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Biomedical subjects

R A Straffon

Publications and source records attributed to R A Straffon.

At least 55 records · Page 3Linked to original sources
PubMed1981

Experience with extracorporeal renal operations and autotransplantation in the management of complicated urologic disorders.

Renal autotransplantation with or without an extracorporeal renal operation was performed 45 times upon 43 patients. Twenty-one patients underwent renal autotransplantation as surgical treatment for renovascular hypertension, all of whom are cured or have improved postoperatively. Sixteen renal autotransplants were performed upon 14 patients with extensive ureteral disease, 14 of which were successful. Six patients with carcinoma centrally located in a solitary kidney underwent extracorporeal partial nephrectomy and autotransplantation. Three of these patients are alive with functioning autografts and are tumor-free from one to five years postoperatively. Two patients with multiple recurrent renal calculi were successfully treated by extracorporeal pyelolithotomy and autotransplantation with pyelovesicostomy. An extracorporeal renal operation and autotransplantation can provide the best solution for selected urologic problems not correctable by conventional methods.

Humans↗
PubMed1981

The effect of sterile ureteral reflux on intact and diverted upper urinary tracts.

We studied the effect of sterile ureteral reflux on intact and diverted upper urinary tracts. Five dogs underwent transvesical left ureteral meatotomy and anastomosis of the right ureter to a refluxing ileal conduit. Several normal nonrefluxing renal units were also studied. At 6 months, renal function studies were not significantly different among control, ilealureteral, and vesicoureteral refluxing renal units. No radiographic or histopathologic abnormalities were observed in experimental renal units. Sterile intestinalureteral and vesicoureteral reflux do not seem to cause functional or morphologic renal damage.

Animals↗
PubMed1980

Anatrophic nephrolithotomy for removal of staghorn or branched renal calculi.

Forty anatrophic nephrolithotomies were performed in 38 patients between November, 1965, and December, 1977, to remove staghorn or branched renal calculi. Thirty-six (95 per cent) of the patients' preoperative urine cultures were infected, and postoperatively 35 of the cultures (88 per cent) were sterile. Magnesium ammonium phosphate calculi were present in the majority of patients (67 per cent). In 6 patients (15 per cent) transient nephrocutaneous fistulas developed. Thirty-six of the 40 renal units (90 per cent) had improved or stable intravenous pyelograms postoperatively. The patients had been followed for an average of twenty months (four to one hundred and twelve months). In 6 patients (15 per cent) recurrent renal calculi developed, and 3 patients (8 per cent) had residual calculi during this period.

Adult↗
PubMed1980

Renal revascularization in patients with total occlusion of the renal artery.

A total of 15 patients with renovascular hypertension underwent revascularization of totally occluded renal arteries. Preoperative clinical assessments suggesting renal salvageability include urographic visualization of the involved kidney, renal length greater than 9 cm., filling of the distal renal arterial tree on angiography and elevated renal vein renin levels. Postoperatively, hypertension was cured or improved in 14 patients and there was 1 failure. Over-all renal function improved in 9 of 10 patients with preoperative azotemia and stabilized in the remaining 5 patients. Revascularization can be done successfully in properly selected patients with complete renal artery occlusion, with control of hypertension and reversal of renal failure.

Adult↗
PubMed1980

Surgical management of branch renal artery disease: in situ versus extracorporeal methods of repair.

Herein are presented the techniques and their respective indications that have been found most effective in replacing the renal artery and its branches. Aortorenal bypass and, occasionally, splenorenal bypass can be tailored to achieve in situ repair of most branch renal artery lesions. Extracorporeal renal revascularization and autotransplantation have been done on onar disease. Revascularization with preservation of renal parenchyma can now be achieved in almost all patients with branch renal artery disease.

Aorta, Abdominal↗
PubMed1980

The effect of parathyroidectomy in patients with normocalcemic calcium stones.

With the entity of normocalcemic primary hyperparathyroidism increasingly prevalent in the literature the treatment of parathyroidectomy has been advocated. A total of 21 patients with recurrent calcium-containing calculi and normocalcemia underwent parathyroidectomy. Of the 21 patients 1 had an adenoma, 9 had hyperplasia and 11 had normal glands. Of the 19 patients followed stones ceased forming in 32 per cent, while in 42 per cent calculi continued to form. Of 5 patients with multiple unassessable calculi 1 ceased passing stones. We conclude that the entity of normocalcemic hyperparathyroidism is rare and repeated serum calcium determinations to identify true hypercalcemic hyperparathyroidism are necessary.

Adult↗
PubMed1980

Extracorporeal renal surgery and autotransplantation: indications, techniques and results.

Renal autotransplantation and/or an extracorporeal renal operation has been done 67 times in 65 patients. The indications for operation were severe ureteral injury in 8 patients, urinary undiversion in 2, renovascular hypertension in 10, carcinoma in a solitary kidney in 3, recurrent renal colic in 1 and donor arterial reconstruction before renal transplantation in 43. Methods of renal preservation and operative repair are described. Sixty-five operations were successful and 2 operations failed because of severe perirenal fibrosis in patients undergoing urinary undiversion. Renal autotransplantation and extracorporeal reconstruction can provide the best solution for selected urologic problems not correctable by conventional methods.

Extracorporeal Circulation↗
PubMed1980

Preservation of ischemically damaged canine kidneys. Cold storage versus perfusion.

Dog kidneys subjected to a period of warm ischemia followed by either simple cold storage or hypothermic pulsatile perfusion were autotransplanted 24 hr after harvesting, and a contralateral nephrectomy was performed at the same time. Renal function was comparable with both techniques, and all dogs survived. When kidneys were subjected to 30 min of warm ischemia followed by one of the two preservation methods, renal function was again comparable and 50 per cent of the animals in each group survived. We conclude, therefore, that for 24 hr of canine renal preservation, cold storage is as effective as pulsatile perfusion even when the kidney has been initially subjected to 30 min of warm ischemia.

