29 results on '"Hatch DA"'
Search Results
2. Progranulin AAV gene therapy for frontotemporal dementia: translational studies and phase 1/2 trial interim results.
- Author
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Sevigny J, Uspenskaya O, Heckman LD, Wong LC, Hatch DA, Tewari A, Vandenberghe R, Irwin DJ, Saracino D, Le Ber I, Ahmed R, Rohrer JD, Boxer AL, Boland S, Sheehan P, Brandes A, Burstein SR, Shykind BM, Kamalakaran S, Daniels CW, David Litwack E, Mahoney E, Velaga J, McNamara I, Sondergaard P, Sajjad SA, Kobayashi YM, Abeliovich A, and Hefti F more...
- Subjects
- Humans, Middle Aged, Female, Male, Aged, Intercellular Signaling Peptides and Proteins genetics, Intercellular Signaling Peptides and Proteins cerebrospinal fluid, Genetic Vectors, Animals, Treatment Outcome, Translational Research, Biomedical, Mice, Neurofilament Proteins genetics, Neurofilament Proteins cerebrospinal fluid, Neurofilament Proteins blood, Frontotemporal Dementia genetics, Frontotemporal Dementia therapy, Frontotemporal Dementia cerebrospinal fluid, Progranulins genetics, Genetic Therapy adverse effects, Genetic Therapy methods, Dependovirus genetics
- Abstract
GRN mutations cause progranulin haploinsufficiency, which eventually leads to frontotemporal dementia (FTD-GRN). PR006 is an investigational gene therapy delivering the granulin gene (GRN) using an adeno-associated virus serotype 9 (AAV9) vector. In non-clinical studies, PR006 transduced neurons derived from induced pluripotent stem cells of patients with FTD-GRN, resulted in progranulin expression and improvement of lipofuscin, lysosomal and neuroinflammation pathologies in Grn-knockout mice, and was well tolerated except for minimal, asymptomatic dorsal root ganglionopathy in non-human primates. We initiated a first-in-human phase 1/2 open-label trial. Here we report results of a pre-specified interim analysis triggered with the last treated patient of the low-dose cohort (n = 6) reaching the 12-month follow-up timepoint. We also include preliminary data from the mid-dose cohort (n = 7). Primary endpoints were safety, immunogenicity and change in progranulin levels in cerebrospinal fluid (CSF) and blood. Secondary endpoints were Clinical Dementia Rating (CDR) plus National Alzheimer's Disease Coordinating Center (NACC) Frontotemporal Lobar Degeneration (FTLD) rating scale and levels of neurofilament light chain (NfL). One-time administration of PR006 into the cisterna magna was generally safe and well tolerated. All patients developed treatment-emergent anti-AAV9 antibodies in the CSF, but none developed anti-progranulin antibodies. CSF pleocytosis was the most common PR006-related adverse event. Twelve serious adverse events occurred, mostly unrelated to PR006. Deep vein thrombosis developed in three patients. There was one death (unrelated) occurring 18 months after treatment. CSF progranulin increased after PR006 treatment in all patients; blood progranulin increased in most patients but only transiently. NfL levels transiently increased after PR006 treatment, likely reflecting dorsal root ganglia toxicity. Progression rates, based on the CDR scale, were within the broad ranges reported for patients with FTD. These data provide preliminary insights into the safety and bioactivity of PR006. Longer follow-up and additional studies are needed to confirm the safety and potential efficacy of PR006. ClinicalTrials.gov identifier: NCT04408625 ., (© 2024. The Author(s).) more...
- Published
- 2024
- Full Text
- View/download PDF
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3. Bilateral hydronephrosis secondary to endometriosis managed by endoscopic ureteral stent placement in a captive Guinea baboon (Papio papio).
- Author
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Dallwig RK, Langan JN, Hatch DA, Terio KA, and Demitros C
- Subjects
- Animals, Endometriosis complications, Female, Hydronephrosis etiology, Hydronephrosis surgery, Ureteral Diseases etiology, Ureteral Diseases surgery, Endometriosis veterinary, Hydronephrosis veterinary, Papio papio, Stents veterinary, Ureteral Diseases veterinary, Ureteroscopy veterinary
- Abstract
Spontaneous endometriosis is an estrogen-dependent, progressive and painful disease that affects a variety of nonhuman primates, including several species of baboons (Papio sp.). This case documents multimodal management of severe endometriosis in a captive female baboon within a zoological institution. An 18-yr-old, intact female Guinea baboon (Papio papio) was found to have an enlarged uterus. Fifteen months post ovariohysterctomy, scarring associated with endometrial tissue resulted in ureteral strictures, bilateral hydronephrosis, and azotemia. Cystoscopic placement of bilateral ureteral stents with fluoroscopy was performed and resulted in short-term clinical improvement. The animal's condition declined and euthanasia was elected 4 mo after ureteral stent placement. Severe endometriosis with secondary inflammation resulting in bilateral hydroureter and hydronephrosis, as well as concurrent cystitis, ureteritis, and pyelonephritis were confirmed at necropsy. Despite possible complications, ureteral stents can be considered a useful therapeutic option in patients with ureteral disease. more...
