Biomedical subjects
Publications and source records attributed to V K Altebarmakian.
We have found that the blanket philosophy of emergency scrotal exploration in all cases of acute scrotal swelling in boys results in an unacceptably large number of unnecessary explorations. The use of specific aspects of the clinical examination, in conjunction with the radioisotope testicular scan in selected instances, has guided our management of 150 consecutive boys presenting with acute scrotal symptoms.
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We herein report 4 cases of renal cell carcinoma with vena caval extension. Appropriate diagnostic studies and a planned surgical approach is the most effective treatment for intravascular spread. Accurate preoperative staging is important for a successful outcome. Although the technical challenges involved in performing a nephrectomy are substantial, these cases illustrate that standard nephrectomy with evacuation of tumor thrombus, ligation of the left renal vein, and even partial resection of the inferior vena cava can be performed with an acceptably low morbidity.
Anterior sacral meningocele is a rare entity. It arises from a congenital defect of the sacrum and the coccyx through which herniation of the caudal portion of the meninges and their contents occurs, forming a cyst-like structure. The cystic mass, which lies between the rectum and sacrum, produces a variety of symptoms depending on its size and contents and constitutes a diagnostic problem. A case of anterior sacral meningocele is presented, including the physical signs, differential diagnosis, and the dangers of aspiration or surgical intervention.
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Six hundred thirty-two percutaneous renal biopsies were performed in 479 patients between 1965 and 1978. Complications occurred with 86 biopsies, an incidence of 8.5 per cent. Most complications (seventy-six of eighty-six) were minor, and either resolved spontaneously or did not require intervention. There were ten major complications, including 6 patients with gross hematuria requiring blood transfusions, 3 with hemorrhage treated with arterial embolization, and 1 with a symptomatic arteriovenous fistula that was treated with partial nephrectomy. Major complications of percutaneous renal biopsy and the modes of therapy are discussed.
We describe 2 children with renovascular hypertension treated successfully by autotransplantation, as well as an additional child in whom ex vivo microsurgical repair was attempted. The literature is reviewed and all patients within the pediatric age group with renovascular hypertension who were treated surgically are reported. The different types of vascular reconstructive techniques and, particularly, the previous use of autotransplantation are discussed.
Priapism is a complication rarely seen in childhood leukemia. Whatever the etiology the basic pathologic feature is obstruction to venous outflow from the corpora cavernosa. The cavernous bodies are erect but the glans penis and the corpus spongiosum usually remain soft. Various forms of treatment have been advocated for the management of this condition and have met with varying degrees of success. A boy with acute lymphocytic leukemia presented with priapism. Although radiation and chemotherapy induced prompt remission and dramatic decrease in leukocytosis, the priapism persisted. Resolution of the priapism was obtained using the transglandular cavernosum-spongiosum shunt.
More and more renal artery aneurysms are being diagnosed, especially after the introduction of selective arteriography for the evaluation of renovascular hypertension. However, renal artery aneurysm still remains a rare entity. The pathogenesis of renal artery aneurysm is identical to the pathogenesis of arterial aneurysm in other arteries. Symptoms of aneurysm of the renal artery are dependent on a variety of factors, the most important of which are the size of the aneurysm, its location, and whether or not rupture has occurred. The indication for operation on renal artery aneurysm is rupture or threat of rupture. Herein we present a review of the literature and a report of 2 cases which exemplify the capabilities of the surgeon in dealing with such cases.