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Biomedical subjects

J C Cerny

Publications and source records attributed to J C Cerny.

At least 37 records · Page 2Linked to original sources
PubMed1982

Pheochromocytoma in multiple endocrine neoplasia type II: an example of the two-hit theory of neoplasia.

Six kindreds in which pheochromocytomas were present as manifestations of the autosomal dominantly inherited multiple endocrine neoplasia (MEN) type II were studied. The patients underwent bilateral total adrenalectomy with the finding that the pheochromocytomas were bilateral, multifocal, and associated with distinct medullary hyperplasia and reduction in the normal corticomedullary ratio-- features not usually seen in patients with sporadic pheochromocytoma. These findings were exemplified in recent cases of a 34-year-old woman and a 40-year-old man who both had undergone total thyroidectomy for medullary carcinoma of the thyroid. Diagnoses of pheochromocytoma were made by catecholamine studies, computerized tomography, and 131I meta-iodobenzylguanidine (MIBG) scan. Bilateral adrenalectomy was performed with the finding of multiple bilateral pheochromocytomas and adrenal medullary hyperplasia. As in hereditary medullary carcinoma of the thyroid, the histologic findings in pheochromocytomas of the MEN II syndrome are consistent with Knudson's two-mutational-event theory for the initiation of neoplasia, with adrenal medullary hyperplasia representing the manifestation of the first or genetic mutational event and being present invariably in the hereditary cases.

Adrenal Gland Neoplasms↗
PubMed1982

Probable clonal origin of aldosteronomas versus multicellular origin of parathyroid "adenomas".

Adrenocortical adenomas causing hyperaldosteronism in two women heterozygous at the X chromosome-linked glucose-6-phosphate dehydrogenase (G-6-PD) locus exhibited only one G-6-PD isoenzyme. This finding suggests a clonal development for these benign tumors and contrasts with the multicellular origin of parathyroid adenomas reported in three patients from our institution in 1977 and found subsequently in seven other hyperparathyroid women whose cases are reported here. One of these seven patients had hereditary hyperparathyroidism. In this case each of three glands removed showed both A and B G-6-PD isoenzymes in similar ratios as were found in normal tissues. The multicellular origin of hereditary hyperparathyroidism is compatible with the concept of parathyroid lesions being manifestations of the first genetic event in Knudson's two-mutational-event theory for the initiation of cancer. The multicellular origin of sporadic parathyroid tumors suggest that they are caused by some factors stimulating many cells in the parathyroid glands. The young average age of onset of eight cases of parathyroid cancer from five families with hereditary hyperparathyroidism in the literature is also compatible with Knudson's theory. G-6-PD studies of other aldosteronomas, parathyroid tumors, and other endocrine neoplasms may provide important information about the pathogenesis of these conditions.

Adenoma↗
PubMed1981

Bilateral orchiectomy for carcinoma of prostate. Response of serum testosterone and clinical response to subsequent estrogen therapy.

Forty-five patients with symptomatic Stage D carcinoma of the prostate were treated with bilateral orchiectomy. Serum testosterone levels were obtained before orchiectomy, seven days after and a six-month intervals. With relapse after orchiectomy remission patients were treated with diethylstilbesterol (DES) 1 mg. daily. After bilateral complete orchiectomy 40 patients had serum testosterone levels in the anorchic range (21.5 to 39.7 ng./dl) while 5 had testosterone levels between 117 and 187 ng./dl. The mean remission response after orchiectomy was 9.1 months (three to twenty-four months) in the anorchic group and 9.4 months in the imcomplete anorchic group. Mean relapse response to estrogen therapy in the anorchic group was four months (one to six months). While in the incomplete anorchic group mean relapse response to estrogen therapy was 20.8 months (one to sixty). Serum testosterone levels in the imcomplete group decreased with estrogen therapy while those in the anorchic group were stable with estrogen therapy. Our findings suggest that bilateral complete orchiectomy does not always provide serum testosterone levels in the anorchic range. Subsequently these patients show an improved mean response to oral estrogen therapy.

Castration↗
PubMed1981

Renal cysts.

Explore the source record for details and available documents.

Adenocarcinoma↗
PubMed1979

Transurethral resection combined with steroid injection in treatment of recurrent vesical neck contractures.

Vesical neck contractures occur following 5 to 10 per cent of transurethral prostatectomies and an even smaller number of enucleative prostatectomies. Recurrences following both conservative and surgical treatment are common and present management problems to the urologist. Seven patients with recurrent vesical neck contractures were managed with reresection and steroid injection. One hundred per cent of patients responded to this although 1 patient required two procedures. The use of hydrocortisone sodium succinate (Solu-Cortef) versus triamcinolone acetonide (Kenalog) preparations are discussed.

Contracture↗
PubMed1978

Lymphangiography in staging patients with carcinoma of the bladder.

Pedal lymphangiography was used in the evaluation of 28 patients with carcinoma of the bladder. Correlation of the lymphangiogram with histologic examination of the surgically excised pelvic and para-aortic nodes was less than 50 per cent and suggests limited applicability of this diagnostic technique in staging bladder cancer.

Adult↗
PubMed1978

Response of micropenis to topical testosterone and gonadotropin.

