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Biomedical subjects

D F Paulson

Publications and source records attributed to D F Paulson.

At least 109 records · Page 6Linked to original sources
PubMed1984

Surgical correction of Peyronie's disease: the Nesbit procedure.

Surgical therapy for the correction of Peyronie's disease is indicated in patients with severe and chronic penile curvature that does not respond to conservative therapy and that is severe enough to prevent sexual intercourse. The penile prosthesis has been shown to be an effective treatment in patients with associated erectile impotence. However, there is disagreement regarding the procedure of choice in patients with Peyronie's disease and adequate erectile function. Because of the inconsistent results reported for grafting techniques, we used the Nesbit procedure in 12 patients with adequate erectile capacity distal to the plaque. Eleven patients reported satisfactory intercourse postoperatively with excellent anatomical results.

Animals↗
PubMed1984

Radiation therapy versus delayed androgen deprivation for stage C carcinoma of the prostate.

Seventy-three patients with prostatic adenocarcinoma who were believed to have disease limited to the pelvis without evidence of node or bone extension were assigned randomly to either full-field pelvic radiation (40) or delayed hormonal therapy (33). The interval to first evidence of treatment failure was used as the end point of the study. Failures occurred in 13 patients who received radiation therapy and 11 who received delayed hormonal therapy. No difference in disease response could be identified between the 2 treatment groups.

Adenocarcinoma↗
PubMed1984

Carcinoma of the prostate: the therapeutic dilemma.

The management of prostatic carcinoma remains confusing; however, recent studies indicate that treatment selection should be based upon the anatomic extent of disease. Disease that is confined within the anatomic limits of the prostate is best treated by surgically removing the gland. Disease that extends outside of the anatomic confines of the prostate is managed with difficulty and the optimum treatment is as yet undetermined. Disease that is symptomatic and involves distant sites is apparently best treated initially by androgen deprivation and then by multiagent chemotherapy if this fails.

Adenocarcinoma↗
PubMed1983

Stratification of risk factors in renal cell carcinoma.

One hundred fifteen patients underwent surgical treatment of renal cell carcinoma. Survival time was analyzed by statistical regression methods in order to determine the joint significance of stage, using both the Robson and TNM classifications, histologic grade, cell type, and demographic features of the patient sample. Grade and cell type were essentially interchangeable with respect to predicting survival in patients with and without metastatic disease. The strong association between these two factors explains and supports this result. The presence of metastases dramatically altered survival. Local extent of the tumor was an important indicator of survival in the nonmetastatic group of patients, but was not a statistically significant factor in those patients presenting with widespread disease. Venous involvement was not found to be of prognostic significance in either group. Age and weight loss contributed to predicting survival in the nonmetastatic patient group in addition to the measures of disease extent already discussed. Sex and race were not significant indicators of length of survival. In the group of patients with metastatic disease, no difference in survival was observed between soft tissue and bony metastases.

Adenocarcinoma↗
PubMed1983

Monoclonal antibodies to different epitopes on a prostate tumor-associated antigen. Implications for immunotherapy.

Mouse monoclonal antibodies alpha Pro3 and alpha Pro5 bind to different epitopes on an antigen (p54) of 54 kD reduced and 175 kD nonreduced MW. p54 antigen has been characterized previously with regard to tissue distribution using alpha Pro3 monoclonal antibody; the p54 antigen is present in substantially greater quantities in malignant prostatic tissue extracts than in benign prostatic and nonmalignant nonurogenital tissue extracts. In this report, we have established that alpha Pro5 and alpha Pro3 monoclonal antibodies exhibit same molecule-different epitope recognition. That both antibodies recognize the same molecular entity has been established by partial physiochemical characterization of the antigen recognized by the two antibodies and by sequential immunoprecipitation experiments. Different determinant recognition was established by lack of competitive surface binding between alpha Pro3 and alpha Pro5 to a prostatic carcinoma cell line. The p54 antigen can be labeled with glucosamine and immunoprecipitated from urea-solubilized membrane proteins; however, p54 cannot be detected by immunoprecipitation in a glycosylated form in spent culture medium removed from glucosamine-labeled cells. Experiments using indirect cellular immunoassays and directly radioiodinated monoclonal antibody have shown that both alpha Pro3 and alpha Pro5 form stable complexes with p54 antigen on the prostatic carcinoma cell surface. To the extent that modulation occurs upon interaction of p54 with alpha Pro3 and alpha Pro5; endocytosis of the immune complex appears to be the primary route of modulation. Furthermore, modulation by endocytosis is more intense when alpha Pro3 and alpha Pro5 are used in combination than when either monoclonal antibody is used alone. Although in vivo biologic behavior does not invariably correlate with in vitro behavior, careful in vitro analysis of monoclonal antibodies with respect to cell surface behavior, nevertheless, should precede in vivo evaluation. The data presented in this report indicate that preliminary in vitro analyses will expedite the effectiveness of in vivo immunotherapeutic trials; preliminary in vitro evaluations are absolutely essential if monoclonal-toxic agent (e.g., ricin A) conjugates, which must be internalized by the tumor cell to achieve cytotoxicity, are employed as immunotherapeutic agents.

Adenocarcinoma↗
PubMed1983

Management of patients with concurrent primary tumors of bladder and prostate.

