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Biomedical subjects

J D Schmidt

Publications and source records attributed to J D Schmidt.

At least 109 records · Page 6Linked to original sources
PubMed1976

Transverse colon conduit for supravesical urinary tract diversion.

Twenty-two patients with extensive pelvic irradiation underwent supravesical urinary diversion using a transverse colon conduit. Primary diseases were most often carcinoma of the cervix and urinary bladder. Indications for diversion included original treatment planning, radiation cystitis, vesicovaginal fistula, and ureteral obstruction. Operative mortality was low (4 per cent), and most complications were managed by further surgery. Normal upper urinary tracts usually remained normal after diversion; relief of existing hydroureteronephrosis was seen in a majority of patients. Stomal problems have been minimal, and renal function has remained normal or stable. The method affords the use of nonirradiated transverse colon as well as the ureter high above the field of pelvic irradiation and is the preferred diversion in such patients.

Adult↗
PubMed1976

Association of priapism in phenothiazine therapy.

We present 4 patients seen in the last 5 years who had taken thioridazine (Mellaril) prior to development of priapism. One of the 4 patients suffered penile trauma while taking the phenothiazine drug and this is another possible etiologic factor in that case. No underlying urologic or hematologic disorders were present. All patients were treated by corporeal aspiration and corpus cavernosum-corpus spongiosum shunts. The mechanism of phenothiazine=induced priapism is hypothesized as being related to its peripheral adrenergic blockade, perhaps directly blocking the sympathetic impulse for detumescence, although a central nervous system effect must be considered as well. Lastly there exists the possibility of coincidence since phenothiazine treatment is becoming more common and was unrelated to the condition in an additional 6 patients with priapism seen during the same period.

Adult↗
PubMed1976

The continued evaluation of the effects of chemotherapy in patients with advanced carcinoma of the prostate.

The response and duration of survival were evaluated for patients with stage D relapsing prostatic cancer who were randomized to cyclophosphamide (cytoxan), 5-fluorouracil (5-FU) or standard therapy, or to subsequent chemotherapies. The chemotherapies on initial randomization were superior to the standard therapy in the number of responders and duration of response. Survival was longer for responders (stable or partial regression) on chemotherapy by comparison to responders (stable only) on standard therapy. The survival for patients receiving initial and crossover chemotherapy was significantly improved for patients who responded to therapy. Chemotherapy of advanced relapsing stage D prostatic cancer is more beneficially treated by specific chemotherapy as shown in this randomized study.

Carcinoma↗
PubMed1976

Vesicoureteral reflux in recurrent carcinoma of the bladder--implications for treatment and prognosis.

In an evaluation of the use of topical triethylenethiophosphoramide for therapy and prevention of recurrent multiple superficial transitional cell carcinoma of the bladder retrograde cystography was done. Unilateral or bilateral vesicoureteral reflux was demonstrated in 9 consecutive patients studied. Retrospective analysis uncovered 9 additional patients with bladder cancer and reflux. The discovery of vesicoureteral reflux prompts currently unanswerable questions regarding the etiology and pathogenesis of urothelial malignancy, as well as the role of topical chemotherapy in superficial tumors.

Adult↗
PubMed1976

Serum immunoglobulins in genitourinary malignancies.

Serum concentrations of immunoglobulins G, A and M (IgG, Ig A and IgM) were measured by immunodiffusion in a control population of 58 patients and in 165 patients with cancer of the prostate, bladder, kidney or testis. Tumor patients were ranked according to clinical staging. In a smaller group of patients serum levels of IgE were measured by radioimmunoassay. IgG, IgA and IgM concentrations did not correlate with staging or the presence of malignancy. However, a statistically significant correlation between increased IgE levels and advanced bladder cancer (staged D1 and D2) stimulated us to study more patients with bladder tumors. In a subsequent group of 22 bladder tumor patients this trend could not be reproduced. IgE levels did not correlate with a history of allergy in any of the patients tested. Concentrations of immunoglobulins G, A, M and E seem to be unchanged in genitourinary malignancies, although their functional role here has not been assessed qualitatively.

Female↗
PubMed1976

The continued evaluation of the effects of chemotherapy in patients with advanced carcinoma of the prostate.

The response and duration of survival were evaluated for patients with stage D relapsing prostatic cancer who were randomized to cyclophosphamide (Cytoxan),5-fluorouracil (5-FU) or standard therapy, or to subsequent chemotherapies. The chemotherapies on initial randomization were superior to the standard therapy in the number of responders and duration of response. Survival was longer for responders (stable or partial regression) on chemotherapy by comparison to responders (stable only) on standard therapy. The survival for patients receiving initial and crossover chemotherapy was significantly improved for patients who responded to therapy. Chemotherapy of advanced relapsing stage D prostatic cancer is more beneficially treated by specific chemotherapy as shown in this randomized study.

