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Biomedical subjects

J A Stock

Publications and source records attributed to J A Stock.

At least 37 records · Page 2Linked to original sources
PubMed1997

Distal urethroplasty and glanuloplasty procedure: results of 512 repairs.

OBJECTIVES: We describe the distal urethroplasty and glanuloplasty (DUG) procedure, a modification of the Thiersch-Duplay method, and report indications, outcomes, and complications. METHODS: In all, 512 children with glanular, coronal, or subcoronal hypospadias variants underwent the DUG procedure. RESULTS: Follow-up demonstrated excellent functional performance and cosmetic appearance. Complications included 5 fistulae, 2 meatal stenoses, and 4 distal breakdowns of the distal neourethra. The incidence of complications requiring secondary procedures was 2.1% for the entire group. CONCLUSIONS: The DUG repair has allowed us to repair virtually all distal hypospadias variants using the Thiersch-Duplay method. The combined use of the Heineke-Mikulicz meatoplasty in patients with a stenotic meatus and the glanuloplasty as described by Zaontz has allowed the DUG repair to achieve excellent cosmetic and functional results.

Humans↗
PubMed1997

Insurability of children with congenital urological anomalies.

PURPOSE: We sought to determine life insurance underwriting practices for children diagnosed with multicystic dysplastic kidney or unilateral neonatal hydronephrosis, and evaluate whether management options (observation versus operative intervention) have an influence on such practices. MATERIALS AND METHODS: A questionnaire and history of 1 child with multicystic dysplastic kidney and 1 with unilateral neonatal hydronephrosis were distributed to 348 insurance companies licensed to issue life insurance policies in New Jersey. The medical director of each insurance company was requested to indicate the current underwriting practices for life insurance policies based on these 2 case scenarios, and asked whether observation or operative intervention influenced such decisions. RESULTS: Of the 348 insurance companies licensed to issue life insurance 130 (37.4%) responded, including 5 (3.8%) that did not choose to participate in the study, 56 (43.1%) that did not issue life insurance to children and 69 (53.1%) that completed the questionnaire based on current life insurance underwriting practices. For a child with multicystic dysplastic kidney 10 companies (14.5%) would issue life insurance if treatment involved observation only, while 49 (71%) would do so after nephrectomy. For a child with unilateral neonatal hydronephrosis 19 (27.5%) companies would issue life insurance if treatment involved observation only, while 46 (66.7%) would do so after pyeloplasty. CONCLUSIONS: Despite limited long-term data on and uncertainty about the natural course of multicystic dysplastic kidney and unilateral neonatal hydronephrosis, treatment options offered a child with a congenital urological anomaly may have a significant impact on the ability to obtain life insurance. Children with multicystic dysplastic kidney and unilateral neonatal hydronephrosis can usually obtain life insurance after early operative intervention (nephrectomy and pyeloplasty, respectively), although sometimes at higher cost.

Child↗
PubMed1996

Carcinoma of the breast metastatic to the ureter presenting with flank pain and recurrent urinary tract infection.

Urinary tract infection in the female patient is not an uncommon finding. Flank pain associated with urinary tract infection is usually due to calculus disease or pyelonephritis. In patients with history of breast carcinoma, metastasis to the periureteral area with resulting obstruction should be considered. The incidence of metastatic breast carcinoma presenting in this fashion is as high as 7.8 per cent. This case shows a patient with metastatic lobular carcinoma of the breast with ureteral obstruction, causing flank pain and recurrent urinary tract infection. This report emphasizes the importance of long-term follow-up in patients with history of breast cancer, especially invasive lobular carcinoma, and the high degree of suspicion required to diagnose and institute proper therapy.

Aged↗
PubMed1996

Appendiceal cecoplication: a modification of the Malone antegrade colonic enema procedure.

Bowel dysfunction is common in patients with neurogenic bladder dysfunction. In 1990 Malone combined the principles of antegrade colonic washout and the Mitrofanoff nonrefluxing catheterizable channel to produce a continent colonic stoma, the antegrade colonic enema (ACE) procedure. This procedure provides a catheterizable channel through which antegrade washouts are given to provide efficient colonic emptying. We present our modification of the ACE procedure, the appendiceal cecoplication.

