Search PubMed⌕ Search

Biomedical subjects

S Strauss

Publications and source records attributed to S Strauss.

At least 37 records · Page 2Linked to original sources

[Acute, painful, swollen testis in polyarteritis nodosa: a diagnostic problem].

An acutely painful and swollen testis mandates urgent diagnostic and therapeutic measures since this symptom complex may indicate torsion of the testis. Prompt scrotal exploration is necessary if the testis is to be saved from ischemic necrosis. Polyarteritis nodosa (PAN) is a vasculitis involving mainly medium and small sized arteries and may damage any organ. In PAN, the presentation of an acutely painful and swollen testis raises a perplexing diagnostic problem since the symptoms may be related to vasculitis involving the testis on the one hand, or represent primary testicular pathology unrelated to the underlying PAN. A 31-year-old man with PAN who presented with acute pain and swelling in a solitary testis is reported.

Adult↗

Detection and typing of human papillomavirus DNA in paired urine and cervical scrapes.

The prevalence of human papillomavirus (HPV) in paired cervical scrape and urine specimens from 144 women attending a clinic for genitourinary medicine was determined by polymerase chain reaction (PCR) and nested PCR, using degenerate and general primer pairs localized within the L1 region. HPV typing was by restriction fragment length polymorphism (RFLP), type-specific PCR (HPV 6, 11, 16, 18, 33), and partial DNA sequencing of PCR products. HPV DNA was detected in 114 (84%) women. HPV DNA was detected in the specimens of 58 patients after amplification with MY09/MY11 primers and in a further 54 patients after nested PCR with the GP5+/GP6+ primers. A total of 106/136 (78%) of women had HPV DNA positive cervical scrapes and 89 (65%) had HPV DNA positive urine specimens. Both the urine and cervical specimens of 81 women were positive. In 25 women HPV DNA was detected in the cervical specimen only, and in 8 women HPV DNA was detected in the urine specimens only. A total of 108 specimens from 75 patients were typed. For 33 patients HPV typing was achieved in both the cervical and the urine specimens and 19 women had identical types in paired specimens. Multiple HPV infections could be detected in 15 (20%) of 75 women where either the cervical and urine specimen or both of the specimens could be typed. More then one HPV type was found in 8 specimens and from multiple sites (cervix and urinary tract) in the same patients on 7 occasions. The results of this study indicate that the detection of HPVs in the urogenital tract can be maximised through the testing of both cervical scrapes and urine specimens in conjunction with the use of a nested PCR to increase the sensitivity of HPV DNA detection. Also, urine cannot be a direct substitute for a cervical scrape as different HPV types are often detected in the urine compared with those detected in the cervix.

Adolescent↗

Gallbladder contraction in familial dysautonomia.

The impaired function of the autonomic nervous system in patients with familial dysautonomia (FD) is frequently associated with gastrointestinal dysfunction. This study sought to determine whether gallbladder contraction is also affected in these patients. Nine consecutive patients with FD were assessed by real-time ultrasonography for gallbladder volume and calculated percentage of gallbladder contraction before and 45-60 min after a 50 g fatty meal, and compared with nine healthy control patients, matched for age and gender. Gallbladder volume before the fatty meal was found to be larger in healthy controls than in FD patients (25.4+/-9.5 and 15.4+/-7.4 ml3, respectively; p = 0.024). No significant difference was demonstrated between the groups after the fatty meal (controls: 12.1+/-6.0; FD: 9.0+/-6.6 ml, respectively) and the calculated percentage of gallbladder contraction was similar in both groups (controls: 53.4+/-16.6; FD: 44.8+/-18.8%). These results indicate that gallbladder function in FD patients does not differ from the general population and preventive measures for gallstone formation are not required.

Abdominal Pain↗

Detection of human papillomavirus DNA on the fingers of patients with genital warts.

