Lymphangiolipomatosis: a new pathological entity.
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Aged↗
Biomedical subjects
B F Blitz
Publications and source records attributed to B F Blitz.
Same day surgery for radical retropubic prostatectomy: is it an attainable goal?
OBJECTIVES: Economic forces are stimulating a re-evaluation of various management strategies. Recent critical pathways for radical prostatectomy have resulted in reduced length of stay to as low as 2.9 days. METHODS: The time in the operating room and recovery room, average blood loss, length of hospitalization, patient charges, and estimated hospital costs were compared for 20 patients undergoing radical prostatectomy up to 1 year before and for 27 men after initiation of a critical pathway. Under the protocol, patients receive an education booklet and preoperative teaching in preparation for early discharge and an epidural for anesthesia. An anonymous questionnaire was mailed to all patients treated by the pathway after catheter removal. RESULTS: The new pathway resulted in a significant reduction in average time in the operating room (3.7 +/- 0.4 hours versus 4.9 +/- 1.2 hours), estimated blood loss (1204 +/- 527 cc versus 1948 +/- 740 cc), and length of hospitalization (1.7 +/- 0.6 days versus 4.6 +/- 1.5 days). In addition, patient charges and hospital costs were reduced by 32% and 35%, respectively. Thirty-seven percent of the study group was discharged after 1 night compared with 0% in the group treated before the pathway was initiated. Forty-one percent of the study group was not transfused and did not donate blood. Outcome surveys completed by 25 of 27 study patients revealed an overall satisfaction of 96% with 0 of 10 patients who were discharged after one night indicating they would have preferred to be hospitalized longer. CONCLUSIONS: Conventional management of men undergoing radical prostatectomy can be safely modified while preserving patient satisfaction without increasing morbidity. Avoiding peripheral narcotics and emphasizing preoperative teaching has enabled us to reduce length of stay greatly, with same day discharge now an attainable goal.
Adult↗
A simple method using hydrophilic guide wires for the difficult urethral catheterization.
A technique is described that enables successful urethral catheterization in difficult cases using a variety of catheter types and sizes. This method utilizes a urethral catheter that is loaded over a hydrophilic guide wire with the aid of an intravenous catheter. The devices utilized are routinely available to the urologist; therefore, the need for obtaining or stocking special equipment is obviated.
Cystoscopy↗
Applicability of Iceland spar as a stone model standard for lithotripsy devices.
The identification of a universal stone model standard would enable reproducible fragmentation data useful for the design, evaluation, and comparison of various lithotripsy devices. The clinical benefits of such a stone model include the elucidation of setting parameters that would optimize fragmentation strategies. Iceland spar is a pure form of calcite (CaCO3) that was subjected to experimental disintegration by electrohydraulic lithotripsy and extracorporeal shockwave lithotripsy. Iceland spar was fragmented with both lithotripsy methods in a reproducible fashion. The degree of fragmentation was directly related to alterations in either power or shock frequency. Iceland spar is radiopaque, inexpensive, easily obtained, homogenous in composition, and sizable. Iceland spar meets a variety of stone model criteria, warranting its continued investigation as a potential stone model standard.
Calcium Carbonate↗
Effect of epidermal growth factor on prostate cancer cell line PC3 growth and invasion.
Elevated levels of epidermal growth factor (EGF) and epidermal growth factor receptor (EGF-R) have been demonstrated in prostate cancer cell lines and clinical specimens suggesting a role for polypeptide growth factors in prostate tumor cell growth and invasion. To more clearly define the role of EGF in prostate cancer invasion, we undertook a series of studies utilizing the PC3 prostate cancer cell line, an aggressive, hormone-independent cell line derived from a metastatic lesion. No statistical differences were noted in the growth of PC3 cells under serum-free conditions when EGF (10(-10) M-10(-8) M) or monoclonal anti-EGF-R antibody (10(-11) M-10(-8) M) were added. Utilizing the Boyden chamber microinvasion assay, EGF supplemented cells demonstrated a statistically significant augmentation in invasion (P < 0.05) when compared to control cells at each time point in the study. With increasing length of exposure to EGF, the number of concentrations that produced significant invasion increased: day 1 (10(-8) M), day 3 (10(-8), 10(-9) M), and day 5 (10(-7), 10(-8), 10(-10) M). Northern blot analysis of EGF supplemented cells revealed an increase in expression of urokinase plasminogen activator (uPA) RNA, a serine protease involved in the regulation of pericellular proteolysis and membrane degradation. Protein analysis confirmed these findings. Statistically significant inhibition of invasion by anti-uPA antibodies was demonstrated for EGF-stimulated and PC3 control cells. Our results demonstrate that certain concentrations of EGF augment invasion in the PC3 cell line. This enhancement of invasion occurs in part by an overproduction of uPA, an extracellular protease. These findings suggest that the autocrine production of EGF may potentiate tumor cell invasion.
Antibodies, Monoclonal↗