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Biomedical subjects

C V Hodges

Publications and source records attributed to C V Hodges.

At least 19 recordsLinked to original sources

Dipstick chemical urinalysis: an accurate cost-effective screening test.

In a double-blind prospective study of 200 sequential urine specimens the sediment count of leukocytes in the centrifuged urine (white blood cells per high power field) was compared to a chamber count of leukocytes in uncentrifuged urine (white blood cells per microliter.). There was good correlation (coefficient of correlation 0.783, sensitivity 91.9 per cent, specificity 97.6 per cent and efficiency 96.6 per cent) between the more precise chamber count and the more commonly performed sediment count if the methodology of the sediment count was standardized. In a double-blind prospective study the results of the sediment count for leukocytes and erythrocytes were compared to the leukocyte esterase and hemoglobin dipstick results of urine specimens from 1,346 adults who underwent multiphasic screening. The dipsticks were found to be sensitive to physiologic limits for leukocytes and erythrocytes, with only 0.9 per cent false negative results for each. Formed elements in the urine not detectable by dipstick, such as casts and crystals, were present in 3 per cent of the specimens. Among patients who had significant pyuria, hematuria or formed elements not detectable by dipstick chemical urinalysis, no significant pathological condition was detected upon retrospective review. Because the chemical dipstick is not quantitative and because the sensitivity of the dipsticks resulted in many false positive findings compared to the sediment count (red and white blood cells 16.4 and 13.2 per cent, respectively) a protocol is offered in which results of screening urine specimens that are positive on dipstick culture would be confirmed by a properly performed microscopic urinalysis. This protocol as applied to an adult screening population would be an accurate, cost-effective method of urine testing.

Adolescent↗

Emphysematous prostatic abscess: diagnosis and treatment.

We report an unusual case of an emphysematous prostatic abscess. Prostatic abscess is a difficult clinical diagnosis associated with lower urinary tract symptomatology and frequently diabetes mellitus. Computerized axial tomography and transrectal or transurethral ultrasonography can assist in making a specific diagnosis. Definitive treatment is complete surgical drainage, which is achieved by transurethral resection of the prostate. Wide spectrum, adjuvant antibiotic therapy should be given to assure coverage of anaerobic bacteria.

Abscess↗

Stress hematuria: athletic pseudonephritis in marathoners.

Hematuria and proteinuria have been noted in athletes after heavy exercise. Evaluation of 383 marathoners after a 26-mile, 385-yard run revealed hematuria in 17 per cent and proteinuria in 30 per cent. These abnormalities were not related to sex. The condition is transient and appears to be benign. A diagnostic approach to avoid missing significant renal or urologic disease is outlined.

Female↗

Comparison of intracellular flushing and cold storage to machine perfusion for human kidney preservation.

Transplant teams have been reluctant to accept kidneys preserved with intracellular electrolyte flushing followed by simple cold storage, especially when retrieved by non-transplant surgeons or when preservation time exceeds 24 hours. This study from 1 center is a comparison of 40 primary cadaver kidney grafts preserved with Collins' C2 flushing followed by simple cold storage to 37 primary cadaver kidney grafts preserved with cryoprecipitated plasma on the MOX-100 machine. Cold storage time was 10 to 44.5 hours in the C2 group and 3.5 to 39 hours in the machine-perfused group, with a mean of 23 hours in each group. There was no significant difference between the 2 preservation methods no matter who removed the kidney with respect to 1) the incidence of acute tubular necrosis, 2) the 1-month serum creatinine nadir of surviving grafts and 3) the actuarial graft survivals up to 2 years. Among the 40 C2-preserved kidneys 17 were retrieved by community surgeons and 23 were retrieved by transplant surgeons. Human kidneys removed from beating-heart cadaver donors can be preserved satisfactorily with either Collins' 2 flushing followed by simple cold storage or pulsatile machine perfusion, even when preservation times exceed 24 hours.

Adolescent↗

Leukemic infiltration of the prostate: a case report.

A successful transurethral resection of the prostate was performed without complication in a 66-year-old man who presented with acute urinary retention, anemia, leukemia and thrombocytopenia. Preoperative treatment with red cell and platelet transfusions, HLA typing for white cell transfusions and preventative antibiotics made surgical treatment successful. With continued improvement in therapy for hematologic tumors and the improvement in survival, catheter drainage with its concomitant chance for sepsis is not a viable alternative to surgical therapy for prostatism.

Acute Disease↗

Transureteroureterostomy: 25-year experience with 100 patients.

During the last 25 years 100 patients have been subjected to transureteroureterostomy. In 2 cases postoperative death was attributable to other pathologic processes. We treated 94 donor units successfully in this manner. An additional 2 units, normal for several years after transureteroureterostomy, had periureteral fibrosis and stricture owing to the inferior mesenteric artery syndrome and required another definitive surgical procedure. Ninety-seven recipient kidneys remained normal after the procedure.

Adolescent↗

Specific binding of prolactin by the prostate gland of the rat and man.

