PubMed Health⌕ Search

Biomedical subjects

T W Hensle

Publications and source records attributed to T W Hensle.

At least 19 recordsLinked to original sources
PubMed1992

Renal growth factor expression during the early phase of experimental hydronephrosis.

Unilateral ureteral obstruction in the rat leads to hydronephrosis of the affected kidney and renal cell deletion through the process of apoptosis. We studied this experimental model to determine whether acute alterations in renal growth factor expression might be involved in the initiation of the apoptotic response. Northern blot analysis of hydronephrotic, contralateral and sham operated kidney polyadenylated messenger ribonucleic acid (mRNA) was performed to quantitate the expression of mRNA encoding the growth factors epidermal growth factor, transforming growth factor-beta and insulin-like growth factor II during the first 48 hours following ureteral obstruction. Although the expression of the insulin-like growth factor II mRNA was unchanged by ureteral obstruction, the expression of epidermal growth factor mRNA rapidly declined in the obstructed kidney during this period. The loss of epidermal growth factor expression was further confirmed by an immunocytochemical staining procedure that demonstrated high concentrations of epidermal growth factor in control renal tubules and a drastic loss of this staining in obstructed renal tubules. In contrast, expression of transforming growth factor-beta mRNA increased in the obstructed kidney. We believe that the altered growth factor environment of the hydronephrotic kidney might be an initiating factor in the onset of renal apoptosis associated with this condition.

Animals↗
PubMed1992

Vaginal replacement in children.

Between 1980 and 1990, 17 patients underwent total vaginal replacement at our hospital. The majority of these patients presented with müllerian failure or gender reassignment for intersex. Colon vaginal replacement was done in 15 patients and small bowel was used in 2. Complications included prolapse in 2 patients and stenosis in 2. Of the 17 patients 4 are married, 10 are sexually active, only 1 reports dyspareunia and 1 requires home self-dilation.

Adolescent↗
PubMed1991

Eosinophilic cystitis in children.

Eosinophilic cystitis is an uncommon inflammatory disorder of the urinary bladder which causes irritative voiding symptoms and may mimic rhabdomyosarcoma radiographically. In children, eosinophilic cystitis has been previously reported to be self-limiting and requires no specific therapy. Reported herein is a case of a nine-year-old girl in whom eosinophilic cystitis recurred following antireflux surgery, raising the question of an association of eosinophilic cystitis with local trauma such as bladder surgery. Consideration should be given to pretreatment with steroids and antihistamines prior to surgery in these patients.

Child↗
PubMed1991

Cystic adrenal masses in the neonate associated with hemihypertrophy and the relation to the Beckwith-Wiedemann syndrome.

We report 2 cases of unilateral, multilocular, cystic adrenal masses in neonates. Both patients demonstrated somatic hemihypertrophy, which is considered to have the same implications as the Beckwith-Wiedemann syndrome in terms of tumor risk. Pathological examination showed multiple, adrenal cysts without evidence of tumor or routine adrenal hemorrhage. This finding appears to represent a previously unreported association between the spectrum of hemihypertrophy/Beckwith-Wiedemann syndrome and benign cystic adrenal disease.

Adrenal Gland Diseases↗
PubMed1991

Flow cytometric determination of the multidrug resistant phenotype in transitional cell cancer of the bladder: implications and applications.

We detail our experience with a monoclonal antibody to detect the cell surface P-glycoprotein product of the multidrug resistance gene (MDR-1) in the human bladder. A total of 32 patients had 44 different specimens analyzed. The samples consisted of 8 normal bladders, 21 transitional cell carcinomas, 1 mucinous adenocarcinoma, 3 P-0 bladder wall specimens and 10 nonmalignant urothelial samples from cystectomies. P-glycoprotein was not detected in the normal adult or pediatric bladder. Bladder specimens from 3 children with a neurogenic bladder revealed enhanced expression (21%, 14% and 4% positivity). Transitional cell carcinoma usually demonstrates low expression at diagnosis (less than 6%), although 3 patients had enhanced initial expression (11%, 12% and 31%). Three patients treated with chemotherapy demonstrated 56%, 76% and 50% expression of MDR-1. Nonmalignant tissue from cystectomy specimens had low expression of MDR-1. The specificity of this system was confirmed with human bladder cell lines. The ability of flow cytometry to detect and quantify the expression of MDR-1 may allow for the early detection of chemotherapy resistance in patients with transitional cell carcinoma treated with systemic and intravesical therapy.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1991

