Interstitial Iodine-125 seed implantation in the management of prostate cancer: preliminary report at UAB.
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Aged↗
Biomedical subjects
A J Bueschen
Publications and source records attributed to A J Bueschen.
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↗
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↗
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↗
Prostatic 125I implantation--new approach in the management of prostatic cancer.
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Brachytherapy↗
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↗
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↗
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↗
Adjuvant surgical techniques in the removal of staghorn calculi.
Surgical removal of staghorn calculi can be difficult. We describe a retrospective review of 21 patients who underwent 22 operations for the removal of staghorn calculi. Subsequent urinary infections occurred in 30 per cent and recurrent stones developed in 20 per cent of the patients. We emphasize the accuracy and importance of intraoperative roentgenography, the usefulness and morbidity of hemiacidrin irrigation and the postoperative stability of renal function measured by a radionuclide renal function test.
Adult↗
Pathophysiology and recoverability of function and structure in obstructed kidneys.
This article focuses on the effect of obstruction on renal structure and function and the assessment of the degree of recovery following relief of the obstruction.
Child↗
Full thickness skin graft urethroplasty for anterior urethral strictures.
Thirty-two free full thickness skin graft urethroplasties were performed over a thirty-nine-month period. Follow-up of more than six months was available in 27 patients. Results were good or fair in 26 patients (96 per cent). Only 1 patient has been classified as a failure and required reoperation.
Child↗
Upward migration of indwelling ureteral stents.
Polyethylene ureteral stents suspended from the kidney by a pigtail memory in the proximal end were placed bilaterally in a patient with ureteral obstruction secondary to retroperitoneal sarcoma. Both stents migrated upward and 1 migrated into the renal parenchyma. We recommend that these stents be inserted into the renal pelvis, as opposed to the calices, and that sufficient length be allowed to prohibit migration above the bladder.
Catheters, Indwelling↗
Villous polyps of the urethra: a report of two cases.
Two patients with villous polyps of the prostatic urethra are described. The article supports previous observations that the lesion has the morphologic appearance of prostatic tissue. A review of the literature reveals that this rare lesion appears to be specific for the prostatic urethra and behaves as a benign tumor.
Adult↗
Radionuclide evaluation of renal function.
The renal scintillation camera study and the excretory urogram should be considered to be complementary studies. The renal scintillation camera study provides an accurate evaluation of changes in total, differential, and segmental renal function but affords only a gross assessment of anatomic changes. The excretory urogram provides superior information about renal anatomic changes but only inferior information about functional changes of the kidney. The advantages of a renal scintillation camera study with regard to the patient are that it is done in a state of normal hydration, it requires no bowel preparation, it is not associated with allergic reactions, it provides a low radiation exposure, and it is a noninvasive procedure for differential renal function which requires no ureteral catheters.
Adult↗
Enhanced detection of asymptomatic renal masses with routine tomography during excretory urography.
In a prospective study of a diagnositc scheme for evaluating renal masses, it was observed that a significant number of masses (29 per cent) would have been undetected without the aid of routine tomography. The renal masses detected with the aid of tomography are either small or peripheral lesions which cause no impingement upon the renal collecting system. Without specific symptoms referable to a renal mass and without hematuria, many renal masses will be overlooked on standard excretory urography. The general improvement in diagnostic quality, the ease with which this procedure may be added to excretory urography, and the minimal expense involved would be additional factors which should justify the use of routine tomography with excretory urography in any radiology department.
Adult↗
Radionuclide kidney function evaluation in the management of urolithiasis.
Renal and ureteral stones may cause asymmetrical renal damage that is not measured accurately by serum creatinine and blood urea nitrogen studies, excretory urography, nephrotomography and arteriography. We evaluated with a renal scintillation camera study 77 patients who had renal or ureteral calculi. The radionuclide procedure provided an accurate measure of total effective renal plasma flow and differential effective renal plasma flow. It had the additional advantages of being a non-invasive procedure, causing no allergic reactions, requiring no patient preparation and producing low radiation exposure.
Adult↗
Pyeloileocystostomy for ureteral necrosis in pediatric renal transplant recipient.
A pediatric renal transplant patient who had ureteral necrosis treated initially by nephrostomy followed by a subsequent pyeloileocystostomy is reported. This unusual approach to a renal transplant complication is recommended, but only when other methods cannot be utilized.
Child↗
Practical uses of a quantitative renal scintillation camera study.
A quantitative renal scintillation camera study has been described for the evaluation of total renal function and the split function of the two kidneys by a noninvasive technic. It requires no patient preparation, is not affected by bowel gas, and no allergic reactions have been reported. Six cases are reported to illustrate its usefulness with renal tumors, neurogenic bladders, pyelonephritis, nephrolithiasis, congenital anomalies, and renal insufficiency.
Adenocarcinoma↗