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Biomedical subjects

E K Lang

Publications and source records attributed to E K Lang.

At least 91 records · Page 5Linked to original sources
PubMed1978

Multicystic dysplastic kidney: diagnostic considerations and management.

A protocolled diagnostic approach for assessing various cystic and solid masses occurring in the neonate and infant, with particular emphasis on renal masses, is described. This protocol uses diagnostic examinations in such a sequence as to establish the diagnosis with acceptable confidence by the least invasive procedure and, therefore, at minimal cost in time, money, and risk to the patient. Early definitive diagnosis permits triage of patients into a group benefiting from immediate surgical intervention versus those with entities that can safely be followed up expectantly. Moreover, certain diagnostic procedures such as antegrade pyelography can be expanded to serve therapeutic purposes as a temporizing percutaneous nephrostomy, thus preserving renal parenchyma and hopefully improving the general condition of the neonate until a definitive surgical procedure can be safely undertaken to correct the underlying deficit.

Biopsy, Needle↗
PubMed1978

Brush biopsy of pyelocalyceal lesions via a percutaneous translumbar approach.

Percutaneous translumbar selective brush biopsy of pyelocalyceal and ureteric lesions is simple, permits ready access to all calyces as well as the ureter and renal pelvis, and facilitates multiple biopsies from different sites. The ability to retrieve tissue fragments from between the bristles allows histological diagnosis in addition to a Papanicolaou smear. Selective washings can be obtained for bacteriologic diagnosis; in many instances, cultures taken directly from the lesion proved to be different from samples taken from the bladder urine or renal pelvis. This method can be expanded to serve a means of establishing a temporary percutaneous nephropyelostomy.

Adult↗
PubMed1977

Value of polytomography in study of dysphagia due to vertebral osteophytosis.

Polytomography is a simple, noninvasive procedure useful in the diagnosis, preoperative assessment, and follow-up examination of dysphagia due to vertebral osteophytosis. It is especially recommended for all elderly patients undergoing endoscopy to evaluate possible difficulties or hazards which may be encountered due to the presence of osteophytosis. Tomographic study of the esophagus is recommended for all lesions producing dysphagia at the level of the inherently narrowed space of the thoracic inlet, where routine radiography and fluoroscopy are inadequate.

Adult↗
PubMed1977

Renal cyst puncture and aspiration: a survey of complications.

Complications of cyst puncture and aspiration were analyzed in a survey of 5,674 cases reported by 84 institutions. The mean incidence of major complications was 1.4%. For institutions with extensive experience, the incidence of major complications was 0.75%. Minor complications occurred in probably 10% of all patients but were only detectable at institutions undertaking routine followup. Flexible and malleable equipment for puncture lessened the risk of major complications. Approach to lesions in the upper poles of the kidneys via an oblique pathway using fluoroscopic or ultrasound guidance decreased the risk of pneumothorax compared to direct introduction of the needle through the ultrasound transducer. The incidence of complications did not correlate with number of puncture attempts, gauge of puncture equipment utilized, or completeness of cyst evacuation.

Hemorrhage↗
PubMed1977

Asymptomatic space-occupying lesions of the kidney: a programmed sequential approach and its impact on quality and cost of health care.

Sequential roentgenographic investigation of asymptomatic space-occupying lesions of the kidney is credited with establishing the diagnosis in 84.6% of 940 patients using only two examinations. Two thirds of all patients were diagnosed by relatively noninvasive technics such as infusion nephrotomogram, renal scintiscan, and the cyst puncture and aspiration test complex. Only for 2.3% was surgical exploration required to establish a diagnosis. The accuracy and confidence level of the diagnosis obtained by roentgenographic examinations (97%) compared well to that of surgical exploration (98%). Mortality and morbidity, however, were considerably reduced among patients examined according to the sequential roentgenographic protocol, as was the cost for diagnosis both in money and hospitalization time. The predominance of older patients in the group harboring asymptomatic space-occupying lesions of the kidney calls for an approach capable of establishing the diagnosis with acceptable confidence, but at a minimum cost in time, money, and complications. Our program of a systematized roentgenographic investigation of such lesions appears to provide a protocol capable of meeting these demands.

Angiography↗
PubMed1977

The association of ano-urethral and tracheo-esophageal fistulae (a report of two cases).

Anorectal atresia with recto-urethral fistula is one of the most common congenital anomalies afflicting the hindgut (1,2). The "H-type" ano-urethral fistula, however, is relatively rare, similar to the "H-type" tracheo-esophageal fistula which is the least common such anomaly of that region. The association of an "H-type" tracheo-esophageal fistula and an "H-type" ano-urethral fistula and stricture of the anterior urethra is considered a rare combination of anomalies. Two cases of "H-type" ano-urethral fistula with stricture of the anterior urethra and associated in one instance with an "H-type" tracheo-esophageal fistula and the other with esophageal atresia and tracho-escophageal fistula are reported and comment is made on the interesting underlying embryologic defect.

Humans↗
PubMed1975

Arteriography in the assessment of renal trauma. The impact of arteriographic diagnosis on preservation of renal function and parenchyma.

The efficacy of arteriographic triage of patients who sustained renal trauma into two groups, one optimally handled by early surgical intervention and one in whom conservative management guarantees maximal preservation of renal parenchyma, is discussed, based on a study of 190 patients. A substantial increase in the number of patients managed conservatively (73%) is attributable to use of arteriographic selection criteria. A very low rate of complications (2%) appears to substantiate the validity of the criteria on which the selection was based. Similarly, arteriographic criteria made possible substitution of hemi- or partial nephrectomy in almost 42% of patients who would otherwise have been treated by nephrectomy. A very low rate of complications resultant from this procedure justifies its use in these cases. The very low mortality rate (1.6%) of the present series suggests a bonus contribution of arteriography toward the management of associated intra-abdominal injuries. The safety of angiography and the now general availability of angiographic facilities and skilled personnel on a round-the-clock basis, and the policy-determining information derived from these studies, recommend widespread deployment of this method for the assessment of renal injury.

Aneurysm↗