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Biomedical subjects

L K Lloyd

Publications and source records attributed to L K Lloyd.

46 records · Page 3Linked to original sources
PubMed1981

Intraoperative roentgenography in the surgical removal of renal calculi.

Complete surgical removal of staghorn or multiple renal calculi is extremely difficult. Intraoperative roentgenography has been used to decrease the incidence of residual calculi. We herein assess the effectiveness of intraoperative roentgenography and emphasize important operative technical aspects. Between 1973 and 1979, 42 patients underwent 50 operations for the removal of staghorn or multiple renal calculi. Intraoperative roentgenography was used in 47 operations and omitted in 3. Of the 47 operations done with intraoperative roentgenography 31 units were free of stones and 12 had small retained fragments known intraoperatively with verification by postoperative tomography or plain abdominal film. In 1 case of calculus recognized intraoperatively passed during the postoperative period and tomograms demonstrated no residual calculi. Only 3 patients had residual stones postoperatively with negative intraoperative films. The 3 patients who did not have intraoperative roentgenography all had residual fragments. All 3 kidneys were thought to be free of residual stones as determined by visual inspection and nephroscopy. With the aid of intraoperative roentgenography the incidence of residual stones was 23 per cent. Followup for up to 6 years in 45 renal units showed 73 per cent to be free of stones. When properly used intraoperative roentgenography is highly accurate. Films should be obtained before any stones are removed and care should be taken to x-ray the entire kidney even if 2 films are required. Final films should be obtained after all fragments are removed.

Humans↗
PubMed1980

Balloon dilatation of urethral strictures.

Postinflammatory and posttraumatic urethral strictures present a significant clinical problem. Conventional dilatation techniques are usually associated with recurrence and aggravation of the strictures. This is attributed to the mucosal and periurethral trauma associated with conventional dilatation methods. The initial results in seven patients undergoing balloon dilatation for urethral strictures are presented. The method is relatively atraumatic and painless, and better long-term results are anticipated.

Aged↗
PubMed1980

Adjuvant surgical techniques in the removal of staghorn calculi.

Surgical removal of staghorn calculi can be difficult. We describe a retrospective review of 21 patients who underwent 22 operations for the removal of staghorn calculi. Subsequent urinary infections occurred in 30 per cent and recurrent stones developed in 20 per cent of the patients. We emphasize the accuracy and importance of intraoperative roentgenography, the usefulness and morbidity of hemiacidrin irrigation and the postoperative stability of renal function measured by a radionuclide renal function test.

Adult↗
PubMed1980

Intrapartum fetomaternal bleeding in Rh-negative women.

In a series of 1206 consecutive Rh-negative women who delivered Rh-positive infants, fetal erythrocytes were found in the maternal blood of 175 (14.5%) during the postpartum period. In 12 (1.0%) there was evidence of a larger fetomaternal hamorrhage than would be neutralized by a single 300-microgram dose of Rh-immune globulin. Except for manual removal of the placenta, no correlation was found between large fetomaternal hemorrhages and obstetric manipulations, complications, or surgery. Thus, the authors believe that all Rh-negative patients should be screened post partum to ascertain the adequacy of Rh-immune globulin prophylaxis.

Adolescent↗
PubMed1979

Full thickness skin graft urethroplasty for anterior urethral strictures.

Thirty-two free full thickness skin graft urethroplasties were performed over a thirty-nine-month period. Follow-up of more than six months was available in 27 patients. Results were good or fair in 26 patients (96 per cent). Only 1 patient has been classified as a failure and required reoperation.

Child↗
PubMed1978

Radionuclide kidney function evaluation in the management of urolithiasis.

Renal and ureteral stones may cause asymmetrical renal damage that is not measured accurately by serum creatinine and blood urea nitrogen studies, excretory urography, nephrotomography and arteriography. We evaluated with a renal scintillation camera study 77 patients who had renal or ureteral calculi. The radionuclide procedure provided an accurate measure of total effective renal plasma flow and differential effective renal plasma flow. It had the additional advantages of being a non-invasive procedure, causing no allergic reactions, requiring no patient preparation and producing low radiation exposure.

Adult↗
PubMed1977

Intermittent catheterisation: follow-up studies [proceedings].

One hundred twenty-six male spinal cord injury patients whose acute bladder management included indwelling urethral catheters were converted to an intermittent catheterisation programme and most of them subsequently achieved a catheter-free state. A higher prevalence of pyelocaliectasis was observed in these patients compared to previous reports of similar changes in patients upon whom intermittent catheterisation was initiated immediately after injury. Right side predominance of pyelocaliectasis was demonstrated but requires further study. The extent of neurological deficit (complete or incomplete lesions) does not appear to influence the development of pyelocaliectasis. These findings support our contention that intensive urological follow-up is necessary for all spinal cord injury patients even though a catheter-free state has been achieved through use of intermittent catheterisation.

Dilatation↗
PubMed1976

Management of severe hydroureteronephrosis in infants and young children.

Loop cutaneous ureterostomy and cutaneous pyelostomy are safe and effective means of temporary diversion with few complications. Reconstructive operation is delayed until the upper urinary tract has shown maximum improvement in form and function and the patient's tolerance for elective operation has improved. Results of reconstruction may be less than optimal and serious complications may arise. However the staged approach has been shown to be safe and effective. Experience with 29 patients has led to a reassessment of the approach to patients with posterior urethral values and a stronger inclination to primary valve resection, thus avoiding many of the reconstructive procedures ultimately associated with temporary diversion. Patients with posterior urethral valves who have hydronephrotic upper urinary tracts, normal or near normal serum chemistry studies and are free of infection may receive initial valve ablation. All patients with massive hydroureteronephrosis require long-term followup to ensure preservation of renal function regardless of the approach used.

Child, Preschool↗
PubMed1976

Practical uses of a quantitative renal scintillation camera study.

A quantitative renal scintillation camera study has been described for the evaluation of total renal function and the split function of the two kidneys by a noninvasive technic. It requires no patient preparation, is not affected by bowel gas, and no allergic reactions have been reported. Six cases are reported to illustrate its usefulness with renal tumors, neurogenic bladders, pyelonephritis, nephrolithiasis, congenital anomalies, and renal insufficiency.

Adenocarcinoma↗