Search PubMed⌕ Search

Biomedical subjects

A Greenstein

Publications and source records attributed to A Greenstein.

At least 55 records · Page 3Linked to original sources
PubMed1990

Transurethral incision of the bladder neck and prostate.

Between March 1983 and December 1988, 66 men 50 years old and older with symptomatic bladder outlet obstruction underwent transurethral incision of the bladder neck and prostate. Patients selected for incision had a small, clinically benign, prostate and peak urinary flow rate of less than 15 ml. per second. Preoperative and postoperative evaluation included symptom questionnaires and uroflowmetry. A single midline incision was made extending from the bladder neck to the verumontanum. Results were available in 64 of the 66 men who underwent the procedure with a mean followup of 2.24 years. Mean symptom scores decreased from 9.66 preoperatively to 4.59 postoperatively (p less than 0.001) and peak urinary flow rates increased from 7.4 to 14.7 ml. per second (p less than 0.0001). Antegrade ejaculation was preserved in 83.3% of the men who preoperatively had antegrade ejaculation. Subsequent transurethral resection of the prostate was required in 5 patients (7.6%). With a mean followup of greater than 2 years transurethral incision of the bladder neck and prostate was effective in treatment of bladder outlet obstruction caused by a small prostate while maintaining antegrade ejaculation in the majority of patients.

Follow-Up Studies↗
PubMed1990

A fat-specific enhancer is the primary determinant of gene expression for adipocyte P2 in vivo.

The murine gene for adipocyte P2 encodes an adipocyte-specific member of the family of intracellular lipid binding proteins. The region upstream from the start of transcription of this gene has been found to contain binding sites for the transcription factors c-jun/c-fos and C/EBP (CCAAT/enhancer binding protein) and several short sequence elements found in other adipocyte gene promoters, termed fat-specific elements. To identify DNA sequences that were responsible for the high level of transcription of the gene for adipocyte P2 in vivo, we made a series of transgenic mice containing 168 base pairs (bp), 247 bp, 1.7 kilobases (kb), and 5.4 kb of 5' flanking sequence linked to the bacterial gene chloramphenicol acetyltransferase. Although plasmids containing only 168 bp of 5' sequence including the C/EBP and AP-1 (activation protein 1) binding sites were expressed well in cultured adipocytes, high levels of chloramphenicol acetyltransferase activity in the adipose tissue of transgenic mice were not observed until the 5' flanking region was extended to kb -54. An enhancer mapping between kb -4.9 and kb -5.4 upstream from the start of transcription was identified by transfection of further deletions into cultured adipocytes. This enhancer, when linked to a bp -63 promoter fragment from the gene for adipocyte P2, directed very high level chloramphenicol acetyltransferase expression specifically to adipose tissue in transgenic mice. These results identify a functional adipose-specific enhancer and indicate that it is the major determinant of tissue specificity of the gene for adipocyte P2. These results also demonstrate that the proximal-promoter binding sites for AP-1 and C/EBP are not sufficient or necessary to give adipose-tissue-specific expression in vivo, though they may play an important role in the response of this promoter to glucocorticoids.

Adipose Tissue↗
PubMed1990

Short-term effect of a new portable extracorporeal lithotripter on renal function.

Extracorporeal shock wave lithotripsy has become the treatment of choice for upper urinary tract stones. We evaluated the impact of a new lithotripter on the kidneys of 14 nonobstructed patients treated for renal stones, using several physiological parameters and renal ultrasonography. Glomerular filtration rates (GFR) were estimated from the renal scan. Complete disintegration of the stone was accomplished in all but one patient. Treatment did not alter the serum parameters or the renal ultrasonography. Also, no changes were found in the GFR on the follow-up renal scans in both kidneys. The implications of these findings are discussed.

Adult↗
PubMed1989

Potential pitfalls in the obstructive renal scan in patients with double-pigtail ureteral catheters.

In 21 patients with a long-standing internal ureteral double-pigtail catheter we demonstrated the adverse effect of a full bladder on upper system drainage. A pseudo-obstructive pattern noted in these patients on routine scans was immediately rectified by mere bladder emptying and a normal pattern was demonstrated. We suggest the bladder be emptied in all patients with indwelling internal ureteral stents before renographic evaluation.

Catheters, Indwelling↗
PubMed1989

The value of renal scan in acute renal colic--a clinical viewpoint.

The value of emergency room renal scan in acute renal colic was evaluated. Based on obstructive pattern on renal scan, 53 cases were admitted. The results indicate that only in 13 cases (25%) there was a need for further inpatient investigation followed by interventional treatment. In all 13 cases, either elevated fever, impaired renal function or intractable pain were present, in addition to an obstructive renal scan pattern. In the majority (75%) of cases, when there were no adjunctive ominous signs, hospital admission based only on an obstructed renal scan, showed need for conservative therapy only and was rather unjustified.

Adult↗
PubMed1989

Use of gonadotropin-releasing hormone analogue in advanced prostatic cancer: 3 years clinical experience.

