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Biomedical subjects

J M Kaufman

Publications and source records attributed to J M Kaufman.

At least 127 records · Page 7Linked to original sources
PubMed1983

Antegrade pyelography in ureteric duplications with obstructed upper segments.

Percutaneous puncture under fluoroscopic control followed by antegrade pyelography was employed in three children, two of them neonates, suspected of having complete duplication of the ureter with obstructed upper segments on the basis of the excretory pyelographic and ultrasonographic findings. This simple, uncomplicated and definitive method confirmed the diagnosis and demonstrated the course, termination and effects of the dilated ectopic ureter.

Abnormalities, Multiple↗
PubMed1982

Fascial sling for stress urinary incontinence.

Pubovaginal fascial sling operation was done on 15 women with severe stress urinary incontinence who either had had previous unsatisfactory retropubic procedures or had markedly abnormal urethral function determined by extensive urodynamic evaluation. Overall success was 93%, the only failure being in a woman with total loss of bladder and urethral innervation. While the operation is often difficult and temporary postoperative urinary retention common, the high continence rate in a particularly difficult group of patients justifies its use over other operative approaches.

Fasciotomy↗
PubMed1981

Plasma levels of ethinylestradiol (EE) during cyclic treatment with combined oral contraceptives.

The purpose of the present study was to extend the still limited data concerning ethinylestradiol (EE) plasma levels after repeated daily ingestion of a combination pill during the course of classical cyclic treatment. Plasma EE levels were followed in 13 volunteers throughout, in total, 19 treatment cycles with either a 50 ug EE (+ 125ug d-norgestrel) or a 30 ug (+ 150ug d-norgestrel) containing oral contraceptive. In addition, single plasma EE determinations were performed in 110 chronic oral contraceptive users. Whereas different patterns in plasma EE levels (sampling 24 hours following last pill ingestion) were observed among the different volunteers, the mean levels increased progressively during treatment and reflected closely the differences in dosage. The values obtained in the volunteers at the end of the treatment cycle showed important interindividual variations. The findings during a first treatment cycle or during the following ones were similar and for different treatment cycles in the same patient, the patterns in plasma EE levels were consistent. The results for single plasma determinations in chronic contraceptive users (sampling between 8th and 21st day of treatment cycle, 9 to 24 hours since last pill ingestion) showed more pronounced interindividual variations, the individual EE levels being not correlated to parameters such as body weight, body surface, months of oral contraception prior to the study, sex hormone binding capacity or day of the cycle. However, significant differences in mean plasma EE levels were noticed for patients treated with different commercial preparations with identical EE content, suggesting the existence of differences in bioavailability. The relevancy of plasma EE determinations is discussed and from the results of the present study, it is concluded that a strictly standardized time of sampling is an absolute condition for obtaining interpretable results.

Contraceptives, Oral↗
PubMed1981

Operative management of stress urinary incontinence.

A total of 132 women with stress urinary incontinence underwent thorough radiographic and urodynamic evaluation in private urologic practice. With heavy reliance on the readily available technique of bead-chain cystography to differentiate between types I and II abnormalities, and to demonstrate the extent of bladder neck descent, the surgical success rates were 95.8 per cent over-all and 97.3 per cent using the Marshall-Marchetti-Krantz procedure. Postoperative complications were minimal and infrequent except for urinary retention in 31.7 per cent, which was managed easily by intermittent self-catheterization that allowed early hospital discharge without an indwelling catheter.

Female↗
PubMed1981

Effect of domperidone on prolactin (PRL)and thyrotrophin (TSH) secretion.

Domperidone, a novel dopamine receptor blocking substance, unable to cross the blood brain barrier, was tested in twenty euthyroid volunteers of both sexes and in seven women with autonomous nodular goiter. Oral administration of 20 mg domperidone was followed by marked increase in serum PRL in all subjects; the response, being significantly greater in women as compared to men, was maintained in patients with autonomous goiter. The PRL response after oral domperidone was significantly greater than after 200 micrograms TRH intravenously. The PRL response obtained with oral domperidone followed by 200 microgram TRH i.v. was similar to the response obtained with domperidone alone before TRH administration. In euthyroid men the TSH response to 200 microgram TRH administered intravenously 120 min after oral domperidone was significantly greater than in a control TRH test. The data of the present study suggest that dopamine blockade at pituitary (or median eminence) level is able to stimulate maximally the lactotrophs and emphasize the important role of the dopaminergic system in the interrelated regulation of TSH and PRL secretion at the pituitary level.

