Search PubMed⌕ Search

Biomedical subjects

M I Resnick

Publications and source records attributed to M I Resnick.

At least 109 records · Page 6Linked to original sources

Delayed hypersensitivity reaction after infusion of nonionic intravenous contrast material for an excretory urogram: a case report and review of the literature.

Delayed adverse reactions to ionic and nonionic intravenous contrast media have been reported previously. We report a case in which delayed hypersensitivity to iohexol, a nonionic intravenous contrast agent commonly used in excretory urography, resulted in a bi-phasic allergic response. This reaction consisted of a mild post-infusion episode of urticaria, which preceded and was clinically distinct from a moderately severe dermatological eruption. The episode of urticaria was self-limited. The dermatological reaction was treated successfully with antihistamine therapy.

Aged↗

Evidence for the presence of abnormal proteins in the urine of recurrent stone formers.

Two-thirds of matrix of all urinary stones consists of proteins. Despite intense research, their relationship to calculogenesis remains controversial. In an attempt to study excretion of proteins in stone formers, their urinary profiles were analyzed and compared with those of healthy subjects. Two-dimensional gel electrophoresis was employed to obtain high resolution separation of proteins. The urine of patients with histories of idiopathic calcium oxalate (CaOx) calculi contained 7 unique proteins, and 2 others that appeared to be overexpressed. Except for alpha 1-acid glycoprotein, the remaining 8 proteins are previously unknown constituents of urine with molecular weights of approximately 43, 39.5, 29, 26, 25.5, 26.5, 27 and 18.5 kD. Their isoelectric points range from 5.5 to 8.0. Coelectrophoresis of pooled urinary proteins of male and female stone formers disclosed that all 9 proteins had identical charges and molecular weights, regardless of the donors' sex. Analyses of urines of idiopathic recurrent CaOx stone formers who had no radiologically detectable calculi also revealed the presence of these proteins. This excludes the possibility that the proteins might be a consequence of abrasion of urothelial lining by the developing stone(s). Recently defective Tamm-Horsfall mucoprotein (THM) has been implicated in urinary stone formation. Coelectrophoresis of pooled urinary proteins of healthy subjects and stone formers denoted that it had an identical charge and molecular weight in both groups. This suggested that stone formation could not be ascribed to a difference in composition of THM. Whether this is attributable to a dissimilar amino acid sequence of this mucoprotein, remains to be probed.

Calcium Oxalate↗

Anatomic approach to radical perineal prostatectomy.

The recent development of the laparoscopic pelvic lymphadenectomy has obviated the need for open transabdominal surgery for the staging of prostate cancer. In addition, it has become clear that all patients undergoing surgical treatment of localized prostate cancer do not require lymphadenectomy. This has led to the resurgence of the perineal approach to prostate surgery. This operation has been proven to be an effective cancer operation, having low associated morbidity and mortality. An increased understanding of pelvic anatomy has allowed the perineal approach to match the retropubic approach in efficacy and complication rate. Thus, this article serves to integrate an anatomic description of pelvic anatomy with the surgical technique of perineal prostatectomy.

Humans↗

Predisposing factors of systemic fungal infections of the genitourinary tract.

We reviewed 50 patients with genitourinary fungal infections between 1982 and 1992. Infections were classified as simple--localized to the bladder and complex--demonstrated evidence of upper tract and/or systemic infection. Predisposing factors of fungal infections, including diabetes mellitus, prolonged Foley catheter drainage and corticosteroid use, were not significantly different. The incidence of obstructive uropathy (88% versus 20%), malnutrition (88% versus 48%), neoplasia (56% versus 16%), renal failure (24% versus 8%) and prolonged antibiotic use (60% versus 32%) were significantly greater in patients with complex infections. The incidence of fungemia in patients with complex infections was 81% with an associated mortality rate of 36%. Of the patients with complex infections 56% required urological intervention. Given the high incidence of obstructive uropathy with complex fungal infections, upper tract imaging is essential.

Adolescent↗

A new protocol for the followup of renal cell carcinoma based on pathological stage.

There is no consensus concerning which laboratory and imaging studies should be obtained to assess patients after radical nephrectomy for renal cell carcinoma. We retrospectively reviewed 158 patients who underwent radical nephrectomy with a final pathological diagnosis of renal cell carcinoma. Of the patients 21 had node-positive or metastatic disease and 137 had no evidence of metastases at diagnosis. Of the latter group 19 had pathological stage T1N0M0, 82 stage T2N0M0 and 36 stage T3N0M0 (18 stage T3a, 10 stage T3b and 8 stages T3a and b) tumor. Disease recurred in 0%, 14.6% and 52.8% (50%, 44.4% and 75%) of the patients, respectively. The average interval to recurrence was 29.5 months (range 3.5 to 88.8) for patients with stage T2 carcinoma and 22 months (range 3 to 138) for those with stage T3 disease. Based upon our data, followup studies should include a symptom history, serum liver function studies and chest x-rays at defined intervals. Routine use of bone scans and computerized tomography does not appear to be necessary.

