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Biomedical subjects

A J Bueschen

Publications and source records attributed to A J Bueschen.

At least 19 recordsLinked to original sources
PubMed1995

Prostate cancer screening (United States).

In 1995, there will be 244,000 new cases of prostate cancer, and 40,400 deaths from prostate cancer, among men in the United States. The American Cancer Society reports that the incidence rate of prostate cancer is increasing at an accelerated pace, and was 21 percent higher in 1994 than in 1993. The major reason for this steep rise is likely to be due to increased popularity of prostate cancer screening which, by identifying latent, asymptomatic cases, may convert them into clinical cases. Is screening--an important means of cancer control for many sites--a reasonable approach for prostate cancer control? The answer is not straightforward because prostate cancer is not one, but three diseases: a latent form which will cause no harm; a progressive form which will become symptomatic and can kill; and a rapidly progressive form so malignant that it is likely to kill, whether detected early or late. Screen-detection may be worthwhile only for the second form, as tumors of the first form need never be detected, and tumors of the third form progress so rapidly that timely screen-detection is nearly impossible and, if accomplished, may be valueless. As there is no way to differentiate among the three diseases when screening, the possible deleterious effects of screen-detection must be weighed against the benefits.

Adult↗
PubMed1991

Short-term and long-term changes in renal function after donor nephrectomy.

We retrospectively examined the effect of nephrectomy on renal function in 55 living related donors. Renal function was measured with 131iodine-orthoiodohippurate scans. All patients were studied preoperatively, and 1 week and 1 year postoperatively. In 20 patients 10-year followup was available. Compensatory hypertrophy was complete 1 week postoperatively: effective renal plasma flow of the remaining kidney was 32.5% higher than preoperatively. The increase remained stable for at least a year. The degree of compensatory hypertrophy was significantly greater in male patients (46.9% after 1 week) than in female patients (26.7%). Compensatory hypertrophy occurred in all age groups studied and it was most pronounced in patients less than 30 years old. In the patients followed for 10 years effective renal plasma flow decreased from 387.7 ml. per minute 1 week after nephrectomy to 367.4 ml. per minute at 10 years. This result is similar to the decrease seen in the normal population. According to our results, renal donation by living related persons does not lead to long-term decrease in renal function.

Adaptation, Physiological↗
PubMed1990

Transurethral prostatectomy: analysis and comparison of four clinical series.

Charts of 302 patients from four groups who had transurethral prostatectomy were reviewed with respect to patient characteristics and complications. The four groups were similar in average age and amount of tissue resected. Patients from the University of Alabama Hospital and Veterans Administration Hospital tended to have more associated illnesses than patients in the two private practices. Bleeding, the most frequently seen intraoperative and immediate postoperative complication, occurred most often in the University of Alabama Hospital series and in patients with prostates weighing more than 45 gm. Incontinence, the most frequent long-term complication, occurred most often in patients from the Veterans Administration Hospital. Complications and characteristics are compared with those in previously reported series of patients having transurethral prostatectomy and with those of the American Urological Association cooperative study.

Aged↗
PubMed1990

Radiologic evaluation of continent urinary reservoirs.

A variety of methods are currently used for urinary diversion after cystectomy in adults. Radiologists are generally familiar with ileal and colonic conduits but are less familiar with the recently popularized continent urinary reservoirs. We describe and illustrate the surgical technique, normal anatomy, and normal radiographic appearance of a variety of urinary reservoirs, including the Kock pouch, Camey procedure, and various ileocecal reservoirs. Complications of various reservoirs are also discussed and illustrated.

Cecum↗
PubMed1989

Renal angiomyolipoma associated with lymph node involvement and renal cell carcinoma in patients with tuberous sclerosis.

