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Biomedical subjects

J H Texter

Publications and source records attributed to J H Texter.

At least 19 recordsLinked to original sources
PubMed1999

Immunoscintigraphy with indium-111-capromab pendetide: evaluation before definitive therapy in patients with prostate cancer.

OBJECTIVES: No standard noninvasive diagnostic test reliably differentiates patients with organ-confined prostate cancer from those with lymph node metastases. The ability of a radiolabeled monoclonal antibody, indium-111 (111ln)-capromab pendetide, to identify sites of metastatic disease in patients at moderate to high risk of nodal involvement was investigated. METHODS: The study prospectively evaluated 160 patients with prostate cancer scheduled to undergo pelvic lymph node dissection (PLND) before or during definitive treatment. All were at relatively high risk of nodal involvement by virtue of significantly elevated baseline prostate-specific antigen (PSA) values, Gleason scores, and/or locally advanced clinical stages of disease. The histologic findings of the PLNDs were compared with the results of immunoscintigraphy, computed tomography, and magnetic resonance imaging. RESULTS: Among the 152 evaluable patientS studied with 111In-capromab pendetide before PLND, the sensitivity of immunoscintigraphy for lymph node detection was 62% and the specificity was 72%; the positive predictive value was 62% and the negative predictive value was 72%. In comparison, the sensitivity of computed tomography and magnetic resonance imaging was 4% and 15%, respectively, and the specificity was 100% for both procedures on the basis of a large number of negative interpretations. Logistic regression analysis revealed that immunoscintigraphy with 111In-capromab pendetide provided strong, independent evidence of the presence of lymph node metastases. Furthermore, the analysis indicated that certain combinations of PSA, Gleason score, and 111In-capromab pendetide were particularly effective at predicting the risk of nodal involvement. CONCLUSIONS: Immunoscintigraphy with 111In-capromab pendetide outperformed standard diagnostic imaging techniques in the detection of prostate cancer lymph node metastases and provided independent prognostic information that complemented PSA, Gleason score, and clinical stage.

Adenocarcinoma↗
PubMed1998

Multicenter radioimmunoscintigraphic evaluation of patients with prostate carcinoma using indium-111 capromab pendetide.

BACKGROUND: Optimum therapy for prostate carcinoma patients requires accurate staging, but computed tomography (CT) and magnetic resonance imaging (MRI) have limitations as methods for detecting soft tissue metastases. In this study, radioimmunoscintigraphy (RIS) was evaluated for its ability to identify sites of metastatic disease in lymph nodes. METHODS: RIS was evaluated in 51 prostate carcinoma patients at high risk for metastatic disease. An intravenous infusion of indium-111 capromab pendetide was given, followed by nuclear medicine imaging on two separate dates. Bilateral, open pelvic lymph node dissection was performed with additional exploration and biopsy of scan positive extraprostatic regions. Histologic evaluation of removed tissue confirmed the accuracy of RIS. In addition, results were compared with other standard methods for diagnosing patients prior to surgery. RESULTS: Nineteen patients (37%) had evidence of lymph node involvement with RIS. Fifteen of the 19 positive patients had pathologic evidence of cancer in the biopsied lymph nodes. Sensitivity, specificity, accuracy, and the positive predictive value for detection of extraprostatic disease were 75%, 86%, 81%, and 79%, respectively. CT, MRI, and ultrasound of the pelvis demonstrated a combined accuracy of only 48% in detecting lymph node disease. Twenty-five previously undetected sites were deemed positive with RIS. Fourteen of these were biopsy-proven tumor sites, seven were probable tumor sites, and four were assumed to be false-positive. CONCLUSIONS: RIS had an impact on patient management through its detection of occult disease in more than 50% of prostate carcinoma patients studied, and it provided information concerning the likelihood that lymph node metastases would be found during surgery.

Antibodies, Monoclonal↗
PubMed1998

The role of monoclonal antibody in the management of prostate adenocarcinoma.

