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Biomedical subjects

K N Walton

Publications and source records attributed to K N Walton.

At least 19 recordsLinked to original sources
PubMed1987

Kidney changes after extracorporeal shock wave lithotripsy: appearance on MR imaging.

The occurrence of changes in the kidneys after extracorporeal shock wave lithotripsy (ESWL) was evaluated with magnetic resonance (MR) imaging in 34 patients, utilizing T1-weighted spin-echo pulse sequences. Five of the 34 patients underwent bilateral ESWL therapy before MR imaging. Of the 39 kidneys studied, 29 (74%) showed one or more changes on MR imaging: subcapsular or perinephric fluid (n = 10), focal (n = 16) or diffuse (n = 8) loss of the corticomedullary junction (CMJ), and focal areas of increased (n = 7) or decreased (n = 3) signal intensity. The CMJ changes were more prominent with increasing numbers of shock waves administered during the procedure. These relatively subtle changes detected on MR imaging may not be apparent with other imaging techniques. The long-term clinical significance of these findings is not yet known, although no apparent serious renal pathologic condition was detected.

Adult↗
PubMed1987

Sonographic evaluation of renal stones treated by extracorporeal shock-wave lithotripsy.

Real-time sonography was performed on 94 patients the day before and at 24 and 48 hr after extracorporeal shock-wave lithotripsy (ESWL) therapy. The ability of sonography to detect renal stones before ESWL, changes in the calculi after ESWL, and the occurrence of pre- and post-ESWL hydronephrosis was evaluated. Abdominal radiographs and linear renal tomography were used as the standard of comparison. Six other patients had sonography only either before or after ESWL. One hundred patients had a total 105 kidneys treated; 18 kidneys with more than three stones were not included. The other 87 kidneys had 102 stones evaluated by sonography before having ESWL; 66 stones (65%) were identified and 36 were not. Of those calculi not seen, 10 were less than or equal to 5 mm in diameter. Nineteen of the other 26 stones were in the ureter or at the ureteropelvic junction. Comparison of sonograms of 80 kidneys obtained before and after ESWL revealed no change in 37 (46%), more stones or fragments detected in 23 (29%), fewer stones or a change in location in 12 (15%), and an apparent decrease in the size of the original stone in eight (10%). Hydronephrosis was detected by pre-ESWL sonography in 16 kidneys (20%) and was noted to develop after ESWL in 20 (31%) of the 64 other kidneys. These results indicate that the ability of sonography to detect renal calculi is related not only to stone size but also to location. The clinical significance of pre- and post-ESWL hydronephrosis found by sonography must be considered in conjunction with the patient's symptoms, laboratory data, and other radiographic studies. Therefore, the routine use of sonography in the post-ESWL patient does not seem warranted.

Humans↗
PubMed1986

Nonmetastatic bladder cancer associated with hypercalcemia, thrombocytosis and leukemoid reaction.

We reviewed 4 patients with urothelial bladder cancer and hypercalcemia but without evidence of bony metastasis. Of the patients 2 presented with a leukemoid reaction (1 also had thrombocytosis). None of the patients had evidence of bone metastases or other causes of hypercalcemia, such as hyperparathyroidism, sarcoidosis or vitamin D intoxication. All 4 patients received aggressive therapy for the tumors. In each instance the serum calcium returned to normal following radiation therapy or tumor removal, lending support to the theory of humoral hypercalcemia of cancer. A diagnostic and therapeutic approach to such patients is outlined.

Aged↗
PubMed1984

10-year experience with adenocarcinoma of the bladder.

Adenocarcinoma is an uncommon form of bladder carcinoma. We review our 10-year experience with primary adenocarcinoma of the bladder in 28 patients who were managed by a wide range of therapeutic modalities. Our data reaffirm the highly aggressive nature of this lesion. However, aggressive therapy is justified when feasible.

Adenocarcinoma↗
PubMed1984

Transluminal balloon dilation of ureteral strictures.

Ureteral strictures are uncommon problems in urological practice. The nonvascular application of the Grüntzig balloon catheter is proposed as an alternative to surgery in some of these patients. We treated 6 ureteral strictures in 5 patients by balloon dilation with an 83 per cent success rate.

Adult↗
PubMed1981

Secondary tumors of penis.