Renal angiomyolipomas are found in more than half of the patients with tuberous sclerosis. We report on 3 patients with tuberous sclerosis and pathologically aggressive renal angiomyolipoma with retroperitoneal lymph node involvement and/or renal cell carcinoma. All patients have had a benign course. The literature is reviewed and supports the benign nature of this seemingly aggressive disorder. An approach to the evaluation and treatment of a child with tuberous sclerosis and renal angiomyolipoma is presented.

Adolescent↗
PubMed1988

Lymphedema of the penis and scrotum.

The problem of genital lymphedema is commonly secondary to filariasis in most regions of the world. In the Western Hemisphere surgical manipulations usually exacerbate this significant problem. Lower leg edema may also result from these interventional procedures.

Genital Diseases, Male↗
PubMed1986

Complications of radical cystectomy and correlation with nutritional assessment.

Single stage radical cystectomy and ileal conduit remains the procedure of choice for invasive bladder cancer and is a formidable operation performed on an elderly population. A retrospective review of 69 radical cystectomies was done to evaluate not only operative mortality and complication rate, but also the nutritional status of the patients and its relationship to the frequency of complications. Preoperative nutritional status was assessed by total lymphocyte count and serum albumin. There was an operative mortality rate of 2.9 per cent and early complication rate of 41 per cent. The findings suggest that patients with severe nutritional depletion should receive hyperalimentation prior to cystectomy to reduce serious postoperative complications.

Adult↗
PubMed1985

Free full thickness (patch) graft urethroplasty: long-term follow-up.

Thirty-two patients underwent free, full thickness skin (patch) graft urethroplasties between September, 1974, and May, 1978. Sixty-five per cent of the 23 patients available for five-year follow-up had good results from grafts ranging from 3 to 14 cm in length. In patients with good one-year results strictures did not develop during the review period, suggesting the need for only short-term follow-up in this group.

Adolescent↗
PubMed1985

Microsurgical vasovasostomy for reversal of elective bilateral segmental vasectomy.

Microsurgical vasovasostomy for the reversal of elective bilateral segmental vasectomy (vasectomy, vas ligation) was done in 57 patients (61 operations) between May 1977 and March 1984. The length of time between elective segmental vasectomy and subsequent vasovasostomy ranged from 12 to 216 months; the longest period between vasectomy and vasovasostomy resulting in a subsequent pregnancy was 108 months. The patency rate was 83%, with 51% of these patients fathering one or more children (overall pregnancy rate of 41%). Unlike previous studies, ours showed no positive correlation between the presence of postvasectomy sperm granulomas and either patency or pregnancy rate after microsurgical vasovasostomy. The major factor that seemed to affect the success of the procedure was the number of years between vas ligation and vasovasostomy.

Adult↗
PubMed1985

Enzyme activities in prostatic carcinoma related to Gleason grades.

In an effort to identify enzymatic activities in primary prostatic carcinomas that might be complementary to histological and other clinical techniques for the prediction of prognosis, we have assayed several enzymatic activities extracted from prostatic carcinomas. We reported previously that, for each of the studied enzymes, tissues with benign prostatic hyperplasia and prostatic carcinoma showed significantly different activities. With additional patients now included and a longer interval since resection of these tumors, we have found that the histological grade (Gleason's system for grading) of the sample (prostate chip) analyzed is related to several activities extracted from the cancers including arginase (r = -0.81, p less than 0.0001), glucose-6-phosphate dehydrogenase (r = 0.72, p less than 0.0001), and the B isoenzyme of N-acetyl-beta-D-glucosaminidase (r = -0.58, p = 0.0369). Acid phosphatase (r = 0.15, p = 0.5530) and the BB isoenzyme of creatine kinase (r = -0.13, p = 0.5221) are not significantly related to histological grade. In a large series, Gleason grade is related to survival. In our series of 27 patients followed for 20 to 46 months, the Gleason grade (p = 0.22) is not related to survival, but arginase activity is related (p = 0.0392) to survival. In this small series, arginase is more valuable than the best currently proven predictor of survival, Gleason grade. Hexosaminidase B activity approaches being significantly (p = 0.0575) related to survival. Of the 11 patients whose tumors contained the lowest arginase activities, eight are dead. Of the 11 with the highest activities, only one is dead. Several of the enzyme activities in this series of 27 patients complemented each other for the prediction of Gleason grade; for example, glucose-6-phosphate dehydrogenase, arginase, and the BB isoenzyme of creatine kinase were more closely correlated (multiple correlation coefficient, r = 0.77) with the Gleason grade for all chips than was any single enzyme: arginase, r = -0.67; glucose-6-phosphate dehydrogenase, r = 0.67; creatine kinase, r = -0.16. It seems likely that enzymatic analysis may provide an approach that is qualitatively different from and complementary to histological evaluation for the prediction of prognosis in prostatic carcinoma. Verification of this hypothesis will require more patients followed over a longer period of time and will probably be facilitated by analysis of several samples from different locations in each tumor.

