Biomedical subjects
Publications and source records attributed to R Rabinowitz.
Computed tomography can aid in the distinction of calculi from both tumors and clots in the urinary tract. Its availability, simplicity of interpretation, and noninvasiveness establish it as an important diagnostic modality in selected cases when calculus is in the differential diagnosis of upper urinary tract filling defects.
The activity of dopamine beta-hydroxylase in the serum was measured in patients with acute cardiac disorders who were admitted to a coronary care unit. The activity of the enzyme on admission was similar in patients with acute myocardial infarction and in those with other conditions; on discharge, the activity was reduced significantly. Patients with myocardial infarction had the greatest fall in the activity of dopamine beta-hydroxylase. Patients with multiple signs of sympathetic hyperactivity had significantly higher values for the activity of dopamine beta-hydroxylase on admission. Pain was found to significantly increase the activity of the enzyme. These data confirm findings that the activity of dopamine beta-hydroxylase in the serum reflects the intensity of sympathetic activity. The factors contributing to the elevated sympathetic activity in some patients with acute myocardial infarction seem to be nonspecific, but because of the ominous nature of increased sympathetic tone in this condition, it could be advantageous to identify these patients.
Explore the source record for details and available documents.
The aim of the present study was to determine the relationship of the Thy-1 antigenic determinants to the cell surface ganglioside GM1. Exposure of either thymus or bone marrow cells to Thy-1 alloantiserum partially inhibited the binding of [125I]cholera toxin (CT) by the cells. Xenoantibodies to Thy-1 antigens failed to affect the binding of [125I]CT to mouse thymus cells. In the reverse experiments, treatment of either thymus cells or brain homogenate with CT did not alter their capacity to absorb Thy-1 allo- and xenoantibodies. It is concluded that GM1 ganglioside does not constitute a Thy-1 antigenic determinant.
Rats are known to possess antigenic determinants related to the Thy-1.1 allele. Immunization of rats with brain homogenates from mice carrying either the Thy-1.1 or the Thy-1.2 alleles resulted in the production antisera which were cytotoxic for thymus cells of both strains of mice. Lymph node, spleen and cortisone-resistant thymus cells were refractory to the cytotoxic effect of rat anti-mouse brain sera. Peripheral lymphocytes were fully capable of absorbing the cytotoxic activity of the sera on thymus cells, although the concentration of the antigen on their cell surface was considerably less than on thymus cells. Blocking experiments with allo- and xenoantisera to Thy-1 antigens suggested that the antigen detected by rat anti-mouse brain sera is related to the Thy-1 system. The Thy-1 specificity detected by rat antisera seems to differ from previously described Thy-1 antigens in that it attains a high concentration on thymus cells but is relatively deficient in its expression on peripheral T cells.
A unique case of extensive acquired vulvar lymphangiectasis without lymphedema in a child is described. This lesion developed after pelvic exenteration, lymphadenectomy, and radiation therapy for rhabdomyosarcoma of the bladder. These acquired etiologic factors simulated the pathophysiology of congenital lymphangioma. She was successfully treated with surgical excision and vulvar reconstruction.
Two unusual cases of balloon catheter-induced anuria are presented. Certain pediatric patients and neonates, especially those with spastic neurogenic bladders or those who have had bilateral ureteral reimplantation, are more susceptible to this form of urinary obstruction. The use of non-balloon catheters or infant feeding tubes is recommended.
Explore the source record for details and available documents.
The prune belly syndrome of marked abdominal muscle deficiency and associated genitourinary anomalies has been found almost exclusively in male subjects. Of the few reported cases of female patients with this entity most are questionable or incomplete forms. The light microscopic histology and electron microscopic ureteral abnormalities in male subjects have been reported previously. A female newborn with marked abdominal muscle deficiency and severe bilateral ureteropyelocaliectasis is described. Chromosomal studies showed 46 XX karyotype. Histologic examination of the ureter by light microscopy was compatible with the diagnosis.
A case of Y-type urethral duplication is described with urethrograms showing the anterior and posterior channels arising from the prostatic urethra. Postmortem studies revealed the dominant posterior channel and its relationships to the stenotic anterior channel and anus.
A case of Y-type urethral triplication is reported. Urethrograms and urodynamics revealed the stenotic anterior urethras and a functional posterior urethral channel with a normal urethral pressure profile.
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.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Between 1948 and 1959 vesicorectostomy, a permanent anastomosis between the bladder and rectum, was constructed in 7 male patients. Scattered reports of this procedure exist but none since 1959 and long-term followup has never been reported. we present long-term followup, including renal function, excretory urography and voiding cystorectography, and review the quality of life in the 7 patients. The most frequent complication was stenosis of the anastomosis. None of the patients in this series with normal preoperative upper tracts showed radiographic or chemical deterioration postoperatively. Since this procedure maintains urinary continence, does not disturb the normal physiology of the ureterovesical junction and minimizes urinary reabsorption its use should be considered in certain patients as an alternative method of urinary diversion.
The patient reported suffered a transperitoneal stab wound resulting in the isolated complete transection of the left upper ureter. In spite of immediate exploratory laparotomy, the time of recognition of the injury was delayed. The treatment consisted of an ellipitcal spatulated everting uretero-ureterostomy with interrupted fine chromic catgut over a stenting ureteral catheter. The postoperative course was smooth and the final result excellent. The importance of intravenous urography in penetrating abdominal or flank trauma cannot be overemphasized. This is the first reported case of isolated ureteral injury secondary to transperitoneal stab wound.
Of thirty-nine patients with Klippel-Feil syndrome, twenty-five (64 per cent) had significant genitourinary-tract anomalies demonstrated by intravenous urogram and physical examination. The incidence of these anomalies in Feil's three types of the syndrome was essentially the same, unilateral renal agenesis being the most common. A routine intravenous urogram is indicated in patients with this syndrome.