Biomedical subjects
Publications and source records attributed to D R Levin.
'Pitfall' is a trap made by digging a hole in the ground and concealing its opening, and any danger or difficulty that is not easily anticipated or avoided. It is our intention in this article to point out the traps, dangers and difficulties involved in our treatment of three urological injuries. It is clear that the pitfalls are due to the inexact interpretation of parameters used.
Cyclic dysmenorrhea, unilateral abdominopelvic mass, acute urinary retention and renal agenesis ipsilateral to the pelvic mass in a young woman suggest uterus didelphys with unilaterally imperforate vagina.
In a retrospective study, the influence of distilled water, used as the irrigation fluid during and immediately after the complete removal of superficial bladder cancer, on the recurrences of bladder cancer was evaluated. Thirty-two percent recurrence developed in the first year (25 patients) and 50% in the second year (39 patients). The 3-month and 1-year recurrence-free rates were 87.2 and 68% respectively. The results support the concept that recurrences may arise from tumor cell implantation at the time of transurethral management of bladder tumors and may be reduced effectively by using distilled water.
A case of idiopathic calcinosis of the scrotum is presented. This term has been applied to an uncommon disorder characterized by solitary or multiple, firm painless papules or nodules of the scrotum that usually appear during childhood or early adult life. The lesions are skin colored to white-yellow, increase in size and number, may itch or drain a chalky white material. X-ray film reveals calcified shadows. Biopsy specimens of the lesions show masses of calcium deposits in the dermis without evidence of an epithelial lining.
The effect of the prostaglandin-synthesis inhibitor, diclofenac sodium (Voltaren), and of prostaglandin E2 (PGE2) on spermatogenesis in mature dogs has been studied. Diclofenac sodium at 2.0 mg/kg was given subcutaneously once a day for 42 days. The testes were biopsied every 7 days, and spermatogenesis was quantified showing a marked and statistically significant increase (p less than 0.001). Administration of PGE2 in doses of 2.0 mg/kg subcutaneously, once a day for 15 days, produced a marked and statistically significant decrease in spermatogenesis (p less than 0.001), and an increase in the numbers of exfoliated immature germ cells in the seminiferous tubule lumens.
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We report a new case of recurrent transitional cell carcinoma developing in an ileal conduit. Only 7 cases have been reported thus far. These have occurred within 15 months of urinary diversion. Although this is an uncommon urologic lesion, awareness of the possibility requires continued surveillance of patients with an ileal conduit.
A rare case of malignant melanoma metastasizing to the kidney is described. Five other cases were found in the English literature, this being the sixth. A review of the subject is brought up.
Two rare cases of urethro-thigh fistula are described. Both of them occurred following pelvic trauma. We suggest that trauma, hematoma and infection, suppuration, are the etiology for the development of fistula from a torn urethra to the thigh. A review of the English literature failed to reveal other cases of such an unusual complication.
The effect of combined epidural anesthesia and epidural morphine injection is discussed. A group of 98 patients (group A), chosen at random, was operated on under such combined anesthesia and compared to a similar group of 98 patients (group B), equally chosen at random, operated on under either spinal or general anesthesia with no epidural morphine added. Over 87% of group A needed no narcotic drugs for postoperative pain. All patients in the group B needed 60-80 mg of morphine during the first 48 postoperative hours. The quantity of morphine required was the main parameter for comparison. The postoperative course in group A was considerably easier while the operative results were equal in both groups.
The effect of distilled water on exfoliated tumor cells from transitional bladder carcinoma was compared to the effect of chemotherapeutic agents dissolved in saline and in distilled water. The experiment was controlled by comparison to the effect of saline on cells under the same conditions. Distilled water proved as effective as chemotherapeutic agents in distilled water and more destructive than chemotherapeutic agents in saline within the 2-hour time limit of the experiment.
A simple model for assaying bacterial adherence to the urinary tract is presented. Cell suspensions of freshly excised transitional cell tumors were used as substrata for attachment of 3H-adenine-labeled Escherichia coli urine isolates. Quantitative radioactive counts were confirmed by microscopic observations in replicate assays of each condition tested. This model provided for species and organ specificity in studies of the bacterial adherence role in urinary tract infections.
Carcinosarcoma of the prostate is a very rare malignant tumor in men. Only 4 cases have been reported in the English literature. We give herein the 5th case report of carcinosarcoma of the prostate.
A prospective study was conducted on 41 patients with benign prostatic hypertrophy. All patients underwent preoperative gas urethral pressure profilometry. The results showed an accurate correlation between prostatic profile length and prostatic urethral length, as measured after enucleation. The same correlation is found between the above parameters and the weight of the enucleated adenoma. Our results support the value of urethral pressure profile as a useful procedure in the preoperative estimation of prostatic size.
A case of primary ejaculatory failure due to prostatic damage in a 23-year-old patient is presented. This occurred secondary to Y-V operation of the bladder neck which was performed 19 years earlier. To our knowledge, this complication has not been described previously.
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