Search PubMed⌕ Search

Biomedical subjects

J L Weinerth

Publications and source records attributed to J L Weinerth.

At least 37 records · Page 2Linked to original sources
PubMed1985

Complications of percutaneous nephrostolithotomy.

In 224 patients, renal stones were removed from the urinary tract using either direct extraction with a basket or forceps (59 patients), ultrasonic lithotripsy (164 patients), or infusion chemotherapy (one patient). Residual stone fragments were present more frequently in patients treated with ultrasonic lithotripsy (27%) than with direct extraction (5%). Other complications included hemorrhage (eight patients), catheter dislodgement (four patients), large amounts of urine extravasation (three patients), glycine ascites (three patients), infection (two patients), pneumothorax (one patient), and a prolonged ileus (one patient). More complications occurred among the first 50 patients than the last 50 patients, even though more difficult cases, including patients with staghorn calculi, were accepted during the latter period. Although a learning curve exists, complications can be minimized by attempting to treat more favorable cases during the initial experience.

Extravasation of Diagnostic and Therapeutic Materi↗
PubMed1985

Percutaneous approach to nephrolithiasis.

Percutaneous techniques were successful in removing stones from 101 (92%) of 110 kidneys attempted. Ultrasonic lithotripsy was used on 80 kidneys in 74 patients with stones 5-38 mm in diameter. The most common complication was incomplete disintegration with retained stone fragments. Twenty patients were treated by direct stone extraction, either by a stone basket or forceps. The average hospitalization for percutaneous stone removal of 10 days was not significantly different from that for open nephrolithotomy. However, patients undergoing percutaneous stone removal had only a 3-10 day convalescence after hospital discharge before returning to normal activity.

Adolescent↗
PubMed1984

Xanthogranulomatous pyelonephritis in renal transplant recipient.

Xanthogranulomatous pyelonephritis is reported in the native kidney of a renal allograft recipient. Immunoglobulin deposition in the transplant kidney in the absence of cell-mediated rejection, accompanied by selective cultures showing Escherichia coli from the native kidney, led to the diagnosis. Native nephrectomy resulted in resolution of the patient's chronic bacteriuria and creatinine elevation.

Adult↗
PubMed1984

Modified Johnson basket for antegrade stone extraction.

A modification of a classic Johnson stone basket has been made, such that this basket can pass easily over an angiographic guide wire. With this modification, the Johnson stone basket is an excellent instrument for use in an antegrade or a retrograde fashion for retrieving impacted ureteral calculi. Eleven patients had ureteral calculi manipulated. Of the six ureteral calculi manipulated with standard retractable baskets, only three were successfully extracted from impacted positions. Of the five manipulated with the modified Johnson stone basket, however, four were successfully extracted. The modified Johnson stone basket is an essential instrument in percutaneous manipulation of ureteral calculi.

Humans↗
PubMed1984

Long-term management of vasovasostomy patients.

Follow-up of 54 patients undergoing modified single-layer bilateral vasovasostomies are presented with attention to semen quality, pregnancy rates, and postoperative findings potentially inhibiting fertility. The technical success rate was 98%, but 3-month semen analyses varied from "poor" (less than 20(6)/ml; greater than 50% normal motility) of 20% to "excellent" (greater than 26(6)/ml; greater than 50% normal motility) of 35% without effect on long-term pregnancy rates, 50% and 54.5%, respectively. Other factors, such as sperm clumping, prostatitis, and immunologic interference, appear to decrease motility. Close follow-up with attention to factors affecting fertility other than simple concentration and motility are rewarding.

Adult↗
PubMed1984

Percutaneous dissolution of renal calculi using ultrasonic litholapaxy.

The surgical treatment of renal calculi has been markedly changed by percutaneous manipulation and ultrasonic dissolution. The low morbidity and decreased cost of this procedure make it an obvious choice over classic surgical operations. We report our experience with percutaneous ultrasonic stone dissolution in 23 patients.

Adult↗
PubMed1980

Bilateral nephrectomy by the posterior approach.

The experience with 94 patients undergoing bilateral nephrectomy suggests that the posterior retroperitoneal approach has lower morbidity and mortality than transabdominal procedures. In addition, the lack of transgression of the peritoneal cavity facilitates the possible use of chronic peritoneal dialysis in the future management of these patients. The circumstances in which bilateral nephrectomy is indicated are reviewed.

Adolescent↗
PubMed1978

Extraperitoneal gas following nephrectomy: patterns and duration.

The amount and duration of extraperitoneal gas in normal patients after major renal operations have not been documented. This air may be difficult to separate from that owing to abdominal abscess and, therefore, can be a potential source of diagnostic error in the febrile postoperative patient. A prospective study was performed on 41 postoperative patients to determine the incidence, duration and pattern of extraperitoneal gas in patients undergoing renal operations. No patient had an abscess. Of the abdominal films obtained between 1 and 4 days postoperatively 92 per cent demonstrated gas, 71 per cent were positive between 5 and 8 days and 61 per cent were positive between 9 and 12 days postoperatively. Over-all, 34 of 41 patients had extraperitoneal gas demonstrated on the postoperative abdominal radiographs. Linear and bubbly patterns were demonstrated and, in many cases, the appearance was indistinguishable from that of an abscess. It is important that the benign nature of this postoperative gas be appreciated and not mistaken for an abdominal abscess.