Five patients were treated with gonadotropin and topical testosterone for micropenis associated with hypothalamic hypogonadotropic hypogonadism. All patients received 1,000 units of gonadotropin weekly for 3 weeks, with a 6-week interval followed by 10% topical testosterone cream twice daily for 3 weeks. Serum testosterone levels were measured and remained equivalent for both modes of therapy. Average penile growth response with gonadotropin was 14.3% increase in length and 5.0% increase of girth. Topical testosterone produced an average increase of 60% in penile length and 52.9% in girth. The greatest growth response occurred in prepubertal male subjects with a minimal response in postpubertal male subjects. This study suggests that 10% topical testosterone cream twice daily will produce effective penile growth. The response appears to be greater in younger children, which is consistent with previously published studies of age-related 5 reductase activity.

Administration, Topical↗
PubMed1978

Standard water cystometry and electromyography of the external urethral sphincter.

Water cystometry and external urethral spincter electromyography permit an accurate diagnosis and provide a rational foundation for treatment of both neurogenic and nonneurogenic vesical dysfunction. The techniques are compatible with and have enhanced our understanding of the pathophysiology of micturition. Properly performed and interpreted, water cystometry and urethral sphincter electromyography a) are an integral part of the work-up of any patient with incontinence or urinary tract infection, b) together with urethral pressure profilometry and uroflowmetry, assist in the selection of those patients who will or will not benefit from attempted surgical correction of incontinence, and c) can be employed to monitor preoperative and postoperative sequelae of major spinal or paraspinal surgery.

Electromyography↗
PubMed1977

Modification of germinal epithelium ischemia by perfusion.

Three groups of dogs underwent testicular ischemia for a 3-hour period. Group I (10 animals) was not subsequently perfused. Group II (10 animals) underwent subsequent perfusion by a new in vivo reversible method via the internal spermatic artery with heparinized saline. Group III (5 animals) underwent perfusion with Sacks' solution. At 3 weeks' time the histology of the testes of the three groups was compared. Group I showed a 75.5% decrease in the germinal epithelium. Group II showed a 21.4% decrease. Group III showed a 31.8% decrease. The survival rate of the germinal epithelium in the two perfused groups was significantly improved (P less than 0.01).

Animals↗
PubMed1977

Aggressive versus conservative management of stage IV renal cell carcinoma.

Improved modalities to treat metastatic renal cell carcinoma will require an aggressive surgical and chemotherapeutic approach. Nephrectomy with hormonal and non-hormonal chemotherapy does improve median survival and 3-year survival significantly. The use of xenogeneic specific immune ribonucleic acid and Bacillus Calmette-Guerin offers promising immunotherapeutic modalities that may be combined with surgical and chemotherapeutic regimens. Early diagnosis of metastatic disease is important to evaluate properly the results of various modalities of treatment and possibly to improve the efficiency of these modalities. The management of solitary metastatic nodules should involve aggressive resection of the primary and metastatic nodule. Adjuvant hormonal and non-hormonal chemotherapy should be considered in all stages of the disease.

Adenocarcinoma↗
PubMed1977

Xanthogranulomatous pyelonephritis in children.

Xanthogranulomatous pyelonephritis in children, contrary to adult onset, rarely is associated with non-function or calcification. The lesion is predominantly on the left side in children. There appears to be a normal humoral but temporarily impaired cellular immune response in addition to sustained depression of polymorphonuclear chemotaxis. The etiology of this is uncertain but may be attributed partially to hyperosmolarity of serum and urine, and to leukocyte specific antinuclear antibodies. The presence of leukocyte specific antinuclear antibody or cold agglutining may interfere with normal phagocyte chemotaxis requiring tissue macrophages to produce a xanthogranulomatous reaction to bacterial invasion.

Cell Movement↗
PubMed1977

Preoperative localization of adrenal remnants.

Patients with recurrent Cushing's syndrome after bilateral adrenalectomy should have an adrenal scan prior to any attempt at repeat laparotomy. In those patients with a localized remnant on the adrenal scan and no evidence of a tumor of the pituitary gland, unilateral exploratory laparotomy should be considered for removal of the remnant. In our series of five patients fulfilling the aforementioned criteria, we have been successful in terminating the recurrence of Cushing's syndrome in these patients.

Adrenal Cortex↗
PubMed1976

A technique for isolated in vivo renal perfusion.

A new technique for in vivo renal perfusion is described which eliminates the need for autotransplantation. In short term ischemia studies using three solutions, Sacks' solution was found to provide the optimal renal ischemia protection.

Animals↗
PubMed1975

An evaluation of lymphangiography in staging carcinoma of the prostate.

Pedal lymphangiography was done on 38 patients with stages O, A and B carcinoma of the prostate. The lymphangiograms were positive in 19 cases and negative in 19. Of 18 patients who underwent lymphadenectomy (9 with positive and 9 with negative studies) operative findings confirmed the lymphangiogram in 15 (83 per cent). In the 6 patients with osseous metastases and/or enzyme elevation, the lymphangiogram was positive. Furthermore, 13 patients with positive lymphangiograms had negative osseous and enzyme survey, emphasizing that nodal involvement may be the earliest finding in disseminated carcinoma of the prostate. The value of lymphangiography in staging carcinoma of the prostate prior to radical prostatectomy or irradiation seems well established.

Aged↗