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Biomedical subjects

J F Redman

Publications and source records attributed to J F Redman.

At least 181 records · Page 10Linked to original sources

Extensive nephrolithotomy in previously operated solitary kidneys.

The surgical management of 2 patients with large dendritic calculi in previously operated solitary kidneys is presented. Complete nephrolithotomy was accomplished in situ using the anatropic nephrotomy technique of Smith and Boyce. Postoperatively a circle tube nephrostomy was used. The surgical management as described is recommended as an alternative to extracorporeal nephrolithotomy with autotransplantation or simple nephrectomy and dialysis.

Adult↗

Renal angiomyolipoma.

An unusual case of a patient with tuberous sclerosis who presented initially with renal symptoms is presented. Electromicroscopic observations showed the smooth muscles to contain myofilaments and an unusual amount of glycogen. Although the response of the tumor vessels to epinephrine in angiomyolipoma is considered similar to that of renal cell carcinoma in that no vasoconstriction occurs, the reverse occurred in our case. A thin, lucent cleavage line around portions of the periphery of the angiomyolipoma was also noticed. Isolated angiomyolipoma in patients without tuberous sclerosis is difficult to differentiate from renal cell carcinoma; therefore, radical nephrectomy is usually the treatment of choice. Angiomyolipomas associated with tuberous sclerosis are easier to diagnose and are multiple and bilateral; therefore, a more conservative approach usually is indicated.

Adult↗

Unusual masses in the spermatic cord: report of six cases and review of the literature.

Differential diagnosis of spermatic cord swellings includes direct inguinal hernia, hydrocele, spermatocele, hematocele, lipoma, tuberculosis, and filariasis. This communication focuses attention on other unusual swellings of the spermatic cord. Three cases of sarcoma, two cases of foreign body in the spermatic cord, and one case of vasitis are presented. Although unusual, these conditions should be considered in the differential diagnosis of spermatic cord swellings.

Adolescent↗

Medical management of urolithiasis.

Knowledge of the crystalline structure of the calculus provides the basis of the therapeutic plan. Laboratory evaluation depends heavily upon routine urinalysis. Assessment of renal function, serum calcium, phosphorus, uric acid and, in some cases electrolytes is usually indicated, as is urography. General principles of management include maintenance of an ample urine volume, eradication of infection and correction of any obstructing lesions or metabolic abnormalities. Specific antistone regimens are indicated for patients with recurrent urolithiasis.

Anti-Bacterial Agents↗

Rapid formation of a staghorn calculus in the canine kidney. A surgical model.

A model for immediate production of staghorn calculi in dogs is described. A paste made of gray investment is injected into the renal pelvis and allowed to solidify for 30 min. Calculi thus formed have a striking similarity to naturally occurring staghorn calculi and can be utilized by urology teaching programs to initiate residents in the technique of anatrophic nephrolithotomy.

Animals↗

Unsuspected duplex ureters.

Three cases of unsuspected duplex ureters are presented. It is suggested that nonvisualizing upper pole segments should be suspected whenever a duplication occurs on the contralateral side regardless of the radiographic appearance.

Adult↗

Instrument to facilitate nephrostomy.

An instrument to facilitate the placement of a nephrostomy tube is described. The techniques for performing nephrostomies are historically reviewed.

Drainage↗

Penile horn.

A case of penile horn is reported. Its occurrence is uncommon, and treatment consists of excision.

Humans↗

Evaluation of Sacks solution for hypothermic preservation of kidneys.

The efficacy of Sacks solution for hypothermic preservation of dog kidneys was determined. Complete ischemia was produced in one kidney for thirty minutes by clamping the renal pedicle in situ, followed by excision and immediate washout with the cold preservation fluid. Kidneys were stored in Sacks solution at 2 degree C. for forty-eight hours, reimplanted in the donor, and the normal, contralateral kidney was removed. Complete reversal of renal impairment with long-term survival was observed in 2 of 9 animals. Of 7 animals with graft failure, 2 showed the beginning of a tendency to reverse a rising serum creatinine at the time of death or sacrifice. In the remaining 5, creatinine rose unrelentingly until death or sacrifice occurred. The observed 22 per cent survival rate was significantly (p less than 0.05) less than the 83 per cent survival reported by Sacks, Petritsch, and Kaufman. Evidence suggestive of intrarenal deposits of MgHPO4-3H2O was found in 2 of 4 dogs sacrificed for graft failure. This raises questions of the solution's safety as well as its efficacy. We are unable to confirm the success of the original investigators with this new preservation solution.

Animals↗