PubMed Health⌕ Search

Biomedical subjects

J N Kabalin

Publications and source records attributed to J N Kabalin.

At least 73 records · Page 4Linked to original sources
PubMed1991

Prostate-specific antigen is not excreted by human kidney or eliminated by routine hemodialysis.

Serum levels of prostate-specific antigen have assumed a prominent clinical role in the management of prostate cancer. Little is known about the production of prostate-specific antigen, its mechanism of entry into the serum in normal and pathologic states, and mechanism(s) of removal from the serum. This study examined nephrostomy urine specimens, finding no significant excretion of prostate-specific antigen into the renal pelvic urine. Similarly, no significant lowering of serum prostate-specific antigen levels occurred during routine hemodialysis in men with chronic renal failure, nor were ambulatory, pre-dialysis serum prostate-specific antigen levels in these same men with chronic renal failure elevated. It appears unlikely that the kidney plays a significant role in the clearance of prostate-specific antigen from human serum.

Antigens, Neoplasm↗
PubMed1991

Penile implants in the treatment of Peyronie's disease.

The treatment of Peyronie's disease remains controversial. Patients who fail conservative therapy may require surgical intervention to restore the ability to have sexual intercourse. Plaque excision and dermal grafting have not been universally successful, and alternate procedures that rely on the placement of a penile prosthesis have gained in popularity. We reviewed our experience with 35 patients with advanced Peyronie's disease treated with a penile prosthesis. Preoperatively, 55% of the patients were unable to engage in intercourse due to pain or angulation of the penis and 25% were unable to achieve any erection at all. Postoperatively, with a mean followup of 6.9 years, 88% of the patients were able to engage in intercourse and were satisfied with the results obtained. In selected patients with advanced disease the implantation of a penile prosthesis remains a highly successful and satisfying alternative for the treatment of Peyronie's disease.

Adult↗
PubMed1991

Macroscopic vasovasostomy re-examined.

Results of 273 consecutive macroscopic vasovasostomy procedures performed at a single institution over a nine-year period between 1978 and 1987 were reviewed. When patients operated on less than five years after vasectomy were compared with those in whom more than five years had elapsed since vasectomy, significant declines in technical success rates as measured by return of sperm to the ejaculate (93% vs. 74%, p less than 0.004), biologic recovery as measured by mean sperm counts (55 million vs. 35 million) and mean progressive sperm motility (30% vs. 13%), and clinical success as measured by pregnancy rates (52% vs. 30%, p less than 0.02), were observed. Examination of complications of vasovasostomy showed a 7.7 percent overall complication rate and a 1.5 percent incidence of major complications.

Adult↗
PubMed1991

Prostate-specific antigen.

The Scientific Board of the California Medical Association presents the following inventory of items of progress in urology. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, or scholars to stay abreast of these items of progress in urology that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another.The items of progress listed below were selected by the Advisory Panel to the Section on Urology of the California Medical Association, and the summaries were prepared under its direction.

Adenocarcinoma↗
PubMed1990

Penile advancement and lengthening in spinal cord injury patients with retracted phallus who have failed penile prosthesis placement alone.

Even in the presence of a penile prosthesis, a subset of spinal cord injury patients remains unable to maintain a condom catheter securely due to inadequate penile shaft length and disappearance of the corpora beneath the pubic fat pad when in the sitting position. We describe 3 patients in whom a successful resolution to this problem has been achieved with rational surgical management, including lysis of the suspensory ligament of the penis, approximation of the infrapubic soft tissues posterior to the corpora so as to advance the corpora anteriorly and buttress against posterior migration (retraction) in the sitting position, maximizing the length and fit of prosthetic rods, and, when indicated, release of infrapubic skin tethering with a modified Z-plasty technique.

Adipose Tissue↗
PubMed1989

Clonal growth of human prostatic epithelial cells is stimulated by fibroblasts.

The interaction of fibroblasts with adult human prostatic epithelial cells was studied in vitro. Stimulation of epithelial cell proliferation, measured by clonal growth assay, was demonstrated when prostatic epithelial cells were grown in coculture with fibroblasts. Epithelial growth in cocultures with fibroblasts was greater than could be obtained in isolated culture in an "optimized," serum-free medium previously described. Fibroblasts were able to compensate for the deletion of several growth factors from this "optimized" medium, including epidermal growth factor and insulin, but were notably unable to replace bovine pituitary extract. Epithelial growth stimulation identical to that achieved in coculture was produced by medium conditioned by fibroblasts. Similar results were obtained by using fibroblasts of adult human prostate origin, adult human skin, human fetal lung fibroblasts (IMR-90), and mouse 3T3 cells. No difference in response was demonstrated between prostatic epithelial cells derived from normal or malignant tissues. Fixed fibroblast monolayers and extracellular matrix prepared from fibroblast cultures failed to stimulate prostatic epithelial growth. These results suggest that a soluble growth factor is secreted by prostatic fibroblasts and other human fibroblasts of nonprostatic origin, as well as by embryonic mesenchymal cells from nonhuman species, which is capable of producing a marked proliferative response in vitro from adult human prostatic epithelium. This proliferative response could not be reproduced by the addition of a variety of known growth factors to prostatic epithelial cell cultures.

