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Biomedical subjects

V A Politano

Publications and source records attributed to V A Politano.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Clinical experience of tapered distal ileum for construction of a continent colonic urinary reservoir].

Construction of continent colonic urinary reservoir was performed in 44 patients after exenteration for invasive bladder carcinoma or various gynecologic tumors. The distal ileum was tapered over a 14 French red rubber catheter. The ileocecal valve was reinforced with three circumferential silk sutures in a purse-string fashion. Full continence was obtained in all patients (100%). A non-tunneled, non-refluxing ureterocolonic anastomosis was performed in all 88 ureters. No obstruction or reflux was observed in 84 ureters (95%). There were 7 early postoperative complications and 3 of them required reoperation (pelvic abscess 1, urinary leak from ureterocolonic anastomosis 1, pouch-vaginal fistula 1). Moreover, there were 7 late complications and 3 of them required reoperation (stomal stenosis 1, parastomal hernia 2). These results suggest that this method is a safe, simple and useful one for permanent urinary diversion.

Abscess↗
PubMed1988

Periurethral polytetrafluoroethylene injection following urethral reconstruction in female patients with urinary incontinence.

We present our results with periurethral polytetrafluoroethylene (Polytef) injection after urethral reconstruction in 20 female patients with urinary incontinence. These patients have failed previous urethral reconstructive procedures to cure incontinence, including Young-Dees-Leadbetter bladder neck reconstruction, transvaginal urethroplasty, transvaginal urethral plication and vesical flap urethroplasty. Of the patients 4 also underwent a bladder augmentation procedure. After polytetrafluorethylene injection 10 patients (50 per cent) were cured of the incontinence, 2 (10 per cent) had marked improvement from the preoperative condition, 5 (25 per cent) had definite improvement but still wear pads for protection and 3 (15 per cent) had no change from the preoperative condition. Bladder pressure recordings did not demonstrate a difference in results among patients with detrusor stability or instability. Periurethral polytetrafluoroethylene injection remains a valuable procedure in the management of persistent incontinence after bladder neck and urethral reconstruction.

Adult↗
PubMed1988

Stapled and nonstapled tapered distal ileum for construction of a continent colonic urinary reservoir.

A continent colonic urinary reservoir was created in 10 patients who had undergone anterior exenteration for invasive bladder carcinoma. A tapered distal ileal segment with a catheterizable abdominal stoma provided full continence in all 10 patients. Tapering of the terminal ileum was achieved with a gastrointestinal anastomosis stapler in 5 patients or with a bowel clamp in 5 others. Three purse-string sutures of 2-zero silk were placed on the tapered ileal segment to increase the intraluminal pressure. A nontunneled ureterocolonic anastomosis was performed in all 20 ureters. No obstruction or reflux was noted in 19 ureters (95 per cent). Hydronephrosis at the anastomotic site was noted in 1 ureter and was successfully dilated percutaneously.

Adult↗
PubMed1986

Centrifugal cytology: a new technique for urine cytology.

A new technique, centrifugal cytology, appears to have a high recovery rate of malignant cells from voided urine specimens resulting in a high probability of early disease detection and should be considered a good supplement to cytoscopic evaluation of high-risk populations.

Centrifugation↗
PubMed1986

Female urinary incontinence: preoperative selection, surgical complications and results.

A total of 98 women with stress urinary incontinence underwent surgical repair via 3 different techniques: 38 patients underwent a Burch colposuspension (group 1), 25 underwent a Stamey procedure (group 2) and 35 had a modified Pereyra operation (group 3). The main indication for an operation was clinically unacceptable incontinence, and urodynamic studies were done on all patients with associated stress and urge incontinence or who underwent reoperation. Subtracted bladder pressure recording was an important preoperative screening tool, since patients with high pressure instability did worse surgically than those with a stable bladder or low pressure instability. In patients with detrusor stability similar results were achieved for initial surgery and reoperations. Among the patients with a stable bladder with and without a previous anti-incontinence operation the over-all results were better in groups 1 and 3 than in group 2. Complications were of lesser magnitude in groups 2 and 3 than in group 1.

Adult↗
PubMed1986

Sphincterotomy failure in neurogenic bladder disease.

