Entrapped stone basket managed by extracorporeal shock wave lithotripsy.
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Biomedical subjects
Publications and source records attributed to J E Heller.
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We describe the eight case of idiopathic retroperitoneal fibrosis infiltrating the ureter to cause intrinsic obstruction. Discovery of this situation intraoperatively necessitates a change in treatment plan, as ureterolysis is not sufficient.
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A 19-year-old man presented with an acute retraction and entrapment of the left testicle into the abdomen through an indirect inguinal hernia. No previous case reports were found in the literature. The evaluation and treatment of the disappearing or absent testicle are briefly reviewed.
Dramatic progress in the understanding and treatment of erectile impotence has occurred over the past decade. Most cases have an organic cause that is related to vascular (arterial or venous) supply, innervation, or the hormonal milieu of the penis. Multifactorial causes of organic impotence are common and include diabetes mellitus, alcoholism, renal failure, and liver failure. Medications may cause impotence by a variety of mechanisms. The history and physical examination, along with simple laboratory tests, are the mainstay of evaluation and may be performed appropriately by family physicians. Successful new forms of nonsurgical treatment include penile self-injection with papaverine (sometimes with phentolamine) and penile-suction devices. Penile prostheses have been improved greatly in recent years. The patient may select among semirigid, multicomponent inflatable, and self-contained inflatable devices. New surgical treatments include penile arterial revascularization (for atherosclerosis) and ligation of the dorsal vein of the penis (for venous leak).
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We studied 44 patients with calcium urolithiasis on high (900 mg. daily) and low (400 mg. daily) calcium diets. With 24-hour urinary data, we categorized the patients as normocalciuric or hypercalciuric and subdivided the hypercalciuric patients into absorptive and renal types. Abbreviated tests, including the 2-hour fasting urinary calcium-to-creatinine ratio and 24-hour urinary (nephrogenous) cyclic adenosine monophosphate, did not predict accurately whether hypercalciuria was of the idiopathic, absorptive or renal type. However, 24-hour urinary calcium excretions on the low calcium diet had a sensitivity and specificity of more than 90 per cent for reproducing the categorized diagnoses.