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Biomedical subjects

J H DeWeerd

Publications and source records attributed to J H DeWeerd.

At least 19 recordsLinked to original sources
PubMed1984

Renal-nonresponsive, bone-responsive pseudohypoparathyroidism. A case with normal vitamin D metabolite levels and clinical features of rickets.

Clinical signs of rickets developed in a previously healthy 13-year-old girl with normal features. She had hypocalcemia, hyperphosphatemia, elevated alkaline phosphatase and parathyroid hormone levels, and normal vitamin D metabolite levels, with osteitis fibrosa cystica on bone biopsy specimen. Her renal function was normal. Treatment with 1 microgram of calcitriol each day resulted in symptomatic and clinical relief and improvement of the serum chemical values. This patient probably has pseudohypoparathyroidism type 1, with renal nonresponsiveness and bone responsiveness. This disorder has the clinical features of rickets, but represents hyperparathyroid bone disease.

Adolescent↗
PubMed1983

Primary realignment of posterior urethral injuries.

The records of 34 patients with posterior urethral disruptions secondary to blunt pelvic trauma who were treated with primary realignment were reviewed. Among the 29 evaluable patients there was a 38 per cent incidence of stricture (11 of 29), a 3 per cent incidence of incontinence (1 of 29) and a 15 per cent incidence of impotence (4 of 27). Primary realignment has a low morbidity and an acceptable rate of incontinence, impotence and stricture formation, and is recommended in the treatment of posterior urethral injuries.

Adolescent↗
PubMed1982

Invasive bladder carcinoma managed by irradiation and surgery.

Four hundred forty-four patients with invasive vesical carcinoma were entered in a nonrandomized treatment program of preoperative irradiation and surgical extirpation of the primary lesion. Fifteen of the patients did not undergo surgery, and an additional 13 were found at operation to have an inoperable lesion. Thus, 416 patients, at risk for more than two years, were available for statistical study. Pathologic findings constitute the basis for the calculation of crude survival rates. Five-year survival for 107 patients without residual carcinoma was 66 per cent, approximating the 71 per cent for the 160 patients with low-stage carcinoma. By contrast, 149 patients with high-stage carcinoma had a five-year survival of 31 per cent. The need for a yet undefined adjuvant modality is evident.

Carcinoma↗
PubMed1981

Renal cell carcinoma: long-term survival and late recurrence.

In a series of 506 patients with renal cell carcinoma survival was analyzed in terms of pathologic stage, histologic grade, and a combination of stage and grade. Data reveal that stage, grade and the combination are important prognostic indicators. Invasion of the renal pelvis is not an important factor in staging the disease. Women had a better survival rate than men. The prognosis for patients with dark cell tumors was no worse than that for patients with clear cell tumors when correlated with the more important factors of tumor stage and grade. Renal vein involvement alone, excluding concomitant capsular or nodal involvement, had an adverse effect on survival. Of the patients who survived 10 years from the date of nephrectomy 11 per cent had late recurrence.

Adenocarcinoma↗
PubMed1980

Urinary tract reconstruction in renal transplantation. Mayo Clinic experience and review of literature.

Althrough rejection remains the most frequent cause of renal allograft failure, technical problems have contributed and continue to contribute to graft loss. Urologic complications may be caused by technical errors in the donor nephrectomy or in urinary tract reconstruction. During the past decade, however, with advances in medical and surgical management, the reported incidence of urologic complications in renal transplantation has declined steadily. This may be due to (1) more extensive donor and recipient preparation and evaluation for surgery, (2) improvement of surgical technique with increasing experience in donor and recipient, and (3) more refined diagnosis and treatment of urologic and infectious complications.

Adolescent↗
PubMed1977

Late ureteral obstruction mimicking rejection after renal transplantation.

Ureteral obstruction occurring five years or more after renal transplantation is uncommon and may mimic allograft rejection. In 2 patients who had received cadaveric renal allograft, ureteral obstruction was detected six and one-half and five and one-half years after transplantation. In both patients, surgery was needed to restore normal renal function and to prevent further renal damage. Excretory urography is important in the follow-up of patients who have undergone renal transplantation, and conditions such as ureteral obstruction should be ruled out before antirejection treatment is started.

Adult↗
PubMed1977

Supravesical urinary diversion in renal transplantation.

Urinary diversion may be used in patients without a bladder or with irreversible, lower urinary tract abnormalities who might not otherwise be suitable candidates for renal transplantation. Three cases have been described to illustrate three different methods of supravesical urinary diversion that have been employed in association with renal transplantation.

Adolescent↗
PubMed1976

Surgical technic in en bloc bilateral cadaveric nephrectomy for transplantation.

En bloc bilateral cadaveric nephrectomy for transplantation has some advantages over excision of each kidney separately. There is also an advantage of single cannula perfusion through the aorta for two kidneys, especially when multiple renal arteries are present. The anatomic vascular variants are important, as are the incision and the approach to the suprarenal aorta and the lumbar venous drainage of the kidney.

Cadaver↗
PubMed1975

Urologic problems in renal transplantation.

Of 206 patients who underwent 221 consecutive renal homografts, two patients had major urologic complications. One patient had a partial ureteric obstruction requiring surgical intervention and ureterostomy. Another patient had a fistula at the ureteropelvic junction secondary to vigorous diuresis in the presence of acute retention; eventually nephrectomy was required, but the patient survived. In one other instance, urinary extravasation was suspected without substantiation and with uneventful recovery of the patient. The total incidence of major urologic complications was less than 1%, with no related deaths.

Adult↗
PubMed1975

Vesicoureteral reflux in adults.

Vesicoureteral reflux was detected in 200 adults seen in a 4 year period. In group 1 (no history of urinary tract infection and negative urine cultures), all patients had abnormalities on excretory urograms that were suggestive of reflux. In patients with a history of recurrent urinary tract infection (groups 2 and 3), the excretory urograms showed an abnormality in 79 per cent of those with negative cultures and in 83 per cent of those with positive cultures. Thus, reflux should be suspected in patients with a history of recurrent urinary tract infection even if infection cannot be documented with urine culture. Urographic evidence of renal parenchymal scarring, ureteral dilatation, or mucosal striations should also suggest the possibility of vesicoureteral reflux even when the patient may have no urinary tract symptoms. Voiding cystourethrography should be performed in all adults with these findings to exclude the possibility of vesicoureteral reflux.

Adolescent↗
PubMed1975

Experience with lymphoceles after renal transplantation.

Of 215 patients who underwent renal transplantations at the Mayo Clinic, six (2.8 percent) developed perirenal lymphoceles. Diagnosis was made between 5 weeks and 14 months after operation. In all six patients, renal function decreased and eventually a lower quadrant abdominal mass developed. Ipsilateral leg edema, fluid retention, and development of diastolic hypertension should also increase suspicion as to the possibility of lymph collection in the perirenal space. Excretory urography with tomography delineated the lymphocele in each instance; B scan ultrasound may be an additional valuable diagnostic tool. Drainage procedures readily restored normal renal function and, in one instance, drainage also restored the blood pressure to normal. Percutaneous needle aspiration seems to be a temporary measure only, and marsupialization is the preferred definite procedure.

Adult↗