Search PubMed⌕ Search

Biomedical subjects

M J Manyak

Publications and source records attributed to M J Manyak.

At least 37 records · Page 2Linked to original sources
PubMed1996

Practice trends of American urologists in the treatment of impotence, incontinence and infertility.

PURPOSE: Trends of urologist practice patterns in evaluating and treating impotence, incontinence and infertility in the United States were assessed. MATERIALS AND METHODS: In July 1995 the executive interviewing branch of the Gallup Organization selected randomly and interviewed by telephone 533 practicing urologists in the United States who had provided urological patient care for more than 20 hours per week, practiced in 1994 and completed a urological residency program. RESULTS: Treatment of male sexual dysfunction and female urinary incontinence comprises a significant portion of the professional activity of United States urologists. However, evaluation and management of male infertility occupy a small portion of the average urological work load. While more than half of United States urologist office clinical laboratories were inspected in 1994, only 2% failed evaluation due to major deficiencies. CONCLUSIONS: Male sexual dysfunction and female urinary incontinence are major areas of urological practice in the United States but male infertility is not. Few United States urologist clinical laboratories failed inspection because of major deficiencies.

Adult↗
PubMed1995

Free-beam and contact laser ablation of benign prostatic hyperplasia with the KTP/Nd:YAG laser: efficacy and versatility.

This report details the use of the free-beam Nd:YAG laser alone and in combination with contact vaporization for treatment of benign prostatic hyperplasia. Improvements in urinary flow rates and symptoms were noted along with a high degree of patient satisfaction. The portable KTP/Nd:YAG laser wavelengths and the variety of optical fiber configurations provide versatility to the surgeon. This study further supports the use of laser energy as a means to treat urinary outflow obstruction from prostatic enlargement in selected cases.

Aged↗
PubMed1995

Practice trends in the diagnosis and management of benign prostatic hyperplasia in the United States.

PURPOSE: The American Urological Association (AUA) first commissioned the Gallup Organization of Princeton, New Jersey to conduct a study to assess urologists' practice patterns in 1992. MATERIALS AND METHODS: In August 1994 a random sample of 514 American urologists was surveyed by the Gallup Organization regarding practice patterns for the diagnosis and management of benign prostatic hyperplasia (BPH). It asked questions regarding the practice patterns of respondents in their diagnosis and management of BPH. RESULTS: The survey revealed that 99% of the respondents were aware of and used the AUA symptom score index, and that 21% of these respondents had altered their diagnosis and management strategies because of its existence. CONCLUSIONS: Therapeutic recommendations of the respondents based upon AUA symptom score index severity parallel the recently announced federal Agency for Health Care Policy and Research BPH practice guidelines.

Adrenergic alpha-Antagonists↗
PubMed1995

Practice trends in the diagnosis and management of prostate cancer in the United States.

PURPOSE: The American Urological Association first commissioned the Gallup Organization of Princeton, New Jersey to conduct a study to assess urologists' practice patterns in 1991. MATERIALS AND METHODS: A random sample of 514 American urologists was surveyed by the Gallup Organization regarding practice patterns used in the staging and treatment of prostate cancer. The third annual survey taken during August 1994 asked questions regarding the practice of respondents in their diagnosis and management of prostatic cancer. RESULTS: The survey revealed that 95% of the respondents would recommend radical prostatectomy for men younger than 70 years with confirmed clinically localized prostate cancer. CONCLUSIONS: In this patient age group, surprisingly, the survey resulted in some interesting facts: 1) 13% regard hormonal manipulation for early stage cancer appropriate, 2) the respondents used extensive numbers of diagnostic staging studies in the new prostate cancer patient with a prostate specific antigen of less than 10 and 3) despite the obvious increased costs, the majority of patients receiving hormone manipulation were being treated with luteinizing hormone-releasing hormone agonists rather than orchiectomy.

Adult↗
PubMed1995

Practical aspects of photodynamic therapy for superficial bladder carcinoma.

