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Biomedical subjects

M Barkin

Publications and source records attributed to M Barkin.

28 records · Page 2Linked to original sources
PubMed1977

Surgical treatment of the massively dilated ureter in children. Part I. management by cutaneous ureterostomy.

One of the major therapeutic challenges facing the pediatric urologist is the massively dilated ureter. When conservative measures, such as relief of obstruction or treatment of infection, have failed or are likely to fail, surgical treatment must be directed at the massive dilatation itself. These circumstances were encountered in 366 massively dilated ureters in 244 children during a 10-year period. Loop and/or terminal cutaneous ureterostomy was used to manage 125 of these ureters in 74 children. Indications for temporary non-intubated proximal urinary diversion included uncontrolled infection, sepsis, azotemia, significant ureteral redundancy and tortuosity, and questionable over-all renal function. Advantages of loop ureterostomy included more proximal drainage and less stomal problems but terminal ureterostomy required a significantly lesser number of surgical procedures in reconstructing the urinary tract. Temporary splinting of the ureter in dry ureteral reimplantations has diminished markedly the incidence of ureterovesical complications. No instances of permanent vesical contracture were noted after long periods of defunctionalization. After initial reconstruction of 47 cutaneous ureterostomies good results by all parameters were obtained in 68 per cent. Additional surgical procedures in selected initial failures have resulted in a final success rate of 85 per cent.

Dermatologic Surgical Procedures↗
PubMed1976

Ureteral structure and ultrastructure. Part I. The normal human ureter.

Twenty-eight normal human ureters were examined under the light and electron microscope. Three uretero-trigonal units were microdissected. The ureter is a non-layered muscular tube wherein the anatomical unit is muscle bundles that contain heterogeneously oriented muscle cells. Functional continuity of muscle cells is provided through the nexus, which are clearly defined structures. A group of morphologically distinct muscle cells are identified and these may represent the ureteral pacemaker cells. The functional status of muscle cells causes certain morphologic changes and, thus, the cells fixed in contraction differ from those fixed in relaxation and in vitro testing of muscle cell contractility is feasible. The ultrastructure of the normal urothelium and the adrenergic and cholinergic components of ureteral nerves are presented briefly.

Humans↗
PubMed1976

Ureteral structure and ultrastructure. Part II. Congenital ureteropelvic junction obstruction and primary obstructive megaureter.

The structure and ultrastructure were studied of 48 specimens from cases of congenital ureteroplevic junction obstructions and primary obstructive megaureters. Under light microscopy a spectrum of findings occurs, extending from the nearly normal to the clearly abnormal obstructive segments. However, under electron microscopy there were consistent abnormalities: 1) excessive collagen fibers between and around the muscle cells and 2) a group of compromised muscle cells proximal to the collagenous segment. These findings are responsible for functional discontinuity via the nexus and indistensibility of the pathologic areas. The high resolution of the electron microscope allows clearer definition of these obstructions and the impact of these findings on surgical remodeling is discussed.

Dilatation, Pathologic↗
PubMed1975

The surgical approach to Peyronie's disease.

Seven patients with Peyronie's disease were treated by surgical exposure of the fibrous plaque and dermo-jet injection of steroids into the plaque under direct vision. Relief of pain was obtained in 2 of 3 patients and curvature was only moderately improved i 2 of 7 patients. One of 4 patients who were unable to perform coitus because of the curvature noted improvement after the injections. The low rate of response in this small series of patients would suggest that there is no additional benefit in the use of the dermo-jet over percutaneous injection of the plaques. The latter procedure can be performed more easily on a repeated basis over a longer period. Two patients whose plaques were excised and repalced by a dermal inlay graft have had a good response to treatment and it would appear that this technique is useful for the patient who has failed to respond to conservative measures and who is significantly disabled by the disease.

Adult↗