Among 60 spinal cord injury patients who underwent external urethral sphincterotomy 45 experienced success and 15 failed. Failure was established when symptomatic urinary tract infections and high vesical residuals persisted. Urodynamic findings demonstrated detrusor areflexia in 10 patients (66 per cent), detrusor-sphincter dyssynergia in 2 (13.2 per cent), detrusor hyperreflexia with unsustained bladder contractions in 1 (6.6 per cent), and detrusor hyperreflexia and bladder neck obstruction in 2 (13.2 per cent). Among these failures poor detrusor contractility predominated. Detrusor-sphincter dyssynergia may indicate an inadequate surgical relief of obstruction. Bladder neck obstruction may indicate that a bladder neck incision should be considered when an external sphincterotomy is performed.

Adult↗
PubMed1986

Augmentation cystoplasty in the management of neurogenic bladder disease and urinary incontinence.

Vesical augmentation procedures were performed on 15 patients for neurogenic bladder disease and urinary incontinence. Enterocystoplasty with ileum, cecum and sigmoid was used associated with different operations to prevent upper tract deterioration or urinary incontinence. The small bowel stored larger amounts of urine at a lower maximal detrusor pressure at capacity than the large bowel. All ureterointestinal and ureterovesical reimplantations were successful, including 5 ureteroileal with the Camey procedure. The 2 failures, characterized by persistent urinary incontinence, included a male patient who refused intermittent catheterization and a girl with persistent hypersecretion of mucus and recurrent urinary tract infections.

Adolescent↗
PubMed1985

Control of growth, morphology, and alkaline phosphatase activity by butyrate and related short-chain fatty acids in the retinoid-responsive 9-1C rat prostatic adenocarcinoma cell.

The actions of butyrate and related short-chain fatty acids were analyzed on the 9-1C retinoid-responsive rat prostatic adenocarcinoma cell. The 9-1C cells, which are inducible for alkaline phosphatase (AP) by retinoic acid, were also inducible for the enzyme by three- to six-carbon fatty acids. The most effective inducer was the four-carbon acid, butyrate, which caused an essentially linear increase in AP activity in the concentration range of 2 to 10 mM. A comparison of AP induction by butyrate and retinoic acid showed the retinoid to be a more potent inducer of the enzyme by several orders of magnitude. Butyrate and related short-chain fatty acids also suppressed 9-1C cell growth, an effect which is not mediated by retinoic acid in these cells. Total growth suppression was achieved at butyrate concentrations of 5 mM and above; 1.5 mM caused 50% inhibition. As in the case of AP induction, all three- to six-carbon fatty acids suppressed growth to some extent, although butyrate was the most effective. The order of carbon chain length effectiveness for both AP induction and growth suppression by the fatty acids was 4 greater than 5 greater than 3 greater than 6. Butyrate appeared to be unique among the various fatty acids in causing an increase in cell protein. The protein content of 9-1C cells cultured in the presence of 4 mM butyrate for 72 h was more than 4-fold greater than that of control cells. This observation paralleled observations on cell volumes analyzed by forward-angle light-scatter flow cytometry, which showed a concentration-related increase in the cross-sectional areas of 9-1C cells following butyrate treatment. This effect has also been shown, in a recent study, to be mediated by retinoids. One of the most striking effects of butyrate treatment was on cellular morphology. The fatty acid caused 9-1C cells, which normally grow in a disorganized array with no apparent affinity for each other, to spread out and become organized into parallel tracts through the monolayer.

Adenocarcinoma↗
PubMed1984

Significance of asymptomatic bacteriuria in neurogenic bladder disease.

Whether or not to treat bacteriuria (greater than or equal to 100,000 col/cc) in the asymptomatic patient has long been controversial. Fifty-two patients with uncomplicated neurogenic bladder disease secondary to spinal cord injury and bacteriuria were followed throughout their hospitalization. Antibiotics were reserved only for symptomatic patients. Our results indicate the value of no treatment for chronic bacteriuria as an alternative to chronic suppressive therapy.

Adolescent↗
PubMed1984

Transurethral polytetrafluoroethylene injection for post-prostatectomy urinary incontinence.

Transurethral polytetrafluoroethylene (Teflon) injections were performed on 69 men with incontinence following prostatectomy. The etiology of incontinence was transurethral resection of the prostate in 27 patients (group 1), open prostatectomy in 15 (group 2) and radical prostatectomy in 27 (group 3). All patients had been incontinent for more than 1 year and had failed to improve with conservative management. Cure or improvement occurred in 85.1 per cent of the patients in group 1, 79.9 per cent in group 2 and 48.1 per cent in group 3. Reasons for failure included severe bladder instability, severe periurethral fibrosis and leakage of paste. Clinically significant particle migration was not observed.

