Biomedical subjects
J F Glenn
Publications and source records attributed to J F Glenn.
The 1995 staging requirement for approved cancer programs.
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Hypercalcemia and urologic malignancies.
Hypercalcemia may be a manifestation of a variety of disorders including hyperparathyroidism, hypervitaminosis D, sarcoidosis, multiple myeloma, hyperthyroidism, acute osteoporosis, metastatic bone disease, and a number of primary malignancies. Hypercalcemia may be seen in as many as 1.5% of all patients with malignant disease, with or without bony metastases. The neoplasms most commonly associated with hypercalcemia include carcinoma of the lung (all cell types), breast cancer, squamous cell carcinomas, hematologic malignancies, and renal cell carcinoma. Observation of a number of instances of hypercalcemia attendant on urologic malignancies prompts the brief report of 4 characteristic cases with documentation of response to therapy. Management of severe and debilitating hypercalcemia is emphasized. Urologists should be aware of new agents available for such treatment.
Cholinergic drug interactions and heat tolerance.
Acute, subchronic and chronic exposures to cholinergic compounds may result in differing effects. The efficacy of pyridostigmine bromide (PY) prophylaxis against organophosphorus poisoning depends on post exposure atropine (AT) administration. AT induces a dose-dependent increase in rate of rise of core temperature in heat exposed humans and rats. To determine whether AT's anticholinergic potency is altered following PY administration, we examined AT's effects following acute or subchronic (2 weeks) PY administration in the sedentary heat-stressed rat. Four groups of rats were acutely (a, i.v.) treated with saline (SAL) or PY (100 ug/kg) followed by SAL or AT (200 ug/kg), and 4 groups were subchronically (c, osmotic pump) treated with SAL or PY (20 ug/hr) followed by SAL or AT (200 ug/kg). Fifteen minutes following the final injection, rats were subjected to an ambient temperature of 41.5 degrees C until a core temperature of 42.6 degrees C was attained. Heat tolerance times were significantly improved for cPY+SAL over aPY+SAL (241 +/- 9 vs 187 +/- 16 min, mean +/- SE) and for cPY+AT over aPY+AT (76 +/- 9 vs 57 +/- 2 min). The improvement in thermoregulation resulted from increased salivary water for evaporative cooling indicated by % weight loss (corrected for fecal loss) during heat stress: cPY+SAL over aPY+SAL (8.4 +/- 0.3 vs 6.6 +/- 0.5%). This increased heat tolerance resulting from subchronic anticholinesterase administration resembles changes seen with heat acclimation.
Medicine in the twenty-first century.
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Subepididymal orchiectomy: the acceptable alternative.
Orchiectomy remains the standard of therapeutic efficacy in the treatment of advanced prostatic cancer. It also is cost-effective and compliance is assured. Any stigma of a mutilating procedure may be avoided by subepididymal orchiectomy, which offers an acceptable cosmetic result.
Re: Adrenal autotransplantation with attached blood vessels for treatment of Cushing's disease.
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Preclinical evaluation of PDS (polydioxanone) synthetic absorbable suture vs chromic surgical gut in urologic surgery.
A variety of suture materials are available for use in urologic surgery. Urologists have relied on absorbable suture materials which provide transient strength in anticipation that healing will occur before the suture is absorbed. Absorbable sutures thus decrease the chance of stone formation, known to occur on suture material in direct contact with the urinary stream. This report compares the breaking strength retention of polydioxanone (PDS) suture and chronic surgical gut after in vivo residence in the urinary bladder and subcutaneous tissue of the dog.
Medical defense against nerve agents: new directions.
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Surgeons living under DRGs.
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Central respiratory effects versus neuromuscular actions of nerve agents.
The relative contributions of peripheral neuromuscular and central nervous system components in the respiratory failure following acute exposure to organophosphorous anticholinesterase (AChE) agents remain unclear. We examined the effects of the nerve agents, soman, sarin, tabun, and VX on diaphragm contraction, diaphragm electromyogram (EMG), phrenic nerve activity, medullary respiratory-related unit activity, and airflow in the cat. The agents were infused at the rate of 1 LD50 per 15 minutes until respiratory arrest, at which time the phrenic nerve was stimulated supramaximally to test diaphragmic contraction. We found that one of the first signs of respiratory distress is disruption of the normal firing pattern of the medullary respiratory-related neurons. This is followed by changes in phrenic nerve activity, diaphragm EMG, diaphragm contraction and airflow. At the time of respiratory arrest, the medullary respiratory-related units and the phrenic nerve have stopped firing. Immediately following cessation of spontaneous respiration, the diaphragm was tested by stimulating the phrenic nerve with 2 msec pulses of 500 msec duration at 10 Hz and at 100 Hz. Stimulation at 10 Hz consistently produced a frequency-following contraction, while stimulation at 100 Hz produced a tetanic contraction. We conclude that loss of central respiratory drive is the predominant cause of nerve agent-induced respiratory failure, as the diaphragm muscle still contracts tetanically when challenged with a 100 Hz train for 500 msec at the time of respiratory arrest.
Xanthogranulomatous cystitis.
Xanthogranulomatous lesions have been reported in many anatomical sites but only 10 cases involving the bladder have been described, 7 of which were associated with urachal adenoma. To our knowledge, we report the first instance of xanthogranulomatous cystitis in the English literature.
Medical manpower and other strategic issues.
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Seminars for congressional aides: an educational program on the role of the urban academic medical center.
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Nontropical chyluria secondary to massive mesenteric adenitis. Case report with metabolic and immunologic studies.
This report describes metabolic and immunologic studies in a 17-year-old white man with nontropical chyluria secondary to massive mesenteric adenitis. Numerous red cells and mature lymphocytes were observed in the urine, and cystoscopic examination demonstrated chyle emanating from both ureteral orifices. Retrograde studies demonstrated pyelolymphatic backflow, and lymphangiography revealed prominent lymphaticocaliceal communications. Twenty-four-hour urinary studies showed proteinuria and lipiduria, which decreased after lymphangiography and a low-fat diet. Skin tests for delayed hypersensitivity were nonreactive, the lymphocyte count was decreased, and lymphocyte responses to phytohemagglutinin and pokeweed mitogen were normal. Chyluria ceased after interruption and ligation of the renal and mesenteric lymphatics.
Segmental renal vein renins and partial nephrectomy for hypertension in children.
Hypertension in children often is curable surgically. In many instances the causative lesion will be segmental and either vascular or parenchymal. We report on 5 children with a segmental lesion in whom the elevated segmental renal vein renins correctly predicted cure of the hypertension following partial nephrectomy.
Medical manpower and urological practice.
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