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Biomedical subjects

R F Gittes

Publications and source records attributed to R F Gittes.

At least 73 records · Page 4Linked to original sources
PubMed1981

Renal brush biopsy: survey of indications, techniques and results.

Urine cytology is inaccurate in the diagnosis of low grade tumors of the ureter and pelvis. In 1973 the retrograde brush biopsy technique was introduced in an effort to improve diagnostic capabilities. We herein review our experience with retrograde brushing of upper urinary tract radiolucent filling defects in 21 patients during a 6-year period. In addition, we have surveyed other urologists concerning their experience with this new technique. The data accrued from both sources, involving 68 procedures, were analyzed with respect to the results, technique and complications of this procedure. In lesions from which tissue was obtained we found an over-all diagnostic accuracy rate of 78 per cent. The major and minor complication rates were 7 and 34 per cent, respectively. Our results support the conclusion that this procedure is of value in the management of selected patients with problem radiolucent filling defects of the renal pelvis and ureter.

Biopsy↗
PubMed1981

Nephroscopy in chronic unilateral hematuria.

Thirteen patients underwent renal exploration with nephroscopy to localize and to treat chronic unilateral gross hematuria. Recurrent episodes of clot colic were noted in 6 patients, 1 required multiple transfusions and persistent fears of cancer or problems with insurability prompted several patients to seek referral. All patients had undergone bleeding studies, urine culture, cytology, excretory urograms, retrograde pyelograms and selective renal angiography. These studies either were normal or failed to identify the bleeding source. Nephroscopy was recommended after failure of conservative treatments. At operative nephroscopy, done after preliminary cytoscopy to confirm active bleeding, the bleeding sites were identified in all our patients. Discrete submucosal hemangiomas were found in 5 patients and the bleeding could be localized to 1 calix in 7 others. Of our patients 12 underwent partial nephrectomy and 1 had a nephrectomy. To date there has been no recurrence of bleeding in any of these patients. Despite careful histological examination microscopic hemangiomas could be found in only 6 of our specimens. Chronic gross hematuria can be disabling physically and emotionally. In most, if not all, such cases judicious renal exploration with nephroscopy is warranted and cure can be expected with conservative partial nephrectomy.

Adult↗
PubMed1981

Results of inferior vena cava resection for renal cell carcinoma.

A total of 24 patients with renal cell carcinoma involving the inferior vena cava underwent thoracoabdominal radical nephrectomy with removal of tumor thrombus by an open or closed technique. The tumor extended in the inferior vena cava to the level of the renal or lower hepatic veins in 18 patients and it reached the level of the diaphragm or right atrium in 6. Of the 24 patients 3 with preoperative findings minimally suggestive of disseminated disease were shown later to have metastases in the questionable areas, 3 with disease at the level of the diaphragm had incomplete resections, 4 had metastases to regional lymph nodes and 1 had questionable preoperative findings and lymph node metastases. Only 13 of the 24 patients (54 per cent) did not have either disseminated or residual tumor postoperatively. The mean survival duration of this subgroup (20 months) was comparable to that of the group as a whole (21 months). However, 4 patients from this subgroup are free of disease, with a mean followup of 30 months. There was 1 postoperative death. Morbidity, including renal failure, intraoperative hypotension and sepsis, was common. The results in this series suggest that the prognosis for patients with renal cell carcinoma and inferior vena cava involvement is guarded.

Adenocarcinoma↗
PubMed1981

Long term parenteral infusion in the rat: a new technique.

We developed an improved method for continuous parenteral infusion of rats with minimal animals restraint. This method is reliable, relatively inexpensive, and imposes less stress upon the animal than other methods of infusion previously described.

Animals↗
PubMed1981

Resistance to intravenous tumor metastases in the athymic nude mouse: a paradoxic response.

The role of the host immune response in the abatement or prevention of tumor metastasis is unclear. To investigate possible interaction of lymphocytes with tumor cells, the F10 subline of the B16 melanoma was studied after subcutaneous or intravenous injection in original host C57BL/6 mice, Swiss nude mice, and BALB/c nude mice. The F10 tumor grew rapidly after subcutaneous injection in all strains of mice. Although florid pulmonary metastases were detected in the lungs of C57BL/6 mice after intravenous inoculation, both strains of nude mice were markedly resistant to the development of pulmonary metastases (P less than 0.001). Labeling of the B16 F10 melanoma cells with 3H-thymidine demonstrated that the kinetics of tumor cells after intravenous inoculation were similar in C57BL/6 mice and nude mice. Increased natural killer (NK) activity in the nude mouse play an important role in the prevention of pulmonary metastases.

Animals↗
PubMed1981

Segmental replacement of the ureter using tapered and nontapered ileum.

We attempted to reduce the absorptive surface area and maintain the natural antireflux mechanism of the distal ureter by using ileum as an interposed segment rather than a total ureteral substitute in six dogs. In each dog we compared the physiologic effects of a longitudinally tapered ileal segment versus a simple nontapered segment. Information from the intravenous pyelogram, renal function tests, and the pressure flow studies showed preservation of renal function and parenchyma, no secondary dilation of the upper tracts, continued peristaltic activity, no evidence of obstruction or stone formation secondary to mucus production, no early pyelographic abnormalities, and no differences in pressure flow characteristics between the tapered and nontapered segments. We believe that incorporating ileum into the urinary tract to bridge a ureteral defect is a safe and effective clinical alternative.

