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Biomedical subjects

R H Shapiro

Publications and source records attributed to R H Shapiro.

8 recordsLinked to original sources
PubMed2000

Real-time optimized intraoperative dosimetry for prostate brachytherapy: a pilot study.

PURPOSE: To assess the feasibility of real-time intraoperative treatment planning for permanent prostate brachytherapy analyzing the impact on operative time and adequacy of postimplant dosimetry. METHODS AND MATERIALS: Seventeen consecutive patients undergoing permanent brachytherapy for prostate cancer had real-time intraoperative computer-based and optimized treatment planning. The first 8 patients were implanted using a plan generated before the surgery and served to assure the team qualitatively that this could be performed without greatly increasing intraoperative time. They served as control group for expected achieved dosimetry results reviewing the D90, V100, V150 parameters from the dose-volume histograms. The next 9 patients were implanted according to the real-time plan. The times needed to carry out various steps of the procedure were recorded. The achieved dosimetry was then compared to the control group to assure that accuracy was unchanged. RESULTS: The median operative time for patients undergoing intraoperative dosimetry was 57 min. Of this, 21 min were devoted to anesthesia and nursing functions. Postoperative dosimetry showed a median achieved V100 (volume of prostate receiving 100% of prescribed dose) of 97% for the control group. For the real-time dosimetry group, the median V100 was similar at 94%. The V150 (volume receiving 150%) is 49% for both groups. The D90 (dose received by 90% of the target) was normalized for easy comparison and was consistently slightly greater than the prescription dose. CONCLUSION: Treatment planning for permanent brachytherapy of prostate cancer has historically been performed as a computer-generated and optimized plan run weeks in advance of an implant, or according to a set pattern using an intraoperative nomogram. These data show that planning can now be optimized intraoperatively using widely available software without compromising the operative time or implant quality.

Combined Modality Therapy↗
PubMed1998

Vasectomy reversal associated with increased reactive oxygen species production by seminal fluid leukocytes and sperm.

PURPOSE: Reactive oxygen species, which are primarily produced by leukocytes, are generally detrimental to sperm. High reactive oxygen species levels are found in men with abnormal sperm function. Since men often have poor sperm characteristics and infertility after vasectomy reversal, we compared reactive oxygen species in seminal cells of men after vasovasostomy to those of fertile men to determine if reactive oxygen species were elevated in the former group. MATERIALS AND METHODS: We studied semen samples of men with proved fertility (39) and those with previously proved fertility who had undergone vasectomy reversal (45). The presence of leukocytes was determined by Bryan-Leishman staining. Reactive oxygen species endogenous activity was monitored by luminol dependent chemiluminescence in washed cells, including all cells in the semen, and Percoll density gradient purified sperm. RESULTS: After vasovasostomy men had significantly lower sperm concentration, motility and computerized motility measurements than fertile men. Mean reactive oxygen species in washed seminal cells after vasovasostomy was 684 relative light units per second compared to 49 for fertile controls (p < 0.0001). Density gradient purified sperm had 53 and 0.64 relative light units per second, respectively (p < 0.0001). When men with leukocytospermia were excluded from analysis, differences between the groups remained, although 9 times more reactive oxygen species were detected in men after vasectomy reversal with than those without leukocytes in semen. CONCLUSIONS: Higher levels of reactive oxygen species are found in washed seminal cells and purified sperm after vasectomy reversal than in those of fertile men. Although leukocytes are probably a significant source of reactive oxygen species in these groups, they may not account for all of the increased reactive oxygen species after vasovasostomy. Low motility after vasectomy reversal may be related to the detrimental effects of reactive oxygen species produced by leukocytes or sperm, even in men without clinical leukocytospermia.

Adult↗
PubMed1997

Post-traumatic priapism treated with selective cavernosal artery ligation.

Two cases of post-traumatic high-flow priapism after blunt trauma to the penis are presented. Diagnosis of high-flow priapism was accomplished with the use of both color-flow Doppler ultrasound and arteriography, which demonstrated arteriocorporal fistulas. In each patient, angiographic embolization was attempted but abandoned because the distal artery feeding the fistula could not be safely catheterized. Both patients were definitively treated with surgical ligation of the arteriovenous fistula, guided by intraoperative ultrasound. Operative management with arterial ligation provides a safe, selective, and effective alternative treatment to embolization. Two surgical approaches are discussed, one extracorporal and the other transcorporal. We believe that although transcorporal dissection poses increased risks, it is appropriate for arterial priapism of prolonged duration, especially if a well-formed vascular pseudocapsule is identified.

Adolescent↗
PubMed1996

Multiple intradural spinal lipomata with intracranial extension.

An intradural, intramedullary lipoma originating within the upper cervical cord with significant extension into the posterior fossa is reported in an infant. Two additional lipomas were found in the lumbar region. This constellation of findings represents the first description of multiple intradural, intramedullary spinal lipomas with extensive intracranial involvement.

Cerebral Ventricle Neoplasms↗
PubMed1977

Environmental trace analysis of organics in water by glass capillary column chromatography and ancillary techniques. Products of ozonolysis.

A method employing a polymeric sorbent has been used for analysis of volatile organic components in water. Trace level organics are sparged from water with nitrogen gas and are concentrated on Tenax GC prior to analysis with either flame ionization gas chromatography or gas chromatography-mass spectrometry. Glass capillary columns were used to obtain maximum resolution of chromatographic peaks. Specifically, the method has been applied to a qualitative and quantitative study of the products which result from ozonization of secondary treated domestic wastewater. The principal volatile products of ozonolysis are n-hexanal, n-heptanal, n-octanal and n-nonanal. Representative samples contained 0.7 ppb** of n-heptanal and less than 1 ppb of any of the volatile compounds.

Chromatography, Gas↗