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Biomedical subjects

J Wolpert

Publications and source records attributed to J Wolpert.

4 recordsLinked to original sources

Extracorporeal shock wave lithotripsy for calcified ureteral stent.

Calcification of a ureteral stent has been an unusual complication of long-term stent use for bypassing ureteral obstruction or after surgical repair. Open or percutaneous procedures have usually been required to remove the calcification before the stent can be extracted. We report six cases of calcified ureteral stents successfully managed by extracorporeal shock wave lithotripsy (SWL) followed by cystoscopic extraction, thus avoiding open or percutaneous procedures.

Adult

Bilateral testicular injury from external trauma.

Among 79 patients with testicular injury as a result of external trauma 5 had bilateral injury. Such injury occurred in only 1 of 66 patients (1.5 per cent) with blunt trauma versus 4 of 13 (31 per cent) with penetrating trauma. Bilateral ruptures were managed by bilateral partial orchiectomy in 2 cases, and orchiectomy with contralateral débridement and suturing in 1. Of 2 patients with unilateral rupture and contralateral contusion the contusions were treated by evacuation of the hematoma and the ruptures were managed by orchiectomy in 1 and partial orchiectomy in the other. Four patients were available for followup. One patient was hormonally anorchid but he obtained normal erections with testosterone cypionate, 1 had normal serum testosterone concentrations but borderline normal semen analysis, and 1 had reduced erections and borderline normal semen. The remaining patient had normal erections and no semen analysis was performed. The nature of the injury rather than the type of treatment appears to be the primary determinant of the outcome in these cases.

Adolescent

Adult Wilms' tumor. Intraoperative cytology and ancillary studies performed in a case as an adjunct to the histologic diagnosis.

A case of blastema-predominant Wilms' tumor in a 64-year-old woman is reported. Intraoperative cytology of a renal mass was used to rule out malignant lymphoma and neuroendocrine carcinoma. Light and electron microscopy, immunocytochemical staining and flow cytometry (FCM) were also performed. Immunoperoxidase studies of smears showed positive staining for vimentin and negative staining for cytokeratins and epithelial membrane antigen. FCM DNA analysis of paraffin-embedded tissue showed no aneuploid peak. Frozen section interpretation of such tumors as seen in this case may be difficult, requiring distinction among several small-blue-cell neoplasms, including Wilms' tumor, neuroendocrine carcinoma and malignant lymphoma; intraoperative cytology can provide a valuable adjunct to frozen section diagnosis.

DNA, Neoplasm