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Biomedical subjects

E S Lyon

Publications and source records attributed to E S Lyon.

17 recordsLinked to original sources
PubMed1989

Treatment options for proximal ureteral urolithiasis: review and recommendations.

The treatment of proximal ureteral calculi has been altered markedly by recent developments in shock wave lithotripsy (bypass, pushback and in situ), ureterorenoscopy and percutaneous stone removal. In an effort to discern the proper role of these newer treatment options with respect to ureterolithotomy (flank approach or dorsal lumbotomy), we completed a multicentered study in which 142 upper ureteral stone patients in 7 different treatment categories were reviewed retrospectively and contacted for convalescence data. From these data we conclude that before extracorporeal shock wave lithotripsy an upper ureteral stone should be manipulated until it is either pushed back to the kidney or bypassed with a stent. This maneuver should result in successful extracorporeal shock wave lithotripsy in more than 90 per cent of the patients. For those few patients with an impacted upper ureteral calculus ureterorenoscopy is recommended. Given the presently available treatment modalities we conclude that less than 3 per cent of all upper ureteral calculi will require ureterolithotomy. In this last circumstance a dorsal lumbotomy incision appears to be less morbid and yet as effective as anterior ureterolithotomy.

Algorithms↗
PubMed1988

Lidocaine jelly push-back of ureteral stones.

Pushing ureteral stones into the renal pelvis significantly facilitates extracorporeal shock-wave lithotripsy or percutaneous nephrolithotripsy. The technique is simple and less hazardous than mechanically relocating the stone with a wire or a catheter. It requires retrograde injection of 2% lidocaine jelly into the ureter via an 8-10F catheter placed just distal to the stone. Of forty-seven ureteral stones (24 upper, 19 mid, and 4 lower ureter), 44 were relocated successfully.

Humans↗
PubMed1987

Flexible ureteropyeloscopy: diagnosis and treatment in the upper urinary tract.

Flexible ureteropyeloscopy was performed on 59 patients with 2.7, 3.2 or 3.6 mm. endoscopes with a deflectable tip. Techniques for use of these flexible endoscopes are discussed in detail. The endoscope could be passed into the ureter in 58 patients and into the kidney in 52 (88 per cent). The entire collecting system was visualized in 23 of the most recent 29 patients (79 per cent). A diagnosis was achieved in all 23 patients with an intrarenal filling defect demonstrated radiographically. The source of gross hematuria alone could be defined in 9 of 17 patients. Surveillance for tumor was achieved in 5 of 5 patients and for residual calculus in 4 of 4. The endoscope was used to establish continuity successfully in 3 patients with an obstructed ureteropelvic junction. An instrument with a deflectable tip and some technique for irrigation are essential for intrarenal inspection and complete visualization of the ureter. This procedure is valuable in selected patients and it rapidly may become the technique of choice for the diagnosis of intrarenal filling defects. It also is of value in patients with benign, essential hematuria.

Aged↗
PubMed1985

Endoscopic diagnosis and treatment of upper-tract urothelial tumors. A preliminary report.

The technique of transurethral ureteropyeloscopy allows many standard cystoscopic procedures to be extended into the upper urinary tract. This endoscopic method was used to evaluate 31 patients suspected to have urothelial malignancies of the ureter or renal pelvis. Twenty-eight of the patients had the procedure successfully completed (90%), 11 of whom were found to have urothelial tumors. Diagnostic ureteroscopic biopsy in three of these patients revealed high-grade, multifocal tumors and was followed by nephroureterectomy (two patients) or partial ureterectomy (one patient). However, in eight patients, ureteroscopy and biopsy revealed apparently localized, low-grade tumors which were treated by ureteroscopic fulguration or resection. The latter patients have undergone endoscopic surveillance every 3 months (average follow-up, 21 months). The technique of ureteropyeloscopy permits endoscopic access into the ureter and renal pelvis, enabling tissue diagnosis and better preoperative cancer staging without surgical exploration. Although follow-up is short, selected patients with low-grade tumors may be treated primarily by endoscopic means.

Aged↗
PubMed1979

Transurethral ureteroscopy in men using juvenile cystoscopy equipment.

The inadequacies of current procedures to yield exact diagnostic information on the last portion of the ureter in men and the urologists' frequent frustration when manipulations are attempted in the lower ureter have prompted exploration of a direct endoscopic approach to diagnosis and treatment in the terminal ureter. In the last 3 years we have become accustomed to accomplishing ureteroscopy in women on a routine basis to discover and to treat with amazing ease ureteral tumors, calculi, obstructions and so forth. Ureteroscopy in men now has been practiced sufficiently to convince us that it also should join the urologists' armamentarium of diagnostic and therapeutic procedures. Herein is described the equipment and the technique to endoscope the lower ureter.

Cystoscopes↗
PubMed1978

Regulation, purification, and properties of xanthine dehydrogenase in Neurospora crassa.

