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Biomedical subjects

M I Resnick

Publications and source records attributed to M I Resnick.

At least 163 records · Page 9Linked to original sources
PubMed1989

Hormonal therapy for advanced prostatic carcinoma.

Since the work of Huggins and Hodges, hormonal therapy, i.e., orchiectomy or estrogens, has been the gold standard of treatment for patients with advanced adenocarcinoma of the prostate. Recently, many new drugs have been introduced in the hope of achieving a beneficial response as compared with hormonal therapy, while avoiding some of the adverse effects. Various newer agents are reviewed. It appears that while these agents may be attractive secondary to specific effects, they do not appear to offer any survival advantage over diethylstilbestrol or orchiectomy. Finally, the theory of total androgen blockade is reviewed. Institution of total blockade does not appear to offer a survival advantage over standard androgen blockade.

Adenocarcinoma↗
PubMed1989

Ureteral injuries complicating vascular surgery: is repair indicated?

We have managed 8 patients who sustained an iatrogenic ureteral injury during either placement or revision of a vascular graft. Primary repair was performed in all 5 patients diagnosed at injury. Persistent extravasation necessitating nephrectomy occurred in 2 of these patients. The diagnosis was delayed in 3 patients. Two patients underwent successful ureteral reconstruction and 1 required nephrectomy. Graft complications did not occur. Ureteral repair is recommended as the preferred method to manage ureteral injuries associated with vascular reconstruction.

Aged↗
PubMed1989

Side effects of self-administration of intracavernous papaverine and phentolamine for the treatment of impotence.

Beginning October 1985, 111 men agreed to enter a prospective study of the side effects of low dose papaverine/phentolamine therapy. A total of 46 men dropped out, 30 during the initial phase. The percentage of men with painless nodules almost consistently doubled from one followup examination to the next: 8 per cent at 1 month, 17 per cent at 3 months, 32 per cent at 6 months and 57 per cent at 12 months. The average injection frequency of those with nodules was 2 1/2 times higher than those without nodules. Of the men 41 per cent required an increased dose of medications during followup, and 40 per cent of 50 men had at least 1 abnormality of liver function, most of these involving mild to moderate elevations of alkaline phosphatase and lactic dehydrogenase. Priapism was not encountered during self-injection but it did occur twice in 329 physician-administered injections. Careful regular monitoring of patients should continue as some patients enter the second year of treatment.

Adult↗
PubMed1989

The use of transrectal prostatic ultrasonography in the evaluation of patients with prostatic carcinoma.

Transrectal ultrasonography is a relatively new diagnostic technique that has received much of the same enthusiasm that often is associated with the introduction of other new diagnostic or therapeutic instruments. The study allows for imaging of the prostate but benign conditions often cannot be differentiated reliably from malignant ones. The technique has clinical application in staging, monitoring tumor response to therapy and assisting in biopsy. Its role as a screening study when used either alone or in combination with other diagnostic tests has yet to be determined and well controlled, carefully performed investigations with state of the art instruments probably will help to establish the role of this examination when used for this purpose.

Adenocarcinoma↗
PubMed1989

A study of the incorporation of urinary macromolecules onto crystals of different mineral compositions.

A new method used to study the binding of proteins onto calcium oxalate crystals demonstrated this interaction to be a selective process regarding the types of adsorbed proteins. To determine whether the incorporation of urinary macromolecules onto crystals formed in urine in vitro is dependent on the specific crystalline composition, this technique was applied to both uric acid and calcium oxalate crystals. Powdered uric acid was dissolved in urine and the pH lowered to 5.5. The resulting uric acid crystals were centrifuged and the pellet dialyzed against water at pH 8.0. Calcium oxalate crystals produced by the addition of 0.1 M calcium chloride and 0.1 M sodium oxalate to an aliquot of the same urine sample were demineralized with 5% EDTA. Gel filtration chromatography was used to isolate the protein fraction of an aliquot of the urine samples before and after crystallization of uric acid and calcium oxalate. The proteins recovered from the crystals and urine samples were separated by two-dimensional polyacrylamide gel electrophoresis. Analysis of the gels confirmed that the binding of urinary proteins onto crystals is a selective process and indicate that this interaction is dependent on the specific inorganic composition of the crystals.