Cell Communication↗
PubMed1989

Penile prosthesis surgery: review of ten-year experience and examination of reoperations.

Our ten-year experience from September, 1975, to December, 1985, with 417 penile prostheses in 290 patients is presented. Arteriosclerosis and diabetes mellitus were the two most common causes of impotence in our patient population. The Scott inflatable penile prosthesis accounted for the majority of all implants and all device failures. Complications leading to device failure and/or reoperation occurred in 36 percent of all prostheses. However, including repairs, 91 percent of patients were left with a functional prosthesis. Examination of reoperated patients showed an average increase in corporeal length of 1.67 cm with repeat prosthesis operations (p less than 0.001). No increase in incidence of prosthesis failure could be shown after multiple reoperations.

Erectile Dysfunction↗
PubMed1989

Successful implantation of penile prostheses in organ transplant patients.

We present our experience with implantation of penile prostheses in 6 organ transplant recipients, including 2 patients after renal transplantation and 4 patients after cardiac transplantation. We have seen no problems related to prosthesis surgery in this patient population, and in particular have experienced no infectious complications. All patients received strict perioperative antibiotic and steroid coverage. We conclude that erectile impotence in the male organ transplant patient can be successfully treated with penile prosthesis surgery without incurring undue morbidity and with considerable benefit in terms of quality of life in a generally young patient population.

Erectile Dysfunction↗
PubMed1989

Identification of residual cancer in the prostate following radiation therapy: role of transrectal ultrasound guided biopsy and prostate specific antigen.

Transrectal, ultrasound guided needle biopsies were performed in 27 men greater than 18 months (mean 5.2 years) after radiation therapy for prostate cancer. Of the patients 18 (67 per cent) originally had localized (stage A or B), 6 had stage C and 3 had stage D1 prostate cancer. In addition to biopsies directed at any hypoechoic regions of the prostate, multiple systematic biopsies were performed from the apex to the base bilaterally and the seminal vesicles also were biopsied regardless of appearance. Of 27 patients 25 (93 per cent) had post-irradiation biopsies positive for cancer, including 5 of 5 with prostate induration and 20 of 22 (91 per cent) with normal post-irradiation digital rectal examinations. Ultrasound findings per se were poorly correlated with pathological findings in the irradiated prostate. Directed biopsies of hypoechoic areas were positive for cancer in 67 per cent of the cases and isoechoic areas were positive for cancer in 65 per cent. Seminal vesicle biopsies were positive in 7 patients (26 per cent), including 4 with normal post-irradiation rectal examinations and 4 with normal ultrasound appearance. Of 12 patients 10 (83 per cent) with serum prostate specific antigen levels less than 10 ng. per ml. had positive biopsies, as did all 15 with levels greater than 10 ng. per ml.

Aged↗
PubMed1989

Experience with the Hydroflex penile prosthesis.

Between July 1985 and September 1987 we implanted 51 Hydroflex* penile prostheses for treatment of erectile impotence, with a minimum followup of 6 months in all patients and more than 1 year in 43. There have been no mechanical failures and no major complications. Of 47 evaluable patients 38 (81 per cent) are satisfied with the prosthesis. The 9 dissatisfied patients include 3 men who still are experiencing some difficulty operating the pump mechanism and 6 who desired a fuller or stiffer erection than provided by the Hydroflex prosthesis. All of the latter 6 individuals have successfully engaged in intercourse with the Hydroflex device. The patient who previously received a Scott inflatable penile prosthesis may not be as content with the erect state of the Hydroflex device. It also is important to assure adequate distal corporeal length before placement of the Hydroflex prosthesis.

Consumer Behavior↗
PubMed1989

Prostate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. I. Untreated patients.

Serum prostate specific antigen levels were determined (Yang polyclonal radioimmunoassay) in 230 men with untreated adenocarcinoma of the prostate after careful clinical staging. Prostate specific antigen was directly proportional to advancing clinical stage, statistically failing to distinguish only between consecutive stages B2 and B3, and between stages C and D1. Serum prostatic acid phosphatase by radioimmunoassay was unable to distinguish men with stages C plus D1 from B2 plus B3 disease but it could distinguish stages C plus D1 from A2 plus B1 (p equals 0.015). Serum prostate specific antigen was directly proportional to increasing Gleason score. In 59 untreated patients multiple prostate specific antigen values were obtained during a mean followup of 10 months. Of the patients 81 per cent showed a steady increase with time, including 91 per cent of men with clinical stage B2 or greater disease. The rate of increase accelerated with time, and correlated with advancing tumor stage and increasing serum concentration of prostate specific antigen. The rate of increase of prostate specific antigen in clinical stages A and B cancer patients suggested a doubling time of at least 2 years. Serum prostate specific antigen was significantly decreased by transurethral resection of prostatic tissue in patients with cancer, as has been shown previously in patients with benign prostatic hyperplasia.

