Are PSA 8-10 particularly worrisome numbers?
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Biomedical subjects
Publications and source records attributed to L O Platt.
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An 8% and 7% incidence of bladder neck contractures (BNC) requiring relief by transurethral incisions (TUI), (124) was found after review of 1471 TURP's and 71 retropubic prostatectomies. Prevention of BNC was attempted by leaving a one centimeter strip at the time of TURP (62), incising the bladder neck alone (42), or incising the bladder neck and interureteric ridge (65). Bladder neck obstruction occurred in 4.8% of the strips, 14% of the incised bladder necks only, and 3% of the incised bladder neck and contiguous interureteric ridges. A significant cost savings is possible.
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Pain relief was evaluated in 81 patients with acute ureteral colic and the confirmed presence of a calculus. A randomized double-blind comparison of intramuscular 2 and 4 mg. butorphanol and 80 mg. meperidine was used. Pain intensity and pain relief were evaluated at half hour and hourly intervals for 4 hours. A 2 mg. dose of butorphanol was found to be analgesically equivalent to 80 mg. meperidine, while a 4 mg. dose of butorphanol was found to be more effective than 80 mg. meperidine and 2 mg. butorphanol. Each patient received up to 2 doses of analgesic medication when necessary. There was no significant difference in the incidence of side effects among treatments. One patient had visual hallucinations after a 2 mg. dose of butorphanol, possibly owing to its antagonistic activity to significant narcotic experience given previously at another hospital. There was no other evidence of toxicity with butorphanol. It was found to be a safe, effective and wall tolerated drug for the treatment of ureteral colic and is recommended in place of narcotics.
Although carcinoma of the testicle is a rare lesion, one family physician saw three cases in 18 months. He diagnosed all correctly and referred the patients for treatment immediately. All three patients are living and well. We believe his alertness is worthy of note because, given the rarity of the lesion, a low index of suspicion and delayed diagnosis often occur, with less than desirable results.
A method for an intestinal bypass operation is presented. The procedure has been valuable in patients with post-cystectomy intestinal obstruction who did not respond to non-operative measures. A discussion on the possible means to prevent further obstruction is included.
A review of 7 cases of misleading, early diagnosis of hematuria is presented. Each patient was found to have renal cell carcinoma on a repeat study for persistent hematuria. Surgical and postoperative followup results are included.