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Biomedical subjects

A R Kendall

Publications and source records attributed to A R Kendall.

At least 19 recordsLinked to original sources

Computer-assisted microfluorometric detection of individual malignant bladder cells.

A prospective study was done comparing the use of computer-assisted fluorescence photomicroscopy (cytophotometry) with routine cytology for the detection of human bladder cancers. A total of 129 specimens were analyzed from 89 patients. The patients were divided into two groups: Group I, with cancer demonstrated cystoscopically (55 specimens) and Group II, with no demonstrable cancer (74 specimens). The false-negative rate for cytology in the Group I patients was 64 percent but only 7 percent for microfluorometry. The false-positive rate for cytology in Group II was 5 percent but 59 percent for microfluorometry because of the presence of "reactive" cells. The sequential measurement of both routine cytology and deoxyribonucleic acid (DNA) content can be performed on the same cells. When both modalities were employed, the false-negative and false-positive rates were only 4 percent and 5 percent, respectively. The technique and advantages of cytophotometry are discussed in detail, especially in relation to flow cytometry.

Carcinoma, Transitional Cell

Segmental infarct of the testis due to hypersensitivity angiitis.

We present a case of hypersensitivity angiitis causing a segmental infarction of the testis. The lesion presented as a discrete, palpable mass that led to orchiectomy. Hypersensitivity angiitis has not been reported previously to affect the testes or to produce a segmental infarct in any solid organ. A discussion is given of the vasculitides, especially periarteritis nodosa, that may involve the testes.

Humans

Venous intravasation of barium into the inferior mesenteric vein mimicking a coloureteral fistula: a case report and literature review.

Venous intravasation of barium following a barium enema is a rare event. We report a case of barium venous intravasation into the inferior mesenteric vein. Because of the close proximity to the course of the left ureter, this condition was interpreted initially as a coloureteral fistula. After further analysis of the original films, and left retrograde pyelography the true diagnosis was established. A literature review of barium intravasation is presented.

Barium Sulfate

Congenital pelvic arteriovenous malformation with massive prostatic hemorrhage: a case report.

Congenital arteriovenous malformations in the true pelvis are extremely rare: only 7 cases have been described in male patients. We report on a patient who presented with massive hemorrhage after transrectal prostatic biopsy and transurethral resection of the prostate. Diagnosis was established by means of magnetic resonance imaging and confirmed by arteriography. Our attempt at management by embolization and subsequent surgical ligation is described. A literature review and discussion of arteriovenous anomalies are presented.

Aged

Spontaneous subcapsular renal hematoma: diagnosis and management.

Spontaneous subcapsular or perinephric hematoma in the absence of anticoagulation, arteritis or trauma is most likely due to an underlying renal tumor. Eight such patients recently have been evaluated and after nephrectomy 5 had small tumors undetectable by imaging techniques, including computerized tomography or angiography. In 1 patient a tumor was demonstrated preoperatively by angiography and in only 2 was a tumor not found. In the absence of an apparent etiology, patients with spontaneous renal bleeding and a normal contralateral kidney should undergo radical nephrectomy because of the extremely high incidence of small undetectable occult tumors, often less than 2 cm. in size.

Adult

The use of the Nd:YAG laser in urology.

The use of the neodymium:YAG(Nd:YAG) laser in urology in still in its infancy. To date, the most widely published application of this laser is in the treatment of bladder carcinoma. We have utilized the Nd:YAG laser in 23 treatments for superficial bladder tumors. The laser has both advantages and shortcomings, which are thoroughly addressed. In our hands the laser has been a safe instrument for the treatment of these lesions, although we do not recommend its use for tumors greater than 3 cm. We have treated two patients with invasive disease one week prior to planned cystectomy. In one case, no residual tumor was found at cystectomy, while the second patient had viable tumor only in an untreated area. Two patients were successfully treated with the laser for intractable bladder bleeding, one each with primary and secondary bladder tumor. Seven patients with condylomata acuminata were treated with laser therapy. All had excellent results without complication. One patient with urethral bleeding secondary to trauma was treated without success, while one patient with a urethral hemangioma was well treated with the Nd:YAG laser. Thus the Nd:YAG laser would appear to have a place in the urologic armamentarium, but whether it is cost-effective for widespread use remains to be seen.

