Biomedical subjects

I Rothman

Publications and source records attributed to I Rothman.

At least 19 recordsLinked to original sources

PubMed2000

Prostate vascular flow: the effect of ejaculation as revealed on transrectal power Doppler sonography.

OBJECTIVE: The objective of our study was to determine the effect of ejaculation on prostate vascular flow. SUBJECTS AND METHODS: Using power Doppler technology, we performed four transrectal sonographic examinations before and immediately, 6 hr, and 24 hr after ejaculation in 10 healthy volunteers. Images were assessed by three independent observers. RESULTS: Ninety-seven percent of the images ranked as having the least flow were from the baseline examination. There was a significant difference between the rankings when categorized into the four time sets (mean score for the baseline group was 1.1, whereas for the immediate, 6-, and 24-hr postejaculation groups it was 2.5, 2.9, and 2.4, respectively (p<0.0001). The only statistically significant difference was between the baseline and the three remaining groups. Interobserver agreement was high, with the chance-corrected measure of agreement of 0.78. CONCLUSION: Transrectal sonography revealed that prostate vascular flow increases dramatically after ejaculation and remains elevated for at least 24 hr. This observation should be considered when power Doppler sonography is used to assess for potential hyperemia in patients suspected of having prostate abnormalities.

Adult↗

PubMed1999

Prostate histopathology and the chronic prostatitis/chronic pelvic pain syndrome: a prospective biopsy study.

PURPOSE: The chronic prostatitis/chronic pelvic pain syndrome is a common clinical syndrome characterized by lower genitourinary tract symptoms, particularly pain in the perineum or genitalia, voiding symptoms, such as dysuria or frequency, and sexual dysfunction in the absence of uropathogens in the urine or prostatic secretions. The term prostatitis is based on the presumption that prostatic inflammation is important in the pathophysiology of this syndrome. To our knowledge there has been no systematic characterization of the degree and nature of inflammation in the prostate in symptomatic cases. MATERIALS AND METHODS: Prostate histopathology in 368 biopsies from 97 patients with the chronic prostatitis/chronic pelvic pain syndrome was characterized.. RESULTS: Prostatic inflammation was detected in only 33% of patients, including 29% with mild (less than 10 leukocytes per 1 mm. field) and 4% with moderate (between 10 and 200) or severe (more than 200) infiltrate. Of the 3 patients with moderate inflammation 1 had glandular, 1 periglandular and 3 multifocal or diffuse distribution of leukocytes in the interstitium. Some patients had more than 1 pattern of inflammation. CONCLUSIONS: The finding of moderate or severe inflammation in only 5% of 97 patients argues for the need to reevaluate current concepts of the pathophysiology of the chronic prostatitis/chronic pelvic pain syndrome.

Adult↗

PubMed1998

Bladder petechiae after cystoscopy and hydrodistension in men diagnosed with prostate pain.

PURPOSE: We determined if men with prostate pain syndromes have petechiae in the bladder after hydrodistension. MATERIALS AND METHODS: A total of 60 men with the diagnosis of prostate pain and without bacteriuria underwent cystoscopy and hydrodistension under a general or regional anesthetic. RESULTS: Of the 60 men 35 (58%) had moderate to severe petechiae similar in appearance to women with interstitial cystitis after hydrodistension. Men with moderate to severe bladder petechiae had fewer leukocytes in expressed prostatic secretions, smaller bladder capacities and less often testicular pain than men with more normal appearing bladders after hydrodistension. Symptomatic improvement 2 to 6 weeks after hydrodistension was more common in men with moderate to severe petechiae than in those with fewer petechiae. Absence of rectal pain predicted symptomatic improvement after hydrodistension. CONCLUSIONS: We suggest that bladder petechiae, and possibly interstitial cystitis or a related condition, may be more frequently associated with prostate pain syndromes in men than previously appreciated.

Adult↗

PubMed1998

Is ouabain produced by the adrenal gland?

1. Ouabain or a related stereoisomer, termed endogenous ouabain, has been identified in adrenal cortex tissue and culture medium from adrenocortical cells. 2. Angiotensin II and adrenocorticotropin, the main activators of aldosterone secretion from adrenal glomerulosa cells appear to increase the production of this compound. 3. The purpose of this review is to briefly discuss recent available experimental evidence suggesting that endogenous ouabain is secreted by the zona glomerulosa of the adrenal gland.