Most clinicians equate laser use with direct thermal ablation of tissue, but the precise spatial and temporal control of laser energy has made possible a number of diagnostic and therapeutic applications for these unique light sources that do not involve nonspecific thermal destruction of tissue. One such application is the detection and treatment of tissue with compounds that absorb specific types of light, known as photodynamic therapy (PDT). This article examines the practical aspects of PDT for the treatment of superficial bladder carcinoma with an emphasis on dosimetry. The results presented are encouraging and suggest that patient who have diffuse superficial bladder carcinoma refractive to standard treatment methods should be given the benefit of whole bladder PDT before commitment to radical extirpative surgery. Close attention to dosimetry will be required. PDT remains experimental at this stage; it has been approved for general use only in Canada, though filings with regulatory agencies in both the United States and Europe are anticipated in the near future.

Canada↗
PubMed1994

Recombinant human uteroglobin inhibits the in vitro invasiveness of human metastatic prostate tumor cells and the release of arachidonic acid stimulated by fibroblast-conditioned medium.

Uteroglobin (UG) is a potent immunomodulatory and antiinflammatory secretory protein with high levels detected in human prostate tissue. We used three human prostate cancer cell lines (DU-145, PC3-M, and LNCaP) to test the hypothesis that UG may modulate invasiveness of prostatic carcinoma cells in the Boyden chamber assay for invasion through a reconstituted basement membrane preparation. Fibroblast-conditioned medium was used as the chemoattractant. The most invasive cell line was DU-145, followed by PC3-M, whereas the androgen-dependent LNCaP cell line exhibited extremely low invasive potential. Pretreatment of DU-145 and PC3-M cells for 24 h with 0.01, 0.1, or 1.0 microM recombinant UG had no effect on basal invasiveness but inhibited fibroblast-conditioned medium-stimulated invasion in a dose-dependent manner, reaching up to 60.2 and 87.9% inhibition of DU-145 and PC3-M, respectively. UG had no effect on either cell-reconstituted basement membrane adhesion or simple chemotaxis in the absence of reconstituted basement membrane. UG also strongly inhibited the biphasic release of [14C]-labeled arachidonic acid from fibroblast-conditioned medium-stimulated DU-145 cells. These results suggest that UG may modulate prostate tumor cell invasiveness and that the mechanism may include inhibition of the arachidonic acid signal cascade.

Arachidonic Acid↗
PubMed1993

Primary small noncleaved cell lymphoma of kidney.

The kidney is the second most common site for metastasis of lymphoma though it remains asymptomatic and is not commonly detected with cross-sectional imaging studies. Primary renal lymphoma is a very rare lesion whose existence is controversial. The lymphoma reported here presented as a solitary renal mass without any other evidence of disease. Lymphoma should be included in the differential diagnosis for solitary renal masses even though the usual presentation is bilateral. Renal involvement with lymphoma requires a thorough search for extrarenal disease.

Diagnosis, Differential↗
PubMed1990

Fluorescent detection of rabbit endometrial implants resulting from monodispersed viable cell suspensions.

A model for early stage endometriosis was prepared in rabbits by intraperitoneal injection of monodispersed viable endometrial cells. With this model, we have found that DHE fluorescence increases the sensitivity of detection of endometrial tissue. The potential experimental and clinical significance of ectopic endometrial detection by porphyrin fluorescence is enhanced by the recent report of endometrial transplant destruction by PDT. Although caution must be exercised for extrapolation from animal experiments to human conditions, these results encourage further evaluation of photosensitization for the study and potential treatment of disorders involving endometrial tissue.

Animals↗
PubMed1989

Photodynamic therapy of rabbit endometrial transplants: a model for treatment of endometriosis.

The potential of photodynamic therapy for endometriosis was evaluated by autotransplantation of endometrial tissue in 15 female virgin New Zealand white rabbits. After maturation, 14 animals were injected intravenously with 10 mg/kg of dihematoporphyrin ether (DHE) and, 24 hours later, transplants were exposed to 630 nm light at 100 to 210 mW/cm2. Sixteen transplants received 100 J/cm2, 10 transplants received 50 J/cm2; 13 untreated transplants served as controls. In the remaining animal that did not receive DHE, 3 transplants were irradiated with 100 J/cm2. Six days after treatment, transplants were harvested with the underlying musculature, and multiple sections were examined histopathologically. Complete endometrial epithelial destruction was seen in 13 of 16 transplants (81%) in the 100 J/cm2 group and in 6 of 10 transplants (60%) in the 50-J/cm2 group. Nearly complete endometrial epithelial destruction was seen in 2 other transplants in each group. No damage occurred in either the 3 transplants that received 100 J/cm2 without prior DHE or in the 13 transplants with DHE and no irradiation. The sensitivity of ectopic rabbit endometrial tissue encourages further evaluation of photodynamic therapy for the treatment of human endometrial disorders.