The penis, despite its rich vascular supply, is a very uncommon site of metastatic tumor. When present, the prognosis is extremely poor. Four cases of secondary tumors of the penis are presented and the literature reviewed.

Adenocarcinoma↗
PubMed1979

Unusual cause of acute urinary retention in a child.

A five-year-old child presented with a history of acute urinary retention for eighteen hours. Extensive diagnostic evaluation proved the presence of a retrovesical pelvic mass, which on surgical exploration was found to be an acutely inflamed appendix.

Acute Disease↗
PubMed1978

Experience with the Horton-Devine dermal graft in the treatment of Peyronie's disease.

We treated 15 patients with Peyronie's disease surgically with the dermal graft technique described by Horton and Devine. Details of the preoperative management and surgical technique are provided. Return of normal sexual function without residual chordee or pain was achieved in more than 75 per cent of the patients, suggesting that this is the procedure of choice in the management of severe Peyronie's disease.

Adult↗
PubMed1978

Evaluation of human chorionic gonadotropin and alpha fetoprotein in benign and malignant testicular disorders.

The marker proteins alpha fetoprotein and human chorionic gonadotropin are useful adjuncts to clinical evaluation of patients with non-seminomatous testicular germ cell malignant growths during and after therapeutic interventions. Measuring both markers is better than measuring either one alone. An elevated marker assay indicates the presence of active disease. A normal marker assay does not exclude active disease being present. Lastly, these markers are of limited usefulness in the evaluation of undiagnosed testicular masses.

Adolescent↗
PubMed1977

Reconstruction of male external genitalia with elephantiasis.

The surgical rehabilitation of a patient with severely deformed and functionally disabled genitalia due to long-standing lymphedema and infection is described and illustrated. The term "elephantiasis" has been applied to such gross lesions. Appropriate surgery to the penis, scrotum, and perineum has yielded a gratifying result. The principles and techniques of the surgical approach in such an undertaking are presented and discussed.

Axilla↗
PubMed1977

Unsuspected renal tumors associated with renal cysts.

A series of renal tumors associated with renal cysts is presented. Prior to surgical exploration appropriate diagnostic studies failed to indicate evidence of the presence of neoplastic lesions. The importance of surgical exploration of avascular "benign" renal masses is emphasized.

Adenocarcinoma↗
PubMed1976

Hypertension as complication of vesicoureteral reflux in children.

Eight cases are reported of female children presenting with hypertension and found to have primary vesicoureteral reflux with chronic pyelonephritis. In 6 patients renal function was essentially normal while 2 had azotemia and progessive renal deterioration. As a result of early surgical intervention in the form of antireflux procedures, occasionally combined with unilateral nephrectomy for renin-dependent lesions, 5 of the 8 had complete disappearance or amelioration of hypertension with stabilization of renal function. The interactions of each member of the triad--vesicoureteral reflux, pyelonephritis, and hypertension--are reviewed with emphasis on pertinent pathophysiologic concepts regarding their roles in the production of progressive renal deterioration.

Adolescent↗
PubMed1976

Ileal conduit urinary diversion. Ten-year review.

The experience with ileal conduit urinary diversion at Emory University and Affiliated Hospitals over a ten-year period is presented. Included in this review are patients with benign and malignant disease. The indications, technique, results, and complications of this type of urinary diversion are considered. Some differences between ileal conduit diversion of children and adults are discussed.

Adolescent↗
PubMed1976

Gunshot wounds of the ureter: a 15-year review of 63 consecutive cases.

We reviewed 63 consecutive cases of gunshot wounds of the ureter seen during a 15-year period. The importance of prompt recognition and aggressive surgical management is emphasized, with particular attention being placed on adequate debridement and spatulated splinted watertight ureteroureterostomy. Our philosophy of management for individual injuries is discussed along with our complications and results. This series is the largest reported to date of ureteral gunshot wounds.

Adolescent↗
PubMed1975

Urologic complications in renal transplantation.

Our ten-year experience with 141 kidney transplants is reported. Fifty per cent of the grafts are presently functioning, and 22 patients have been followed more than five years. A urologic complication rate of 13 per cent occurred, but 84 per cent of those patients retained their grafts. Only 1.3 per cent of patients with urologic complications died. Improved results can be achieved by good operative technique and aggressive management of complications.

Adult↗