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Biomedical subjects

C Schulman

Publications and source records attributed to C Schulman.

18 recordsLinked to original sources
PubMed1992

Penile extensibility: to what is it related?

Penile extensibility is the difference between the length of the flaccid penis and the penis submitted to a maximal constant traction. This measurement has been proposed for use as a new potential diagnostic method to assess intracavernous fibrosis. To determine the value of this method we measured penile extensibility before and after removing the skin and cavernous tissue in 17 cadavers and 4 patients undergoing penile implantation. In all cases a cavernous tissue biopsy was performed and the percentages of the different structures were objectively quantified by computer analysis. The extensibility decreased with patient age but it was not influenced by removal of the skin and/or cavernous tissue. No correlation was observed between decreased extensibility and the increase in fibrotic elements in the penile tissue. Penile extensibility seems to reflect the elasticity of the tunica albuginea, which is the limiting factor and cannot be an expression of fibrosis of the corpora cavernosa.

Adult↗
PubMed1992

Vascular impotence: focal or diffuse penile disease.

Using computerized image analysis the percentage of smooth muscle fibers was measured in several biopsies of the penis from 10 cadavers and 5 patients with vascular impotence. No significant difference was observed between the proximal and distal areas, and/or between the peripheral and central areas in 1 corpus cavernosum, and between the 2 corpora cavernosa for each patient or cadaver. The percentage of smooth muscle fibers was less in impotent patients in comparison with the cadavers, in which the erectile status was not known, and this reduction occurred throughout both cavernous bodies. Vascular impotence is a diffuse penile disease. Therefore, a cavernous body biopsy can be used to study the penile structure in the assessment of vascular impotence.

Adult↗
PubMed1992

Impotence due to corporeal veno-occlusive dysfunction: long-term follow-up of venous surgery.

Corporeal veno-occlusive dysfunction is an important cause of organic impotence and is characterized by increased flow rates to create and to maintain erection during artificial erection produced by intracavernous saline infusion. Sixty-seven patients with this erectile insufficiency underwent penile ligature-resection of deep dorsal vein between 1982 and 1986, and were evaluated by nocturnal plethysmography, pharmacocavernometry as well as a questionnaire about their sexual life for long-term follow-up. The surgical procedure was controlled in the operating room by reduction of the erectile flow rates. Thirty-one patients were potent postoperatively and were able to have satisfactory intercourse. Results after resection were slightly better than after simple ligation of the deep dorsal vein. Four patients had penile glans insensibility resulting from the surgical dissection. There were 7 relapses several months after the procedure due to leakage through other deeper veins. Eight failures were due to additional psychogenic disorders or to neurologic disease not accurately diagnosed before the treatment because they all developed normal papaverine-induced erection after venous surgery while before it they only developed a slight tumescence. Reduction of the erectile flow rates within normal values was impossible during surgery in 3 patients. Eleven failures were due to concomitant arterial disease. Resection of the deep dorsal vein can restore penile erection in patients with cavernovenous leakage in about 50% of well-selected patients.

Erectile Dysfunction↗
PubMed1992

[Value of PSA in the staging of prostatic cancer].

The clinical value of Serum Prostate Specific Antigen (PSA) in the staging of prostatic carcinoma was evaluated in 62 patients who underwent radical retropubic prostatectomy. Preoperative levels of PSA were compared with the final pathological stage obtained from all surgical specimens examined for capsular penetration, seminal vesical invasion and lymph node involvement. PSA level was closely correlated with the volume and the stage of the prostatic carcinoma. 93% of the patients with PSA < or = 10 ng/ml had tumor confined to the gland. All patients with PSA > 20 ng/ml had extraprostatic tumor extension (stage C or D). Patients with histologically proved prostatic carcinoma, PSA > 20 ng/ml and negative bone scan can be assumed to have extraprostatic disease and/or lymphatic involvement. Patients with PSA (drawn in the requested conditions) < or = 10 ng/ml can be considered to have organ confined disease, and can be spared a bone scintigraphy. Our study indicate an increasing role of PSA in the clinical staging of patients with prostatic carcinoma.

Aged↗
PubMed1992

[S. Raz' method of bladder suspension and treatment of cystocele in urinary stress incontinence (short-term results)].

We performed the transvaginal approach described by S. Raz for stress urinary incontinence and cystocele. 13 patients with cystocele and stress urinary incontinence underwent the four corner Bladder neck suspension 12 patients with stress urinary incontinence alone underwent simple bladder neck suspension. After a median follow-up of 4,1 months 92% were cured of incontinence. Cystoceles grade II and III were completely reduced. These results are comparable with abdominal approach for less morbidity and shorter hospital stay.

Adult↗
PubMed1992

[The role of neoadjuvant treatment prior to radical prostatectomy].

Preoperative hormonal therapy has been recently advocated, but remain controversial. The aim purpose is to achieve downstaging, downgrading and improvement of the surgical results. In the last 80 patients undergoing radical retropubic prostatectomy, 28 had preoperative androgen deprivation, for a period ranging from 2 to 12 months with a mean treatment time of 3 months. Medical castration was obtained with total androgen deprivation. Return to normal value of PSA level in 90% cases and to undetectable level (< 0.25) in 39% of cases, expressing probably reduction of the tumor activity. Total prostatic volume is reduced by 30-50% after three months of treatment. The operative procedure was facilitated by an easier dissection, reducing operative time and blood loss. Recovery of postoperative continence was achieved in a significantly shorter period of time (3 months) as compared with the untreated patients (9 months). Immediate continence was obtained in 70% of patients treated preoperatively. No tumor was found in one specimen but no change was observed in the histological grading of the tumor in all the patients. This present study indicates the interest of a large scale randomized study, in order to show the real benefits of neoadjuvant hormonal treatment in prostate cancer patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[The effects of mepartricin on the symptomatology of prostatic hypertrophy--double-blind controlled trial].

