PubMed Health⌕ Search

Biomedical subjects

L A Klein

Publications and source records attributed to L A Klein.

16 recordsLinked to original sources
PubMed1989

Balloon dilatation for prostatic obstruction. Long-term follow-up.

Balloon dilatation of the prostatic urethra may improve the uroflow in patients with benign prostatic hypertrophy (BPH). In this study, patients were assigned blindly for balloon dilatation (5 men) or observation (3 men). A 36F balloon was inflated in the prostatic urethra with local anesthesia and fluoroscopic guidance for thirty minutes. The effects of the procedure were monitored during a two-year follow-up period. Two of the treated patients had improvement in uroflow and experienced stabilization of clinical symptoms. Two had no significant change in uroflow and required prostatectomy within the observation period. One required prostatectomy soon after dilatation. One of the 3 patients in the control group required prostatectomy in the two-year follow-up period and the other 2 continue to have obstructive symptoms. Although dilatation of the prostatic urethra by balloon may relieve some patients of urinary outflow obstruction due to BPH, it appears that a 36F balloon dilator does not produce dramatic or consistent results, and the effects of larger balloons should be evaluated.

Adult↗
PubMed1979

Management of infected polycystic kidneys.

We report 5 cases of severe uncontrolled infection of polycystic kidneys. Retrograde pyelography antedated infection in 2 of the patients. Difficulty in establishing the diagnosis was demonstrated in all cases. Each patient was treated initially with antibiotics but definitive therapy required an operation in 4 cases.

Adult↗
PubMed1978

Prevention of deep vein thrombosis in urological patients: a controlled, randomized trial of low-dose heparin and external pneumatic compression boots.

A prospective, randomized clinical trial in 83 patients undergoing open urological operations was performed to compare the relative prophylactic efficacy of low-dose heparin and external pneumatic compression (EPC) of the calves in comparison to no treatment in the prevention of deep vein thrombosis (DVT). The diagnosis of deep vein thrombosis was established by the I125 fibrinogen scan and contrast phlebography. The data indicate that EPC is more effective than no treatment (p less than 0.04) and more effective than low-dose heparin (p less than 0.04) in the prevention of DVT. There was one pulmonary embolus in each of the three groups, and in the treatment groups this occurred without evidence of DVT.

Adult↗
PubMed1978

Propranolol protection in acute renal failure.

Activation of the renin-angiotensin system has been implicated as one of the mechanisms involved in acute renal failure. Support of this hypothesis was forwarded by the finding that propranolol, a blocker of renin release, reduced the deleterious effect of ischemia on kidney function. The hypothesis was tested further in these experiments by studying renal blood flow after ischemic injury to rat kidneys with and without propranolol proection. Miniature electromagnetic flow probes measured blood flow after 70 min of total renal artery occlusion. Although brief infusion of propranolol reduced the degree of acute renal failure, it had no effect on renal blood reflow. The data do not support the hypothesis that the renin-angiotensin system plays a role in acute renal failure. Other explanations for the protective effect of propranolol are suggested.

Acute Kidney Injury↗
PubMed1976

In situ dissolution of ureteral calculus.

An obstructing uric acid calculus was successfully managed by dissolution in situ. The methods used are described in detail. Perhaps not applicable in all cases, the ease of the procedure makes it worth considering especially in patients at high risk for open operative intervention.

Allopurinol↗
PubMed1975

B-mode nephrosonography in renal masses. Its use and some limitations.

One hundred B-mode nephrosonograms were reviewed, and 41 percent of these had a diagnosis proved by either arteriography, cyst puncture or tissue examination. There were 8 proved normal sonograms with one error, an upper pole renal cell carcinoma in a kidney badly distorted by chronic pyelonephritis and ureteral obstruction. Overlying ribs and anatomic distortion contributed to the misinterpretation. Sonic diagnosis of solid tumor was correct in all proved cases. Cysts were diagnosed in 23 patients; six were in error. Four were called cysts less than 3 cm. in diameter. If the lower limit of sonographic resolution is considered 3 cm., the accuracy for diagnosed simple cysts becomes 90 per cent.

Adenocarcinoma↗
PubMed1975

Extended angiography in diagnosis and treatment of renal carcinoma.

