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Biomedical subjects

H W Herr

Publications and source records attributed to H W Herr.

268 records · Page 15Linked to original sources
PubMed1975

Intermittent catheterization in neurogenic bladder dysfunction.

Experience with intermittent catheterization in 449 patients with traumatic cord bladder during a 9-year period is presented. There were 317 patients who were discharged from the hospital free of the catheter and maintain balanced bladder function on long-term followup. Of these catheter-free patients 45 per cent have sterile urine at any one time. Intermittent catheterization is the method of choice to establish a catheter-free state and reduce infection among spinal cord injury patients. It is a useful conservative method in long-term therapy of patients with non-traumatic neurogenic bladder dysfunction.

Evaluation Studies as Topic↗
PubMed1975

External sphincterotomy in traumatic and non-traumatic neurogenic bladder dysfunction.

Experience with external sphincterotomy in 40 patients with traumatic and non-traumatic neurogenic bladder is reviewed. The procedure is a safe, reliable technique designed to establish a balanced neurogenic bladder in patients with detrusorsphincter dyssynergia. Spincterotomy should be performed in most patients before consideration of supravesical diversion.

Follow-Up Studies↗
PubMedDate not supplied

A comparison of hospital-based charges following partial and radical nephrectomy.

OBJECTIVE: Recent studies demonstrate similar survival rates in patients treated with either partial or radical nephrectomy for renal tumors less than 4 cm. We retrospectively compared the hospital based charges for these two procedures in a similar cohort of patients treated at Memorial Sloan-Kettering Cancer Center. PATIENTS AND METHODS: A retrospective review of 103 consecutive cases of renal tumors less than 4 cm treated by either radical or partial nephrectomy from 1996 to 1999 was conducted. Overall hospital charges were calculated by analyzing 18 separate departmental charge categories including room and board, pharmacy, radiologic tests, operating room charges, and laboratory services. RESULTS: A total of 66 partial and 37 radical nephrectomies were analyzed. No difference was found in the mean charge per procedure ($16,660, partial and $16,545, radical); (p > .05). The major cost drivers for partial and radical nephrectomy respectively were: 1) room and board, 42% and 44%; 2) operating room charges, 28% and 25%; 3) pathology, 6% and 6%; 4) recovery room, 6% and 7%; and 5) biochemistry, 5% and 5%. Significant increases in charges for partial nephrectomy were noted from the blood bank services and intraoperative surgical supplies. The median length of stay (5 days) was identical for partial and radical nephrectomy. No difference was found in the complication rate for these procedures (p > .05). CONCLUSION: Hospital-based charges for radical and partial nephrectomy are similar at when performed at a tertiary care referral center.

Adult↗
PubMedDate not supplied

Immunotherapy of bladder tumors.

Immunotherapy has been applied topically, intralesionally and systemically in the treatment of local, regional, and metastatic bladder cancer. Results from multiple clinical trials conducted in the past 10 years have been disappointing in patients with locally advanced or disseminated disease, but immunotherapy has contributed significantly to the successful treatment of superficial bladder tumors. Immunotherapy offers improved means of eradicating existing tumors and, more important, preventing potentially life-threatening new tumor occurrences by favorably altering preneoplastic lesions (chemoprevention).

Antibodies, Monoclonal↗
PubMedDate not supplied

Tobacco smoking, occupation, and p53 nuclear overexpression in early stage bladder cancer.

Epidemiological studies show an increased risk of bladder cancer associated with tobacco smoking and occupational exposures. Certain carcinogens in tobacco and occupational exposures cause DNA damage and may produce specific mutations. TP53 is considered a common target for carcinogenic agents, and mutations of this gene are reported to be the most frequent nuclear abnormalities in human cancer. In order to investigate the relationship between tobacco smoking, occupations, and altered patterns of p53 expression, we have analyzed a group of 109 incident patients with superficial transitional cell carcinoma of the bladder. We assessed p53 nuclear overexpression by the use of anti-p53 antibody PAb1801 and immunohistochemistry, and identified 45 of 109 patients (41%) displaying p53-positive phenotype. We observed a significant association between the number of cigarettes smoked per day and p53 nuclear overexpression (p = 0.02). The odds ratios were 2.3 for those smoking 1-2 packs per day and 8.4 for smoking more than 2 packs per day. Similar estimates were obtained after controlling for age, sex, and race. Elevated odds ratios were also observed for dye-/ink-related (odds ratio = 2.0; 95% CI, 0.4-9.4) and cooking-related occupations (1.8, 0.6-5.0), although those were not statistically significant. These data support the hypothesis that certain carcinogens derived from cigarette smoking and occupations may induce TP53 mutations, which in turn are involved in early steps of bladder carcinogenesis.

Aged↗