Carcinoma↗
PubMed1976

Pitfalls in clinical staging of bladder tumors.

Errors in clinical staging of bladder carcinoma occur in about 50 per cent of patients. Sources of error include (1) a variable assortment of diagnostic studies performed, (2) inexactitudes inherent in the diagnostic measures employed, (3) insufficient corroboration by surgical and pathologic staging, (4) the lack of a satisfactory means for detecting micrometastases, and (5) a generalized confusion regarding the multiple classifications available for clinical staging. More precise clinical staging will be influential in treatment decision-making and in prognosis. Minimum requirements for clinical staging of the primary tumor currently include complete examination, excretory urography, cystoscopy, bimanual examination under anesthesia, and transurethral resection or biopsy. Polycystography, triple contrast cystograpy and arteriography may be helpful occasionally to document muscle invasion. Pedal lymphangiography and lymphography can in selected cases be helpful in detecting otherwise silent nodal involvement in spite of its inability to demonstrate many primary or regional lymph nodes. Familiarity with the above diagnostic options and the advantages and limitations of each is essential for each physician caring for a patient with bladder carcinoma. Conversion to TNM classification for bladder carcinoma that is similar to that of the UICC seems appropriate (1) because of its more rational approach to extent of involement by primary tumor, lymph node and distant sites, and (2) in order for our western hemisphere urologists to communicate better with our colleagues from around the globe. Such a system is now under consideration by a subcommittee of the American Joint Committee on Staging and End Result Reporting.

Aged↗
PubMed1975

Metastatic carcinoma of penis complicated by hypercalcemia.

A fifty-three-year-old man with epidermoid carcinoma of the penis metastatic to the right inguinal lymph nodes and adjacent areas was found to have persistent hypercalcemia. Associated with this biochemical abnormality was an elevated parathormone activity in the absence of any bony metastases. Other than a transient response to furosemide-inducded diuresis he was refractory to treatment with oral inorganic phosphates and mithramycin. Ablation of the primary tumor did not affect his hypercalcemia. However, when therapy using external irradiation and parenteral bleomycin was directed to the metastases, his serum calcium stabilized and became normal and remained so until further progression of his humor. We postulate that the penile cancer metastases were elaborating parathyroid hormone-like substances responsible for the hypercalcemia and suppression of normal parathyroid activity.

Calcium↗
PubMed1975

Transverse colon conduit: a preferred method of urinary diversion for radiation-treated pelvic malignancies.

In the management of pelvic malignancies treated by radiation the standard ileal conduit is subject to many hazards related to the use of damaged tissues. The transverse colon affords the use of a short isolated segment of non-irradiated bowel as a urinary conduit. The ureters can be dissected well above the field of pelvic irradiation. Eight patients with bladder or cervical carcinoma treated with high doses of external radiotherapy are presented to demonstrate the usefulness of the transverse colon in supravesical urinary diversions.

Adult↗
PubMed1975

Chemotherapy of prostatic cancer.

Until the last few years very little information has been available regarding the potential of chemotherapy in prostatic cancer. Few drugs have been adequately tested to determine their efficacy, if any. Of the little conventional chemotherapy that has been documented, only diethylstilbestrol diphosphate (Stilphostrol, Honvan) has been safe, effective (at least in relieving bone pain) and available for repeat courses of treatment. The several well controlled clinical trials recently embarked upon and described in this article should reveal much about the effectiveness in prostatic cancer of agents already accepted in chemotherapy of other malignancies. Newer drugs will also require thorough testing. At this time no specific recommendations for chemotherpay other than the use of intravenous diethylstillbestrol diphospate can be made. Agents like estramustine phosphate (Estracyt) and flutamide (SCH-13521) with little to no bone marrow, liver, or renal toxicity are very promising. Studies of single-agent, sequential, and combined chemotherapy will necessarily lead to safe effective chemotherapy as adjuncts to surgery and/or radiotherapy for prostatic cancer in all stages.

Aged↗
PubMed1975

Treatment of genitourinary infections.

The diagnosis of urinary tract sepsis is being made more often today because of increased awareness of the condition and improved techniques in the detection and management of genitourinary disorders. Patients developing urinary tract sepsis (bacteremia or septicemia) usually demonstrate certain predisposing factors: underlying chronic disease, advanced age, general debility, or recent urinary tract sepsis is easily made in a patient who has a sudden onset of fever, chills, malaise, nausea, and vomiting, along with tachycardia and a drop in blood pressure. Cultures should be taken from urine and blood samples, but therapy should be instituted immediately rather than after obtaining the results of cultures.

Anti-Infective Agents, Urinary↗