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Biomedical subjects

E F Reda

Publications and source records attributed to E F Reda.

22 records · Page 2Linked to original sources

Elusive vesicoureteral reflux in children with normal contrast cystograms.

Recurrent pyelonephritic episodes in children with normal contrast cystograms pose a difficult management problem, since the lack of demonstrable reflux adversely affects the treatment. A total of 10 children with clinical symptoms of pyelonephritis in whom normal contrast cystograms had been performed properly subsequently had significant degrees of reflux detected by isotope cystography. These findings indicate that isotope cystography should be included in the evaluation of patients with pyelonephritis in whom reflux is not confirmed by conventional contrast medium techniques.

Adult↗

Human monorchism: a clinicopathological study of unilateral absent testes in 65 boys.

We reviewed the medical records of 65 boys with surgically and pathologically proved monorchism. A striking laterality to the left side was identified. In 83 per cent of the patients wolffian structures were present and in 20 per cent microscopic evidence of a terminal nubbin of hyalinized, calcified or hemosiderin-containing tissue was noted. These findings strongly suggest that in most instances of monorchism a testis had been present and had undergone subsequent in utero degeneration. Characterization of the hormonal changes associated with unilateral absent testes was done by determining fasting morning levels of luteinizing hormone and follicle-stimulating hormone. In a subgroup of monorchid boys and age-matched prepubertal unilateral cryptorchid boys luteinizing hormone release factor stimulation also was performed to determine if endocrine analysis could predict the absence of 1 testis.

Adolescent↗

Detrusor instability: a delayed complication in association with the artificial sphincter.

Of 45 children with an artificial sphincter 6 had elevated filling pressure of the detrusor and/or uninhibited contractions of the bladder after the implantation surgery, which produced hydronephrosis in 3 and urinary incontinence in 3. All affected individuals had myelodysplasia (17 per cent of this subgroup), 3 had evidence of tethering of the spinal cord and 3 may have had unrecognized detrusor hypertonicity, which was masked by the low outlet resistance before sphincter implantation. Corrective surgery consisted of either decompressive laminectomy with untethering of the spinal cord or augmentation cystoplasty when indicated. Factors affecting the change in the detrusor postoperatively, and recommendations for improved selection and surveillance of individuals undergoing implantation of the artificial device are promulgated.

Child↗

Dermal graft correction of extraordinary chordee.

Severe degrees of primary chordee and persistent or recurrent chordee following previous surgical attempts at correction present a challenging problem. Inadequate resection of involved tissues, which may involve all layers of the penile investiture, or recurrent scarring of the ventral skin, Buck's fascia and tunica albuginea is usually the cause. Reoperation to achieve penile straightening often is unsuccessful unless all chordee-bearing tissue is resected extensively. Excision of large segments of tunica albuginea or wide separation of the margins creates a defect that tends to heal by dense scarring unless the defect is bridged by a graft. Various autogenous materials have been used, including blood vessel, fascia, free fat graft, dermis and tunica albuginea, as well as prosthestic materials, such as polytetrafluoroethylene, with varying results. A series of patients with extensive chordee is presented in whom tunical resection was necessary to achieve penile straightening. The results of free dermal graft replacement of the tunica are reported.

Adolescent↗