Biomedical subjects
Publications and source records attributed to M I Resnick.
Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the soluble proteins of the rat ventral, lateral, and dorsal prostate showed characteristic patterns for each lobe. Protein content in the lobes also differed; the ventral prostate had a significantly greater concentration than the other two.
An assay technique for determination of renal neuraminidase (sialidase) activity is described. Consistent and reproducible results were obtained in studies of rat renal tissue. Neuraminidase activity was detected in all human renal specimens studied; however the degree of activity was not related to the presence of renal calculi or infection.
Twenty-four hour urine specimens from 26 active stone formers and 15 non-stone formers were passed through an ultrafilter that retained all molecules with a molecular weight greater than 50,000. Microscopic spherical bodies that laked alizarin red were observed in the urinary ultrafiltrate from 24 of 26 active stone formers. Only three of 15 non-stone-forming control urines contained these bodies. Histochemical studies showed the presence of calcium, phosphorus, and carbohydrate-protein complexes. No crystalline elements were detected.
The effects of castration and estrogen administration on prostatic fluid proteins were compared in two groups of dogs. Prostatic fistulae were created in 10 animals and prostatic fluid secretions stimulated by electroejaculation. After a stabilization period, five animals were administered polyestradiol phosphate and the remaining five were castrated. After 3 months estrogen administration was discontinued and depo-testosterone was administered to the castrate animals. Fluids were collected at weekly intervals throughout the study and prostatic fluid proteins separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis. No difference between animal receiving estrogen and castrated animals was noted and administration of testosterone to castrate animals reestablished a normal protein pattern.
Brazilian squirrel monkey kidneys removed before and after administration of parathormone were studied by microdissection, polarizing microscopy, alizarin red and von Kossa's stains, and microchemical analysis. Intralumenal crystalline-matrix masses were observed in both groups but were increased in frequency after parathormone administration. Specific staining showed the presence of calcium and phosphorus, and specific chemical tests suggested the presence of uric acid or urate salts. Refractile alizarin red positive droplets were observed in the tubular cells of the pars convoluta in parathormone-treated animals. Urinary stone formation in these animals is unique in that the location and types of stones produced are similar to that seen in man. The squirrel monkey is a good experimental model to study renal stone disease and further studies of its etiology, structure, composition, and means of control should be performed.
A formal protocol, controlled metabolic evaluation is essential to the most effective treatment of any patient with renal calculi, regardless of the crystalline composition of the stone. The design of the protocol and of the data sheets should be compatible with ease of diagnosis and selection of corrective therapeutic measures. These data also serve as a reference to monitor response to treatment. Treatment is highly individualized with the objective to reduce all potentially crystallizable ions to basal levels. If this is difficult to accomplish certain ratios of ions are brought to as near normal values as possible.
Two patients with a struvite staghorn calculus in crossed fused renal ectopia are described. The susceptibility of these patients to urinary tract infection is discussed as is the anomalous extrarenal arterial vasculature to the ectopic and non-ectopic kidneys. Both patients were treated successfully with anatrophic nephrolithotomy and each has remained free of recurrent calculous disease to date.
Recent concepts in calcium metabolism are being applied to the renal stone-forming patient. As our understanding of physiological mechanisms improves urinary cyclic nucleotide determinations are becoming useful in applied patient care. The changes in urinary cyclic adenosine monophosphate excretion as related to the different forms of hypercalciuria are reviewed.
Our original series of patients with prostatic carcinoma treated with irradiation as the initial modality has been updated. The over-all 5-year survival rate for patients with stage III carcinoma of the prostate was 55 per cent--26 per cent were alive with residual disease and have had post-irradiation hormone manipulation, while 29 per cent were alive without metastases at 5 years.
Gray scale transrectal ultrasonography has proved to be a valuable adjunct in the evaluation of patients with tumors of the prostate and bladder. Its application in patients with prostatic disease is in the detection of early asymptomatic tumors, in the accurate staging of local disease and in the following of patients after the institution of specific treatment. Although it is not being used for the detection of bladder tumors the procedure is a reliable means to evaluate the degree of tumor invasion so that proper therapy can be instituted.
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There were 30 patients with solitary kidneys containing staghorn claculi who have been subjected to nephrolithotomy with extensive plastic revision of strictured calices using local renal hypothermia. These patients have been followed for 8 months to 16 years and all have had a recent in-hospital evaluation of renal function and recurrent stone formation. No surgical mortality occurred (death within 3 months of operation). Seven patients have died postoperatively, only 1 of whom had associated progressive deterioration of renal function as a contributory cause of death. It is concluded that surgical removal of calculi from a solitary kidney is a relatively safe procedure that results in significant improvement in the patient's well being. The degree of improvement is of such a nature that it may be equated to "cure of the disease" in 63 per cent of the patients.
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Technological advances, particularly the advent of the gray scale technique, has greatly extended the application and usefulness of this modality to clinical diagnoses and surgery. The ultrasonic beam uniquely provides anatomical profiles in the transverse (cross-sectional) and sagittal (longitudinal) planes of the body. Intra-rectal and intra-vaginal ultrasonic probes have provided unique definition of both the normal and pathologic anatomy of the pelvic organs. The present report is drawn from a continuing experience with ultrasonography of the genitourinary system with an update of current technological advances. Ultrasonography has proven especially valuable in the following clinical applications: 1) Early diagnosis of cancer (especially of the prostate); 2) Accurate staging of cancer of the bladder and prostate; 3) Monitoring of the response of the pathologic process to therapy.
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Gray scale transrectal ultrasonography has proved to be a valuable adjunct in the evaluation of patients with tumors of the prostate and bladder. Its application in patients with prostatic disease is in the detection of early asymptomatic tumors, in the accurate staging of local disease and in the following of patients after the institution of specific treatment. Although it is not being used for the detection of bladder tumors the procedure is a reliable means to evaluate the degree of tumor invasion so that proper therapy can be instituted.
This study has been designed to investigate possible potentiation of testosterone and dihydrotestosterone by estradiol and prolactin in augmenting weight and citric acid content of the rat lateral prostate. Using these parameters, we hoped to indirectly assess the effect of estradiol and prolactin on 5alpha-reduction as it acts on the conversion of testosterone to dihydrotesterone. In the first part of the study, 87 castrate and 14 control rats were used to assess the effect of testosterone or dihydrotestosterone when supplemented with estradiol; in the second part of the study, 121 castrate-hypophysectomized rats separated into three groups according to age and stage of maturation were used to assess the effect of prolactin in supplementing testosterone and dihydrotestosterone. Estradiol appears to have a greater effect on 5alpha-reduction than does prolactin; however, other pathways of androgen metabolism are altered by these agents. These alternate pathways are discussed.