Adolescent↗

Use of transrectal ultrasound and biopsy in the detection of prostate cancer.

Prostate cancer is the most common cancer diagnosed in U.S. men. In today's current urologic practice, there is considerable controversy regarding the appropriate treatment of prostate cancer. Transrectal ultrasound (TRUS) is the preferred modality for prostate imaging with established roles in the assessment of prostate size and guidance of accurate biopsies. This review will emphasize the history of TRUS and biopsy, patient preparation, technique of biopsy, interpretation of biopsies, and indications for repeat biopsies. The information gained by TRUS and biopsy is useful in counseling patients about potential treatment options.

Biopsy↗

High resolution 2-dimensional electrophoretic analysis of proteins in saline bladder washings.

Human urine contains a spectrum of proteins derived from various organs in the body. This investigation was undertaken to identify a group of proteins secreted primarily by bladder urothelium. Saline bladder washouts were collected from 9 male and 4 female patients undergoing routine cystoscopic examination. Each sample was sieved, desalted, freeze-dried and solubilized in urea mix. identical amounts of proteins were pooled according to donor sex. All individual and pooled samples were then subjected to 2-dimensional gel analysis using the ISO-DALT system. Profiles of both groups of subjects were highly reproducible, comparable and resembled those of urine and plasma. Several hundred spots were visualized although most of them as yet remain unrecognized. The proteins identified in bladder washouts include albumin, transferrin, IgG gamma-heavy chain, Gc-globulin, alpha 1-antichymotrypsin, alpha 1-antitrypsin, alpha 1-acid glycoprotein, G4, IgG light chains, alpha 1-microglobulin, and low and high density lipoproteins. Most importantly, while some abundant urinary macromolecules such as Tamm-Horsfall mucoprotein and most acidic urinary proteins were undetectable, albumin and transferrin were relatively less expressed. The 2-dimensional profiles we developed can be used as a data base to study urothelium derived proteins in various disease conditions such as bladder cancer.

Cystoscopy↗

Ureteropelvic junction obstruction secondary to periureteral lipoma.

We report a unique case of extrinsic ureteral obstruction secondary to a periureteral lipoma discovered during pyeloplasty for an apparent ureteropelvic junction obstruction. We discuss the importance of preoperative recognition of rare extrinsic causes of ureteropelvic junction obstruction.

Adult↗

Dorsal nerve block for management of intraoperative penile erection.

Intraoperative penile erection during general anesthesia can delay or prevent the completion of cystoscopic or penile surgical procedures. The dorsal penile nerve block is offered as a treatment for intraoperative erection. Advantages of this technique include less potential for cardiovascular complications and improved postoperative analgesia.

Adult↗

Laparoscopic pelvic lymphadenectomy and radical perineal prostatectomy: a viable alternative to radical retropubic prostatectomy.

Laparoscopic pelvic lymphadenectomy and radical perineal prostatectomy performed under the same anesthetic provide accurate surgical resection of localized carcinoma of the prostate with reduced intraoperative blood loss, minimal postoperative discomfort, short hospital stay (mean 4.1 days), high level of postoperative continence (81% completely dry after 4 months postoperatively) and low morbidity (4 complications). The clinical records of 37 patients undergoing this combined procedure during the last 22 months were reviewed retrospectively and the efficacy of the procedure was evaluated. This combined treatment modality avoids an abdominal incision and pelvic drains, and is associated with minimal postoperative discomfort and a short hospital stay. Laparoscopic pelvic lymphadenectomy combined with radical perineal prostatectomy is an alternative to open pelvic lymph node dissection and radical retropubic prostatectomy.

Adenocarcinoma↗

Duplication of inferior vena cava: its importance in retroperitoneal surgery.

Anomalies of the inferior vena cava arise infrequently. Knowledge of their presence can be established preoperatively with a variety of radiologic studies. This knowledge can prevent hemorrhagic complications from occurring during surgery. We present a case report of a patient with renal cell carcinoma and duplication of the inferior vena cava.

Carcinoma, Renal Cell↗

Xenografts of primary human prostatic carcinoma.

