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Biomedical subjects

F C Koleski

Publications and source records attributed to F C Koleski.

6 recordsLinked to original sources
PubMed2002

Retroperitoneal schwannoma mimicking an adrenal lesion.

Schwannomas are usually benign tumors that arise from the nerve supporting the Schwann cell. The majority arise at the cranial nerves or nerves of the upper extremities. Most patients with retroperitoneal schwannomas present with vague abdominal or back pain. We present a case in which a retroperitoneal mass thought to be arising from the adrenal gland on computed tomography and magnetic resonance imaging was found after excision to be a Schwannoma. The available literature on retroperitoneal schwannomas is then discussed.

Adrenal Gland Neoplasms↗
PubMed2000

Use of epidermal growth factor and collagen synthesis inhibition as adjuvant to healing of ureteroureteral anastomosis.

BACKGROUND AND PURPOSE: When treating a ureteral narrowing by endopyelotomy or endoureterotomy, the urologist hopes that after the narrowed area is cut, it will heal with a patent lumen. A ureteral stent is usually left in place to provide a framework for healing. In cases of failure, histologic examination shows a predominance of collagen. We evaluated the effects of epidermal growth factor (EGF) and a collagen synthesis inhibitor, halofuginone, as adjuncts to ureteral healing. MATERIALS AND METHODS: Ten female pigs underwent ureteroureteral anastomosis bilaterally, with the left side being stented. They were then randomized to receive EGF (N = 4), halofunginone (N = 3), or saline (control; N = 3). On postoperative day 30, the ureters were examined grossly and histologically. RESULTS: The lumens of the ureters were significantly larger in the animals that received either EGF or funginone than in the control animals. The epithelium was significantly thicker in the animals that received halofunginone than in the controls or animals receiving EGF. The thickness of the smooth muscle and adventitia was similar in the three groups. Stenting improved the results. CONCLUSION: Both EGF and halofuginone show promise as adjuncts to endopyelotomy and endoureterotomy.

Adjuvants, Pharmaceutic↗
PubMed1999

Incidence of urolithiasis in cystectomy patients after intestinal conduit or continent urinary diversion.

The purpose of this study was to determine the incidence of nephrolithiasis in radical cystectomy patients treated with either intestinal conduit or continent urinary diversion. The charts from 94 patients who had undergone radical cystectomy with urinary diversion at our institution from 1988 to 1998 were reviewed retrospectively for this study. Charts and radiographs from all patients were examined for renal function and evidence or urinary tract calculi. Two groups were compared: group I patients had undergone diversion with an intestinal conduit, and group II patients had received a continent diversion (primarily involving an Indiana pouch). Conduit diversions were typically done with a freely refluxing anastomosis (Bricker), whereas continent diversions were done with a nonrefluxing ureteral-intestinal anastomosis. Group I consisted of 54 patients who had undergone ileal conduit (50) or colon conduit (4) diversion with a mean follow-up of 2.5 years (range 0.6-7.0 years). Group II consisted of 40 patients who had undergone continent diversion (33 Indiana pouches, 7 orthotopic diversions) with a mean follow-up of 3.1 years (range 0.5-10.5 years). Laboratory studies of serum blood urea nitrogen, creatinine, and CO(2) were similar between the two groups. Six patients in group I developed urolithiasis, all in the upper tract. Stones developed at a mean of 3.1 years after urinary diversion. Three patients required operative intervention, whereas the others were managed expectantly. One patient in group II had an upper tract stone at the time of presentation for his bladder cancer, but no patient developed new upper tract stones during the present study period. Two patients in group II developed pouch calculi at a mean of 5 years after diversion; both required surgical intervention. In our study the risk for upper tract urolithiasis seemed higher in the intestinal conduit group (group I), with 11% of the patients developing stones. In the continent diversion group, no patient developed upper tract stones, although two patients (5%) developed pouch stones. Refluxing urine may contribute to an increased risk for stone formation after urinary diversion, whereas pouch stasis may contribute to stone formation in the continent diversion group.

Aged↗
PubMed1999

Carcinosarcoma of the prostate.

We present a rare case of carcinosarcoma of the prostate occurring in a 60-year-old white male. This diagnosis was initially missed after a transurethral resection of the prostate (TURP) had been performed to alleviate the patient's urinary obstructive symptoms. After recurrence of symptoms within a short period, another TURP was performed and the diagnosis of carcinosarcoma was then established. The patient then underwent a radical cystourethroprostatectomy with bilateral lymphadenectomy and ileal conduit diversion. Carcinosarcoma of the prostate is a very aggressive disease that often has a poor prognosis, especially when it has spread out of the prostate. Surgical removal of the prostate seems to be the best option for treatment in the select group of patients in which the disease remains confined to the prostate.

Carcinosarcoma↗
PubMed1999

Splenosis as a cause of testicular pain: laparoscopic management.

This is a case report of a 37-year-old man with severe testicular pain unresolved after conventional investigative and therapeutic methods. On the basis of his history of abdominal trauma followed by emergency splenectomy and evidence of functioning splenic tissue on a radionuclide scan, the diagnosis of splenosis was established. Laparoscopic exploration was done, and the initial diagnosis confirmed. Splenic tissue located at the right inguinal ring was removed. Testicular pain abated after the procedure.

Adult↗