Biomedical subjects
Publications and source records attributed to N F Wasserman.
A case of keratinizing desquamative squamous metaplasia (KDSM) of the upper urinary tract is presented showing a "goblet" sign. The relationship between KDSM, cholesteatoma, and leukoplakia is discussed and conservative management is recommended.
We report on 2 patients with bilateral renal oncocytoma treated in the last 5 years. One patient underwent bilateral partial nephrectomy for a solitary tumor in each kidney. Both tumors were confirmed to be renal oncocytomas by light and electron microscopic examination. After 4 years this patient had no evidence of local recurrence or distal metastasis. The second patient presented with bilateral multiple renal oncocytomas. Transabdominal bilateral renal exploration revealed 2 tumors in the right kidney and 3 tumors in the left kidney. Right radical nephrectomy and enucleation of the left renal tumors were performed. Examination by light and electron microscopy confirmed that all tumors from both kidneys were oncocytomas. Only 8 cases of bilateral renal oncocytoma have been reported in the literature, including our 2 cases. In 6 of these 8 cases the tumors were multicentric, which may be a characteristic of bilateral renal oncocytoma. Recognizing the coexistence of multicentricity and bilaterality is important because more conservative treatment is required. However, a favorable prognosis may still be anticipated.
There have been few reported cases of ureteral diverticula less than 4 mm in diameter; these are best described as pseudodiverticula based on their appearance in specimens obtained for pathologic study. An additional 23 patients are reported, 15 of whom were examined by urinalysis, urine culture, cystoscopy, and cytologic studies of the urine. Cytologic findings are of interest because of previous reports suggesting an association between ureteral diverticula and transitional cell carcinoma in the urinary tract. Hematuria, transitional cell carcinoma, and benign prostatic hyperplasia were the most common presenting conditions. Infection was found in only three. Diverticula were multiple in 91%, bilateral in 69%, and were predominantly upper and midureteral in location. Urine cytologic studies failed to detect early uroepithelial malignancy, but nonspecific cellular atypia and an association with malignancy in 30% of these patients suggests that close follow-up of patients with ureteral pseudodiverticulosis is prudent.
Mass- or polyplike defects of the gastric fundus were found on upper gastrointestinal examination in five patients, representing 7% of those who had undergone splenectomy. In four cases, the splenectomies were performed 1--5 months earlier, and, in one, the splenectomy was performed 10 years before. Dense adhesions were the cause of the defects in two patients. Plication deformity was thought to be a possible cause in the others. Recognition of the nonneoplastic nature of such defects is important in preventing unnecessary surgery. Computed tomography and endoscopy may be helpful in confirming the diagnosis.
A patient with multiple large hyperplastic (metaplastic) polyps of the colon is reported. Hundreds of polyps, some over 3 cm in size, were distributed uniformly throughout the large bowel. There was no evidence of polyps in the stomach or small intestine. The polyps, except for their large size, had the histologic features of hyperplastic polyps. This condition can be clinically confused with adenomatous polyposis coli.
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A rare pseudodiverticular pattern of metastatic malignancy to the ureter is reported along with pathologic findings at postmortem examination in three patients. There was no clinical or pathological obstruction. This pattern is due to malignancy-induced edema in the subepithelial connective tissues and muscularis propria causing displacement of these layers into the ureteral lumen resulting in an undulating epithelial surface. The epithelium itself is normal. Metastases to the ureter is uncommon in life unless associated with ureteral obstruction. Ureteral pseudodiverticulosis found in vivo in a nonobstructed patient with known metastatic malignancy is likely due to inflammatory causes and usually reversible with antibiotic and medical therapy. A patient with widespread malignancy showing nonreversibility of the ureteral pseudodiverticular pattern, even in the absence of obstruction, should be considered a candidate for impending obstruction and followed closely for ureteral stent placement.
Quality control of the contrast and density of mammograms is of extreme importance not only because of patient dose considerations but also because of the need to monitor changes in the breast over extended periods of time. A phantom and test technique has been developed and used at two institutions for monitoring the ability of mammographic generators and phototiming systems to provide consistent contrast and density. The phantom consists of a solid acrylic block and an embedded aluminum step wedge designed specially for low kVp use. Optical densities of various portions of the phantom are used to determine constancy of density and contrast. By minimizing fluctuations due to processing and film handling, normal variations were reduced enough to determine changes in contrast and density due to generator and phototimer changes equivalent to those monitored in processor quality control programs. The data have been correlated with changes in processor function. Changes in density and contrast values have also been related to phototimer malfunction and reduced image quality.
Human prostatic secretion and seminal plasma contain certain protein kinase activities. Protein kinases play important roles in regulating a vast variety of cellular functions. The objective of this study was to determine whether one of these protein kinase activities in human prostatic secretion and seminal plasma is due to CK2, a messenger-independent, serine/threonine protein kinase that has considerable potential as a regulatory enzyme. By employing an anti-CK2 antibody and a CK2-specific peptide substrate, we have established that CK2 is present in these secretions. Approximately 70% of the CK2 activity present in seminal plasma of normozoospermic men (n = 49) is correlated to the number of sperm originally present in the semen. Further, both the prostate gland and the seminal vesicles are sources of CK2 activity in the seminal plasma of vasectomized men (n = 38). Although there was considerable variation between individuals in CK2 activity, the variation in repeat semen samples of the same vasectomized men (n = 6) was within 21%. There was no correlation of CK2 activity in seminal plasma with age for vasectomized (27-48 years, n = 38), oligozoospermic (28-43 years, n = 24), or normozoospermic men (26-48 years, n = 49). These data suggest that the majority of CK2 activity in the seminal plasma of normozoospermic men originates from sperm but that the prostate and seminal vesicles are accessory sex-gland sources of this enzyme.