The role of impaired physician programs.
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Biomedical subjects
Publications and source records attributed to C R McKinley.
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A 31-year-old woman who had undergone bilateral ureterosigmoidostomy at age five had a moderately differentiated adenocarcinoma at the anastomotic site that was not detected by preoperative studies or intraoperative palpation. The authors review other reports of anastomotic carcinomas occurring after ureterosigmoidostomy for benign disease and recommend a diagnostic protocol. Whenever the urine is diverted away from the sigmoidostomy (rediversion), the anastomotic site should be resected. Ureterosigmoidostomy should be undertaken only with the understanding that meticulous long-term follow-up is mandatory.
Lesions of the seminal vesicle can be evaluated by the transrectal needle approach. Biopsy, aspiration of contents for culture and cytology, injection of contrast medium for x-ray and drainage of cysts or abscesses can be done with this approach.
There have been 14 cases of anterior urethral valves reported in the literature. The main diagnostic test in these cases has been voiding cystourethrography since retrograde urethrography is believed to be useless. Two additional cases of anterior urethral valves are presented to demonstrate the usefulness of the retrograde urethrogram as a valuable adjunctive diagnostic study.
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The case of a 12-year-old boy with neurofibromatosis, kyphoscoliosis, and hypertension is reported. The association of neuroflibromatosis and kryphoscoliosis is well known. There are no reports on the association of neurofibromatosis and hypertension in the orthopaedic literature. The cause was found to be intrarenal vascular abnormalities which are characteristic of neurofibromatosis. Other possible causes of hypertension in this disease are discussed. This patient was successfully treated by a partial nephrectomy.