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Biomedical subjects

L A Matthews

Publications and source records attributed to L A Matthews.

11 recordsLinked to original sources
PubMed1997

Renal transplantation using a kidney with a large benign cyst.

We report a case in which a living donor kidney that contained a large benign cyst was successfully transplanted between a mother and her daughter. The donor, a 53-year-old woman, had good renal function, but her right kidney contained a large 4-cm cyst that had a benign appearance on computed tomography. At operation the cyst was proven to be benign by frozen-section histological examination and the transplant was performed. Both donor and recipient continue to enjoy satisfactory renal function 3 years after transplantation. A review of the literature regarding renal cysts and management strategies for use of cystic kidneys in transplantation are presented.

Adult↗
PubMed1997

Nonoperative treatment of major blunt renal lacerations with urinary extravasation.

PURPOSE: We determined whether nonoperative treatment of major renal lacerations with urinary extravasation adversely affects patient outcome. MATERIALS AND METHODS: We reviewed all nonoperatively treated patients who presented between 1983 and 1994 with blunt renal trauma with major lacerations on initial staging computerized tomography. Patients with major lacerations associated with (31) and without (15) extravasation were compared for complications, blood transfusions and length of hospital stay. RESULTS: Urinary extravasation spontaneously resolved in 27 of 31 patients (87.1%), while 4 (12.9%) required a ureteral stent for persistent extravasation. No complications occurred in patients without extravasation. Mean hospitalization was 8.3 and 7.7 days for patients with isolated renal injuries with and without extravasation, respectively. Blood transfusions were required in 4 patients with and none without extravasation. CONCLUSIONS: Nonoperative treatment of major renal lacerations with urinary extravasation is safe and effective. Although delayed intervention may be required, complications can often be treated with endourological or percutaneous methods.

Adolescent↗
PubMed1997

Effect of preoperative human chorionic gonadotropin on intra-abdominal rat testes undergoing standard and Fowler-Stephens orchiopexy.

PURPOSE: We attempted to determine whether preoperative human chorionic gonadotropin (HCG) improves fertility in intra-abdominal rat testes subjected to orchiopexy. MATERIALS AND METHODS: Newborn male Sprague-Dawley rats were made cryptorchid by bilateral gubernaculum excision at age 14 days. Select rats served as controls and underwent sham operations. Half of the animals were injected with 10 international units HCG daily from days 14 to 28. On day 28 the animals were divided into group 1-6 that underwent sham operation with or without HCG, group 2-6 with cryptorchidism with or without HCG, group 3-22 that underwent standard orchiopexy with or without HCG and group 4-22 that underwent Fowler-Stephens orchiopexy with or without HCG. Contralateral orchiectomy was performed simultaneously. On day 65 each male rat was mated with 2 female rats for 3 ovulatory cycles. RESULTS: Mean testicular weight was markedly decreased in cryptorchid compared to sham operated testes (87.2 versus 344 mg./100 gm. body weight). Mean testicular weight was similar after standard and Fowler-Stephens orchiopexy. HCG enhanced mean testicular weight after sham operation, standard orchiopexy and Fowler-Stephens orchiopexy (403 versus 344, 193 versus 176 and 194 versus 175 mg./100 gm. body weight, respectively) but these differences were not statistically significant. Fertility was present in all 6 sham operated, 0 of the 6 cryptorchid, 1 of the 11 standard orchiopexy and 1 of the 8 Fowler-Stephens orchiopexy rats. Of the HCG treated animals 2 of the 8 that underwent Fowler-Stephens orchiopexy and 1 of the 8 that underwent standard orchiopexy were fertile. Mean weight of the testes associated with pregnancy was significantly greater than those not associated with pregnancy (p < 0.001). CONCLUSIONS: The intra-abdominal rat testis has limited fertility potential after orchiopexy that is not improved with preoperative HCG. After orchiopexy fertility correlates closely with testicular weight.

Animals↗
PubMed1996

Urolithiasis and cystic fibrosis.

PURPOSE: We determined whether cystic fibrosis patients are at increased risk for the development of urolithiasis. MATERIALS AND METHODS: Telephone interviews were conducted with 201 cystic fibrosis patients older than 15 years to identify those with a history of urolithiasis. Histories were confirmed by chart review, and only patients with urolithiasis documented by excretory urography, renal ultrasound or spontaneous passage of a stone were included. RESULTS: A total of 11 patients (5.5%) had documented urolithiasis, with 2 or more episodes in 7. Mean age at initial episode was 27.0 years (range 19 to 33). CONCLUSIONS: Cystic fibrosis patients may be at increased risk for urolithiasis compared to age-specific prevalence rates for stone disease in the general population.

Adult↗
PubMed1995

Impotence associated with blunt pelvic and perineal trauma: penile revascularization as a treatment option.

Erectile dysfunction (impotence) is a well-known complication of blunt pelvic and perineal trauma. The mechanism of injury is usually related to the trauma itself, via shearing of the penile blood vessels in the pelvis, or via direct trauma to the blood vessels in the perineum. The diagnostic evaluation of these patients should include evaluation of the nervous supply of the penis, the penile arterial tree and the veno-occlusive mechanism. Penile revascularization is a reasonable treatment option for this group in that many injured patients are young and show arterial injury, with minimal or no veno-occlusive dysfunction. Proper patient selection and precise operative technique should allow for restoration of erectile dysfunction in these patients.

Humans↗
PubMed1995

The nonoperative approach to major blunt renal trauma.

The treatment of major blunt renal trauma remains controversial, with opinion divided between those who favor expectant management and those who favor surgical exploration. The goals of each treatment regimen are to assure patient safety while simultaneously preserving renal function. It is our policy at Case Western Reserve, MetroHealth Medical Center (Cleveland, OH) that all hemodynamically stable patients be initially treated by observation. Renal exploration is reserved for those patients who become unstable or who develop complications. In this review, we compare our results with those in the literature in an attempt to determine whether a selective nonoperative approach to major renal trauma fulfils the goals of patient safety and renal preservation.

Humans↗