PubMed Health⌕ Search

Biomedical subjects

I N Frank

Publications and source records attributed to I N Frank.

At least 19 recordsLinked to original sources
PubMed2000

Splenic B cell lymphoma with lymphocyte clusters in peripheral blood smears.

EDTA induced clumping of lymphoid cells, both benign and malignant, in peripheral blood samples has been reported only rarely. Such clustering presents the laboratory and pathologist with unique difficulties in the accurate diagnosis of these disorders. A case of low grade B cell splenic lymphoma is presented with lymphocyte clumping in smears made from EDTA anticoagulated peripheral blood, the fourth case described in which neoplastic lymphoid cells form clusters in vitro in peripheral blood. The association with splenic lymphomas (three of the four cases) is intriguing but its significance remains uncertain.

Aged↗
PubMed1998

DNA cytometry and chromosome 9 aberrations by fluorescence in situ hybridization of irrigation specimens from bladder cancer patients.

OBJECTIVES: To determine the sensitivity and specificity of combining fluorescence in situ hybridization (FISH) measurement of chromosome 9 and DNA cytometry of bladder irrigation specimens in the detection of bladder cancer. METHODS: Bladder irrigation specimens were obtained from 37 normal control patients and 317 bladder cancer patients during cystoscopic examinations. Bladder cancer patients were sampled in the absence of observable tumor (256 specimens) and concurrently with tumor (204 specimens). Chromosome 9 copy number was determined on a cellular basis by FISH, and cellular DNA content was determined by Feulgen DNA staining and image cytometry. RESULTS: Sensitivity of chromosome 9 FISH was 42% for all tumors and was not correlated to transitional cell carcinoma tumor grade, while the sensitivity of DNA cytometry was 55% and improved with increasing grade from 38% for grade 1 to 90% for grade 3 tumors. The results of FISH and DNA cytometry were combined, resulting in specificity of 92% and sensitivity of 69% for grade 1, 76% for grade 2, and 97% for grade 3 tumors. CONCLUSIONS: The lack of increase with grade in the percentage of positive specimens by FISH supports the hypothesis that chromosome 9 aberrations are critical events in bladder tumorigenesis for many patients. These data demonstrate the presence of cells in irrigation specimens with specific genomic lesions of chromosome 9 and DNA content. Combining FISH on chromosome 9 and DNA cytometry provides an increase in sensitivity to transitional cell carcinoma over either test alone.

Carcinoma, Transitional Cell↗
PubMed1996

Clinical evaluation of prostate biopsy parameters: gland volume and elevated prostate-specific antigen level.

PURPOSE: To determine whether excess prostate-specific antigen (PSA) improves the accuracy of predicting positive biopsy results. MATERIALS AND METHODS: Results of prostate biopsy in 130 consecutive patients were correlated with transrectal ultrasound (TRUS) findings, digital rectal examination results, serum PSA level, and excess PSA (serum PSA level minus predicted PSA level [prostate volume x 0.12]), alone and in combination. Random sextant biopsy was performed in all patients, as well as directed biopsy of any suspicious lesion seen at TRUS. RESULTS: Excess PSA alone was most accurate in the prediction of positive biopsy results. Use of an excess PSA of > or = 0 ng/mL instead of a serum PSA level of > 4 ng/mL to initiate prostate biopsy increased the positive yield from 49% to 56% and accuracy from 51% to 62%, eliminating 21% of biopsies while maintaining sensitivity at 94% (vs 95% with serum PSA level). CONCLUSION: Use of only excess PSA of > or = 0 ng/mL to initiate prostate biopsy results in the best combination of sensitivity and specificity compared with the other standard parameters.

Aged↗
PubMed1994

Bladder irrigation specimens assayed by fluorescence in situ hybridization to interphase nuclei.

Bladder irrigation specimens provide a sampling of the entire bladder urothelium and are the most practical sample for longitudinally monitoring patients. This study presents cross-sectional fluorescence in situ hybridization (FISH) analyses with correlated DNA cytometry data on 76 patients monitored for recurrent bladder tumors. FISH probes complementary to centromeric satellite sequences for chromosomes 1, 7, 9, 11, 15, and 17 were used. Aberrations in copy number were observed for chromosomes 1, 7, 11, and 17 principally in patients with aneuploid tumors. Monosomy of chromosome 9 was observed in 39% of the diploid and 31% of the specimens with high hyperdiploid fraction. Significantly, 24% of patients with a history of bladder cancer but with no clinical evidence of disease exhibited monosomy of chromosome 9. This suggests a persistent and significantly large population of abnormal cells in the absence of clinical evidence of disease. Loss of chromosome 9 relative to DNA ploidy was observed in 24% of patients with no evidence of disease, in 59% of patients with tumor, and in 79% of patients with histologically confirmed transitional cell carcinoma, grades 1-3. Loss of chromosome 15 was also observed in a large percentage of patients. Loss of chromosome 15 was observed in 41% of specimens from patients in whom no tumor was seen, in 38% of specimens from patients with tumor, and in 67% of specimens from patients with histologically confirmed transitional cell carcinoma. Results of this study document the use of bladder irrigation specimens as a specimen source for FISH analyses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Renal cell carcinoma: incidental diagnosis and natural history: review of 235 cases.

