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Biomedical subjects

C C Rife

Publications and source records attributed to C C Rife.

At least 19 recordsLinked to original sources
PubMed1992

Stage D1 prostate cancer treated by radical prostatectomy and adjuvant hormonal treatment. Evidence for favorable survival in patients with DNA diploid tumors.

BACKGROUND: Stage D1 disease is found in at least every sixth patient undergoing bilateral pelvic lymphadenectomy and radical retropubic prostatectomy (RRP) for clinically localized prostate cancer (PC). Previous recommendations for monotherapy using surgery, radiation, or systemic therapy alone for Stage D1 disease have usually been associated with a poor outcome in regard to progression and survival. Unlike other pathologic stages, D1 disease treated with RRP is mainly related to DNA ploidy pattern in regard to all end points (progression and survival) and immediate adjuvant hormonal treatment (AHT) rather than to the usual pathologic variables, including the number of positive nodes. METHODS: Complete DNA ploidy information was available in 370 patients with Stage D1 disease (age range, 40-77 years; mean, 64 years) undergoing RRP with or without AHT with a follow-up of up to 22 years (mean, 5 years). RESULTS: Overall, 80% of all DNA ploidy classes (diploid, 37%; tetraploid, 46%; and aneuploid, 17%) had AHT that highly significantly delayed progression for diploid (P less than 0.0001) more than tetraploid (P less than 0.0001) and more than aneuploid (P less than 0.0001) tumors. Significant prolongation of the disease-free interval might have improved the quality of life for tetraploid and aneuploid patients. Survival (crude and cause-specific) was significantly (P = 0.02) improved only for diploid patients who received AHT but not for tetraploid and aneuploid patients. This was due to the significantly accelerated death rate after progression in those patients with early AHT for tetraploid and aneuploid (but not diploid) tumors. Delayed (on progression only) AHT resulted in high progression rates for all DNA ploidy classes (aneuploid greater than tetraploid greater than diploid); e.g., 21 of 30 diploid patients progressed and 6 patients died from disease at a median of 31.5 months in spite of immediate hormone treatment on progression. RRP and AHT for patients with Stage D1 disease resulted in a highly significant delay in overall progression (76% at 10 years) and excellent local control, depending on DNA ploidy pattern (diploid greater than tetraploid greater than aneuploid) compared with a treatment regimen without AHT (24% overall nonprogression); only 20% of all patients with AHT are projected to die of disease at 10 years. Disease in diploid patients (37%) treated with AHT rarely progressed and those patients are unlikely to die of disease in 10 years or less; delayed (on progression) hormone treatment for diploid patients seemed ineffective. Inclusion of values for prostate specific antigen led to a higher failure rate on progression, and this is dependent on DNA ploidy class (diploid greater than tetraploid greater than aneuploid). CONCLUSION: Only patients with nondiploid tumors should be entered into prospective studies using innovative adjuvant treatment protocols to improve survival.

Adult↗
PubMed1991

Transureteroureterostomy with cutaneous ureterostomy: a 25-year experience.

We reviewed 67 patients who underwent transureteroureterostomy with cutaneous ureterostomy for benign (32) and malignant (35) disease in regard to the indications for and complications of the procedure. The most common complications included urine leakage at the ureteroureterostomy, stomal stenosis and calculus formation. Renal function improved or remained stable in 75% of the patients. Transureteroureterostomy with cutaneous ureterostomy is a viable alternative diversion technique in a select group of patients.

Adult↗
PubMed1989

Bladder carcinoma presenting with rectal obstruction.

Two patients with bladder carcinoma that caused annular constriction of the rectum are described. A mechanism of local invasion by genitourinary malignancies (bladder and prostate) involves penetration of the rectovesical fascia of Denonvillier and circumferential rectal spread. Treatment of complete or partial obstructing lesions includes surgery, radiotherapy, or chemotherapy (or combination), as well as several new techniques, notably laser destruction and transrectal tumor resection.

Carcinoma, Transitional Cell↗
PubMed1988

Comparison of techniques for vesicourethral anastomosis: simple direct versus modified Vest traction sutures.

Radical retropubic prostatectomy has become a mainstay surgical procedure in the treatment of cancer of the prostate. There has been controversy, however, regarding the most appropriate method of vesicourethral reconstruction. We examined the records of 692 consecutive patients who underwent a radical retropubic prostatectomy from 1978 through 1984 at the Mayo Clinic. Of these, 416 patients underwent a modified Vest procedure, and in 276 patients a direct simple anastomosis was fashioned. In comparing these two methods, our review showed no substantial difference in complications, including the rate of urinary incontinence.

Adenocarcinoma↗
PubMed1988

Neodymium:YAG laser treatment of cystitis glandularis.

We report a case of severe cystitis glandularis of the entire bladder, which caused a large retrovesical mass and bilateral hydronephrosis. Treatment included whole bladder neodymium:YAG laser therapy, a technique not previously reported for this extent of disease. The etiology, diagnosis, treatment and malignant potential of cystitis glandularis are discussed.

Adult↗
PubMed1987

Urodynamic evaluation of patients after the Camey operation.

