Biomedical subjects
Publications and source records attributed to D D Venable.
We report a unique occurrence of primary urethral melanoma in a black man. The biological relationships to melanocyte/melanin site densities or to precursor mucosal lesions are discussed as possible etiological factors in the occurrence of this rare neoplasm.
A 44-year-old man had an abscess involving the left psoas muscle and inferior pole of the left kidney associated with characteristic sulfur granules of actinomycosis. The patient was treated with surgical drainage and debridement and with intensive and prolonged penicillin therapy, resulting in a clinical cure and resolution of both the hydronephrosis and the retroperitoneal mass.
The occult unilateral hydronephrotic kidney is often discovered during the genitourinary evaluation of patients sustaining blunt abdominal trauma. Few cases have been reported documenting the angiographic, computerized tomography (CT), and ultrasound appearances. Two cases are described which demonstrate that relatively minor trauma can precipitate hematuria and hypovolemic shock. Angiography demonstrated the bleeding site in both cases and was utilized in conjunction with other parameters of clinical assessment to plan initial management. CT and ultrasound proved to be useful noninvasive diagnostic parameters for baseline and follow-up studies in patients undergoing conservative management. They accurately demonstrated the degree of hydronephrosis, residual renal parenchymal, and resolving hematoma.
Metoclopramide (Reglan) has been widely used as a motility agent because of its contractile effects on gastrointestinal smooth muscle. This agent also may demonstrate significant effects in the urinary system; however, controlled studies of possible effects on bladder function have not been previously reported. Metoclopramide effects on the detrusor smooth muscle were studied using a canine model system. Metoclopramide was compared with bethanechol chloride and a control substance in a random double blind study. Preliminary data from this animal model suggests that metoclopramide significantly increased detrusor contractility as manifested by a decrease in bladder capacity, an increase in detrusor peak voiding pressure and a decrease in post-void residual volume. These effects were similar to those manifested by parenteral bethanechol chloride.
Pure intrarenal lipomas of sufficient size to be of surgical significance are among the rarest of renal tumors. A review of the literature to date revealed only 17 cases reported previously that met the histologic requirements of a pure intrarenal lipoma. We report an additional case in which the large tumor became clinically apparent following blunt trauma and rupture.
The purpose of this paper is to present the computed tomography (CT) and ultrasound findings in one case of membranous obstruction of the inferior vena cava (IVC). Although the incidence of membranous obstruction of the IVC is rare in the United States, the diagnosis is essential because of the association of this lesion with portal fibrosis and hepatocellular carcinoma. Membranous obstruction of the IVC is suggested by the findings of a filling defect within the IVC at the level of either the diaphragm or right atrium. Until more specific CT and ultrasound features are described, an inferior vena cavogram will remain the definitive diagnostic procedure for membranous obstruction of the IVC.
While prostatic adenocarcinoma is associated classically with osseous or lymphatic metastasis, it can present clinically with protean manifestations. We describe 4 cases that demonstrate unusual patterns of metastatic spread, including isolated supraclavicular mass, pleural effusion, suprapubic and genital skin metastasis, and priapism. Newer immunohistochemical staining techniques for prostate specific antigen and prostatic acid phosphatase can assist in localization of the metastatic adenocarcinoma to a prostatic origin.
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Signet ring cell adenocarcinoma of the bladder is a rare tumor that usually presents as a diffuse and infiltrating neoplasm, similar to the linitis plastica type of gastric adenocarcinoma. We report the thirteenth case of primary signet ring cell adenocarcinoma of the bladder, which is documented by light microscopic, immunohistochemical and electron microscopic studies. the pertinent medical literature is reviewed and analyzed. In general, this tumor present with hematuria and irritative symptoms, and may yield equivocal radiologic and cystoscopic findings. It is characterized by a rather rapid growth rate, infiltration of the surrounding pelvic organs, and variable response to radiotherapy and radical surgery. The prognosis is apparently favorably modified by early detection of localized forms of the tumor and aggressive treatment.
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