BACKGROUND: Prostatic carcinoma is both the most common invasive cancer and the second most common cause of cancer deaths in men in the United States. Before 1991, attempts to propagate prostatic carcinoma from primary tumors for periods longer than 3 months were unsuccessful in vivo and in vitro with rare exceptions. In 1991, we reported establishment of slowly growing tumors for six of 10 human primary prostatic carcinomas approximately 2-6 months after transplantation. However, none of the tumors were larger than 5 mm or serially transplantable. PURPOSE: Our purpose in this study was to determine whether human primary prostatic carcinoma could be grown as serially transplantable xenografts. METHODS: Cells from primary prostatic carcinomas obtained from transurethral prostatic resections or total prostatectomies in 20 patients were injected subcutaneously into male nude mice on the day of surgery. Sustained-release testosterone pellets were placed subcutaneously in the mice 2-24 days before transplantation of tumors and at intervals of 10-12 weeks. Serial transplantations in subsequent generations of mice were carried out by similar methods. Chromosome analysis was performed on six tumors. RESULTS: Six of 20 primary prostatic carcinomas have grown sufficiently to permit serial transplantation into second mice; four have been documented histopathologically in the second mouse and serially transplanted into three or more successive mice. When a single primary tumor was injected into several mice by the same procedure, tumors failed to grow in some recipients but became serially transplantable in others. Growth of these tumors is slow and irregular, with frequent regressions. Short-term cultures of 10 tumors, eight of which were injected into mice in parallel, were initiated on the day of surgery; CWR31, which was successfully transplanted serially, exhibited only aberrant metaphases and showed clonal, chromosomal changes in culture. Including CWR31, three of the six tumors for which chromosomal analysis was successful contained clonal aberrations. Preliminary studies of SCID (severe combined immunodeficient) mice suggest that they are not superior to nude mice for establishment of serially transplantable prostatic carcinoma xenografts. CONCLUSIONS: A proportion of human primary prostatic carcinomas can be grown as xenografts. Four new serially transplantable xenografts (CWR21, CWR31, CWR91, and CWR22) are currently propagated in our laboratory, a resource that was not previously available. IMPLICATIONS: Our experience suggests that the most important factor in serial transplantation is the collaboration of urologists and pathologists in expediting placement of the tumor in cold saline, examination of the frozen section, and transplantation.

Animals↗

Study of activities of arginase, hexosaminidase, and leucine aminopeptidase in prostate fluid.

Our previous studies demonstrated that extracts of the cancerous prostate tissues exhibit increased activities of arginase and hexosaminidase and decreased activity of leucine aminopeptidase. In an endeavor to devise a reliable, noninvasive and cost effective method for the diagnosis of prostate carcinoma, prostate fluids collected from 123 patients were analyzed for arginase, hexosaminidase, and leucine aminopeptidase. Based on the clinical diagnoses, the patients were divided into four groups: 13 men with chronic prostatitis, 29 with no recognized prostatic lesions, 63 with benign prostatic hyperplasia, and 18 with prostate cancer. The prostate fluids had no detectable arginase activity. The means of the total (units/mL) and the specific activities (units/mg of protein) of hexosaminidase and leucine aminopeptidase varied, albeit there were no significant differences in the four groups of patients recruited in this study. It was concluded that the profiles of enzymes in prostate fluids might differ from that in the secreting prostate tissues and that the results of enzyme analysis in prostate fluids for the diagnosis of cancer should be interpreted with caution.

Adolescent↗

Two-dimensional analysis of proteins in unprocessed human urine using double stain.

In the present study, a revised two-dimensional (2-D) map of proteins in unprocessed human urine was established. Spot urines were obtained from ten healthy men and ten healthy women each in Dewar flasks over a mixture of protease inhibitors. The specimens were sieved, desalted and freeze-dried, and identical amounts were pooled according to sex. The resulting samples were dissolved in urea mix and subjected to 2-D gel analysis employing the ISO-DALT system: the electrophoretograms were developed by double stain. We visualized more protein spots than reported previously, though most of them as yet remain unidentified. With the exception of similar relative positions of major protein spots, the samples demonstrated different patterns: urine of women, in general, had more spots and a greater proportion of low molecular weight proteins. Besides alpha 1-acid glycoprotein and the most acidic urinary proteins (MAUP), which were discerned earlier only in the ACIDO-DALT system, the ones known to precipitate while processing the samples were also detected. The 2-D profiles we established could be used as a diagnostic aid to study the excretion of proteins under various disease conditions.

Electrophoresis, Gel, Two-Dimensional↗

Spinal cord compression secondary to prostate carcinoma: treatment and prognosis.

Of 35 patients with prostate carcinoma and suspected spinal cord compression 26 (74%) had myelograms and/or magnetic resonance imaging studies demonstrating epidural spinal cord compression. In 5 of 26 patients (19%) spinal cord compression was the first indication of prostate cancer. All patients were initially treated with radiation, steroids and androgen deprivation therapy. Three patients underwent laminectomy. Of 12 patients (100%) ambulatory at presentation 12 remained ambulatory. Of 12 patients (83%) who were paraparetic at presentation 10 were ambulatory after treatment. However, 2 of these patients subsequently had recurrent compression and became paraplegic. Overall, 7 of 26 patients (27%) had recurrent compression. Of 5 patients who either presented with paraplegia or in whom paraplegia developed secondary to recurrent spinal cord compression 4 remained paraplegic despite treatment. The average survival of these 5 patients after treatment was 3.9 months versus 18 months for the group as a whole. In ambulatory or paraparetic patients radiation, androgen deprivation therapy and steroids are effective palliative therapy. However, patients who present with paraplegia or in whom paraplegia developed secondary to recurrent compression are often not palliated by this combination therapy. Prophylactic radiation of vertebral metastases discovered concurrently with compressive metastases may be valuable in preventing paraplegia.

Aged↗