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Biomedical subjects

R F Gittes

Publications and source records attributed to R F Gittes.

At least 91 records · Page 5Linked to original sources
PubMed1979

Sexual impotence: the overlooked complication of a second renal transplant.

The incidence of sexual impotence in 20 men who have received at least 2 kidney transplants was 65% compared to 10% after the first transplant. The importance was transient (2 to 4 months) in both affected men after the first transplant but permanent (2 to 10 years) in 6 men after the second operation. We attribute this increased percentage of impotence to the second end-to-end arterial anastomosis that requires division of the internal iliac arteries. We suggest that the second transplant be placed end-to-side into the common iliac artery.

Adult↗
PubMed1979

Dissolution of cystine ureteral calculus by irrigation with tromethamine.

An alternative to surgical intervention in cases of symptomatic cystine calculi is presented. A large obstructing ureteral calculus in a patient who had undergone 4 prior lithotomies was dissolved during a 5-day period by irrigation via a ureteral catheter with tromethamine-E, an alkaline organic amine intravenous solution.

Adult↗
PubMed1979

Nephroscopy.

Nephroscopy has become an increasingly important adjunctive procedure in the diagnosis and treatment of patients with suspected calyceal calculi, essential renal hematuria, and selected forms of renal tumors. Great advances have been made in the instrumentation and technical aspects of the procedure, and it is hoped that further progress in these areas will render nonoperative renal endoscopy useful even in cases of renal hematuria and infected kidneys.

Endoscopes↗
PubMed1978

Adrenal autotransplantation.

New tools for the diagnosis of adrenal diseases and the development of successful techniques to treat patients with bilateral tumors of the kidney have increased the number of procedures involving removal of both adrenals. Offering to these patients an adrenal autograft represents more than a superfluous medical exercise, since a successful outcome of the graft will relieve them of the burdens and risks of long-term postoperative steroid replacement therapy. The aim of this review is to bring to mind the possibility of autografting adrenal glands in some clinical situations and to emphasize some points that could be relevant in obtaining successful results. The available data justify clinical trials with the procedure.

Adrenal Gland Neoplasms↗
PubMed1978

Sexual impotence: the overlooked complication of a second renal transplant.

THE INCIDENCE OF SEXUAL IMPOTENCE IN 20 MEN WHO HAVE RECEIVED AT LEAST 2 KIDNEY TRANSPLANTS WAS 65 PER CENT COMPARED TO 10 PER CENT AFTER THE FIRST TRANSPLANT. The impotence was transient (2 to 4 months) in both affected men after the first transplant but permanent (2 to 10 years) in 6 men after the second operation. We attribute this increased percentage of impotance to the second end-to-end arterial anastomosis that requires division of the internal iliac arteries. We suggest that the second transplant be placed end-to-side into the common iliac artery.

Adult↗
PubMed1978

Intratesticular grafts: the testis as an exceptional immunologically privileged site.

The testis is an immunologically privileged site despite a normal lymphatic drainage, whereas the anterior chamber of the eye is a privileged site because it lacks normal lymphatics. Parathyroid grafts were transplanted between several strains of inbred rats (Buffalo leads to Lewis and Lewis X Brown Norway F1 leads to Lewis). Allografts were placed in the testis, thigh muscle, prostate, lymph nodes, anterior chamber of the eye and adrenal gland. The survival of intratesticular allografts also was tested in animals whose pituitary gonadotropins were suppressed by testosterone and estradiol implants. The effects of steroid implants were documented by measuring testosterone and progesterone concentrations in the serum and whole testis homogenates of these animals. Allograft survival was judged by fasting plasma calcium concentrations. The data show that 1) the adrenal is included among naturally occurring immunologically privileged sites, 2) the prolonged survival of intratesticular allografts may be related to the local production of steroid hormones, although allograft survival is not critically dependent on pituitary gonadotropins and 3) temperature differences and a high zinc concentration within the testis are not important to allograft survival.

Adrenal Glands↗
PubMed1977

Effects of immunosuppression on the rejection of methylcholanthrene tumor isografts.

The effect of immunosuppression with azathioprine, methylprednisolone, or both, on primary and secondary immune responses to a transplanted tumor was studied. The ability to reject a methylcholanthrene-induced squamous cell carcinoma of the prostate in Lewis rats was determined by rechallenge with tumor cells after amputation of the primary transplant. Oral azathioprine (20 mg/kg/day) increased the incidence of tumors in a primary challenge, but did not affect the ability of immunized rats to reject subsequent tumor isografts. Similar results were obtained with 2 mg/kg day intraperitoneal (IP) azathioprine, 2 mg/kg IP methylprednisolone, and the combination of 2 mg/kg/day IP methylprednisolone and 10 mg/kg/day IP azathioprine. It appears that immunosuppression by azathioprine affects the proliferation of sensitized cells during the immunological response to antigens of this specific tumor. Immunosuppression does not appear to alter substantially the processing of tumor-specific antigens or the cytotoxic effectiveness of the immune system. This data is reassuring to the concern of whether transplantation in patients previously cured of cancer is safe.