Specific binding sites for 125iodine-prolactin are present in membrane particles obtained from the rat ventral prostate, human benign prostatic hyperplasia and prostatic adenocarcinoma. In the ventral prostate glands of young rats (1 to 4 months old) specific binding of 125iodine-prolactin is higher than in older animals (greater than 8 months old). Subcellular distribution studies revealed that specific 125iodine-prolactin binding activity is associated primarily with the 15,000 and 100,000 g particulate membrane fractions of the rat ventral prostate and human prostate glands. In rats between 2 and 4 months old significant increases in the prolactin binding activity in the 100,000 g membrane fraction of the ventral prostate are observed to occur without concomitant increases in prolactin binding activity in the 15,000 g fraction. The level of specific 125iodine-prolactin binding activity present in the human prostate gland is lower than that observed in the rat ventral prostate gland. Localization of specific prolactin binding sites in the rat ventral psotate and the human prostate gland suggests that prolactin could influence the function of these tissues directly.

Animals↗

Radical prostatectomy for carcinoma: 30-year experience and 15-year survivals.

Three strata of medical care are shown in this series of patients undergoing radical prostatectomy for carcinoma: (1) Medical School Hospital patients had an average age 4 years greater than patients in the other 2 groups and the lowest 15-year survival rate of 15 per cent. 2) The Veterans Hospital patients had an average age 4 years younger than patients in the Medical School Hospital group but there was little opportunity for preventive care by early diagnosis and they had a 15-year survival rate of 26 per cent. 3) The Emanuel series of private patients had good preventive private medical care, allowing for earlier diagnosis in a patient population without other serious medical problems, and a 15-year survival rate of 61 per cent. The 15-year survival figures for other modalities of therapy, including various types of radiation, chemotherapy and immunotherapy, are necessary for meaningful evaluation of efficacy.

Aged↗

Extravesical ureteral ectopia.

A case of an extravesically ectopic single ureter draining into the seminal vesicle is presented. Age of diagnosis, embryology of ureteral ectopia, and locations of the ureteral orifice are discussed. Suggestions are made for the diagnosis and treatment of ureteral ectopia.

Adolescent↗

Adrenal cortical carcinoma.

A review of 28 cases of adrenal cortical carcinoma provides some insights into the natural history of this disease and suggests modifications in current techniques of diagnosis and management. Our patients ranged in age from 1 to 69 years but it is notable that all of our male patients were more than 39 years old. In addition the men tended to have high stage tumors that were nonfunctional. Female patients, on the other hand, were more evenly distributed in terms of stage, function and age at diagnosis. Staging was extremely important and is discussed in some detail. A dismayingly large number of patients were found to have stage 3 or 4 tumor at initial diagnosis, suggesting that aggressive and rapid evaluation and a high index of suspicion are important to optimize survival. Function is helpful but non-function is common and should not dissuade one from the diagnosis. Excretory urography with tomography followed by angiography frequently will provide the diagnosis. Endocrinologic evaluation should be done with alacrity. Survival with high stages of disease is poor and lengthy evaluation should not be allowed to delay prompt and, hopefully, curative surgery. Surgical resection is the key to cure; chemotherapy and radiotherapy provided relatively poor results in our hands although mitotane has shown a 34 to 54 per cent response rate.

Adolescent↗

Radical cystectomy for bladder cancer.

We reviewed 52 consecutive patients who had undergone radical cystectomy for bladder cancer prior to 1962 and have been followed for 15 to 23 years. The over-all survival rates at 5, 10 and 15 years were 38, 27 and 17%. Pathologic staging was the most important prognostic factor in the series.

Adult↗

Revascularization of totally occluded renal arteries.

Two cases of total renal artery occlusion are presented. The clinical durations of occlusion were 10 days and 6 months. Revascularization procedures were successful in both patients, resulting in return of renal function and alleviation of hypertension. Our 2 cases and a review of 30 other cases demonstrate that the maximum duration of main renal artery occlusion with subsequent return of renal function is unknown.

Aged↗

Impotence: a diagnostic approach.

A diagnostic approach to erectile impotence using a sexual function questionnaire, nocturnal penile plethysmography, penile blood pressure measurement, cavernosograms, cystometrograms and plasma testosterone levels is presented. Case examples demonstrate the clinical value of these diagnostic tools. Psychogenic impotence should be diagnosed only after nocturnal penile plethysmography has demonstrated the presence of complete erections.

Adult↗

The influence of retrograde contrast medium on urinary cytodiagnosis: a preliminary report.

It has been recommended that before retrograde brushing of upper urinary tract lesions to diagnose malignancy the contrast medium should be washed away with saline because of possible cellular distortion. There were 21 paired specimens from 19 patients submitted for urinary cytodiagnosis. One specimen was a contrast medium wash, similar in pH and osmolality to urine, and the other a saline wash. Cellular detail was adequate for cytodiagnosis in 20 of the 21 contrast medium specimens. Of 7 specimens from patients with malignancy 3 were diagnosed correctly as malignant, 1 was classified as suspicious and 3 were falsely negative in the contrast wash group. Of the 3 falsely negative diagnoses 2 were changed to malignant when the paired saline wash specimens were examined. Urologists should not discard the contrast medium specimen prior to retrograde brushing but should send it along with a saline wash specimen for cytodiagnosis because the discarded contrast material and irrigant may have diagnostic cells.

Contrast Media↗

The effect of human serum on 3H-thymidine incorporation in human prostate tumors in tissue culture.

Human prostatic tumors, 4 adenomas and 4 adenocarcinomas, were established in tissue culture. We used the incorporation of 3H-thymidine into deoxyribonucleic acid as a measure of cell activity to compare the effects of supplementing the culture media with human or fetal calf serum. 3H-thymidine incorporation was greater with human serum, with up to 120 per cent increase observed. The addition of dihydrotestosterone (10(-8)M.) did not enhance or inhibit 3H-thymidine incorporation.

Animals↗