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Biomedical subjects

W Bähren

Publications and source records attributed to W Bähren.

At least 19 recordsLinked to original sources
PubMed2001

Interferon-gamma in 5 patients with cutaneous radiation syndrome after radiation therapy.

BACKGROUND: Irradiation can cause acute inflammatory responses as well as chronic fibrotic alterations of the skin. Cutaneous radiation fibrosis evokes a complex of therapeutic problems. However, therapeutic options, apart from surgical approaches, are limited. PATIENTS AND METHODS: Five female patients suffering from severe cutaneous fibrosis were treated with interferon-gamma on a low-dose regimen, 3 x 100 microg/week subcutaneously for 6 months, then once per week for another 6 months. In 4 patients, skin thickness was measured with high-frequency (20 MHz) ultrasound in a clinically well-defined target skin lesion. In 1 patient, nuclear magnetic resonance imaging was performed to quantify the extent of cutaneous radiation fibrosis and to monitor the therapeutic outcome. RESULTS: All patients suffered from radiation-induced cutaneous fibrosis. Additionally, in 1 patient, a fistula, as assessed by lymph vessel scintigraphy, and in another patient a radiation ulcer was diagnosed. In all patients, reduction of radiation-induced fibrosis could be documented. Both fistula and radiation ulcer regressed completely under interferon-gamma therapy. CONCLUSION: Low-dose interferon-gamma therapy is a new and effective treatment modality for cutaneous radiation fibrosis caused by radiation therapy. The positive impact of interferon-gamma on our patients warrants randomized double-blind trials on therapy of radiation fibrosis.

Adolescent↗
PubMed2000

The radiation accident in Georgia: clinical appearance and diagnosis of cutaneous radiation syndrome.

BACKGROUND: Eleven male Georgian soldiers were accidentally exposed to radiation by cesium 137 during their training in a military exercise camp in Lilo, Georgia between November 1996 and May 1997. OBJECTIVE: The characteristic sequelae of accidental cutaneous irradiation and available diagnostic methods are described. METHODS: Magnetic resonance imaging (MRI) of radiation ulcers was performed in all patients; thermography was performed in 2. In 7 patients ulcers and white macules were examined with high-frequency 20 MHz sonography; histologic results were obtained from all patients. RESULTS: Predominant lesions were radiation ulcers in 11 patients and white hairless macules in 7. MRI showed ulcers down to the muscles and an increase of signal intensity in the musculature in 9 cases. The corresponding muscle histology demonstrated vasculitis in 7 patients and necrosis in 2. In 2 patients, MRI signal intensity of the musculature was normal. In 3 patients, 20 MHz sonography showed dermal defects; 1 patient had cutaneous fibrosis. Thermography demonstrated hypothermic zones with extended inflammatory zones adjacent to the radiation ulcers in both patients examined. CONCLUSION: High-frequency 20 MHz sonography, MRI, and thermography are useful noninvasive methods for diagnosis of the extent of cutaneous radiation syndrome and for therapy planning.

Adult↗
PubMed1997

[Recurrent pneumothorax after surgical resection treatment].

Between 1984 and 1994, 27 men and 4 women with primary spontaneous pneumothorax were treated surgically by excision of the bullae, without pleurectomy. The purpose of the present study was to establish by computed tomography (CT) of the lung whether the excision permanently eliminated the cause of pneumothorax. The median follow-up was 72 (21-127) months. There were two patients with recurrences (6.4%) who were operated on again. Sixteen of 31 patients had new blebs in the apex of the lung as documented by postoperative CT. The study indicates that simple excision of the bullous area cannot prevent the recurrence of blebs.

Adolescent↗
PubMed1996

[Acute diagnosis of thoracic injuries of therapeutic relevance in severely injured and polytraumatized patients].

PURPOSE: To determine the value of supine chest radiography in comparison to orientating chest CT in the initial diagnostic evaluation of severely polytraumatised patients. MATERIAL AND METHODS: 303 patients with primary indication for a cranial CT following trauma were investigated between 1988 and 1993. After performing the cranial CT all patients underwent a chest CT with an average of 6 CT slices without changing the position of the patient and with a median scan time of 4 minutes. The results of the chest CT were correlated with the findings of the supine chest radiography in regard to therapeutically relevant pathological changes. RESULTS: The sensitivity in detection of pneumothorax in supine chest radiography was 53% versus 97% in CT, atelectasis 20% versus 94%, lung contusion 79% versus 99%, haemotothorax 62% versus 97%. More fractures were found conventionally (sensitivity 94%) than by chest CT (sensitivity 44%). CONCLUSION: Supine chest radiography of polytraumatised patients is clearly inferior to orientating chest CT in demonstrating posttraumatic lesions; obtaining therapeutically relevant information justifies the additionally needed small amount of time.