OBJECTIVE: To determine whether patients with genital warts carry human papillomavirus (HPV) DNA on their fingers. METHODS: 14 men and eight women with genital warts had cytobrush samples taken from genital lesions, finger tips, and tips of finger nails. Samples were examined for the presence of HPV DNA by the polymerase chain reaction. RESULTS: HPV DNA was detected in all female genital samples and in 13/14 male genital samples. HPV DNA was detected in the finger brush samples of three women and nine men. The same HPV type was identified in genital and hand samples in one woman and five men. CONCLUSION: This study has identified hand carriage of genital HPV types in patients with genital warts. Although sexual intercourse is considered the usual mode of transmitting genital HPV infection, our findings raise the possibility of transmission by finger-genital contact.

Condylomata Acuminata↗

Cricoid cartilage masquerading as a tumour on thyroid ultrasound.

On ultrasound scanning of the thyroid gland in a sagittal plane, the cricoid cartilage can falsely create the impression of a mass in the gland if the transducer is angled slightly medially. The illusion of a mass is fortified on transverse view if the cricothyroid and inferior pharyngeal constrictor muscles, which lie between the upper pole of the thyroid gland and the cricoid cartilage, are misinterpreted as a solid lesion. The purpose of this study was to describe the ultrasound features of the cricoid cartilage and to determine the frequency in which a pseudolesion is created. In 15 of 26 volunteers the cartilage was seen as a hypoechoic structure surrounded by an anechoic halo and containing foci of calcification, closely resembling a thyroid nodule. In 11 of the subjects, with a mean age of 55 years, the cartilage was heavily calcified, poorly visualized and did not simulate a thyroid lesion. Awareness of the cause and appearance of this pseudolesion should help radiologists avoid a potential pitfall and prevent unnecessary invasive procedures.

Adult↗

Risk factors associated with postpartum ovarian vein thrombosis.

Thrombosis of the ovarian vein is a remarkable process occuring within a few days of labor in 1:500-1:2000 women. Its presentation is characterized by fever, abdominal pain and occasionally by a palpable abdominal mass that in earlier years sometimes lead to explorative laparotomy. With the advent of modern imaging techniques the diagnosis can be made relatively easily. The pathogenesis has been attributed to an infectious process expanding from the uterus to the right ovarian vein and stasis. A predisposition towards thrombosis has not been so far explored. In this study we retrospectively analysed the clinical features, diagnosis and treatment of 22 patients with objective documentation of post partum ovarian vein thrombosis (POVT) and assessed potential risk factors. In 11 of the 22 patients (50%) inherited prothrombotic risk factors were detected as follows: 4 were heterozygous for factor V G1691A, 2 had protein S deficiency, one had protein S deficiency and was heterozygous for factor V G1691A, and 4 were homozygous for MTHFR C677T. Eight of the 11 patients who bore a prothrombotic predisposition underwent cesarean section. Taken together, the data suggest that POVT may result from the combined effect of an infection, cesarean section and a prothrombotic tendency.

Adult↗

[Epidermoid cyst of the spleen].

Splenic cysts are rarely found or diagnosed. Excluding cases of trauma, the events preceding their development have not been fully understood. We describe a 22-year-old woman in her 34th week of pregnancy in whom ultrasound revealed a cystic lesion 8 x 10 cm. in diameter in the left upper abdomen. Further imaging tests followed by laparotomy confirmed the splenic origin of the cyst. Splenectomy was performed and the lesion was histopathologically defined as an epidermoid cyst.

Adult↗

Why a foundation?

Explore the source record for details and available documents.

Charities↗

The management of a person with haemophilia who has a fixed flexed hip and intractable pain.

The clinical picture of a fixed flexed hip associated with pain in a person with haemophilia is suggestive of a haemorrhage in that area. Sonography facilitates differentiation between a haemarthrosis, intraperitoneal haemorrhage, subperiosteal bleed, a bleed into the soft tissue around the hip joint or a psoas haematoma. All these aforementioned causes may result in the same clinical presentation. Two cases are described in which coxhaemarthrosis resulted in a flexion contracture of the joint associated with severe intractable pain. Narcotic drugs failed to alleviate the severe pain. Joint aspiration produced dramatic pain relief and early joint rehabilitation.

Adult↗

Role of ultrasound-guided fine-needle aspiration biopsy in evaluation of nonpalpable thyroid nodules.

