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Biomedical subjects

W F Thon

Publications and source records attributed to W F Thon.

33 records · Page 2Linked to original sources
PubMed1992

Transcutaneous registration of cavernous smooth muscle electrical activity: noninvasive diagnosis of neurogenic autonomic impotence.

Registration of cavernous electrical activity was shown to be a possible method for the evaluation of cavernous autonomic innervation. Recent studies in patients with normal erectile function showed that cavernous electrical activity is synchronous throughout the entire cavernous bodies. Therefore, we examined the feasibility of transcutaneous registration of cavernous electrical activity in 8 normal and 62 impotent patients. In the sitting patient cavernous electrical activity was recorded with a 2-channel electrophysiological unit. Recording was done with a coaxial needle electrode in the proximal left cavernous body and with surface electrodes bilaterally on the penile shaft. In 7 of 8 normal patients swelling of the penile shaft after circumcision resulted in a dramatically decreased amplitude of the potentials. In 41 of 62 impotent patients recordings were similar. In 10 of 62 patients no recording or markedly decreased amplitudes were noted with the surface electrodes and in these patients a small penis or penile retraction with consecutive electrode displacement was found. Careful repositioning of the surface electrodes with the patient in the supine position resulted in similar recordings in 9 (inconsistently in 4). In 11 of the 62 patients more information was obtained with the surface than with the needle electrode. Our results show that recording of cavernous electrical activity can be done in a completely noninvasive manner using surface electrodes with similar or even better information obtained than with needle electrodes.

Action Potentials↗
PubMed1992

[Vasectomy: minor intervention--grave sequelae].

Claims for compensation following dissatisfaction with the results of medical treatment have increased in frequency over the last few years. Medical records, such as declarations of consent and operation reports, often constitute important evidence in legal proceedings, particularly in the field of surgery. Before a vasectomy is performed for the purpose of contraception, detailed information must be given on how safe this is as a method of birth control and the patient must be made aware of the importance of sperm count controls after the operation. The surgeon is held responsible if it can be shown that a failed sterilization is due to ligation of only one vas deferens or to failure to notice an accessory one. Claims for compensation can include support for children up to the age of 18 years and financial compensation to the mother in respect of the labour pains.

Humans↗
PubMed1991

Single potential analysis of cavernous electrical activity.

Recording of cavernous electric activity was performed in 178 patients with erectile dysfunction and in 37 normal patients. In 34/37 normal patients, potentials of a uniform shape were recorded during flaccidity: At cut-off frequencies of 0.5-500 Hz, the length was 8-18 (mean 12.8, SD 2.8), the amplitude 250-750 (mean 444, SD 109) microV, and the polyphasity 8-22 (mean 13.8, SD 3.3). In impotent patients with upper motor neuron lesions or peripheral lesions, specific types of potentials were observed. In 11/14 impotent patients with insulin-dependent diabetes for over 20 years and clinical findings of cavernous myopathy, potentials showed low amplitude, irregular shape, and slow depolarizations. In 51% of the consecutive impotent patients, abnormal findings of cavernous electric activity were recorded. Our clinical study suggests that single potential analysis of cavernous electric activity (SPACE) may be useful in the diagnosis of cavernous autonomic neuropathy and cavernous smooth muscle myopathy.

Action Potentials↗
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↗
PubMed1988

Benign testicular tumors: a case for testis preservation?

Between June 1980 and June 1986, 345 inguinal explorations for intrascrotal space-occupying lesions were performed. In 47 patients benign testicular tumors were diagnosed (13.5%). In 32 of the 47 tumors (68%), the testis could be preserved by excision or enucleation of the tumor. In the remaining 15 patients a high semicastration was carried out: in 12 cases macroscopic examination or frozen section revealed doubtful benignity (6 Leydig cells tumors, 5 dermoid cysts and 1 epidermoid cyst), in 3 patients because of extensive involvement of the testis. In a follow-up period of 1-7 years none of the patients has shown evidence of tumor recurrence or metastasis. Changing the concept of not incising the parietal tunica of the testis and regarding clear-cut macroscopic and histological criteria of benignity on frozen section will safely lower the testicular loss rate from up to 80% to about 30% when benign tumors are encountered.

Dermoid Cyst↗
PubMed1988

[Segmental unilateral priapism--a case report].

A case of segmental priapism in a 24-year-old man with congenital spherocytosis is presented. Preoperative cavernosography and computer tomography clearly revealed thrombosis of the left proximal corpus cavernosum. Because the lesion had already been in existence for 5 weeks irrigation to flush out the thrombosis was no longer possible.

Adult↗
PubMed1988

[Diagnosis of enuresis--results of urodynamic studies].

The results of clinical evaluation of 71 patients with primary or secondary enuresis are presented. In 66 patients a complete urodynamic assessment was possible. 35 percent of these patients showed a normal urodynamic pattern, in 45 percent detrusor hyperreflexia and in 18 percent a combination of detrusor hyperreflexia and a functional infravesical obstruction was demonstrated.

Adolescent↗
PubMed1987

[Position of surveillance therapy in clinical stage I testicular non-seminoma].

