Persistence of müllerian duct structures in a genetic male with distal monosomy 10q.

Persistent müllerian duct syndrome (PMD) with antimüllerian hormone (AMH) deficiency is usually associated with mutations or deletions of the AMH gene, although many cases have no identified gene association. We report on a genetic male with PMD and AMH deficiency associated with distal monosomy 10q. A term 3,230 g infant was born to a healthy 27-year-old.

Utility of an intra-operative cystogram with a simulated voiding phase after endoscopic treatment of vesicoureteral reflux.

Purpose: To assess the utility of intraoperative cystogram with a simulated voiding phase after endoscopic treatment of vesicoureteral reflux (VUR).

Methods: From September 2003 to June 2005, 24 children underwent injection of deflux for the treatment of VUR. A total of 38 ureters were treated.

Impact of stone location on success rates of endoscopic lithotripsy for nephrolithiasis.

Objectives: To determine whether stone location affects the stone-free rates of endoscopic lithotripsy for nephrolithiasis.

Methods: From January 2002 to August 2006, 245 patients with 272 stones, ranging from 4 to 20 mm in size, underwent ureteroscopy (URS) with laser lithotripsy at West Virginia University Hospital. The patients were followed up postoperatively with noncontrast spiral computed tomography, abdominal plain radiography, renal ultrasonography, or retrograde pyelography.

Laparoscopic pyeloplasty for ureteropelvic junction obstruction in a horseshoe kidney.

With a continued movement toward minimally invasive surgical interventions, the range of applications treated with laparoscopic surgery will continue to grow. Laparoscopy is a preferred method for various reasons, including decreased postoperative pain, shorter inpatient hospital stays, and decreased convalescence. Ureteropelvic junction obstruction (UPJO) has traditionally been treated by open pyeloplasty.

Pediatric xanthogranulomatous pyelonephritis masquerading as complex renal mass.

We present a case of focal xanthogranulomatous pyelonephritis (XGP) in a pediatric patient. This case illustrates the variable presentation of the entity and the difficulty in making a preoperative diagnosis. In contrast to the usual diffuse form of XGP, the focal form permits less radical treatment in cases such as this one.

Impact of patient age on distal hypospadias repair: a surgical perspective.

Objectives: To assess whether the age at which the initial hypospadias repair is performed influences the complication rate of hypospadias repair.

Methods: The records of 325 consecutive patients who underwent initial hypospadias repair were reviewed. The patients with glanular and coronal hypospadias underwent repair with either meatoplasty and glanuloplasty or a glans approximation procedure.

Candida albicans: the estrogen target for vaginal colonization.

Background: Estradiol (E(2)) stimulates colonization of the vagina by Candida albicans. Although this yeast expresses an estrogen-binding protein (EBP), the cellular target for estrogenic modulation of this infection is unresolved. Findings support direct E(2)-induced C.

Strangulation injuries of the glans penis: a case series.

Penile strangulation is a devastating injury with a spectrum of causes and possible outcomes. Causes can be intentional or unintentional. Objects such as ball bearings, rings, condoms, and rubberbands have caused this condition, as have hair and plastibell rings.

Kidney transplantation in children with urinary diversion or bladder augmentation.

Purpose: Urinary tract anomalies or dysfunction leaves the bladder unsuitable for urine drainage in a significant proportion of children presenting for kidney transplantation. We reviewed a multi-institutional experience to determine the ramifications of kidney transplantation in children with bladder augmentation or urinary diversion.

Materials And Methods: During a 28-year period 18 boys and 12 girls 1.

Fate of the contralateral leg after infrainguinal bypass.

Purpose: To identify variables predictive of the need for future vascular intervention in a leg contralateral to one currently undergoing infrainguinal bypass.

Methods: We reviewed the records of 450 consecutively treated patients undergoing infrainguinal bypass for occlusive disease to examine the outcome of a previously untreated contralateral leg. Patients with coexistent contralateral limb-threatening ischemia at the time of initial ipsilateral operation were excluded, as were patients with bilateral disease who underwent a staged contralateral procedure within 3 months of the ipsilateral operation.

Comparison of percutaneous endopyelotomy with open pyeloplasty for pediatric ureteropelvic junction obstruction.

Purpose: Percutaneous endopyelotomy has been shown to be effective in the management of ureteropelvic junction obstruction in adults and secondary ureteropelvic junction obstruction in children. There are little published data regarding endopyelotomy as a primary treatment in children.

Materials And Methods: During 3 years we performed 8 endopyelotomies and 20 open pyeloplasties for primary ureteropelvic junction obstruction and compared the results.

Preventing warm ischemia with a polyurethane bag during renal transplantation.

We have developed a technique that reduces the rewarm time during renal transplant vascular anastomoses by supporting the kidney in a slush-filled sterile polyurethane bag. There were no complications related to the use of this technique.

Cardiac allograft tolerance induction with limited immunosuppression.

We evaluated the efficacy and systemic toxicity of cyclosporine G, rapamycin, and cyclosporine A with multiple donor-specific blood transfusions in the stringent ACI to Lewis heterotopic cardiac transplant model. In addition, all animals received a 28-day post-operative course of cyclosporine A. Systemic toxicity was assessed by measuring recipient body weight at 30 and 60 days posttransplantation and at the time of graft rejection.

Induction of long-term graft tolerance and donor/recipient chimerism.