Adolescent↗
PubMed1995

Ketoconazole for prevention of postoperative penile erection.

OBJECTIVES: To determine if ketoconazole, an inhibitor of testosterone synthesis, can prevent postoperative spontaneous erections in patients undergoing penile surgery. METHODS: Ketoconazole was administered to 8 patients, aged 14 to 42 years, who underwent penile surgery. All patients received ketoconazole 400 mg orally three times daily starting on the day of surgery. Liver function tests were obtained preoperatively and after the completion of treatment. RESULTS: Ketoconazole successfully prevented erections in all patients. None of the patients demonstrated liver function abnormalities. CONCLUSIONS: Ketoconazole is a reliable method to prevent postoperative penile erection. With the proper monitoring of liver function tests and the avoidance of drug interactions, ketoconazole therapy also appears to be safe.

Adolescent↗
PubMed1995

Fibrous hamartoma of infancy: a report of two cases in the genital region.

OBJECTIVES: Fibrous hamartoma of infancy (FHI) is an uncommon subcutaneous proliferative lesion usually found in the upper portions of the body, particularly in males during the first 2 years of life. We report 2 cases of FHI in the genital region. METHODS: We retrospectively reviewed the charts of children treated at Children's Hospital and Health Center, with FHI located in the genital region. RESULTS: We report 2 cases of FHI in the genital region, 1 involving the scrotum and 1 the labium majus. CONCLUSIONS: FHI should be considered in the differential diagnosis of genital masses in children. The histologic features are characteristic, local excision of the tumor is curative, and the local recurrence rate is low.

Child↗
PubMed1995

Correlation of renal biopsy and radionuclide renal scan differential function in patients with unilateral ureteropelvic junction obstruction.

To understand better the relationship among radionuclide renal scan differential function, renal histology and the outcome of pyeloplasty we performed ipsilateral renal biopsies in a series of patients undergoing primary pyeloplasty. A total of 17 consecutive patients with unilateral ureteropelvic junction obstruction underwent renal biopsy at the time of pyeloplasty. Biopsies were examined systematically after sections were stained with hematoxylin and eosin, periodic acid, Schiff, Jones modified silver or Masson trichrome stains, and they were reviewed by 1 pathologist. Biopsy results were correlated with preoperative and postoperative radionuclide renal scan differential functions. Patient age ranged from 1 month to 7 years (mean 19.8 months). Renal biopsy was abnormal in 6 kidneys, of which 5 had a preoperative differential function of less than 33%. None of these kidneys had evidence of postoperative improvement in renal function on followup scans despite a technically successful result. All remaining 11 kidneys had normal biopsies and a preoperative differential function of greater than 44%. We conclude from these data that patients with ureteropelvic junction obstruction with a differential function of less than 35% have a high probability of significant histological changes on biopsy and a low probability of postoperative improvement in differential function.

Biopsy↗
PubMed1995

Distal hypospadias.

Distal hypospadias, where the urethral meatus is located subcoronal or more distal, is one of the most common congenital anomalies in males. The embryology and etiology of hypospadias, timing of repair, surgical techniques, anesthesia for and complications of hypospadias repair are reviewed.

Humans↗
PubMed1995

Hematuria in children. A practical approach.

The investigation of hematuria in children should never be allowed to pose a greater risk to the child's health than does the problem itself. For this reason, angiography and cystoscopy are rarely employed in the evaluation. The evaluation of the child should proceed methodically and rest firmly on a well-taken history and results of physical examination. The microscopic examination of the urinary sediment is the cornerstone of the evaluation process and can itself suggest the origin of the hematuria. Red cell casts, if present, indicate glomerulonephritis and obviate further urologic evaluation. Genitourinary imaging should be tailored to each clinical situation.

Algorithms↗
PubMed1995

Neonatal circumcision.