- Published
- 2011
- Full Text
- View/download PDF
4. Editorial comment.
- Author
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Hatch DA
- Subjects
- Female, Humans, Male, Kidney Transplantation immunology, Nephrectomy, Transplantation Immunology
- Published
- 2011
- Full Text
- View/download PDF
5. Penile myofibroma occurring in a dorsal hood prepuce.
- Author
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Rao MV, Polcari I, Barkan GA, and Hatch DA
- Subjects
- Humans, Infant, Male, Myofibroma complications, Penile Neoplasms complications, Myofibroma pathology, Penile Neoplasms pathology, Penis abnormalities
- Abstract
Dorsal hood prepuce is a common congenital anomaly of the penis. Neoplasms of the prepuce are very rarely seen in children. We present an interesting case of a penile myofibroma encountered during circumcision of a dorsal hood foreskin in an 8-month-old infant., (Copyright © 2011 Elsevier Inc. All rights reserved.) more...
- Published
- 2011
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6. Long-term urological complications in survivors younger than 15 months of advanced stage abdominal neuroblastoma.
- Author
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Koyle MA, Hatch DA, Furness PD 3rd, Lovell MA, Odom LF, and Kurzrock EA
- Subjects
- Abdominal Neoplasms pathology, Female, Humans, Infant, Kidney Diseases etiology, Male, Neoplasm Staging, Neuroblastoma pathology, Retrospective Studies, Survivors, Time Factors, Abdominal Neoplasms complications, Kidney Diseases epidemiology, Kidney Neoplasms epidemiology, Neoplasms, Second Primary epidemiology, Neuroblastoma complications
- Abstract
Purpose: We evaluated the long-term urological complications in survivors of infant advanced stage abdominal neuroblastoma., Materials and Methods: The records of patients who presented during an 8-year period with surgical problems related to the kidney and who had survived advanced stage (IV and IV-S) neuroblastoma were reviewed., Results: Of 7 patients identified 3 had complications of obstruction from retroperitoneal fibrosis and 4 had renal cell carcinoma. In the renal cell carcinoma group 3 patients had synchronous, multifocal, bilateral tumors and 1 had a tumor in a solitary kidney. Pathological examination of renal cell carcinoma revealed oncocytoidy with solid and papillary patterns. One patient underwent bilateral nephrectomy but in the remaining 3 renal preservation surgery was performed. All 7 patients have no progression of secondary complications 2 to 8 years after initial presentation., Conclusions: Survivors of advanced stage abdominal neuroblastoma may be predisposed to long-term urological complications well after initial diagnosis. Because of the risk of renal damage from obstruction secondary to retroperitoneal fibrosis, and the propensity to have renal cell carcinoma, close long-term followup using abdominal imaging is recommended. more...
