PubMed1978

Levamisole in ascariasis. A multicenter controlled evaluation.

An analysis is presented of 10 clinical studies from various countries where levamisole 50--150 mg was compared to pyrantel, piperazine, and placebo in a total of 1,734 patients, mostly children (levamisole: 830, controls: 904), suffering from ascariasis either as a single infection or usually mixed with other nematode infections. Degree of infection and efficacy of treatment were determined by quantitative coproparasitological methods. Levamisole produced higher cure rates (91%) and egg reduction rates (98%) than pyrantel, piperazine, or placebo. The efficacy of levamisole was unrelated to the patients' sex and age, the severity of infection, the presence of another worm infection, the type of associated worm infections, or the egg-counting technique. The overall incidence of reported adverse reactions was lower after levamisole than after piperazine, pyrantel or placebo; abdominal pain and headache, the most frequent complaints after levamisole, were related to the initial severity of ascariasis. Follow-up examinations 6 months after treatment suggested that levamisole might delay reinfection.

Adolescent↗