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Biomedical subjects

D D Dietrick

Publications and source records attributed to D D Dietrick.

10 recordsLinked to original sources
PubMed1995

Core cancer length in ultrasound-guided systematic sextant biopsies: a preoperative evaluation of prostate cancer volume.

OBJECTIVES: Evidence has been presented that biologic aggressiveness of prostate carcinoma increases with volume and that cancers less than 0.5 cc may be regarded as clinically insignificant for immediate treatment. We have analyzed the ability of core cancer length on needle biopsy to predict cancer volumes near the 0.5 cc threshold for distinction between incidental versus clinical carcinoma. METHODS: Systematic sextant transrectal ultrasound-guided prostate biopsies were performed on 110 men who then underwent radical prostatectomy for adenocarcinoma. The core cancer length within each biopsy was compared with the volumes of clinical and incidental carcinomas in the prostatectomy specimen. RESULTS: Among incidental (nonpalpable) cancers, 14% of those under 0.2 cc were detected, but 44% at 0.2 to 0.5 cc and 92% of those more than 0.5 cc were detected. Among clinically suspected carcinomas, 2 mm or longer core cancer length reliably predicted a cancer of 0.5 cc or larger, but among incidental cancers, it predicted a tumor of 0.2 cc or larger. A 3-mm core cancer length threshold predicted 0.5 cc for both groups. The high frequency of incidental cancers under 0.5 cc impaired the predictive value of multiple positive needle cores. Bilateral positive biopsy results indicated bilateral extension of clinical cancer in only 59% of cases. CONCLUSIONS: A core cancer length of 3 mm or more on one or two needle biopsies reliably predicts cancer of clinically significant volume (0.5 cc or larger). The high detection frequency of smaller incidental carcinomas on biopsy impairs the reliability of volume estimation from multiple positive needle cores and mandates that treatment decisions be made with knowledge of core cancer length.

Adenocarcinoma↗
PubMed1994

Spermatic cord metastasis from transitional cell carcinoma of the bladder.

A case of transitional cell carcinoma of the bladder metastasizing to the spermatic cord is reported. This represents the only clinically recognized site of tumor recurrence in a man treated with radical cystoprostatectomy followed by four cycles of adjuvant cis-platinum/methotrexate/vinblastine (CMV) chemotherapy for Stage D1 disease (local pelvic lymph node involvement). The existing literature concerning metastatic tumors of the spermatic cord is reviewed.

Aged↗
PubMed1993

Large, organ confined, impalpable transition zone prostate cancer: association with metastatic levels of prostate specific antigen.

We present 3 of 25 patients with massive, occult transition zone cancers 7 to 86 cc in volume. Despite serum prostate specific antigen (PSA) levels of 150 to 456 ng./ml. (Yang polyclonal assay), all 3 were organ confined at radical prostatectomy and have undetectable serum PSA levels by an ultrasensitive assay at 300 to 650 days postoperatively. This clinical syndrome includes a highly elevated PSA level, benign prostatic hyperplasia on digital rectal examination, a nondiagnostic transrectal ultrasound and frequently negative transrectal or perineal needle biopsies. Clinical recognition of this syndrome plus systematic biopsies of the transition zone are the keys to diagnosis and potential cure of these patients. These cases may explain the 10% rate of men who present with metastatic prostate cancer and a normal rectal examination, much of the discrepancy between focal cancer on biopsy and large cancers in radical prostatectomy specimens, and why some men have an extraordinarily high serum PSA level and organ-confined cancer at prostatectomy.

Adenocarcinoma↗
PubMed1992

Inflammatory pseudotumor of the bladder.

Inflammatory pseudotumor of the bladder is an unusual benign lesion arising from the bladder submucosa. We present 2 cases and describe the clinical presentation, and radiographic and histological findings. This benign lesion must be differentiated histologically from several malignant lesions of the bladder. Complete surgical excision, either by transurethral resection or partial cystectomy, appears to be curative.

Adult↗
PubMed1992

Intravesical migration of intrauterine device.

Intrauterine devices have been plagued by many early and late complications, including uterine perforation and migration into adjacent structures. To our knowledge only 18 cases have been reported in the literature of migration of an intrauterine device into the bladder. We report on a 38-year-old woman in whom an intrauterine device eroded from the uterus 3 years after placement. The device remained asymptomatic in the pelvis for an additional 13 years before the patient presented with urinary symptoms. The literature is reviewed.

Adult↗
PubMed1988

Surgical management of renal cell carcinoma with intracaval neoplastic extension above the hepatic veins.

Cardiopulmonary bypass, hypothermia, temporary cardiac arrest and exsanguination represent the next logical step in the evolutionary management of intracaval neoplastic extension with renal cell carcinoma. This method of management provides control of the circulation of the entire body and allows for careful dissection in a bloodless field with less risk of embolization. From 1981 to 1986, 15 patients were treated with intracaval neoplastic extension of renal cell carcinoma above the level of the most inferior hepatic veins. In 6 patients mobilization of the vena cava with division of the hepatic veins to the caudate lobe allowed excision of the tumor and tumor thrombus without cardiopulmonary bypass (group 1). The remaining 9 patients underwent cardiopulmonary bypass and hypothermia (group 2). There was 1 postoperative mortality in the entire group. Most patients had advanced regional disease but the feasibility of this technique has been demonstrated. Survival appeared to be less in the bypass group. Although some of the patients have had metastatic disease, the quality of life and survival have been prolonged in many of these acutely ill patients.

Actuarial Analysis↗
PubMed1981

Induction and development of mouse liver glutathione S-transferase activity.

Mouse liver glutathione S-transferase activity at birth was 1/10 that of adults, and increased steadily with each successive week of age until adult values were reached at 8 weeks. Activity was inducible with phenobarbital; however, the percentage increase in activity was dependent upon substrate. 2 distinct peaks of transferase activity were obtained on CM-cellulose chromatography. The ratios of transferase activity observed for each peak demonstrated that glutathione S-transferase activity in mouse liver is associated with at least 2 distinct proteins with differing substrate specificities.

Aging↗
PubMed1981

Effect of inhibitors of the de novo pyrimidine biosynthetic pathway on serum uridine levels in mice.

Since C57BL X DBA F1 (hereafter called BDF1) mice possess a relatively constant concentration of serum uridine [9.7 +/- 1.3 (S.D.) nmol/ml], circulating uridine is available to cells with an intact pyrimidine salvage pathway and thus could influence the effectiveness of certain antitumor agents which inhibit de novo pyrimidine biosynthesis and whose cytotoxic properties are reversed by uridine. Three inhibitors of the de novo pyrimidine biosynthetic pathway were studied to determine their effects on circulating uridine concentration in BDF1 mice. Pyrazofurin and 6-azauridine were found to have no significant effect on serum uridine levels when administered as a single dose or on 4 consecutive days. In contrast, N-(phosphonacetyl)-L-aspartate reduced serum uridine levels by 55% when administered either as a single dose or on 4 consecutive days. This reduction could contribute to the antitumor effectiveness of N-(phosphonacetyl)-L-aspartate by limiting the rescue of cells possessing a salvage pathway. D-Galactosamine, a stimulator of the de novo pyrimidine pathway, was also studied and found to increase total liver uridine (uridine plus uracil nucleotides and uridine diphosphate esters) by 4-fold at 8 hr, returning to normal by 24 to 48 hr. However, these large effects were not reflected in the serum.

Amides↗