Biomedical subjects

Adam E Perlmutter

Publications and source records attributed to Adam E Perlmutter.

9 recordsLinked to original sources

PubMed2006

Impact of patient age on distal hypospadias repair: a surgical perspective.

OBJECTIVES: To assess whether the age at which the initial hypospadias repair is performed influences the complication rate of hypospadias repair. METHODS: The records of 325 consecutive patients who underwent initial hypospadias repair were reviewed. The patients with glanular and coronal hypospadias underwent repair with either meatoplasty and glanuloplasty or a glans approximation procedure. Patients with subcoronal hypospadias and penile hypospadias underwent repair with tubularized incised plate urethroplasty. The patients were divided into 6-month age groups, and the complication rates were analyzed by age group using the chi-square test. RESULTS: A total of 325 hypospadias repairs were performed from January 1999 to January 2005 by a single surgeon. Of the 325 cases, 194 tubularized incised plate procedures were performed, 69 meatoplasty and glanuloplasty procedures were performed, and 53 glans approximation procedures were performed. Nine tubularized island flap urethroplasties performed for penoscrotal hypospadias were excluded because we did not perform a significant number of proximal urethroplasties. Nineteen patients (6.0%) developed urethrocutaneous fistulas and six (1.9%) demonstrated dehiscence. Overall, 2 patients (2.2%) who underwent surgical repair within the first 6 months of age developed complications compared with 23 patients (10.3%) who underwent initial hypospadias repair when they were older than 6 months of age (P = 0.006). CONCLUSIONS: Tubularized incised plate, meatoplasty and glanuloplasty, and glans approximation urethroplasty are all excellent options for the surgical correction of hypospadias in the appropriately selected patient. The results of our study have indicated that complications are minimized when hypospadias repair is performed when the patient is 4 to 6 months of age.

Age Factors↗

PubMed2006

Renal cell carcinoma and end stage renal disease.

PURPOSE: Patients with ESRD secondary to acquired renal cystic disease have been reported to have a higher incidence of RCC than the general population. We examined the clinical and pathological significance of incidental renal masses in patients with ESRD. MATERIALS AND METHODS: From January 1994 to July 2000, 852 consecutive patients with ESRD who were being considered for renal transplantation at University of Mississippi Medical Center were evaluated with renal ultrasound as part of assessment for possible kidney transplantation. Those patients with ultrasound suspicious for a malignant renal lesion were further evaluated with CT of the abdomen with and without intravenous contrast medium. Any patient with CT findings suspicious for RCC was recommended to undergo radical nephrectomy before kidney transplantation. RESULTS: A total of 19 patients had CT criteria for a possible malignant renal lesion. Seven patients had Bosniak class 3 renal cysts and 12 patients had solid, enhancing renal masses. Of the patients 17 underwent radical nephrectomy. On pathological examination 14 patients had RCC with a 1.64% prevalence in the population screened. Mean Fuhrman nuclear grade in our patients was 2.45. CONCLUSIONS: RCC in patients with ESRD are of clinical significance, considering the size, grade, histology and pathological stage of these tumors. The higher prevalence of clinically significant RCC in patients with ESRD as well as the risk of cancer progression while patients are on immunosuppressive medications justifies screening for RCC in patients with ESRD who are awaiting renal transplantation.

Carcinoma, Renal Cell↗

PubMed2005

Laparoscopic retroperitoneal resection of blind-ending bifid ureter in patient with recurrent urinary tract infections.

Blind-ending bifid ureters are rare congenital anomalies. Symptomatic patients require surgical resection of the blind-ending ureter. Traditionally, open resection of the blind-ending segment has been performed. We describe a laparoscopic retroperitoneal three-port approach for resection of blind-ending bifid ureters. We believe this is a viable and less-invasive alternative to traditional open surgical resection of a blind-ending segment.

Adult↗

PubMed2005

Rhabdomyosarcoma of tunica vaginalis masquerading as hydrocele.

Paratesticular rhabdomyosarcomas are rare tumors with aggressive growth patterns. Multimodal therapy with surgery, chemotherapy, and radiotherapy provides the patient with an excellent long-term prognosis. These tumors often present in the first two decades after birth. We report on the case of an 18-year-old man with a paratesticular rhabdomyosarcoma.

Adolescent↗

PubMed2005

Periprostatic pheochromocytoma.

In adults, 10% of pheochromocytomas are extra-adrenal. Most extra-adrenal pheochromocytomas occur in the organ of Zuckerkandl. Occasionally, pheochromocytomas can arise from paraganglion chromaffin cells in other locations. We present the case of a 63-year-old hypertensive man with a periprostatic pheochromocytoma. Our patient underwent surgical extirpation of the pheochromocytoma, while sparing the prostate from resection. His blood pressure has remained well controlled postoperatively without the addition of antihypertensive medications.

Humans↗

PubMed2005

Primary synovial sarcoma of the kidney.

Primary renal synovial sarcomas (SS) are rare tumors of the kidney. Faria first described primary renal synovial sarcoma in 1999. Twenty-one cases of primary renal synovial sarcoma have been reported to date. Primary renal synovial sarcomas can exist in either a monophasic or a biphasic pattern. The monophasic variant of primary renal synovial sarcoma is more common and tends to have a better prognosis than the biphasic variant. We present the case of a 61 year-old woman with a monophasic variant of primary renal synovial sarcoma.

Female↗

PubMedDate not supplied

Emphysematous cystitis: a case report and literature review.

Emphysematous cystitis (EC), a rare form of cystitis, is often an incidental radiological finding but it can be associated with diffuse abdominal or suprapubic pain. The clinical course can vary from asymptomatic infection to fulminant sepsis. We present the case of a 79-year-old woman with diffuse abdominal pain, back pain accompanied with low-grade fevers, urinary frequency, urinary urgency, and emesis who was ultimately found to have emphysematous cystitis. A review of the etiology, pathogenesis, diagnosis and treatment options follows.

Abdominal Pain↗

PubMedDate not supplied

Management of esophageal carcinoma.

Esophageal cancer is a devastating disease and among the most lethal malignancies worldwide. Despite advances in chemotherapy and radiation techniques, tumor stage at the time of presentation is the most important predictor of patient survival. Surgical resection offers the only curative treatment currently employed and transhiatal, transthoracic and en bloc esophagectomy are all standard surgical procedures used in the treatment of this disease. The Surgical Oncology Service of the West Virginia University Hospital favors the transhiatal approach since it offers lower morbidity and mortality without compromising survival when compared with transthoracic and en bloc esophagectomies.

Adenocarcinoma↗

PubMedDate not supplied

Overuse-related vascular injury of the hand--hypothenar hammer syndrome: a case report.

Although rare, vascular insufficiency is a well-recognized cause of hand pain, making a significant impact in the athletic and labor industry. Surgically correctable lesions are important to recognize since definitive treatment may alter the course of the disease and affect outcomes. Hypothenar hammer syndrome (HHS) results from anatomic predisposition and exposure to acute and chronic stress. Arteriography is the gold standard of diagnosis and severe symptomatic cases are treated with surgical resection and re-establishment of blood flow. We report such a case of HHS, its clinical course and management.

Aorta, Thoracic↗