Adolescent↗
PubMed1995

[Radiographically demonstrable spinal changes in asymptomatic young men].

PURPOSE: To find reliable data of the incidence of different variations of the spine. MATERIAL AND METHODS: Standardised radiographic examinations of 10,922 young, healthy pilot aspirants of the German air force were made. Radiographic examination included the whole spine in a.p. and lateral projection, the cervical spine in oblique projection and in a subunit of 5781 men the lumbar spine in oblique projection. RESULTS: The following incidences were found: mild habit scoliosis: 80.4%, structural scoliosis: 9%, severe thoracal kyphosis without severe lumbar lordosis: 5.1% and together with severe lumbar lordosis: 30.8%, mild forms of kyphosis of adolescence: 23.3%, severe forms: 2.1% and cuneiform deformation of vertebral body: 4.9%, sacralization: 7.8%, lumbarization: 5.9%, spondylolysis: 6.2%, spondylolisthesis: 4.3% and lumbar chondrosis: 2.1%. Chondrosis of the thoracal and cervical spine, osteochondrosis and coalescent vertebral bodies were found in less than 0.8% each. CONCLUSION: In only 2.6% were there no pathological findings. This shows importance of radiological spine examinations especially for industrial and preventive medicine.

Adolescent↗
PubMed1994

[Bilateral ureteroiliac fistula coincident with radiotherapy and ureteral splint].

Fistulas between the iliac artery and the ureter are uncommon. Overall, fewer than 20 cases have been described in the literature. We report the first bilateral case, in which there was an association with indwelling bilateral ureteral stents and a history of radiation therapy following hysterectomy performed because of malignancy. The patient presented with massive gross haematuria.

Angiography↗
PubMed1992

[Failed sclerotherapy trials with the V. spermatica interna. A retrospective analysis in 1141 patients with idiopathic varicocele].

From July 1988 until December 1990 1141 patients with left-sided idiopathic varicocele underwent phlebography of the spermatic internal vein, and percutaneous sclerotherapy with sodium morruate (Varicocid) was intended to be performed. In 125 of these patients sclerotherapy was not feasible. The reasons for this were analysed in a retrospective study. According to the anatomical situation of the spermatic vein, there were significant differences in technical success. In case of incompetent valve of the spermatic vein at the renal origin (type I, 2A, 3, 4A), selective probing and following sclerotherapy was possible in 97%. Anatomic variations with competent valve of the spermatic vein (type 0, 2B, 4B) led to difficulties in selectively probing the vessel, and sclerotherapy was feasible in only 72.7%. In these angiographically difficult cases, spasm of the spermatic vein and/or perforation prevented sclerotherapy in 29 of 125 patients.

Adolescent↗
PubMed1992

[Long-term results of corpus cavernosum auto-injection therapy in treatment of patients with chronic erectile dysfunction].

From May 1985 to July 1989, 143 patients suffering from chronic erectile dysfunction (21-70 years old) underwent constant corpus cavernosum auto-injection therapy (CCAT) with papaverine alone (1257 injections) or with a standardized papaverine-phentolamine mixture (11035 injections). On the basis of these 12,292 protocol auto-injections and over 4 years' experience with intracavernosal auto-injection therapy we conclude: CCAT, especially with the papaverine-phentolamine mixture, constitutes an effective therapy (full rigidity in 95.9%) with tolerable side-effects for chronic erectile dysfunction when preceded by careful patient selection and thorough multidisciplinary evaluation, especially in the case of arterial and/or neurogenic aetiology of the erectile dysfunction; in addition, the contraindications must be strictly observed, the treatment and technique fully explained, and a regular system instituted. CCAT is generally well accepted by the patients and their partners (100%/98.3%) and has distinct positive effects on self-esteem (77.8%), performance anxiety (84.4%) and partnership (79.5%). The most serious side-effect was prolonged erection (25 out of 12,292 injections). In 3 patients reversible fibrotic changes near the tunica albuginea were observed.