The clinical course of 33 male patients presenting with concurrent primary tumors of the bladder and prostate was reviewed. Twenty-four of 33 patients were treated by radical cystoprostatectomy. The remaining 9 patients were treated by more conservative means. Seventy-four per cent of the patients survived five years. A rationale for management of concurrent primary tumors of the bladder and prostate is presented.

Adult↗
PubMed1983

Squamous carcinoma of urinary bladder.

The clinical course of 56 patients with squamous cell carcinoma of the urinary bladder and poorly differentiated transitional cell carcinoma with squamous metaplasia were compared. Survival was evaluated to compare treatments and biologic potentials of these neoplasms. Squamous cell carcinoma of the urinary bladder behaves as poorly differentiated transitional cell carcinoma with squamous metaplasia, and survival is significantly poorer than in poorly differentiated transitional cell carcinoma. While survivals are limited, only radical, surgical extirpation can be associated with significant patient salvage.

Aged↗
PubMed1983

The predictive value of 2,-4, dinitrochlorobenzene skin testing in patients with bilharzial bladder cancer.

A group of 40 patients with bilharzial bladder cancer underwent quantitative skin testing with dinitrochlorobenzene and purified protein derivative of tuberculin before radical surgery. Correlations were made between various clinical parameters, patient outcome, skin test results and pathologic changes in the resected bladder and draining lymph nodes. Striking associations between dinitrochlorobenzene responses and tumor stage, tumor recurrence and several specific parameters of lymph node stimulation were found, while no correlations were made with the pathologic grade, size or type of tumor, degree of schistosomal infestation or tumor bed inflammation. Purified protein derivative responses showed no correlation with any parameter examined. Patient outcome also showed a good correlation with tumor stage and draining lymph node reaction. These findings indicate that dinitrochlorobenzene skin testing as a presumptive test of cell-mediated immunity may represent a good predictor of clinical outcome in patients with bilharzial bladder cancer, and correlates well with draining lymph node stimulation.

Dinitrochlorobenzene↗
PubMed1982

Comparison of cinoxacin and nalidixic acid in patients with cystitis.

A single-blind comparative study was undertaken in 95 patients with cystitis. Each patient received either cinoxacin. 250 mg. qid or nalidixic acid, 1 Gm. qid for seven to fourteen days. Fifty-five patients fulfilled all the criteria for efficacy evaluations; in the cinoxacin-treated group, 26 patients (93 per cent) had a satisfactory symptomatic response, and in the nalidixic acid group there were 25 patients (93 per cent) with a satisfactory symptomatic response. The bacteriologic response was also similar in both groups. One patient in each group became reinfected with a new pathogen and in 1 patient, who received conoxacin, the causative pathogen was not eliminated. four female patients in the cinoxacin group had seven adverse drug reactions, compared with 9 patients in the nalidixic acid group who had 18 adverse reactions. It is concluded that cinoxacin has advantages over nalidixic acid for the treatment of patients with cystitis due to susceptible organisms.

Adult↗
PubMed1982

Late intrascrotal metastases from renal cell carcinoma.

A case of bilateral epididymal metastases appearing sixteen years after nephrectomy for renal cell carcinoma is reported. A literature review of intrascrotal metastases from renal cancer reveals that they are uncommon. The possible mechanisms of spread are discussed.

Adenocarcinoma↗
PubMed1982

Seminal vesiculography: limited value in vesiculitis.

Seminal vesiculograms were performed on 44 men being evaluated for chronic perineal pain consistent with seminal vesiculitis. The vesiculograms were performed prior to antibiotic instillation into the vas deferens. Vesiculograms were abnormal in 32 of the 44 patients (73%). The most common abnormality was the presence of multiple small diverticula producing a feathery appearance of the vas deferens (64%), a finding present in only 19 per cent of patients being evaluated for infertility and 20 per cent of normal patients. Asymmetry and incomplete filling of the seminal vesicles were less common abnormalities. Seventeen of these patients had seminal vesiculectomies for persistent or recurrent pain, and 15 have been followed long enough to assess the results. The histologic examination of the excised seminal vesicles was abnormal in only 3 patients (20%), despite radiographic abnormalities in 10 (67%) and improvement after surgery in 12 (80%). Seminal vesiculography may be useful to exclude anatomic abnormalities prior to instillation, but does not appear sufficiently specific to warrant use as the primary diagnostic examination for patients suspected of having seminal vesiculitis.

Adult↗
PubMed1982

The role of seminal vesiculography in the evaluation of male infertility.

Although most cases of male infertility are the result of primary testicular abnormalities (either maturation arrest, decreased spermatogenesis, or germinal hypoplasia), obstruction of the genital tract is a well recognized and potentially correctable cause of infertility. Seminal vesiculography is an excellent method of evaluating the male genital tract not only for obstruction but also for other structural lesions that may cause infertility. In 27 patients undergoing vesiculography as part of an evaluation of infertility, obstruction was found in 25%. Three patients (11%) were found to have nonobstructing structural lesions as a possible cause of infertility. Patients with obstructive lesions were found to have significantly lower semen volumes than those with patent outflow tracts. The continued role of seminal vesiculography in the evaluation of male infertility is discussed.

Adult↗