The relative efficacy of the recently introduced gonadotropin-releasing hormone (GnRH) analogues in advanced prostatic cancer, compared with surgical castration, is still debatable. High patient compliance, lack of side effects, and absence of the psychological impact of castration, seem to be the most prominent advantages cited. Our long-term follow-up in a group of 19 prostate cancer patients treated with GnRH analogue also indicated high patient compliance and mild side effects. However, we found a discrepancy between local prostatic regression and general clinical responsiveness, and a poorer therapeutic effect than that obtained with surgical castration. In this group of patients follow-up with either prostatic acid phosphatase or prostatic specific antigen seems promising. We found a high correlation between disease state and prostatic markers. We suggest that GnRH analogues are another addition to the armamentarium for treating advanced prostatic carcinoma, yet are limited in their therapeutic effectiveness.

Acid Phosphatase↗
PubMed1988

Alpha-adrenergic blocker for posthernioplasty urinary retention. Prevention and treatment.

In a prospective, randomized study, 102 patients over the age of 60 years underwent inguinal hernioplasty. We compared a group of 58 patients who received phenoxybenzamine hydrochloride with a control group of 44 patients. The phenolsulfonphthalein test was performed in all patients. Twenty-six (25.5%) of the 102 patients developed acute urinary retention after the hernioplasty; all of them were in the control group. All of these 26 patients had pathological phenolsulfonphthalein test. In 21 of these 26 patients, urinary retention disappeared within 48 hours following phenoxybenzamine administration.

Aged↗
PubMed1987

Familial polyposis coli. Results of mucosal proctectomy with ileoanal anastomosis.

The outcome of mucosal proctectomy with ileoanal anastomosis in patients with polyposis coli has not been well studied. A series of 25 patients with polyposis treated at the Mount Sinai Hospital over a period of ten years is reported. The mean age of the patients was 23 years. Early postoperative complications were present in seven patients and consisted of thrombophlebitis (three), pelvic sepsis (three), and retraction of the anastomosis (one). Intestinal obstruction requiring laparotomy occurred in another five patients. Twenty-three patients were followed for a mean of 47 months after closure of the ileostomy. Ninety-one percent are satisfied with the operative results. The mean number of bowel movements per 24 hours is 6.0. All patients are continent, but eight have occasional episodes of rectal seepage at night. Nearly 50 percent require some antidiarrheal medication. New adenomatous polyps have developed just above the dentate line in four patients. Patients with polyposis coli seem to have fewer serious complications requiring excision of the ileoanal anastomosis than patients with ulcerative colitis. They also should have lifelong surveillance of the entire gastrointestinal tract even after total colectomy with ileoanal anastomosis.

Adolescent↗
PubMed1987

Phantom kidney--a pitfall in radionuclide study of urinary tract.

A survey was done on 39 nephrectomized patients who underwent our routine radionuclide kidney study including blood flow imaging at various periods postoperation. Perfusion of varying degree was demonstrated in the area of the nephrectomized kidney in 17 patients showing equal or less activity than the actual kidney. This so-called phantom kidney was reproducible in the same patient and was found four weeks to ten years after nephrectomy. Thirteen phantom kidneys were found on the left side and four on the right. Seven were after simple nephrectomy, four after radical nephrectomy, and six after nephroureterectomy. Besides being a source of error in interpretation in kidney imaging, the appearance of this residual postnephrectomy blood flow is difficult to explain, particularly in the cases of radical nephrectomy.

Adult↗
PubMed1985

Nephrogenic adenoma: benign proliferative lesion of urothelium.

Three new cases of a rare benign proliferative lesion of the urothelium (nephrogenic adenoma) are hereby added to the existent 58 reported cases. All 3 lesions occurred in the bladder. Two of the 3 cases presented with a history of surgical interventions on the bladder, and the third patient had a history of chronic cystitis and pyelonephritis, and was on chronic dialysis. Diagnosis was made on histologic examination of cystoscopic biopsy of the lesions. Transurethral resection and/or fulguration was the treatment of choice. There was no recurrence of the lesions on follow-up cystoscopic examination.

Adenoma↗
PubMed1984

Anal carcinoma in patients with Crohn's disease.

Three patients with Crohn's disease and carcinoma of the anus are reported and compared to a group of patients with anal cancer and no inflammatory bowel disease. The three patients with Crohn's disease were relatively young women with significant perianal disease. There were two squamous cell lesions and one cloacogenic tumor in this group. The relative incidence of anal cancer as a proportion of all colorectal cancer, in patients with Crohn's disease (14%) was found to be significantly higher than the incidence of anal cancer in patients without inflammatory bowel disease (1.4%). Possible reasons for the increased incidence of anal cancer in Crohn's disease mentioned were: an overall increase in malignancies in inflammatory bowel disease, the high incidence of perianal disease, and the chronic long-standing perianal inflammation present. All patients with Crohn's disease, especially if they have active perianal disease, should be observed for the occurrence of anal cancer.

Adult↗
PubMed1984

[Sarcomatoid carcinoma of the kidney].

Sarcomatoid renal carcinoma is an uncommon renal malignancy with an aggressive biological behaviour and very poor survival rate. We treated lately 4 patients, three of which died shortly after the operation. The case reports are presented and the histology and the clinical implications are discussed.

Aged↗