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Biomedical subjects

R F Gittes

Publications and source records attributed to R F Gittes.

At least 55 records · Page 3Linked to original sources
PubMed1985

The role of germinal epithelium and spermatogenesis in the privileged survival of intratesticular grafts.

The testis is an immunologically privileged site. Since earlier studies excluded testicular steroid production as an essential factor, the present study evaluates the role of germ cells and spermatogenesis in the privileged survival of allografts within the testis. We used a Sertoli cell-only testis model and adolescent unilateral cryptorchidism in inbred rats to eliminate germ cells and spermatogenesis selectively. Parathyroid allografts were implanted into these sites, normal testes and beneath the renal capsule (a nonprivileged site) in appropriately matched controls. With at least 15 rats in each group, privileged allograft survival was shown to be unaffected by eliminating germ cells and spermatogenesis (p less than .005). Experimental evidence suggests the presence of an active process which incidentally permits privileged allograft survival within the testis, but which exists teleologically to protect the developing sperm from autoimmune attack. This is in addition to the passive anatomical separation provided by the blood-testis barrier. Our cumulative data strongly implicates the Sertoli cell in this process.

Animals↗
PubMed1985

Differentiation of malignant from benign adrenal masses: predictive indices on computed tomography.

CT findings in 43 adrenal masses were analyzed to see which features correlated most significantly with malignancy. Size, contrast enhancement, and consistency emerged as important discriminators of malignant from benign adrenal masses. These three factors were further analyzed by logistic regression technique to examine the joint influence of computed tomographic (CT) features in prediction of malignancy. As a result of logistic regression analysis, a table of estimated probability of malignancy as a function of tumor size alone and another table of estimated probability as a joint function of size and contrast enhancement were developed. Given a similar patient sample and by using the data given, it would be possible to predict chances of malignancy in an adrenal mass if its CT features are known; for example, a 5-cm adrenal mass without enhancement has a 0.31 probability of malignancy; with enhancement, a 0.68 probability.

Adenoma↗
PubMed1984

Ultrasound diagnosis of small asymptomatic bladder carcinoma in patients referred for gynecological scan.

We report on 4 patients with bladder cancer detected during pelvic ultrasound for gynecological indications without urinary symptoms. Only 1 of the 4 patients had hematuria. All 4 patients were treated by cystoscopic excisional biopsy and no further operation was required. We stress that the bladder often is forgotten during pelvic ultrasound and that sonography is a sensitive, noninvasive tool to examine the bladder.

Adult↗
PubMed1984

The effect of ureteroperitoneostomy on renal mass in fasted rats.

The "work" hypothesis of renal compensatory hypertrophy has always been opposed to the established observation that the peritoneal reabsorption of 1 rat kidney's excretion after ureteroperitoneostomy does not result in a compensatory increase in total renal mass. But urine peritonitis in the U-P rats could result in a lower intake of food and/or less efficient digestion, thus making it difficult for rats to undergo compensatory renal growth. To eliminate nutrition as a factor, all rats were fasted after undergoing either uninephrectomy, uretero- peritoneostomy , or a sham operation. Uninephrectomized rats maintained their residual renal mass better than their sham controls under fasting conditions (109 +/- 11.3 versus 95 +/- 5.7 mg. per 100 gm. body weight, p less than .001). But the final renal mass and body weight of uretero- peritoneostomized rats and sham-operated rats was the same. Thus the added excretory burden of uretero- peritoneostomized rats does not have the renal-sparing effect observed after uninephrectomy in fasted rats and urine peritonitis is not a sufficient explanation for this lack of response to uretero- peritoneostomy . It can be maintained that, since uretero- peritoneostomy has no renotrophic effect, there is a qualitative difference between uninephrectomy and uretero- peritoneostomy as stimuli for renal compensatory hypertrophy.

Animals↗
PubMed1983

Prostate cancer.

Explore the source record for details and available documents.

Humans↗
PubMed1983

Posterior lumbotomy: surgery for upper tract calculi.

Posterior lumbotomy, modified by the adjuvant use of nephroscopy and postoperative stents, is presented as a preferred approach to upper ureteral, pelvic, or caliceal calculi. Its limited morbidity, brief hospitalization, brief operative time, and total efficacy of removal of calculi are the standards with which newer techniques described in this symposium must be compared.

Adult↗
PubMed1982

The effect of uretero-peritoneostomy on renal mass in rats with porto-caval shunts.

It is established that peritoneal reabsorption of 1 kidney's excretion after uretero-peritoneostomy does not result in a compensatory increase in renal mass. To test whether a factor in normal urine which is deactivated by passage through the liver becomes renotrophic if absorbed directly into the systemic blood, either unilateral uretero-peritoneostomy or intraperitoneal infusion of normal urine was performed in rats with prior porto-caval shunts. No significant growth occurred in the intact kidney(s) of such rats. Uninephrectomy did cause compensatory hypertrophy in porto-caval rats. Thus the porto-caval shunt did not alter the inability of peritoneal urine to induce compensatory hypertrophy in spite of the obvious added excretory load.

Adaptation, Physiological↗
PubMed1982

The comparative medical costs of 2 major procedures available for the treatment of stress urinary incontinence.

Female urinary stress incontinence is a common surgical problem. We reviewed the case records of 71 women who were operated upon for stress incontinence at our medical center from 1975 to 1980. Of these women 30 underwent the Pereyra-Stamey endoscopically controlled suspension of the bladder neck and 41 underwent the Marshall-Marchetti-Krantz repair. We compared the major components of care contributing to the cost of each surgical procedure. At current 1980 prices a significant saving of 4 days in hospital stay and of $2,500 in total medical costs can be effected by choosing the Pereyra-Stamey technique over the Marshall-Marchetti-Krantz procedure. No important differences were noted in complications, operating room time or surgeon's fees.

Boston↗
PubMed1982

Locally extensive renal cell carcinoma--current surgical management of invasion of vena cava, liver, or bowel.

Review of a personal and combined experience in cases of renal cell carcinoma invading the vena cava, liver, or bowel, has been carried out. The methodology in each of these situations is described. The long term results for survival after vena cava invasion are less than 20% at 5 years--lower than previous optimistic estimates. The long term survival with invasion of the liver or bowel is negligible. However, excellent palliation is achieved and the urological surgeon should be prepared to carry out the additional resection of adjacent invaded liver or bowel to achieve palliative nephrectomy in such cases when the invasion is found at the operating table.

Adenocarcinoma↗
PubMed1982

Bench surgery in renal tumors.

Extracorporeal or "bench" surgery is useful in highly selected cases of renal cell carcinoma in a solitary kidney, those with large tumors involving the center third of the kidney or multiple tumors. This author reports on its use in 7 patients out of 25 operated for cure for tumor in a solitary kidney. Except for 1 postoperative non-cancer death, all are now alive and free of tumor between 2 and 10 years after surgery.

Adenocarcinoma↗