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Biomedical subjects

F C Lowe

Publications and source records attributed to F C Lowe.

62 records · Page 4Linked to original sources
PubMed1984

Ureteropelvic junction obstruction in adults.

Ureteropelvic junction obstruction (UPJ) in adults is more common than generally appreciated. It may mimic other diseases and may be associated with abdominal pain, hypertension, and recurrent pyelonephritis. Diagnosis and surgical correction were frequently delayed with an average duration of symptoms of 3.2 years for 31 adult patients. Only 4 adults (13%) were diagnosed at the time of their initial onset of symptoms. Nephrectomies were performed on 24 per cent of renal units. Accessory lower pole renal vessels were found in 52 per cent of the adults with UPJ obstruction, twice the rate found in children. Intravenous digital subtraction angiography and diuretic radionucleotide renography should be considered in the evaluation of an adult patient with a UPJ obstruction because of the high rate of accessory vessels. If accessory vessels are present on the contralateral side, especially postnephrectomy, there is heightened concern for the remaining kidney and close follow-up with ultrasonography is recommended.

Adolescent↗
PubMed1984

Acquired renal cystic disease in the end stage kidney: urological implications.

A unique form of acquired renal cystic disease occurs commonly in the end stage kidneys of patients with chronic renal failure. Recent experience with 3 cases of acquired renal cystic disease has made us aware that the condition has significant urological implications. The pathogenesis of this disease is unknown but may be related to tubular obstruction, ischemia or the accumulation of toxic products. The diagnosis of acquired renal cystic disease is established by either ultrasound or computerized tomography, both of which demonstrate bilateral multiple small cysts scattered throughout the cortex and medulla of the contracted end stage kidney. Acquired renal cystic disease usually is asymptomatic but may be associated with either hemorrhage or neoplasia. Autopsy studies have revealed renal tumors in up to 45 per cent of the patients with acquired renal cystic disease. These tumors usually are small but our case 3 was a renal cell carcinoma that measured 4 cm. in diameter. Also, there have been other recent reports of large tumors and deaths of metastatic renal carcinoma in patients with acquired renal cystic disease. Patients with chronic renal failure should undergo periodic examination of the native kidneys by either ultrasound or computerized tomography. It may be difficult to distinguish benign from malignant lesions radiologically, and nephrectomy may be indicated when the diagnosis is uncertain.

Adenocarcinoma↗
PubMed1984

Penile gangrene: a complication of secondary hyperparathyroidism from chronic renal failure.

We present the third case and first reported survivor of penile gangrene due to secondary hyperparathyroidism from chronic renal failure. The patient was treated with distal penectomy and subtotal parathyroidectomy. This case stimulated us to review the metabolic and vascular changes associated with secondary hyperparathyroidism in chronic renal failure. Secondary hyperparathyroidism may cause diffuse vasculitis and vascular calcification, which can lead to widespread ischemic necrosis and gangrene. Early medical therapy, including oral phosphate binders, is crucial to maintain the serum calcium-phosphate product below precipitation level. Subtotal parathyroidectomy is indicated for patients in whom progressive arterial and soft tissue calcification develops despite medical therapy.

Gangrene↗
PubMed1984

Biochemical methods for predicting metastatic ability of prostatic cancer utilizing the dunning R-3327 rat prostatic adenocarcinoma system as a model.

