Biomedical subjects
Publications and source records attributed to P Pandey.
Seminal vesicle abscess, a rare urologic entity, is usually diagnosed with computerized tomography (CT) scan. We report a case of seminal vesicle abscess that required a transrectal ultrasonography to confirm the diagnosis. An analysis of 20 cases of seminal vesicle abscess reported in the literature is also reviewed.
Progressive elevation of the prostate specific antigen (PSA) level after radical prostatectomy for adenocarcinoma is generally considered as irrefutable evidence of recurrent tumor. We assessed the results of 62 biopsies of the vesicourethral anastomosis in 41 men who had 3 or more consecutive PSA levels of 0.4 ng./ml. or greater after radical prostatectomy and no evidence of metastatic disease. The median PSA at the time of the first biopsy was 2.2 ng./ml. (range 0.4 to 50). Histological confirmation of recurrent cancer was established after 1 biopsy procedure in 39% of the patients and after 1 or more biopsy procedures in 59%. Biopsy was positive in 78% of 23 patients with an abnormal digital rectal examination, 40% of 5 with an abnormal transrectal ultrasound only, and 23% of 13 with a normal digital rectal examination and ultrasound. Among the patients with and without biopsy proved tumor recurrence there were no significant differences between the pathological stage or histological grade of the primary tumors, the month after surgery of the first detectable PSA level, the PSA doubling time, the month after surgery of the positive biopsy or the last negative biopsy, and the PSA level at the time of the positive biopsy or the last negative biopsy. In 6 cases benign prostatic tissue only was recovered from 1 or more biopsy specimens. This experience demonstrates that in patients with a detectable PSA after radical prostatectomy recurrent cancer may be difficult to document by biopsy of the vesicourethral anastomosis.
To identify prostate specific antigen (PSA) functions of prognostic significance in regard to treatment with androgen deprivation for prostate cancer we analyzed the pretreatment PSA, PSA half-life, PSA nadirs, times to PSA elevation and PSA doubling times in 245 patients with localized and 78 with metastatic disease who were treated with this modality. There was a direct correlation between the pretreatment PSA and the time to PSA elevation in patients with localized cancer (p = 0.000003) but no significant correlation in those with metastatic cancer. The PSA half-life was highly variable and did not correlate with other PSA functions of prognostic significance. Incremental increases in the PSA nadir correlated with the time to PSA elevation in patients with localized and metastatic cancer (p < 0.000001 and p = 0.00009, respectively), and with other parameters of prognostic significance. The median PSA doubling time in 26 patients with localized cancer in whom distant metastases did not develop (7.5 months) was significantly longer than that in 7 in whom new metastases developed (2.5 months) and in 43 with preexisting metastatic cancer (2.5 months) (p < 0.05 and p < 0.0001, respectively). In the 7 patients with localized cancer in whom metastases developed the median of the ratios of the PSA when the metastases were manifest and the pretreatment PSA was 0.14, and in 24 patients with preexisting metastatic cancer the median of the ratios of the antemortem PSA and the pretreatment PSA was 1.2. These data show that PSA synthesis by prostate cancer is reduced after androgen deprivation but that the PSA nadir and PSA doubling time following treatment provide important prognostic information.
PURPOSE: The histology of ultrasound guided seminal vesicle biopsies is assessed and the results are correlated with clinical or pathological stage of prostate cancer. MATERIALS AND METHODS: A total of 517 consecutive men underwent bilateral (515) or unilateral (2) seminal vesicle biopsy during sextant biopsy of the prostate. RESULTS: Seminal vesicle epithelium and muscularis were identified in 490 of 1,032 biopsy specimens (47%) and smooth muscle consistent with seminal vesicle muscularis was identified in 393 (38%). The seminal vesicle biopsy was positive for cancer in 7 of 123 patients (6%) with with clinical stages T1c and T2 tumors, 27 of 60 (45%) with stages T3 to 4 disease and 9 of 13 (69%) with metastatic cancer. Of 39 patients who underwent radical prostatectomy 1 of 36 (3%) without and 0 of 3 (0%) with seminal vesicle invasion had a positive seminal vesicle biopsy. CONCLUSIONS: Seminal vesicle epithelium and muscularis or smooth muscle consistent with the seminal vesicle muscularis can be procured in most patients using contemporary ultrasound guided biopsy techniques. However, apparently false-negative seminal vesicle biopsies are not uncommon and seminal vesicle biopsies contribute little to the staging of T1c and T2 tumors.
Present communication deals with the synthesis of complexes of [N-(p-tolylsulphonyl)-N'-n butyl-urea], with certain transition metals viz. Cu(II), Zn(II), Fe(II) and Cd(II). Structures of all the complexes have been established on the basis of their consistent elemental and spectral analysis. Also, it reports their in vivo hypoglycemic screening on albino rats. Out of all the complexes studied, Zn-Tolbutamide complex could be recommended as more potent hypoglycemic agent in lieu of tolbutamide alone.
We assessed the actuarial survival of 357 patients with localized prostate cancer who were treated with radical prostatectomy or radiation therapy at a Veterans Affairs Medical Center between 1980 and 1991 and who were followed for a median of 59 months. During this period patients with clinical stages A2 and B tumors who had an anticipated life expectancy of 10 years or greater were generally treated with surgery. Patients with stages A2 and B tumors who were not candidates for surgery and those with stage C tumors were generally treated with radiation therapy. There were no significant differences among the cause specific, clinical disease-free and prostate specific antigen disease-free survival curves of patients with stages A2 and B tumors who were treated with radical prostatectomy (138) or radiation therapy (138) but the all cause and metastases-free survival curves favored the surgery group (p < 0.000001 and 0.046, respectively). There was no significant difference between the all cause survival curves of the patients with stages A2 and B tumors and of 81 patients with stage C tumors who were treated with radiation therapy. However, the cause specific survival curves favored the patients with stages A2 and B tumors (p = 0.000007). This study demonstrates that there is a high risk of death from co-morbidities in a hospital based population of American veterans with localized prostate cancer who are not candidates for radical prostatectomy.
BACKGROUND: The purpose of the study was to determine whether a difference is noted in the rate of prostate specific antigen (PSA) elevation after radical prostatectomy or radiation therapy for localized prostate cancer. METHODS: PSA doubling times were calculated by linear regression analysis in 50 patients who had been treated by radical prostatectomy and who had three or more increasing PSA levels and in 55 patients who had been treated with radiation therapy and who had three or more increasing PSA levels. RESULTS: No significant difference was noted in the mean PSA doubling times in the two patient groups when stratified by the site of tumor recurrence or by pretreatment tumor stage, tumor grade, or acid phosphatase level. CONCLUSIONS: Because the PSA doubling time probably parallels the tumor growth rate, these data suggest that the malignant potentials of recurrent tumor after radical prostatectomy and after radiation therapy are equivalent.
We present an assessment of 200 patellar fractures treated mostly (175) by partial patellectomy. In 23 cases in which the quadriceps mechanism was 75% intact (MRC power approximately 4), the fractures were treated conservatively, with an overall acceptable result. The operative series with an average follow-up of 3 years has shown 80.3% excellent to good results. A classification of fractures of the patella, based on the anatomical fracture line and quadriceps functional loss as recorded in 690 case histories, is suggested.
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