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Biomedical subjects

L S Baskin

Publications and source records attributed to L S Baskin.

At least 109 records · Page 6Linked to original sources
PubMed1992

Carcinoma of male urethra: management of locally advanced disease with combined chemotherapy, radiotherapy, and penile-preserving surgery.

Squamous cell carcinoma of the urethra is a rare urologic malignancy. In spite of aggressive management with radical and often times disfiguring surgery and/or radiation therapy, prognosis remains poor. Initial success in treating squamous cell carcinoma of the esophagus and anal canal has been reported with a combined radiation and chemotherapy protocol. In hopes for improving the treatment outcome for patients with squamous cell carcinoma of the urethra, we have applied the new combination chemotherapy/radiation therapy protocol. Herein, we report the successful downstaging (clinical Stage C to pathologic Stage TO) and treatment of squamous cell carcinoma of the anterior urethra with combination chemotherapy/radiation therapy. This was followed with penile-preserving surgery to document local control of disease and to avoid the morbidity of a radical disfiguring operation.

Aged↗
PubMed1992

Congenital defect in sinusoidal smooth muscles: a cause of organic impotence.

We report 2 cases of primary impotence due to a congenital defect in the compliance of the sinusoidal spaces secondary to fibrosis and atrophy of the smooth muscles. Both patients were young adults at presentation. Diagnosis of this rare entity was achieved by penile Doppler ultrasound and cavernosometry/cavernosography of the cavernous bodies. Both patients underwent placement of a penile prosthesis, during which biopsy samples of the cavernous tissue were obtained, and diagnosis was confirmed by light and electron microscopy.

Adult↗
PubMed1992

Pelvic pain without pelvic organs.

We report on 4 patients with persistent, severe pelvic pain unresponsive to removal of the bladder, uterus, ovaries and fallopian tubes. Of the patients 3 had a diagnosis of interstitial cystitis and 1 had voiding dysfunction. We conclude that severe pelvic pain may not be responsive to the elimination of pelvic organs and alternative organ-preserving therapies should be considered.

Adult↗
PubMed1992

Bladder rehabilitation with dorsal rhizotomy and ventral neuroprosthesis.

Two patients with severe neuropathic bladders were successfully treated with selective dorsal rhizotomy in conjunction with a ventral root neuroprosthesis. Both patients achieved stabilization of their renal function, continence, resolution of vesicoureteral reflux, and relief from indwelling urethral catheters. This alternative form of management avoids the complications of other operative approaches.

Adult↗
PubMed1992

Normal growth with renal insufficiency owing to posterior urethral valves: value of long-term diversion. A twenty-year follow-up.

Twenty-five patients with posterior urethral valves have been monitored for 10-29 years (mean 18 years). Eight underwent diversion because of impaired renal function (creatinine greater than 0.8 mg/dl) accompanied by unimproved upper tract form and function after valve ablation. In the nondiverted group, 6 patients (35%) progressed to renal failure; in the diverted group 5 patients (63%) did so (p = 0.30). Of 13 patients whose lowest serum creatinine in the first year after valve ablation was greater than 0.8 mg/dl, 9 (69%) went on to renal failure (p = 0.02); in the remaining 12 patients, only 2 (17%) did so (p = 0.008). The mean age for renal failure was 13 years for both groups. The Tanner scale rating (mean percent height) for all patients at 10 years was 61% for the diverted group and 35% for those without diversion (p = 0.004). When the patients treated after the age of 1 year (n = 7) were excluded from the calculation, the rating remained different (54% diversion, 26% no diversion; p = 0.012). We conclude that the boy born with urethral valves and serious upper tract damage is at risk for renal failure, especially during the teen years. An undefined relationship appears to exist between urinary obstruction and growth. In our study, the boys who underwent diversion continued to grow along a normal Tanner height curve.

Adolescent↗
PubMed1991

Simultaneous resection of renal carcinoma and abdominal aortic aneurysm.

A 62-year-old man with a 6.5 cm abdominal aortic aneurysm and coexistent left renal cell carcinoma was treated by simultaneous radical left nephrectomy and abdominal aortic aneurysm repair. Care was taken to avoid potential infection of the bypass graft by inadvertent contamination with urine. Pathologic examination of the left kidney revealed a renal cell carcinoma, clear cell type, with no evidence of invasion into the renal vein or lymph node metastases. The patient had an uncomplicated recovery and is well and free of disease four years after operation. In cases of equivalently life threatening surgical diseases, simultaneous resection is warranted.

Aorta, Abdominal↗
PubMed1991

Unusual appendiceal pathology presenting as urologic disease.