At present, there is no established diagnostic method by which the metastatic ability of an individual prostatic cancer can be accurately predicted. Metastasis is a multistep process, the first critical step of which is invasion. Tumor invasion has been suggested to involve a variety of hydrolytic enzyme activities; therefore, the tumor levels of these activities might be indicative of the overall metastatic ability of the cancer. In order to evaluate if the quantitative levels of hydrolytic enzymes can be used to predict the metastatic ability of individual prostatic cancers, five different Dunning R-3327 rat prostatic adenocarcinoma sublines, with widely varying metastatic abilities, were assayed for the respective levels of a variety of hydrolytic enzyme activities (collagenase, trypsin-like, cathepsin B, neutral protease, N-acetyl-beta-glucosaminidase, chymotrypsin-like, leucine aminopeptidase, elastase, and plasminogen activator). These studies demonstrated that most hydrolytic activities are not elevated when going from normal prostate to prostatic cancer. In addition, only the levels of elastase and chymotrypsin-like activity were found to be consistently higher in highly metastatic prostatic cancers than in either the normal prostate or low-metastatic prostatic cancers. It was found that, by combining the relative activities of elastase and chymotrypsin-like activity and then dividing by the relative activities of N-acetyl-beta-glucosaminidase, a biochemical metastatic index could be constructed which accurately reflected the respective metastatic ability of the Dunning sublines.

Adenocarcinoma↗
PubMed1983

Wound dehiscence in bladder exstrophy: an examination of the etiologies and factors for initial failure and subsequent success.

During the last 8 years 20 patients were seen for secondary or repeat closure for exstrophy of the bladder following dehiscence after initial closure. Various factors that may have contributed to the initial problems have been investigated. Wound infection (42 per cent) and bladder prolapse (46 per cent) were the major etiologies for initial failures. In 6 patients (30 per cent) colon conduits were required for bladder augmentation or colocolostomy, which emphasized the importance of achieving a good result at initial closure. Our successful protocol (only 5 per cent reclosure rate for 60 closures) is outlined.

Anti-Bacterial Agents↗
PubMed1983

Ileal trigonal conduits: 10-year followup.

Nonrefluxing ileal trigonal conduits were constructed in 21 patients with neurogenic bladder to prevent the long-term sequelae of standard ileal conduit urinary diversion. Although the initial results at 5 years were encouraging the findings at 10 years were not as promising. Of the patients 50 per cent had evidence of pyelographic deterioration. Reflux occurred in 41 per cent of the renal units. Over-all, 8 patients (45 per cent) have done well. Today, these patients probably would not have undergone diversion.

Adolescent↗
PubMedDate not supplied

Coadministration of tamsulosin and three antihypertensive agents in patients with benign prostatic hyperplasia: pharmacodynamic effect.

Tamsulosin, an alpha 1A-adrenoceptor antagonist, has recently been approved to treat patients with symptomatic benign prostatic hyperplasia (BPH). Tamsulosin is highly selective for prostatic receptors with minimal affinity for vascular receptors. Therefore, it should have little effect on blood pressure and should not potentiate other agents' antihypertensive activity. To test this hypothesis, we conducted three randomized, double-masked, placebo-controlled studies to evaluate how coadministration of tamsulosin would affect the pharmacodynamic profiles of nifedipine, enalapril, and atenolol. Each study enrolled 12 hypertensive men aged 45 years or older whose blood pressure was being controlled with maintenance doses of nifedipine (study 1), enalapril (study 2), or atenolol (study 3). All 36 subjects were treated with placebo for 5 days and then randomly assigned to either placebo (control group) or tamsulosin therapy (0.4 mg/d for 7 days followed by 0.8 mg/d for 7 days) in addition to continuing their maintenance antihypertensive therapy. Blood pressure and pulse rate were monitored over a 24-hour period on study days 4, 11, and 19. Coadministration of tamsulosin in these small studies had no clinically significant effects on the pharmacodynamic action of nifedipine, enalapril, or atenolol; it produced no clinically significant differences in pulse rate and blood pressure, did not alter electrocardiographic or Holter monitoring results, and did not cause increased side effects. Coadministration of tamsulosin with the three antihypertensive agents studied had a favorable safety profile. Our results in these small studies indicate that the dose of nifedipine, enalapril, or atenolol did not require adjustment in patients given tamsulosin, which may give tamsulosin an advantage over other alpha-blocking agents used to treat patients with BPH. Now that tamsulosin has been approved in the United States, further clinical use may confirm these findings.

Adrenergic alpha-Antagonists↗