- Published
- 2001
7. Kidney transplantation in children with urinary diversion or bladder augmentation.
- Author
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Hatch DA, Koyle MA, Baskin LS, Zaontz MR, Burns MW, Tarry WF, Barry JM, Belitsky P, and Taylor For RJ
- Subjects
- Adolescent, Child, Child, Preschool, Female, Graft Survival, Humans, Infant, Male, Postoperative Complications, Kidney Transplantation immunology, Plastic Surgery Procedures, Urinary Bladder surgery, Urinary Diversion, Urologic Surgical Procedures
- Abstract
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 1.7 to 18 years old (mean age 12.1) received 31 kidney transplants. Cause of end stage renal disease was renal dysplasia in 8 cases, posterior urethral valves in 5, obstructive uropathy in 5, neurogenic bladder/chronic pyelonephritis in 4, spina bifida/chronic pyelonephritis in 3, prune belly syndrome in 3 and reflux in 2., Results: Of the patients 17 had augmented bladder (ileum 9, ureter 5, sigmoid 2 and stomach 1), 12 had incontinent urinary conduits (8 ileum, 6 colon) and 1 had a continent urinary reservoir. Surgical complications included 1 case each of stomal stenosis, stomal prolapse, renal artery stenosis, urine leak, enterovesical fistula and wound dehiscence. Medical complications included urinary tract infection in 21 cases and metabolic acidosis in 5. A bladder stone developed in 1 patient. There was no correlation between the incidence of symptomatic urinary tract infections and type of urinary drainage. Acidosis was more common in patients with augmented bladder (4 of 17 versus 1 of 14) but there was no correlation between the bowel segment used and the occurrence of acidosis. Graft survival was 90% at 1 year, 78% at 5 years and 60% at 10 years. Etiology of graft loss included chronic rejection in 6 cases, noncompliance in 4 and acute rejection in 1. There were no deaths., Conclusions: Drainage of transplanted kidneys into an augmented bladder or urinary conduit is an appropriate management strategy when the native bladder is unsuitable or absent. Patients with kidney transplants drained into augmented bladder or urinary conduit are at increased risk for urine infection. Graft survival is not adversely affected compared to historical controls when a kidney transplant is drained into a urinary conduit or augmented bladder. more...
- Published
- 2001
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8. Adjunctive antibiotic/anticoagulant lock therapy in the treatment of bacteremia associated with the use of a subcutaneously implanted hemodialysis access device.
- Author
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Boorgu R, Dubrow AJ, Levin NW, My H, Canaud BJ, Lentino JR, Wentworth DW, Hatch DA, Megerman J, Prosl FR, Gandhi VC, and Ing TS
- Subjects
- Humans, Pilot Projects, Renal Dialysis instrumentation, Anti-Bacterial Agents administration & dosage, Anticoagulants administration & dosage, Bacteremia drug therapy, Bacteremia etiology, Catheters, Indwelling adverse effects, Renal Dialysis adverse effects
- Abstract
To improve vascular access for hemodialysis, a new device (Dialock Hemodialysis Access System, Biolink Corporation, Middleboro, MA) has been developed. Implanted subcutaneously, the device is accessed by percutaneous puncture. Attached to the device are two catheters that are implanted into the superior vena cava or right atrium. Clinical results thus far have been promising. However, use of this device is not free from infectious complications. In the present pilot study, 25 maintenance hemodialysis patients were implanted with 26 Dialock devices. The incidence of bacteremia was 2.9/1,000 catheter days. In 14 episodes of bacteremia in 8 patients the infection was successfully treated with a combination of systemic antibiotic treatment and adjunctive antibiotic/anticoagulant lock therapy. The lock therapy entailed the instillation of both an antibiotic and an anticoagulant into the device. We believe that the antibiotic/anticoagulant lock technique is an effective, adjunctive therapeutic modality in the treatment of infections related to the use of indwelling vascular access devices. more...
- Published
- 2000
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9. Estimating detrusor pressure at home in pediatric patients with myelomeningocele.
- Author
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Damaser MS, Brzezinski K, Walter JS, Wheeler JS, Schroeder LS, and Hatch DA
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Infant, Male, Pressure, Urodynamics, Urology methods, Meningomyelocele physiopathology, Urinary Bladder physiopathology
- Abstract
Purpose: We evaluated a method of estimating detrusor pressure at home in patients with myelomeningocele who perform clean intermittent catheterization to empty the bladder., Materials and Methods: Patients with myelomeningocele who perform clean intermittent catheterization underwent cystometry. At home they determined bladder pressure before draining a full bladder and after partial draining with the bladder almost empty. Home estimate of detrusor pressure was calculated using the formula, full bladder pressure - almost empty bladder pressure., Results: A total of 4 boys and 5 girls with a mean age plus or minus standard deviation of 9.6+/-7.9 years who were enrolled in our study made 16.9+/-15.2 home bladder pressure and volume recordings weekly each during a mean of 5.8+/-4.3 months. Mean bladder capacity determined at home was significantly greater than cystometric capacity (354+/-185 versus 250+/-146 ml.). At a mean home and cystometric volume of 190+/-110 ml. full bladder pressure at home was not significantly different from cystometric vesical pressure (31.0+/-8.8 versus 27.5+/-7.5 cm. water). At a mean volume of 23+/-15 ml. mean home almost empty bladder pressure was not significantly different from cystometric abdominal pressure at full and almost empty volumes (14.1+/-5.5 versus 17.0+/-7.4 and 15.5+/-5.8 cm. water). Mean home estimate of detrusor pressure was not significantly different from cystometric detrusor pressure (17.0+/-6.3 versus 10.2+/-9.2 cm. water)., Conclusions: Estimation of detrusor pressure at home is reliable and accurate in patients who perform clean intermittent catheterization. These pressure determinations may be used as a baseline for rapid identification of changes in bladder function. more...
