Biomedical subjects
Publications and source records attributed to I Gersh.
A case of primary lymphosarcoma of the prostate in a seventy-one-year-old patient is presented. He had palliative surgical treatment and radiotherapy but died seven months later of heart failure with signs of metastatic disease. Treatment of this condition should include surgery and irradiation. Only its early discovery might change the prognosis.
An operative procedure for the repair of primary vesicoureteral reflux in 51 children (83 renal units) is described, its merits are discussed and its advantages are stressed. Reflux was prevented in 90.2 per cent of the children and 74.5 per cent of the patients remained free of infection. No obstruction has occurred in our series as compared to a 5 per cent incidence rate in cases of ureteroneocystostomy. Our procedure is not recommended for megaureters with reflux or for recurrent vesicoureteral reflux.
Postoperative jaundice is an occasional complication of major surgery. Four illustrative cases are described and a mechanism of development is suggested. The jaundice may seem to be biochemically of the obstructive type. Most of the bilirubin is of the conjugated type. The disturbance of liver function can be caused by several factors, including massive transfusion, hematoma in tissues, shock, heart failure, anoxia, infection and perhaps medications. Postoperative jaundice by itself is not of cardinal importance in deciding the prognosis of the patient.
A case of identical twins with bilateral vesico-ureteral reflux is presented. This case supports the hypothesis that primary vesico-ureteral incompetence may be an inherited lesion. The importance of investigating close relatives, especially identical twins, is stressed.
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