An unusual manifestation of testicular lymphoma.
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Diplopia↗
Biomedical subjects
M Ziegelbaum
Publications and source records attributed to M Ziegelbaum.
Electrohydraulic lithotripsy of ureteral calculi: the Stony Brook experience.
We have used electrohydraulic lithotripsy for the treatment of ureteral calculi in a total of 29 patients. By combining the use of a 3.0 Fr electrode and a 9.5 Fr rigid ureteroscope, we have been able to successfully treat the majority of our patients with ureteral calculi. Bypass stenting of obstructing ureteral stones aided in access and effectiveness of ureteroscopy and endoscopic lithotripsy. The success rate in our series of 30 primary treatments was 80%; failures were primarily related to stone composition. In summary, we have found electrohydraulic lithotripsy of ureteral calculi to be a safe and effective treatment modality and routinely used it for stones throughout the length of the ureter that were either impacted or too large to extract primarily.
Calcium Oxalate↗
Arteriovenous malformation of spermatic cord.
A case of an arteriovenous malformation of the spermatic cord presenting as a hard scrotal mass is described. This is the first reported case of an arteriovenous malformation of the spermatic cord, and therefore this benign lesion should be included in the differential diagnosis of paratesticular masses.
Adult↗
Reversal of end stage renal failure with surgical revascularization in patients with atherosclerotic renal artery occlusion.
A total of 9 patients with end stage renal failure caused by atherosclerotic renal artery occlusion underwent surgical revascularization with subsequent recovery of renal function. The duration of dialysis preoperatively ranged from 1 week to 13 months. In all cases renal viability was being maintained by collateral vascular supply. Postoperatively, renal function improved immediately and no patient required subsequent dialysis. Excellent over-all rehabilitation was achieved in all patients. Six patients currently are alive at a mean interval of 4.0 years postoperatively and with satisfactory renal function (mean serum creatinine 2.7 mg. per dl.). Three patients died at a mean interval of 6.8 years postoperatively and they all maintained satisfactory renal function (mean serum creatinine 3.0 mg. per dl.) until death. In some patients with end stage renal failure caused by atherosclerotic arterial occlusion surgical renal revascularization can yield extended survival with freedom from chronic dialysis.
Aged↗
Two-color immunofluorescence flow cytometric analysis of lymphocytes in long-term renal allograft recipients.
We used 2-color immunofluorescence flow cytometry (FACS 440) and monoclonal antibodies (Becton-Dickinson) to study peripheral blood lymphocytes subsets from 26 patients with well functioning renal allografts for longer than 5 years. Comparisons were made to a group of 25 healthy volunteers and 25 dialysis patients awaiting renal transplantation. As anticipated, there was no significant difference with respect to the absolute number or percentage of activated (T11+ and HLA-DR+) and cytotoxic (Leu-2+ and Leu-15-)T lymphocytes among the 3 groups. However, there was a significantly decreased absolute number (p equals 0.0001) and percentage (p equals 0.0001) of suppressor cells (Leu-2+ and Leu-15+) in the transplant patients compared to the healthy control group. No significant differences existed between the transplant and dialysis groups. There also was an increase in the percentage (p equals 0.000) but not in the absolute number of T helper lymphocytes (Leu-3+ and Leu-8-) in the transplant population compared to healthy controls. No significant difference existed between the transplant and dialysis groups. These findings suggest that a normal value of cytotoxic (Leu-2+ and Leu-15-) and activated (T11+ and HLA-DR+) T lymphocytes may be a good prognostic indicator of long-term survival of renal allografts. Also, the highly significant decrease in the number of Leu-2+ and Leu-15+ cells in long-term, well functioning allografts indicates that additional functional characterization of this subset may be necessary.
Adult↗
Baseline renal function and surgical revascularization in atherosclerotic renal arterial disease in the elderly.
From 1975 to 1984, 107 patients greater than or equal to 60 years of age had surgical revascularization at the Cleveland Clinic for correction of atherosclerotic renal arterial disease. To evaluate the effect of baseline renal function (RF) on outcome in older patients, the patients were retrospectively divided according to their preoperative serum creatinine levels into Group I, less than or equal to 1.4 (N = 26), and Group II, greater than or equal to 1.5 (N = 81). Extrarenal atherosclerosis was more frequent in Group II (P less than .005). Higher rates of complications were seen both in Group II and with extrarenal atherosclerosis, but these associations did not achieve statistical significance (P = .07). Baseline RF did not affect results, but after revascularization, the fall in diastolic blood pressure was greater in Group I (28.2 +/- 4.4 mmHg v 17.4 +/- 1.8 mmHg, P less than .05). No such effect was noted in systolic blood pressure or in the frequency of cure or improvement v failure. Operative mortality for the entire group was 2.8%.