Abdomen↗
PubMed1977

Ureteral obstruction of solitary kidneys by iliac artery aneurysms.

Two patients with solitary kidneys had ureteral obstruction caused by iliac artery aneurysms. Both patients were treated successfully with ureterolysis and temporary proximal diversion. Iliac artery aneurysms generally remain asymptomatic; however, patients may have urologic complaints (such as hematuria, flank pain, anuria, or a pulsatile urinary stream), and severe complications may develop as a result of an obstructive uropathy. Diagnosis is confirmed by cystoscopy when a mass is present, intravenous pyelography, retrograde pyelography, and arteriography. Treatment must be individualized with consideration of the etiology of the aneurysm and condition of the patient. Surgical correction of the aneurysm may be appropriate. Ureterolysis, with proximal diversion as a temporary safety valve, is a useful procedure particularly when the patient has a solitary kidney.

Aged↗
PubMed1977

Minimal mortality of renal surgery.

Eight hundred fourteen renal operative procedures were reviewed to determine overall mortality and to identify patients at risk. The over-all mortality was 1.35%, but as high as 30% in patients with uremia and spesis. Carcinomatosis contributed to higher mortality in other groups. In the absence of these three factors renal surgery was associated with very low or no postoperative (thirty day) mortality.

Adolescent↗
PubMed1977

Long-term results with forty-five living related renal allograft recipients genotypically identical for HLA.

During the past decade 45 living related renal allografts have been performed between siblings genotypically identical for HLA. In each case all available family members were serotyped and haplotype analysis was performed. Immunosuppressive therapy consisted of standard azathioprine and prednisone regimens. Only one instance of HLA-D incompatibility was documented. HLA-A, -B haplotypes were identical in each case. Histopathological evaluation by light, immunofluorescence, and electron microscopy was completed. Four patients experienced acute cellular rejection with mild long-term impaired renal function. Five patients had acute cellular rejection but subsequently experienced long-term normal renal function. Twenty-three patients had little or no rejection documented and half of these patients are being maintained without steroid therapy. Five patients had histologically proven acute humoral rejection and, of these, three subsequently lost their allografts whereas two regained relatively normal renal function. Recurrent glomerulonephritis was documented in six cases. One was lobular, one crescentic, and one dense-deposit membranoproliferative glomerulonephritis. Three cases of IgA nephropathy were diagnosed. In each case the recurrent glomerulonephritis reflected the same histopathology and clinical course as the disease realized in the host kidneys. Eighty-seven percent of the 40 surviving patients have been rehabilitated completely and are fully employed.

Follow-Up Studies↗
PubMed1977

Experimental basis for intraoperative calculus localization by ultrasound.

Experiments were conducted in order to prove the usefulness of ultrasound, B-Scan and A-Mode, and A-Mode alone in the localization of small (3 to 10 mm) fragments of foreign materials in renal substance. Clinical experience indicates that stone fragments as small as 3 mm can be localized intraoperatively using A-mode alone, sterilized with gas for use in a surgical field.

Diagnostic Techniques, Surgical↗
PubMed1976

Surgical validation of angiographic studies of renal lesions.

We reviewed 428 renal arteriograms done during a 5-year period to document the accuracy of angiography in the diagnosis of renal mass lesions and non-function. Subsequently, 198 kidneys (46%) were explored for treatment and diagnostic confirmation. Of the kidneys explored 87 (44%) were radiologically diagnosed as benign cysts. At exploration 6 diagnostic errors were proved, including 3 malignant and 3 benign lesions. The falsely negative malignancy rate was 3% in this category. The angiographic diagnosis of definite tumor was proved to be 100% accurate at operation. However, 3 tumors were benign, representing an 8% falsely positive diagnosis for malignancy. Of the kidneys explored 8% were angiographically diagnosed as being indeterminate. A variety of lesions were found, including 1 benign tumor, 1 malignant tumor and 5 inflammatory lesions. Two malignant lesions were found when exploring angiographically defined hydronephrosis. The remaining kidneys explored carried various diagnoses and were all proved to be correct surgically. Operative mortality was 0.5% but 9 kidneys with benign lesions were sacrificed owing to diagnostic indecision.

Adenocarcinoma↗
PubMed1976

Renal transplantation between HL-A haploidentical donor-recipient pairs: functional and morphological evaluation.

Fifty-nine recipients received renal allografts from an HL-A haploidentical family member. Immunogenicity of the incompatible haplotype was measured by skin grafts exchanged within each family when possible, and renal allograft recipients were assigned prospectively to two groups depending on the skin graft survival time (Group 2A greater than 15 days; Group 2B less than 15 days). If skin grafts could not be accomplished, the patients were place in an unclassified group, Group 2. Renal function at one and 2 years following engraftment did not differ between the two groups. Mixed lymphocyte stimulation of recipient lymphocytes by mitomycin-treated donor lymphocytes also was comparable in the groups. Histopathological evaluation by light, immunofluorescence, and electron microscopy at least 6 months following allografting did not distinguish between the groups. The only differentiating characteristic was that Group 2A patients did not experience their primary rejection episode until an average of 18 days following transplantation, whereas Groups 2B and unclassified 2 had their initial primary rejection episode at average days 9 and 5, respectively. In our clinical program, matching for HL-A halotypes continues to be the best predictor for long-term renal function in consanguineous renal transplantation.

Antibody Formation↗