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Biomedical subjects

J S Vordermark

Publications and source records attributed to J S Vordermark.

At least 19 recordsLinked to original sources
PubMed1996

Urologic manifestations of postpolio syndrome.

To determine the character and prevalence of bladder dysfunction among persons with a history of polio, we conducted a survey of randomly selected polio survivors. The survey solicited information on the acute episode of polio and the nature of late-onset neurologic symptoms that could be attributed to postpolio syndrome. There were 242 female and 88 male respondents to the study. Symptoms attributable to postpolio syndrome were present in 87.2% of female subjects and 73.9% of male subjects. Respondents with postpolio syndrome had a significantly greater prevalence of urologic symptoms than seen among respondents without postpolio syndrome, although no dominant pattern of voiding dysfunction was noted. The early onset of erectile dysfunction was more common among male subjects with postpolio syndrome than among male subjects without postpolio syndrome. Genuine stress incontinence was seen in 36.3% of the survey population. Sixteen women with postpolio syndrome underwent surgical repair for urinary incontinence, with a success rate of 60.5%. Bladder disorders are common among persons with PPS, but further clinical and urodynamic data are necessary to define the nature and magnitude of this dysfunction.

Adult↗
PubMed1995

Combined Leydig cell and Sertoli cell dysfunction in 46,XX males lacking the sex determining region Y gene.

We have evaluated 3 individuals with a rare form of 46,XX sex reversal. All of them had ambiguous external genitalia and mixed wolffian and müllerian structures, indicating both Leydig cell and Sertoli cell dysfunction, similar to that of patients with true hermaphroditism. However, gonadal tissue was not ovotesticular but testicular with varying degrees of dysgenesis. SRY sequences were absent in genomic DNA from peripheral leukocytes in all 3 subjects. Y centromere sequences were also absent, indicating that testis development did not occur because of a low level mosaicism of Y bearing cells. The subjects in this report demonstrate that there is a continuum in the extent of testis determination in SRY-negative 46,XX sex reversal, ranging from nearly normal to minimal testicular development.

Child↗
PubMed1993

Epidermoid cysts of testes and role of sonography.

Four patients with histologically proved epidermoid cysts of the testicle were managed with radical orchiectomy. High-resolution testicular sonography demonstrated similar findings in all cases, but these findings were not specific and did not preclude other malignant or teratomatous lesions. The lack of both unique clinical features and specific sonographic findings would suggest that extreme caution must be used if wedge resection or enucleation is contemplated for a patient with presumed epidermoid cyst.

Adolescent↗
PubMed1992

The effects of ileocystoplasty on the development of renal failure in a rat model 5/6 nephrectomy.

We examined the effects of ileocystoplasty on renal function and bone mineral content in 160 juvenile male Wistar-Furth rats with and without renal insufficiency induced by 5/6 nephrectomy. At intervals up to 20 weeks blood, bone and kidney samples were obtained with the animals under anesthesia and then they were sacrificed. Serum parameters of renal function and calcium metabolism were measured. Samples of bone were analyzed for calcium, magnesium and phosphorus content. At 20 weeks after 5/6 nephrectomy renal function was decreased by approximately half. The decrease in renal function and the changes in renal histology were identical in animals with and without ileocystoplasty. Bone mineral content in the animals with renal insufficiency with or without ileocystoplasty was not different from sham operated animals or from animals with an ileocystoplasty and normal renal function. These studies demonstrate that ileocystoplasty per se does not hasten the progression to renal failure or produce bone demineralization in rats having moderate renal insufficiency.

Animals↗
PubMed1990

Management of pregnancy after major urinary reconstruction.

Major reconstructions of the urinary tract are being performed with increasing frequency. However, published experience concerning pregnancy after urinary reconstruction is limited. Complications in women who have undergone such complex procedures may endanger them or their fetuses and can disrupt the reconstruction or impair renal function. To counsel better those patients who have undergone urinary reconstruction and who desire to bear children, and to develop an approach to the management of their pregnancies, we reviewed the available literature. We found that the incidence of complications was low during pregnancy after a genitourinary reconstruction; the majority of women had an uneventful pregnancy and vaginal delivery. Close observation of renal function and prophylaxis against urinary tract infection during pregnancy are recommended. Elective cesarean is advised for women who have had a reconstruction of the bladder neck or urethra or who have received an artificial urinary sphincter. Urologists and gynecologists must continue to report the outcome of pregnancy in their patients who have undergone reconstruction so that we may develop meaningful data about the incidence of complications.

Female↗
PubMed1986

Experience with single stage hypospadias reconstruction.

Our experience with single stage primary hypospadias repair in 96 patients over a 12-month period is reviewed. The ages ranged from 7 months to 14 years with an average of 3.5 years. Seventeen patients were 18 months or younger at the time of operation. Meatal advancement and glanuloplasty (MAGPI) was performed in 46 patients mainly with coronal and glanular hypospadias. There was a fistula rate of 4%. The modified Mathieu and Mustarde operations were used for subcoronal and distal hypospadias. The transverse preputial island flap technique was found to be very versatile and was employed in 33 patients. The fistula rate was 18% and proximal urethral stricture rate 9%. These complication rates are considered quite acceptable in busy centers where surgeons in training are involved in these operations. It is concluded that by mastering a relatively limited number of techniques, single stage hypospadias reconstruction can be undertaken in almost all cases at the optimal time.

Adolescent↗
PubMed1985

Surgical approaches to block dissection of the inguinal lymph nodes.

Block dissection of the inguinal lymph nodes is associated with a high incidence of complications, the most frequent of which are related to wound healing. To determine the optimal surgical approach, a review of our experience over the last 10 years was undertaken. Fifty inguinal lymph node dissections are presented. The patients were divided into four groups according to the surgical incision used. The duration of hospital stay and incidence of complications were compared. We conclude that the optimal surgical approach is an elliptical incision removing a 4 cm width of skin over the inguinal nodes. Incisions that did not sacrifice at least a 4 cm width of skin had an inordinately high complication rate and a prolonged hospital stay. Approaches to wound closure, the management of bulky disease and primary lesions in continuity with the groin, and the use of adjunctive measures to reduce morbidity are discussed.

Adult↗
PubMed1984

Testicular torsion: management with ultrasonic Doppler flow detector.

The use of the ultrasonic Doppler flow detector in the management of acute testicular torsion is described. The Doppler can be used to diagnose torsion accurately and also to monitor manual detorsion. In this series detorsion was a reliable procedure which avoided emergency exploration in 5 of 8 patients with acute torsion. The advantages and limitations of the Doppler flow detector are presented.

Adolescent↗