Biomedical subjects
Publications and source records attributed to M I Resnick.
Arteriography performed in the preoperative evaluation of a patient with horseshoe kidney and renal calculi revealed a common origin of the inferior mesenteric artery and an anomalous left lower polar renal artery. The origin of the anomaly and its clinical significance are reviewed.
Many variables are known to be associated with the formation of calcium oxalate urolithiasis but none is essential for the initiation or growth of stones. It is likely that the predisposition to stone formation is related to multiple factors. We herein describe still another metabolic state that seems to predispose to calcium oxalate stone disease, namely heterozygosity for cystinuria. Cystine screening tests were done on 24-hour urine specimens obtained from 126 patients in whom recurrent calcium oxalate stones form and 84 controls and quantitative amino acid determinations were done on all positive specimens. Of those studied 17 of 126 stone patients and 1 of 84 controls were heterozygous cystinurics. A test of the differences between the relative frequencies of cystinuria heterozygotes in the 2 groups with Fisher's exact test revealed them to be highly significant (p less than 0.001). Our study indicates that carrier status for 1 of the cystinuria genes predisposes to calcium oxalate stone formation but, like other factors related to urolithiasis, it is not a necessary cause of stone disease.
The use of a purge size rotameter for the determination of maximum urinary flow rates represents an inexpensive and non-invasive method to detect obstructive or neurogenic lower urinary tract abnormalities. We have used the device to identify successfully selected patients with such abnormalities.
A count of all recorded hospitalized cases of Forsyth County, North Carolina residents with a primary discharge diagnosis of renal (kidneyand/or ureteral) stone in 1977 is obtained by age, race and sex, and used in conjunction with the census data to estimate age-adjusted prevalence rates. The over-all prevalence rate is 2.08 per thousand population, which agrees well with results of earlier investigations. For white male subjects the age-adjusted prevalence rate is 3.64 per thousand, for white female subjects 1.44, for non-white male subjects 0.97 and for non-white female subjects 0.34. The white to non-white ratio and the male to female rates are compared with earlier published values. For all groups the prevalence rate increases with age, attaining a maximum in the 40 to 60-year category for whites and somewhat later for non-whites. Beyond age 60 prevalence drops, reaching 0 or near 0 in the 80 to 89-year range. A simple phenomenological model is suggested to explain the observed race and sex differences in the prevalence rates.
A male newborn presented with mild azotemia, an abdominal mass and non-visualized right kidney on excretory urography. Evaluation, including ultrasound and surgical exploration, revealed the simultaneous occurence of crossed fused renal ectopia and multicystic kidney.
Between 1965 and 1976, 54 children with urolithiasis were evaluated and treated. Age, sex, race distribution, patient symptomatology, stone localization and type are outlined. The relationship of stone formation to urinary infection and/or genitourinary anomalies is reviewed, and treatment and recurrence patterns are studied.
A formal protocol, controlled metabolic evaluation is essential to the most effective treatment of any patient with renal calculi, regardless of the crystalline composition of the stone. The design of the protocol and of the data sheets should be compatible with ease of diagnosis and selection of corrective therapeutic measures. These data also serve as a reference to monitor response to treatment. Treatment is highly individualized with the objective to reduce all potentially crystallizable ions to basal levels. If this is difficult to accomplish certain ratios of ions are brought to as near normal values as possible.
Weak electron paramagnetic resonance (EPR) signals from a number of calcium oxalate renal stones are attributed to an iron oxalate component. The g-value of the resonance is 2.0036 and its width is approximately 9 gauss. The EPR resonance from stones has the same characteristics as resonances from iron introduced into calcium oxalate and oxalic acid as an impurity. A sharp increase in EPR signal when calcium oxalate renal stones are exposed to intense light is attributable to the reduction of Fe3+ and the formation of the oxalate radical ion (C2O4)-.
Two noninvasive methods of localizing the site of urinary tract infection, urinary lactic dehydrogenase (LDH) isoenzymes and antibody coating of bacteria in the urinary sediment, have been prospectively compared with the bladder washout technique in a series of children with urinary tract infection. Fifteen children had infection localized in the upper tract. Urinary LDH isoenzymes correctly localized the infection in 14 children; however, the infection was correctly localized by the antibody coating of bacteria in only eight patients (P less than .02). Fourteen children had lower tract infection by the bladder washout technique. Urinary LDH isoenzymes localized the infection in all 14 children, whereas the antibody coating correctly localized the infection in ten children (P less than .05). This study shows the urinary LDH isoenzyme pattern to be a more accurate technique than the detection of antibody-coated bacteria for localizing the site of urinary tract infection.
Twenty-four hour urine specimens were obtained from 20 active calcium oxalate stone formers, 20 inactive calcium oxalate stone formers, 8 struvite stone formers, and 9 non-stone forming controls. Proteins with molecular weights less than 50,000 daltons were concentrated by ultrafiltration and separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Fourteen of the 17 active calcium oxalate stone formers had low molecular weight urinary proteins (less than 35,000 daltons) present in their urine whereas none of the inactive stone formers or struvite stone formers had similar patterns. Only one of the nine control patients had similar proteins present.
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Prostatic nodules detected on rectal examination of 50 patients were evaluated by the usual means and by prostatic ultrasonic scanning. Nodules were characterized as being either malignant, benign, inflammatory or stones. Those patients without evidence of calcification on radiography underwent prostatic biopsy and the histological findings were compared to the ultrasonic study. All histologically confirmed malignancies were diagnosed preoperatively and there were no instances of falsely negative ultrasonic studies.
A retrospective analysis was conducted on 30 patients who had undergone anatrophic nephrolithotomy for staghorn calculus disease in a solitary kidney. No statistically significant difference (p greater than 0.1) was found between the average preoperative and postoperative renal function values. Of 27 patients who were infected preoperatively 19 were rendered free of further urinary tract infection and 24 of 30 patients (80 per cent) had no further recurrence of renal calculi. Because of the predictable morbidity and mortality associated with the non-operative management of staghorn calculus disease these patients are managed best by the complete surgical removal of all calculi and intensive antimicrobial therapy.
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Castrate male Sprague-Dawley rats were treated with either testosterone; testosterone and estradiol; testosterone, estradiol and 2-Bromo-alpha-Ergocryptine (CB-154), an inhibitor of prolactin secretion; or testosterone and CB-154. Estradiol potentiated testosterone-induced growth of the dorsal, lateral, and ventral prostate and this effect was not counteracted by CB-154. Estradiol only induced hypertrophy of the dorsal and ventral prostate, however, hyperplastic changes occurred in the lateral prostate.
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