Biomedical subjects
Publications and source records attributed to M Cendron.
Germ cell testicular tumor is a previously undescribed entity in association with von Hippel-Lindau disease. This case exemplifies the variety of pathologic entities encountered in von Hippel-Lindau disease and stresses the importance of thorough evaluation of the patient, as well as careful follow-up, to ensure early detection of potentially malignant lesions.
The Mitrofanoff procedure (appendicovesicostomy and creation of a low-pressure urinary reservoir) is a technically innovative way of providing patients with a form of continent diversion. The principles behind the procedure are use of a narrow, supple conduit, which, when brought out to the skin as a catheterizable stoma, will provide continence by acting as a flap-valve and attachment of the conduit to a low-pressure urine storage reservoir by an antireflux mechanism. Upper-tract contamination is prevented by an antireflux mechanism at the level of the distal ureters. Strict attention to every step of the procedure is mandatory. Emptying of the reservoir is achieved by clean intermittent catheterization. Long-term results are good in a majority of patients with careful selection and education. Life-long follow-up of patients is mandatory.
Rupture of the corpus cavernosum is a rare but probably under-reported entity. It truly represents a urological emergency and current recommendations are for early surgical intervention. We review 5 cases with evaluation, treatment and followup. Delays in treatment lead to long-term complications, such as erectile dysfunction and penile curvature.
The coincidence of systemic amyloidosis and xanthogranulomatous pyelonephritis has been reported previously only once. Clinical findings, such as the nephrotic syndrome, cardiac and autonomic nervous system dysfunction, and adrenal insufficiency, are suggestive and a thorough investigation to rule out other causes of secondary amyloidosis is warranted. We report a case of xanthogranulomatous pyelonephritis associated with secondary systemic amyloidosis and the nephrotic syndrome. Treatment consisted of nephrectomy and intensive supportive care. The unique clinical, radiographic and pathological aspects of this case are discussed.
We assessed the fertility of 40 patients who underwent orchiopexy between 1950 and 1960. Testicular biopsies also had been performed at operation, a practice exceptional for the era. Of 23 patients with unilateral undescended testes who attempted to have children 20 (87 per cent) were successful. In contrast, only 3 (33 per cent) of 9 patients with bilateral undescended testes fathered children. Over-all sperm counts in 16 patients were low but they were not predictive of paternity. Testicular biopsy specimens were reviewed and the fertility index was determined. In most cases a good correlation was found between histological status and paternity status.
Urinary retention and the possible consequence of infection after total joint replacement is an important subject to urologists and orthopedic surgeons. A prospective, randomized study was performed in 77 elderly female patients with total joint replacement to test whether twenty-four-hour catheterization perioperatively or straight catheterization postoperatively in the recovery room might reduce the control group's incidence of postoperative urinary tract infection (9%), urinary retention (57%), and subsequent urinary catheterizations. In 16 percent of the patients who had straight catheterization in the recovery room a urinary tract infection developed postoperatively, and 65 percent of these patients required at least one more catheterization with 13 percent requiring a subsequent indwelling Foley catheter. The patients who had perioperative (immediately preoperatively and for 24 hours postoperatively) catheter drainage had a zero incidence of retention and only a 4 percent incidence of urinary tract infection. We recommend this regimen for elderly female patients undergoing total joint replacement under spinal anesthesia.
Intracellular parasitism of host macrophages is the pathologic hallmark of leishmaniasis. Since the organisms are found almost exclusively in this type of cell, the possibility that specific macrophage plasma-membrane determinants mediate the attachment to promastigotes of Leishmania tropica was investigated. Plasma membrane vesicles were prepared from human monocytes/macrophages and erythrocytes, radioiodinated, and incubated with L tropica promastigotes, erythrocytes, or Sephadex beads. Macrophage plasma-membrane vesicles bound to promastigotes to a significant extent but did not bind to intact erythrocytes or to an inert particle. In contrast, erythrocyte membrane vesicles did not bind to promastigotes. The binding of macrophage plasma-membrane vesicles to promastigotes demonstrated the characteristics of a receptor-ligand interaction in terms of specificity, saturability, competitive inhibition, and temperature independence. These results suggest the presence of one or more intrinsic binding sites on the macrophage plasma membrane to which promastigotes can attach. If this is the case, therapeutic intervention by strategies that inhibit attachment of this obligate intracellular parasite to its target host cell may be possible.
Distal hypospadias is one of the most common conditions encountered by the pediatric urologist. For many years it was considered to be a non-surgical pathology, since attempts to correct this condition was cosmetically unsatisfactory and more problems were caused rather than resolved. Over the last 15 years, early in the 80's, John Duckett rekindled the interest in this pathology whose treatment had advanced very little since the era of Mathieu. This article is a posthumous tribute to my mentor, John W. Duckett, who contributed considerably to the advancement of surgical treatment of hypospadias.