Arteriosclerosis↗
The identification of lymphocyte phenotypes in peripheral blood of long-term renal allograft patients.
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Antibodies, Monoclonal↗
The use of 99mtechnetium in the diagnosis of patent processus vaginalis.
We report 2 cases of scrotal swelling after placement of peritoneal catheters. 99mTechnetium intraperitoneal scanning was used to identify a patent processus vaginalis in each case. This simple, rapid, and nontoxic method can be used routinely to screen patients for a subclinical hernia before institution of intraperitoneal therapy.
Adult↗
Conservative surgery for transitional cell carcinoma of the renal pelvis.
From 1972 to 1986, 14 patients underwent a conservative operation for transitional cell carcinoma of the renal pelvis. Most of these patients had low grade (12), noninvasive (10) tumors involving a solitary functioning kidney (12). The operations performed were open pyelotomy with tumor excision and fulguration (8 patients), partial nephrectomy (5) and percutaneous nephroscopic fulguration (1). There was 1 operative death. Of the 13 surviving patients 8 (62 per cent) remained free of transitional cell carcinoma postoperatively, while 5 (38 per cent) had recurrent disease. Six patients (46 per cent) presently are free of tumor 6 months to 5 years postoperatively. Conservative surgical techniques can provide satisfactory treatment for selected patients with renal pelvic transitional cell carcinoma when preservation of functioning renal parenchyma is necessary to avoid kidney failure.
Adult↗
Management of renal arterial disease in the elderly patient.
From 1979 until 1984, 70 elderly (greater than or equal to 65 years of age) patients with atherosclerotic renal arterial disease underwent surgical revascularization (SR, N = 46) or percutaneous transluminal renal angioplasty (PTRA, N = 24). After SR, there were no operative deaths and seven major complications. After PTRA, there were six major complications, including two deaths. The clinical success rate with SR was better than with PTRA both in terms of amelioration of hypertension (100.0 versus 27.3 per cent) and preservation of renal function (85.0 versus 68.4 per cent). SR can be done safely and is the most effective treatment for elderly patients with renal artery disease.
Aged↗
Splenorenal bypass in the treatment of renal artery stenosis: experience with sixty-nine cases.
From 1962 to 1984 splenorenal bypass was performed in 69 patients with renal artery disease caused by either atherosclerosis (n = 54) or fibrous dysplasia (n = 15). Renal revascularization was performed to control hypertension in 27 patients, to preserve renal function in nine patients, and for both of these reasons in 33 patients. The mean follow-up interval is 5.4 years. Postoperatively hypertension was cured or improved in 52 of 60 patients (87%); the serum creatine level was improved or stable in 37 of 42 patients (88%) who underwent revascularization to preserve renal function. Postoperative graft thrombosis (n = 2) or stenosis (n = 3) occurred in five patients (7%). Splenorenal bypass is an excellent method of revascularization of the left renal artery, particularly for patients with a troublesome aorta that precludes performance of an aortorenal bypass.
Adolescent↗
The association of Peyronie's disease with HLA B7 cross-reactive antigens. A case report of identical twins.
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Aged↗
Acute urinary retention associated with flecainide.
A case of acute urinary retention, presumably secondary to the use of the antiarrhythmic drug flecainide, is presented. A mechanism for this effect is proposed based on the possibility of a local anesthetic effect on bladder mucosa.
Acute Disease↗
Trends in surgical revascularization for renal artery disease. Ten years' experience.
We reviewed our experience with surgical revascularization (SR) for renal artery disease (RAD) in 361 patients from 1975 through 1984 to illustrate the evolving role of SR in the management of these patients. The time intervals selected for comparison were 1975 through 1980 (n = 174) and 1981 through 1984 (n = 187). Since 1981, in patients with atherosclerosis, SR has been done more often in elderly patients (30% vs 10.4%), in patients with generalized atherosclerosis (87% vs 73%), and for the sole purpose of preserving renal function (36% vs 14%). Since 1981, fewer patients with atherosclerosis have undergone SR solely to treat renovascular hypertension (26% vs 41%). Since 1981, in patients with fibrous dysplasia, SR has been done in more patients with branch renal artery disease (70% vs 28%). These trends in the performance of SR have been due to the advent of percutaneous transluminal angioplasty as effective therapy for certain patients, improved results of SR in elderly patients with atherosclerosis, an enhanced appreciation of advanced atherosclerotic RAD as a correctable cause of renal failure, and the development of more effective techniques for SR in patients with severe aortic atherosclerosis and branch RAD. The overall clinical results of SR remain excellent in properly selected patients with RAD.
Adult↗