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Biomedical subjects

T J Rohner

Publications and source records attributed to T J Rohner.

At least 37 records · Page 2Linked to original sources
PubMed1986

Adrenal cortical carcinoma: case report.

Adrenal cortical carcinoma is a rare malignant tumor, comprising only 0.02 to 0.04% of all cancers [Nader et al, Cancer 52: 707-11, 1983; Didolkar et al, Cancer 47: 2153-61, 1981; Hajjar et al, Cancer 35: 549-54, 1975]. The mean age of presentation for females is 36.6 years and for males, 48 years. In general, women have a higher percentage of functioning adrenal tumors. Functional tumors are hormonally active with excess steroid production in serum and urine with associated clinical signs and symptoms.

Adrenal Cortex Neoplasms↗
PubMed1986

Metastatic seminoma with regression of testicular primary: ultrasonographic detection.

We report a case of seminoma of the testis metastatic to the retroperitoneum. Biopsy of the retroperitoneal mass revealed anaplastic seminoma. No testicular mass could be palpated. Testicular ultrasonography showed a hypoechoic 3 X 2 cm. area in the left testis suggestive of a primary testicular tumor, most likely a seminoma. Histological evaluation of the resected testis revealed fibrous tissue but no definable tumor.

Adult↗
PubMed1986

Androgen priming and response to chemotherapy in advanced prostatic cancer.

A total of 67 patients with progressive stage D2 prostatic cancer refractory to orchiectomy was entered in a controlled clinical trial to test whether androgen priming enhances the efficacy of cytotoxic drugs. All patients were treated continuously with aminoglutethimide and hydrocortisone to lower adrenal androgen secretion and were given cyclic intravenous chemotherapy. In addition, the 34 patients randomized to the stimulation arm received fluoxymesterone for 3 days before and on the day of chemotherapy. There was 33 controls. The median duration of followup was 24 months. A modestly higher response rate (objective remission plus disease stabilization) was observed in the stimulation arm (85 versus 72 per cent, p less than 0.05) when the analysis was restricted to the evaluable patients. However, a larger fraction of unevaluable patients was present in the stimulation group (41 versus 16 per cent), mostly as a result of toxicity from fluoxymesterone, which prompted early discontinuation of treatment. Thus, when data analysis included all patients the response rate actually was slightly higher in the control than in the stimulation arm (60 versus 50 per cent, p not significant). No difference was observed in median duration of response (9 months in both groups) or over-all survival. Our data suggest that at least in those patients with advanced disease androgen priming does not seem to enhance significantly the antitumor effect of the combination of amino-glutethimide and chemotherapy, and is associated with significant toxicity. These largely negative results may be explained by the large number of hormone-resistant cells present in tumors that have become refractory to orchiectomy.

Aged↗
PubMed1984

Clinical effect of aminoglutethimide, medical adrenalectomy, in treatment of 43 patients with advanced prostatic carcinoma.

The initial treatment of patients with Stage D prostatic carcinoma with orchiectomy or estrogens is successful in giving objective and subjective improvement for variable periods of time. However, after initial endocrine treatment patients generally relapse, and go on to further progression of their disease. However, a subgroup of approximately 22% of these Stage D prostatic cancer patients respond to either surgical adrenalectomy or hypophysectomy, indicating some degree of continued hormonal responsiveness. Forty-three previously castrated patients with Stage D prostatic carcinoma were treated with 1000 mg of aminoglutethimide and 40 mg of hydrocortisone daily and have been evaluated using the criteria of the National Prostatic Cancer Project. Progression of disease after initial hormonal therapy has varied from 3 to 25 months. One patient has had a complete response, and continues in remission after 290 weeks of therapy. Partial objective responses have been observed in 6 patients, and 10 patients have remained objectively stable for an average of 35 weeks in this latter group.

Adenocarcinoma↗
PubMed1983

Cystectomy and urinary diversion: a safe procedure for elderly patients.

Cystectomy and urinary diversion have been done on 28 patients more than age seventy with a zero perioperative mortality. Nine female patients with an average age of 77.6 years and 19 male patients with an average age of 74.4 years with 3 patients being greater than age eighty, are the subject of this review. Complication rate, blood loss, and hospital stay were not significantly different from patients having cystectomy and urinary diversion who were seventy years of age or less. Twenty-seven of the 28 patients had muscle-invading tumors; 12 patients are alive with a median survival of greater than thirty months. Five of 10 patients who did not receive radiation therapy are alive; 7 of 18 patients who received some form of radiation therapy are alive. Six patients had been treated initially with 7,000 rad for definitive therapy of bladder carcinomas. In carefully selected patients, when appropriate attention is paid to general patient status, cardiovascular system, pulmonary function, and fluid and electrolyte status, cystectomy and diversion can be completed with an acceptable rate of morbidity.

