The Journal of urology
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We describe a case of a solitary pelvic kidney coexisting with adrenal and pelvic neuroblastoma in a child with multiple malformations, including microcephaly, hypertelorism, aortic coarctation and a bifid uterus. The association of a solitary kidney and neuroblastoma has not been reported previously.
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A case of malignant hyperthermia in a young girl with vesicoureteral reflux and multiple congenital abnormalities is discussed. Malignant hyperthermia is a relatively newly defined problem that is associated with anesthesia. It is being recognized with increasing frequency, particularly in children with multiple musculoskeletal anomalies. ⋯ It is a drug-induced syndrome of hypermetabolism that may represent an inborn error of metabolism. Recognition, prophylaxis and crisis management are reviewed, and the use of dantrolene sodium in the care of patients with malignant hyperthermia is discussed. Because recognition of malignant hyperthermia is an important concern for the practicing urologist, the principles of identifying the patient at risk, as well as managing the crisis, should be familiar to the clinician.
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Survival of patients undergoing cystectomy for invasive carcinoma of the bladder has improved significantly in recent decades. Although this improved survival is accredited widely to the use of preoperative radiation therapy review of the available data raises questions regarding the validity of such conclusions. Important disadvantages, including increased morbidity, are associated with long course (4,000 to 5,000 rad) preoperative radiation. Although these disadvantages are minimized with a short course regimen (1,600 to 2,000 rad) the case for its efficacy remains unconvincing.
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Among 30 male children seen for the Praer-Willi syndrome 21 had at least 1 undescended testis (70 per cent). In 14 of the 30 patients both testes were undescended (45 per cent). ⋯ Testicular biopsy showed a Sertoli-cell-only appearance in 4 patients. The usual indications for orchiopexy of undescended testes may need to be modified in patients with the Prader-Willi syndrome.
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The Journal of urology · Jun 1980
Case ReportsCushing's syndrome: complication of triamcinolone injection for urethral strictures in children.
We report 2 cases of Cushing's syndrome following intralesional triamcinolone acetonide injections of urethral strictures in children. The pharmacology of triamcinolone and its 2 parenteral forms, triamcinolone acetonide and triamcinolone diacetate, is discussed. For children we recommend the short-acting triamcinolone diacetate at 4-week intervals with dosage adjusted to age. In adults either type of triamcinolone may be used but triamcinolone acetonide should be given at 6-week intervals.