Seventy one patients were treated with mepartricin or placebo in three urological centres for a mean duration of 102 days (extremes: 60 and 142 days). An analysis of the results was carried out for 34 patients in the placebo group and 36 patients in the mepartricin group. The results indicate a significant improvement in both the placebo group and the mepartricin group. The irritative and obstructive symptoms are improved in the active treatment group with a response rate of the order of 70%, compared to approx. 45% in the placebo group. An improvement of the values on the flow meter, though not statistically significant, is observed following treatment with mepartricin, compared to the placebo group. There were no significant differences in the evolution of the prostate gland volume, determined by ultrasound in the placebo group and the active treatment group. Side-effects were minor and only one patient reported epigastric pain.

Aged↗
PubMed1988

Study of neuropeptide Y-containing nerve fibers in the human penis.

Neuropeptide Y 1-36 (IR-NPY) immunoreactive nerve-fiber processes have been observed in tunicae of veins and arteries and in smooth muscles of the human penis taken at autopsy or during surgery by use of light- and electron-microscopic immunohistochemical techniques. Numerous IR-NPY nerve fibers were mostly concentrated in the inner part of the adventitia close to the media of the arterial and venous vessels and among the intracavernous smooth muscle cells. IR-NPY nerve fibers were less abundant in veins than in arteries. Positive somata were not observed in the penises. At the ultrastructural level, IR-NPY were localized exclusively in large, dense granules of nerve terminals by means of the postembedding immunogold technique. In the deep dorsal vein, IR-NPY nerve fibers were also located in the media formed by an outer circular and an inner longitudinal layer. In the intracavernous and dorsal arteries, they showed the highest density in the inner part of the adventitia. In the corpora cavernosa and in the corpus spongiosum, IR-NPY nerve processes were intermingled between the smooth-muscle fibers around the sinusoid spaces. IR-NPY nerve fibers were present in the cavernous nerves close to the central arteries. The urethra did not show any IR-NPY-positive nerve fibers. This peculiar distribution of IR-NPY nerve fibers suggested that they could participate in regulating arterial and venous blood flow and intracavernous smooth-muscle tone. NPY may therefore be of importance in some of the mechanisms of penile erection especially during detumescence.

Adolescent↗
PubMed1987

[Pipemidic acid in the prevention of recurring cystitis in women].

The efficacy, safety and acceptability of pipemidic acid in the treatment and the prophylaxis of cystitis in women have been evaluated. After curative treatment, patients received prophylaxis using the compound for a duration of 6 months, and were followed up a further 4 month-period without specific therapy. During the prophylaxis period, no relapse was observed in over 85% of the treated patients. In 15% of cases, a pathogen reappeared along with recurrence of the preexisting symptoms. An increase to 29% of the cases was noted after the withdrawal of the treatment over a month study period. The pathogens involved in the cases of relapse during the prophylaxis period were sensitive to pipemidic acid in 1/3 of cases (6/18 cases), and resistant in 2/3 (12/18 cases) of cases. Those involved in relapses during the observation period were sensitive in 1/2 of the cases (8/16 cases), resistant or intermediate in 1/2 of the cases (8/16 cases). Thus, prophylactic treatment with pipemidic acid has a favorable influence on the number of relapses in patients with recurrent cystitis.

Cystitis↗
PubMed1987

[The course of renal function in vesicorenal reflux. Study using I-123 Hippuran].

Fifty-two patients with vesicoureteral reflux (age: 6.4 +/- 6.2 years) were examined by IVP, voiding cystouretrography and 123 I-Hippuran studies. 17 patients were not operated; 26 had an antireflux, 9 an urethral surgery. The follow-up was 2 years for 39 of these patients, with at least one evaluation per year. The observations were: Unoperated patients were younger, had a lower radiological grade of reflux and renal functional impairment was less frequent. Functional impairment was initially equally distributed in unilateral (53%) and bilateral (54%) reflux. Radiological grade of reflux had an unsatisfactory predictive value for functional renal status. Functional renal status at 2 years was unchanged in 82% of patients. Improvement was observed in 8%, deterioration in 10%. These results were not influenced by the choice of treatment. However, reflux persistence was more frequently observed in the un-operated group (50% versus 5%). Renal transit times of 123 I-Hippuran did not correlate with the functional status or the radiological grade of reflux.

Adolescent↗
PubMed1978

Adjuvant therapy of T1 bladder carcinoma: preliminary results of an EORTC randomized study.

This paper reports the preliminary results of an ongoing clinical trial in patients with category T1 bladder cancer who are randomized after transurethral resection to receive either thiotepa, VM-26, or no treatment. While there are no significant differences between the three treatment groups with respect to the time until first recurrence, thiotepa has significantly reduced the recurrence rate as compared to either VM-26 (P = 0.03) or no treatment (P = 0.04) among the 215 patients for whom follow-up information is currently available.

Humans↗
PubMed1978

A simple method for measuring separate glomerular filtration rate using a single injection of 99mTc-DTPA and the scintillation camera.

A new technique for measuring glomerular filtration in each kidney has been developed using a scintillation camera and the 99mTc-DTPA complex. The technique has been applied to 101 children with various uropathies. Correlations with the total and separate creatinine clearance, the HgCl2 uptake test, and the maximal urinary concentration have been good. The reproducibility of the method has been satisfactory in a small number of patients. The test is particularly adapted to children because of its simplicity, reduced trauma, short duration (20 minutes) and low-radiation dose. In contrast to some other radioisotope techniques, it can be carried out in infants.

Adolescent↗