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Biomedical subjects

A M Shanberg

Publications and source records attributed to A M Shanberg.

At least 37 records · Page 2Linked to original sources
PubMed1992

Modification of Le Bag ileocolonic pouch with improved results. Review of 17 cases.

The use of detubularized terminal ileum and cecum to construct a highly compliant, low-pressure, continent ileocolonic pouch was first described by Light and Engelman and was termed the "Le Bag." Results were excellent in terms of continence and preservation of renal function; however, nocturnal incontinence persisted in a substantial number of patients. We have modified the original procedure in 17 patients by performing a urethral-cecal anastomosis instead of using a tail of nondetubularized ileum. In addition, in those patients in whom a urethral anastomosis is contraindicated, we have modified the nipple as the continence-providing mechanism. Overall daytime and nighttime continence rate is 94 percent. Of the 13 patients with urethral-cecal anastomoses, only 1 patient requires intermittent catheterization. The remainder are voiding by Valsalva maneuver and with minimal residual urine. Based on our experience with the Le Bag ileocolonic pouch, we believe it is an excellent choice for total bladder replacement or continent diversion--the advantages being the relative ease of construction, minimal long-term complications, and near total urinary continence.

Adolescent↗
PubMed1992

Adenocarcinoma in a müllerian duct cyst.

A case of adenocarcinoma involving a müllerian duct cyst is presented. The presentation, treatment, and pathological and radiological appearance are discussed. The embryology and history of this entity are reviewed.

Adenocarcinoma↗
PubMed1992

Followup prostate biopsy in patients with carcinoma of the prostate treated by 192iridium template irradiation plus supplemental external beam radiation.

We reviewed our experience with 81 patients who had undergone followup needle biopsies of the prostate between 12 and 27 months after 192iridium template radiotherapy combined with external beam radiation therapy. When broken down by stage 82% of the patients with stage A2, 92% with B1, 95% with B2 and 55% with C disease demonstrated a negative biopsy and adequate local control of the cancer. We believe that in elderly patients, poor risk patients with early stage disease and stage C lesions this low morbidity, low mortality therapy offers a viable option to other modalities of treatment.

Aged↗
PubMed1992

The use of continent diversion in the management of rhabdomyosarcoma of the prostate in childhood.

Three children with rhabdomyosarcoma of the prostate treated with combination chemotherapy and radiation therapy underwent radical extirpation with continent diversion to the urethra. This urological procedure is technically feasible even in the small child (2 years old) and offers chance for cure. Radical cystectomy with continent diversion need not be considered as mutilating surgery.

Child, Preschool↗
PubMed1989

Partial transposition of the penis and scrotum with anterior urethral diverticulum in a child born with the caudal regression syndrome.

Caudal regression is a rare anomaly often associated with urogenital abnormalities. We report a case of the caudal regression syndrome associated with partial transportion of the penis and scrotum, and a giant anterior urethral diverticulum. We also report our surgical technique for 1-stage reconstruction of the external genitalia, as well as a review of the embryological development of this anomaly.

Abnormalities, Multiple↗
PubMed1988

A technique for ureteral stump ablation.

A total of 5 children underwent successful electrofulguration of a distal ectopic ureteral stump with reflux. Electrofulguration was performed endoscopically in 4 girls and in 1 boy the stump was ablated during an open operation. The procedure, which is simple and safe, obviates the potential nidus for recurrent infection.

Choristoma↗
PubMed1987

Use of Nd:YAG laser in treatment of bladder cancer.

A total of 53 patients were treated with neodymium:yttrium-aluminum garnet (Nd:YAG) laser and followed up for two years. Three patients had carcinoma in situ (CIS); 4 had Ta lesions; and 28 had TINxMo, 8 had T2NxMo, and 10 had T3NxMo lesions. The patients with CIS received a combination of Nd:YAG laser and intravesical bacillus Calmette Guérin (BCG) instillation. The remainder of the patients received no supplementary chemotherapy. No tumor recurrence was noted in those with Ta lesions. Tumor recurred in 18 per cent of patients with T1 lesions, and 33 per cent of those with T2 lesions; 80 per cent of patients with T3 lesions had resistant or residual tumors. In patients with CIS, there was no tumor recurrence. Nd:YAG laser is effective in Ta, T1, and T2 bladder cancers, with low recurrence rate and minimal complications. In very select, high-risk patients with small lesions, and in those who refuse cystectomy, there may be a place for laser therapy for either palliation or definitive treatment of T3 invasive tumors of the bladder.

Adult↗
PubMed1986

Use of bupivacaine as block to relieve postoperative pain in pediatric orchiopexy and hernia repair.

