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Biomedical subjects

I C Yoder

Publications and source records attributed to I C Yoder.

At least 37 records · Page 2Linked to original sources
PubMed1986

Spontaneous and traumatic rupture of renal cysts: diagnosis and outcome.

Twenty-five patients with spontaneous or traumatic rupture of known renal cysts were encountered over an 18-year period. Blunt abdominal trauma and iatrogenic trauma during retrograde endoscopy accounted for four traumatic ruptures. In 21 patients, spontaneous communication occurred between the cyst and the collecting system or the perinephric space. Hematuria was the most frequent manifestation (21 patients [84%]), followed by flank pain (17 patients [68%]). The diagnosis was made by means of infusion nephrotomography in 22 patients, computed tomography in two, and retrograde pyelography in one. Follow-up information was obtained in 21 patients. The communication of the cyst with the collecting system closed spontaneously in 11 patients and persisted in two. Six patients were operated on because of coexisting stones, persistent hematuria, infection, or the uncertain nature of the cyst, and two underwent cyst evaluation by percutaneous needle aspiration. Renal cyst rupture is an infrequent, usually self-limiting event that may sometimes pose diagnostic dilemmas.

Abdominal Injuries↗
PubMed1986

Radiation dose reduction during hysterosalpingography: an application of scanning-beam digital radiography.

Hysterosalpingography was performed in 31 patients by means of a low-dose scanning-beam digital radiographic system. The technique permits adequate evaluation of gynecologic abnormalities while allowing significant reduction in radiation: 2.4-mR (6.1 X 10(-7) C/kg) exposure to the skin and 0.7-mrad (7 X 10(-6) Gy) mean dose to the ovaries per image obtained. Sixteen patients demonstrated readily recognizable and documented abnormalities, corroborated by laparoscopy, laparotomy, or other supportive evidence.

Adolescent↗
PubMed1986

Diagnostic morphologic and urodynamic antegrade pyelography.

Diagnostic antegrade pyelography, with a thin needle, is basically a simple procedure that can be performed relatively rapidly under local anesthesia with few complications of significance. Its role, however, is frequently crucial to subsequent patient management. During morphologic antegrade examination, aspirated urine can be analyzed for tumor cells (cytologic examination), infection (smear, culture), or other biochemical alterations. The use of antegrade pyelography in the demonstration of internal diversion, ureteral fistula, and the site and cause of obstruction is well established. Dynamic antegrade study is crucial in the assessment of many pyeloureteral units in which the issue of current obstruction is equivocal or uncertain. Absolute renal and bladder pressures are obtained simultaneously; these and the calculated differential pressure provide objective data relative to ureteral resistance to urine flow and renal nephron preservation.

Adult↗
PubMed1985

Percutaneous occlusion of ureteral leaks and fistulae using nondetachable balloons.

High-output ureteral fistulae were managed percutaneously in 3 patients with pelvic malignancies. Urine flow was diverted by combining percutaneous nephrostomy catheter drainage with transrenal balloon occlusion of the affected ureter proximal to the site of extravasation. This technique can be used either alone as the definitive method of treatment or as the initial procedure to preserve renal function and reverse the inflammatory reaction prior to subsequent surgical repair; its primary application is in patients in whom antegrade or retrograde ureteral stenting is not feasible or possible.

Aged↗
PubMed1984

Diagnosis and treatment of pyonephrosis.

This article examines current radiologic imaging and interventional techniques used in the diagnosis and initial treatment of pyonephrosis. Included is a review of all pyonephrotic series published in the English literature since 1970. Although the authors found that two thirds of pyonephrotic kidneys are still removed at surgery, there is an increasing emphasis on preservation of renal function. Percutaneous nephrostomy provides an excellent tool for drainage of pus and determination of residual renal function prior to definitive surgery.

Adolescent↗
PubMed1983

Contrast-medium-induced electrocardiographic abnormalities: comparison of bolus and infusion of methylglucamine iodamide and methylglucamine/sodium diatrizoate.

A double-blind study comparing electrocardiographic (ECG) abnormalities induced by methyglucamine iodamide and methylglucamine/sodium diatrizoate was conducted in 189 patients. The media were each administered by both bolus and infusion. Iodamide caused fewer ECG changes both by injection and infusion. This contrast medium also resulted in fewer ECG changes in the patient groups with known prior ECG abnormalities, cardiovascular disease, arrhythmias, ischemia, or renal impairment and in those over 50 years of age. Digitalis did not increase the frequency of ECG abnormalities with either medium. With diatrizoate, the lower bolus dose produced as many major ECG changes in the presence of preexisting ECG abnormalities (arrhythmias, ischemia) or prior cardiovascular disease as the three-times-larger infusion dose more slowly administered; conversely, the opposite was found when renal insufficiency or older age existed. The conclusion is that iodamide media caused fewer ECG abnormalities and may be less hazardous.

Arrhythmias, Cardiac↗
PubMed1983

Pyonephrosis: imaging and intervention.

A series of 70 pyonephrotic kidneys drained by percutaneous nephrostomy tube was examined to evaluate the contribution of radiologic imaging to the diagnosis of pyonephrosis and to assess the diagnostic and therapeutic role of drainage by percutaneous nephrostomy catheter. The diagnosis of pyonephrosis is suspected when the clinical symptoms of fever and flank pain are combined with the radiologic evidence of obstruction to the urinary tract. Sonography gives a prompt diagnosis of hydronephrosis, and needle puncture of the kidney yields pus and establishes the presence of pyonephrosis. A percutaneous nephrostomy catheter is then inserted and serves for initial drainage of infected urine and for evaluation of residual kidney function before definitive surgery. The nephrostomy catheter is used for diagnostic nephrostograms, ureteral perfusions, therapeutic dissolution of stones, and indefinite drainage of the kidney. In 10 azotemic patients, the blood urea nitrogen and serum creatinine values returned to normal levels after antibiotic therapy and nephrostomy drainage of infection. Long-term evaluation of residual renal function by means of an excretory urogram or a renogram was available in another 26 patients and 25 of them showed function of the previously pyonephrotic kidney.

