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Biomedical subjects

F B Scott

Publications and source records attributed to F B Scott.

At least 19 recordsLinked to original sources
PubMed1999

Scanning electron microscopy of the second-instar larva of Gasterophilus nasalis.

The second-instar larva of the bot fly Gasterophilus nasalis (L.) (Diptera: Gasterophilidae) is described for the first time, based on scanning electron microscope (SEM) studies. On the pseudocephalum the larva bears an antenomaxillary sensory complex formed by the antenna (coeloconic sensilla) and the maxillary palp with a set of six coeloconic sensilla and four basiconica sensilla. The oral opening is latero-posteriorly limited by small spines, and exhibits strongly ornamented maxillae and mandibles. The thoracic and abdominal segments are circled by two bands, each with two rows (except the last segment that has one row) of backwardly pointed spines, and have cuticular depressions. Trichoid and campaniform sensilla surround the larval segments. The anterior spiracular opening is a small aperture. The terminal end of the eighth abdominal segment shows a spiracular cavity, lateral tubercles, eight basiconic and two trichoid sensilla. Each spiracular plate has two slightly curved slits, each with a serrated rima. There is a probable ecdysial scar. The findings of this ultrastructural study are compared with those other of larval flies.

Animals↗
PubMed1993

Pregnancy in patients with the artificial urinary sphincter.

Since 1974, 71 female patients between 3 and 25 years old have undergone implantation of the artificial urinary sphincter for treatment of urinary incontinence. Of these women 9 have become pregnant and delivered 11 normal children. In 2 women the artificial urinary sphincter was removed because of erosion before conceiving, while the remaining 7 had a functional artificial urinary sphincter in place at conception, and subsequent pregnancy and delivery. All 11 women had normal pregnancies and, aside from the normally increased frequency of urination and a slight increase in urinary leakage due to elevated pressure on the bladder from the adjacent uterus, the urinary continence was unchanged. Of the women 4 underwent cesarean section at the advice of their obstetricians and the remainder had uneventful vaginal deliveries. During the course of the pregnancies the patients or their obstetricians consulted 1 of us for advice regarding management of the delivery because of the presence of the artificial urinary sphincter. The normalcy of the pregnancies and deliveries led us to conclude that the presence of a functioning artificial urinary sphincter did not increase the risk of complications during pregnancy and childbearing.

Adolescent↗
PubMed1989

Experience with the artificial urinary sphincter model AS800 in 148 patients.

The latest version of the artificial urinary sphincter, AS800, was used in 148 patients with urinary incontinence of different etiologies. Followup ranged from 3 to 37 months, with an average of 20.8 months. There were 112 (76 per cent) male and 36 (24 per cent) female patients. The cuff was implanted around the bladder neck in 78 patients (53 per cent) and around the bulbar urethra in 70 (47 per cent). Socially acceptable urinary control was achieved in 90 per cent of the 139 patients with active devices in place. It was necessary to remove the sphincter in 11 patients (7.4 per cent). The reasons for removal were infection and erosion in 8 patients (5.4 per cent), infection without erosion in 2 (1.3 per cent), and erosion due to excess pressure and poor tissues in 1 (0.7 per cent). Comparison of success and failure rates associated with incontinence of different etiologies revealed that patients with incontinence after failure of a conventional antistress incontinence operation and those with incontinence after transurethral resection or radical prostactectomy had the highest success rate, and that patients with incontinence secondary to pelvic fracture or exstrophy and epispadias had the highest failure rates. The deactivation feature (the lock) of the new artificial sphincter model was beneficial for primary deactivation, urethral catheterization or cystoscopy, or for elective nocturnal decompression of the bladder neck or urethral tissues.

Equipment Design↗
PubMed1989

The artificial urinary sphincter. Experience in adults.

The author's experience and results of implanting the artificial sphincter into 406 adults from June 1972 through March 1988 are reviewed. The early experience in which the device was pressurized by means of valves has been compared with later experience with the device whose pressure is controlled by means of a balloon. The degree of continence has been assessed according to the model of the device, the etiology of the incontinence, the location of the cuff, and the pressure that was chosen. The patients have been grateful to achieve an improved quality of life with social urinary continence brought about by improvements in the prosthesis. Additional improvements in the fitting of the cuff might bring even better results.

