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Biomedical subjects

J J Kaufman

Publications and source records attributed to J J Kaufman.

At least 37 records · Page 2Linked to original sources
PubMed1986

Fine needle aspiration biopsy of the prostate gland: a study of 103 cases with histological followup.

Fine needle aspiration specimens of the prostate gland were compared to histological material in 103 patients. The sensitivity was 95 per cent, specificity 97 per cent and efficiency 87 per cent. Initial core needle biopsy compared to the final histological diagnosis in this study had a sensitivity of 76 per cent, specificity 100 per cent and efficiency 71 per cent. Fine needle aspiration by a well trained cytopathologist is less traumatic, and has fewer side effects and a higher sensitivity rate than conventional core needle biopsy.

Biopsy, Needle↗
PubMed1985

The Kock pouch as a urinary reservoir. Pitfalls and perspectives.

The Kock continent urinary reservoir is a feasible alternative to traditional methods of urinary diversion in properly motivated patients who are anxious to exchange a convenient external appliance for frequent reservoir catheterization. The major shortcomings are increased operative time, loss of a long segment of small bowel, and an approximate 10 percent incidence of major reoperation. Long-term results are unknown. Facility with the operation requires extensive experience and attention to detail. Most complications are related to inadequate fixation of the intussuscepted valves and improper placement of a short terminal segment in the abdominal wall. Early repair of malfunctioning valves and distal segments that are difficult to catheterize is essential to prevent more severe acute complications. Whether the Kock pouch will replace the standard methods of urinary diversion must be determined by more extensive clinical experience and long-term results.

Adult↗
PubMed1985

Result of treatment of patients with stage D1 prostatic carcinoma.

Between 1972 and 1982, 59 patients who had documented pelvic lymph node metastases, proved by pelvic lymphadenectomy, were available for analysis. Radical retropubic prostatectomy was the primary treatment in 33 patients with or without other therapies, while 23 patients received external beam radiation therapy as their primary treatment. Three patients received hormonal therapy alone. Forty-two of 59 patients are alive for a crude survival of 71 per cent. Sixteen patients have died of metastases. Patients with low-grade tumors, small tumor burden, and limited lymph node metastases had excellent short-term survival after radical prostatectomy.

Carcinoma↗
PubMed1985

Primary carcinoid tumor of testis with metastasis.

A primary carcinoid tumor of the testis metastatic to one preaortic lymph node in a forty-three-year-old man is reported. The case was of great clinical interest not only because of the extreme rarity of testicular carcinoid with metastasis but also because of a coincidental bacterial endocarditis.

Adult↗
PubMed1985

The use of collagenase in the treatment of Peyronie's disease.

Purified clostridial collagenase was administered intralesionally in 31 men with Peyronie's disease. Within 4 weeks of treatment 20 patients showed an objective improvement. Pain was eliminated in 13 of 14 patients with this complaint at presentation within the same 4-week period. The ability to have intercourse was restored in 3 of 4 patients with this problem. Except for a small corporeal rupture at the site of injection in 1 patient, no significant untoward effects were noted. During the mean 9.8-month followup 1 recurrence of bending was noted.

Adult↗
PubMed1985

The management of superficial bladder tumors and carcinoma in situ with intravesical bacillus Calmette-Guerin.

A phase II study was performed to assess the role of bacillus Calmette-Guerin as a prophylaxis against recurrent stages O and A bladder tumors, and in the treatment of existing superficial bladder tumors and carcinoma in situ. Tice strain bacillus Calmette-Guerin (1 vial, 2 to 8 times 10(8) organisms in 60 cc saline) was instilled intravesically without cutaneous inoculation. Instillations were given weekly for 6 weeks and then monthly or until recurrence in 22 patients with a history of recurrent tumors, while 22 with existing stages O and A transitional cell carcinoma, and 19 with carcinoma in situ were treated weekly for 8 weeks and then monthly for 12 months or until failure. Complications included cystitis in 88 per cent of the patients (severe in 20 per cent), fever in 15 per cent, a flu-like syndrome in 13 per cent, edema and pruritus in 1.5 per cent, and ureteral stenosis in 1.5 per cent. Twelve patients (19 per cent) did not complete the study owing to toxicity. Of the patients in the prophylaxis group 67 per cent have had no tumor recurrence 10 to 26 months (mean 15 months) after therapy. Of the patients with existing tumors 36 per cent had complete regression following bacillus Calmette-Guerin therapy and 23 per cent had a partial response. Among the patients with carcinoma in situ 13 (68 per cent) had reversal to normal urothelium and 3 (16 per cent) had marked improvement. None of the patients had recurrence at 11 to 20 months. Intravesical Tice strain bacillus Calmette-Guerin is effective as a prophylaxis against recurrent superficial bladder tumors and in the treatment of carcinoma in situ.

BCG Vaccine↗
PubMed1985

Quantum chemical and other theoretical studies of carcinogens, their metabolic activation and attack on DNA constituents.

We have carried out a variety of different types of studies on carcinogens: ab-initio quantum chemical, including generation of electrostatic molecular potential contour (EMPC) maps and graph theoretical generation of polycyclic aromatic hydrocarbon (PAH) structures and characterization of the "carcinogenic" bay regions. Polycyclic aromatic hydrocarbon (PAH) carcinogens are activated metabolically from precarcinogen (PAH's) through proximate carcinogens (PAH epoxides and dihydrodiols) to ultimate carcinogens (PAH dihydrodiolepoxides) which then attack DNA constituents. We carried out ab-initio MODPOT/VRDDO/MERGE calculations on a variety of these molecules using our own ab-initio programs which incorporate as options a number of desirable options for ab-initio calculation on large molecules. From these electronic wave functions, we generated electrostatic molecular potential contour (EMPC) maps around these molecules. These EMPC maps indicated predictively the positions at which epoxides would form and the propensity and geometrical preference to form dihydrodiols and dihydrodiolepoxides. We performed spin and symmetry analyses for attack of O adding across C = C bonds or inserting in C-H or N-H bonds. We also carried out ab-initio calculations for attack of ultimate carcinogens on DNA constituents. Using graph theory we generated all possible structures for any arbitrary numbers of aromatic rings and also set up a graph theoretical characterization of the "carcinogenic" bay region. Most recently, we have incorporated this into a computer program for global prediction of toxicity.