Adrenal Cortex↗

PubMed1997

Bacteria in the prostate tissue of men with idiopathic prostatic inflammation.

PURPOSE: Although antibiotics represent the first line of treatment for prostatitis syndromes, physicians can document infection in remarkably few cases. We examined the relationship of genitourinary infection to inflammatory prostatitis in 85 subjects without bacteriuria. MATERIALS AND METHODS: Evaluation consisted of cultures of urethra, urine and transperineal prostate biopsies, specifically for commensal and fastidious organisms, and leukocyte counts of expressed prostatic secretions. RESULTS: Men with inflamed expressed prostatic secretions (25) were more likely to have any bacterial isolation (p = 0.01), positive cultures for anaerobic bacteria (p = 0.03), higher total bacterial counts (p = 0.02) and more bacteria, species isolated (p = 0.02) in prostate biopsy cultures than men without expressed prostatic secretion inflammation (60). CONCLUSIONS: Bacterial colonization/invasion of the prostate may be associated with inflammatory prostatitis in some cases.

Adult↗

PubMed1997

Randomized clinical trial of an absorbable stent for vasectomy reversal.

PURPOSE: More successful methods of vasectomy reversal would benefit those undergoing this treatment and might also increase the popularity of vasectomy. We conducted a randomized, prospective clinical trial of vasectomy reversal methods, comparing a new absorbable stent with 2-layer reattachment. MATERIALS AND METHODS: We studied 116 men seeking vasectomy reversal between November 1990 and March 1994. Data were analyzed primarily by intention to treat. RESULTS: Patients in the stent (64 cases) and no stent (52) randomized groups were similar in age distribution, age of spouses, years since vasectomy, proportion who had undergone prior vasectomy reversal and proportion who had previously achieved pregnancy. Operation time was more than 19 minutes shorter in the stent randomized group (p = 0.006). Fewer patients in the stent than the no stent group had patent vasovasostomies (81.0 versus 89.6%, respectively, p = 0.2) postoperatively. Fewer stent randomized patients had motile sperm (76.2 versus 81.3%, respectively, p = 0.5) and normal total motile sperm counts (49.2 versus 52.1%, respectively, p = 0.8) than did those without a stent. Conception occurred in 22 and 51% of all couples in the stent and no stent groups. The relative risk of conception among those in the stent group was 0.42 (95% confidence interval 0.24 to 0.71, p = 0.002). A Mantel-Cox log-rank test comparing pregnancies in each group according to the number of postoperative months revealed that the no stent group achieved more earlier pregnancies (p = 0.003). CONCLUSIONS: The 2-layer microscopic vasovasostomy results in greater pregnancy rates than vasovasostomy using the absorbable stent.

Absorption↗

PubMed1996

Psychological and physical factors involved in chronic idiopathic prostatitis.

Idiopathic prostatitis is a common, often chronic condition in which psychological factors are suspected to play a role. Men with chronic prostatitis (n = 51) and a control group of 34 men without any chronic pain condition, equivalent on demographic characteristics, were compared on psychological and perineal muscle tension measures. Prostate-specific antigen and expressed prostatic secretion cell counts were also measured. Chronic prostatitis patients were consistently more elevated than controls on hypochondriasis, depression, and hysteria (MMPI), and on somaticization and depression (Brief Symptom Inventory), and were less elevated on masculine/instrumentality (Personal Attributes Questionnaire) scales. A cluster analysis of MMPI profiles revealed that 57% of the chronic prostatitis patients produced generally unelevated MMPI profiles, whereas the remaining 43% fell into two groups with distinct patterns of distress. The results indicate depression and psychosocial distress are common among chronic prostatitis patients, calling for careful evaluation and attention to psychological symptoms.

Adolescent↗

PubMed1996

Congenital malformations in newborns of women with established and gestational diabetes in Washington State, 1984-91.