- Published
- 1999
10. Resistive indices in the evaluation of infants with obstructive and nonobstructive pyelocaliectasis.
- Author
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Vade A, Dudiak C, McCarthy P, Hatch DA, and Subbaiah P
- Subjects
- Dilatation, Pathologic, Humans, Infant, Kidney Calculi diagnostic imaging, Kidney Calculi pathology, Predictive Value of Tests, Prospective Studies, Sensitivity and Specificity, Hydronephrosis diagnostic imaging, Kidney Pelvis diagnostic imaging, Kidney Pelvis pathology, Ultrasonography, Doppler, Pulsed
- Abstract
Diagnosing obstructive uropathy by renal resistive indices calculated from duplex Doppler sonographic waveforms has been supported as well as challenged in the radiology literature relating to adults. Despite reports of normally higher resistive indices in children as compared to adults, two studies have documented high sensitivity and specificity of renal Doppler sonography in the diagnosis of obstructive uropathy in children, using the same discriminatory criterion of a resistive index of 0.7 or greater as used in adults. We evaluated 43 infants with significant or bilateral pyelocaliectasis secondary to both obstructive and unobstructive uropathy and found no significant difference in the mean resistive indices or the mean difference in resistive indices of two kidneys in one patient. We conclude that Doppler sonography in infants has no value in differentiating obstructive from nonobstructive pyelocaliectasis. more...
- Published
- 1999
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11. Initial results of a new access device for hemodialysis technical note.
- Author
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Levin NW, Yang PM, Hatch DA, Dubrow AJ, Caraiani NS, Ing TS, Gandhi VC, Alto A, Davila SM, Prosl FR, Polaschegg HD, and Megerman J
- Subjects
- Adult, Aged, Bacterial Infections etiology, Female, Humans, Male, Middle Aged, Regional Blood Flow, Renal Dialysis adverse effects, Catheters, Indwelling, Renal Dialysis instrumentation
- Abstract
Background: A new subcutaneous device (DIALOCKtrade mark) provides vascular access to patients who currently require hemodialysis (HD). The device consists of a port-like valve, implanted subcutaneously below the clavicle, which provides a linear flow passage to two catheters placed in the right atrium via the internal or external jugular vein. The valve is accessed percutaneously with needle-cannulas that functionally convert the device to twin catheters for connecting the patient to the HD lines., Methods: The device was implanted in 10 outpatients under local anesthesia. Patients used the device during dialysis 3 times/week, and data were collected on blood flow, pressures, adverse events and patient and nurse satisfaction., Results: The device was used for HD almost immediately (median 3 days after implantation) and functioned successfully for more than nine months (mean +/- SD 7.3 +/- 1.5) in all but one patient who died of unrelated causes after one month; there were >800 dialysis sessions total. Blood flows over 300 ml/min were consistently achieved (average 326 +/- 40) with venous and arterial pressures of 200 +/- 44 and -246 +/- 29 mm Hg, respectively. After 66 patient-months, condition of the needle puncture sites remained satisfactory. Five systemic infections occurred in four patients, producing 2.3 bacteremic episodes per 1000 patient-days. All resolved without the need for device removal. There were no infections at the puncture sites. Two patients required fibrin sheath stripping of their catheters, one whose heparin lock was not changed for 23 days (for reasons unrelated to the device). Patient and nurse acceptance was excellent., Conclusion: The device represents a positive improvement in the area of HD access. more...
- Published
- 1998
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12. New access device for hemodialysis.
- Author
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Levin NW, Yang PM, Hatch DA, Dubrow AJ, Caraiani NS, Ing TS, Gandhi VC, Alto A, Davila SM, Prosl FR, Polaschegg HD, and Megerman J
- Subjects
- Adult, Aged, Equipment Design, Female, Humans, Male, Middle Aged, Catheters, Indwelling, Renal Dialysis instrumentation
- Abstract
A new subcutaneous device (Dialock; Biolink Corp., Middleboro, MA) provides vascular access to patients who currently require hemodialysis (HD). The device consists of a port-like valve, implanted subcutaneously below the clavicle, which provides a linear flow passage to two catheters placed in the right atrium via the jugular vein. The valve is accessed percutaneously with needle-cannulas that functionally convert the device to twin catheters for connecting the patient to the HD lines. Interdialytic patency is maintained using a standard heparin lock. The device has been implanted in 10 outpatients under local anesthesia, with almost immediate use for HD (median, 3 days) and has functioned successfully for more than 6 months (mean +/- SD, 4.0 +/- 1.7; > 400 dialysis sessions). Blood flows over 300 ml/min were consistently achieved (average, 320 +/- 50) with venous and arterial pressures of 197 +/- 42 mmHg and -241 +/- 31 mmHg, respectively. After 40 patient-months, condition of the needle puncture sites remains satisfactory. Four systemic infections have occurred in three patients; all have resolved without the need for device removal. There have been no infections at the puncture sites. One patient whose heparin lock was not changed for 23 days (for reasons unrelated to the device) required fibrin sheath stripping of his catheters. Patient and nurse acceptance has been excellent. The device may offer substantial improvement over conventional devices for HD access. more...