Adolescent↗
PubMed1983

Complications of pediatric percutaneous renal procedures: incidence and observations.

Successful definitive (complete) percutaneous renal procedures in the pediatric age group were performed in 97 per cent of antegrade pyelograms, in 94 per cent of ureteral perfusions (Whitaker test), in 98 per cent of nephrostomies, and 100 per cent of both retroperitoneal fluid drainages and renal aspiration biopsies. Significant complications, or those necessitating specific treatment or prolonged hospitalization, were 1.1 per cent. 0.7 per cent, 15.2 per cent, 0 per cent, and 0 per cent, respectively, for the above procedures. Not surprisingly, certain operators are more adept than others at successfully performing procedures and at avoiding some but not all complications (see Tables 2 and 3). Proper training, experience, and adherence to basic principles are important. However, there were no deaths, no kidneys lost, and no transfusions or operations required as a result of any complication from the pediatric percutaneous renal procedures; correction of any existing blood coagulation disorder is necessary prior to their performance to avoid potentially fatal hemorrhage.

Biopsy, Needle↗
PubMed1982

Renal cysts: curios and caveats.

Interesting, unusual, and confusing renal cysts from a group of 200 cysts punctured percutaneously during the past decade are presented. Some cases illustrate pressure phenomena in cysts adjacent to each other or causing calyceal obstruction. Also reported are cyst wall findings, unusual cyst configurations, infection in pre-existing cysts, examples of cysts simulating renal cell carcinoma, and renal cell carcinoma presenting as cysts. In unusual cases, percutaneous needle puncture remains the procedure of choice for establishing the diagnosis of benign simple cyst versus malignancy or infection, or for determining the relationship of a cyst with the collecting system or with other cysts. Cyst puncture may also result in iatrogenic changes.

Adenocarcinoma↗
PubMed1982

Ultrasonic inaccuracies in diagnosing renal obstruction.

Renal ultrasound is an excellent screening examination for suspected urinary tract obstruction. Its usefulness is based on the ability to detect hydronephrosis. However, it must be recognized that a significant number of conditions exist which can mimic or produce dilatation of the collecting system without urinary tract obstruction. Similarly, obstruction without hydronephrosis, although infrequent, exists. Situations causing either false positive or false negative renal sonograms are discussed. Renal sonography suggesting hydronephrosis should be followed with additional diagnostic studies to confirm or exclude obstruction. Similar persistence should be used when obstruction is strongly suggested clinically, and ultrasound fails to demonstrate hydronephrosis.

Adult↗
PubMed1982

Impressions on floor of female bladder: "the female prostate".

The "female prostate" denotes an impression on the base of the female bladder resembling the enlarged male prostate radiographically. Though the finding is widely recognized, confusion exists as to its significance. The differential diagnosis is moderately extensive, and includes retroverted uterus, anterior vaginal tumors, urethral and bladder floor tumors, benign and malignant bony pelvic lesions, urethral diverticulum, and postsurgical changes. Several cases are presented illustrating the previously mentioned causations. An impression on the floor of the female bladder should not be routinely dismissed as inconsequential without thorough evaluation.

Adult↗
PubMed1982

Peripelvic cysts: an impostor of sonographic hydronephrosis.

Static and real-time ultrasound examinations have proved clinically useful in the evaluation of renal obstruction. False-negative findings are rare. False-positive findings have been reported as being due to slightly dilated, nonobstructed urinary systems causing the ultrasonographic appearance of mild (grade I) hydronephrosis. The authors describe the ultrasonographic appearance of 16 false-positive cases that had suggested moderate (grade II) to severe (grade III) hydronephrosis in collecting systems subsequently shown to be completely unobstructed. This appearance was caused by peripelvic cysts. These cases emphasize the screening role of ultrasound and the need to employ additional diagnostic modalities to verify the presence of hydronephrosis and renal obstruction.

Cysts↗
PubMed1981

Angiodilator technique for hysterosalpingography in cervical os stenosis.

Obstruction of the endocervical canal of the uterus, frequently encountered after cauterization or cone biopsy, may result from a variety of benign and malignant diseases. Severe stenosis of the cervical os has made hysterosalpingography difficult. In ten patients, progressive dilatation with small vascular dilators was successful.

Adult↗
PubMed1981

Whitaker test after pyeloplasty: establishment of normal ureteral perfusion pressures.

Twenty-seven patients underwent percutaneous ureteral perfusion after successful surgical repair of ureteropelvic junction obstruction in order to determine the perfusion pressures in ureters without obstruction. In each patient, the postoperative ureteropelvic junction appeared widely patent and the rest of the ureter appeared entirely normal. Ureteral perfusion was performed via percutaneous puncture of the collecting system; the pressure in the pelvis was measured through this needle and bladder pressure was monitored through a urethral catheter. "Absolute" (renal pelvic) and "differential" (renal pelvic minus bladder) pressures were measured at 10, 15, and 20 ml/min perfusion rates. Absolute and differential pressures rose as the perfusion rates increased; absolute pressure rose but differential pressure fell as the bladder was filled. The upper limit of normal differential pressure encountered with the bladder empty was 13 cm of water during perfusion at 10 ml/min.

Adolescent↗