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Biomedical subjects

F Hinman

Publications and source records attributed to F Hinman.

At least 19 recordsLinked to original sources
PubMed1979

Unilateral abdominal cryptorchidism.

The unilateral non-palpable undescended testis is considered separately from other forms of cryptorchidism. It is less likely to be fertile, it is more prone to malignancy and it is more difficult to place. Removal rather than orchiopexy often is in the best interests of the child.

Castration↗
PubMed1979

Urodynamic testing: alternatives to electronics.

Electronic urodynamic testing, including bladder pressure, urethral pressure profile, voiding rate and velocity, and electromyography, is expensive in terms of equipment, operator and time. Clinical urodynamic testing, including voiding habits and timing, bladder capacity, residual urine volume, voiding cystography, cystometrography and neurologic evaluation, is readily done in the office. Analysis of common syndromes requiring urodynamic assay shows that clinical urodynamic testing may be more useful than electronic urodynamic testing for appropriate treatment.

Child↗
PubMed1979

Directional growth of renal calculi.

The forces involved in shaping urinary calculi reside in crystalline characteristics and especially in local influences. Box pleves may restrict passage and, by allowing mobility, help shape a round calculus. Fixation, occurring with a rapidly growing infection stone, facilitates initial growth on a matrix mold in a funnel pelvis, further aided by pelviocaliceal paralysis from bacterial endotoxins and later by stasis. Branched calculi are further shaped by contact with the pelvic and infundibular walls. Through pressure and mucous coating they grow only at the ends. Late caliceal obstruction frees the ends for clubbing. Consideration of these forces aids in prognosis and surgical removal, and may offer opportunities for prevention.

Calcium Oxalate↗
PubMed1979

Microphallus: distinction between anomalous and endocrine types.

Operative treatment of microphallus has been proscribed in recent reports. It is not indicated for the more common endocrine type because of deficient gonadotropin, primary testicular disorder or end-organ defect. However, an operation may be quite necessary for the other form owing to defective morphogenesis--the anomalous type. Representative cases provide evidence that the method of treatment depends on the type of microphallus.

Child↗
PubMed1978

Obstructive renal cysts.

Renal cysts usually are asymptomatic, produce no harm to the kidney and require no treatment once diagnosed. However, an occasional expanding cyst causes progressive obstruction to caliceal or pelvic outflow. Herein is reported observations on 4 patients in whom cysts produced significant obstruction to the pelvic or major caliceal outflow. In 3 cases treatment was by decompression, with resolution of the obstruction. Two requirements must be met for a cyst to obstruct: 1) it must lie at or near the hilus and 2) it must have turgor sufficient to overcome the pressure of the intrapelvic urine. In contrast to most renal cysts those producing significant obstruction require operation.

Adult↗
PubMed1978

Directional growth of renal calculi.

The forces involved in shaping urinary calculi reside in crystalline characteristics and especially in local influences. Box pelves may restrict passage and, by allowing mobility, help shape a round calculus. Fixation, occurring with a rapidly growing infection stone, facilitates initial growth on a matrix mold in a funnel pelvis, further aided by pelviocaliceal paralysis from bacterial endotoxins and later by stasis. Branched calculi are further shaped by contact with the pelvic and infundibular walls. Through pressure and mucous coating they grow only at the ends. Late caliceal obstruction frees the ends for clubbing. Consideration of these forces aids in prognosis and surgical removal, and may offer opportunities for prevention.

Calcium Oxalate↗
PubMed1977

Intermittent catheterization and vesical defenses.

The effectiveness of intermittent catheterization in eradicating bacteriuria in patients requiring catheterization for inadequate voiding was subjected to a mathematical analysis to establish its theoretical basis. It can be shown that, at 1 extreme, with 6 ml. urine remaining in the bladder, assuming reasonable hydration, catheterization must be done at least every 2 to 2 1/2 hours to limit bacteriuria. In contrast, if as little as 0.5 ml. urine is left behind, catheterization may be done every 4 to 5 hours to achieve the same result. Moreover, from the graphic depiction of the calculation it is seen that a reduction in the intervals between catheterization has a much greater effect than an increase in the urinary output in the reduction of the bacterial count. The volume of residual urine after catheterization was directly determined by measurement of phenolsulfonphthalein that was washed out after drainage by catheter in the female dog and in women. In the dog it averaged 0.435 ml. but in women it was somewhat greater than that after normal voiding. Upon applying the equation relating frequency of catheterization and urinary output to residual urine in a clinical program of intermittent catheterization, we found that the usual (convenient) schedule often resulted in showing that an unattainably small volume of urine would have to be left in the bladder. Actual measurement of residual urine by the modified phenolsulfonphthalein test provides the data needed to design a program of intermittent catheterization for each patient that will lead to urinary sterility.

Animals↗
PubMed1977

Reaction of the vesical wall to bacterial penetration: resistance to attachment, desquamation and leukocytic activity.

