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Biomedical subjects

F F Marshall

Publications and source records attributed to F F Marshall.

At least 127 records · Page 7Linked to original sources
PubMed1984

The influence of epididymal agenesis on the development and maturation of the testis: experimental model and clinical correlations.

The August X Copenhagen (ACI) rat provides an excellent model to study the effect of congenital epididymal anomalies on testicular function. Despite epididymal absence, testicular maturation and function are unchanged until puberty. At puberty, with increased testicular fluid and spermatozoa output, involution of germinal epithelium occurs. This involution is similar to the changes seen with ligation of the efferent ductules of the epididymis. These findings suggest that in this mammalian model the testis functions normally until the pubertal period. At that time, because of proximal epididymal agenesis and failure to reabsorb testicular secretions, intratesticular hydrostatic pressure increases with rapid germinal epithelial atrophy. Clinical correlations are made in patients with epididymal abnormalities, especially in association with undescended testis.

Animals↗
PubMed1984

Ureteropelvic junction obstruction in adults.

Ureteropelvic junction obstruction (UPJ) in adults is more common than generally appreciated. It may mimic other diseases and may be associated with abdominal pain, hypertension, and recurrent pyelonephritis. Diagnosis and surgical correction were frequently delayed with an average duration of symptoms of 3.2 years for 31 adult patients. Only 4 adults (13%) were diagnosed at the time of their initial onset of symptoms. Nephrectomies were performed on 24 per cent of renal units. Accessory lower pole renal vessels were found in 52 per cent of the adults with UPJ obstruction, twice the rate found in children. Intravenous digital subtraction angiography and diuretic radionucleotide renography should be considered in the evaluation of an adult patient with a UPJ obstruction because of the high rate of accessory vessels. If accessory vessels are present on the contralateral side, especially postnephrectomy, there is heightened concern for the remaining kidney and close follow-up with ultrasonography is recommended.

Adolescent↗
PubMed1984

A new technique for management of renal cell carcinoma involving the right atrium: hypothermia and cardiac arrest.

A 36-year-old man presented with massive edema below the axillae, pleural effusion and renal cell carcinoma with a tumor thrombus extending up the vena cava to the right atrium. A metastatic evaluation was negative otherwise. Hypothermia, cardiac arrest and temporary exsanguination in conjunction with cardiopulmonary bypass were used to create a bloodless field for excision of the renal cell carcinoma and its tumor thrombus. The patient has had total resolution of all symptoms and edema. Hypothermia and cardiac arrest facilitated greatly surgical excision and may be a useful adjunct in the excision of malignancies with massive involvement of the great vessels or heart.

Adenocarcinoma↗
PubMed1984

In situ management of renal tumors: renal cell carcinoma and transitional cell carcinoma.

In the last 8 years 15 patients with malignant neoplasms in functionally solitary kidneys underwent in situ excision of the tumor with preservation of renal parenchyma. Of 10 patients with renal cell carcinoma 8 underwent partial nephrectomy, 1 had a central wedge resection and 1 had enucleation of 3 tumors. After followup of 6 months to 4.7 years 6 patients are free of disease. One patient died of metastatic cancer and 1 of cardiovascular disease. Of 5 patients with transitional cell carcinoma of the kidney (including 2 with parenchymal invasion) 2 underwent partial nephrectomy and 3 underwent extensive resection of renal pelvic lesions. After followup of 6 months to 7 years 2 patients are alive, 2 died of metastatic disease and 1 died of metastatic bladder carcinoma. Only 1 of the 5 patients had locally recurrent tumor. These data demonstrate the efficacy of in situ management of renal tumors in selected patients with solitary kidneys or compromised renal function.

Adenocarcinoma↗
PubMed1983

Spectrum of unrecognized posterior urethral valves in the adult.

The spectrum of symptoms and findings associated with posterior urethral valves can vary and mimic other conditions. Three cases of congenital posterior urethral valves in adult males are presented. Two patients were on dialysis with end-stage renal failure at the time of diagnosis after many earlier urologic evaluations. One patient subsequently received two cadaver renal transplants. The remaining patient presented with typical symptoms of prostatitis and was found to have posterior valves with a dilated posterior urethra and intraprostatic reflux on voiding cystourethrography.

Adult↗
PubMed1983

Therapeutic embolization of the kidney with detachable silicone balloons.

Detachable silicone balloons were used for therapeutic renal artery embolization in 14 patients. Hematuria was controlled by occlusion of the arteriovenous fistulas in 6 patients and aneurysms in 3. The method was used for preoperative occlusion of the renal artery in 4 patients with renal cell carcinoma and for renal ablation in an attempt to cure hypertension in 1 additional patient. Detachable silicone balloons offer a safe and precise method for the occlusion of traumatic arteriovenous fistulas and aneurysms of the renal artery branches. Although balloon embolization also can be applied to the preoperative occlusion of renal neoplasms the conventional embolization techniques using absorbable gelatin sponge and coils are equally effective with less expense. No complications were observed in our 14 patients.

Adenocarcinoma↗
PubMed1983

Intraoperative localization of renal calculi.

Various techniques are available for the intraoperative localization of renal calculi. Newer fiberoptic systems have improved nephroscopy. Intraoperative x-rays employing mammography film can identify radiopaque renal calculi 1 to 2 mm in diameter. Coupled with intraoperative x-rays, ultrasonography allows rapid, essentially three-dimensional localization of both radiopaque and radiolucent stones. A recent technique of intraoperative pneumopyelography may also serve as an adjunct to intraoperative radiography.