Anterior urethral polyp associated with hematuria in six-year-old child.

Anterior urethral polyps are rare, occur only in male patients, and have been associated with obstruction, terminal hematuria, and enuresis. We believe this is the fifth reported case of anterior urethral polyp associated with terminal hematuria. The radiographic findings, treatment, and pathology are reviewed.

Child↗
PubMed1991

Urinary tract reconstruction in children.

Urinary tract reconstruction and continent urinary diversion in children present a significant technical challenge. A major commitment is mandated from both surgeon and patient. We believe that although the principles and objectives of total bladder replacement rely on basic surgical and physiological tenets, the attainment of a successful outcome also requires patient involvement and cooperation.

Child↗
PubMed1991

Complications of urinary tract reconstruction.

Urinary tract reconstruction has benefited a vast number of patients with dysfunctional lower urinary tracts caused by congenital abnormalities, previous surgery, or both. Reconstructive efforts have been innovative and continue to evolve. With this evolution, new complications continue to appear, and in order to minimize the risk to the patient, we must recognize our previous lessons. Appropriate patient selection is essential in achieving a successful outcome in this group. The patient's neurologic status, urologic anatomy, renal function, and motivation are also important factors in choosing the appropriate patient and correct surgical approach. Close follow-up remains the single most important element in assuring long-term well-being for most of these patients.

Foreign-Body Migration↗
PubMed1990

The flow cytometric analysis of undescended testes in children.

Flow cytometric analysis was performed on the testicular aspirates of 45 consecutive children with unilateral cryptorchidism undergoing elective orchiopexy or orchiectomy. Concomitant histological analysis was performed on the testicular tissue obtained from either biopsy or orchiectomy specimens. In all cases deoxyribonucleic acid histograms appeared to correspond with microscopic appearance. Histograms from prepubescent patients demonstrated 85 to 95% of cells in the diploid (2c) peak and less than 10% of cells in the tetraploid peak (4c), representing prepubertal testes without active spermatogenesis. Three distinct patterns of ploidy were identified in postpubertal children corresponding to the histological appearances of normal spermatogenesis, maturation arrest and the Sertoli-cell-only syndrome, respectively. In addition, we identified an aneuploid cell population in the specimen from 1 patient, suggesting that this testis may be at risk for future malignant degeneration. We conclude that flow cytometry of testicular aspirates is an easy and effective means of testicular evaluation, which may permit predictions regarding the fertility and malignant potential of undescended testes in postpubertal children.

Adolescent↗
PubMed1979

Improved life expectancy for children with exstrophy of the bladder.

Life-table techniques demonstrate a 98% ten-year survival, a 96% 20-year survival, and 91% 35-year survival of children with exstrophy of the bladder. These figures represent a vast improvement over the earlier figures, due in large part to technical advances that have been made in areas of surgery, anesthesia, and antibacterial and metabolic therapy.

Adolescent↗
PubMed1979

Delayed development of the scrotum in exstrophy.

Early attempts at orchiopexy should be avoided in children with exstrophy, since the testes will often descend spontaneously by puberty. In many cases the scrotum will grow much larger and will become pendulous by puberty. In a patient with a rudimentary scrotum orchiopexy will only result in fixing the testes in an abnormally high position owing to the lack of a sac into which to place them. If the scrotum develops later the testicles will probably be unable to descend further. Scrotal skin should not be used for urethroplasty operations in children with exstrophy and special techniques should be applied if it is necessary to repair hernias in these patients. In the child with partially descended testes but with only a small patch of wrinkled scrotum efforts may be undertaken to increase scrotal size by topical hormone treatment (or by injections) before the onset of puberty to help fertility and emotional development.