Two hundred thirty-five cases of histologically proved renal cell carcinoma (1976-1987) were reviewed to determine the impact of incidental tumor detection on the natural history of this cancer. One hundred sixty-eight patients (71.5%) presented with clinical signs and/or symptoms of renal pathology. Of these, 25 (18%) were investigated without consideration of renal cell carcinoma in the differential diagnosis. Sixty-seven cases (28.5%) were diagnosed as an incidental finding on diagnostic imaging for extrarenal symptomatology. Approximately 30 percent of patients were found to have metastatic disease on initial presentation regardless of incidental, or suspected discovery of these tumors. Stages A and B tumors were encountered with equal frequency in patient groups with both suspected and incidental diagnosis. Intravenous pyelography was the diagnostic modality used to detect the diagnosis in 83 percent of cases. While incidental detection of renal cell carcinoma has become more frequent than in previous years, it appears to have impacted minimally on the discovery of earlier stage tumors than those with presenting clinical symptoms. In contrast to prior reports, our data show that the natural history of renal cell carcinoma is not significantly altered by the incidental detection of tumor.

Carcinoma, Renal Cell↗
PubMed1991

DNA slit-scan flow cytometry of bladder irrigation specimens and the importance of recognizing urothelial cells.

DNA slit-scan flow cytometry was used to analyze 150 bladder irrigation specimens from 83 patients. Specimens were categorized into groups based on cystoscopy, histology, and cytopathology. Cells were stained for DNA with propidium iodide using a whole cell protocol. Non-specific fluorescence in the cytoplasm of some urothelial cells together with differential DNA staining of cell types in certain specimens was noted. DNA frequency distributions were analyzed using a semi-automated technique. Data were gated using slit-scan morphological features to remove cellular debris, multiple nuclei, and cells exhibiting nonspecific cytoplasmic fluorescence. Specimens were classified abnormal if they were aneuploid or had a hyperdiploid fraction (HDF) greater than 8%. The sensitivity to abnormality was 89% for grade 3 transitional cell carcinoma (TCC), 70% for grade 2 TCC, and 67% for grade 1 TCC. Specificity was 61%. Specimen data were then reprocessed using slit-scan morphological features to enrich for urothelial cells. The urothelial cells were identified by the ratio of nuclear diameter to cell diameter. This method was found to be in good agreement with immunofluorescent labeling of urothelial cells using the urothelium-selective T16 monoclonal antibody. The sensitivity to abnormality remained 89% for grade 3 TCC and 70% for grade 2 TCC, but fell to 52% for grade 1 TCC. Specificity for the urothelial cell enriched data increased to 77%. Reprocessing of data to enrich for urothelial elements resulted in 16 fewer specimens with an aneuploid DNA distribution and 2 fewer specimens with increased HDF.(ABSTRACT TRUNCATED AT 250 WORDS)

Aneuploidy↗
PubMed1989

Intravesical formalin for hemorrhagic cystitis: analysis of therapy.

In an extensive search of the literature 235 cases of intractable hemorrhagic cystitis treated with intravesical formalin were identified. Effectiveness of therapy, rate of recurrence of hematuria, morbidity and mortality were analyzed with respect to concentration of formalin and to the etiology of hematuria. Increasing concentrations of formalin slightly improved effectiveness of therapy and reduced the rate of recurrence of hematuria. However, this often resulted in an increase in morbidity. When patients were categorized according to the etiology of intractable hematuria it was noted that lower concentrations of formalin were effective in controlling hematuria caused by either cyclophosphamide cystitis or unresectable carcinoma of the bladder. In contrast, higher formalin concentrations were required to control bleeding due to radiation cystitis.

Administration, Intravesical↗
PubMed1986

Multidimensional slit-scan detection of bladder cancer. Preliminary clinical results.

A multidimensional slit-scan flow system was developed for the automated recognition of abnormal cells derived from cancer of the uterine cervix and its precursors. It provides great sensitivity in both its ability to recognize cellular abnormality and to deal with the myriad potential causes of false alarms in an automated flow system. While its initial application was the automated recognition of the spectrum of neoplasia in gynecologic cytology samples, a preliminary study was carried out using specimens obtained from the urinary bladder. Cellular material was collected by bladder irrigation and stained with the fluorochrome acridine orange. One hundred fifty-three bladder irrigation specimens, including 115 abnormal specimens containing cells derived from neoplastic lesions of the bladder epithelium, were analyzed. For the purposes of this study, abnormal specimens from the urinary bladder included specimens containing cells derived from the following lesions of the urothelium: dysplasia (atypical hyperplasia), carcinoma-in-situ, and transitional cell carcinoma, grades 1-3. Approximately 50,000 cells were analyzed for most specimens. Of the 38 presumed normal specimens (specimens containing only normal urothelial components), four were instrument classified abnormal. For the 69 specimens containing cells derived from transitional cell carcinoma, grade 1, 1-2, 2, 66 were correctly classified as abnormal while three were classified as normal.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma in Situ↗
PubMed1984

Congenital posterior urethral valves in an adult.