Dose-Response Relationship, Drug↗
PubMed1991

[Nitroglycerin test for the diagnosis of erectile dysfunction].

In 33 patients with erectile dysfunction arterial inflow was measured by Doppler-sonography over the superficial dorsal and deep cavernous arteries in the proximal section after local application of 1.6 mg glycerol trinitrate (nitroglycerin) to the glans penis. With this test we were able to reveal a minimal increases in maximal systolic flow over both arteries at 29/66 measurement sites. This is thus an easier way of localizing penile vessels in the flaccid state. In no case did we see tumescence or rigidity.

Administration, Topical↗
PubMed1990

Diagnosis of venous incompetence in erectile dysfunction. Comparative study of cavernosography and Doppler ultrasound.

In 26 of 214 patients with erectile dysfunction and proved venous incompetence by cavernosography, an additional bidirectional Doppler ultrasound was performed also to demonstrate venous outflow disturbances. All except one leakage in the superficial and deep dorsal veins could be demonstrated as well as 4 of 6 cavernosum-glandular shunts. Bidirectional Doppler ultrasound visualized a continuous retrograde blood flow from the sulcus coronarius to the root of the penis in superficial and deep dorsal penile veins as well as in ectopic penile veins, an orthograde blood flow in the sulcus coronarius in cavernosum-glandular shunt.

Erectile Dysfunction↗
PubMed1990

Erectile response to intracavernous injection of vasoactive drugs after penile prosthesis removal.

Two patients with a history of penile prosthesis removal presented for non-prosthetic treatment of their erectile dysfunction. The first patient had a penile implant for two years before it was removed and showed extensive cavernosal fibrosis. He did not respond to intracavernosal injection of vasoactive drugs. The second patient had the prosthesis for four weeks. He showed no evidence of cavernosal fibrosis and responded well to the intracavernous injection. He has been in an intracavernous autoinjection program for more than one year without complications.

Aged↗
PubMed1990

[Results of multidisciplinary assessment of patients with erectile dysfunction].

A total of 326 patients with chronic erectile dysfunction were investigated by a multidisciplinary approach. It was found that several causes combined (multifactorial genesis) in 77.1%. Organic causes alone were found quite frequently, viz. in 43.6%, while primarily psychogenic causes alone were found in only 5.5%; in contrast, combined organic and psychogenic causes were found in 46.0%. There were pathologic organic findings in 89.6%: vascular in 74.5% (arterial 64.1%, cavernous/venous 30.4%), neurogenic in 42.0%; side effects of drugs in (10.1%); endocrine (7.7%) and local penile causes (4.3%) are not so important in erectile dysfunction. Treatment suited to the pathogenesis was instituted (psychotherapy, vein ligation, self-injection of vasoactive drugs into the corpus cavernosum).

Adult↗
PubMed1989

Primary erectile dysfunction.

We evaluated 67 patients 18 to 60 years old (mean age 28.5 years) with primary erectile dysfunction (absence of full sustained erections since early childhood or puberty) using a multidisciplinary approach. Organic causes of the erectile dysfunction were found in 57 of the 67 patients (85 per cent): 12 (18 per cent) had neurological, 35 (52 per cent) arteriogenic and 35 (52 per cent) venogenic abnormalities. Psychogenic factors were diagnosed in 11 patients (16 per cent), while in 4 (6 per cent) a classification was not possible. Concomitant psychogenic abnormalities were found in 39 of the 57 patients (68 per cent) with organic primary erectile dysfunction. Our results suggest that primary erectile dysfunction is caused mainly by organic factors. However, for successful therapy the frequent secondary psychogenic abnormalities must be considered.

Adult↗
PubMed1989

Percutaneous sclerotherapy of idiopathic varicocele in childhood: a preliminary report.

Of 31 boys 10 to 16 years old referred for treatment of a left grade II or III varicocele 28 underwent percutaneous sclerotherapy. Due to anatomical and technical obstacles sclerotherapy was not possible in 3 boys. At follow-up 1 of 16 boys (6.2 per cent) had a mild recurrence detected by Doppler sonography of the spermatic cord. Percutaneous sclerotherapy had no serious side effects, and proved to be an efficient and convenient treatment of left varicocele in childhood.

Adolescent↗