Adult↗
PubMed1979

The exstrophy support team: a new concept in the care of the exstrophy patient.

The concept of the exstrophy support team is reported. It has extended the care of children with exstrophy into a lifelong continuum of effective assistence, not just by way of medical and surgical interaction but through knowledgeable and sympathetic coordination. There has been a spectacular improvement in over-all lifetime survival and much greater patient interest and appreciation with better followup and maintenance so that we can help quickly and effectively when problems arise. Now that we have achieved an increased longevity for these patients, we must be able to assure them the best possible quality of life.

Bladder Exstrophy↗
PubMed1979

The unheralded hazard of ureterosigmoidostomy.

Patients with ureterosigmoid urinary diversions always have some anal leakage of a malodorous mixture of feces and urine, especially at night or when passing gas. They obtain limited continence only by consciously keeping their buttocks tensed toegher. Their unusually high elimination frequency weds them to a bathroom for the rest of their lives. The universal prevalence of this truly severe burden of liquid fecal incontinence, which a patient is asked to bear after ureterosigmoidostomy diversion, is not well recognized and should be clearly revealed to the patient before a choice of procedure is made.

Adolescent↗
PubMed1978

Autosuturing device in intestinal urinary conduits.

The autosuturing device has been used to close the base of 41 urinary intestinal conduits: 12 colonic, 25 ileal, and 4 jejunal. The techniques are described. There were no urine or bowel leaks, although in one postoperative gastrointestinal bleeding occurred in association with a partial small-bowel obstruction probably related to the stapled enteroanastomosis. Use of the instruments reduced peritoneal contamination and facilitated conduit manipulation. Operating time was reduced. Four patients have passed stones composed of struvite and apatite with staples embedded within. The autosuturing device should be considered an alternative rather than a substitute for conventional proximal conduit closure and bowel anastomoses.

Adult↗
PubMed1978

Ileal conduit hemorrhage secondary to portal hypertension.

The clinical features and management of 3 patients who presented with the triad of massive hemorrhage from the ileal conduit, portal hypertension due to liver disease, and portosystemic varices related to the conduits are described. One patient, a class C cirrhotic, was treated conservatively and died of blood loss and hepatic coma. Two patients were managed with splenorenal shunts initially, followed by creation of colon conduits, and are currently doing well. Surgical approximation of areas draining in the portal and systemic circulation with subsequent development or adhesion-related varices probably explains the predilection for involvement of the ileal conduit and may explain the presence of varices in mild to moderate portal hypertension before other signs of hepatic decompensation are evident. Superior mesenteric angiography with special attention directed at the venous phase is necessary to document this entity.

Adult↗
PubMed1978

Urologic manifestations of Wegener granulomatosis.

Wegener granulomatosis is a disease characterized by necrotizing granulomatous angiitis involving the upper and lower respiratory tracts and the kidneys. The introduction of cyclophosphamide in the treatment of Wegener granulomatosis has dramatically altered the rapidly fatal course of the disease and has altered our thinking regarding its management. Recently we have cared for 3 patients who demonstrated a dramatic spectrum of urinary tract pathology related to Wegener granulomatosis. The cases presented offer three points for consideration by the urologist: (1) the manifestations of the disease in the genitourinary tract can be varied and can present in a dramatic fashion; (2) the rapid progression of renal failure and the nearly uniform mortality associated with the disease have changed largely because of the use of cyclophosphamide; and (3) our approach toward patients with renal failure on the basis of Wegener granulomatosis can be altered, and renal transplantation is certainly feasible with the increased longevity afforded these patients by cyclophosphamide.

Adult↗