- Published
- 1998
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13. Home bladder pressure monitoring in children with myelomeningocele.
- Author
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Andros GJ, Hatch DA, Walter JS, Wheeler JS, Schlehahn L, and Damaser MS
- Subjects
- Child, Cholinergic Antagonists therapeutic use, Humans, Manometry, Posture physiology, Pressure, Urinary Bladder, Neurogenic physiopathology, Urinary Catheterization, Urinary Tract Infections physiopathology, Urination physiology, Home Nursing, Meningomyelocele physiopathology, Self Care, Urinary Bladder physiology, Urodynamics physiology
- Abstract
Purpose: We evaluate a pressure gauge used at home for patients with myelomeningocele on clean intermittent catheterization to provide a system for inexpensive frequent monitoring of bladder pressures., Materials and Methods: Subjects with myelomeningocele using clean intermittent catheterization underwent cystometry in the laboratory. At home they obtained weekly volumes and bladder pressures before and after emptying. Home estimate of detrusor pressure was defined as full bladder pressure minus empty bladder pressure. Medication changes, subject position and urinary tract symptoms were noted., Results: A total of 11 subjects 10.5+/-7.3 years old have been enrolled and have made 16.7+/-12.6 weekly home bladder pressure and volume recordings in 4.7+/-3.1 months. Bladder capacities measured at home were 132+/-47% of cystometric capacities. At volumes of data overlap home full pressures (31+/-10 cm. water) were not statistically different from cystometric vesical pressures (25+/-9 cm. water). Home empty pressures (7+/-4 cm. water) were similar to cystometric abdominal pressures (14+/-8 cm. water). Home estimates of detrusor pressures (23+/-7 cm. water) magnified differences in full and empty pressures, and were significantly greater than cystometric detrusor pressures (11+/-11 cm. water). In 2 subjects significant increases in home full pressures occurred, which were associated with cessation of anticholinergic medication and infection., Conclusions: Home monitoring of bladder pressure is a simple, inexpensive and accurate method of obtaining frequent bladder pressures in patients with myelomeningocele. These pressures are consistent over a large range of volumes and times, and could potentially be used to identify quickly changes in patient condition. more...
- Published
- 1998
14. Re: Intracorporeal phenylephrine reduces thioridazine (mellaril) induced priapism in a child.
- Author
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Hatch DA
- Subjects
- Child, Humans, Male, Penis, Priapism chemically induced, Phenylephrine administration & dosage, Priapism prevention & control, Thioridazine adverse effects
- Published
- 1997
15. Kidney transplantation in patients with an abnormal lower urinary tract.
- Author
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Hatch DA
- Subjects
- Humans, Kidney Failure, Chronic complications, Kidney Failure, Chronic surgery, Urinary Bladder surgery, Urinary Bladder Diseases complications, Urinary Bladder Diseases surgery, Urinary Diversion methods, Urinary Reservoirs, Continent, Kidney Transplantation, Urinary Tract abnormalities
- Abstract
Several factors influence the decision about which type of urinary drainage is best for any given patient. In a patient who has undergone cystectomy, supravesical drainage is required. However, many patients with upper tract urinary diversion have bladders that can be rehabilitated to provide adequate urinary storage. In most patients who have not had a cystectomy, the bladder can be augmented with bowel to achieve a suitable capacity. The urethral resistance component of continence can be achieved using bladder neck reconstruction, periurethral injection, or artificial urinary sphincter. Intermittent catheterization may be required following lower tract reconstruction. When reconstruction is possible, the native bladder is usually the best option for kidney transplant drainage. In general, one should provide an effective, low-pressure means of urine drainage that the patient can manage. With improvements in surgical technique and with better immunosuppressive regimens, kidney transplantation can be performed safely in patients with abnormal lower urinary tracts. Using appropriate bladder rehabilitation or supravesical diversion can preserve and even improve a patient's life style. more...