To determine the contribution of the bladder wall to defense against infection we designed a series of experiments wherein movement of introduced bacteria and inflammatory processes (cystitis) were observed by an autoradiographic technique. As a first defense line the bladder mucosal surface showed strong resistance against bacterial attachment and penetration. Moreover, epithelial cells gripped and penetrated by bacteria were desquamated and eliminated through voiding, thus arresting deeper invasion into the bladder wall. When organisms did penetrate the bladder wall they were phagocytized by polymorphonuclear leukocytes and macrophages in the submucosa and muscularis. In contrast, once leukocytes had migrated into the urine within the bladder they no longer participated in phagocytosis. Organisms also entered the veins, the lymphatics or both and disappeared rapidly from the local site through the action of the reticuloendothelial system. These observations indicate that in addition to mechanical emptying resistance to bacterial attachment, desquamation of invaded cells, activity of leukocytes and macrophages, and disappearance of bacteria from local site are 4 mechanisms whereby the bladder resists and fights infection.

Animals↗
PubMed1977

Reaction of the vesical wall to bacterial penetration: resistance to attachment, desquamation, and leukocytic activity.

To determine the contribution of the bladder wall to defense against infection we designed a series of experiments wherein movement of introduced bacteria and inflammatory processes (cystitis) were observed by autoradiographic technique. As a first defense line, the bladder mucosal surface showed strong resistance against bacterial attachment and penetration. Moreover, epithelial cells gripped and penetrated by bacteria were desquamated and eliminated through voiding, thus arresting deeper invasion into the bladder wall. When organisms did penetrate the bladder wall, they were phagocytized by polymorphonuclear leukocytes and macrophages in the submucosa and muscularis. In contrast, once leukocytes had migrated into the urine within the bladder, they no longer participated in phagocytosis. Organisms also entered the veins, or the lymphatics, or both, and disappeared rapidly from the local site through the action of the reticuloendothelial system. These observations indicate that--in addition to mechanical emptying--resistance to bacterial attachment, desquamation of invaded cells, activity of leukocytes and macrophages, and disappearance of bacteria from local site are four mechanisms whereby the bladder resists and fights infection.

Animals↗
PubMed1976

Complications of vesicoureteral operations from incoordination of micturition.

Recently, a study was made of 8 boys with complications after corrective surgical procedures for dysfunction of the voiding mechanism. One of these patients already had been subjected to irreversible diversion before the basic disorder was recognized but the majority was treated with suggestion (often with hypnosis) as well as with drugs affecting the smooth muscle (1 adolescent was too hostile to accept treatment). Because the bladder was dysfunctional, the operations either failed or sequelae persisted until measures such as suggestion, hypnotherapy and retraining reversed the incoordination of micturition. Operation or reoperation in 5 children might not have been necessary if bladder coordination had been established earlier. The case of boys with poor urinary control but free of neurologic stigmas are suspect. If they require an operation for repair of congenital urinary defects such as reflux, equal attention must be paid to psychologic and habit patterns causing bladder dysfunction. Otherwise, the operation is done essentially into a neurogenic bladder. It is concluded that psychologically conditioned incoordination of voiding may alone produce mid and upper tract damage. The cases of boys with problems of urinary control not explained by neurologic or anatomic defects should be suspected and corrective surgical procedures may fail if bladder dysfunction is not corrected by retraining, suggestion and even hypnotherapy.

Child↗
PubMed1976

The antibacterial effect of the bladder surface: an electron microscopic study.

To explore an intrinsic bladder defense mechanism we examined interaction between Escherichia coli and bacterial size particles (polystyrene latex balls) and the vesical luminal surface by scanning and transmission electron microscopy. The bacteria and the latex spheres were held in folds of the cellular luminal surface. Voiding (bladder contraction) resulted in the entrapment of a large number of bacteria and particles by these microplicae, with their apparent engulfment in vesicles below the cell surface. Some urine was probably contained in the folds and vesicles, thus reducing the volume of residual urine in the bladder. Since leukocytes were rarely seen in the model studied they presumably do not play an immediate role against acute infection in the normal bladder. These observations indicate that fixation of bacteria to the mucosa is 1 step in the mechanism whereby the normally functioning bladder resists infection.

Animals↗
PubMed1976

Meatal recolonization in bitches.

Colonization of the urethrovaginal area precedes urinary tract infection in women. Among the potential factors limiting colonization by fecal pathogens is bacterial interference, the ability of established commensals to inhibit colonization by pathogenic bacteria. Since the microcontour of the canine distal urethra possesses microvilli like those in the vagina rather than the microplicae found at higher levels and also has similarities in cellular glycogen content the meatal area would be expected to respond to hormonal influences like the vagina. The normal canine urethrovaginal flora was determined by serial cultures. It consisted principally of Staphylococcus epidermidis, Corynebacterium and Acinetobacter-Haemophilus. Estrus produced a selective overgrowth of beta-Streptococcus and Acinetobacter-Haemophilus. A normal canine transient, Escherichia coli, and a normal resident, Corynebacterium, persisted only for a short time (4.5 days) unless inoculated during estrus, when they remained for a mean period of 70 days. In contrast, human Escherichia coli and Pseudomonas persisted only a short time, whether during anestrus (4.8 days) or during estrus (8.5 days). The commensals had returned fully by 14 days after sterilization, while those in estrus overresponded. Thus, indigenous bacteria inhibit establishment of certain foreign species in the urethra and hormones enhance the susceptibility to colonization.

Acinetobacter↗