Carcinoma

Diverticular abscess of colon: irritative bladder symptoms.

Diverticular disease can affect the bladder in subtle ways. Presented herein is a case of a chronic abscess secondary to diverticulitis presenting as irritable vesical symptoms overlooked for several years. The value of pelvic computerized tomography in the diagnosis is stressed.

Abscess

Percutaneous management of a pyelocaliceal diverticular abscess.

A renal abscess secondary to obstruction and infection of a pyelocaliceal diverticulum was managed successfully percutaneously. The diverticulum spontaneously re-established communication with the renal collecting system. No surgery was required and the patient was well 2 years later.

Abscess

Benign prostatic hyperplasia. Evaluation, management, and operative indications.

Although signs and symptoms of benign prostatic hyperplasia are found in an estimated 90% of men by the age of 70, less than 10% are likely to require surgery. If symptoms are mild and findings on urinalysis negative, nothing further need be done except follow-up evaluation in six months. Many patients stabilize without any progression of disease. When treatment is necessary, there is at present no alternative to surgery. Transurethral resection is the preferred procedure. Reoperation is seldom necessary.

Humans

Lasers in urology. I. Laser physics and safety.

Interest in the use of the laser in urology is increasing. A thorough understanding of the physical principles governing the laser will aid greatly in the choice of the proper laser for each indication. The tenets of laser safety are stressed, along with the current federal guidelines.

Environmental Exposure

Lasers in urology. II. Laser therapy.

To date four laser wavelengths are commercially available which have urologic applications. The experience with all of these lasers is reviewed. The major urologic lesions treatable by the laser are: condylomata acuminata, superficial penile carcinoma, and bladder carcinoma. The carbon dioxide (CO2) laser is most applicable for external genital lesions while the Nd:YAG laser is better suited for the endoscopic treatment of bladder tumors. Due to its preferential absorption by hemoglobin, the argon laser is useful in treating vascular lesions. The tunable dye laser with hematoporphyrin-derivative therapy has exciting potential, but is too new to evaluate its therapeutic efficacy.

Argon

Inclusion cyst of the tunica albuginea: demonstration by ultrasound.

A 35-year-old man discovered a 1-cm nodule at the upper pole of the left testicle after blunt focal trauma. While the pain, tenderness, and location suggested hematoma or appendiceal torsion, the demonstration by ultrasound of the size, cystic nature, and extraparenchymal location was consistent with the rarely documented cyst of the tunica albuginea.

Adult

Practical approach to stress urinary incontinence.

Stress urinary incontinence (SUI) in women is more frequent in the multiparous patient, especially in those postmenopausal after withdrawal of hormonal stimulation of the pelvic supportive tissues. With loss of support of the vesical neck and urethra, sphincter incompetence may result. A patient whose symptoms are purely irritative (urinary frequency, nocturia, urgency, or urge incontinence), without a significant degree of stress incontinence, should not benefit from any operation.

Aged

Specific red cell adherence testing and radiotherapy.

The presence or absence of measurable blood group antigens on the surface of a bladder carcinoma has aided in the prediction of the biologic potential of that patient's transitional cell carcinoma. Confusing data has arisen as to the reliability of the determination of specific red cell adherence testing following radiotherapy. The authors of this report have examined the presence of red cell antigens on the bladder tumor and adjacent uninvolved epithelium in patients before and after radiotherapy. Two groups of patients were studied: those receiving 2000 rad of radiation prior to radical cystectomy and those receiving 6000 rad as definitive therapy. In neither group did radiation therapy alone affect the measurement of blood-group antigens on the bladder carcinoma. In some cases the uninvolved mucosa does show alteration in the measurement of the blood-group antigens before and after radiotherapy, and thiotepa instilled intravesically after radiotherapy may affect the measurement of the uninvolved mucosa as well as the bladder tumor itself.

Blood Group Antigens