We compared the effect of different immunosuppressive drug regimens on both mean and long-term allograft survival and the histologic appearance of donor/recipient chimeras in the ACI to Lewis rat heterotopic cardiac transplant model. Intraabdominal cardiac transplantation was performed in standard fashion and microchimerism was assessed using immunohistochemical staining of cut sections of recipient spleen and lymph nodes. All of the drug regimens studied resulted in excellent mean allograft survival.

Catheter-directed thrombolysis following vena cava filtration for severe deep venous thrombosis.

Massive deep venous thrombosis with marked venous outflow obstruction can result in limb loss or end-organ injury. Systemically administered drugs may not reach thrombi in therapeutic concentrations and surgical and thrombolytic strategies carry a small but real risk of pulmonary embolus--similar to the risks with anticoagulation alone. We therefore developed a strategy in which catheter-directed thrombolysis was used to deliver high concentrations of a plasminogen activator directly to the thrombus combined with placement of a downstream Greenfield filter to protect patients from pulmonary embolus.

L-arginine improves endothelium-dependent vasorelaxation and reduces intimal hyperplasia after balloon angioplasty.

Reductions in nitric oxide (NO) activity persist after arterial intimal injury and may be a factor in the development of intimal hyperplasia. NO inhibits in vitro platelet aggregation, leukocyte adhesion, and smooth muscle cell growth, all of which are key components in the process of intimal hyperplasia. We hypothesized that long-term supplementation with L-arginine, the precursor of NO, would increase NO production and thereby improve endothelium-dependent vasorelaxation and simultaneously reduce intimal hyperplasia.

The role of inflammatory cytokines in wound healing: accelerated healing in endotoxin-resistant mice.

Unlabelled: The role of cytokines in normal wound healing remains poorly defined. In vitro, tumor necrosis factor alpha (TNF-alpha) decreases collagen accumulation, perhaps by increasing collagenase activity. The current study was undertaken to test the hypothesis that cytokines impair wound healing and collagen production.

Peripheral arterial thrombosis in the nephrotic syndrome.

Peripheral arterial thrombosis is a rare complication of nephrotic syndrome that occurs in conjunction with a hypercoagulable state and results in a high rate of limb loss and death. We report a case of brachial artery thrombosis in a pediatric patient with nephrotic syndrome, antithrombin III deficiency, and antecedent vessel trauma. An extensive review of the literature is presented.

Immunotherapy of murine transitional cell carcinoma of the bladder using alpha and gamma interferon in combination with other forms of immunotherapy.

BCG immunotherapy is very effective in the treatment of superficial transitional cell carcinoma of the bladder, but its significant toxicity may limit its use in some patients. In an effort to find less toxic and potentially more effective treatments we investigated the possible immunotherapeutic potential of combinations of Alpha Interferon (1000 IU) and Gamma Interferon (500 IU) with bacillus Calmette Guerin (BCG) (10(7) cfu), Interleukin-2 (4000 IU), and Keyhole Limpet Hemocyanin (50 micrograms.) in the MBT2 murine bladder cancer model.

Inhibition of prostaglandin E2-stimulated cAMP accumulation by lipopolysaccharide in murine peritoneal macrophages.

Treatment of murine peritoneal macrophages with 100 nM prostaglandin E2 (PGE2) produced a rapid biphasic increase in intracellular cAMP that was maximal at 1 min and sustained through 20 min. Pretreatment of macrophages with 100 ng/ml of lipopolysaccharide (LPS) for 60 min prior to PGE2 decreased the magnitude of cAMP elevation by 50%, accelerated the decrease of cAMP to basal levels, and abolished the sustained phase of cAMP elevation. The effect of LPS was concentration-dependent, with maximal effect at 10 ng/ml in cells incubated in the presence of 5% fetal calf serum and at 1 microgram/ml in the absence of fetal calf serum.

Techniques for outpatient hypospadias surgery.

With careful attention to patient selection and anesthesia, as well as easy-to-manage dressings and urinary diversions, outpatient surgery for all degrees of hypospadias can be performed safely and economically. By using these techniques over an eighteen-month period all hypospadias operations were performed in the outpatient department. This included thirty-four minor operations as well as twenty-five major hypospadias repairs.

Posterior flank approach to the peritoneum for ventriculoperitoneal shunting.

We report a technique for insertion of a distal shunt catheter into the peritoneal cavity through a posterior incision. This has been helpful in patients with impaired access anteriorly. It may also be useful in elective situations.

Examination of relative rates of cAMP synthesis and degradation in crude membranes of adipocytes treated with hormones.

The impact of changes in the activation state of the low Km cAMP phosphodiesterase (PDE) on cAMP output in adipocyte membranes was assessed by measuring the product of cAMP synthesis and degradation in the membrane preparation simultaneously. Crude membranes were prepared from adipocytes treated with the cAMP analog, 8-pCl phi S-cAMP and from adipocytes treated with 2 nM insulin. Using membranes from control and treated cells, adenylate cyclase was activated with various concentrations of forskolin and cAMP production (synthesis minus degradation) was measured with and without complete PDE inhibition using the specific inhibitor CI-914.

Comparison of in vivo activity of fluconazole with that of amphotericin B against Candida tropicalis, Candida glabrata, and Candida krusei.

Fluconazole (UK-49,858) is a new oral bis-triazole antifungal agent with demonstrated activity against Candida albicans. Because of the increasing importance of infections due to other species of Candida, we studied the efficacy of fluconazole in a rat model of established systemic candidiasis, using clinical isolates of C. tropicalis, C.