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Biomedical subjects

W K Mebust

Publications and source records attributed to W K Mebust.

At least 37 records · Page 2Linked to original sources
PubMed1990

Testicular neoplasms: seminoma.

From 1969 to 1984, 58 patients with a diagnosis of testicular seminoma were seen and treated at the University of Kansas Medical Center. The median age was 34 years (range of 20 to 62 years). The American Joint Committee on Cancer Staging System was followed: stage I (34 patients); stage II (6); stage III (8); and stage IV (10). Forty-two patients had typical seminoma, and 16 had anaplastic histology. Nine patients had elevated B subunit of human chorionic gonadotropin, and nine had a history of cryptorchidism. Fifty-six patients received radiation treatment, and seven received chemotherapy with or without radiation. The median follow-up was 7 years (range 3 to 16 years). The overall disease-free (absolute) survival according to stage was: stage I, 91% (100%); stage II, 66% (80%); stage III, 75% (85%); and stage IV, 50% (50%). There were no late complications. The survival for patients with anaplastic histology or with elevated B subunit of human chorionic gonadotropin was not significantly different from that of typical seminoma.

Adult↗
PubMed1990

Transurethral prostatectomy.

Transurethral prostatectomy is one of the most common operations today. In the United States, more than 90 per cent of patients with bladder outlet obstruction from BPH have their surgery done transurethrally. The operation is associated with a very low mortality rate, and the immediate postoperative results are excellent. The long-term results also appear to be satisfactory according to chart review data. However, insurance claims data suggest higher later mortality and reoperation rates than have been reported previously. Further studies, such as a randomized trial, will be necessary to evaluate the long-term outcome of transurethral prostatectomy further.

Humans↗
PubMed1989

Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients.

The mortality rate for transurethral prostatectomy was 0.2 per cent in 3,885 patients reviewed retrospectively. The immediate postoperative morbidity rate was 18 per cent. Increased morbidity was found in patients with a resection time of more than 90 minutes, gland size of more than 45 gm., acute urinary retention and patient age greater than 80 years, and in the black population. Of the patients 77 per cent had significant pre-existing medical problems. Operative mortality, significant morbidity and hospital stay were reduced in comparison to studies done 15 and 30 years ago.

Age Factors↗
PubMed1989

Transurethral prostatectomy: practice aspects of the dominant operation in American urology.

In a national survey of all American urologists transurethral prostatectomy accounted for 38 per cent of the major surgical procedures performed by the respondents. They regarded the operation as complex and they believe achievement of proficiency requires that more be performed during residency training than any other urological operation. Furthermore, they assigned transurethral prostatectomy a significantly higher relative value than have medical economists doing research in the field of physician reimbursement. The effect of recent legislated congressional reductions in the allowable Medicare fees for transurethral prostatectomy is discussed along with the impact of these reductions on urological patient care and the American urologist. Practice patterns and geographic variations in the costs of transurethral prostatectomy also are considered.

Adult↗
PubMed1988

Surgical management of benign prostatic obstruction.

The incidence of transurethral resection of the prostate (TURP) and indications for prostatectomy are compared among earlier studies with the preliminary results of a recent national cooperative study of 3,885 patients undergoing transurethral prostatectomies at thirteen health centers in the United States. Clinical evidence indicates that TURP continues to be a successful procedure, with 97 percent of patients doing well in the first four months postoperatively in the most recent study. Although the incidence of TURP-related morbidity has been relatively consistent among three large-scale studies conducted during the past three decades, mortality has steadily declined from 2.5 percent to 0.2 percent.

Follow-Up Studies↗
PubMed1986

Papaverine-induced priapism: 2 case reports.

Intracorporeal papaverine injection therapy for impotence has been reported recently as a therapeutic option with low morbidity. We report 2 cases of papaverine-induced priapism that required surgical intervention.

Adult↗
PubMed1985

Treatment of renal cell carcinoma with renal infarction, delayed nephrectomy, medroxyprogesterone, and xenogeneic immune RNA.

The authors have used xenogeneic immune ribonucleic acid (RNA) in the treatment of patients with renal cell carcinoma. This has been used in conjunction with renal artery embolization, delayed nephrectomy, and progestational therapy, using immune RNA derived from sheep cell lymphocytes immunized with patient's tumor. Four of 5 patients with Stage I disease had extremely large primary tumors. This group is alive with no evidence of disease at twelve to twenty-four months. There are no Stage II tumors in this group. One patient with Stage III tumor is alive at twenty-two months without evidence of disease. Three patients with metastases are stable at five to twenty-two months. Two patients have progressive disease at three and six months. This treatment has not been effective in patients with massive tumor burden. The results in the other groups are encouraging.

Carcinoma, Renal Cell↗
PubMed1985

A comparison of end versus loop stomas for ileal conduit urinary diversion.

We compared the loop and end stoma techniques for ileal conduit urinary diversion in 54 and 27 adults, respectively, with serious bladder disease during a 3-year interval. Followup by trained enterostomal therapists averaged nearly 2 years for all patients. Stenosis occurred in 12 end stomas (44 per cent) but not in any loop stomas. We believe that this result reflects the inherently better blood supply of the loop stoma, which we recommend over the end ileostomy for patients undergoing ileal diversion.

Adult↗
PubMed1985

In vitro peripheral monocyte culture: possible use as a prognostic indicator for renal cell carcinoma patients.

