PubMed Health⌕ Search

Biomedical subjects

S T Cochran

Publications and source records attributed to S T Cochran.

9 recordsLinked to original sources
PubMed1991

Noninvasive radiological diagnosis of renal vein thrombosis in renal transplantation.

Thrombosis of the allograft renal vein is a rare complication of renal transplantation. Of 557 consecutive renal transplants performed between January 1, 1985 and November 30, 1989, 3 cases occurred for an over-all incidence of 0.4%. In 2 cases the diagnosis was made preoperatively with renal scintigraphy and duplex Doppler sonography. No graft was salvaged, despite timely diagnosis in 2 patients. We conclude that the diagnosis of renal vein thrombosis in the renal allograft recipient should be suspected clinically and by the radiographic findings of absent perfusion on renal scintigraphy, and the detection of an arterial signal, albeit abnormal, on duplex Doppler sonography. When diagnosed, nephrectomy appears to be the only treatment.

Adult↗
PubMed1991

Percutaneous nephrostomy tube placement: an outpatient procedure?

The authors report their experience with 56 percutaneous nephrostomies (PCNs) performed on an outpatient basis on 55 patients. Complications included pain that required use of parenteral medication in four patients, bleeding in three that resolved spontaneously, and shaking chills or fever in 12. This last complication, considered to be a sign of sepsis and treated with antibiotics, occurred more frequently than the 1.4%-4.5% infectious complication rate reported in the literature. Antibiotic use during and after PCN significantly decreased the likelihood of sepsis. In the high-risk group, antibiotic administration during and after PCN decreased the risk of developing signs of sepsis from 50% to 9%. On the basis of the authors' results and the findings in the literature about antibiotic prophylaxis, guidelines are recommended to improve the safety of PCN as an outpatient procedure. In the majority of instances PCN should still be considered to be more safely performed as an inpatient procedure at this time.

Adult↗
PubMed1989

Wilms tumor (nephroblastoma) in the adult patient: clinical and radiologic manifestations.

Wilms tumor (nephroblastoma), a primary renal neoplasm containing primitive blastema and embryonic glomerulotubular structures, is seen rarely in adults. To identify clinical and radiologic criteria for preoperative diagnosis of adult Wilms tumor, we studied 29 cases reported in the literature from 1975 to 1987 (all patients were 15 years old or older) and four newly diagnosed cases. The mean age of patients was 30 years; 80% were less than 35 years old. Each patient presented with a large, rapidly growing, abdominal mass (average duration of symptoms, less than 2 months), had no constitutional symptoms (e.g., weight loss, fever), and otherwise were healthy (80%). Twenty-six patients had IV or retrograde pyelograms. Twenty-three showed a nonspecific mass effect. In seven (78%) of nine patients, abdominal CT scans showed a large, inhomogeneous mass with large areas of low density and increased enhancement of the compressed remaining normal renal parenchyma, which resembled a pseudocapsule. In five (63%) of eight patients, sonograms showed a complex mass with large cystic components. In 18 (82%) of 22 patients, arteriograms showed a hypovascular mass with fine wavy or zigzag (creeping-vine) neovascularity. We conclude that a rapidly growing renal mass in a young patient (less than 35 years old) that is shown to be complex and cystic by CT or sonography and that is hypovascular with fine, wavy neovascularity on arteriography is suggestive of adult Wilms tumor (75-80%). An awareness of this constellation of findings may be helpful in diagnosing this unusual tumor before surgery.

Adolescent↗
PubMed1979

Nephromegaly in hyperalimentation.

Nephromegaly associated with hyperalimentation and its effect on renal function were studied. Renal size was determined in 44 patients receiving total parenteral nutrition (TPN). Of 26 patients in whom kidney size could be determined before and during TPN, all but one had normal-size kidneys before TPN. Six had no increase in renal size, and kidneys increased in size in 20. One or both kidneys became abnormally large in 9 patients. There was no detectable change in renal function and kidneys decreased in size upon discontinuation of hyperalimentation. Abnormal renal size bore no relation with weight gain or liver function tests.

Adolescent↗
PubMed1979

Augmentation enterocystoplasty.

The anatomy and radiographic appearance of five types of augmentation enterocystoplasty (ileocystoplasty, cecocystoplasty, ileocecocystoplasty, sigmoidocystoplasty, and enterourethroplasty) are described. Retrograde cystrography is the procedure of choice for optimal visualization of an augmented bladder and most complications. Excretory urography is useful for following concurrent upper tract disease and ureteral stenosis. Critical factors in a optimal examination are maximal filling of the bladder and radiographs in multiple projections.

Cecum↗
PubMed1978

Complete obstruction of the gastric antrum in children following acid ingestion.

We report on two children who experienced delayed complete obstruction of the gastric antrum following concentrated acid ingestion. Both patients required initial tube gastrostomy and subsequent antrectomy with intestinal reconstruction. Unlike the more common alkaline corrosives, ingested acids tend to spare the esophagus and gastric fundus. While gastric perforation and vascular collapse may occur immediately following overwhelming acid ingestion, the more common course is chronic gastric antral inflammation with subsequent fibrosis and, in some cases, complete stricture. Delayed surgical reconstruction is recommended to permit the acute inflammation and edema to subside.

Adolescent↗
PubMed1977

Obstruction of the airways by the heart and pulmonary vessels in infants.

It is well known that certain cardiovascular abnormalities, frequently compress the airways in infants [1]. Two additional cardiac mechanisms of airway obstruction are described in this paper: progressive compression of the bronchial tree by left sided cardiac enlargement and infantile cardiac asthma due to compression of the small airways by pulmonary venous congestion. Functional and reversible collapse of the trachea is a frequent finding in cardiac asthma. Infants with these entities often appear to have primary pulmonary disease when in fact the underlying cause of their distress is cardiac in origin.

Airway Obstruction↗