We examined the relationship between diabetes in pregnancy and the development of congenital malformations, in a population-based retrospective study using birth certificate data for all liveborn children delivered from 1984 until 1991 in Washington State. Births to mothers with established and gestational diabetes numbered 1511 and 8869 respectively. For comparison we selected 8934 births to mothers without diabetes. The prevalence of congenital malformations in neonates was 7.2%, 2.8% and 2.1% among mothers with established diabetes, gestational diabetes, and without diabetes, respectively. Newborns of mothers with established diabetes were more likely to have a congenital malformation than newborns of non-diabetic mothers (prevalence odds ratio = 4.0; 95% confidence interval 3.1-5.1). In contrast, there was only a slightly higher prevalence of congenital malformations among newborns of mothers with gestational diabetes (prevalence odds ratio = 1.3; 95% CI 1.0-1.6). The association with maternal established diabetes was greater for neonates with multiple malformations (7.8; 95% CI 3.3-18.1) than for single malformations (2.9-95% CI 2.1-3.9). Four to seven fold associations were observed with skeletal, cleft lip/palate, neural tube and heart abnormalities. The association of established diabetes with congenital malformations was nearly twice as strong among female neonates (prevalence odds ratio = 5.4; 95% CI 3.7-8.0) than among male neonates (prevalence odds ratio = 3.1; 95% CI 2.2-4.5). No such variation was observed for associations with gestational diabetes. This study enlarges on previous work relating congenital anomalies to established diabetes and supports the possibility of a weak association with gestational diabetes.

Adult↗

PubMed1996

Sickness impact of chronic nonbacterial prostatitis and its correlates.

PURPOSE: There is evidence that many patients experiencing chronic idiopathic prostatitis or prostadynia not only have recurrent physical symptoms but also display a range of psychological symptoms, such as depression or anxiety, suggesting that the symptoms of chronic prostatitis may seriously impact on quality of life functioning. We investigated the degree of sickness impact of chronic prostatitis, and the differential importance of physical and psychological symptoms in predicting sickness impact. MATERIALS AND METHODS: The sickness impact profile as well as several symptom measures were administered to 39 patients with chronic prostatitis. Multiple regression analyses were performed to evaluate what proportion of the variance in quality of life or functional status was explained by physical and psychological symptoms. RESULTS: The sickness impact profile mean total score of chronic prostatitis patients was within the range of scores reported in the literature for patients suffering myocardial infarction, angina or Crohn's disease. Pain was the only physical symptom that significantly contributed towards explaining variance in sickness impact. Psychological symptoms added significantly to the amount of predicted variance. CONCLUSIONS: The results indicate a need for careful evaluation and attention to sickness related dysfunctions in patients with chronic prostatitis.

Adult↗

PubMed1995

Prostatodynia and interstitial cystitis: one and the same?

OBJECTIVES: To investigate further the observation that men with prostatodynia may represent a subset of patients with interstitial cystitis. METHODS: The charts of 20 patients with the diagnosis of nonbacterial prostatitis or prostatodynia who underwent cystoscopy and bladder hydrodistention were retrospectively reviewed. RESULTS: The primary complaint of all 20 patients was genital or rectal pain, or both. Ten patients reported irritative voiding symptoms. Twelve of the 20 patients developed petechial hemorrhages involving the bladder uroepithelium on hydrodistention. Bladder biopsies revealed no significant histopathologic abnormalities. Nine of the 12 patients who developed petechial hemorrhages reported symptomatic improvement at 2- to 3-week follow-ups compared with none of the 8 patients without petechial hemorrhages. CONCLUSIONS: These findings suggest that the diagnosis of interstitial cystitis should be considered in patients with nonbacterial prostatitis or prostatodynia.

Adult↗

PubMed1994

Urethral meatal warts in men: results of urethroscopy and biopsy.

Human papillomavirus is a common sexually transmitted infection associated with cervical dysplasia. We investigated the extent of urethral human papillomavirus infection by performing urethrocystoscopy on 90 men who presented to a sexually transmitted disease clinic with external meatal warts. A total of 83 men underwent biopsies and in 49 human papillomavirus typing was done. Of 90 men with external meatal warts 75 (83.3%) had no other warts, while 15 (16.7%) also had more proximal lesions. Only 5 men (5.6%) had lesions at or beyond the pendulous urethra. Of the 90 men 12 (13.3%) had 2 warts, 3 (3.3%) had 3 warts and none had more than 3 warts. A total of 39 men had human papillomavirus type 6/11, 1 had type 31/33/35 and 9 were negative for human papillomavirus antigens. Histological evaluation of biopsies showed no dysplasia. Our study confirms that the frequency of internal urethral warts is low. Human papillomavirus infection was not associated with urethral dysplasia.

Adolescent↗

PubMed1991