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Biomedical subjects

R A Watson

Publications and source records attributed to R A Watson.

At least 55 records · Page 3Linked to original sources
PubMed1985

Incidental carcinoma of the prostate: significance of staging transurethral resection.

We compared the results of staging by a second circumferential transurethral resection and/or transperineal needle biopsy in 42 patients with stage A prostatic adenocarcinoma on initial transurethral resection (defined as tumor of low grade, Gleason sum 2 to 4, and low volume, less than 5 per cent of the specimen or less than 3 foci). Transurethral resection only was done in 16 patients, transperineal needle biopsy only in 2 and both procedures in 24. In the 24 patients who underwent both procedures residual carcinoma was identified by transurethral resection in 6 and confirmed by transperineal needle biopsy in only 1. Thirty-two patients (76 per cent) had no residual carcinoma. Of the 10 patients (24 per cent) with residual carcinoma 5 underwent radical prostatectomy with pelvic lymphadenectomy, 1 had interstitial irradiation with pelvic lymphadenectomy and 1 had pelvic lymphadenectomy only. No lymphatic metastases were detected; persistent carcinoma confined to the prostate was noted in all 5 patients who had undergone radical prostatectomy and 3 of these tumors were upstaged because of higher grade and/or volume. We conclude that residual carcinoma cannot be assessed accurately with transperineal needle biopsy, whereas transurethral resection staging enabled us to define a substantial number of our patients (24 per cent) with persistent disease. Importantly, upstaging by either low volume/high grade or high volume carcinoma was identified in 3 patients at the time of radical prostatectomy. However, the true stage and prognosis of those patients with persistent low volume and low grade prostatic carcinoma remain to be determined.

Adenocarcinoma↗
PubMed1984

Ifosfamide: chemotherapy with new promise and new problems for the urologist.

Ifosfamide, a chemotherapeutic agent, offers new hope as well as new problems for the uro-oncologist. The "good news" is that this drug is achieving marked benefits in treating resistant testis tumors and may even hold hope for patients with renal cell carcinoma. The "bad news" is that a price must be paid in toxicity--predominantly a severe and restrictive hemorrhagic cystitis. A breakthrough is the finding that oral administration of acetylcysteine (Mucomyst) may, to a large extent, prevent this untoward side effect.

Acetylcysteine↗
PubMed1983

Allergic reaction to protamine: a late complication of elective vasectomy?

Nucleoprotamines are a normal component of human sperm cells. Antibodies against these protamines develop in 22 to 33 per cent of patients undergoing elective vasectomy. These antibodies, in turn, have been shown to cross-react with medicinal protamines, which are extracted commercially from the testes of salmon and certain other fish. This cross-reactivity against protamines raises the possibility that patients who have undergone elective vasectomy may be at increased risk of an allergic reaction developing if they are later exposed to protamine as a medication. Since medicinal protamines currently enjoy widespread clinical use, this information should be borne in mind by those clinician using protamine and by urologists when counselling patients concerning elective vasectomy for sterilization.

Adult↗
PubMed1983

Anatomy and pathology of the male pelvis by magnetic resonance imaging.

Magnetic resonance imaging (MRI) of the male pelvis was performed in 25 subjects: five normal volunteers; six patients with carcinoma of the bladder; nine with benign nodular hyperplasia (including five with concomitant bladder carcinoma); nine with prostatic carcinoma; and one with a lymphocele after radical prostatectomy. The display of normal anatomy is enhanced by the ability of the MRI device to provide images in direct transverse, sagittal, and coronal planes. Sessile and pedunculated types of bladder carcinoma are readily shown due to the superior ability of MRI for soft-tissue characterization. Direct sagittal scans are advantageous for evaluation of tumors at the bladder base, and by combining two different planes of images, the extent of the neoplasm is better delineated. In the analysis of the prostate, MRI displays the gland in three dimensions and therefore allows accurate volumetric measurements. The greatest potential of MRI seems to be its ability to detect pathology confined to the gland. However, it is not yet known if a neoplastic nodule can be differentiated from chronic prostatitis. Unlike x-ray CT, metallic clips produce no streaking artifacts, giving MRI a definite advantage in the evaluation of patients after radical surgery. These observations were made on a small number of patients. If the results are confirmed with a larger number of patients, MRI will assume a prominent role in the clinical evaluation of bladder and prostate cancer.

Adult↗
PubMed1982

Medical information systems: assessing impact in the areas of hypertension, obesity and renal disease.

This study described the influence of a computerized medical record summary system in three disease areas (hypertension, obesity and renal disease) observed in the course of a controlled, randomized and prospective study of 479 Northwestern University Clinic patients. Experimental patients, who had available automated record summaries, and control patients, who had available only the manual record, were compared on several medical tests and procedures whose yearly occurrence was considered good medical practice for this patient population, and were compared as well as several measures of outcome of medical care. Evidence suggesting better care and outcome of care among patients with computerized record summaries available is presented.

Computers↗
PubMed1981

Triamterene stone: advantage of crystallographic analysis.

Microscopic crystallographic analysis of renal calculi provides clinically useful information concerning the pathogenesis of stone disease and is, therefore, superior to conventional chemical analysis of stones. The advantages of crystallography, performed at a centralized, experienced stone-analysis center, are highlighted by the recent discovery of triamterene deposits in kidney stones. Deposits of other medications and their metabolites have also been uncovered. Two case reports are presented, the clinical implications of these and related findings are discussed.

Adult↗
PubMed1980

A closer look at serum prostatic acid phosphatase as screening test.

Radioimmunoassay techniques for the detection of serum acid phosphatase are reported to provide substantial improvement in test sensitivity and test specificity. Calculation of the positive predictive value for this assay, however, does not support its use as a screening modality. Indiscriminate use of this test may have serious medical, psychological, and economic ramifications.

Acid Phosphatase↗