- Published
- 1994
16. A review of renal transplantation into bowel segments for conduit and continent urinary diversions: techniques and complications.
- Author
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Hatch DA
- Subjects
- Humans, Kidney Failure, Chronic complications, Postoperative Complications, Kidney Failure, Chronic surgery, Kidney Transplantation, Urinary Diversion, Urinary Reservoirs, Continent
- Published
- 1994
17. Fate of renal allografts transplanted in patients with urinary diversion.
- Author
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Hatch DA, Belitsky P, Barry JM, Novick AC, Taylor RJ, Jordan ML, Sagalowsky AI, and Zaontz MR
- Subjects
- Adult, Child, Creatinine blood, Female, Follow-Up Studies, Graft Rejection, Humans, Life Tables, Male, Retrospective Studies, Survival Analysis, Time Factors, Treatment Outcome, Kidney Transplantation mortality, Kidney Transplantation physiology, Urinary Diversion
- Abstract
Fifty-five kidneys were transplanted into 50 patients with supravesical urinary diversion at 16 transplant centers between 1970 and 1991. Of the 32 males and 18 females, 40 were adults (> or = 18 years) and 10 were less than 18 years old at the time of first transplant. Mean follow-up was 7.8 years. At last follow-up, 94% of recipients were alive and 73% of the kidneys were functioning. Fifteen kidneys were lost: 9 to rejection, 3 to noncompliance, and 3 patients died with a functioning kidney. Ten (18%) transplants were followed by surgical complications. Twenty-four (44%) were followed by medical complications of which urinary tract infection was most common. Recipients age 18 or younger had more urinary tract infections than older patients. No patient had urinary stones and no patient required medical treatment for metabolic abnormalities. We conclude that drainage of kidney transplants into a supravesical urinary diversion is an effective treatment for end-stage renal disease patients without adequate urinary bladders. more...
- Published
- 1993
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18. Pediatric urological manpower report. Pediatric Urological Manpower Committee of the American Association of Pediatric Urology.
- Author
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Shapiro E and Hatch DA
- Subjects
- Humans, United States, Workforce, Pediatrics statistics & numerical data, Urology statistics & numerical data
- Abstract
The American Association of Pediatric Urology initiated a Pediatric Urological Manpower Study in 1991. A 24-question survey was distributed to the members of the Society of Pediatric Urology and the American Academy of Pediatrics Section on Urology. The objective of the questionnaire was to obtain information related to fellowship training, regional distribution of pediatric urologists, and practice patterns and attitudes. As of December 31, 1991, 345 questionnaires were distributed, and 244 (71%) were completed and entered into a computer program. The number of pediatric urologists was evenly distributed among 3 consecutive 10-year age groups ranging between age 31 and 60 years. The majority (78%) of urologists practicing 100% pediatric urology were between 31 and 50 years old. Approximately 60% of the responders practiced full-time (100%) pediatric urology and 59% of this group were university based. Pediatric urologists were practicing in 42 states and the District of Columbia. Based upon the United States Department of Commerce 1990 census, the number of pediatric urologists practicing in each state in relation to the total pediatric (less than 18 years old) populations was determined. The number of pediatric urology fellowships has steadily increased since the mid 1950s. Currently, more than 10 fellows are trained annually. Of the 172 responders practicing at least 75% pediatric urology 24% indicated that practice was "too busy" and 53% indicated that practice was "just right." Approximately 44% of the responders were considering adding a partner: 21 indicated that they planned to add a partner in 1 year, 65 in 5 years and 10 in 10 years. Hopefully, the Pediatric Urological Manpower Study will serve as a useful instrument for assessing the pediatric practice patterns and training needs in the United States, thereby enhancing the quality of urological care for children. more...
- Published
- 1993
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19. Use of kidney internal splint/stent (KISS) catheter in urinary diversion after pyeloplasty.
- Author
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Ritchie E, Reisman EM, Zaontz MR, Hatch DA, Wacksman J, and Maizels M
- Subjects
- Adolescent, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Male, Kidney Pelvis surgery, Postoperative Care instrumentation, Stents, Urinary Catheterization instrumentation, Urinary Diversion instrumentation
- Abstract
We report on the use of a new catheter, the kidney internal splint/stent (KISS), to facilitate renal urine drainage following pyeloplasty. The catheter combines the desirable qualities of nephrostomy tube diversion, anastomotic stent, and trocar placement in a single tube. The special construction of its lumen diminishes the likelihood of obstructed drainage. Our experience using the KISS catheter with 31 patients undergoing pyeloplasty shows it provides effective internal and external urinary diversion. more...