Adult↗
PubMed1989

Obstructive uropathy in patients with benign prostatic hyperplasia.

In an attempt to determine the role of obstructive prostatic hyperplasia as a cause of irreversible renal function the records of 32 men with a diagnosis of benign prostatic hyperplasia and renal failure were reviewed. Patients were classified as either having a serum creatinine of more than or less than 4 mg.per 100 ml. when they were discharged from the hospital. Admission serum creatinine levels were comparable in both groups. Characteristics of the group with permanently impaired renal function included a longer mean duration of symptoms, higher incidence of urinary tract infection, lower average volume of residual urine and greater incidence of small kidneys with increased parenchymal echogenicity. These data assist in the objective prediction of patients who will have irreversible renal dysfunction when presenting with obstructive benign prostatic hyperplasia.

Acute Kidney Injury↗
PubMed1989

Surface interaction between glycosaminoglycans and calcium oxalate.

Molecules and macromolecules are known to alter the process of crystallization, either through inhibition or promotion of nucleation, growth, and/or aggregation. One particular group of macromolecules, glycosaminoglycans (GAGs), has been of interest in our laboratory. The GAGs chondroitin A, chondroitin C, heparan sulfate, dermatan sulfate, hyaluronic acid, and keratan sulfate have all been shown to be inhibitors of calcium oxalate crystallization. Heparin, the only GAG which is not naturally present in urine, is the most potent inhibitor of all GAGs. Using the method of Langmuir isotherm adsorption, we studied the adsorption of certain GAGs onto calcium oxalate crystals. Under standardized conditions, heparin, chondroitin C, hyaluronic acid, and pentosan polysulfate (a synthetic polyanionic molecule similar to, but a weaker inhibitor than, heparin) were adsorbed onto calcium oxalate. The total amount of GAG required to maximally cover the crystal surface, as well as the equilibrium concentration at which surface was half-covered with GAG (inversely related to the desorption energy) were measured. Chondroitin C was adsorbed in the greatest amount, followed by heparin, pentosan polysulfate, and finally hyaluronic acid. Using the method of fiducial limits, the only insignificant difference was between heparin and chondroitin C, and between hyaluronic acid and pentosan polysulfate. Pentosan polysulfate required significantly higher equilibrium concentration than heparin and hyaluronic acid to cover half of the surface of the calcium oxalate crystals. The principle of Langmuir isotherm adsorption can be useful in predicting the effects of macromolecules on crystallization. Weaker inhibitors bind with less affinity than do stronger inhibitors. Further work is underway to characterize other inhibitors and promoters.

Adsorption↗
PubMed1989

The effect of verapamil on the treatment of detrusor hyperreflexia in the spinal cord injured population.

Verapamil, a calcium channel blocker, was tested alone and in combination with oxybutynin chloride for its clinical effectiveness in the treatment of detrusor hyperreflexia in a spinal cord injured population. Fourteen patients with detrusor hyperreflexia were included. All patients were treated with oxybutynin chloride alone and with the combination of oxybutynin chloride and verapamil. Six of the patients were also studied on no medication and verapamil alone. Cystometric and clinical comparisons were made with each change in drug dosage. Verapamil 240SL, when used alone, produced a delay in the first detrusor contraction as compared to no medication in 5 of the 6 patients but clinical improvement was insignificant. Clinical improvement with tolerable side effects was noted in 13 of the 14 patients treated with the combination of oxybutynin chloride and verapamil over oxybutynin alone. Our early experience with verapamil suggests that it may be a valuable adjunct in the treatment of detrusor hyperreflexia.

Adult↗
PubMed1989

Self-injection of papaverine and phentolamine in the treatment of psychogenic impotence.

