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Biomedical subjects

F Hinman

Publications and source records attributed to F Hinman.

At least 55 records · Page 3Linked to original sources
PubMed1980

Alternatives to orchiopexy.

With improved surgical techniques orchiopexy has become possible in patients with cryptorchidism who previously were forced to alternatives, including no treatment at all, a trial of hormonal therapy or orchiectomy. However, the mere presence of a testis in the scrotum may not benefit some patients, that is neither enhancing fertility nor reducing malignancy. A prosthesis may provide comparable appearance and psychologic support. No treatment is indicated in cases of severe mental retardation, ejaculatory failure (as with the prune belly syndrome) and certain endocrine syndromes. Hormonal therapy, helpful in bilateral prepubertal cases, also may be useful in certain endocrine disorders. Orchiectomy is indicated in unilateral cases with severe neurogenic disturbances that preclude ejaculation, in prepubertal patients with 1 abdominal testis and in postpuberal boys with unilateral cryptorchidism at any site. If risk versus benefit is assessed for each patient these alternatives may be better for him than orchiopexy.

Adolescent↗
PubMed1980

Etiologic factors in Peyronie's disease.

The cause of Peyronie's disease remains obscure. Reports based upon limited data reach conclusions that remain unverified. Leads are needed. Can available information open avenues for further studies? From reports in the literature and from observations in the laboratory and on patients, it is probably that two factors are involved; one, an inherent tendency to abnormal production of fibrous tissue; the other, mechanical stresses which stimulate and direct location of deposit. The fibrous tissue production appears to be an individual diathesis, from systemic factors yet undefined. Mechanical stresses, which may incite a latent fibrous response, occur with repeated penile overextension at sexual intercourse and during erections while sleep in the prone position. Such forces could overstretch the dorsal portion of the more rigid and already completely extended deep layer of the tunica albuginea. The repair of these minute lesions would involve laying down of fibrous tissue which, being even less extensible, transmits the stretching force to the uninvolved adjacent tissue; the defect in the latter then heals and contributes to the enlarging plague. Together, the ensuing pain and the deformity reduce the vigor of the erections, thus limit the progression of the disease. The previous findings on the origins of the fibrous tissue are reviewed. Observations on models and tissue by examining the site of the plague, its size and the plane of curvature are described. The course of the disease with and without treatment is described.

Coitus↗
PubMed1980

Syndromes of vesical incoordination.

An analytic approach to the continuum of micturitional disorders is provided, as is a discussion of the pharmacologic regimens that provide symptomatic relief.

Adult↗
PubMed1979

Unilateral abdominal cryptorchidism.

The unilateral non-palpable undescended testis is considered separately from other forms of cryptorchidism. It is less likely to be fertile, it is more prone to malignancy and it is more difficult to place. Removal rather than orchiopexy often is in the best interests of the child.

Castration↗
PubMed1979

Urodynamic testing: alternatives to electronics.

Electronic urodynamic testing, including bladder pressure, urethral pressure profile, voiding rate and velocity, and electromyography, is expensive in terms of equipment, operator and time. Clinical urodynamic testing, including voiding habits and timing, bladder capacity, residual urine volume, voiding cystography, cystometrography and neurologic evaluation, is readily done in the office. Analysis of common syndromes requiring urodynamic assay shows that clinical urodynamic testing may be more useful than electronic urodynamic testing for appropriate treatment.

Child↗
PubMed1979

Directional growth of renal calculi.

The forces involved in shaping urinary calculi reside in crystalline characteristics and especially in local influences. Box pleves may restrict passage and, by allowing mobility, help shape a round calculus. Fixation, occurring with a rapidly growing infection stone, facilitates initial growth on a matrix mold in a funnel pelvis, further aided by pelviocaliceal paralysis from bacterial endotoxins and later by stasis. Branched calculi are further shaped by contact with the pelvic and infundibular walls. Through pressure and mucous coating they grow only at the ends. Late caliceal obstruction frees the ends for clubbing. Consideration of these forces aids in prognosis and surgical removal, and may offer opportunities for prevention.

Calcium Oxalate↗
PubMed1979

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.

Child↗
PubMed1978

Obstructive renal cysts.

Renal cysts usually are asymptomatic, produce no harm to the kidney and require no treatment once diagnosed. However, an occasional expanding cyst causes progressive obstruction to caliceal or pelvic outflow. Herein is reported observations on 4 patients in whom cysts produced significant obstruction to the pelvic or major caliceal outflow. In 3 cases treatment was by decompression, with resolution of the obstruction. Two requirements must be met for a cyst to obstruct: 1) it must lie at or near the hilus and 2) it must have turgor sufficient to overcome the pressure of the intrapelvic urine. In contrast to most renal cysts those producing significant obstruction require operation.

