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Biomedical subjects

S H Shrom

Publications and source records attributed to S H Shrom.

12 recordsLinked to original sources
PubMed1986

Surgical treatment of reflux in neurologically impaired child.

Ninety-three consecutive patients with neurologically impaired bladders were evaluated for vesicoureteral reflux. Of 22 patients found to have reflux, 3 had spontaneous remission of reflux, 8 were maintained on suppressive antibiotic therapy, and 11 required ureteral reimplantation. A total of 14 refluxing renal units underwent ureteroneocystostomies. Twelve of 14 have had no postoperative reflux. The remaining two renal units are now free of reflux following augmentation cystoplasty. The modified Hutch ureteroneocystostomy is particularly suited for use in patients with neuropathic bladders, in that no submucosal tunnel is necessary. The operative technique is described.

Adolescent↗
PubMed1985

Augmentation ileocystoplasty in neuropathic bladder.

Augmentation cystoplasty is a viable treatment modality in patients with neuropathic bladder. Indications include incontinence despite pharmacologic manipulation, persistent hydroureteronephrosis, vesicoureteral reflux, and propantheline bromide intolerance. Eight patients have had augmentation cystoplasties, with all obtaining normal bladder capacity, intravesical pressure, and voiding frequency. Reflux and hydronephrosis have been eliminated or significantly reduced in those patients who had experienced those problems prior to augmentation. Four cases are presented.

Adolescent↗
PubMed1981

Megalourethra.

Megalourethra is a rare congenital disorder involving the formation of the anterior urethra. Both clinical varieties, the scaphoid and fusiform types, involve extensive defects in the formation of the spongiosum urethra. Our experience with 5 patients is discussed with particular reference to associated anomalies, diagnostic procedures, timing of surgical intervention, and definitive reconstructive surgery.

Abnormalities, Multiple↗
PubMed1980

Effect of bacterial metabolic state on vesical mucosal adherence.

14C-labeled Escherichia coli was introduced into acid-treated and intact rabbit bladders in vivo. Live, dead, and metabolically inhibited bacteria displayed similar interaction with the urothelium with and without intact surface mucoprotein. Disruption of the mucoprotein layer by acid reduced the defense potential in each group to a similar degree. Neither active metabolism nor bacterial cell death seems to enhance bacterial adherence to bladder mucosa.

Adhesiveness↗
PubMed1978

Bladder surface mucin. Examination of possible mechanisms for its antibacterial effect.

We have previusly provided physiologic and histochemical data implicating the bladder surface mucin layer as an important new antibacterial defense mechanism. This mucin or its contents seems to act as an "antiadherence factor", inhibiting bacterial adherence to the bladder mucosa and thereby facilitating the removal of bacteria by the voiding process. The present study was designed to investigate three mechanisms by which the mucin might repel bacterial attachment. Our data suggest that neither IgA nor a chelating agent are anti-adherence factors. We did find, however, that pH had a significant effect on the adherence of bacteria to mucosal cells stripped of their mucin layer. This result suggest that electrochemical charge is important in bacterial adherence. We beleive that the mucin layer both provides an electrochemical coat on the bladder surface that is a poor substrate for bacterial adherence and blocks the receptor sites of the transitional cells to which the microbes might adhere.

Adhesiveness↗
PubMed1977

Role of urothelial surface mucoprotein in intrinsic bladder defense.

To implicate further the surface mucoprotein as the factor responsible for preventing bacterial attachment to the bladder mucosa, rabbit urothelium was severely disrupted and allowed to regenerate for varying periods of time. Quantitative measurements of the attachment of 14C-labeled Escherichia coli were correlated with the histologic presence of the surface mucoprotein. Control levels of bacterial attachment were observed only when the PAS-positive layer had regenerated, further supporting the role of this layer in the bladder's antibacterial defense.

Adsorption↗
PubMed1976

Formalin treatment for intractable hemorrhagic cystitis: a review of the literature with 16 additional cases.

Acute, exsanguinating hemorrhagic cystitis secondary to cyclophosphamide therapy, radiation therapy, or an infiltrating bladder tumor may be managed successfully with intravesical Formalin therapy. The indications for its use, the technique, success rates, and complications are discussed. This treatment was effective in 14 of 16 patients in the present series and 79 of 90 cases reported in the literature. Dilutions of 4% or less were as effective as a 10% dilution and were associated with far fewer complications. The early use of Formalin in the treatment of intractable hemorrhagic cystitis is recommended.

Adult↗
PubMed1976

Bladder defense mechanism.

In order for micro-organisms to infect the urinary tract they must adhere to the vesical mucosa so that they remain after voiding. Experiments in our laboratory demonstrated that the bladder has a self-protective mechanism capable of preventing bacterial adherence to the surface. Histochemical staining demonstrated that this substance is a mucopolysaccharide. Treatment of the mucosa with acid disrupted the protective layer and resulted in a 20 to 100-fold increase in bacterial adherence. Within 24 hours this layer reappeared and binding was again reduced to normal. This phenomenon was not related to microbial species or metabolic activity.

Adhesiveness↗