Biotransformation↗
PubMed1984

"O" ring urinary ostomy appliance.

A non-adhesive urostomy system represents a major departure from ostomy appliances that have been used to date. Experience of 123 ostomates who have lived with the traditional as well as the new appliance indicates a high degree of patient acceptance and satisfaction. The "O" ring appliance promises to simplify and improve the quality of life for patients who are committed to this form of urinary disposition.

Disposable Equipment↗
PubMed1984

Bilateral renal cell carcinoma and renal cell carcinoma in the solitary kidney.

We report on 43 patients with renal cell carcinoma in a solitary kidney, 39 of whom underwent a potentially curative resection. Of 36 patients who had a nephron salvaging procedure only 4 required ex vivo surgical resection. The survival curves of patients with solitary or bilateral lesions are similar, and depend more on the adequacy of tumor resection and tumor stage than on the fate of the contralateral kidney. Crude survival in this series was 64 per cent for patients followed for more than 1 year.

Adenocarcinoma↗
PubMed1984

Radiation therapy in carcinoma of the prostate: a contributing cause of urinary incontinence.

We believe that radiation therapy as a postoperative adjuvant or preceding salvage prostatectomy for carcinoma is particularly conducive to the complication of urinary incontinence by virtue of its sclerosing effect on residual sphincter mechanisms. Obviously, such dual therapy will continue to prevail in the foreseeable future but patients should be notified of the added risk and be prepared for further treatment of the incontinence. Unfortunately, these patients have an extra risk of complications and failure from anti-incontinence operations.

Adult↗
PubMed1984

Ammoniagenic coma following ureterosigmoidostomy.

Ammoniagenic coma or episodic stupor is a rare complication of ureterosigmoidostomy. We report a case with the unusual features of normal liver function and normal liver biopsy. With extremely rare exception, ammoniagenic coma will not occur in the presence of normal ornithine-urea cycle synthesis in the liver.

Adolescent↗
PubMed1984

Epsilon aminocaproic acid and the control of post-prostatectomy bleeding: a prospective double-blind study.

We randomized 61 patients undergoing transurethral resection of the prostate in a double-blind parallel fashion to receive epsilon aminocaproic acid or an equivalent volume of placebo solution immediately after the operation. All blood loss during the first 72 hours postoperatively was monitored. Four patients were nonevaluable . The use of epsilon aminocaproic acid caused no significant complication or side effect. There was no significant difference in regard to blood loss, hospital stay or days on catheter drainage between the 2 groups. We conclude that the routine use of epsilon aminocaproic acid after transurethral resection of the prostate is not warranted.

Aminocaproates↗
PubMed1984

Blood pH and brain uptake of 14C-morphine.

14C-Morphine was injected iv in control awake rats or in rats subjected to metabolic alkalosis or acidosis. Ten minutes later, radioactivity was determined within each of seven brain regions, after correction was made for intravascular tracer. In each region, parenchymal radioactivity was correlated positively and significantly (P less than 0.05) with arterial blood pH. Brain radioactivity was twofold to threefold greater in alkalotic rats (mean pH = 7.62) than in acidotic rats (mean pH = 7.16). The results are consistent with the pH-partition hypothesis for drug entry into the brain and indicate that morphine uptake can be increased by elevating the fraction of lipid-soluble uncharged morphine base in blood, by means of alkalosis. The observations may account for an exaggerated morphine-induced analgesia in alkalotic patients.

Acidosis↗
PubMed1984

Skinfold measurements in children. A comparison of Lange and McGaw calipers.

Two types of calipers to measure skinfolds have been compared in adults, but the same type of comparison has not been done in a pediatric population who generally would have smaller skinfolds. Biceps and triceps skinfold measurements were made in 240 pediatric patients ranging in age from 2 weeks to 18 years. Skinfold measurements obtained with a McGaw caliper were on the average 12.6 percent lower than those obtained with a Lange caliper on the same patient. Differences between measurements by two investigators using the same caliper on the same patient averaged 20.4 percent for the Lange caliper and 17.6 percent for the McGaw caliper (root mean square differences). We conclude that McGaw and Ross plastic calipers would be an adequate substitute where cost prohibits the use of Lange calipers.

Adipose Tissue↗
PubMed1984

Plaster splints: techniques and indications.

Various plaster splints can be used in the management of many acute musculoskeletal injuries seen in the emergency setting. These include gutter splints of thumb, radial and ulnar types; volar forearm, sugar-tong and posterior elbow splints, and knee, short leg and stirrup splints. When properly made, these devices afford symptomatic relief, mechanical support and sometimes even definitive therapy for fractures and soft tissue injuries of the extremities.

Arm Injuries↗
PubMed1984

Ureteral injury from ureteroscopic stone manipulation.

A ureteroscopy for stone removal resulted in a tear of the ureter and extensive necrosis requiring ureteroneocystostomy. Urologists are urged to report complications of upper tract endoscopy and to apprise patients of the inherent dangers.

Endoscopy↗