Acid Phosphatase↗
PubMed1981

Comprehensive renal scintillation procedures in spinal cord injury: comparison with excretory urography.

A 131iodine orthoiodohippurate comprehensive renal scintillation procedure was performed and compared to results of excretory urography in 200 spinal cord injury patients. No severe urographic abnormalities were undetected by the comprehensive renal scintillation procedure. Only 1.4 per cent of renal units had greater than minimal pyelocaliectasis or ureterectasis in the presence of a normal radionuclide examination. A relatively large number of abnormalities were detected on the renal scintillation procedure when the excretory urogram was normal. Serial followup will be required to determine the significance of these findings but present data suggest that a comprehensive renal scintillation procedure and a plain film of the kidneys, ureters and bladder may be used for screening upper urinary tract abnormalities in lieu of an excretory urogram. This is particularly advantageous for the spinal cord injury population, since there have been no toxic or allergic reactions reported, no bowel preparation or dehydration is required and there is relatively low radiation exposure.

Humans↗
PubMed1981

Intraoperative roentgenography in the surgical removal of renal calculi.

Complete surgical removal of staghorn or multiple renal calculi is extremely difficult. Intraoperative roentgenography has been used to decrease the incidence of residual calculi. We herein assess the effectiveness of intraoperative roentgenography and emphasize important operative technical aspects. Between 1973 and 1979, 42 patients underwent 50 operations for the removal of staghorn or multiple renal calculi. Intraoperative roentgenography was used in 47 operations and omitted in 3. Of the 47 operations done with intraoperative roentgenography 31 units were free of stones and 12 had small retained fragments known intraoperatively with verification by postoperative tomography or plain abdominal film. In 1 case of calculus recognized intraoperatively passed during the postoperative period and tomograms demonstrated no residual calculi. Only 3 patients had residual stones postoperatively with negative intraoperative films. The 3 patients who did not have intraoperative roentgenography all had residual fragments. All 3 kidneys were thought to be free of residual stones as determined by visual inspection and nephroscopy. With the aid of intraoperative roentgenography the incidence of residual stones was 23 per cent. Followup for up to 6 years in 45 renal units showed 73 per cent to be free of stones. When properly used intraoperative roentgenography is highly accurate. Films should be obtained before any stones are removed and care should be taken to x-ray the entire kidney even if 2 films are required. Final films should be obtained after all fragments are removed.

Humans↗
PubMed1980

A macrofunction for computer processing of comprehensive renal function studies.

Details of a series of computer programs associated with a complex renal function procedure, all linked together into a single "macrofunction" are presented. Input consisted of not only in vivo nuclear medicine information, but also data concerning patient identification, urine volumes, voiding time, urine specific gravity, blood pressure and other pertinent information. Computer output consisted of images, curves and typed information presented in an integrated format ready for inclusion into the patient's record. Clinical evaluation of this comprehensive renal function macrofunction has proved to be useful, econominal, rapid and accurate. It has conveniently sorted a wide variety of disease states and provided clinical information not available from any other non-invasive technique.

Adult↗