- Published
- 1993
- Full Text
- View/download PDF
20. Preventing hematomas during artificial erection.
- Author
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Hatch DA
- Subjects
- Humans, Injections methods, Intraoperative Care methods, Male, Hematoma prevention & control, Penile Diseases prevention & control, Penile Erection
- Abstract
Subcutaneous hematoma can be avoided during artificial erection by placing the injection needle through the glans penis into the corpus cavernosum. Blood from the puncture site in the corpus is then absorbed through the drainage system of the corpus spongiosum. more...
- Published
- 1990
21. Hypospadias hidden by a complete prepuce.
- Author
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Hatch DA, Maizels M, Zaontz MR, and Firlit CF
- Subjects
- Child, Child, Preschool, Circumcision, Male, Humans, Hypospadias embryology, Hypospadias surgery, Infant, Male, Urethra embryology, Hypospadias diagnosis, Penis embryology
- Abstract
Nine boys were found to have hypospadias despite the presence of a complete prepuce. The urethral meatus was in the subcoronal position in six boys, the distal shaft position in one boy and on the corona glandis in two boys. Although it is generally thought that boys with hypospadias have a dorsal hooded prepuce resulting from incomplete development of the ventral phallus, we have found hypospadias in boys with complete preputial development. Thus, physicians who perform circumcision should fully retract the prepuce to detect occult hypospadias before completing the procedure. Parents of newborns with hypospadias and a complete prepuce should be told, before circumcision, that preputial tissues may be needed to repair the hypospadias. more...
- Published
- 1989
22. A randomized study of intravenous fluid replacement following living-donor renal transplantation.
- Author
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Hatch DA, Barry JM, and Norman DJ
- Subjects
- Adult, Clinical Trials as Topic, Glomerular Filtration Rate, HLA Antigens analysis, Humans, Kidney physiopathology, Nephrectomy, Random Allocation, Renal Dialysis, Tissue Donors, Fluid Therapy, Kidney Transplantation
- Abstract
Fourteen adult recipients of living-donor kidneys preserved with ice-cold intracellular electrolyte solution were randomly assigned to receive either high fluid replacement (total volume of urine output + 30 ml/hr) or low fluid replacement (constant 125 ml/hr) during the first 48 hr after grafting. High replacement recipients had significantly higher fluid intake and urine output than did low replacement recipients. However, net fluid balance at the end of the 48-hr study period was positive for both groups and not significantly different. Fractional excretion of sodium was directly related to urine output in all patients. Serum osmolality, serum sodium concentration, and urine sodium concentration were not significantly different in the treatment groups. Urine osmolality was significantly higher in the low-replacement group at 24 and 36 hr after transplantation. The i.v. replacement of total urinary output is unnecessary in adult recipients of living-donor kidneys preserved with ice-cold intracellular electrolyte solution because such grafts can conserve sodium and water immediately after transplantation. more...
- Published
- 1985
- Full Text
- View/download PDF
23. Urological complications in pediatric renal transplantation: management and prevention.
- Author
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Zaontz MR, Hatch DA, and Firlit CF
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Hematoma etiology, Hemorrhage etiology, Humans, Hydronephrosis etiology, Infant, Kidney injuries, Lymphocele etiology, Male, Pelvis, Renal Artery Obstruction etiology, Retroperitoneal Space, Rupture, Spontaneous, Urinary Bladder Diseases etiology, Urinary Incontinence etiology, Urinary Tract Infections etiology, Urologic Diseases prevention & control, Urologic Diseases therapy, Kidney Transplantation, Postoperative Complications, Urologic Diseases etiology
- Abstract
From 1973 through 1986, 166 consecutive renal transplants were performed in 143 patients. Urological complications included ureteral leakage/obstruction/necrosis, urinary tract infection, pyelonephritis, pelvic lymphocele, pelvic abscess, pelvic hematoma, infected hydrocele, bladder calculus, labial edema, renal artery/segmental stenosis, hydronephrosis, urinary incontinence, renal allograft malrotation and kidney rupture. Management options and preventive measures to avoid some of these dilemmas are highlighted. more...
- Published
- 1988
- Full Text
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24. Parallel incision, unstented extravesical ureteroneocystostomy: followup of 203 kidney transplants.