Ten patients were evaluated urodynamically 3 to 18 months after they underwent the Camey operation. Of these patients 2 had total diurnal and nocturnal continence, 1 was totally incontinent and 6 were incontinent to various degrees that necessitated the use of 1 to 3 pads or diapers per day. All but 2 of the Camey neobladders had cystoplasty contractions at a capacity of 50 to 200 ml. The 2 totally continent patients had no cystoplasty contractions. The bladder in the totally incontinent patient had good capacity, good compliance and low pressure contractions up to a volume of 400 ml. The condition in this patient may be attributed to sphincteric incontinence. Urinary flow is achieved by abdominal straining and is interrupted. Vesicoureteral reflux occurred in 3 of 20 renal units.

Aged↗
PubMed1987

Perioperative and postoperative complications from bilateral pelvic lymphadenectomy and radical retropubic prostatectomy.

The complications experienced by 692 consecutive patients who underwent bilateral pelvic lymphadenectomy and radical retropubic prostatectomy from 1978 through 1984 were analyzed. Four patients (0.6 per cent) died in the perioperative or early postoperative period. Pulmonary embolus developed in 19 patients (2.7 per cent) and severe to total urinary incontinence occurred in 34 (5 per cent). Our large series suggests that radical retropubic prostatectomy with staging bilateral pelvic lymphadenectomy can be performed in a safe manner with minimal postoperative morbidity.

Adenocarcinoma↗
PubMed1982

Preliminary investigation of EMG biofeedback induced relaxation with a preschool aged stutterer.

A 4 1/2-yr.-old stutterer was run on a series of comparative speech tasks and EMG recording periods to assess the potential of using EMG biofeedback-assisted relaxation to reduce stuttering. The basic finding was that the subject was able to reduce the level of tension in the laryngeal area by using EMG biofeedback but not without some difficulty. The effect of EMG biofeedback training on his frequency of stuttering was small but in the direction of less stuttering.

Biofeedback, Psychology↗
PubMed1981

Medical treatment of the infertile male.

In summary, the effective treatment of certain disorders of male infertility is possible. As in all areas of medicine, the more specific the diagnosis, the more specific the treatment, and, as expected, the greater the success of treatment. Much of the confusion regarding the efficacy of the medical treatment of infertility has been generated by the use of empiric treatment modalities without thorough diagnostic evaluation. Further advances in knowledge pertaining to the mechanism of infertility should increase the precision of our forms of treatment, thus producing increased rates of success.

Arginine↗
PubMed1980

Prolactin--added dimension in male genitosexual disorders.

Prolactin-producing pituitary adenomas known to cause amenorrhea and galactorrhea in the female have been implicated recently in male infertility and impotence. Knowledge of the pathophysiology of prolactin and of the choices of treatment for these tumors is an important adjunct to the urologist's armamentarium.

Adenoma↗
PubMed1979

Reevaluation of vest technique of vesicourethral reconstruction in radical retropubic prostatectomy.

Vesicourethral reconstruction after radical retropubic prostatectomy was done by the Vest technique in 36 patients and by direct vesicourethral anastomosis in 100 patients. Complications resulting from the two methods of vesicourethral reconstruction were similar. Incontinence after radical retropublic prostatectomy appears not to be related to the method of vesicourethral reconstruction but occurs because of damage during surgery or postoperative scarring of the distal sphincteric mechanism.

Humans↗
PubMed1979

Urine cytology of transitional cell neoplasms.

The extrinsic and intrinsic factors which influence the interpretation of cytologic findings are explained in detail. Although plagued by limitations that have yielded false-positive and false-negative results, through research, attempts are being made to improve the efficacy of urine cytology in the detection of neoplasms of the urinary tract.

Adult↗
PubMed1977

Clinical observations on sixty-nine cases of in situ carcinoma of the urinary bladder.

In the course of screening 35,000 urological outpatients with urine cytological examinations, cytological indication of cancer was found in 106 patients in the absence of a cystoscopically visible bladder tumor. Sixty-nine of the 106 patients have biopsy-proven in situ carcinoma of the bladder, all transitional in type and anaplastic. Follow-up data on effects of therapy are available on 58 patients treated by various means, including total cystectomy, partial cystectomy, transurethral fulguration, intravesical thiotepa, and external radiation. The duration of symptoms before diagnosis was remarkably long, and the prolonged course of the in situ lesion was also noteworthy. Differences in the observed behavior of in situ bladder carcinoma may be due, in addition to differences in host resistance, to the existence of two pathogenetic forms of bladder cancer, one arising in an extensive field of abnormal epithelium and the other developing in a focal area of abnormality.

Adult↗
PubMed1976

Morphological and clinical observations of patients with early bladder cancer treated with total cystectomy.

In 21 cases, early bladder cancer was detected by urine cytology, although not by cystoscopy, and was treated by total cystectomy. The neoplasms, all transitional cell carcinomas of moderate to high degrees of anaplasia, were entirely in situ in 17 of the 21 patients; in 4, although mainly in situ, the tumors showed additional minimal microinvasion. Widespread mucosal involvement was demonstrated in every case by step-sectioning, and extension into the prostatic ducts occurred in 7 of the 19 male patients and into the mucosa of one or both distal ureters in 12 patients. Premalignant atypia of the mucosa was also widespread and direct intramucosal spread of cancer cells was a significant factor, particularly along the prostatic ducts and ureters. The duration of significant symptoms (follow-up for 9 years before cystectomy in several cases and for 8 years in 1 histologically proved case) suggests that the evolution of these tumors may be considerably longer than previously documented.

Aged↗