An adult male with posterior urethral valves who had obstructive urinary symptoms and painless gross hematuria is presented. The diagnosis, development, and treatment of posterior urethral valves is discussed. The importance of also treating the hypertrophied bladder neck is stressed.

Adult↗
PubMed1983

Simplified new approach to endoscopic photography.

Information obtained by endoscopic examination can be shared with others by viewing sequentially through the same endoscope, "teaching attachments" allowing viewing ports through the same instrument, drawings based on the observers' recollection of the findings, and by endoscopic photography. Of these methods, endoscopic photography has the important advantages of speed and faithfulness of reproduction. Herein, we describe a simple technique for endoscopic color still-photography with illustrations of normal and pathologic findings.

Cystoscopy↗
PubMed1983

Ultrasonic examination of scrotum. Review of 108 cases.

Ultrasound is a reliable and safe method for the evaluation of scrotal anatomy. The usual method of ultrasonic examination has been contact scanning with a conventional articulated arm scanner. We herein report our experience in 108 cases using an ultrasonic technique which provides panoramic scans of the entire scrotum and precision tomographic plane placement without distorting the scrotum or causing patient discomfort.

Genital Diseases, Male↗
PubMed1981

Automated water-path ultrasonic examination of scrotum.

A new method of examining the scrotum by ultrasound with an automated water-path scanner is described. This method allows immobility of the scrotum in a more acceptable and painless way than in contact scanning methods. Panoramic scans of the entire scrotum and precision tomographic plane placement are advantages over conventional techniques. A description of normal scrotal anatomy includes the mediastinum of the testis, an important scrotal landmark. Representative cases of benign and malignant scrotal disease are presented to emphasize the utility of water-path scanning.

Adolescent↗
PubMed1981

Blunt renal trauma in the pediatric patient.

Injury to the kidney from blunt trauma occurs rather frequently in the active, pediatric patient. Early evaluation and treatment of these children is essential in order to preserve maximum renal function. Ninety cases of pediatric renal trauma from blunt injury have been reviewed. The majority of these responded well to careful conservative, non-operative management. Many of those requiring surgical intervention responded well to initial conservative treatment followed by surgical intervention conducted as an elective procedure within the first week after injury. Five case reports with associated radiographic studies are presented.

Adolescent↗
PubMed1980

Primary localized amyloidosis of urinary bladder.

Primary localized amyloidosis of the bladder is rare. Two new cases are presented, and 44 cases from the literature are reviewed. The disease tends to occur in a younger age group in men than in women. It presents most frequently with gross painless hematuria, and usually appears at cystoscopy as a tumefied, yellowish, and occasionally ulcerated lesion. The amyloid deposits usually involve suburothelial connective tissue, suburothelial vessels, and less markedly the vesical muscularis. The treatment varies from transurethral resection to total cystectomy with urinary diversion. Transurethral resection appears to be the treatment of choice, if feasible. Close follow-up of the patient is necessary because of the frequency of multiple recurrences, which may require an ablative procedure.

Adult↗
PubMed1980

Percutaneous aspiration in the treatment of renal abscess.

The conventional treatment of a renal abscess has been surgical exploration, drainage and marsupialization of the cavity. There have been isolated reports in the literature regarding the successful use of systemic antibiotics alone in the management of patients with renal abscesses. We report a case in which percutaneous aspiration of a renal abscess led to successful non-operative management. In addition, 4 previously reported cases of renal abscesses treated with this modality are analyzed.

Abscess↗
PubMed1979

Artifactual urethral stricture in male child.

Artifactual urethral obstruction at the suspensory ligament of the penis may be produced if the penis is left in its normally dependent position during a urethrogram. We present 2 such cases to re-emphasize this phenomenon so that caution is taken in interpreting distal bulbous urethral strictures.

Child↗
PubMed1979

Leydig cell tumor of testis.

In adult patients with Leydig cell tumor of the testis, endocrinologic signs occur in 30 per cent of the cases and often precede the onset of a palpable testicular mass. Gynecomastia is the most common endocrinologic manifestation and probably is due to increased estrogen secretion by the Leydig cells. In the patient with adrenogenital syndrome and testicular enlargement it is difficult to distinguish Leydig cell tumor from adrenal rest hypertrophy. Four patients with Leydig cell tumor and endocrinologic manifestations are discussed; three are adults who presented with gynecomastia and the fourth is a patient with congenital adrenogenital syndrome. In the adult patient inguinal orchiectomy is the treatment of choice, while in the patient with adrenogenital syndrome initial management by high-dose steroid suppression should be attempted prior to testicular exploration.

Adrenal Cortex Neoplasms↗