Administration, Oral↗
PubMed1980

Complications of electrohydraulic lithotresis.

The urologic literature reports excellent success with minimal complications utilizing electrohydraulic lithotresis for bladder calculi. Our recent experience with 10 patients suggests that small stones of struvite/carbonate apatite composition can be fragmented easily, but larger stones, particularly of uric acid or oxalate composition, may be better handled by open cystolithotomy. Failure to disrupt stones occurred in 6 patients. Significant complications developed in 3 of these patients, including breakage of the electrode tip in 2 and sepsis in another related to prolonged operative time.

Adult↗
PubMed1980

Potentiation of warfarin by trimethoprim-sulfamethoxazole.

Potentiation of warfarin by trimethoprim-sulfamethoxazole (TMP-SMX) has been reported occasionally but not in the urologic literature. Three cases are presented in which significant bleeding developed when TMP-SMX was added for the patient already on warfarin anticoagulants. The mechanism of this interaction is uncertain but probably involves competitive protein binding by the two drugs.

Aged↗
PubMed1980

Mycoplasma pneumonia with fulminant evolution into diffuse interstitial fibrosis.

A fatal case of interstitial pneumonia caused by Mycoplasma pneumoniae with fulminant evolution into diffuse interstitial fibrosis is reported. Treatment with tetracycline and corticosteroids failed to arrest the progress of the disease. Fatal Mycoplasma pneumoniae infections have been reported previously and some degree of pulmonary fibrosis has been described in a few cases but as far as could be ascertained there are no other well-documented cases of diffuse interstitial fibrosis with proved Mycoplasma pneumoniae infection.

Adult↗
PubMed1979

Urodynamics in stress urinary incontinence.

Stress urinary incontinence was evaluated urodynamically in 86 women in private urologic practice. While 31 patients had failed prior surgical repairs and 58 patients (67.4 per cent) reported irritative symptoms of frequency, nocturia, urgency and urge incontinence unstable bladders were found in only 5 women (5.8 per cent) over-all, in 6.5 per cent of those patients failing a previous operation and in 8.6 per cent of those patients with irritative symptoms. Urethral pressure profiles were decreased mildly in patients with, compared to those without, stress urinary incontinence but considerable overlap existed and no improvement was seen in 20 patients cured with an operation. Excretory urography, post-voiding residual urine volumes and sphincter electromyography usually were normal. Women with stress urinary incontinence consistently showed poor transmission of cough to the urethra so that the intravesical pressure exceeded the intraurethral pressure.

Adult↗
PubMed1978

Bladder injuries associated with cesarean section.

Bladder injury during cesarean section is unusual and may occur by failure to empty the bladder preoperatively, inadequate bladder flap reflection or incision into the vagina rather than the lower uterine segment. Three bladder injuries during cesarean section are reported. Although 2 women recovered normally 1 has persistent vesicoureteral reflux. With liberalization of indications for cesarean section bladder injuries may be seen more frequently.

Adult↗
PubMed1978

Complications of permanent bladder catheter drainage in spinal cord injury patients.

We reviewed the effect of permanent bladder catheter drainage on the course of 59 long-term spinal cord injury patients. Current renal function, findings on excretory urography and major renal, bladder, genital and urethral complications were tabulated. Although all long-term spinal cord injury patients had severe renal function, depression and abnormal excretory urograms patients with indwelling bladder catheters had a significantly higher complication rate than those managed without an indwelling catheter.

Adult↗
PubMed1977

Functional striated sphincter component at the bladder neck: clinical implications.