PURPOSE: A study using monoclonal antibody ProstaScint was conducted to determine the role of radioscintigraphy for evaluation of patients with adenocarcinoma of the prostate. Previous evaluations determining sensitivity and toxicity for this agent were conducted in a multicenter study. MATERIALS AND METHODS: ProstaScint scans were used for preoperative staging in patients presumed to be candidates for total prostatectomy and a subsequent study was performed for the detection and localization of recurrent prostate cancer following definitive therapy. RESULTS: The monoclonal antibody scan detected localized recurrent cancer in 43 patients who were possible candidates for external beam radiation therapy. CONCLUSIONS: The monoclonal antibody conjugate ProstaScint provides additional information in detection and localization of recurrent prostate cancer and would be helpful in the selection of patients for subsequent external beam radiation therapy.

Adenocarcinoma↗
PubMed1995

Analysis of hypospadias and fistula repair.

A total of 83 children underwent hypospadias repair from 1977 to 1991. The method of repair was based on individual patient pathology. Meatal advancement and glanuloplasty repair (MAGPI) was the most common operation performed (n = 37) followed by flip flap (n = 19), free tube graft (n = 11), and vascularized tube graft (n = 16). Fistula formation was the most common complication, with an overall incidence of 16 per cent. Fifty-four per cent of fistulas occurred following free tube graft urethroplasties, and 25 per cent of fistulas were noted following vascularized tube graft procedures. After 1986 the fistula rate decreased to 11 per cent in vascularized tube grafts, indicating a learning curve for this procedure. Seventy per cent of all fistulas required uncomplicated surgical repair, and 30 per cent closed spontaneously. We present our experience involving hypospadias repair, fistula formation, and management with an emphasis on penile hypospadias.

Follow-Up Studies↗
PubMed1993

Monoclonal antibodies in ovarian and prostate cancer.

Radioimmunoscintigraphy (RIS)--using radiolabeled monoclonal antibodies (MoAbs) to image disease--is a growing subspecialty of nuclear medicine. RIS of the reproductive tracts of men and women has shown encouraging results in imaging both primary lesions and metastases of these cancers. Ovarian cancer is the most fatal gynecologic cancer in the United States, and prostate cancer is the most prevalent form of cancer in men. Several MoAbs against reproductive tumor antigens were used with limited success in clinical trials before 1989. Most recently, MoAbs CYT-103 (satumomab pendetide) and OV-TL 3 have shown promise as safe, sensitive imaging tools for ovarian cancer. Although to date more agents have been used to image ovarian carcinoma than prostate cancer, research has been restimulated in prostate carcinoma imaging because of development of a promising MoAb conjugate, CYT-356. Radionuclide indium-111 appears to be the most promising radiolabeled to date for ovarian and prostate carcinoma RIS performed in the United States. In future clinical trials, consideration of safety issues and a standardization of methods among institutions using RIS are needed before the use of MoAb technology in cancer imaging will become routine. Comparative studies with more traditional methods like computed tomography are needed, as well as more trials comparing radioimmunoscintigraphic findings with pathological evidence.

Female↗
PubMed1993

Current applications of immunoscintigraphy in prostate cancer.

While adenocarcinoma of the prostate has always been one of the top three lethal malignant diseases in adult men, the ever-increasing size of the older male population due to prolonged life expectancy has added to the importance of this condition. It is estimated that over 133,000 new cases of prostatic cancer will be diagnosed this year and some 34,000 men will die from the disease. Thus, the importance of early detection and accurate staging has become more critical, particularly since safe and effective treatments are available. There is still considerable debate as to the most effective means of detection and routine screening procedures for prostatic cancer in men over the age of 50 yr. Digital rectal examination, prostatic-specific antigen determinations and rectal ultrasonography are the most successful and cost-effective screening procedures available. Regardless of the technique used, simple, accurate and reproducible staging is essential. Total surgical removal of the prostate, whether by radical retropubic or perineal approach, along with a lymph node dissection, is a potentially curative procedure. This is true provided the clinical staging is accurate and no undetected metastatic lesions are present. It is in this latter area that current technology is lacking. Routine technetium bone scans are not specific for prostatic cancer. Similarly, abdominal/pelvic computed tomography studies fail to detect lesions in localized prostatic cancer. A tumor-specific scan that detect not only bony lesions but also soft-tissue lesions would be optimal. Some believe that monoclonal antibodies directed at tumor-specific antigens afford this opportunity. We report on the Phase 1 clinical study results using an indium-labeled conjugate of the 7E11-C5.3 murine monoclonal antibody in patients with prostate cancer.