To determine the role of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) in the evaluation of incidentally diagnosed nonpalpable thyroid nodules (NP-TN), we compared the diagnostic yield of US-FNAB in NP-TN larger than 10 mm in diameter, with palpation-guided (P-FNAB) in palpable thyroid nodules (P-TN) in the same hospital setting. Of 108 consecutive patients with NP-TN (female/male: 97/11, age: 55.2 +/- 14.3, mean +/- SD), malignancy was identified in 8 patients (7 with thyroid papillary carcinoma, 4 of which had extrathyroidal spread, and 1 patient had metastasis of pulmonary adenocarcinoma). Male gender was associated with higher prevalence of malignancy (p = 0.09) while calcification and/or cystic degeneration of the nodule did not predict the cytological findings. Malignancy was identified in 16 of 151 consecutive patients with P-TN (female/male: 139/12, age: 44.1 +/- 9.5, mean +/- SD) indicating a similar rate of malignancy in both NP-TN and P-TN. In the P-TN group thyroid cancer was more common in males (p = 0.007), and the US properties of the nodule did not predict its cytological diagnosis. In conclusion, because similar rates of cancer are detected by FNAB in both NP-TN and P-TN, an FNAB is recommended for NP-TN larger than 10 mm.

Adenocarcinoma↗

Serial sonography and colour flow Doppler imaging following testicular and epididymal sperm extraction.

Percutaneous epididymal sperm aspiration (PESA), percutaneous testicular sperm aspiration (TESA) and testicular sperm extraction (TESE) are invasive procedures and their consequences on the testis have not been clearly defined. In order to relate the sonographic and colour Doppler flow changes to the clinical data, 14 patients with non-obstructive and six with obstructive azoospermia were examined by the same roentgenologist immediately before, at 5 days, 2 weeks, 2 and 6 months after the surgical procedure. Testicular volumes remained unchanged during the follow-up period in both the non-obstructive and obstructive groups. Of the non-obstructive group, focal testicular lesions were seen in 20 of the 26 testes (77%) 5 days after the procedure and in 54% by 6 months. Ten were hypoechoic, of which six converted to echogenic foci, three remained hypoechoic and one disappeared at 6 months. The other 10 were echogenic lesions, three of which were no longer visible at 6 months and the remainder were unchanged. In the obstructive azoospermic group, focal lesions were not found. Extratesticular abnormality consistent with haematoma was demonstrated in four non-obstructive cases, which disappeared at the 6 month examination, and in none of the obstructive azoospermic patients. Whether residual focal lesions in the testes have long-term effects remains to be evaluated. In the obstructive azoospermic group, the aspirations performed did not leave any sonographic abnormalities.

Epididymis↗

Transrectal ultrasonographically assisted radical retropubic prostatectomy.

Radical prostatectomy is associated with difficulty in determining the division site of the urethra adjacent to the apical region of the prostate. We present the results of a feasibility clinical trial in three patients to determine whether intraoperative transrectal ultrasonography may assist during radical retropubic prostatectomy. Using this technique the apex is readily identified and a detailed view of the urethral stump could be obtained. In one case residual apical tissue was identified and excised. The creation of the vesicourethral anastomosis was documented and its water tightness was demonstrated. We conclude that transrectal ultrasonography can be performed during radical retropubic prostatectomy and may be helpful in selected cases.

Adenocarcinoma↗

Torsion of the testicular appendages: sonographic appearance.

Torsion of the testis and torsion of the testicular appendages have similar presenting features, namely, acute testicular pain and swelling. The former condition requires urgent surgical intervention to save the testis; the latter condition can be treated conservatively. Despite the frequency of torsion of the appendix testis, which is the most common cause of acute hemiscrotum in the child, only occasional references to this entity are found in the radiological literature. We describe five cases in which an enlarged, homogeneously echogenic appendix testis was seen medial or posterior to the head of the epididymis. All cases were accompanied by hydrocele and thickening of the scrotal wall. Among the five cases, enlargement of the head of the epididymis was seen in four and increased testicular blood flow in two. Scanning in the coronal and transverse planes above the testis was useful in locating the enlarged, twisted appendix.

Adult↗