Biomedical subjects
Publications and source records attributed to A J Bueschen.
Thirty-two free full thickness skin graft urethroplasties were performed over a thirty-nine-month period. Follow-up of more than six months was available in 27 patients. Results were good or fair in 26 patients (96 per cent). Only 1 patient has been classified as a failure and required reoperation.
Polyethylene ureteral stents suspended from the kidney by a pigtail memory in the proximal end were placed bilaterally in a patient with ureteral obstruction secondary to retroperitoneal sarcoma. Both stents migrated upward and 1 migrated into the renal parenchyma. We recommend that these stents be inserted into the renal pelvis, as opposed to the calices, and that sufficient length be allowed to prohibit migration above the bladder.
Two patients with villous polyps of the prostatic urethra are described. The article supports previous observations that the lesion has the morphologic appearance of prostatic tissue. A review of the literature reveals that this rare lesion appears to be specific for the prostatic urethra and behaves as a benign tumor.
The renal scintillation camera study and the excretory urogram should be considered to be complementary studies. The renal scintillation camera study provides an accurate evaluation of changes in total, differential, and segmental renal function but affords only a gross assessment of anatomic changes. The excretory urogram provides superior information about renal anatomic changes but only inferior information about functional changes of the kidney. The advantages of a renal scintillation camera study with regard to the patient are that it is done in a state of normal hydration, it requires no bowel preparation, it is not associated with allergic reactions, it provides a low radiation exposure, and it is a noninvasive procedure for differential renal function which requires no ureteral catheters.
In a prospective study of a diagnositc scheme for evaluating renal masses, it was observed that a significant number of masses (29 per cent) would have been undetected without the aid of routine tomography. The renal masses detected with the aid of tomography are either small or peripheral lesions which cause no impingement upon the renal collecting system. Without specific symptoms referable to a renal mass and without hematuria, many renal masses will be overlooked on standard excretory urography. The general improvement in diagnostic quality, the ease with which this procedure may be added to excretory urography, and the minimal expense involved would be additional factors which should justify the use of routine tomography with excretory urography in any radiology department.
Renal and ureteral stones may cause asymmetrical renal damage that is not measured accurately by serum creatinine and blood urea nitrogen studies, excretory urography, nephrotomography and arteriography. We evaluated with a renal scintillation camera study 77 patients who had renal or ureteral calculi. The radionuclide procedure provided an accurate measure of total effective renal plasma flow and differential effective renal plasma flow. It had the additional advantages of being a non-invasive procedure, causing no allergic reactions, requiring no patient preparation and producing low radiation exposure.
A pediatric renal transplant patient who had ureteral necrosis treated initially by nephrostomy followed by a subsequent pyeloileocystostomy is reported. This unusual approach to a renal transplant complication is recommended, but only when other methods cannot be utilized.
A quantitative renal scintillation camera study has been described for the evaluation of total renal function and the split function of the two kidneys by a noninvasive technic. It requires no patient preparation, is not affected by bowel gas, and no allergic reactions have been reported. Six cases are reported to illustrate its usefulness with renal tumors, neurogenic bladders, pyelonephritis, nephrolithiasis, congenital anomalies, and renal insufficiency.
This report describes the separation of cells exhibiting histochemically demonstrable acid phosphatase from suspensions of cells obtained from human prostatic carcinomas by velocity sedimentation. In the unseparated suspensions of cells, 40.5 +/- 7.7% of nucleated cells contained histochemically evident acid phosphatase. After cells were separated by velocity sedimentation, 86.4 +/- 9.4% of the nucleated cells in the purest fractions exhibited histochemically demonstrable acid phosphatase activity. More than 95% of these cells excluded trypan blue. To our knowledge, this is the first report of a method for the separation of viable epithelial cells from human prostatic carcinomas.
A study was made of 136 patients with vesicoureteral reflux with the conventional radiologic modalities of voiding cystourethrography and IVP. In addition, a 30-minute quantitative scintillation camera study was used. Comparison of these studies indicates that most periodic re-evaluations with IVP can be eliminated in favor of the scintillation study with its markedly reduced radiation dosage and lack of allergic type reactions. Unfortunately, as the quantitative scintillation camera study has been performed in these patients, it has been impossible to diagnose the presence of vesicoureteral reflux. Therefore, voiding cystourethrography or direct radionuclide cystography must be repeated at some time to determine if conservative management has been successful. The benefit of the routine use of the quantitative scintillation camera study in the early postoperative period seems to be strongly supported even by the small group of patients studied.
Nitrofurantoin, sulfamethizole and cephalexin peak urinary drug concentrations were studied in patients and non-human primates with unequally functioning pyelonephritic kidneys. The peak urinary drug concentration of the poorly functioning kidney in comparison to the better kidney was greater than its percentage relative blood flow or creatinine clearance but variable in its relationship to creatinine concentration, osmolality and sodium concentration. Although for each unit of creatinine clearance the poorly functioning kidney had a higher peak urinary drug concentration than the better functioning kidney, for each kidney the peak urinary drug concentration seemed to be directly proportional to the creatinine clearance, the drug dosage and the renal mechanisms of drug excretion. Nitrofurantoin in the usual recommended dosage did not reach minimal inhibitory urinary drug concentration below a unilateral creatinine clearance of 20 ml. per minute. Whereas, sulfamethizole and cephalexin reached peak urinary drug concentrations greater than the minimal inhibitory concentration at the lowest studied unilateral creatinine clearance of 4 and 11 ml. per minute, respectively.
Collagenase, trypsin, and pronase were used in separate, parallel experiments to obtain cell suspensions from human prostates obtained from surgical resections and autopsies. All of the examined prostates demonstrated benign hyperplasia. The dissociation using pronase gave both the largest number of nucleated cells and the largest proportion of viable cells from prostates. Surgically resected prostates gave a larger number of cells per gram of tissue than prostates obtained from autopsy. Cells obtained from surgically resected prostates were separated both by isopycnic sedimentation and by velocity sedimentation in a previously described isokinetic gradient. We studied fifteen prostates obtained at surgery; using pronase, we obtained 2.1 plus or minus 3.5 times 10(6) cells/g. Of these cells, 34.0 plus or minus 14.7% contained histochemically demonstrable acid phosphatase. Cells from six prostates were separated by velocity sedimentation in the isokinetic gradients; in the purest fractions from the isokinetic gradients, 81.0 plus or minus 12.2% of nucleated cells had histochemically demonstrable acid phosphatase. The cells in the purest fractions appeared to be epithelial cells. More than 99% of these separated cells excluded trypan blue. Isopycnic sedimentation was not an effective means of purifying epithelial cells from human prostates.