Biomedical subjects
Publications and source records attributed to J F Redman.
Partial nephrectomy has a place in the management of renal calculous disease. It should be limited, however, only to patients in whom calculi or calcareous material are both demonstrable and inaccessible by any other means or to patients in whom there are discrete areas of distortion, dilatation, or disease predisposing to the formation of stones with stones present.
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Microscopic tumor embolization is an uncommon cause of respiratory insufficiency. This finding has been reported previously in only 2 patients with carcinoma of the prostate. The diagnosis should be suspected in a patient with cancer of the prostate who was unexplained dyspnea or respiratory failure. Treatment consists of either bilateral orchiectomy or hormonal therapy. A case is reported of adenocarcinoma of the prostate with widespread microscopic pulmonary embolization causing respiratory failure.
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Testicular Leydig cell hyperplasia was observed in two brothers presenting with progressive sexual precocity at 2 yr of age. Virilization was shown to result from increased secretion rather than decreased clearance of gonadal testosterone. Testosterone hypersecretion appeared to be gonadotropin independent, as basal and gonadotropin-releasing hormone-induced serum LH concentrations were low by both RIA and bioassay. Adrenal steroidogenesis was demonstrated to be normal by ACTH stimulation, dexamethasone suppression, and split adrenal venous function tests. Testicular histology revealed immature reproductive structures in the 2 yr old, but advanced spermatogenesis in the 3 yr-old brother. The etiology of both Leydig cell hyperplasia and reproductive testicular maturation in the absence of significant gonadotropin secretion remains to be established.
The second case of complete severance of the prostatomembranous urethra without an associated pelvic fracture is reported.
A patient with torsion of a previously operated testicle is reported, and techniques of prophylactic orchiopexy are discussed.
A personal series of consecutive explorations for undescended testes is presented, with particular emphasis on the impalpable testis. It is concluded that without preoperative radiographs an exploration through an inguinal skin incision for either unilateral or bilateral undescended testes will 1) allow for correction of the usually present patent processus vaginalis peritonei, 2) provide for identification of either a testis or blind-ending spermatic vessels and 3) give adequate exposure for the accomplishment of a single stage orchiopexy if indicated regardless of the location of the testis.
Three cases of reflux and a blind-ending duplication of the ureter are presented. Management was by ureteroneocystostomy. This procedure is recommended as an alternative to the arduous excision of the accessory ureter.