This study prospectively assessed the use, effectiveness, and sexual and psychosocial impact of self-injection treatment in 15 men with psychogenic impotence. Sixty percent dropped out of self-injection treatment by 6 months. Those who remained used self-injections about four times monthly with a 94% success rate. Frequency of intercourse and sexual satisfaction increased. Anxiety decreased, and trends toward improvement in depression and self-esteem were evident. Qualitative data indicated that performance anxiety was not alleviated, dependence upon injections for intercourse remained, symptom substitution did not occur, and capacity for intimacy was not improved.

Erectile Dysfunction↗
PubMed1989

Results of ultrasonography of the prostate.

The role of transrectal ultrasound of the prostate is evolving, and with time, increased experience, and the completion of controlled clinical studies, its range of clinical applications and its true usefulness in practice will be more clearly established. The authors review techniques and equipment, image characteristics, clinical applications, and continuing controversies.

Humans↗
PubMed1989

Transrectal ultrasonography for staging tumors of the urinary bladder.

Transurethral ultrasonography appears to help the urologist stage transitional cell tumors of the bladder. On the basis of the depth of invasion, one can determine whether transurethral resection of tumors will be adequate or whether segmental resection or cystoprostatectomy is required. The adequacy of transurethral resection of tumors can be monitored by comparing the depth of resection with the initial ultrasound examination. Pelvic lymph nodes cannot be assessed by transurethral ultrasound, and therefore CT, MRI, or lymphangiography must be used as well. Currently, CT scanning is the preferred modality because it is noninvasive, simple, inexpensive, and widely available. Other pelvic disorders, including gynecologic disease and neoplasms of gastrointestinal, neural, or bony origin, also may be assessed by transurethral ultrasonography, although experience with its use for these purposes is limited.

Humans↗
PubMed1989

Urolithiasis in primary care.

Urolithiasis is a common, multifactorial, medically manageable disease. Primary care physicians can play a prominent role in metabolic evaluation and medical treatment of patients with urolithiasis. Patients should be referred for urologic evaluation in the presence of intractable urinary tract infection, progressive renal damage, urinary obstruction, refractory pain, or presence of stones of uncertain etiology. Expectant management of symptomatic ureteral stones can be undertaken by a primary care physician in conjunction with urologic support. Interventional treatment of urinary stones has improved markedly with the availability of extracorporeal shock-wave lithotripsy, and percutaneous stone removal. In patients with certain types of urinary stones, medical treatment can greatly reduce the incidence of subsequent stone-forming episodes.

Diagnosis, Differential↗
PubMed1988

Iatrogenic colon and rectal injuries associated with urological intervention: report of 14 patients.

Iatrogenic large bowel injuries are a potential complication of many urological procedures. During the last 6 years we have cared for 14 patients with iatrogenic injuries involving either the colon or rectum. The injuries occurred as a complication of radical prostatectomy, percutaneous stone removal, nephrectomy, urethral catheter placement, percutaneous suprapubic catheter placement and penectomy with associated cystoprostatectomy. One patient died of these complications, while in most instances hospitalization was prolonged and additional operative intervention often was required.

Adult↗
PubMed1988

Complex struvite calculi treated by primary extracorporeal shock wave lithotripsy and chemolysis with hemiacidrin irrigation.

Ten patients with complex struvite stones were treated successfully with primary extracorporeal shock wave lithotripsy followed by chemolysis with 10 per cent hemiacidrin renal irrigation. The average number of treatments per renal unit was 1.2 and an average of 2,688 shocks was administered per treatment. No patient required a blood transfusion. Ureteral obstruction did not occur in those patients receiving planned hemiacidrin irrigation immediately after extracorporeal shock wave lithotripsy. At 6-week followup 9 patients were free of residual fragments. The combination of extracorporeal shock wave lithotripsy and hemiacidrin chemolysis represents a satisfactory alternative to the traditional surgical management of complex struvite calculi.

Adult↗