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Biomedical subjects

W J Cromie

Publications and source records attributed to W J Cromie.

At least 19 recordsLinked to original sources
PubMed1992

Persistent müllerian duct syndrome with transverse testicular ectopia and spermatogenesis.

Normal male sexual differentiation is dependent on at least 2 factors: 1) testosterone and 2) müllerian inhibiting factor. The absence of müllerian inhibiting factor is responsible for a rare form of male pseudohermaphroditism, the persistent müllerian duct syndrome or hernia uteri inguinale. Patients with this syndrome present with persistent müllerian structures and the syndrome may be associated with transverse testicular ectopia. Additionally, most patients have azoospermia. We report a case of persistent müllerian duct syndrome with transverse testicular ectopia in which sperm are documented in the ejaculate.

Adult↗
PubMed1990

Augmentation myoperitoneocystoplasty.

The use of isolated intestinal segments is currently the best method of augmenting bladder capacity. The ability to perform a successful augmentation cystoplasty using nonintestinal tissue would decrease the morbidity of the operation. We studied the use of skeletal muscle-backed parietal peritoneal tissue in augmentation cystoplasty. In the experimental group animals, bladder capacity increased by 67% and urothelial regeneration was observed histologically. Problems with electrolyte abnormalities, urosepsis, or excessive mucous production were not encountered. In conclusion, a myoperitoneal flap may serve as a template for augmentation cystoplasty. Further investigation using this technique is warranted.

Animals↗
PubMed1989

Development of an in vitro model for the disruption of extracellular matrix components in the study of congenital renal parenchymal dysmorphism.

We attempted to refine a model system for the study of renal parenchymal malformations and demonstrate its use with a preliminary study of the induction of congenital renal dysmorphism. A technique is described whereby 3-day chick embryos are explanted from their shells and cultured in vitro in specially constructed polyethylene chambers. At 8 days of development, the time of ureteral induction of the metanephric mesenchyme, 6-diazo-5-oxo-norleucine, an inhibitor of proteoglycan biosynthesis, is administered as a single microinjection into the posterolateral body wall. Histological examination of fixed metanephric tissue revealed a gross deficiency in the number of differentiated tubules in norleucine-treated animals. A morphometric analysis was made of the actual area occupied by differentiated tubules in the norleucine-treated and control kidneys between 10 and 15 days of development. This analysis revealed a total tubule surface area of control kidneys of more than 2 times greater than that of embryos injected with norleucine at ureteral induction.

Abnormalities, Drug-Induced↗
PubMed1989

Testicular salvage and age-related delay in the presentation of testicular torsion.

Testicular torsion represents a continuing source of morbidity among male patients. Early diagnosis and surgical exploration improve testis salvage but even this approach will result in orchiectomy if there is excessive delay in patient presentation. A 10-year retrospective review of testicular torsion was performed. The interval between onset of scrotal pain and presentation to the emergency department was determined. A specific age-related delay in presentation was identified between patients less than 18 years old (group 1, median delay 20 hours) and those greater than 18 years old (group 2, median delay 4 hours, p less than 0.001). At exploration 44 per cent of the group 1 patients required orchiectomy versus 8 per cent in group 2. Patients less than 18 years old are a high risk group for testicular loss after torsion and represent more than 90 per cent of the orchiectomies performed. We believe that this group should be targeted for improved health education, emphasizing early evaluation of scrotal pain to improve testicular salvage.

Adolescent↗
PubMed1988

The Mitrofanoff principle: an alternative form of continent urinary diversion.

The Mitrofanoff procedure for continent urinary diversion was described in 1980. This principle has been expanded upon and used to achieve continent urinary diversion in virtually any indicated clinical setting. We report 3 cases treated by the Mitrofanoff principle to illustrate the spectrum of clinical situations to which it is applicable. The Mitrofanoff principle represents a viable form of continent urinary diversion.

Adolescent↗
PubMed1986

Gonadal stromal tumors: a report of the Prepubertal Testicular Tumor Registry.

A total of 15 gonadal stromal tumors in prepubertal boys has been reported to the Prepubertal Testicular Tumor Registry of the Section on Urology of the American Academy of Pediatrics. Leydig cell tumors invariably are benign and patients usually present with precocious puberty when they are 5 to 9 years old. Other gonadal stromal tumors either present in infancy as a scrotal mass and exhibit a benign behavior or occur later in childhood and may be malignant.

Child↗
PubMed1985

Evaluation and treatment of the preadolescent varicocele.

Varicocele is the most common surgically correctable cause of male infertility. In adult patients with varicocele and infertility, pregnancy rates following varicocelectomy range as high as 55 per cent in comparison with a pregnancy rate of only 7 per cent in unoperated controls. The initial presentation of varicocele occurs during puberty with the incidence in 13-year-old boys already equivalent to that in the general male population. This occurrence has been referred to as the childhood or adolescent varicocele. Varicocele is a progressive disorder in many if not in all cases, with an obvious individual variation in the time course of progression. The effects of a unilateral lesion are often noted in the contralateral testis. Based upon present knowledge, it is not possible to predict accurately the time course of progression in individual cases of childhood varicocele. However, significant prognostic features in adolescents with varicocele include the following: (1) testicular atrophy, or arrested testicular growth; (2) high-grade varicocele (grade II or III); (3) bilateral lesions; (4) pathologic GnRH stimulation test; and (5) histologic picture of Leydig-cell hyperplasia. The presence of these features either alone or in combination is an indication for treatment in our hands. Unlike adults with varicocele, it is not practical to follow children and adolescents with spermatograms.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1979

Management of the abdominal undescended testicle.

Of the orchiopexies performed for abdominal undescended testicles 85 per cent have resulted in satisfactory testicular growth and position. Three-fourths of these cases were in boys with the prune belly syndrome. We are satisfied with our recent experience using the Fowler-Stephens procedure to salvage intra-abdominal undescended testicles. An analysis of the failures in 5 testes early in this series, resulting in partial atrophy, has helped us to avoid technical errors through attention to the following details: 1) preservation of a broad pedicle of peritoneum overlying the mobilized vas, 2) avoidance of any dissection of the spermatic cord and 3) high ligation of the spermatic vessels well above the point of confluence of the vas and spermatic vessels. Although the Fowler-Stephens procedure has some risk of testicular ischemia and atrophy we believe it to be the preferred way to gain mobility on a short tethering gonadal vascular pedicle.

Child, Preschool↗
PubMed1979

Paratesticular rhabdomyosarcoma in children.

The clinical characteristics, surgical treatment, clinical grouping, chemotherapy, radiotherapy, complications and survival of paratesticular rhabdomyosarcoma are discussed. When the combined approach of radical inguinal orchiectomy, retroperitoneal node dissection, chemotherapy and radiotherapy when indicated is used a survivorship in excess of 80 per cent can be anticipated for all stages of disease. A combined multidisciplinary approach to this lesion is stressed to achieve improved survivorship in this previously lethal lesion.

Child↗
PubMed1979

Ketamine as a detumescence agent during hypospadias repair.

Ketamine hydrochloride was used successfully to produce detumescence in 7 children undergoing hypospadias repair. There have been no complications or side effects. We recommend ketamine hydrochloride as a useful adjunct in managing corporeal erections during urologic procedures.

Child, Preschool↗