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Biomedical subjects

W R Pitts

Publications and source records attributed to W R Pitts.

At least 37 records · Page 2Linked to original sources
PubMed1997

The "open artery hypothesis" in survivors of myocardial infarction.

In survivors of acute myocardial infarction, the restoration of antegrade flow in the infarct-related coronary artery may improve prognosis by a mechanism independent of its effect on left ventricular function. Survival may be enhanced even when restoration of flow is accomplished days or weeks after the acute event. In a series of retrospective studies of survivors of a first myocardial infarction, it was shown that long-term survival is significantly better in those with than in those without antegrade flow in the infarct-related artery. It is hypothesized that late restoration of antegrade flow in the infarct-related artery renders the border zone of the infarction more electrically stable, thereby diminishing the incidence of ventricular tachyarrhythmias and sudden death.

Adult↗
PubMed1992

The dangerous ureter.

Seven patients with recurring transitional cell carcinoma of the urinary bladder were treated with repeated transurethral resections of these tumors and were given adjuvant intravesical chemotherapy or bacillus-Calmette Guerin (BCG) vaccine. Carcinoma either in the ureters or renal pelves subsequently developed in these patients. Unfortunately, 2 patients had inoperable tumors when the diagnosis was confirmed. When treating patients with recurring carcinoma of the urinary bladder, the possibility of upper urinary tract tumors developing must always be considered. Hence, the necessity of frequent urinary and ureteral cytology examinations proceeding to excretory urography, retrograde pyelograms, computerized tomography (CT) scans of the upper tracts, or ureteroscopy as may be necessary to locate small tumors or to diagnose carcinoma in situ.

Aged↗
PubMed1990

Simultaneous pulmonary and renal malignancy.

Simultaneous primary malignancy of the lung and kidney has been rarely recognized during life. Three patients with synchronous primary pulmonary and renal cancer are described. The pulmonary tumors were asymptomatic and were discovered on plain chest roentgenography. The renal tumors, also asymptomatic, were incidentally discovered on CT, performed for staging. Although one patient was treated with interleukin-2 for a presumed solitary pulmonary metastasis from renal carcinoma, in all three patients, both the kidney and lung tumors were eventually removed either concurrently or sequentially. Prior autopsy case series are reviewed. In the elderly, synchronous asymptomatic pulmonary and renal malignancy is not surprising, and it should be approached as a distinct clinical problem. With the use of chest roentgenography for screening high risk populations and CT for staging, simultaneous primary pulmonary and renal malignancy will probably be recognized increasingly.

Adenocarcinoma↗
PubMed1988

Palliation of carcinoma of the rectum and pararectum using the urologic resectoscope.

Palliation of low lying anorectal and pararectal lesions frequently involves a colostomy. Using the urologic resectoscope for transanal resection of these lesions, a colostomy was avoided in 14 of 15 patients. There was good palliation of obstruction, bleeding and pain. The procedure does not require anesthesia, extreme positioning, surgical assistants, new equipment, new techniques or prolonged operative time. In selective instances, transanal resection of low lying anorectal and pararectal lesions offers excellent palliation.

Aged↗
PubMed1987

The natural history of patients less than 40 years old with bladder tumors.

We treated 19 men and 6 women less than 40 years old with bladder tumors. The average patient age at diagnosis was 30.6 years and the mean followup was 65 months. Gross hematuria was present in 84 per cent and excretory urography showed a mass in the bladder in 44 per cent of the patients. Of 8 patients less than 30 years old 6 had papilloma and 2 had grade II to III, stage O transitional cell carcinoma. All patients with papillomas were free of disease. The pathological reports of the patients more than 30 years old revealed papilloma or grade I, stage O transitional cell carcinoma in 9, grade II to III, stage O to A papillary transitional cell carcinoma in 6 and invasive disease in 2, 1 of whom died. Of the 9 patients with papilloma or grade I, stage O disease 77 per cent are currently free of disease. Of those with grade II to III, stage O to B papillary transitional cell carcinoma only 1 is free of disease, while 6 have had resectable recurrences. One patient with grade II to III disease was lost to followup. Accordingly, all patients, regardless of age, should be treated as aggressively as necessary on the basis of the stage and grade of the tumor.

Adolescent↗
PubMed1986

Extragonadal retroperitoneal germ cell tumors without apparent testicular involvement. A search for the source.

Extratesticular germ cell neoplasms without apparent testicular primary tumors are rare. The origin of these neoplasms has been debated in the literature for decades. With the advent of effective chemotherapy for extratesticular germ cell neoplasms, the origin of these tumors becomes more than academic. We report on 3 cases of retroperitoneal germ cell neoplasms with microscopic intratesticular primary tumors. All patients with extragonadal germinal cell tumors of the testes should undergo thorough investigation for an occult testicular primary tumor despite a normal testis examination. We review previously reported cases of extratesticular germ cell neoplasms without an apparent testicular primary tumor.

Adult↗
PubMed1981

Normal pregnancy and delivery after ileal conduit urinary diversion.

Lower urinary tract diversion via an ileal conduit is not a contraindication to pregnancy and subsequent normal spontaneous vaginal delivery. This is true regardless of the etiology of underlying urologic dysfunction as long as maternal renal function and general health remain stable and obstetrical considerations of the underlying congenital abnormality of the patient do not preclude conception and delivery.

Female↗
PubMed1980

Ultrasonography, computerized transaxial tomography and pathology of angiomyolipoma of the kidney: solution to a diagnostic dilemma.

The review of 9 anatomically proved cases of angiomyolipomas of the kidney has revealed characteristic findings of marked echoes on ultrasonography and areas of fat attenuation on computerized transaxial tomography. These 2 findings should resolve the diagnostic dilemma in this benign lesion and prevent the need for operation intervention in most cases.

Adult↗