Aged↗
PubMed1983

Bladder cancer: results of radical cystectomy for invasive and recurrent superficial tumors.

The operative management of bladder carcinoma was reviewed retrospectively in 76 patients: 57 had muscle invasion and 19 had rapidly recurring or extensive superficial tumors requiring aggressive therapy. Of the patients 9 had been managed initially elsewhere with radiation treatment for cure and underwent salvage cystectomy at our institution. The results are discussed comparing patients receiving no radiation (11 of 20 alive) and 4,000 rad given preoperatively (11 of 20 alive), and patients with no muscle invasion but recurrent or extensive superficial tumors (14 of 19 alive).

Aged↗
PubMed1983

Clinical and biochemical effect of aminoglutethimide in the treatment of advanced prostatic carcinoma.

Treatment of male patients with advanced prostatic carcinoma and disease progression after initial endocrine therapy frequently is unsatisfactory. However, approximately 20 per cent of these patients respond to surgical adrenalectomy or hypophysectomy, indicating continued hormonal responsiveness. A total of 25 previously castrated men with stage D carcinoma received 1,000 mg. aminoglutethimide and 40 mg. hydrocortisone daily. The patients were evaluated using the criteria of the National Prostatic Cancer Project. One patient has had a complete response and is in remission after 275 weeks of therapy. A partial response was noted in 4 patients, while the disease was objectively stable in 6. Pre-treatment testosterone and dihydrotestosterone levels were measured in 9 of 25 patients and were significantly reduced statistically during aminoglutethimide therapy (p less than 0.01). Response and drug toxicity are discussed.

Adenocarcinoma↗
PubMed1980

Fungal cystitis: awareness, diagnosis and treatment.

We report 4 cases of fungal cystitis. All patients had severe urgency, frequency and nocturia with sterile pyuria and microhematuria. Significant fungal growth was observed on routine blood agar cultur. Bladder biopsy was necessary to rule out tumor. Of the patients none responded to watchful waiting, 1 responded to intermittent daily bladder instillation of amphortericin B, 2 improved with oral 5-fluorocytosine, in addition to amphotericin B bladder instillations, and 1 required intravenous amphotericin B after unsuccessful response to 5-fluorocytosine and amphotericin B bladder treatments.

Amphotericin B↗
PubMed1980

Complications of the non-refluxing colon conduit.

The non-refluxing colon conduit has been offered as a superior alternative to the ileal conduit for long-term supravesical urinary diversion. The main advantage would seem to be that the upper tracts can be protected by the formation of a ureterocolic anastomosis without reflux, thereby preventing the deterioration associated with ileal conduits, which is presumably secondary to reflux and ascending infection. Although a colon operation is potentially more hazardous than a small bowel operation the short-term complication rates are not significantly different. We report 2 cases of stenosis of the ureterocolic anastomosis to emphasize that this serious complication continues to be a potential problem with any procedure of this type. With long-term followup its present incidence in 8 to 10 per cent of the patients may exceed the incidence of conduits with reflux. In our 2 cases severe stenosis of the ureter within the tunnel was encountered at reoperation. Techniques that may help prevent stenosis include preservation of periureteral adventitia, careful formation and closure of the submucosal tunnel, forming an anastomosis free of tension and tapering the ureters, when necessary, adequately but not excessively. Correction of this complication may require lysis of surrounding adhesions, a ureterocolic anastomosis with reflux, transureteroureterostomy, transureteropyelostomy, replacement of the ureter with small bowel or nephroureterectomy.

Adolescent↗
PubMed1980

Effect of norepinephrine and isoproterenol on in vitro detrusor muscle contractility and cyclic AMP content.

Norepinephrine, isoproterenol, and the phosphodiesterase inhibitor, theophylline, caused relaxation of in vitro dog detrusor strips associated with significant increases in detrusor cyclic AMP content. Bethanechol-induced detrusor contractions and alpha-adrenergic detrusor contractile responses to norepinephrine after propranolol were not associated with changes in cyclic AMP. Cyclic nucleotide metabolic pathways exist in detrusor muscle and offer another investigative approach to bladder dysfunction.

Animals↗
PubMed1978

Altered in vitro adrenergic responses of dog detrusor msucle after chronic bladder outlet obstruction.

Muscle strips from the bladder body and dome of normal and control dogs usually demonstrate a relaxing (beta-adrenergic) response to norepinephrine. After bladder outlet obstruction was caused by urethral constriction, all body muscle strips from 7 of 12 dogs (58 per cent) demonstrated contractile (alpha-adrenergic) responses to norepinephrine. Bladder base muscle strips continued to show alpha-adrenergic responses. Desensitization or decreased beta-adrenergic receptor activity may play a part in causing the low compliance and detrusor instability seen in patients with bladder outlet obstruction.

Animals↗