Animals↗
PubMed1988

Photodynamic therapy: response of normal canine urethra using a cylindrical fiber.

Normal urethral response to photodynamic therapy (PDT) utilizing a cylindrical fiber was assessed in ten study and two control NIH fox-hounds. The canine urethras were treated 48 hours after intravenous injection of 3 mg/kg dihematoporphyrin ether (Photofrin II). A 1-mm fused silica optical fiber, with the distal 2-3 cm modified for cylindrical light distribution (660-microns diameter), was placed in the pendulous urethra. An argon-pumped dye laser delivered 100 mW of 630-nm light for 7 minutes (42 J) to the treatment area. Urethroscopy using either a 2.5-mm or a 2.8-mm flexible pediatric bronchoscope with video recording capability was performed immediately after PDT (12 animals) and 6 weeks later (nine animals); intravenous urography was performed 3 days and 6 weeks after PDT. There was no evidence of either urethral damage or stricture formation in any animal. Histopathology of the first three study specimens, obtained at 6 weeks, confirmed the absence of any pathology. Flexible instrumentation facilitates post-treatment assessment. This study demonstrates for the first time that, when a cylindrical fiber is used, photodynamic therapy may be applied to the urethra without damage to the normal urethral mucosa. This result has implications for potential treatment of initial or recurrent carcinoma in situ of the urethra using PDT.

Animals↗
PubMed1988

Expression of a uteroglobin-like protein in human prostate.

Phospholipase A2 (PLA2) is a key enzyme that initiates the arachidonic acid cascade responsible for the synthesis of prostaglandins and leukotrienes, compounds well known for their inflammatory properties. Inhibition of this enzyme may modulate prostaglandin and leukotriene tissue levels. Uteroglobin is a potent PLA2 inhibitor found in rabbit uterus, prostate, seminal vesicle, and tracheobronchial tree. Tissue from ten human patients undergoing prostatectomy was examined for presence of a uteroglobin-like protein. Seven patients underwent transurethral resection and three had an open prostatectomy. Preoperative diagnosis in nine of the 10 patients was benign prostatic hypertrophy. One suspected, poorly differentiated, adenocarcinoma was confirmed and one unsuspected, well differentiated, adenocarcinoma was discovered. Specimens were submitted for Western blot, electron microscopy with immunogold staining, radioimmunoassay, and immunofluorescence. Six patients had evidence of uteroglobin-like protein, three with high levels (greater than or equal to 1000 pg./mg. protein), two with moderate levels (75 to 250 pg.), one with a low level (less than or equal to 75 pg.). Uteroglobin-like protein was present in all three patients who underwent open prostatectomy and in three of the seven patients with transurethral resections. The uteroglobin-like protein level was 2.5 to five times greater in both prostatic utricle specimens. All four assays corroborated these results. Because rabbit uteroglobin coats sperm and masks spermatic antigenicity in the rabbit female genital tract, this report of biochemical and immunological evidence for uteroglobin-like protein in the human prostate may have implications for human male fertility.

Adenocarcinoma↗
PubMed1988

Response of normal canine ureter to photodynamic therapy using a cylindrical fiber.

Photodynamic therapy (PDT) was performed utilizing a cylindrical optical fiber to determine feasibility of distal ureteral treatment on 10 study and two control NIH foxhounds. The study animals were administered three mg./kg. dihematoporphyrin ether (Photofrin II) intravenously followed 48 hours later by open cystotomy. One ureter was irradiated with 42 joules of 630 nm. light delivered by a 660 micron diameter optical fiber modified for cylindrical light distribution. Intravenous urography was performed both at three days and six weeks post PDT. Hydroureteronephrosis was revealed in one treated ureter and one untreated ureter. Mild dilatation of the ureter was noted by urography in another treated ureter and in one ureter that did not undergo light irradiation; no distal obstruction was revealed in either case by proximal infusion of saline or by histopathology. Nine of the 10 treated ureters were found to have either no abnormal pathology or only minimal lymphocytic infiltration. In this study, the normal ureter was shown to tolerate photodynamic therapy at energy densities equivalent to those used to effect tumor regression and the feasibility of using a cylindrical optical fiber for treatment of ureteral malignancies was confirmed.

Animals↗