Adenocarcinoma↗
PubMed1992

Success and patient satisfaction following the Stamey procedure for stress urinary incontinence.

A long-term followup survey to determine patient satisfaction following Stamey endoscopic vesicourethral suspension was obtained by means of a mail-in questionnaire. A total of 284 charts was reviewed and surveys were mailed, 17 of which were returned for lack of a forwarding address. A total of 192 replies was received for a 72% response rate. Overall improvement was found to be 82%, with approximately half of these patients found to be totally dry. When asked if they would be willing to go through the experience again 65% said they would. Criteria for the success or failure of the procedure were determined, weighing the degree of dryness against the previously mentioned question. With these criteria there was an overall success rate of 73%. Pulmonary disease, body weight greater than 86 kg., prior Marshall-Marchetti-Krantz procedure and concomitant abdominal hysterectomy lowered the success rate. Prior hysterectomy and concomitant vaginal hysterectomy had no influence on the success rate.

Female↗
PubMed1991

Testicular scanning: evaluating the acute scrotum in the clinical setting.

In a retrospective study of patients with acute scrotal pain presenting to the hospitals of Southern Illinois University School of Medicine from January 1982 until September 1987, determination was made of the appropriate use of testicular scan for definitive diagnosis. Though the testicular scan is a highly sensitive and specific examination in the identification of testicular torsion, we believe its routine use in clinical practice is limited. Appropriate utilization of the examination requires its use in high-risk groups with equivocal physical findings or in patients with unusual presentations of age, anatomy, or neurologic deficit. The scan if used for routine screening of the acute scrotum would result in needless delays and unjustifiable expense when it is mandatory that the treatment be immediate surgical exploration.

Acute Disease↗
PubMed1990

Genital outflow tract obstruction in an adolescent with cloacal exstrophy.

The combination of congenital anomalies in patients with cloacal exstrophy presents a difficult management problem. Experience with these problems is limited because of the infrequent occurrence of the disorder and because few patients survive to adulthood. The present paper describes a 14-year-old female who presented with hyperchloremic metabolic acidosis, secondary to retained urine in a redundant ileal conduit, and symptoms of müllerian outflow tract obstruction. The literature is reviewed on genetic females with cloacal exstrophy, revealing a high incidence of müllerian fusion defects. Data are presented showing that women with cloacal exstrophy have a high potential incidence of genital outflow tract obstruction. These patients must be followed closely during adolescence so that diagnosis and treatment may be initiated early.

Abnormalities, Multiple↗
PubMed1982

Role of computed tomography in the evaluation and management of carcinoma of the prostate.

Between January 1978 to March 1980, 25 patients with biopsy-proven prostate carcinoma were evaluated by computerized tomography (CT). CT differed from clinical stage in 7 of 25 patients (28%). In 6 of the 7 patients, change in stage resulted because of demonstration of extracapsular extension and/or pelvic lymph node involvement. Twelve of the 25 patients (48%) underwent surgery with histological confirmation of CT findings. Ct identified nodal involvement accurately in 10 of 12 patients (83%). We recommend use of CT for initial staging, treatment planning and assessment of response in the management of prostate cancer.

Carcinoma↗
PubMed1981

Complications of the Gianturco coil in preoperative infarction of renal cell carcinoma.

Percutaneous artery occlusion has been described for a multitude of clinical problems, including preoperative infarction of the kidney for renal cell carcinoma. The Gianturco wool coil provides a relatively new method for occlusion. Few complications with this device have been reported. We describe our experience with complications in 3 patients and discuss methods of their prevention.

Adenocarcinoma↗