Adult↗
PubMed1988

Iatrogenic chordee following insertion of inflatable penile prosthesis.

Chordee deformity is a rare complication following insertion of the inflatable penile prosthesis through a penoscrotal incision. The deformity occurs as a result of failure to inflate and deflate the device and to maintain the penis against the abdomen in the immediate postoperative period. When this occurs it can be corrected by incision of the fibrous scar and replacement with synthetic graft material.

Humans↗
PubMed1988

Use of the AS800 device in exstrophy and epispadias.

Urinary continence is one of the more difficult goals to achieve in patients with exstrophy or epispadias. The artificial genitourinary sphincter provides an alternative to reconstruction of the bladder neck for management of this problem. Although excellent continence can be obtained with bladder neck reconstruction, results of a second procedure of this type seldom are reported. We used the AS800 device in 16 patients with exstrophy and epispadias, 13 of whom had undergone a prior bladder neck operation. We defined our results as total success and continence success, and have achieved over-all rates of 69 per cent (excludes those awaiting revision) and 90 per cent (those with an active device), respectively. Although the frequency of revision and erosion was significant, the ultimate outcome in this difficult patient group was satisfactory.

Adolescent↗
PubMed1988

The artificial urinary sphincter: review and progress.

Urinary incontinence, the inability to retain urine, creates a misery that cannot be overestimated. The foul odor emanating from the patient repels family and friends to such an extent that it affects the social life of the sufferer. Total incontinence, that is, the continuous loss of urine as opposed to the loss associated with coughing or sneezing, is the most severe type of the malady. For such individuals, the artificial sphincter offers hope for a new life. Incidences of total urinary incontinence as a result of radical prostatectomy in the treatment of carcinoma of the prostate have been reported in the range of 5-50%. Incontinence may occur as a result of injury to the proximal urethra, and it is usually present to some extent in patients with neurogenic bladder dysfunction caused by spinal cord injury, myelomeningocele, or other conditions that affect the micturition centers of the nervous system. Some patients whose urinary tract is completely obstructed and who are therefore unable to urinate, as for example individuals who sustain traumatic complete transection of the urethra with resulting obstructive fibrosis of the urethra, or those patients whose neurogenic spastic sphincter inhibits satisfactory voiding, may benefit from reconstructive surgery or ablation of their pathologic sphincter in order to restore urination. Rehabilitation of such patients can then be complete with implantation of an artificial sphincter to provide urinary control. The alternatives for management include diapers, the placement of external collecting or occlusive devices, or major surgery in which the intestinal tract is used either for conducting the urine to an abdominal collecting bag or as a bladder substitute that is periodically emptied by catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)

Catheterization↗
PubMed1987

Urinary undiversion and implantation of the artificial urinary sphincter in a 73-year-old man.

We report a case of successful urinary undiversion and implantation of an artificial urinary sphincter in a 73-year-old man, who had undergone ileal loop urinary diversion elsewhere for treatment of urinary incontinence secondary to transurethral prostatectomy. The rationale for our decision to perform undiversion is presented. Evaluation of patient history and physical examination are necessary, as well as delineation of the anatomy and function of the upper and lower tracts by laboratory, radiological and urodynamic examinations. Each undiversion case is unique. Treatment must be individualized and should be initiated only after meticulous weighing of the advantages and disadvantages of the different therapeutic alternatives. A complete explanation to the patient is important. Highly satisfying results can be expected in appropriately selected cases.

Aged↗
PubMed1987

Use of fresh placental membranes for bladder reconstruction.

Several biodegradable and artificial materials have been used in the urinary tract for partial or total replacement of the bladder. Most of the graft materials have resulted in stone formation, collapse, rejection, or extrusion of the graft without adequate reconstruction of a functional bladder. In this paper, we present our assessment of the use of placental membranes as a feasible, economic, and acceptable organic agent for bladder reconstruction. Eight mongrel dogs were subjected to supratrigonal cystectomy, and then a 10 X 10 centimeter patch of human placental membrane was sutured to the remaining trigone in a watertight fashion. The dogs were sacrificed twelve weeks after surgery. Histologic examinations revealed evidence of regeneration of normal-appearing smooth muscle along the path of a retracting placental patch, and thus of reconstitution of a normal-appearing and functioning bladder. On the basis of this study, we believe that placental membranes, because of their low antigenic properties and easy availability, provide an excellent graft material for the urinary tract. Further studies concerning the application of this graft material in various pathological conditions are now in progress.