Bupivacaine was utilized for postoperative analgesia in patients undergoing orchiopexy and hernia repair. In a study of 75 pediatric patients, ranging in ages from twelve months to twelve years, who had undergone orchiopexy and hernia repair during a three-year period, 42 received bupivacaine hydrochloride as a local infiltration block anesthesia to relieve postoperative pain; 33 patients did not receive bupivacaine. Patients receiving bupivacaine had less postoperative pain and were more comfortable when leaving the hospital within a few hours after surgery.

Bupivacaine↗
PubMed1986

Bilateral nephrectomy for Wilms tumor.

Bilateral nephrectomy was performed in 4 patients with bilateral Wilms tumor. The current philosophy regarding the need to preserve maximum renal parenchyma is discussed. New guidelines suggested by the National Wilms Tumor Study group discourage unilateral nephrectomy and partial nephrectomy at initial exploration for bilateral Wilms tumor. Alternatively, it is recommended that continued treatment with chemotherapy and/or radiation therapy followed by second and third-look operations to maximize preservation of renal parenchyma be done with bilateral nephrectomy as a last resort option.

Child, Preschool↗
PubMed1985

Treatment of interstitial cystitis with the neodymium-YAG laser.

Five patients with severe interstitial cystitis that had not responded to conventional means of therapy were treated with the neodymium-YAG laser. Of the 5 patients 4 demonstrated cessation of severe bladder pain and frequency of urination within several days after therapy. These patients also were studied objectively by measuring bladder capacity, which was found to be increased over-all. Complication rates from this modality of therapy were extremely low. The patients have been followed for 3 to 15 months after treatment and to date have had no recurrent symptoms of severe interstitial cystitis, although some have had mild recurrent voiding symptoms.

Aged↗
PubMed1985

Pheochromocytoma with hypercalcemia: case report and review of literature.

We report a case of severe hypercalcemia and a pheochromocytoma of the right adrenal gland. The patient underwent adrenalectomy, following which the hypercalcemia disappeared. Parathormone assay of the adrenal tumor revealed high levels of activity despite normal serum parathormone activity. This suggests that the etiology of hypercalcemia in patients with pheochromocytoma is related to ectopic secretion of a parathormone ectopic peptide-like substance.

Adrenal Gland Neoplasms↗
PubMed1985

Lasers in medicine.

Explore the source record for details and available documents.

Bronchial Neoplasms↗
PubMed1984

Neodymium-YAG laser: new treatment for urethral stricture disease.

This is a preliminary report concerning the use of Neodymium-YAG laser for urethral strictures. A new technique, not previously described, is explained, and the early results and complications are analyzed. The results were documented with urethrograms and uroflowmetry. We believe the Nd:YAG laser is a safe and effective means of treating urethral strictures. Also it reduces the cost of treatment, and the patients return to work in four to five days.

Aged↗
PubMed1983

Treatment of prostatic carcinoma by pelvic lymphadenectomy, temporary Iridium-192 implant, and external irradiation.

Forty patients with clinically localized adenocarcinoma of the prostate have been treated by a combination of pelvic lymphadenectomy, temporary Iridium-192 implantation, and external irradiation with follow-up of one to five years. 192Ir implant delivers a minimum tumor dose of 3,000 rad to A2 and B1 lesions and 3,500 to B2 and C lesions. Two weeks later patients receive 4,000 rad of external irradiation to the prostate over four to five weeks. Patients with pelvic nodal metastases receive 5,000 rad to the pelvis with a midline block at 4,000 rad. All patients have had a complete local response as judged by clinical criteria. Prostate needle biopsies have been performed on 16 patients one year or less after treatment, with 15 biopsies benign. The technique appears to offer excellent local control of prostatic adenocarcinoma with acceptably low morbidity.

Adenocarcinoma↗
PubMed1983

Management of prostate carcinoma. Combination of pelvic lymphadenectomy, temporary Ir-192 implantation, and external irradiation.

Forty patients with prostate adenocarcinoma had bilateral pelvic lymphadenectomy, temporary Ir-192 implantation, and external irradiation. With the implant, the prostate received less than or equal to 3,000 rad (30 Gy) for A2 and B1 and 3,500 rad (35 Gy) for B2 and C lesions in 40-45 hours. Ten days to 2 weeks later, 4,000 rad (40 Gy) external irradiation was given in 4-5 weeks using AP and PA parallel opposed fields, a "box," or rotation. Patients with positive nodes were given 5,000 rad (50 Gy) to the pelvis with a midline block at 4,000 rad (40 Gy) so that the prostate received 7,000-7,500 rad (70-75 Gy). All patients were free of local recurrence. Treatment was tolerated well, with rapid regression and few complications.

Adenocarcinoma↗