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Biomedical subjects

M Wosnitzer

Publications and source records attributed to M Wosnitzer.

12 recordsLinked to original sources

Rapid detection methods for bacterial identification in urologic office laboratory.

A regulatory era is taking shape under the Health Care Financing Administration (HCFA) which eventually will be implemented under the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88). Sweeping changes are planned for all laboratories, including physician's office and group practice offices. Both of these groups have previously been exempt from federal controls. Though many urologists have been doing urine cultures and colony counts in their offices for a long time, it is important that precise bacterial identification also be done for good patient care, to control quality and cost, and for more rapid results. Herein, we review many commercial kits now available for precise bacterial identification in the office laboratory. These are largely unknown to most practicing urologists but have been available to microbiologists. They easily can be learned and used in an office or group practice Urologists are competent to perform these tests, especially with a review course or with assistance from their local hospital microbiology laboratory.

Microbial Sensitivity Tests

New versatile operating room table and mobile C-arm fluoroscopic system.

The rapid development of endourologic procedures and ultrasonic renal stone surgery has left most hospital operating rooms without a suitable radiolucent operating table and a safe up-to-date C-arm fluoroscopic unit for these operations. A new radiolucent operating room table top combined with a new mobile C-arm fluoroscopy unit will allow versatility in the operating room for these percutaneous antegrade renal and ureteral operations. This table offers the additional benefits of being excellent for transurethral resection of the prostate, bladder tumors, litholapaxy, and cystoscopy as well as open bladder, prostate, trauma, and renal surgery. It also offers adequate space under it so that the microsurgeon can get his knees under the table while seated to do vasovasostomy and vasoepididymostomy with comfort. The urologist can thus perform all types of surgery on one table top and also relieve the cystoscopy room of a crowded schedule by doing some endoscopic surgery in the regular operating room.

Fluoroscopy

Aid to stabilize hinged Strauch clamp during microvasovasostomy.

Urologists using the large and small Strauch clamps for microvasovasostomy have found that these clamps allow splendid visualization of the end and mucosa-lined lumen of each vas. However, an assistant must stabilize the clamp by holding it while in the "folded" position or else both the clamp and the ends of the vas will move when the sutures are placed in the mucosal lining of the lumens and in the muscular wall of the vas. A simple clamp holder has been designed to stabilize the "folded" Strauch clamp while these sutures are being placed. After the initial "critical" sutures are placed to line up the lumen of each end of the vas, the clamp is unfolded and used in the straight position for placement of the remaining necessary muscular sutures. This allows the surgical assistant to have two free hands rather than one and greatly reduces difficulties with keeping the vas in focus while placing the initial critical sutures.

Humans

Optical magnification and Doppler ultrasound probe for varicocelectomy.

Varicocelectomy is usually considered a simple urologic operation. However, it is most frequently difficult to visualize and identify the 0.5 mm internal spermatic artery and tiny lymphatic channels when cutting and ligating the internal spermatic veins. The internal spermatic artery and tiny lymphatic channels can be damaged easily, cut, or ligated during this procedure. This occurs surprisingly more often than is realized by the surgeon. By introducing optical magnification or the operating microscope at the time the veins are identified, the surgeon can easily find and dissect off adherent lymphatics or the internal spermatic artery with some microsurgical instruments, and thereby preserve these vessels rather than cut or damage them inadvertently. The sterile Doppler probe also can be utilized to help identify and confirm the location of the internal spermatic artery if it is not easily found in the spermatic cord.

Arteries