Circumcision remains the most common operation performed in males in the United States. When performed by an experienced operator, circumcision is usually a safe and simple operation. The medical benefits of circumcision appear to exceed the risks of the procedure. The history, embryology, indications, techniques, and complications of neonatal circumcision are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1994

The management of proximal hypospadias using a 1-stage hypospadias repair with a preputial free graft for neourethral construction and a preputial pedicle flap for ventral skin coverage.

A total of 77 patients with proximal hypospadias underwent a 1-stage hypospadias repair using a preputial free graft for neourethral construction and a preputial pedicle flap for ventral skin coverage. Of the patients 84% achieved excellent functional and cosmetic results with 1 procedure.

Follow-Up Studies↗
PubMed1988

Inhibition of human leukaemic thymidylate kinase and L1210 ribonucleotide reductase by dinucleotides of adenosine and thymidine and their phosphonate analogues.

Dinucleotides of adenosine and thymidine in the ApnT series (n = 3,4,5 and 6) and their corresponding phosphonate analogues, where a methylene group replaces the oxygen between the alpha and beta phosphorus atoms adjacent to thymidine, have been evaluated as inhibitors of human leukaemic thymidylate kinase (dTMP kinase, EC 2.7.4.9) and ribonucleotide reductase (EC 1.17.4.1) from L1210 cells. Ap3T, Ap4T, Ap2cpT and Ap3cpT were poor inhibitors of both enzymes. Ap5T, Ap6T and their phosphonate analogues were potent inhibitors of dTMP kinase, possibly acting as bisubstrate analogues (IC50 values: Ap5T, 7.9 microM; Ap4cpT, 5.8 microM; Ap6T, 5.4 microM; Ap4cpT, 4.0 microM). For CDP reductase, where these compounds may bridge activity/effector sites on the M1 subunit of the enzyme, Ap5T and Ap6T were inhibitors with IC50 values of 14.4 microM and 20.3 microM respectively. The phosphonate series of compounds was far less active. The thymidine moiety of the compounds was essential for inhibition since Ap5A was inactive against both enzymes. dTTP, although a poor inhibitor of thymidylate kinase was a potent negative effector of CDP reductase (IC50, 19.3 microM). Significantly, Ap5T was not hydrolysed to release dTTP under the conditions of the assay. These studies show that the activities of both enzymes may be modulated by nucleotide analogues.

Adenosine↗
PubMed1988

Dinucleotide analogues as inhibitors of thymidine kinase, thymidylate kinase, and ribonucleotide reductase.

P1-(Adenosine-5')-Pn-(thymidine-5') tri-, tetra-, penta-, and hexaphosphates (ApnT) plus the analogues with a methylene group alpha, beta to the thymidine residue (ApncpT) were synthesized by coupling the appropriate two nucleotides, having activated one by morpholine. These were tested as potential dinucleotide inhibitors of thymidine kinase, thymidylate kinase, and ribonucleotide reductase. All three enzymes bind ATP and thymidine or its nucleotides and therefore might be inhibited by dinucleotides containing adenosine and thymidine. Ap5T and Ap6T strongly inhibited all three enzymes (IC50 = 2.4-20 microM). Ap4cpT and Ap5cpT also strongly inhibited the two kinases (IC50 = 4-20 microM) but were much weaker inhibitors of the reductase (IC50 = 130 and 230 microM).

Adenine Nucleotides↗
PubMed1987

Synthesis and ribonucleotide reductase inhibitory activity of analogues of 2,3-dihydro-1H-imidazo[1,2-b]pyrazole (IMPY).

A series of derivatives of the ribonucleotide reductase inhibitory anti-tumour agent 2,3-dihydro-1H-imidazo[1,2-b]pyrazole (IMPY), including all the methyl analogues, have been synthesised. IMPY itself caused 50% inhibition of L1210 tumour-derived ribonucleotide reductase at a concentration of 0.39 mM, comparable with enzyme obtained from other sources. The analogues proved to be no better than IMPY, either as inhibitors of this enzyme or of the growth of L1210 cells in vitro. No correlation was apparent between biological activity and position of substitution.

Antineoplastic Agents↗