Search PubMed⌕ Search

Biomedical subjects

J Wacksman

Publications and source records attributed to J Wacksman.

At least 55 records · Page 3Linked to original sources
PubMed1990

Suture material in bladder surgery: a comparison of polydioxanone, polyglactin, and chromic catgut.

A comparison of polydioxanone, polyglactin, and chromic catgut suture was performed in 120 rat bladders studying propensity for infection, degree of inflammation, calculogenic potential, changes in urine pH, and suture absorption. None of the sutures predisposed to infection and there was wide variability but no correlation in urine pH. Although initially the polydioxanone incited a greater inflammatory response, by six months all three sutures were similar. The absorption of polydioxanone was slower than chromic catgut suture, but similar to the absorption of polyglactin. There was no significant difference in calculogenic potential between the suture materials tested over a six-month period. Based on this study in rats, polydioxanone suture would appear to be equal to catgut and polyglactin suture in bladder surgery.

Animals↗
PubMed1987

Repair of hypospadias using new mouth-controlled microscope.

The use of optical magnification (loupes) to repair hypospadiac anomalies in children is well known. A mouth-controlled operating room microscope (Zeiss OPMI 6CH Contraves Stand) became available that has been utilized in 34 cases of hypospadias repair which included 13 flip-flap, 4 MAGPI, 14 Hodgson XX (modified Asopa), and 3 other procedures. Other results show that in 2 patients fistula developed and in 1 meatal stenosis. Based on our experience, we believe this new microscope compares favorably with previous results and allows the surgeon to use small sutures with great accuracy.

Humans↗
PubMed1987

Percutaneous pyeloplasty in children: experience in three patients.

Three children with congenital ureteropelvic junction (UPJ) obstruction were treated with percutaneous pyeloplasty. A 22-gauge Chiba needle was placed within the renal pelvis, and the nephrostomy tract was dilated. A full-thickness incision was made endoscopically in the posterolateral wall of the narrowed UPJ. An internal stent was then placed and left in position for 6-8 weeks. Percutaneous surgery was successful in two of three cases. The unsuccessful procedure may have resulted from inadequate UPJ stenting. The authors believe percutaneous pyeloplasty can be safely and successfully performed in children with congenital UPJ stenosis.

Adolescent↗
PubMed1986

Use of the Hodgson XX (modified Asopa) procedure to correct hypospadias with chordee: surgical technique and results.

The management of patients with hypospadiac anomalies requires sound surgical judgment to obtain optimal results. From January 1983 to June 1985, 150 patients were operated on for hypospadias. Of these patients 37 underwent the Hodgson XX (modified Asopa) repair. Two patients suffered urethral fistulas, 1 had meatal stenosis and 1 had mild torsion. No strictures were noted. Based on our findings it appears that the Hodgson XX (modified Asopa) procedure provides excellent results for patients with hypospadias and chordee.

Humans↗
PubMed1986

Low grade pelviureteric junction obstruction with normal diuretic renography.

We report five patients with normal diuretic renograms who underwent Whitaker pressure perfusion testing. They were found to have normal pressure at low flow rates (2-4 ml/min) and an abnormally elevated pressure at high flow rates (8-10 ml/min). Because of persistent symptoms, two patients underwent surgery, while the other three have been followed up. Our findings indicate that a negative diuretic renogram in a well hydrated patient with good renal function may not rule out low grade obstruction. Renal pelvic perfusion at low flow rates as well as high flow rates is recommended to determine better the function of the pelviureteric junction.

Adolescent↗
PubMed1984

Results of early hypospadias surgery using optical magnification.

Between 1977 and 1981, 106 children were operated on for hypospadias anomalies. Of these patients 51 have undergone the modified flip-flap urethroplasty or meatal advancement and glanuloplasty, 30 were repaired using a 1-stage Hodgson or Duckett tube urethroplasty, 10 have completed a 2-stage Belt-Fuqua procedure and 15 were treated for multiple complications. A urethrocutaneous fistula developed in 4 patients (4 per cent), meatal stenosis in 3 (3 per cent) and a transient urethral stricture in 1 (1 per cent). All procedures were performed using optical magnification, 2.5 times during the first 1 1/2 years followed by 4.5 times during the subsequent years. In addition, 58 children completed repair before age 2 years, with a mean age of 16 months, with no difference in complication rate. These results indicate that through the use of optical magnification hypospadias surgery can be accomplished safely using a 1-stage reconstruction repair before the child is 2 years old.

Humans↗
PubMed1983

Initial results with the Cohen cross-trigonal ureteroneocystotomy.

Between January 1976 and December 1980, 109 children with 157 ureters with reflux were seen in consultation. Of these ureters 52 were operated upon using the Cohen cross-trigonal technique, while 105 were followed conservatively. The operative procedure is a complete intravesical ureteral mobilization followed by the creation of a submucosal tunnel across the base of the bladder. Followup studies, including an excretory urogram and voiding cystourethrogram, showed minimal hydronephrosis in 1 ureter and persistent grade I reflux in 1 ureter. Evaluation of these initial results indicates that the Cohen cross-trigonal ureteroneocystotomy is a safe and effective antireflux procedure.

