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Biomedical subjects

H Grabstald

Publications and source records attributed to H Grabstald.

At least 37 records · Page 2Linked to original sources
PubMed1980

Complications of ureteroileal conduit with radical cystectomy: review of 336 cases.

Review of complications of the ileal conduit in patients undergoing radical cystectomy for bladder cancer showed a statistically significant increase in renal calculi, ureteral obstruction, acute and chronic pyelonephritis and deterioration of renal function by 60 months postoperatively. Ureteroileal fistulas occurred in 3.3 per cent, stomal stenosis in 5.1 per cent, intestinal fistulas in 5.4 per cent, severe intestinal obstruction in 6 per cent and abdominal wound infection or dehiscence in 20.2 per cent of the cases. The over-all operative mortality was 13.7 per cent, with 8 per cent of the deaths attributed to complications from the ileal conduit. Comparison of colonic conduits to ileal conduits as a means of urinary diversion with radical cystectomy for bladder cancer demonstrated no convincing evidence of its superiority.

Adult↗
PubMed1980

Flow cytometry in bladder cancer detection and evaluation using acridine orange metachromatic nucleic acid staining of irrigation cytology specimens.

A new technique for simultaneous multiparameter deoxyribonucleic acid, ribonucleic acid and nuclear size measurements by flow cytometry was applied to the examination of bladder irrigation cytology specimens from 107 urologic patients. The cell samples from patients with bladder carcinoma could be distinguished from normal by 2 features: 1) an increase in the proportion of bladder epithelial cells with more than diploid deoxyribonucleic acid and 2) aneuploid cell peaks. These criteria identified 12 of 13 cases of invasive carcinoma, 24 of 28 cases of carcinoma in situ and 11 of 13 cases of papillary carcinoma. An increased proportion of cells with more than diploid deoxyribonucleic acid or aneuploidy was found in 9 of 14 patients with papilloma and 6 of 19 patients with a history of bladder tumors but no evident disease at present--these were believed owing to increased epithelial proliferative rates or nuclear chromatin abnormalities not visible by light microscopy. None of the 20 patients who had never had bladder tumors was abnormal. While the results in this small clinical trial have been most encouraging an additional descriptor of nuclear chromatin structure is believed necessary to discriminate benign, reactive proliferative epithelium from neoplasm when the latter is near diploid or shedding few cells. Studies to develop such a parameter presently are under way.

Acridine Orange↗
PubMed1980

Controversies concerning lymph node dissection for cancer of the penis.

Cancer of the penis represents one of the two genital cancers (testis cancer is the other) in which cure may frequently be effected in the presence of lymph node metastases. The questions that are raised include if and when therapeutic or prophylactic lymphadenectomy is indicated. Extended node dissection is governed, to an extent, by recognition of the seriousness of pelvic node involvement and by uncertainty regarding the status of the contralateral side with proof of disease on one side. The sentinel node theory, with its potential impact on the possible approach to these problems, must be confirmed or denied before our present therapeutic philosophy is modified.

Humans↗
PubMed1979

A critical analysis of response criteria in patients with prostatic cancer treated with cis-diamminedichloride platinum II.

Cis-diamminedichloride platinum II (DDP), 50--70 mg/m2 iv, q 3w was administered to 25 patients with Stage D adenocarcinoma of the prostate. Since the assessment of tumor regression in a disease-oriented phase II study demands a clear end-point of response, case selection was restricted to patients who had objectively measurable lesions, i.e., nodes, skin, lung, and liver metastasis. Partial remission occurred in 3 (12%) and stabilization of disease in 1 patient. Responders lived 53 weeks vs. 20 weeks for non-responders. In the dosage and schedule used in this protocol, DDP was not an active agent in the treatment of prostatic cancer. Various patient characteristics are examined and correlations made between remission rates and survival in this study vs. 4 other response schemata. A critical analysis of patient selection, "lead time" -- diagnosis to chemotherapy, and the definitions of the terms "measurable" lesions, "evaluable" parameters, "objective response", stabilization of disease and response criteria employed in the 4 schemata are also discussed.

Adenocarcinoma↗
PubMed1979

The rationale of urinary diversion in cancer patients.

A retrospective review of 218 consecutive nephrostomies done on uremic cancer patients has revealed an alarming incidence of postoperative morbidity and mortality. This review has raised legitimate questions regarding the value of palliative urinary diversion. We present a rationale to assist physicians in the management of this clinical problem.

Adolescent↗
PubMed1978

Spermatic cord sarcoma in adults.

The clinical courses are presented for 6 patients with sarcoma of the spermatic cord seen between 1967 and 1976. There were 3 fibrosarcomas, 2 liposarcomas and 1 malignant fibrous histiocytoma, making the total reported cases of spermatic cord sarcoma 212. Management of spermatic cord sarcoma is discussed.