- Author
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Barry JM and Hatch DA
- Subjects
- Follow-Up Studies, Humans, Methods, Urinary Catheterization, Kidney Transplantation, Ureter surgery, Urinary Bladder surgery
- Abstract
A parallel incision, unstented extravesical ureteroneocystostomy was used in 203 human kidney transplants. The reoperation rate was 1 per cent. Extravasation of urine occurred in 3 patients, 1 of whom required surgical repair. One patient required transurethral fulguration of a ureteral bleeder. Two patients had grade 1 reflux and none required repair. No patient had ureteral obstruction at the anastomosis. This simple technique is useful because ureteral length and bladder dissection are minimal, and no separate cystotomy is required. The adequacy of the submucosal tunnel is judged when the ureter is passed through it. more...
- Published
- 1985
- Full Text
- View/download PDF
25. Müllerian remnant causing bladder outlet obstruction.
- Author
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Tank ES and Hatch DA
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Cysts surgery, Follow-Up Studies, Humans, Infant, Male, Mullerian Ducts surgery, Urinary Bladder Neck Obstruction surgery, Urography, Cysts diagnostic imaging, Mullerian Ducts diagnostic imaging, Urinary Bladder Neck Obstruction diagnostic imaging
- Abstract
Less than one-third of patients with persistent müllerian duct remnants develop bladder outlet obstructive symptoms. We report on two cases of bladder outlet obstruction caused by massive dilatation of persistent müllerian duct remnants. Such structures should be suspected when outlet obstructive symptoms occur in patients with hypospadias and/or undescended gonads. Care should be taken to identify possible urethral obstruction distal to the prostatic urethra as a cause of gross enlargement of persistent müllerian duct remnants. more...
- Published
- 1986
- Full Text
- View/download PDF
26. Prevention of hematoma during artificial erection.
- Author
-
Hatch DA and Tank ES
- Subjects
- Humans, Male, Hematoma prevention & control, Penile Diseases prevention & control, Penile Erection
- Published
- 1988
- Full Text
- View/download PDF
27. Re: Ureteroneocystostomy in Renal Transplantation: A Simple Transvesical Technique.
- Author
-
Hatch DA and Barry JM
- Subjects
- Cystostomy adverse effects, Humans, Cystostomy methods, Kidney Transplantation
- Published
- 1989
- Full Text
- View/download PDF
28. Hernias complicating chronic ambulatory peritoneal dialysis in children.
- Author
-
Tank ES and Hatch DA
- Subjects
- Child, Female, Follow-Up Studies, Hernia, Inguinal surgery, Hernia, Umbilical surgery, Humans, Ligation, Male, Hernia, Inguinal etiology, Hernia, Umbilical etiology, Peritoneal Dialysis, Continuous Ambulatory
- Abstract
The sustained hydraulic pressure developed within the peritoneal cavity during chronic ambulatory peritoneal dialysis (CAPD) may develop any actual or potential defect in the inguinal or umbilical area into a clinical hernia. Seven of 19 children have developed inguinal hernias after initiation of CAPD. Demonstration of the presence of a processus vaginalis by peritoneography during catheter placement permits their repair at that time. Late development of clinical indirect inguinal hernias early in our experience after high ligation of the processus vaginalis emphasizes the fact that tight closure of the internal ring is necessary. more...
- Published
- 1986
- Full Text
- View/download PDF
29. Significance of immediate preoperative bacteriuria with pyuria in renal transplant recipients.
- Author
-
Hatch DA and Barry JM
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Bacteriuria complications, Kidney Transplantation, Pyuria complications, Surgical Wound Infection etiology
- Abstract
The presence of bacteriuria and pyuria on urinalysis immediately before renal transplantation has resulted in cancellation of surgery because of concern about post-transplant wound infection. Of 113 renal transplant recipients reviewed 41 (36 per cent) had 5 or more white blood cells per high power field with bacteria in either a voided urine or bladder washout specimen obtained just before grafting. Of those 41 patients 2 suffered postoperative wound infections. Of 72 patients (64 per cent) with less than 5 white blood cells or no bacteria on a preoperative specimen 1 suffered a wound infection (p not significant by Fisher's exact test). Preoperative urine cultures and operative bladder cultures of all 3 patients failed to yield the organisms found later in the wound infections. The factors of sex, insulin-dependent diabetes, delayed graft function, living related versus cadaver donor and pre-transplant splenectomy had no significant relationship to wound infection rates. Renal transplantation can be performed safely in patients who have pyuria and bacteriuria but no signs or symptoms of infection. more...
- Published
- 1987
- Full Text
- View/download PDF
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