An in vitro assay was applied to follow 39 patients with renal cell carcinoma. A mononuclear cell-rich fraction was cultured from peripheral blood of patients over a period of 7 days. The number of adherent matured monocytes (macrophages) was analyzed and quantitated at the end of the culture period. Functional activities were analyzed by antibody-coated sheep red blood cells and nonspecific esterase staining techniques. Macrophage yield in patients with detectable tumor burden was 2.06 +/- 2.81 X 10(4) cells/ml blood, and mean values at 3, 6, and 9 months post nephrectomy were 3.67 (n = 21), 6.73 (n = 12), and 9.41 (n = 10) X 10(4) cells/ml blood, respectively. Some of the patients were followed over 30 months. The improvement was significant, and macrophage yield was close to normal values (8.24 +/- 3.14 X 10(4) cells/ml). In the absence of other reliable in vitro assays for these patients, this assay appears to be highly useful in following these patients during the postsurgical period.

Capillaries↗
PubMed1984

Inferior vena caval replacement after resection of left renal tumor in canine model.

An animal model simulating the necessity of replacing the inferior vena cava (IVC) with a prosthetic graft is described. Six dogs underwent replacement of the IVC with an expanded polytetrafluoroethylene (E-PTFE) graft using an interrupted-suture technique. Three dogs served as controls, undergoing resection and autograft of the native IVC. Distal side-to-side femoral arteriovenous fistulas were constructed in each case and allowed to remain for six weeks. Subcutaneous heparin and prophylactic antibiotics were administered in the early postoperative period. All grafts were patent at six months, indicating a potentially successful technique for reconstruction of the IVC involved in disease or trauma.

Animals↗
PubMed1984

Renal cell carcinoma--angioinfarction.

In our experience the mortality rate in 46 patients who underwent angioinfarction for renal cell carcinoma was 4 per cent. Fever, ileus and leukocytosis were noted in 86 to 90 per cent of our patients. The use of absolute ethanol as a medium for renal infarction was associated with a significant incidence of damage to other organs. A 30 per cent decrease in tumor volume following angioinfarction using absorbable gelatin sponge and Gianturco coils was noted in 75 per cent of the patients. There was no evidence of metastatic tumor reduction and we could not document any significant decrease in operative time or blood loss. It would appear that there is some increased survival rate in patients with metastasis who are given adjuvant immune ribonucleic acid therapy. However, the numbers in our series are not significant to draw any definite conclusion. It is apparent that patients treated with infarction, delayed nephrectomy and medroxyprogesterone acetate did not have any significant survival over those treated with palliative nephrectomy or chemotherapy. The macrophage maturation assay may be useful during clinical followup.

Adenocarcinoma↗
PubMed1984

Incidence of lymph node involvement in localized carcinoma of the prostate.

Bilateral pelvic lymphadenectomy was performed in 100 patients as a staging procedure. Sixty-one patients received iodine 125 radioisotope implant and 39 patients received external radiation therapy. The overall incidence of lymph node metastases was 27 percent. The incidence of lymph node involvement was 14 percent with clinical stage A2 disease, 3 percent with stage B1, 44 percent with stage B2, and 40 percent with stage C disease. The grade of the tumor influenced the incidence of lymph node metastases. Only 6 percent of grade I tumors had lymph node metastases, whereas 26 percent of grade II tumors and 71 percent of grade III tumors showed lymph node metastases.

Adenocarcinoma↗
PubMed1983

Immune RNA therapy as an effective adjuvant immunotherapy after surgery: an animal model.

Transfer of tumor immunity as adjuvant cancer therapy has been a topic of intense interest. We have examined the efficacy of various combinations of surgery, xenogeneic immune RNA, xenogeneic normal RNA, tumor vaccine, and nonspecific splenocytes as adjuvant therapy for B16 melanoma in the C57BL/6J mouse system. B16 melanoma was transplanted by trocar into the right hind limb of 6-week-old mice. The tumors were readily palpable on the ninth day posttransplantation. The tumors were amputated at that time under mild anesthesia. Immune RNA was prepared by hot phenol extraction from immune sheep spleens. Various combinations of immune RNA, normal RNA, and tumor antigen, with or without normal mouse spleen cells, were administered every other day for a total of 10 injections. The survival and mode of death was followed up to 120 days. All mice without any treatment died within 30 days. Immunotherapy had no effect on the survival of mice that did not have surgical therapy. Individual group comparisons between mice that underwent surgery only and mice that had surgery plus immune RNA immunotherapy revealed a striking statistical improvement (P less than 0.01). Comparing all groups that received amputation plus various combinations of adjuvant immunotherapy showed no statistical difference in survival. However, immune RNA appears somewhat superior to normal RNA or antigen only. It appears that adjuvant immune RNA immunotherapy following surgical excision in the B16 melanoma model significantly improves survival and retards the spread of metastases.

Adjuvants, Immunologic↗
PubMed1983

Culture of peripheral monocytes in vitro in patients with renal cell carcinoma: a possible prognostic indicator.

An in vitro assay has been applied in 23 patients with renal cell carcinoma. A mononuclear cell-rich fraction was cultured from peripheral blood of patients with renal cell carcinoma. The number of monocytes maturing into macrophages was quantitated over a period of 7 days. Monocyte maturation was significantly lower in patients with renal cell carcinoma than in normal individuals. Of 10 patients tested both pre- and post-nephrectomy, 8 patients showed clinical improvement after surgery. In all 8, the posttreatment macrophage yield improved significantly from the pretreatment values to approach normal values. In 2 patients found to have metastasis postoperatively, the macrophage yield continued below normal levels. Our results suggest that the in vitro maturation of macrophages from mononuclear cells may parallel clinical events.

Adenocarcinoma↗