Adenocarcinoma↗
PubMed1989

Prostate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. II. Radical prostatectomy treated patients.

Serum prostate specific antigen was determined (Yang polyclonal radioimmunoassay) in 102 men before hospitalization for radical prostatectomy. Prostate specimens were subjected to detailed histological and morphometric analysis. Levels of prostate specific antigen were significantly different between patients with and without a Gleason score of 7 or greater (p less than 0.001), capsular penetration greater than 1 cm. in linear extent (p less than 0.001), seminal vesicle invasion (p less than 0.001) and pelvic lymph node metastasis (p less than 0.005). Prostate specific antigen was strongly correlated with volume of prostate cancer (r equals 0.70). Bivariate and multivariate analyses indicate that cancer volume is the primary determinant of serum prostate specific antigen levels. Prostate specific antigen was elevated 3.5 ng. per ml. for every cc of cancer, a level at least 10 times that observed for benign prostatic hyperplasia. Prostate specific antigen is useful as a preoperative marker because no patient with lymph node metastasis had serum levels of less than 10 ng. per ml. (4 times the upper limit of normal range). Of the patients with greater than 50 ng. per ml. two-thirds had microscopic lymph node metastasis and 90 per cent had seminal vesicle invasion. Serum prostatic acid phosphatase levels showed a significantly weaker correlation with cancer volume (r equals 0.51) and every other pathological parameter. Of the patients 73 per cent had serum prostatic acid phosphatase levels in the normal range (0 to 2.1 ng. per ml.), including 7 per cent who had pelvic lymph node metastasis. Postoperative prostate specific antigen values were available in 97 of 102 patients, with a mean and maximum followup of 12 and 38 months. No patient with pelvic lymph node metastasis achieved an undetectable prostate specific antigen level without adjunctive therapy (hormonal or radiation). No difference in preoperative or postoperative prostate specific antigen levels, cancer volume, seminal vesicle invasion or incidence of pelvic lymph node metastasis was seen between patients with no capsular penetration and those with minimal capsular penetration (1 cm. or less total linear extent of full thickness penetration), providing the first quantitative evidence that small amounts of capsular penetration may not be of biological or prognostic significance.

Acid Phosphatase↗
PubMed1989

Prostate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. III. Radiation treated patients.

Serum prostate specific antigen was determined (Yang polyclonal radioimmunoassay) in 183 men after radiation therapy for adenocarcinoma of the prostate. A total of 163 men had received 7,000 rad external beam radiotherapy and 20 had been implanted with 125iodine seeds. Only 11 per cent of these 183 patients had undetectable prostate specific antigen levels at a mean interval of 5 years since completion of radiotherapy. Prostate specific antigen levels after radiotherapy were directly related to initial clinical stage and Gleason score before treatment. Multiple prostate specific antigen determinations were performed with time in 124 of 183 patients. During year 1 after radiotherapy prostate specific antigen levels were decreasing in 82 per cent of the patients but only 8 per cent continued to decrease beyond year 1. Of 80 patients observed greater than 1 year after completion of radiotherapy 51 per cent had increasing values and 41 per cent had stable values. Increasing prostate specific antigen values after radiotherapy were correlated with progression to metastastic disease and residual cancer on prostate biopsy. Total serum acid phosphatase levels were poorly related to prostate specific antigen levels, were less effective in discriminating patients with metastatic disease and provided no additional information beyond that provided by prostate specific antigen.

Acid Phosphatase↗
PubMed1989

Prostate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. IV. Anti-androgen treated patients.

Serum prostate specific antigen was determined (Yang polyclonal radioimmunoassay) in 45 patients after anti-androgen therapy for stage D2, untreated adenocarcinoma of the prostate. Of the patients 9 per cent had undetectable prostate specific antigen levels and 22 per cent were within the normal range (0.0 to 2.5 ng. per ml.), with a mean interval of 2 years since introduction of therapy. Multiple prostate specific antigen values following anti-androgen therapy were available in 36 of 45 patients. The majority of the patients demonstrated an initial, often dramatic decrease in prostate specific antigen levels during the first 6 months after introduction of therapy. After 6 months 21 of 29 patients (72 per cent) had increasing prostate specific antigen levels. Data suggest that serum prostate specific antigen determination 6 months after introduction of therapy is capable of distinguishing patients with a favorable and persisting response to anti-androgen therapy from those in whom a limited response can be expected.

Adenocarcinoma↗