Adult↗
PubMed1983

Multilocular renal cysts in adults. Possible relationship to renal adenocarcinoma.

Three grossly typical multilocular renal cysts are described. In one case, results from cytologic examination of a cyst aspirate were suggestive of malignancy. In this and the second case, histologic examination revealed cysts lined by attenuated to pump epithelium, with mild cytologic atypia and clear cytoplasm. The third case, arising in the clinical setting of chronic renal insufficiency, had the above histologic features as well as papillary proliferations and septal invasion by clear cells, interpreted as a renal adenocarcinoma. Although the preoperative evaluations in each case were suggestive of a multilocular cyst, a cystic or partially necrotic adenocarcinoma could not be ruled out. The concept of renal adenocarcinoma arising in a multilocular cyst is controversial. Because the natural evolution of multilocular cysts is indolent, these papillary and clear cell changes may represent a malignant neoplasm or a peculiar atypical hyperplasia.

Adenocarcinoma↗
PubMed1982

The diagnosis and management of spontaneous rupture of the ureter.

Spontaneous rupture of the ureter is rare. It usually is associated with calculous disease and most often occurs in the upper ureter. The surgical management includes drainage of the urinoma and proximal nephrostomy drainage with urinary reconstruction if necessary. Even with good surgical management secondary nephrectomy sometimes is required. The clinical course of 2 patients is described and the literature is summarized.

Adult↗
PubMed1982

Nonlymphomatous metastatic tumor to the testis.

A patient with pancreatic carcinoma presented with an initial left testicular mass that proved to be metastatic adenocarcinoma of the pancreas. Regional spread of the pancreatic carcinoma may have created venous and lymphatic obstruction with inferior passage of tumor emboli to the testis. A summary of nonlymphomatous secondary tumors of the testis also is presented.

Adenocarcinoma↗
PubMed1982

Testicular atrophy associated with agenesis of the epididymis in the ACI rat.

The male ACI rat has a congenital Wolffian duct defect manifested by unilateral agenesis of the kidney, ureter, seminal vesicle, ductus deferens, and most of the epididymis. In the adult the testis on the affected side is markedly smaller than the contralateral testis and spermatogenesis is absent. In addition, in vitro perfusion of the affected testis revealed significantly less testosterone secretion than did the contralateral testis. Moreover, electron microscopy revealed that the smooth endoplasmic reticulum of the Leydig cell was significantly decreased. Thus, the affected testes clearly showed deranged spermatogenesis and Leydig cell structure and function. The ACI rat model may provide insight into the potential effects of congenital epididymal abnormalities on the testis of the human.

Animals↗
PubMed1982

Computerized tomography in the diagnosis of transitional cell carcinoma of the kidney.

We present 8 patients with transitional cell carcinoma of the kidney who underwent preoperative computerized tomographic examination of the lesions. The computerized tomographic findings are discussed and are correlated with the conventional radiographic appearance. The tumor presents on computerized tomographic examination as a solid mass in the renal pelvis and/or in a ballooned calix, with displacement and compression of the renal sinus fat. It shows attenuation values of 8 to 20H and enhances minimally after intravenous injection of iodinated contrast material. Trapping of contrast material in curvilinear caliceal spaces or in compressed collecting ducts around the periphery of the tumor results in crust-like rims of contrast density tightly and persistently encircling portions of the tumor. Retention of contrast material in obstructed tubules results in accentuated delayed enhancement of the renal parenchyma surrounding the larger lesions. A striated parenchymal pattern, secondary to uneven collecting duct obstruction, also may be seen on delayed views. The reniform contour of the kidney usually is preserved even in the presence of larger neoplasms.

Adenocarcinoma↗
PubMed1982

The urological evaluation and management of patients with congenital lower urinary tract anomalies prior to renal transplantation.

Previously, patients with chronic renal failure and major congenital anomalies of the lower urinary tract (often with urinary diversion) were thought to be poor candidates for renal transplantation. Pre-transplant evaluation and possible urinary reconstruction are essential in these patients to achieve successful renal transplantation. Ten patients, including 7 adults, presented with congenital anomalies of the lower urinary tract that were responsible for renal failure. Percutaneous suprapubic cystostomy aided in the assessment of bladder function. Undiagnosed posterior urethral valves were found in 2 adults. Patients with exstrophy, neurogenic bladder or a contracted bladder (with augmentation cystoplasty) had urinary drainage into the bladder at the time of renal transplantation. Sometimes an imperfect bladder can be used for urinary drainage with transplantation but, otherwise, intestinal conduits are still a viable alternative.

Adult↗
PubMed1981

Control of prolonged, benign, renal hematuria by silver nitrate instillation.

Four patients with protracted benign hematuria underwent silver nitrate instillation of the upper collecting system. The doses varied from 10 ml. of 0.25 per cent silver nitrate to 14 ml. of 1 per cent silver nitrate. In all 4 cases the hematuria resolved within four days without significant complications. At follow-up extending from three to twenty-four months there have been no recurrences of gross hematuria. Silver nitrate instillation appears to be a safe and effective method of treating benign renal hematuria, thus obviating the need for extirpative surgery.

Adult↗