Adult↗
PubMed1978

Directional growth of renal calculi.

The forces involved in shaping urinary calculi reside in crystalline characteristics and especially in local influences. Box pelves may restrict passage and, by allowing mobility, help shape a round calculus. Fixation, occurring with a rapidly growing infection stone, facilitates initial growth on a matrix mold in a funnel pelvis, further aided by pelviocaliceal paralysis from bacterial endotoxins and later by stasis. Branched calculi are further shaped by contact with the pelvic and infundibular walls. Through pressure and mucous coating they grow only at the ends. Late caliceal obstruction frees the ends for clubbing. Consideration of these forces aids in prognosis and surgical removal, and may offer opportunities for prevention.

Calcium Oxalate↗
PubMed1977

Intermittent catheterization and vesical defenses.

The effectiveness of intermittent catheterization in eradicating bacteriuria in patients requiring catheterization for inadequate voiding was subjected to a mathematical analysis to establish its theoretical basis. It can be shown that, at 1 extreme, with 6 ml. urine remaining in the bladder, assuming reasonable hydration, catheterization must be done at least every 2 to 2 1/2 hours to limit bacteriuria. In contrast, if as little as 0.5 ml. urine is left behind, catheterization may be done every 4 to 5 hours to achieve the same result. Moreover, from the graphic depiction of the calculation it is seen that a reduction in the intervals between catheterization has a much greater effect than an increase in the urinary output in the reduction of the bacterial count. The volume of residual urine after catheterization was directly determined by measurement of phenolsulfonphthalein that was washed out after drainage by catheter in the female dog and in women. In the dog it averaged 0.435 ml. but in women it was somewhat greater than that after normal voiding. Upon applying the equation relating frequency of catheterization and urinary output to residual urine in a clinical program of intermittent catheterization, we found that the usual (convenient) schedule often resulted in showing that an unattainably small volume of urine would have to be left in the bladder. Actual measurement of residual urine by the modified phenolsulfonphthalein test provides the data needed to design a program of intermittent catheterization for each patient that will lead to urinary sterility.

Animals↗
PubMed1977

Reaction of the vesical wall to bacterial penetration: resistance to attachment, desquamation and leukocytic activity.

To determine the contribution of the bladder wall to defense against infection we designed a series of experiments wherein movement of introduced bacteria and inflammatory processes (cystitis) were observed by an autoradiographic technique. As a first defense line the bladder mucosal surface showed strong resistance against bacterial attachment and penetration. Moreover, epithelial cells gripped and penetrated by bacteria were desquamated and eliminated through voiding, thus arresting deeper invasion into the bladder wall. When organisms did penetrate the bladder wall they were phagocytized by polymorphonuclear leukocytes and macrophages in the submucosa and muscularis. In contrast, once leukocytes had migrated into the urine within the bladder they no longer participated in phagocytosis. Organisms also entered the veins, the lymphatics or both and disappeared rapidly from the local site through the action of the reticuloendothelial system. These observations indicate that in addition to mechanical emptying resistance to bacterial attachment, desquamation of invaded cells, activity of leukocytes and macrophages, and disappearance of bacteria from local site are 4 mechanisms whereby the bladder resists and fights infection.

Animals↗
PubMed1977

Reaction of the vesical wall to bacterial penetration: resistance to attachment, desquamation, and leukocytic activity.

To determine the contribution of the bladder wall to defense against infection we designed a series of experiments wherein movement of introduced bacteria and inflammatory processes (cystitis) were observed by autoradiographic technique. As a first defense line, the bladder mucosal surface showed strong resistance against bacterial attachment and penetration. Moreover, epithelial cells gripped and penetrated by bacteria were desquamated and eliminated through voiding, thus arresting deeper invasion into the bladder wall. When organisms did penetrate the bladder wall, they were phagocytized by polymorphonuclear leukocytes and macrophages in the submucosa and muscularis. In contrast, once leukocytes had migrated into the urine within the bladder, they no longer participated in phagocytosis. Organisms also entered the veins, or the lymphatics, or both, and disappeared rapidly from the local site through the action of the reticuloendothelial system. These observations indicate that--in addition to mechanical emptying--resistance to bacterial attachment, desquamation of invaded cells, activity of leukocytes and macrophages, and disappearance of bacteria from local site are four mechanisms whereby the bladder resists and fights infection.

Animals↗