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Biomedical subjects

F Hinman

Publications and source records attributed to F Hinman.

At least 37 records · Page 2Linked to original sources
PubMed1988

Financing residency training in urology.

Five educators concerned with changes occurring in the financing of medical education and care reviewed the present status of residency programs and their financing. Future support depends on political decisions as well as demonstrable needs. The effects of anticipated reductions in funding for residents and their programs may be countered by the development of alternative sources and the restructuring of present programs for more efficient operation. The need for leadership is clear.

Costs and Cost Analysis↗
PubMed1988

Selection of intestinal segments for bladder substitution: physical and physiological characteristics.

Detubularized bowel segments provide greater capacity at lower pressure and require a shorter length of intestine than do intact segments. Four factors account for their superiority: 1) their configuration takes advantage of the geometric fact that volume increases by the square of the radius so that a patch or pouch has a larger diameter than a tube, 2) they accommodate to filling more readily because, as LaPlace's law states, the container with the greater radius and, thus, the greater mural tension will hold larger volumes at lower pressure, 3) compliance is superior to that of the tubular bowel and 4) contractile ability is blunted by the failure of contractions to encompass the entire circumference. For these reasons detubularized segments store more urine at lower pressures.

Biophysical Phenomena↗
PubMed1987

Management of the intra-abdominal testis.

A survey was made of 30 pediatric urologists for their current practice. Localization, important for operative approach, is done by venography and arteriography; ultrasonography, computed tomography and magnetic resonance imaging; and laparoscopy, the last most often immediately before operation. The preferred operation is the long-loop vas orchiopexy; two-stage orchiopexy and microsurgical auto-transplantation are alternatives.

Child↗
PubMed1986

Capsular influence on benign prostatic hyperplasia.

Attention in both research and treatment has been directed primarily at the BPH, that is the periurethral growth rather than to the surrounding prostate. If this growth could be prevented, or if, once developed, the growth process could be reversed, the problem of prostatic obstruction would be solved. At present, no medical solution acceptable to the patient is apparent. Since the capsule assumes such a dominant role in obstruction, equal attention should be paid in laboratory and clinical research on means for reversing the activities of this compressed prostate on BPH and the outflow tract.

Humans↗
PubMed1986

Nonneurogenic neurogenic bladder (the Hinman syndrome)--15 years later.

Every child with day and night wetting is a suspect for vesicourethral dysfunction on a behavioral basis, which, when severe, appears as a syndrome that we have called the nonneurogenic neurogenic bladder. Futile attempts by the child at sphincteric urinary control in the face of uncontrollable bladder contractions not only produce the symptoms but also the anatomical and functional changes: vesical trabeculation, distortion of the ureterovesical orifices and dilatation of the upper tracts, along with residual urine and consequent bacteriuria. These changes are indistinguishable from obstructive or, particularly, neurogenic factors, although these causes must be ruled out. Urodynamic investigations in these children show incoordination between detrusor contraction and the expected but not forthcoming urethral sphincteric relaxation. Since these children usually are toilet trained initially, the incoordination appears to be a learned behavior or habit, perhaps as a response to under-appreciated detrusor contractions. Reversal of the syndrome is achieved by suitable medication and by some form of suggestion or retraining. Reparative operations will fail if done before the system is balanced.

Child↗
PubMed1984

Resident research, part-time.

During residency training, research must be cost-effective in these times of constraint. Its value lies in helping the resident critically analyse each clinical problem and understand the basic physiopathologic processes, in adding new skills, in preparing the resident for an academic career, in improving abilities in writing and speaking, and in providing the satisfaction of accomplishment. The principal limitations on a full year in research are inadequate funds for support and the unwillingness of residents to take that much time out of their clinical training. Alternatives are for the resident to take 1 or 2 afternoons each week during clinical training to work on an ongoing project in an established laboratory or, preferably, to formulate an original project and carry it out under supervision in the departmental laboratory, or in the cystoscopic, operating or outpatient facilities. To do this requires an interested, available preceptor, a stimulating idea (preferably the resident's), a limited experimental design, regular time free from clinical duties, and enough funding and help. Opportunities exist in most programs but enthusiasm and direction is required to realize them. Since a declining number of physicians are applying to the National Institutes of Health, it is important that students and residents become stimulated to enter fields of research. But such stimulation requires support.

Attitude↗
PubMed1983

Accelerated obstruction at the ureteropelvic junction in adults.

Accelerated obstruction at the initially normal or minimally abnormal ureteropelvic junction was seen in 5 kidneys in 4 women after intervals of 2 to 15 years. Three kidneys had to be removed although the patients had been under observation. Hydronephrosis from ureteropelvic junction obstruction does not always progress gradually from the prenatal period but may rapidly increase in the adult without adequate warning.

Adult↗
PubMed1981

Branched calculi: shapes and operative approaches.

Branched calculi (infection stones) typically arise in intrarenal pelves. They expand to touch the pelvic wall and then grow peripherally, keeping contact with the walls of the pelvis and greater than or equal to 1 infundibula. Filling the infundibulum obstructs the calix and allows terminal expansion of the stone. From study of a series of stones such a sequence might be reconstructed. The shape of the calculus and collecting structures was traced and classified from excretory urograms of 50 consecutive renal units. The funnel pelvis, usually intrarenal, contained a stone either extending into the ureteropelvic junction (24 cases) or stopping short of it (9 cases). Pelvic or infundibular and caliceal dilatation around the stone was found in the remaining 8 and 9 cases, respectively. These patterns of growth of branched calculi directly bear on the approaches and technique for the operative removal. Because typical branched calculi arise in the intrarenal pelvis a high transverse intrahilar incision is necessary. Less intrahilar dissection is needed for cases in which the pelvis is dilated above and around the stone. Counter-incisions through the parenchyma or anatrophic nephrolithotomy is reserved for those patients with infundibular obstruction and resulting expanded caliceal stones.

Humans↗
PubMed1981

The future for surgery and the surgical specialties through research and development.

Progress in the field of surgery and its specialties depends on persistent effort in research and development, especially as the work force increases and the disciplines are encroached upon and restricted. The present efforts in research and development are hampered principally because few bright young students and residents select careers in research. The financial return and job security are lower than in the private sector, and few students are exposed to the stimulation and rewards of the laboratory. To have investigators who will actively advance the field, the surgeon must make the research career more attractive and assume the responsibility of recruitment and direction. Working as a role model, side by side with student or resident, the surgeons may hope to transfer their interests to them so that they keep the fields of surgery growing.

Career Choice↗
PubMed1980

Microphallus: distinction between anomalous and endocrine types.

Operative treatment of microphallus has been proscribed in recent reports. It is not indicated for the more common endocrine type because of deficient gonadotropin, primary testicular disorder or end-organ defect. However, an operation may be quite necessary for the other form owing to defective morphogenesis--the anomalous type. Representative cases provide evidence that the method of treatment depends on the type of microphallus.

Diagnosis, Differential↗