Amnion↗
PubMed1987

Outpatient implantation of penile prostheses under local anesthesia.

Penile implantation can be accomplished safely under local anesthesia on an outpatient basis. This reduces cost and should be considered more frequently than the current practice. The techniques and routines for performing penile implantation under local anesthesia are described.

Ambulatory Surgical Procedures↗
PubMed1986

Inflatable and noninflatable penile prostheses: comparative follow-up evaluation.

This evaluation was conducted with 63 men who were organically impotent and subsequently received either an inflatable penile prosthesis (n = 43), a noninflatable penile prosthesis (n = 14), or both in succession (n = 6). The patient groups were compared for sexual satisfaction, sexual activity, mental status, complications, satisfaction with prosthesis, and relationship changes. The methods of evaluation were the Derogatis Sexual Functioning Inventory and two unstandardized questionnaires. Significant differences were found between the two patient groups: inflatable prosthesis recipients report being more sexually satisfied, more satisfied with their implant, experiencing less psychiatric distress, having a more rapid postsurgical recovery, more sexually active, and experiencing more positive changes in relationships with their partners than do recipients of a noninflatable prosthesis. The data suggest that the inflatable prosthesis may be a more favorable choice for most individuals than noninflatable devices.

Adaptation, Psychological↗
PubMed1986

The impact of the artificial urinary sphincter in the neurogenic bladder on the upper urinary tracts.

The charts and x-rays of 120 neurogenic bladder patients who underwent artificial sphincter implantation for treatment of urinary incontinence between 1973 and 1984 were reviewed retrospectively. Patients were followed for 3 to 130 months (average 36.8 months). The upper urinary tracts remained unchanged in 108 patients (90 per cent). Renal growth in children was undisturbed. Transient hydroureteronephrosis occurred in 8 patients (6.7 per cent) and progressive hydroureteronephrosis occurred in 4 (3.3 per cent). A total of 26 patients with vesicoureteral reflux (39 ureters) underwent ureteral reimplantation. Our results indicate that implantation of the artificial urinary sphincter in neurogenic bladder patients has minimal adverse impact on the upper urinary tracts, followup should be long-term and should include an IVP, outflow obstruction should be eliminated preoperatively by means of external sphincterotomy in male patients and bladder flap urethroplasty in female patients, similarly, adequate emptying of the bladder always must be assured during followup, if hydroureteronephrosis is detected early appropriate treatment can restore normal upper tracts, the presence of previously damaged upper tracts without evidence of obstruction is not a contraindication for artificial sphincter implantation and an antireflux operation in combination with artificial sphincter implantation is feasible.

Adolescent↗
PubMed1985

The use of the AMS-AS800 artificial sphincter for continent urinary diversion. I. Investigations, including pressure-flow studies, using rabbit intestinal loops.

The AS 800 genitourinary artificial sphincter was implanted in 40 New Zealand rabbits to evaluate its possible use for continent urinary diversion. This evaluation included the effects of varying closing pressures of the cuff implanted around isolated bowel loops. Six-weeks postoperative investigations included pressure/flow studies, autopsies, microangiographies and histologic evaluations. The sphincter was able to achieve continence during perfusion of the intestinal loop, maximum pressures being dependent on cuff pressures. Consistent changes were: 1) the formation of a thin fibrous capsule around the subcutaneously implanted pump, 2) the development of a fibrous sheath around the bowel beneath the cuff, and 3) fibrous and peritoneal reactions at the cuff site. In uncomplicated cases, the bowel wall tolerated the cuff pressure well, without macroscopic signs of atrophy. However, sphincter-related complications (1. infection, 2. erosion, 3. reduction of bowel circumference beneath the cuff) were pressure dependent and seen mainly in high pressure groups. Based on these results, the application of the sphincter for continent urinary diversion should include: low pressure urinary reservoirs, low pressure cuffs and most essentially, strict avoidance of infection.

Animals↗