Adult↗
PubMed1978

Gallium and bleomycin scans in the clinical staging of testis tumor.

Twenty-one patients with testicular tumors had gallium scans prior to retroperitoneal lymph node dissection. Eleven of 14 patients found to have nodal involvement had positive scans, and 2 of 7 patients with negative nodes had false positive scans. Bleomycin scans were positive in 4 of 5 patients with nodal metastases. While these scans provide a simple, non-invasive and occasionally useful technique for the clinical staging of testis neoplasms, they do not, in our experience, significantly supplement other staging procedures.

Bleomycin↗
PubMed1977

Adriamycin in advanced urinary tract cancer: experience in 42 patients and review of the literature.

Forty-two patients with measureable, advanced, genito-urinary cancer received Adriamycin. Significant clinical responses (CR/PR) occurred in only five (14%) of 35 adequately treated patients. Four additional patients achieved a minimal response anf four others showed stabilization of their disease for 4 to 9 months. Review of the literature suggests an overall response rate of 20%. Patients with a urinary diversion lived significantly longer (P 0.006) than patients who did not have this procedure (42.5 months vs 21.5 months). The need to define various patient characteristics in future chemotherapeutic trials in bladder cancer is discussed.

Adenocarcinoma↗
PubMed1977

A comparative study of two preoperative radiation regimens with cystectomy for bladder cancer.

This report surveys the results of two programs of preoperative irradiation with radical cystectomy for bladder cancer in 205 patients. Irradiating the true pelvis to 4000 rads in 4 weeks with radical cystectomy after 6 weeks was implemented in 119 patients (Group 1) from 1959 to 1965; 2000 rads given in 1 week to the true pelvis and radical cystectomy within the following week was implemented in 86 patients (Group 2) from 1966 to 1970. Determinate survival without evidence of recurrence at 5 years was 43% in Group 1 and 42% in Group 2. Mortality with recurrence of bladder cancer in 5 or more years was 44% in group 1 and 42% in group 2. Pelvic complications occurred in 13% of group 1 and 9% of group 2.

Adenocarcinoma↗
PubMed1977

Rectal invasion by benign prostatic hyperplasia.

Rectal invasion by benign prostatic hyperplasia occurred subsequent to an open transrectal biopsy of the prostate gland. Frequent transrectal resections of the prostate controlled this unusual lesion initially. However, massive intrarectal regrowth of this clinically malignant but histologically proved benign prostatic enlargement required eventual pelvic exenteration.

Humans↗
PubMed1977

The clinical utility of plasma and urinary carcinoembryonic antigen in patients with genitourinary disease.

Carcinoembryonic antigen was measured in the urine and plasma of 108 patients with several types and various stages of genitourinary cancer. The value of the carcinoembryonic antigen assay as an early indicator of neoplastic disease was evaluated and a correlation was made between the extent of disease and the concentration of urinary and plasma carcinoembryonic antigen. Patients were classified according to stage of tumor involvement as follows: no evidence of disease, non-malignant disease, non-invasive disease, no known metastasis, regional metastasis and disseminated metastasis. The urinary carcinoembryonic antigen levels more closely paralleled the extent of disease than did the plasma carcinoembryonic antigen levels in patients with bladder cancer. Neither urinary nor plasma carcinoembryonic antigen levels were useful in assessing the extent of disease in patients with prostatic or testicular cancer. Studies related to microbiological interference in the carcinoembryonic antigen assay indicated that bacterial counts up to 10(5) organisms per ml. did not interfere. Cytological studies indicated that the presence of white blood cells, atypical cells and malignant cells could result in elevated urinary carcinoembryonic antigen levels.

Carcinoembryonic Antigen↗
PubMed1977

Radiation therapy of ureteral metastases from breast cancer.

A series of 6 patients with ureteral metastases from breast carcinoma treated by radiation therapy has been evaluated. Most patients received a tumor dose of 3,600 rads in 3 to 4 weeks, and showed remarkable clinical improvement, with relief of the ureteral obstruction and reversal of symptoms and signs of uremia after radiation therapy. One patient died before an adequate dose of radiation therapy could be given. Early recognition and early treatment of ureteral metastases have been stressed. Radiation therapy techniques have been described.

Adult↗
PubMed1977

Cryosurgery in the treatment of bone metastases from renal cell carcinoma.

Solitary metastasis is uncommon, occurring in 1.6% to 3.2% of patients with renal cell carcinoma. Because of the potential of survival, amputation of an extremity with a metastasis is frequently advocated, particularly after successful nephrectomy. The cure rate with amputation is approximately 30%. Cryosurgery for treatment of localized and limited bony metastasis in an alternative to more radical surgery. This is a report of follow-up observation of the original series of cases as well as the addition of 4 new cases with multiple metastasis.

Adenocarcinoma↗