Biomedical subjects
Publications and source records attributed to E L Lewis.
A case is reported of congenital absence of left ureter with the left renal pelvis presenting as a diverticulum of the bladder. This occurred in a patient with at least eight other major congenital anomalies.
Videotapes were analyzed to assess sperm motility and morphology in the semen of 5 fertile donors and 20 infertile patients. The slow motion playback control of the video recorder allowed simultaneous assessment of the motility and morphology of individual sperm cells. Similar values were obtained with this method for abnormal morphology more often were immotile or weakly motile than were the normal sperm in the same ejaculates. Normal oval sperm in the semen of infertile men were less likely to be motile and tended to swim more slowly than did morphologically normal sperm in the semen of fertile men.
Successful percutaneous transluminal angioplasty was performed in 3 cases of renal artery stenosis where the effect upon renal blood flow was quantified by video dilution technique. This technique adds important information to pressure gradients and renin assays obtained during the dilatation procedure.
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A series of renal tumors associated with renal cysts is presented. Prior to surgical exploration appropriate diagnostic studies failed to indicate evidence of the presence of neoplastic lesions. The importance of surgical exploration of avascular "benign" renal masses is emphasized.
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To examine the relationship between gross hematuria and sickle cell disorders, all patients admitted to Grady Memorial Hospital with the diagnosis of a sickle cell disorder during a 14-month period were reviewed. Of 115 such patients, 65% had sickle cell disease and 35% had sickle cell trait. None of the former but seven of the latter group had gross hematuria. Mean age of the seven was 30 years. Comprehensive examinations and laboratory studies showed that all were free of concomitant disease. Physical findings, diagnostic modalities, and treatment were reviewed. Findings suggest that conservative therapy (bed rest, hydration, and diuresis) is usually effective.
A case of seminoma in an abdominal testis is presented in which abnormal liver enzyme as well as elevated human chorionic gonadotropin levels were present which returned to normal after surgical extirpation of the primary lesion. A review of pertinent literature and implications of these unusual findings are presented.
The experience with ileal conduit urinary diversion at Emory University and Affiliated Hospitals over a ten-year period is presented. Included in this review are patients with benign and malignant disease. The indications, technique, results, and complications of this type of urinary diversion are considered. Some differences between ileal conduit diversion of children and adults are discussed.
Our ten-year experience with 141 kidney transplants is reported. Fifty per cent of the grafts are presently functioning, and 22 patients have been followed more than five years. A urologic complication rate of 13 per cent occurred, but 84 per cent of those patients retained their grafts. Only 1.3 per cent of patients with urologic complications died. Improved results can be achieved by good operative technique and aggressive management of complications.
A strain of Staphylococcus aureus (no. FAR4) has been isolated at intervals, for 32 months, from the sputum of a patient with cystic fibrosis of the lung. Changes in the properties of isolates of this strain over the first 18 months have been reported previously (Lacey et al., 1973 and 1974). During the last 14 months (May 1973 to July 1974), further evolution has occurred to produce a total of 31 distinct phenotypes. Recent changes are as follows. 1. The ability of isolates to produce penicillinase in vitro was closely correlated with flucloxacillin therapy. Inactivation of flucloxacillin by penicillinase was demonstrated by diffusion testing (but not MIC determination) in vitro and may have occurred to a significant extent in vivo. 2. Lincomycin-resistant mutants slowly disappeared from the sputum after the termination of clindamycin therapy. 3. All of the recent isolates were resistant to erythromycin, possibly because of the linkage of the genes coding for erythromycin resistance with those coding for the production of delta-haemolysin; delta-haemolysin may be an important "virulence factor".
The in-vitro action of the sulphamethoxazole/trimethoprim combination (cotrimoxazole) against coliforms, Proteus spp, and Staphylococcus aureus was re-examined. In nutrient broth the components of cotrimoxazole did not produce bacteriostatic synergy against most sulphonamide-resistant and a significant proportion of sulphonamide-sensitive strains. Any bactericidal action appeared to be due to the trimethoprim component. After addition to urine the combination was only bacteriostatic against most coliforms and Proteus spp over six hours. Further clinical trials are needed to determine the circumstances under which cotrimoxazole is superior to either trimethoprim or sulphonamides against some infections, particularly of the urinary tract.
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Co-trimoxazole was found to have a predominantly bacteriostatic effect upon 28 urinary isolates of Enterobacteriaceae in nutrient broth and was never bactericidal in artificially infected urine. The components of co-trimoxazole were tested individually and trimethoprim was found to be at least as effective as co-trimoxazole in nutrient broth and in urine. Trimethoprim alone produced some bactericidal effect in urine but this was antagonized by sulphamethoxazole. Laboratory tests for evaluating these drugs may give a misleading impression of their activity in vivo. Further clinical comparisons should therefore be made between trimethoprim and cotrimoxazole to determine when trimethoprim should be used in preference to the combination.
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Explore the source record for details and available documents.