Aged↗
PubMed1984

The management of spermatic cord liposarcomas.

We review 3 cases of spermatic cord liposarcoma that have been followed for 12 months to 5 years after diagnosis. Inguinal orchiectomy rendered adequate treatment. Preoperative diagnosis of liposarcoma of the spermatic cord is unusual although gray scale sonography may be of some assistance. A review of the literature reveals that adjunctive medical or surgical treatment appears to be superfluous.

Adult↗
PubMed1984

Periurethral polytetrafluoroethylene injections in incontinent female subjects with neurogenic bladder disease.

Urinary incontinence in female subjects with bladder instability secondary to neurogenic bladder disease is difficult to manage. Many times pharmacologic manipulation and the standard anti-incontinence surgical procedures are unsuccessful. We have found that the urethral occlusive technique using polytetrafluoroethylene (Teflon) paste is highly effective in maintaining continence. We describe 6 patients who achieved complete urinary control and empty the bladder with the use of intermittent catheterization. All of the patients are extremely satisfied with the end results of urinary continence and have accepted self-catheterization well.

Adult↗
PubMed1983

Management of massively refluxing megaureters.

We report on 15 patients with massively refluxing megaureters in 28 renoureteral units. All had a history of urinary tract infections, and 14 were treated with initial vesical drainage. All had ureteral reimplantation, and half of those who initially underwent diversion did not require tailoring. Overall success was 87 per cent.

Child↗
PubMed1983

Postmenopausal vesical endometriosis.

Vesical endometriosis in a postmenopausal patient is reported. An abdominal hysterectomy had been performed twenty-four years previously, and exogenous estrogens had not been administered. The patient was treated surgically with a partial cystectomy.

Endometriosis↗
PubMed1983

Prostatic recurrences in the management of superficial bladder tumors.

Mitomycin C has proved to be useful as prophylaxis against superficial bladder tumor recurrences. However, there is a significant incidence of prostatic urethral recurrences. Careful followup with urine cytology and cystoscopy, and bladder and prostatic urethral biopsies should be done at regular intervals.

Adult↗
PubMed1983

Fibrosarcoma of the penis: case report and review of the literature.

We report a case of fibrosarcoma of the penis and review the literature. We believe that amputation is the most effective therapy and the role of lymphadenectomy is equivocal. All cases should be reported to better define the roles of various oncologic modalities of therapy.

Aged↗
PubMed1983

Effect of retinoic acid on the growth and morphology of a prostatic adenocarcinoma cell line cloned for the retinoid inducibility of alkaline phosphatase.

Cells derived from the G-subline of the Dunning R-3327 rat prostatic adenocarcinoma were selected on the basis of their inducibility for alkaline phosphatase (AP) activity by retinoic acid. A p-nitrophenylphosphate-agarose overlay procedure was used to identify AP-inducible clones. The frequency of AP-inducible cells in one rapidly growing tumorigenic clone, designated 9-1C, has remained at 100% during at least 4 months of continuous culture. In culture, 9-1C cells had a mean population-doubling time in log phase of 14 hr. Retinoic acid (10 microM) did not significantly affect the rate of growth in log phase. It did, however, cause the cultures to saturate at a cell density which was 40% lower than that of control cultures. This effect on saturation density was reversible within 24 hr after removing retinoic acid from the medium. Retinoic acid-treated cells occupied greater areas on the culture dish surface, and the cross-sectional area of these cells, measured on dispersed cells by light-scatter flow cytometry, was 35 to 40% greater than that of control cells. The inducibility of 9-1C cells for AP activity decreased as the culture density increased. Cells of the 9-1C clone produced tumors when injected into male and female Fischer X Copenhagen F1 rats. No histological differences were detected between tumors grown in male and female rats. Although the tumors were poorly differentiated, primitive acinar-like structures were observed. Cells staining uniformly positive for AP activity were distributed randomly throughout the tumors. In the acinar-like structures, AP activity was localized only on the apical surfaces of the cells lining the lumens. This was also the site of enzyme activity in acini of the lateral component of the dorsolateral prostate, the source of the original R-3327 tumor. In the lateral prostatic component, AP activity was also found in the basal region of the acini, and the secretory material filling the lumens was strongly positive for the enzyme. These two regions of the tumor acini were negative for AP activity. With the exception of activity in capillaries at the basal surface, the acini of the dorsal component of the dorsolateral prostate were devoid of AP activity.

Adenocarcinoma↗