Biomedical subjects
T W Hepperlen
Publications and source records attributed to T W Hepperlen.
Polyethylene double-pigtail ureteral stents.
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Double pigtail ureteral stent.
Problems encountered in patients with ureteral obstruction treated with single pigtail polyethylene ureteral catheters (stents) were largely due to positioning difficulties, proximal migration, and irritation of the bladder mucosa by the distal flange. A new, double pigtail modification of this self-retained internal stent limits migration, minimizes irritant side effects, and facilitates endoscopic, percutaneous, and open surgical positioning over a springwire guide. These stents provide useful alternative to surgical correction or external tube diversion in many patients with complicated ureteral obstruction.
The pigtail ureteral stent in the cancer patient.
Nephrostomy has been the standard procedure for urinary diversion when ureters are obstructed by cancer. However, recent reports have revealed significant problems related directly to the nephrostomy. The indwelling, internal ureteral stent eliminates many of these problems. We herein describe the course and survival of 20 patients in whom the pigtail ureteral stent was used to relieve ureteral obstruction caused by cancer. In these cases an over-all prolonged longevity, better quality of life and fewer complications have been noted when compared to cases of nephrostomy diversions.
Self-retained internal ureteral stents: a new approach.
Definitive surgical treatment of ureteral obstruction may not be appropriate in patients with advanced malignancy, complex benign ureteral disease or even simple obstructive disease accompanied by unacceptable operative risk. Endoscopic placement of self-retained internal ureteral catheters (stents) offers satisfactory relief for many of these patients. A new 6F pigtail ureteral stent and placement technique are described. These stents are placed easily, effective and well tolerated for short-term drainage in selected patients with ureteral obstruction.
Effect of prostaglandins, nitrofurantoin, and Escherichia coli on response of human vas deferens to norepinephrine.
Surgical specimens of human vas deferens, mounted isometrically in vitro, were tested for their reactivity to norepinephrine, the major neurohumoral control mechanism in this tissue, under a variety of conditions. There was no significant difference in reactivity (measured as amplitude and frequency of contraction) between vasa obtained under either spinal or local anesthesia. Similarly, the age of the donor (range, 20 to 79 years) had no effect on either measure of reactivity. Prostaglandins A1 (10(-7) gm/ml) and E2 (10(-9) gm/ml), Escherichia coli (10(5) organisms/ml), and E. coli endotoxin (10(-7) gm/ml) did not affect norepinephrine responses, suggesting that the role of these compounds in problems of fertility is not related to an alternation in sperm transport through the vas. Nitrofurantoin (10(-5) gm/ml) also had no effect on reactivity to norepinephrine, providing further evidence that low sperm counts in patients taking this drug are more appropriately attributed to a direct effect on spermatogenesis than to an effect on sperm transport.
Epithelialization after cystotomy.
Cystotomies were performed on mature guinea pigs using aseptic technique, and one layer closure with polypropylene sutures. It was found that epithelialization over the suture material was completed by 3 days and that epithelialization of the bladder mucosa itself after a mucosa-mucosa approximation was completed within 4 days. The main significance of this investigation is that the normal bladder mucosa was completely healed within 4 days.