Animals↗
PubMed1977

Medical therapy of experimental infection stones.

Struvite bladder calculi were induced in rats with an intrarenal injection of urease-producing human T mycoplasma strain T960. Acetohydroxamic acid was effective in inhibiting calculous formation. Methylene blue, tetracycline, orthophosphate, diphosphonate, and hydrochlorothiazide had no inhibitory effect.

Animals↗
PubMed1977

Replacement of the damaged or neoplastic ureter by ileum.

Ileum was used as a ureteral replacement in 12 patients, 7 of whom had solitary kidneys. The conditions that necessitated an operation included renal pelvic and ureteral complications of calculi, a variety of traumatic ureteral injuries, retroperitoneal fibrosis and ureteral neoplasms. Renal function has been well preserved and electrolyte imbalance has been minimal.

Adult↗
PubMed1977

Detrusor-urethral sphincter dyssynergia.

Inappropriate contraction or failure of relaxation of either the internal (smooth muscle) or external (striated muscle) urethral sphincter or both coincident with detrusor contraction results in a micturitional disorder known as detrusor-urethral sphincter dyssynergia. Based on our clinical experience with more than 200 spinal cord subjects and serial urodynamic observations on some of these individuals from the time of injury, various grades of dyssynergia (1 to 3) were recognized. The duration and completeness of suprasacral cord injury essentially determined the degree of dyssynergia. Internal sphincter dyssynergia was encountered less often in this group. A review in relation to pathophysiology and management of this micturitional dysfunction is presented.

Adolescent↗
PubMed1977

Inflammatory carcinoma of the bladder and interstitial cystitis.

Two patients were treated for interstitial cystitis after having had bladder biopsies that did not reveal tumor. However, in both cases an aggressive carcinoma of the bladder later proved to be present when simple cystectomy for the "benign" disease was done. The masquerade of carcinoma of the bladder as interstitial cystitis and the pitfalls inherent in making the correct diagnosis are emphasized. The possibility of underlying bladder carcinoma should be excluded in any patient who presents with symptoms of chronic cystitis. Urinary cytology is most helpful but repeated bladder biopsy with careful serial sectioning may be necessary to establish the diagnosis of malignancy. It is not known whether the carcinomas were primary or secondary developments in our cases. The term inflammatory carcinoma of the bladder is proposed to call the attention of clinicians and pathologists to this lethal imitator.

Adult↗
PubMed1977

Morbidity of pelvic lymphadenectomy and radical prostatectomy for prostatic cancer.

Radical retroperitoneal pelvic lymphadenectomy is associated with rather minimal morbidity but, when combined with radical prostatectomy, the morbidity is increased. The only complication that seemed to be solely owing to the lymphadenectomy was lymphocele formation, which occurred in 10 per cent of the patients. This rate is below that reported in the gynecologic-oncology literature.

Adult↗
PubMed1977

Anteromedian external urethral sphincterotomy: technique, rationale and complications.

Experiences are presented with bilateral (3 and 9 o'clock incisions) and anteromedian (12 o'clock incision) external urethral sphincterotomy in 84 patients with neuropathic vesicourethral dysfunctions. Hemorrhage and loss of reflexogenic erections have been notably absent in 31 patients who underwent anteromedian sphincterotomy. The rationale is discussed for the preference of anteromedian over bilateral sphincterotomy based on postoperative complications. The postoperative, radiologically aided cystosphincterometric and electromyographic studies during micturition indicated the adequacy of the surgical procedures, satisfying the urodynamic criteria, although dyssynergic myolectric activity of the periurethral striated muscle continued to exist.

Electromyography↗
PubMed1977

Functional contribution of autonomic innervation to urethral striated sphincter: studies with parasympathomimetic, parasympatholytic and alpha-adrenergic blocking agents in spinal cord injury and control male subjects.

Mechanisms underlying urethral pressure changes at the external sphincter region after administration of neuropharmacologic agents were investigated with cystosphincterometric studies and electromyography of the external urethral sphincter in adult patients with spinal cord injury and control male subjects. Bethanechol chloride, propantheline or phentolamine were administered to 37 spinal cord injury men and 3 normal controls. After cystectomy 3 additional spinal cord injury patients were subjected to bethanechol studies. The results of these studies suggested that the pressure changes in the external sphincter zone were caused predominantly by the concurrent changes produced in the detrusor and/or the smooth muscle components of the proximal urethra and of the external sphincter zone.

Adolescent↗