Animals↗
PubMed1980

Autoregulation in rats with transplanted supernumerary kidneys.

Autoregulation of mammalian renal function is implicit in the fact that a few hours after removal of one kidney the activity of the intact nephrons in the other kidney suddenly increases, both in glomerular filtration and tubular reabsorption. There follows a slower but easily measured increase in renal mass-compensatory hypertrophy in each residual nephron. That response to a reduction of nephrons has been well studied, but the adaptation of normal renal function to additional nephrons could not be tested until microsurgical techniques made it possible to transplant one or two additional kidneys into normal rats. We report here sequential measurements of the total renal function of rats with three and four kidneys. Our results indicate that autoregulation maintains total renal function at normal levels in spite of a doubling in the number of nephrons and apparent renal mass.

Animals↗
PubMed1980

Rat model for carcinogenesis in ureterosigmoidostomy.

A rat model is used to study the carcinogenesis that occurs when urine is surgically diverted into the fecal stream, as in ureterosigmoidostomy. Adenocarcinoma of the colon occurs adjacent to the urine inlet. It is completely prevented by proximal diversion of the feces, implying that fecal carcinogens are activated locally by the urine or the urothelium.

Adenocarcinoma↗
PubMed1980

Congenital penile curvature without hypospadias.

Congenital curvature of the penile shaft without hypospadias is a rare problem that poses cosmetic and functional disability. It is caused by disparate growth of the penile corpora. Surgical repair of 7 cases is reviewed, with follow-up of two to eight years. The results of these 7 cases are added to 13 other cases reported previously. The Nesbit technique was used with the modification of (1) preserving the dorsal neurovascular bundle to avoid anesthesia and lymphedema of the glans in selected cases, and (2) intraoperative use of saline-induced erections and Allis clamp " tucks" of the tunica albuginea to insure a satisfactory repair.

Adolescent↗
PubMed1980

Correlation of sperm granulomas and sperm autoantibodies in inbred rats.

The relationship between sperm granulomas and antisperm antibodies is speculative. Some investigators believe that sperm granulomas are the result of humoral sensitization, whereas others doubt that they represent an immunologic phenomenon at all. We performed transabdominal bilateral vasectomies by ligation or transection in Brown Norway, Lewis, Fischer, and Sprague-Dawley rats. These strains are known to differ in incidence of antisperm antibody formation following vasectomy. Serum was obtained monthly for determination of antibodies by indirect immunofluroescence. Animals were killed at 6 months and examined for the presence of antisperm antibodies and sperm granulomas. Both antibodies and granulomas were found in 71% of Brown Norway rats. Granulomas were found in all rats of other strains, whereas the incidence of antibodies ranged from 25% to 50%. Thus a specific immunologic relationship between sperm granulomas and antisperm antibodies has not been confirmed.

Animals↗
PubMed1980

Radiocolloid scintigraphic mapping of the lymphatic drainage of the prostate.

Radionuclide lymphoscintigraphy with the new microcolloid 99mtechnetium antimony sulfide is a diagnostic technique with potential application in patients with urologic malignancy. Scintigraphic images were obtained after simple interstitial injection into the prostate of 9 normal dogs and 2 patients with prostatic cancer and into the testis in 2 dogs. The images show the physiologic lymphatic drainage of the organs injected.

Adenocarcinoma↗
PubMed1980

Angiogenic activity as a marker of neoplastic and preneoplastic lesions of the human bladder.

Angiogenic activity has been assessed in biopsy specimens from 49 patients with transitional cell carcinoma, benign prostatic hypertrophy and vesicoureteral reflux. Over 95% of the specimens containing malignant and premalignant transitional epithelium stimulated capillary proliferation on rabbit iris. In contrast, less than 10% of normal tissues had this effect. Sixty-one per cent of specimens with inflammatory round cells were angiogenic but this was reduced to 10% by preincubation with rabbit antihuman lymphocyte serum. Cystitis cystica also induced capillary proliferation even if incubated with the antilymphocyte serum. Angiogenic capacity may be an early marker of preneoplastic and neoplastic lesions of the human bladder.

Angiogenesis Inducing Agents↗
PubMed1980

Influence of exogenous glucocorticoids and ACTH on experimental adrenal autografts.

Minced adrenal autografts under the renal capsule in adrenalectomized rats were studied by means of serial plasma corticosterone determination and histologic examination. The effect of daily treatment with dexamethasone with or without daily porcine adrenocorticotropic hormone (ACTH) gel was determined. Control autografted rats regained normal corticosterone levels by the 2nd week and at 80 days showed full regeneration of adrenal grafts. Dexamethasone treatment completely suppressed corticosterone and resulted in striking atrophy persistent at 80 days. Porcine ACTH plus dexamethasone resulted in full regeneration with cellular hypertrophy exceeding that of controls, but the corticosterone levels in samples drawn just before the scheduled ACTH injections were very low because the effect of ACTH gel lasted only 12 hr and endogenous ACTH was suppressed. Plasma levels at 40 days were 22.8 +/- 5.9 (SD) for controls, 3.8 +/- 6.1 for dexamethasone, and 5.1 +/- 4.8 for dexamethasone plus porcine ACTH. The results indicate that ACTH is necessary for the optimal regeneration of implanted adrenal autografts.

Adrenal Glands↗