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Biomedical subjects

V Braren

Publications and source records attributed to V Braren.

At least 19 recordsLinked to original sources

Beta-2-microglobulin as renal diagnostic agent.

Our group has undertaken the determination of serum levels of beta-2-microglobulin in 250 patients. We have compared this diagnostic entity to radioisotopic glomerular filtration rate, serum creatinine, and blood urea nitrogen. We have also analyzed the cost effectiveness of each of these diagnostic entities and combinations thereof. We conclude that beta-2-microglobulin is a simple test to perform; it is specific, sensitive, and accurate. Its cost effectiveness is excellent. We advocate its wide clinical usage.

Adolescent

Clean intermittent catheterization in children.

The results of the application of clean intermittent catheterization to children are discussed. Of 34 patients only 7 maintained persistently sterile urine and 52 per cent had more than 1 positive culture in the followup period. Complications of the application of this technique are discussed. The major complication rate was 15 per cent and 6 per cent were considered failures of therapy. Only 1 of the 34 patients demonstrated progression of upper tract disease by excretory urography during the followup period. Intermittent catheterization was found to be effective in preserving renal function as well as helping to improve patient social acceptability.

Adolescent

Sacral agenesis: diagnosis, treatment and followup of urological complications.

Sacral agenesis is an uncommon congenital anomaly that usually is accompanied by other orthopedic anomalies but often occurs singularly. We report our experience in the treatment and long-term followup of 4 cases of pure sacral agenesis. We strongly stress the need for early diagnosis and long-term careful followup. In our group the diagnosis was often overlooked and followup was poor. Studies must be undertaken to determine the type and degree of neurogenic vesicopathy in each child since this may vary from one patient to the next. We urge the early and long-term use of intermittent catheterization.

Adult

Use of the umbilical area for placement of a urinary stoma.

Children with myelodysplasia are best managed in medical centers by a team consisting of a urologist, an orthopedist, a neurosurgeon, a pediatrician, a social worker, an orthotic technician and physical therapists. A co-operative approach aids in the selection of a urinary diversion stoma site which will not interfere with the multiple orthopedic procedures these children must undergo. The urologic and orthopedic complications and benefits of 24 patients with umbilical stoma are compared with 24 patients with matched right lower quadrant stoma. The incidence of urologic complications is equal, while the orthopedic advantages manifest by the first group vastly outweigh the problems encountered in the second group. We advocate the use of a midline stoma site for urinary diversion in children with myelodysplasia.

Child

Urinalysis.

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False Negative Reactions

Urinary tract calculous disease after renal transplantation.

We report 3 cases of a series of 372 (0.8 per cent) renal transplant recipients in whom urinary tract calculi developed as a complication of the procedure. In each patient symptoms were minimal and not classic of calculous disease. We disagree with the contention that all such patients have either hypercalcemia, infection, or tubular acidosis, although thorough evaluation is indicated. We believe this entity should be considered in problematic renal transplantation patients. Conservative therapy is advocated when the situation permits.

Adult

Renal carcinoma discovered incidentally by arteriography during evaluation for hypertension.

Since June 1, 1971 patients undergoing evaluation for hypertension have been evaluated with rapid sequence excretary urography, abdominal aortography and selective renal arteriography. Renal venous assays have been done in selected patients. Through July 31, 1974, 812 arteriographic studies in new hypertensive patients have been done. In 6 of these patients renal tumors were discovered by arteriography only and were not suggested by symptoms, urinalysis nor diagnosed on hypertensive excretory urography. This high incidence surprised us and we hope others will review their arteriographic series of hypertensive patients.

Adenocarcinoma

Extended biopsy followup after full course radiation for resectable prostatic carcinoma.

Extended biopsy followup of 17 relatively young men with resectable prostatic cancer treated by external supervoltage radiotherapy is presented. Although 6 of the 8 surviving patients now have negative biopsies, the over-all survival rate and the over-all incidence of negative biopsies are not so encouraging, with only 35 per cent rendered free of tumor. Thus, the role of radiotherapy in resectable prostatic carcinoma should be critically scrutinized. More accurate staging is needed. Hopefully, more sophisticated studies of diagnostic and prognostic value will be available in the near future.

Adult

Anterior transposition of urethra.

The case reports of 3 patients who underwent anterior transposition of the urethra are presented. Our modification is believed to shorten the operative procedure and to be equally satisfactory compared to the results presented by previous urologic surgeons. We join those who recommend this operation in the thin female patient who has a neurogenic bladder with constant leakage around the indwelling urethral catheter despite use of larger size tubes.

Abdominal Muscles