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Biomedical subjects

A H Bennett

Publications and source records attributed to A H Bennett.

10 recordsLinked to original sources

Persistent müllerian duct syndrome with transverse testicular ectopia and spermatogenesis.

Normal male sexual differentiation is dependent on at least 2 factors: 1) testosterone and 2) müllerian inhibiting factor. The absence of müllerian inhibiting factor is responsible for a rare form of male pseudohermaphroditism, the persistent müllerian duct syndrome or hernia uteri inguinale. Patients with this syndrome present with persistent müllerian structures and the syndrome may be associated with transverse testicular ectopia. Additionally, most patients have azoospermia. We report a case of persistent müllerian duct syndrome with transverse testicular ectopia in which sperm are documented in the ejaculate.

Adult

An improved vasoactive drug combination for a pharmacological erection program.

Papaverine hydrochloride (smooth muscle relaxant), phentolamine mesylate (alpha-adrenergic blocking agent) and prostaglandin E1 (vasodilator and smooth muscle relaxant) were combined to produce a potent vasoactive drug therapy for use in a pharmacological erection program. Doses of 2.5 cc papaverine (30 mg./cc), 0.5 cc phentolamine (5 mg./cc), 0.05 cc prostaglandin E1 (500 micrograms./cc) and 1.2 cc 0.9% normal saline were combined to produce a vial of 4.25 cc for patient convenience. Twenty unit vials were made from the 1 cc vial of prostaglandin E1, the most expensive ingredient. The solution is physiologically active for at least 6 months and can be stored at room temperature although refrigeration is recommended. The pH of the solution is 4. This vasoactive drug combination has been used in 116 patients for diagnostic testing and subsequent treatment. A dose of 0.25 cc has been effective for diagnosis and treatment in the majority of patients with mild to moderate arteriogenic and/or venogenic and diabetic impotence. For patients with neurogenic dysfunction 0.1 to 0.125 cc was the usual dose. Two patients had a prolonged erection requiring irrigation, 1 on the day of initial testing and 1 on home therapy. Pain at the site of injection or during intercourse was noted in only 2 patients and to date no fibrosis or plaques have been found.

Adult

Use and abuse of retrograde pyelography.

Retrograde pyelography to demonstrate the renal pelvis and ureters is a common urologic procedure. Newer contrast materials and better radiographic techniques have obviated many of the previous indications for retrograde studies were independently reviewed by two urologists and a radiologist to determine if the studies were indicated, appropriately timed, informative, and complete. Our results indicate a high percentage of these examinations are incompletely performed and uninformative and could have been replaced by noninvasive studies. What constitutes a complete retrograde study and when to utilize this examination is discussed.

Evaluation Studies as Topic

The familial liver donor in renal transplantation.

A survey is made of the 20-year experience with more than 300 living donors in renal transplantation at the Peter Bent Brigham Hospital. Details are given pertaining to the first transplantation of the kidney from one living person to another in December 1954. The surgical technique, the complications and the results of renal transplantation from a living donor are summarized. The philosophic and psychologic problems encountered are described. A comparison of results summarized by Murray of living, related donor transplants to cadaveric donor transplants is included. This paper constitutes a salute to the familial living donor.

Adult

Vasectomy without complication.

In a four-year period 500 outpatient vasectomies were performed by the author. Bilateral scrotal incisions were used in all cases as were metal clips to occlude the vas deferens. Operating time rarely exceeded fifteen minutes. No failures and no sperm granulomas were encountered. Complications were rare and included a single scrotal hematoma and six minor infections. Unilateral absence of the vas deferens was noted in 2 patients. The technique to be described is a simple, complication-free method of vasectomy.

Humans

Recovery of renal function after prolonged unilateral ureteral obstruction.

Concepts of renal counterbalance and animal experiments have long supported nephrectomy for prolonged complete unilateral ureteral obstruction. The situation in humans has been clarified by only a few reported cases. Herein we report 3 cases with relief of obstruction after at least 28, 28 and 150 days. Evidence is presented to support renal preservation in similar cases.

Adult

The usefulness of ultrasound in the evaluation of renal masses in adults.

The efficacy of ultrasonography in the diagnosis of renal masses in our own series and in the recent literature has been reviewed. Ultrasonography in combination with cyst puncture approaches 100 per cent accuracy in the diagnosis of lesions more than 3 cm. in diameter that can be adequately delineated. Complications appear to be minimal.

Adenocarcinoma