We report on 3 cases of unusual appendiceal pathology presenting as urologic disease: 2 cases were benign mucoceles and 1 a malignant mucocele or cystadenocarcinoma of the appendix. Two cases presented as pelvic masses causing urinary frequency and the third with fever and hydronephrosis. The appendix must remain in the differential diagnosis for both acute and chronic disease processes.

Appendix↗
PubMed1991

Magnetic resonance imaging of renal calculi: an in vitro study.

Extracorporeal shock wave lithotripsy (ESWL) has been established as a standard method of urinary stone treatment. Poor fragmentation with an increased rate of complications has been noticed with certain calculi types (calcium oxalate monohydrate and cystine). In devising appropriate pre-operative strategies, it would be useful to know the calculi composition. We have investigated the in vitro utility of using magnetic resonance imaging (MRI) in analyzing urinary calculi. Our in vitro analysis found no difference in signal characteristics between calculi of varying composition. The absence of signal can be understood from a molecular basis. We conclude that MRI will not offer any assistance in characterizing the composition of urinary calculi.

Humans↗
PubMed1990

Pyoderma gangrenosum presenting as Fournier's gangrene.

We report a case of pyoderma gangrenosum presenting as Fournier's gangrene. Although both processes have a similar presentation effective management is markedly different. Whereas broad-spectrum antibiotics and aggressive surgical débridement are necessary to control Fournier's gangrene, immediate institution of corticosteroids and local wound care are indicated for pyoderma gangrenosum.

Adult↗
PubMed1990

Necrotising soft tissue infections of the perineum and genitalia. Bacteriology, treatment and risk assessment.

Necrotising soft tissue infections of the perineum and genitalia are associated with a high rate of mortality and morbidity. We reviewed the records of 29 consecutive patients to investigate the possible correlation between clinical outcome and number of types of bacteria cultured, focus of infection, presence of diabetes, patient age, renal function and delay until presentation. The patients had an average of 3.9 bacterial organisms cultured intra-operatively (range 1-9). Patients with a rectal focus of infection had a greater number of bacteria and required longer hospitalisation and more operative procedures than patients with dermal or urethral foci. Those over the age of 60 had significantly longer hospital stays and higher mortality. Diabetes and impaired renal function did not increase mortality or morbidity. Suprapubic cystostomy was required in 24 patients (83%), diverting colostomy in 9 (31%) and orchiectomy in 3 (10%). Six patients (21%) died despite broad spectrum antibiotics and aggressive and frequent surgical debridement.

Adolescent↗
PubMed1990

Treatment of infants with neurogenic bladder dysfunction using anticholinergic drugs and intermittent catheterisation.

The use of anticholinergic drugs in infants with neurogenic dysfunction has not been well documented. In this study, 35 neonates at risk of upper urinary tract damage from neurogenic dysfunction were treated from infancy with anticholinergics, in combination with clean intermittent catheterisation. None of the patients showed upper urinary tract deterioration with follow-up ranging from 6 to 72 months, although 2 required vesicostomy--1 due to difficulty with catheterisation and 1 due to possible anticholinergic side effects. Only 2 (6%) have had clinical pyelonephritis. Twenty-five (76%) are virtually dry between catheterisation. We conclude that anticholinergics are safe and effective, even in the neonatal period, when used in combination with clean intermittent catheterisation for the treatment of neonates with neurogenic bladder dysfunction.

Combined Modality Therapy↗
PubMed1990

Perphenazine-induced priapism.

A 29-year-old man experienced four episodes of prolonged painful erection while being treated with perphenazine for paranoid schizophrenia. Each episode of priapism lasted five hours or longer. On two occasions, aspiration of blood from the corpora cavernosa resulted in detumescence; the other episodes were successfully managed with operative shunting of blood from the congested cavernosa. Perphenazine was discontinued after the fourth episode of priapism and antipsychotic treatment with thiothixene was subsequently initiated. During 16 months of follow-up, the patient has reported normal erections without repeat episodes of priapism.

Adult↗
PubMed1989

Human cytochrome c oxidase during cardiac growth and development.

Human heart mitochondrial cytochrome c oxidase specific content and specific activity was measured in five fetuses 15-21 weeks gestational age and in five patients whose age ranged from 6 days to 22 years. None had evidence of cardiac pathology. An increase in cytochrome c oxidase specific content and specific activity was observed in the fetal heart with increasing gestational age (0.13-0.38 nmol heme a/mg protein and 67-295 nmol O2 utilized/min/mg protein) and from the neonatal period (0.35 nmol heme a/mg protein and 140 nmol O2/min/mg protein) to adulthood (1.2 nmol heme a/mg protein and 1104 nmol O2/min/mg protein). A marked increase was observed postnatally between 4 and 19 months.

Adolescent↗