New and highly sophisticated advances in uro-angiography need to be systematically analyzed and presented for evaluation. Our experience with these techniques applied to renal carcinoma is reviewed. This series demonstrates the important features of angiography in the diagnosis and treatment of renal carcinoma although the number of patients was not large enough to permit statistical treatment of the data. We anticipate that close cooperation between radiologist and urologist will continue to produce advances such as annotated in this report.

Adenocarcinoma↗
PubMed1975

Disruption of the renal pelvis by blunt trauma.

Blunt trauma to the renal pelvis is exceedingly rare and such trauma of the ureter is only slightly more common. A tetrad of radiologic findings should suggest the diagnosis when there is a high index of suspicion. It would seem that early surgical treatment would be the preferred program but in the face of serious associated trauma there is little lost by waiting. Nineteen days elapsed between injury and repair in this case. That duration may be excessive, but as shown in this case the result was excellent and the patient's retroperitoneum was never infected. We do not advocate a purposeful delay of this duration but on the other hand there is no reason to assume that it is particularly harmful.

Abdominal Injuries↗
PubMed1975

Beta-adrenergic (isoproterenol) regulation of antidiuretic hormone.

Antidiuretic hormone (ADH) and isoproterenol (ISO) both cause renal retention of water when infused iv into animals. It has been suggested that the agents share a common mechanism of action but the current work reveals marked differences in the effect of ISO and ADH on urinary excretion of sodium (ISO produces fall from 50 plus or minus 14 to 3 plus or minus 0.6 mu Eq per 20 min, P greater than 0.0005; ADH causes a fall from 62 plus or minus 14 to 45 plus or minus 9, P greater than 0.05) and creatinine (ISO causes a fall from 157 plus or minus 14 to 71 lus or minus 13, P greater than 0.0005; ADH produces fall from 155 plus or minus 12 to 145 plus or minus 14, P greater than 0.05), which suggest that the actions of the agents may differ. To study that possibility, ISO was infused into normal rats and rats with hereditary diabetes insipidus (DI rats) due to a genetic defect in ADH production. Doses previously used (0.2 mug per kg per min, and doses 10 and 100 fold less were infused. At 0.002 mug per kg per min, urine osmolality in both groups of rats declined (DI rats from 177 plus or minus 22 to 141 plus or minus 13 MOsm per kg, P greater than 0.01, and normals from 162 plus or minus 17 to 142 plus or minus 15 MOsm per kg, P greater than 0.05). At 0.02 mug per kig per min, there was no significant change is osmolality. At 0.02 mug per kig per min, osmolality rose in both groups but the response was significantly blunted in the DI rats (normals: 351 plus or minus 32 to 626 plus or minus 79 mOsm per kg, P greater than 0.005; DI rat: 204 plus or minus 23 to 241 plus or minus 30 P greater than 0.05). It is concluded that intravenous ISO has a dual effect on water excretion; at low doses it is associated with reduced urinary osmolality possibly by direct renal action and at high doses it is associated with antidiuresis by stimulating release of pituitary ADH.

Animals↗
PubMed1975

alpha-Adrenergic (norepinephrine) effect on antidiuretic hormone activity.

The mechanism by which norepinephrine (NE) inhibits the antidiuretic activity of anti-diuretic hormone (ADH) was studied in anesthetized normal and ADH-deficient rats. NE infusion increased aortic blood pressure and resulted in increased urine volume and sodium and potassium excretion without changes in creatinine excretion. p-Aminohippuric acid excretion did not change in normals and rose (from 34 +/- 9 to 51 +/- 11, P less than 0.025) in ADH-deficient rats. Urine osmolality fell in normals (from 363 +/- 29 to 298 +/- 42, P less than 0.05) but not in ADH deficients (from 332 +/- 29 to 363 +/- 26, p less than 0.1). ADH-deficient rats given 50 muU per kg-min of ADH intravenously responded with antidiuresis, including hyperosmolality (from a range of 225 to 240 to a range of 332 to 333, P less than 0.025). When NE was infused at 0.5 mug per kg-min, no inhibition of hyperosmolality was noted but natriuresis and augmented volume excretion occurred. At 1.5 mug per kg-min, NE completely reversed the hyperosmolality induced with ADH. The results suggest that NE-induced pressure diuresis reduces osmolality only when ADH is present in the system and so by competitive inhibition of ADH action on the renal tubule.

Aminohippuric Acids↗