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Biomedical subjects

S B Levitt

Publications and source records attributed to S B Levitt.

At least 55 records · Page 3Linked to original sources
PubMed1981

Urodynamics in children. Part I. Methodology.

We evaluated 237 children for various disorders in the urodynamic laboratory. A total of 334 studies was done, using a 6-channel recorder combined with a portable fluoroscopic unit. Simultaneous recordings of intravesical pressure, intra-abdominal pressure, urine flow rate, external urethral electromyography and cystourethrography were obtained during bladder filling and voiding. These objective tests have provided us with an insight into the nature of a variety of voiding dysfunctions in children. Details of the methods used for urodynamic testing in these children are outlined and compared to other methods that have been proposed.

Adolescent↗
PubMed1981

Urodynamics in children. Part II. The pseudoneurogenic bladder.

We evaluated 83 children for recurrent urinary infections, day and night urinary incontinence or both for more than 1 year in the urodynamic laboratory. Bladder instability and/or bladder sphincter dyssynergia was encountered in 74 children. Pharmacologic manipulation of detrusor and sphincter function and biofeedback therapy were highly successful. Routine and random urethral dilation, urethrotomy and fulguration, and/or resection of ill-defined urethral obstructions is unwarranted. Rational treatment requires individualization based upon an objective evaluation by thorough and careful urodynamic testing.

Adolescent↗
PubMed1979

Use of pre-existing ureterocutaneous anastomosis as conduit in renal allotransplantation.

This report details 2 patients with unusable bladders whose renal allografts were anastomosed to an existent end cutaneous ureterostomy. The literature on renal allotransplants into intestinal conduits is reviewed. Use of existent, mature end cutaneous ureterostomies is suggested as an alternative to an intestinal conduit in patients with unusable bladders who require renal allografts.

Adult↗
PubMed1979

The value of the negative radionuclide scrotal scan in the management of the acutely inflamed scrotum in children.

Torsion of the testis remains a clinical diagnosis and confirmatory testing is not required when the classic signs and symptoms are present. Conflicting laboratory data or adjunctive diagnostic studies should not dissuade the surgeon from exploration when the clinical index of suspicion is high. In those patients having equivocal clinical findings when the diagnosis of torsion is not clear-cut radionuclide scrotal imaging may be useful. In this series a negative scrotal scan at the time of acute scrotal pain did predict reliably the diagnosis of non-torsion, suggesting that in the appropriate clinical setting scrotal imaging is useful in avoiding surgical exploration.

Adolescent↗
PubMed1979

Wilms tumor, misdiagnosed preoperatively: a review of 19 National Wilms Tumor Study I cases.

This study establishes the difficulty in making specific diagnoses in children with retroperitoneal tumors when only excretory urograms are used in diagnosis. Complementary use of excretory urography and ultrasonography should make the number of preoperative errors less by separating cases of Wilms tumor from those with cystic disease. This investigation underscores the hazards inherent in the use of preoperative irradiation and chemotherapy, since some children with benign disease are likely to receive inappropriate therapy.

Child↗
PubMed1979

Static testicular imaging utilizing 201Tl.

Successful testicular imaging of rat and rabbit testes was achieved utilizing the radiopharmaceutical Thallium-201. These observations indicate the usefulness of Thallium-201 as an agent for testicular imaging and suggest a clinical application in localizing the impalpable testis in humans.

Animals↗
PubMed1978

Endocrine tests in phenotypic children with bilateral impalpable testes can reliably predict "congenital" anorchism.

Congenital anorchism is a rare condition. Bilateral impa-pable undescended testes are relatively common by comparison. Surgical exploration has been regarded as the final arbiter between anorchism and bilateral cryptorchism. Exploration has not proved completely reliable in making this differentiation. Endocrine studies, particularly the human chorionic gonadotropin (HCG) stimulation test together with measurements of basal plasma gonadotropins, can reliably exclude "functioning" testicular tissue. Eleven fully evaluated and operated cases support this contention. In the specific clinical setting of a normal phenotypic male child with a 46XY karyotype and no müllerian structures palpable on rectal examination, nonfunctioning testes on endocrine testing means congenital anorchism and surgical confirmation is unnecessary. In contradistinction, a positive HCG test would appear to mandate through and extensive surgical exploration.

Child↗
PubMed1978

Xanthogranulomatous pyelonephritis-presentation as acute renal failure in a child with a solitary kidney.

A 4-year-old girl, who had been in perfect health, presented with the acute onset of renal failure and abdominal mass. Investigations revealed a solitary left kidney which on histology had the typical features of xanthogranulomatous pyelonephritis. The child had no previous history suggestive of chronic renal disease and had no radiologic evidence of renal osteodystrophy. She had no improvement in renal function and has gone on to hemodialysis and transplantation. The unique mode of presentation and the unusual features of this case are discussed.

Acute Kidney Injury↗
PubMed1977

Prolapsing urethral polyp in child with hypospadias.

This report details the first published case of a urethral polyp presenting as a prolapse through the proximally displaced meatus of a child with hypospadias. Urethral obstruction, a symptom common to other reported urethral polyps, was absent. The congenital nature suggests a benign neoplastic process as the etiologic factor.

Humans↗
PubMed1977

Bladder evaluation in pediatric patients before undiversion in previously diverted urinary tracts.

An easily performed test is described for simulating physiologic micturition in the defunctionalized bladder. Accurate clinical observations of continence and emptying capabilities before undiversion or transplantation are therefore possible. The test has predicted accurately adequate functional capabilities of the bladder in a series of children after total reconstruction. Moreover, when abnormal bladder function is identified by this technique a more physiologic state is provided for further investigation by more sophisticated urodynamic techniques. Successful retesting after appropriate corrective measures have been taken will avoid complications in the undiverted patient.

Abdominal Muscles↗
PubMed1976

Iatrogenic microphallus secondary to circumcision.

Three cases of apparent microphallus secondary to overzealous circumcision are presented. Proper diagnosis avoids unnecessary diagnostic studies. Moreover, a good functional and cosmetic result is virtually assured with appropriate resurfacing and thick split thickness skin grafting of the penile shaft. The best treatment would appear to be prevention of the complication by adequate instruction to personnel doing routine circumcisions.

Child↗
PubMed1976

Urine extravasation secondary to upper urinary tract obstruction.

To the best of our knowledge, this is the first reported case of renal salvage in a neonate with presumed spontaneous perirenal leakage of urine associated with ureteropelvic junction obstruction. Many instances of such extravasation in this age group have been described with lower urinary tract obstructions. As in the latter cases, the occurrence of extravasation secondary to upper tract obstruction need not preclude primary reconstruction.

Edema↗