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Biomedical subjects

N E Peterson

Publications and source records attributed to N E Peterson.

At least 19 recordsLinked to original sources
PubMed1993

Lidocaine as topical anesthesia for bladder mappings and cold-cup biopsies.

We describe the use of lidocaine as a topical anesthetic for 35 patients undergoing random bladder biopsies (bladder mappings) and cold-cup resection of small bladder lesions. Serum lidocaine levels were measured 7 to 10 minutes after instillation of the anesthetic using fluorescent polarization immunoassay. Adequate pain control was noted in 33 of 35 patients (94%), with negligible serum lidocaine levels noted in all 35. One patient had a 2 cm. tumor on the anterior wall of the bladder making resection with topical anesthesia suboptimal and 1 patient required 1 mg. supplemental intravenous midazolam hydrochloride to complete the procedure. We conclude that topical lidocaine is a safe, inexpensive and effective mode of anesthesia for bladder mappings and cold-cup biopsies of small bladder lesions. However, it may be inadequate for lesions large enough to require resection rather than cold-cup biopsy and those at poorly accessible regions of the bladder.

Aged↗
PubMed1992

Urogenital linitis plastica metastatic from stomach.

We herein describe an example of gastric linitis plastica metastatic to the urinary bladder. A comprehensive appraisal of the literature yields only one similar reported case. Our patient experienced an objective partial response to neoadjuvant chemotherapy.

Adenocarcinoma↗
PubMed1992

Positive hydrocele cytology accompanying testis seminoma.

Accurate palpation of the testis may be obscured by the presence of a hydrocele. Analysis of hydrocele fluid is seldom reported. We describe the cytologic demonstration of malignant cells within a hydrocele accompanying testicular seminoma. Although this connection is not unexpected, it is only rarely documented.

Adult↗
PubMed1991

Spermatic cord for onlay coverage of urethral defect.

Segmental urethral necrosis may accompany scrotoperineal gangrene, and primary closure of the urethral defect may unacceptably reduce urethral dimensions. This dilemma has been managed successfully in 5 patients by application of the intact spermatic cord to the urethral defect and approximation to its margins. A representative case is described.

Aged↗
PubMed1991

Lidocaine as a topical anesthetic for bladder biopsies.

The use of lidocaine as a topical anesthetic in bladder biopsies is described. Lidocaine was used in 7 patients undergoing random bladder biopsies and serum lidocaine levels were measured 7 to 10 minutes after instillation. Adequate pain control was noted in each patient with negligible serum lidocaine levels even in the face of denuded bladder mucosa.

Administration, Topical↗
PubMed1990

Traumatic bilateral renal infarction.

Spontaneous recovery from biopsy-verified bilateral post-traumatic renal infarction in a 20-year-old patient is described, with clinical and renal stability maintained after 60 months of follow-up. A comprehensive analysis of recorded data yields no similar example, but several cases claiming subsequent viability after varying types of management bear clinical and histologic similarities. Management options may be influenced by these data.

Accidents, Traffic↗
PubMed1989

Atypical metastases from transitional vesical carcinoma.

A patient with documented transitional vesical carcinoma also manifested bilateral pulmonary nodules of extraordinary and uncharacteristic dimensions, confirmed as metastatic by transthoracic needle biopsy. A summary of reported uncommon manifestations of metastatic bladder cancer is reported, as well as recommended reactions to pulmonary lesions of indeterminate origin.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Traumatic bilateral renal infarction.

Published examples of unilateral and bilateral renal artery thrombosis attest to their usual subjection to nephrectomy at diagnosis or soon thereafter, eliminating the opportunity for spontaneous improvement which would enlighten the issue of how often late recovery may occur, and under what circumstances. Seven cases of renal artery thrombosis and five patients with renal artery embolization extracted from the literature have included documentation of patchy histologic viability within otherwise total infarction. Conversely, 47 reports of renal artery thrombosis culminating in nephrectomy or examined post mortem include no reference to any of these histologic features. Presumptions are speculative regarding whether these features were absent, overlooked, or unexamined. Their incidence cannot be estimated--only the possibility of recoverable renal function in an unknown number of involved patients. It may be presumed that the majority of kidneys exposed to sustained arterial interruption will undergo irreversible infarction, with an undefined small subgroup later developing renal hypertension. An unknown number, however, may fortuitously possess arterial collateralization competent to support sufficient numbers of viable nephrons to sustain adequate renal function. It is further speculated that shared pathophysiologic features establish the opportunity for misdiagnosis of renal cortical necrosis, which carries a documented potential for spontaneous recovery. Impulsive bilateral nephrectomy may therefore be unjustified, particularly in consideration of the minimal potential hazards of nonremoval. In the event of convalescent problems of renal origin, delayed nephrectomy remains an option. The requirement for interval hemodialysis is further influenced by the advantages accruing from retention of the native kidneys relative to calcium metabolism and blood product replacement. A final consideration relates to the advisability of secondary revascularization of spontaneously recovered kidneys for the purpose of further improving renal perfusion and renal function. It may be argued that stable renal function at levels compatible with a tolerable or uncompromised lifestyle is best undisturbed, with the intention of avoiding iatrogenic mishap. A more objective consideration relates to the observed late, progressive deleterious influences of hyperfiltration imposed upon the reduced population of surviving nephrons (3); would this process been exaggerated by improved perfusion? Dietary protein restriction has been advocated for patients at risk. Identification of late functional deterioration would initiate a reconsideration of therapeutic revascularization.

Collateral Circulation↗
PubMed1989

Complications of renal trauma.

The potential deleterious consequences of renal trauma are well known, but reported incidences diverge broadly and are often exaggerated by the inclusion of sequelae of inconsequential nature and of disorders that may have antedated injury. The author adds unnecessary renal exploration and surgery to the usual list of complications, deliberately provoking consideration of the unresolved controversy over the relative merits of aggressive and conservative management of injuries of intermediate severity.

Humans↗
PubMed1988

Fulguration-ablation of atypical accessory urethra.

A male adolescent presented with perineal dribbling during voiding. Evaluation revealed an accessory urethra originating from the prostatic urethra. There was persistent anatomical and functional dominance of the dorsal orthotopic urethra, constituting a reversal of the arrangement most commonly described for urethral duplication. Successful ablation of the accessory urethra was accomplished by electrofulguration. The salient features of urethral duplication are reviewed.

Adolescent↗