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Biomedical subjects

S A Kramer

Publications and source records attributed to S A Kramer.

At least 91 records · Page 5Linked to original sources
PubMed1981

Comparative morphology of primary and secondary deposits of prostatic adenocarcinoma.

In 42 patients with metastatic adenocarcinoma of the prostate, histopathologic specimens of the original prostatic biopsy and lymphatic metastasis were classified using the grading system of tumor differentiation described by Gleason et al. The observed similarity between prostatic biopsy morphologic and the morphology in the corresponding lymphatic metastasis supports the concept that the histologic growth pattern of the primary tumor is reduplicated in the metastatic lesions. The observation that a more anaplastic pattern did not appear in the metastatic deposits implies that factors other than cellular loss of differentiation are responsible for the cells' ability to metastasize.

Adenocarcinoma↗
PubMed1981

Identification of ureteroileal obstruction by retrograde loopography.

Retrograde loopography in 106 patients (212 renal units) with ileal conduit urinary diversion was assessed to define the accuracy of this study in identifying ureteroileal obstruction. In 171 renal units (81%), the radiographic findings demonstrated by retrograde loopography correlated appropriately with the findings on excretory urography. However, in 41 renal units (19%) with absent ileoureteral reflux, there was no evidence of ureteroileal obstruction by excretory urography. This potential disparity between excretory urography and retrograde loopography has limited our use of the latter study for selected patients in whom the excretory urogram demonstrates (1) evidence of progressive upper tract deterioration, (2) anastomotic obstruction, or (3) patients with chronic renal failure or iodide sensitivity in whom the intravenous administration of contrast material may be contraindicated.

Adolescent↗
PubMed1981

Correction of total incontinence in male and female epispadias.

Between 1946 and 1980, 54 patients with epispadias and total urinary incontinence were evaluated at our institution. Factors critical to the achievement of complete continence include deferral of surgery until at least 3 yr of age, the patient having a well-developed bladder with adequate capacity and musculature, and maturation of the prostate at puberty in males. Complete continence was obtained in 9 of 11 female patients (82%). Fourteen of 35 male patients obtained complete urinary continence in the initial postoperative period. Complete urinary control was delayed until puberty in 11 additional patients, for an overall success rate of 25 of 35 males (71%). The significant increase in continence with the onset of puberty in males demonstrates the importance of expectant management of the child's progress in relation to the potential contribution of prostatic maturation in the development of urinary control.

Adolescent↗
PubMed1981

Transpubic urethroplasty in children.

In 12 children with membranous urethral strictures transpubic urethroplasty has been performed successfully with minimal morbidity and no mortality. Of the 12 patients 8 are completely continent after transpubic urethroplasty, 2 have partial continence and 2 are incontinent. Wedge resection of the pubic symphysis afforded satisfactory exposure to the prostatic urethra, and none of the 12 patients experienced orthopedic instability, abnormal gaits or pelvic girdle pain. In 3 patients there was loss of erectile function after pelvic injury, which reflects the significant risk of impotence after crush injury to the pelvis with rupture of the posterior urethra.

Adolescent↗
PubMed1981

Prognosis of patients with stage D1 prostatic adenocarcinoma.

Of 44 patients with clinically localized prostatic adenocarcinoma and regional lymphatic metastases proved by staging pelvic lymphadenectomy 11 were treated by radical prostatectomy, 20 received extended field radiation and 13 were assigned to delayed hormonal therapy. The median survival for the entire group was 39.5 months. None of the 3 treatments appeared superior in prolonging survival. Furthermore, no enhancement of disease control could be demonstrated in either treatment group. Patients with prostatic adenocarcinoma and positive nodes appear to have equivalent adverse biological potential and should be candidates for treatments designed to produce systemic effect.

Adenocarcinoma↗
PubMed1980

Bilateral adrenal neuroblastoma.

Bilateral adrenal neuroblastoma is extremely rare, with isolated case reports considered to represent metastatic spread rather than simultaneous occurrence. This patient was found to have synchronous, separate, and equal size neoplasms that morphologically and ultrastructurally are neuroblastoma. We believe that these findings represent the unusual occurrence of simultaneous primary adrenal neuroblastoma reflecting multicentric origin of this neoplasm.

Adrenal Gland Neoplasms↗
PubMed1980

Experience with Gleason's histopathologic grading in prostatic cancer.

The inaccuracy of clinical staging as a predictor of the biologic potential of prostatic cancer has prompted evaluation of additional methods of assessment. We reviewed 228 patients with prostatic adenocarcinoma who presented during a 4-year period. Of the 228 patients 144 with no detectable bony disease underwent staging pelvic lymphadenectomy with or without preliminary bilateral pedal lymphangiography. Histopathologic specimens of the primary diagnostic prostatic biopsy were classified with Gleason's grading system of tumor differentiation. Of the patients with Gleason's sum of 8, 9 or 10, 93 per cent had regional nodal metastases, regardless of preliminary clinical stage. Furthermore, no patient with Gleason's sum of 2, 3 or 4 had nodal metastatic disease. The incidences of falsely positive and falsely negative lymphangiograms were 29 and 35 per cent, respectively, reflecting the unreliability of pedal lymphangiography to predict nodal involvement accurately in patients with prostatic cancer. The Gleason system of histopathologic grading was reliable and reproducible, and afforded an accurate prediction of the surgical stage of disease.

Adenocarcinoma↗
PubMed1979

Complications of Small-Carrion penile prosthesis.

Seventy-six patients with impotence have undergone insertion of the Small-Carrion penile prosthesis at Duke University Medical Center. Twenty patients experienced postoperative complications. Seven of these 20 patients lost one or both prostheses either by spontaneous extrusion or surgical removal. Although success with this procedure is well documented, complications may be significant when they occur and awareness of these problems is essential for proper management. The benefits of this procedure are reviewed, and reported complications and their management are discussed.

Erectile Dysfunction↗
PubMed1979

Traumatic rupture of the female urethra.

The clinical course of 4 female patients with complete traumatic rupture of the urethra was evaluated in an effort to propose guide lines for the investigation and initial management of this unusual injury. Treatment modalities are determined by the level of urethral injury and the subsequent effect on continence. We recommend a retropubic approach for bladder neck injuries, a transvaginal approach for proximal urethral ruptures with reanastomosis over a stenting catheter and acceptance of a hypospadiac neomeatus for distal urethral ruptures.

Adult↗
PubMed1979

Primary non-urachal adenocarcinoma of the bladder.

The clinical course of 34 patients with non-urachal adenocarcinoma of the bladder was reviewed and compared to the world experience. The 5-year survivorship was 19 per cent, with only 1 patient being free of disease. Metaplasia with formation of glandular elements reflects the unstable potential of the transitional cell and may be associated with the biologic aggressiveness of the tumor.

Adenocarcinoma↗