Animals↗
PubMed1980

Effect of immunologic donor pretreatment on survival of perfused canine renal allografts.

We evaluated the effect of immunologic donor pretreatment followed by perfusion preservation on canine renal allograft survival. Donor-recipient pairs were selected on the basis of dog erythrocyte identity, a negative white blood-cell crossmatch, equivalent dog leukocyte matching, and significant mixed lymphocyte culture stimulation. Four hours before nephrectomy, all donors were pretreated with either normal saline or cyclophosphamide and methylprednisolone. After donor nephrectomy, all grafts were preserved by pulsatile perfusion for 24 hr. Transplantation into the matched recipient was performed with simultaneous bilateral nephrectomy. No significant difference was found in the postoperative serum creatinine levels or median allograft survival between the two groups. This controlled study showed no beneficial effect of donor pretreatment on survival of perfused canine renal allografts.

Animals↗
PubMed1979

Endarterectomy and patchgraft angioplasty in treatment of atherosclerotic renovascular hypertension.

From 1962 to 1978, 56 patients underwent transrenal endarterectomy as surgical treatment for renovascular hypertension. Over-all results were 39 per cent cured, 36 per cent improved, and 25 per cent failed. Criteria for selecting patients with atherosclerotic renal artery disease for surgical treatment are reviewed. Transrenal endarterectomy is a simple operation and should continue to be applied in the management of properly selected patients.

Adult↗
PubMed1979

Palatal metastases in renal cell carcinoma.

Renal cell carcinoma may metastasize early in its course and sometimes before the primary lesion becomes apparent. Two cases of renal cell carcinoma with the initial manifestation of metastases to the roof of the mouth are presented. The mode of metastases to the palate is discussed.

Adenocarcinoma↗
PubMed1979

Aortorenal reimplantation in treatment of renovascular hypertension.

From 1964 to 1977, 33 patients underwent aortorenal reimplantation as surgical treatment for renovascular hypertension. Over-all results were 13 patients cured (39 per cent), 15 patients improved (46 per cent), and there were 5 failures (15 per cent). The results were equally satisfactory in patients with atherosclerotic or fibrous renal artery disease. Postoperative arterial stenosis or occlusion occurred in 5 patients (15 per cent). Aortorenal reimplantation is an effective method of renal revascularization in properly selected patients, and long-term results are comparable with those of aortorenal bypass.

Adolescent↗
PubMed1979

Half and total body radiation for carcinoma of the prostate.

Despite recent advances in the treatment of stage D carcinoma of the prostate many patients become refractory to all therapeutic modalities. Progressive and incapacitating pain is one of the most difficult symptoms to manage. Ten patients with severely symptomatic metastatic adenocarcinoma of the prostate have been treated with either single or sequential doses of half body radiation using 800 rad delivered by a Linac 10 mV linear accelerator. There were 15 courses of half body radiation delivered and a good to excellent response was noted in 11 instances. Results often were immediate and the duration of the response was variable. Treatment was well tolerated with no fatal complications. Half and total body radiation appears to offer significant palliation and its use with other forms of therapy warrants further investigation.

Humans↗
PubMed1979

Use of penile corporeal injection to assess coronal hypospadias.

Coronal hypospadias is a frequent abnormality of the genitalia. It is recommended that patients with coronal hypospadias be assessed with the technique of penile corporeal injection during anesthesia and any patient with coronal hypospadias should be circumcised with the utmost caution and surgical discretion.

Child↗
PubMed1979

A simplified, cost-effective approach to the diagnosis of pheochromocytoma.

Plasma catecholamines have been used for diagnosis and computerized tomography scanning for localization in 21 patients with proved pheochromocytoma. Blood catecholamines were obtained in 20 of the patients and were elevated significantly in every instance. Successful localization of the tumor was accomplished by excretory urography in only 47% of the cases, by selective angiography in 85% and by abdominal computerized tomography scanning in 88%. In 7 patients preoperative identification and localization of the tumor were determined correctly by computerized tomography scanning alone. Data in our series suggest that the diagnosis and localization of pheochromocytoma can be accomplished usually by a simple blood test and body scan. More elaborate and sometimes hazardous studies should be necessary only in exceptional cases, usually with tumors less than 3 cm. in diameter.

Adrenal Gland Neoplasms↗
PubMed1979

Aortorenal bypass with a branched saphenous vein graft for renal artery disease extending into the branches.

Improved vascular reconstructive techniques now enable renal revascularization in patients with extensive renovascular disease. Two patients are reported who underwent aortorenal bypass with a branched saphenous vein graft for disease involving the main renal artry and its major segmental branches. This technique represents an excellent means of achieving successful renal revascularization in some patients with branch renal artery disease.

Adult↗
PubMed1979

Experimental and clinical hepatorenal bypass as a means of revascularization of the right renal artery.

In patients with severe atherosclerosis of the abdominal aorta or previous operations on the abdominal aorta, right renal revascularization may be difficult to achieve using aortorenal bypass. An experimental study was performed demonstrating the efficacy of hepatorenal bypass as an alternative operative procedure in this regard. Follow-up studies in these dogs demonstrated no adverse postoperative effects on hepatic function or morphology. In addition, two patients underwent hepatorenal bypass with a saphenous vein graft as surgical treatment for azotemia and hypertension caused by atherosclerotic right renal artery stenosis. Postoperatively, the blood pressure diminished and renal function improved in both patients. No evidence of persistent hepatic dysfunction was observed.

Animals↗