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Biomedical subjects

C C Carson

Publications and source records attributed to C C Carson.

At least 19 recordsLinked to original sources
PubMed1992

The effect of isolated high-energy shock wave treatments on subsequent bacterial growth.

To determine whether high-energy shock waves possess bactericidal potential, ATCC strains of Escherichia coli, Streptococcus faecalis, Pseudomonas aeruginosa and Staphylococcus aureus were suspended in solution at concentrations approximating 10(6) bacteria per milliliter, placed in polypropylene cryovials, and immersed in the water bath of a Dornier HM3 lithotriptor. Each cryovial was then fluoroscopically guided to the epicenter of the f2 focal point and 2000 shocks at 20 kV applied. Suspensions were then serially diluted and colony counts obtained. The procedure was then repeated with 4000 shocks at 20 kV from the Dornier HM3 and 4000 shocks at intensity level 4 from a Wolff Piezolith 2200 shock wave lithotriptor. Comparison of shock-wave-treated and sham-treated bacterial suspensions revealed no significant difference in bacterial growth according to the colony count technique. We conclude that high-energy shock waves, whether generated by spark gap or piezoelectric array, do not possess significant bactericidal activity.

Enterococcus faecalis↗
PubMed1992

Endoureteropyelotomy in adults. Review of procedure and results.

We report on 17 adult patients who underwent antegrade endoureteropyelotomy for primary (7) and secondary (10) ureteropelvic junction obstruction. Complications were limited to failure to relieve the obstruction, which occurred in 2 patients (12%) requiring a subsequent open pyeloplasty. The two failures were due to high insertion of the ureter in one, and lower renal pole vessel in the other case. A new endoureteropyelotomy stent was developed to enhance healing and patient comfort. No failures occurred due to technical difficulties.

Adolescent↗
PubMed1992

Penile metastasis secondary to supraglottic squamous cell carcinoma: review of the literature.

We report an unusual supraglottic carcinoma metastasis to the penis. Review of the literature revealed more than 300 cases of metastatic lesions to the penis, excluding primary neoplasms from skin, urethra and blood. Of these metastatic neoplasms 16 originated above the diaphragm, only 4 of which were from the head and neck region. The most common neoplastic metastases to the penis in order of frequency were from the bladder, prostate, rectum and rectosigmoid areas, and kidney in 32, 30, 13 and 8% of the cases, respectively. The incidence of other primary tumor sites that metastasize to the penis is extremely rare.

Carcinoma, Squamous Cell↗
PubMed1991

Inflatable penile prosthesis: effect of device modification on functional longevity.

The Scott inflatable penile prosthesis has undergone a continual evolution since its introduction in 1973. A review of 266 patients at Duke University Medical Center who received primary implantation of AMS inflatable penile prostheses from 1979 to 1988 revealed the modifications in the prosthesis have increased the functional longevity and hence the reliability of this surgical treatment for erectile impotence.

Erectile Dysfunction↗
PubMed1991

Pharmacologically induced erections among geriatric men.

Intracavernous injection of vasoactive drugs for the treatment of erectile impotence has become a standard therapeutic technique. Previous reports detailing experience with this treatment are based on patient populations significantly younger than most patients who suffer from impotence. The geriatric population, which comprises the majority of patients with importance, is unique due to the physical, psychological and social changes associated with the aging process. To characterize better elderly men with impotence, and determine whether intracavernous injection therapy is safe and effective in this age group, a retrospective analysis was performed upon patients attending the male sexual dysfunction clinic at our university medical center who received a standard papaverine and phentolamine mixture (30 mg. papaverine and 1.0 mg. phentolamine per ml.). The etiology of impotence, degree of patient satisfaction and complication rate of 65 patients 65 years or older (mean age 70 years) undergoing papaverine plus phentolamine self-injection therapy were compared to a similar size group of impotent men approximately 20 years younger (mean age 47 years). Significant differences in etiology of impotence were evident between the 2 groups. Treatment response rates were equal for the 2 age groups although elderly patients required a higher dose of papaverine and phentolamine to obtain an erection, and used the medication less frequently. Complications were few, of minimal consequence and occurred with equal frequency between the 2 age groups.

Adult↗
PubMed1991

Surgical management and prognosis of renal cell carcinoma invading the vena cava.

A total of 44 patients with renal cell carcinoma and vena caval tumor thrombus underwent surgical resection. Of these patients 27 had primary tumor confined within Gerota's fascia, negative lymph nodes and no distant metastases (stage T3cN0M0). Patients who underwent extraction of a mobile tumor thrombus from the vena cava had a 69% 5-year survival rate (median 9.9 years) but patients with tumor thrombus directly invading the vena cava had a 26% 5-year survival rate (median 1.2 years), which improved to 57% (median 5.3 years) if the involved vena caval side wall was resected successfully. Of these patients 17 had renal cell carcinoma with vena caval thrombus as well as extrafascial extension, regional lymphadenopathy or distant metastases, and the 5-year survival rate was less than 18% in all groups (median survival less than 0.9 years). Prognosis was determined by the pathological stage of the renal cell carcinoma and by the presence or absence of vena caval side wall invasion but not by the level of tumor thrombus extension. Patients with incomplete resection of localized renal cell carcinoma with tumor thrombus do not survive any longer than those with extensive cancer, positive lymph nodes or distant metastases. However, when partial venacavectomy establishes negative surgical margins then survival markedly improves.

