Biomedical subjects
Publications and source records attributed to D E Novicki.
Renal axis variations occurring in age-grouped populations are described. We discovered a significant difference in renal axis deviations between young and old population groups with a tendency for a more vertical axis as age increases. Possible reasons for these changes are proposed. We suggest that not all renal axis deviations in the elderly population require extensive evaluation.
Paratesticular mesotheliomas are uncommon tumors. We report 2 such cases and discuss their clinical and pathological findings.
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We used exchange saturation analysis at 15 degrees to quantitate total cytoplasmic and nuclear androgen receptor content of 70 patient specimens. Cytoplasmic androgen receptor contents (fmol/mg DNA) for eight specimens of clinically benign hyperplasia, 14 specimens of histologically hyperplastic prostate obtained at cystoprostatectomy, and carcinomatous and noncarcinomatous prostate obtained at radical prostatectomy for prostatic carcinoma, 48 specimens, respectively, were 830 +/- 165 (mean +/- S.E.), 890 +/- 445, 955 +/- 240, and 750 +/- 95. Nuclear androgen receptor contents of these same specimens, respectively, were 275 +/- 40, 235 +/- 30, 345 +/- 25, and 350 +/- 30; whereas, the values of the cytoplasmic/nuclear receptor content, respectively, were 3.25 +/- 0.55, 3.05 +/- 0.80, 2.50 +/- 0.50, and 2.80 +/- 0.40. Multiway analyses of variance of these cross-sectional data showed that there was no significant difference (p greater than 0.05) between group mean values. This result principally reflects the fact that the families of values for the four tissue groups were highly heterogenous with broad overlap. The results would not appear to be unduly influenced by carcinomatous epithelial cell content of the specimens, because cytoplasmic and nuclear androgen receptor content were not related to specimen carcinomatous epithelial cell content. Paired analyses of receptor content in carcinomatous and noncarcinomatous prostate specimens from the same prostate showed enhanced or unchanged receptor content in 58% (cytoplasmic) and 62% (nuclear) of specimens. Our studies show that cross-sectional analyses of androgen receptor content fail to distinguish carcinomatous prostate from noncarcinomatous prostate. However, paired analyses of these tissues from the same gland identify distinguishing differences. The clinical relevance of these observations remains to be examined.
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Coagulum pyelolithotomy has become a popular means to extract renal calculi in selected circumstances. Serious complications with this procedure have not been previously reported. A case report of an operative death due to a pulmonary embolus is presented, because of which we designed a canine laboratory study to determine the relationship between coagulum injection into the renal pelvis and thrombo-embolic phenomena. Positive lung scans were detected in a large number of animals related to the volume of the coagulum used and the concentration of the thrombin injected. Judicious use of this procedure with suggested cautions is proposed.
Fifty-five patients with 64 incidentally discovered renal masses were evaluated with sonography and/or computerized tomography (CT scanning). Cyst puncture or surgical exploration confirmed the nature of the mass in all cases. We demonstrate that ultrasound is accurate in evaluating renal mass lesions 3 cm. in size or greater, but cannot distinguish between simple or hemorrhagic cysts. CT scanning can characterize lesions 1.5 cm. or greater in size, and those masses that are clearly cystic by CT scanning do not require further evaluation. Masses found to be indeterminate or solid by CT scanning require a more traditional approach. A 9.1-per cent incidence of malignant tumors in this series emphasizes the need for a complete and meticulous evaluation of all renal masses.
A one-layer technique for microscopic vasovasostomy is described. There was an 83-per cent return of sperm and 50-per cent pregnancy rate using this technique. With attention to detail, both vasa can be reanastomosed within two hours.
In about two-thirds of all cases of non-traumatic spontaneous perirenal hemorrhage the etiology can be determined by common urologic diagnostic modialities. However, in the other third the etiology will remain obscure and exploration for diagnosis may become necessary. Because 50 per cent of these preoperatively undiagnosed cases have proved to be associated with small renal tumors primary nephrectomy should be considered strongly. An illustrative case is presented with a brief review of the literature to date.
Complications found in 47 individuals who underwent radical retroperitoneal node dissection were retrospectively analyzed. Our results indicate no mortality and an over-all complication rate of 29.7 per cent. An increased number of complications was noted in those patients who underwent elective appendectomy and in those node dissection above the renal vessels.
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A significant relationship between Peyronie's disease and histocompatibility antigens of the B7 cross-reacting group is described. The association of Peyronie's disease with a group of immunologically cross-reacting antigens, rather than with a single antigen, suggests that a yet undetermined agent of specific molecular configuration involves in some way its pathogenesis. This finding has diagnostic application and adds a new dimension to the etiologic investigation of Peyronie's disease.
The Chiba needle was used to puncture 14 central renal masses believed to be cysts. Of these masses 13 were cysts and 1 was a peripelvic liposarcoma. Arteriography was not done before puncture. No complications occurred when these central masses surrounded by parenchyma or adjacent to hilar structures were punctured. Renal cyst puncture and cystography using the Chiba needle are safe methods for optimal diagnosis of central and peripelvic systs.
The preoperative staging procedures used in 45 patients with surgical Stage I and Stage II nonseminomatous germ cell tumors of the testis were analyzed retrospectively. Our results indicate that gallium-67-citrate scan and supraclavicular lymph node biopsy add little information in the routine preoperative evaluation of these patients. Bipedal lymphangiography, in our experience, was no more accurate than excretory urograms in selecting patients with retroperitoneal disease and in addition provides no information regarding the status of the upper urinary tract. Thus, we suggest that physical examination, excretory urography, chest x-ray film, whole lung tomography, serum tumor markers, and liver scan provide sufficient information to proceed with surgical treatment when appropriate.
This is the second known case of retroperitoneal fibrosis in a middle-aged black man whose tissue type was HLA-B27 positive. The HLA-B27 antigen is present in only 4 per cent of black American male subjects and may be important in the diagnosis and management of patients with primary retroperitoneal fibrosis. A genetic predisposition is suggested for the development of idiopathic primary retroperitoneal fibrosis in patients who are HLA-B27 antigen positive.