Anatomical proximal extension of the striated urethral sphincter muscle towards the bladder neck was assessed functionally in normal male subjects and in patients with upper motor neuron lesions. Synchronous cystosphincterometric studies were performed and urethral pressure responses were studied (contraction complexes) at the vesicourethral junction, the supramontane prostatic urethra and the membranous urethra to repeated bulbocavernosus stimuli. All subjects demonstrated positive responses at the membranous urethra. Contraction complexes with amplitudes of less magnitude were elicited at the vesicourethral junction and at the supramontane prostatic urethra in 48 and 71 per cent of the total number of subjects, respectively. The functional significance of the striated muscle component at the bladder neck in patients with detrusor-striated sphincter dyssynergia is described.

Adolescent↗
PubMed1977

Bladder cancer and squamous metaplasia in spinal cord injury patients.

The influence of long-term indwelling urethral catheterization was studied by random bladder and urethral biopsies in 62 spinal cord injury patients. Six patients (10 per cent) had diffuse squamous cell bladder carcinoma, 4 of whom had no tumor visible endoscopically. Five of the patients with cancer were among 25 patients (20 per cent) managed with an indwelling urethral catheter for more than 10 years (average 21 years, range 15 to 30 years). The other cancer patient had been free of the catheter for 27 years after suprapubic cystotomy for 4 years. Gross and microscopic hematuria was associated with cancer. Squamous metaplasia of the bladder was significantly greater in patients who had been catheterized for more than 10 years (80 per cent), compared to those catheterized for less than 10 years (42 per cent) and patients without catheters (20 per cent). Urethral squamous metaplasia increased slightly in long-term catheterization patients. Urinary infection was universal and did not distinguish patients with inflammation, metaplasia or cancer. Therefore, the duration of indwelling catheterization seems to be the major factor in squamous changes in these patients.

Adult↗
PubMed1977

Prostatectomy in factor XI deficiency.

Factor XI deficiency, an uncommon inherited coagulopathy characterized by an absence of bleeding history but bleeding after an operation or trauma, has not been reported previously in urologic patients. The diagnosis is made by a specific factor assay after an abnormal partial thromboplastin time and the treatment is fresh frozen plasma. Four patients with factor XI deficiency underwent open prostatectomy and all experienced excessive postoperative bleeding and prolonged hospitalization. Treatment with fresh frozen plasma controlled bleeding in 3 patients, 1 of whom suffered congestive heart failure from the fluid load imposed. The fourth patient bled heavily despite fresh frozen plasma and required several additional procedures and 29 units of blood and packed cells.

Aged↗
PubMed1976

Compensatory renal adaptation after progressive renal ablation.

A quantitative study of compensatory adaptation in renal growth, function, and blood flow after progressive renal ablation was performed in the rat. Four weeks after surgery, renal mass increased 31% in control animals (Group A), 81% in nephrectomized rats with 50% ablation of total renal mass (Group B), and 168% in rats subjected to 75% ablation of total renal mass (Group C). Whole animal glomerular filtration rate (GFR) was reduced to 68% of control levels after nephrectomy (Group B), while renal blood flow (RBF) was 81% of control. Similarly, RBF was 68% of control in Group C with ablation of 75% of renal mass, while GFR was reduced to 49% of control. Since the adaptive increases in RBF exceeded those of GRF, the filtration fraction fell from 0.39 in Group A to 0.35 in Group B, and to 0.29 in Group C. Mean nephron GFR (whole animal GFR per total number of glomeruli) was 47 nl per min in Group A and increased 60% to 76 nl per min in Group B and 136% to 112 nl per min in Group C. Compensatory changes in mean nephron blood flow (RBF per total number of glomeruli) exceeded those of nephron filtration rate. Mean nephron blood flow increased from 215 nl per min in Group A to 404 nl per min in Group B (88%) and to 724 nl per min in Group C (237% over contol). These data indicate that the compensatory changes in growth, function, and blood flow after resection of renal mass correlate with the amount of tissue removed. Changes in RBF parallel but exceed those of mass and function, especially after extensive renal ablation. No apparent limitation to the compensatory response was seen under the conditions of this study.

Adaptation, Physiological↗