Adult↗
PubMed1990

Primary carcinoma of the upper urinary tract. Effect of primary and secondary therapy on survival.

The pathologic material and medical records of 76 patients with primary upper urinary tract carcinomas were reviewed to identify the role of grade and stage in predicting survival; to determine any differences in survival between ureteral and renal pelvic carcinoma; to understand the role of local therapy in low grade, low stage tumors; and to establish the usefulness of adjuvant therapies in metastatic disease. Kaplan-Meier survival curves with Cox-Mantel analysis for statistical significance revealed both grade and stage to be excellent predictors of survival. No differences in survival were noted between renal pelvic and ureteral carcinomas for equivalent stage tumors. For low grade, low stage tumors, although there was an increased risk of local recurrence with local therapy, there were no differences in survival between patients treated with local therapy or radical surgery. Finally, cisplatin-based chemotherapy seemed to improve survival in patients with metastatic disease.

Adenocarcinoma↗
PubMed1990

Renal calculus disease.

The incidence of renal calculus disease increases with age and can be found as chronic or acute problems in elderly patients. The majority of stones are composed of calcium oxalate, but the incidence of infected stones increases in elderly, debilitated patients. Treatment of renal calculus disease has been revolutionized in the past decade through the use of percutaneous and extracorporeal techniques to eliminate standard open surgery. Medical therapy to control recurrent renal calculus disease has been effective in decreasing chronic nephrolithiasis.

Aged↗
PubMed1989

Role of linear tomography in evaluation of patients with nephrolithiasis.

One hundred twenty-four consecutive patients with suspected or known nephrolithiasis were referred for evaluation by linear tomography. Renal calculi were detected in 98 patients (79%). Linear tomography revealed more renal calculi than did preliminary KUB films in 46 patients (37%), although in only 10 cases (8%) was the tomogram positive if the KUB was negative. Exact quantification of the numbers and locations of renal stones is important in patients to be managed metabolically, and in those being evaluated in advance of or following percutaneous or extracorporeal lithotripsy.

Humans↗
PubMed1989

Caliceal colic: fact or fiction.

We treated 11 patients who presented with flank pain and nonobstructing caliceal stones with extracorporeal shock wave lithotripsy. Long-term success as measured by relief of symptoms and a state free of stones was attained in 82 per cent of the patients, implying that this form of treatment is indicated for symptomatic caliceal stones.

Colic↗
PubMed1989

Lessons learned in patients with large steinstrasse.

Experience with 19 patients (25 ureters) who suffered the complication of a large steinstrasse (a third or more of the ureteral length) has led to lessons regarding the management of this complication as well as to insights into patient presentation, metabolic consequences, and the efficiency of diagnostic and therapeutic modalities. Few symptoms were present in a large percentage of patients despite urinary obstruction, decreased renal function, infection and in several cases impending sepsis. Large stone burdens, bilateral treatment, inability to debulk stone burden before extracorporeal shock wave lithotripsy and unexpected fragment movement were definite predisposing factors in the development of this complication. Double pigtail stents and percutaneous nephrostomy alone did not always prevent or resolve the problem. Combined use of percutaneous nephrostomy and ureteroscopic ultrasonic or laser lithotripsy appears to be the most effective treatment modality in patients who fail brief observation. This approach can be combined under appropriate circumstances with a secondary extracorporeal shock wave lithotripsy or percutaneous nephrolithotripsy treatment in the staged management of complex upper urinary tract calculous disease.

Combined Modality Therapy↗
PubMed1989

Fibromuscular hyperplasia of the seminal vesicle.

Examination of tissue removed during seminal vesiculectomy typically reveals few pathological abnormalities, although some tumors and cysts have been described. We report a case of seminal vesicle enlargement and pain due to fibromuscular hyperplasia. Complete pain relief ensued after seminal vesiculectomy.

Adult↗
PubMed1989

Infections in genitourinary prostheses.

During the past two decades, the use of implantable prostheses has experienced exponential growth. In urology, penile prostheses have been especially popular. Although many mechanical problems have been reported, the most disastrous complication is infection, which usually mandates prosthesis removal and often leads to severe disability or loss of function of the organ in which the prosthesis was implanted. The author reviews the pathogenesis, microbiology, diagnosis, and treatment of genitourinary prosthesis infections.

Female↗