Child↗
PubMed1983

Timing of elective hypospadias repair in children.

Psychological concerns for the timing of medical procedures on children result from the longstanding realization that events and behavioral patterns of childhood have wide-ranging effects on the later behavior of the adult. A review of the literature regarding the effects of surgery on psychological development is presented. Particular reference is made to the impact of genitourinary surgery with specific emphasis on the repair of hypospadias, a congenital anomaly affecting 1:250 to 1:400 live male births. Studies of adults who underwent hypospadias repair as children suggest that they are psychologically different from their peers who did not have this surgery. Specifically, as adults they frequently have sexual difficulty despite erectile competence and they generally occupy less responsible, less competitive, and less independent professions than similarly intelligent cohorts. These findings imply that the experience of hypospadias or its surgical repair may in some way affect psychological development. By examining these experiences in light of emotional and cognitive development and the emergence of body image and sexual identity, predictions for psychologically optimal timing of surgery are made. Importance of the role of the family in the psychological outcome and a discussion of surgical considerations are also provided.

Age Factors↗
PubMed1982

Results of testicular autotransplantation using the microvascular technique: experience with 8 intra-abdominal testes.

Children with intra-abdominal testes comprise a small group presenting for surgical management of the undescended testicle. During the last 4 years 6 children with 8 intra-abdominal testes have undergone testicular surgery. In 7 testicles the technique involved high intraperitoneal division of the testicular pedicle with reanastomosis of the distal spermatic artery and vein to the inferior epigastric artery and vein using the operating room microscope. Microsurgery on the 7 intra-abdominal testicles led to good results in 6 cases. In 1 testicle venous infarction occurred secondary to venous congestion. Although many children with intra-abdominal testes have been managed using the standard Stephens-Fowler technique, we believe that microsurgical reanastomosis will improve the previously reported results.

Adolescent↗
PubMed1980

Cerebellar ataxia, opsoclonus, and occult neural crest tumor. Abdominal computerized tomography in diagnosis.

A 9-month-old female with opsoclonus and ataxia was examined. Computerized axial tomography (CT) of her abdomen identified a retroperitoneal mass of neural crest origin that was not recognized by more conventional roentgenographic methods. The syndrome of cerebellar ataxia, myoclonus, and opsoclonus, and its relationship to neural crest tumors is reviewed along with the usefulness of abdominal CT.

Cerebellar Ataxia↗
PubMed1980

Screening excretory urography in patients with cryptorchidism or hypospadias: a survey and review of the literature.

Hypospadias and cryptorchidism constitute common problems in urology for which the use of routine screening urography has been challenged recently. To assess better current thinking 233 urologists who devote a significant part of their practice to children were surveyed as to the number of procedures performed as well as to the instances when excretory urography was obtained. Of 163 physicians who responded 70 per cent do not favor routine screening urography in cryptorchid patients, while approximately 50 per cent believe that it is worthwhile in hypospadias. In the cryptorchid responses there was a definite decrease in the percentage of physicians obtaining x-rays as the yearly volume of cases increased (50 per cent with less than 10 cases per year and 18 per cent with greater than 20 cases per year), while this relationship was not maintained for hypospadias. A review of the literature correlates well with this survey in that excretory urography is not necessary in cases of cryptorchidism but its value is still debated in cases of hypospadias.

Cryptorchidism↗
PubMed1980

Technique of testicular autotransplantation using a microvascular anastomosis.

The use of the operating room microscope to accomplish microscopic anastomosis is gaining wider application. The technique to accomplish autotransplantation of the intra-abdominal testes involves division of the spermatic artery and vein with reanastomosis to the inferior epigastric vessels under the operating room microscope. The over-all success rate cannot be assessed without long term follow-up study, but this procedure offers more potential success than vascular pedicle division alone and will eliminate staged orchiopexy.

Cryptorchidism↗
PubMed1979

Techniques of urinary undiversion surgery in children.

During the past eight years, reestablishment of previously diverted urinary tracts has become more frequent. During the past three years, 11 patients have been evaluated and 7 subsequently operated on to reestablish continuity of the urinary tract. Four patients were eliminated from surgical consideration because of the extent of renal disease. The surgical procedures involve the use of ileum as well as the transureteroureterostomy with the psoas hitch procedure to reestablish urinary continuity. Examination of the over-all results illustrates urinary undiversion surgery in children is worthwhile. The initial results with neuropathic bladder disease has been a little discouraging, and more data will be required before a conclusion can be reached.

Adolescent↗
PubMed1979

Use of penile corporeal injection to assess coronal hypospadias.

Coronal hypospadias is a frequent abnormality of the genitalia. It is recommended that patients with coronal hypospadias be assessed with the technique of penile corporeal injection during anesthesia and any patient with coronal hypospadias should be circumcised with the utmost caution and surgical discretion.

Child↗