Since the initiation of a 'surveillance' therapy the role of retroperitoneal lymph node dissection as standard treatment in the management of patients with clinical stage I nonseminomatous germ cell testicular tumor (NSGCTT) continues to be debated. Noninvasive staging techniques (CT scans, lymphography, ultrasound and serologic tumor markers) help to identify more accurately patients with distant metastases. 'Surveillance' alone as a possible treatment modality following orchidectomy in selected patients with clinical stage I NSGCTT requires cooperative and reliable patients. In our urological clinic surveillance alone is not justified any longer because of a noncompliance rate of 10% and a relapse rate of 30%, although the early detection of small-volume metastatic disease, lymphadenectomy and polychemotherapy result in a high rate of cure. Any patient should be excluded from 'wait and see' protocols if metastatic prognostic factors such as vascular infiltration of the primary tumor or local tumor stage greater than pT1 are identified.

Biomarkers, Tumor↗
PubMed1987

[2 years' experiences with cavernosal autoinjection therapy].

Between February 1985 and January 1987, 186 patients with erectile dysfunction were selected for cavernosal autoinjection therapy (CAT). After more than 4800 protocolled autoinjections and 10-230 CAT/pt., no cavernous fibrosis, penile deviation or cavernitis occurred. The only serious side effects were prolonged erections in about 10% during diagnostic and less than 1% during therapeutic use. These prolonged erections could be easily treated by puncture and aspiration of corpora cavernosa or intracavernosal injection of Metaraminol.

Drug Therapy, Combination↗
PubMed1987

[Venous insufficiency of the corpora cavernosa as (additional) cause of erectile dysfunction].

In 25-30% of the patients with erectile dysfunction, venous insufficiency is the (additional) reason for the erectile failure. Surgical procedures and prognosis depend largely on the precise localisation of the pathological drainage. The venous leakage is proven and exactly localized by a multiprojectional cavernosography, measurement of the maintainance flow and intracavernous pressure monitoring. The most reliable screening test for venous erectile dysfunction is the intracavernous application of a standardised vasoactive drug combination.

Erectile Dysfunction↗
PubMed1987

[Ureteral stump metastasis of a hypernephroma. A case report].

Ureteral stump metastasis after tumor nephrectomy is very rare. To date 43 cases have been published. In our patient this type of metastasis was diagnosed 2 years after nephrectomy for renal adenocarcinoma with prominent rhabdomyosarcomatoid components. The pathogenesis of ureteral stump metastasis is discussed.

Adrenalectomy↗
PubMedDate not supplied

[Urologic monitoring of children with meningomyelocele].

In addition to neuropediatrical, neurosurgical and orthopedical care a continuous urological surveillance is indicated in children with myelodysplasia. Urodynamic assessment, voiding cystourethrography, kidney- and residual urine, ultrasound, excretory urography and radioisotope studies at birth and periodically until puberty are performed to evaluate the urinary tract. Early and specific treatment of bladder dysfunction is necessary to prevent urinary infection and preserve renal parenchyma. Urodynamic testing showed evidence of neurogenic bladder dysfunction in 13 of 14 evaluated children (including 8 newborns): detrusor-sphinkter-dyssynergia in 57 percent, detrusor hyperreflexia in 21 percent and detrusor areflexia in 14 percent. 4 of 5 children with detrusor-sphkincter-dyssynergia were treated effectively with anticholinergic agents and clean intermittend catheterization.

Adolescent↗
PubMedDate not supplied

Prognostic value of p27Kip1 and p21WAF/Cip protein expression in muscle invasive bladder cancer.

Two genes, namely p27Kip1 and p21WAF/Cip1 that reveal distinct structural homology, have been identified as inductors of cell cycle arrest at the G1-checkpoint to prevent entry of somatic cells into the S phase of the cell cycle when substantial DNA damage has occurred. It was demonstrated that the p21WAF/Cip1 gene is induced by pathways dependent and independent from a functionally intact p53 tumour suppressor protein. It has been suggested that decreased expression both of the p21WAF/Cip1 and p27Kip1 protein may contribute to the development of human malignancies due to loss of critical antiproliferative mechanisms. So far, the role of altered p21WAF/Cip1 and mainly of a decreased p27Kip1 protein expression in patients with muscle invasive bladder cancer has not been investigated. In the present study, 50 tumour specimens from 50 patients undergoing radical cystectomy (T2-T4) were investigated for different biological and clinical characteristics as possible prognostic factors: age, depth of tumour infiltration (T-stage), histological grading (G), lymph node status as well as immunohistochemical staining for the p21WAF/Cip1 and p27Kip1 proteins. The median recurrence-free survival for patients with and without retained p21WAF/Cip1 protein expression was 54 months (3-86 months) and 13 months (1-40 months), respectively (p=0.07). During univariate analysis, loss of p21WAF/Cip1 protein expression (p=0.02), T-stage (p=0.02) and histological grading (p=0.03) were significant prognostic factors for survival, among which a negative reaction for the p21WAF/Cip1 protein (p=0.02) as well as T-stage (p=0.005) remained independent significant predictors during multivariate analysis. Loss of p27Kip1 protein expression was not correlated with the recurrence-free or the overall survival of the patients. Prospective studies are needed to confirm the independent prognostic potential of cell-cycle associated proteins such as p21WAF/Cip1 in patients with muscle invasive bladder cancer. The availability of more refined prognostic factors should assist decision making regarding the value of more aggressive treatment options, such as adjuvant or neoadjuvant chemotherapy, for defined subgroups of patients.

Adult↗