Xanthine dehydrogenase (EC 1.2.1.37) is the first enzyme in the degradative pathway by which fungi convert purines to ammonia. In vivo, the activity is induced 6-fold by growth in uric acid. Hypoxanthine, xanthine, adenine, or guanine also induce enzyme activity but to a lesser degree. Immunoelectrophoresis using monospecific antibodies prepared against Neurospora crassa xanthine dehydrogenase shows that the induced increase in enzyme activity results from increased numbers of xanthine dehydrogenase molecules, presumably arising from de novo enzyme synthesis. Xanthine dehydrogenase has been purified to homogeneity by conventional methods followed by immunoabsorption to monospecific antibodies coupled to Sepharose 6B. Electrophoresis of purified xanthine dehydrogenase reveals a single protein band which also exhibits enzyme activity. The average specific activity of purified enzyme is 140 nmol of isoxanthopterine produced/min/mg. Xanthine dehydrogenase activity is substrate-inhibited by xanthine (0.14 mM), hypoxanthine (0.3 mM), and pterine (10 micron), is only slightly affected by metal binding agents such as KCN (6 mM), but is strongly inhibited by sulfhydryl reagents such as p-hydroxymercuribenzoate (2 micron). The molecular weight of xanthine dehydrogenase is 357,000 as calculated from a sedimentation coefficient of 11.8 S and a Stokes radius of 6.37 nm. Sodium dodecyl sulfate-gel electrophoresis of the enzyme reveals a single protein band having a molecular weight of 155,000. So the xanthine dehydrogenase protein appears to be a dimer. In contrast to xanthine dehydrogenases from animal sources which typically possess as prosthetic groups 2 FAD molecules, 2 molybdenum atoms, 8 atoms of iron, and 8 acid-labile sulfides, the Neurospora enzyme contains 2 FAD molecules, 1 molybdenum atom, 12 atoms of iron, and 14 eq of labile sulfide/molecule. The absorption spectrum of the enzyme shows maxima between 400 and 500 nm typical of a non-heme iron-containing flavoprotein.

Enzyme Induction↗
PubMed1978

Transurethral ureteroscopy in women: a ready addition to the urological armamentarium.

Ureteroscopy via the transurethral route and limited to the terminal ureter in women lends itself to inclusion in the urological armamentarium. The technique requires no equipment other than routine urological instruments and makes endoscopic inspection, biopsy and resection within the distal ureter possible. The procedure is done with the patient under anesthesia, following urethral dilation to 32F. With the aid of a small caliber cystoscope, 20F or smaller, straight Jewett sounds can be passed into the urethra alongside the cystoscope and directed under cystoscopic control into the ureteral orifice. The orifice is then dilated gently, using 12, 14 and, if necessary, 16F sounds. One of the standard pediatric cystoscopes can then be introduced easily into the orifice. Currently, the technique is being used routinely in women with transitional cell carcinoma involving the ureteral orifice or intramural ureter. In 1 patient a tumor arising from within the lower ureter was resected successfully using a pediatric resectoscope.

Carcinoma, Transitional Cell↗
PubMed1976

Glomiform and fibrillar cytoplasmic inclusions.

Glomiform inclusions, also called tubular arrays in endoplasmic reticulum, are found in the epithelial cells of glandular tissues of a patient with systemic lupus erythematosus, a patient with Reye's syndrome, and a dog. Their three dimensional structure is interpreted as a skein of contorted tubules of endoplasmic reticulum. Fibrillar inclusions found in the pancreatic acinar cells of two patients are believed to represent altered zymogen granules.

Adult↗
PubMed1976

Leiomyosarcoma of the inferior vena cava.

The thirty-second case of leiomyosarcoma of the inferior vena cava and the twelfth resectable patient in the series is presented. A review of the literature demonstrates a marked female preponderance (5 to 1). The most common presenting symptom is right abdominal pain and a palpable mass. The different surgical problems generated by the involved segment of the cava are discussed. Noteworthy is the high incidence of Budd-Chiari syndrome owing to hepatic vein obstruction with involvement of the upper third of the cava in the postmortem cases. An argument is developed for debulking the tumor for palliation when it is not completely removable.

Humans↗
PubMed1976

Echinococcal disease of the kidney.

A case of hydatid disease of the kidney is presented. The parasitology, diagnostic evaluation and surgical treatment for the entity are discussed.

Aged↗
PubMed1975

Primary carcinoid tumor of the urethra.

The first reported case of a carcinoid tumor of the urinary tract is presented. Because of rapid local recurrence and distant spread early radical surgery is recommended. Several methods of palliation of the carcinoid syndrome-surgical, pharmacologic and chemotherapeutic-are discussed.

Humans↗
PubMed1975

Matrix calculi.

Matrix calculi are an uncommon form of urinary tract concretion. They must be considered in the differential diagnosis of a radiolucent mass within the renal collecting system or ureter. The clinical and radiographic features of three cases are presented and the literature of matrix calculi is reviewed.

Bacteriuria↗
PubMed1975

Further experience with circle tube nephroureterostomy urinary diversion.

Circle tube nephroureterostomy as an alternative method of urinary diversion has now been used in 80 patients, representing a wide variety of clinical problems. The technique offers several advantages over nephrostomy or intubated ureterostomy. Additional extensive experience with the procedure has substantiated the initially favorable impressions.

Follow-Up Studies↗