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Biomedical subjects

R J Boxer

Publications and source records attributed to R J Boxer.

16 recordsLinked to original sources
PubMed1982

Radiographic grading system for renal cell carcinoma with clinical and pathological correlation.

Clinical records, pathological specimens, and radiographs of 106 patients with renal cell carcinoma were reviewed and coded for computer analysis. Twenty radiographic features of the tumor were examined for their possible prognostic significance. Three angiographic signs were associated with an unfavorable prognosis: tumor size greater than 10 cm, poor definition of tumor margins, and parasitic circulation. A new radiological grading system was developed based on these signs. Upon comparison with existing clinical staging and pathological grading systems, the new system predicted prognosis equally well. In addition, it has the advantages of predicting prognosis preoperatively and being simple for clinical use.

Adenocarcinoma↗
PubMed1979

Renal carcinoma: computer analysis of 96 patients treated by nephrectomy.

We submitted to computer analysis 109 items of pathologic, clinical and survival data from 96 patients with renal carcinoma treated by nephrectomy with or without adjuvant therapy between 1956 and 1976. The combined 1, 5 and 10-year calculated survival rates for potentially curable non-metastatic renal carcinoma (stages I, II and III, provided the regional lymph nodes were not involved) were 95, 61 and 47 per cent, respectively, compared to 1, 5 and 10-year survival rates of 61, 5 and 0 per cent, respectively, for stage IV tumors. The cytoplasmic appearance (clear or granular) was not a significant microscopic feature relevant to survival of the patient but the grade of the tumor was predictive of the outcome of disease. Other features of renal carcinoma, particularly invasion of the renal vein and, to a lesser degree, perinephric fat, were not as prognostically significant in this series. In this retrospective study we further analyze the clinical, radiologic, pathologic and survival data of this group of patients.

Adenocarcinoma↗
PubMed1979

Cath-A-Cyst: a new urinary catheter.

A new disposable catheter assembly using the advantages of the Foley catheter, filiform and followers is presented. This new system obviates emergency urologic consultation or further trauma to a patient with a difficult urethra to catheterize.

Disposable Equipment↗
PubMed1979

Replacement of the ureter by small intestine: clinical application and results of the ileal ureter in 89 patients.

Partial or total replacement of the ureter by small intestine was performed at the University of California/Los Angeles Hospital and affiliated hospitals 94 times in 92 patients from 1954 to 1978. Indications included recurrent calculi, ureteral stricture, fistula, congenital obstruction of the ureter and ureteral carcinoma with a solitary kidney. A special use has been for undiversion of an ileal conduit. Followup evaluation was possible in 95% of the patients and ranged from 6 months to 23 years. Thirty-six patients were followed for more than 5 years. The operation was judged successful in 81% of the cases. Serum creatinine was unchanged or decreased in 75.7% and the pyelogram was unchanged or showed decreased dilatation in 84.6% of the patients. Although reflux was seen in 40 of 55 patients who had cystograms 39 (97.5%) were considered to be treated successfully. Indications for and results of the operation are discussed. The procedure is recommended as optimal therapy for carefully selected situations when the normal urinary tract cannot be used.

Child↗
PubMed1978

Methods of cost control in urologic care.

The urologist now has the capability of significantly reducing the cost of care for his patients. Major savings could occur by performing procedures, laboratory tests, and roentgenographic studies in proper sequence. The use of outpatient evaluations and surgery can save the patient expensive hospital room charges. Proper utilization of equipment would markedly decrease costly duplication of services. Quality of care cannot and will not be affected by these cost-saving measures. Furthermore, retrospective and prospective clinical studies should be instituted immediately to determine the pathophysiology of genitourinary disease, specifically answering the question of which laboratory tests have the highest diagnostic yield. Protocols could be started to eliminate wasteful low-yield procedures and to maximize diagnosis and therapy while minimizing cost. Finally, controls must be placed on the continuing trend toward an excess of physicians.

Ambulatory Care↗
PubMed1978

Non-metastatic hepatic dysfunction associated with renal carcinoma.

A retrospective computer analysis of 102 patients treated for renal tubular carcinoma revealed 7 patients who presented with non-metastatic hepatic dysfunction. Of these 7 patients 5 also had the triad of fever, weight loss and fatigue. Only 1 patient survived more than 10 years after nephrectomy. A review of the literature on non-metastatic hepatic dysfunction revealed a significant interval between onset of symptoms and detection of the underlying renal malignancy, as well as a poor over-all survival rate if the syndrome persisted after nephrectomy.

Adenocarcinoma↗
PubMed1978

Replacement of the ureter by small intestine: clinical application and results of the ileal ureter in 89 patients.

Partial or total replacement of the ureter by small intestine was performed at the University of California/Los Angeles Hospital and affiliated hospitals 94 times in 92 patients from 1954 to 1978. Indications included recurrent calculi, ureteral stricture, fistula, congenital obstruction of the ureter and ureteral carcinoma with a solitary kidney. A special use has been for undiversion of an ileal conduit. Followup evaluation was possible in 95 per cent of the patients and ranged from 6 months to 23 years. Thirty-six patients were followed for more than 5 years. The operation was judged successful in 81 per cent of the cases. Serum creatinine was unchanged or decreased in 75.7 per cent and the pyelogram was unchanged or showed decreased dilatation in 84.6 per cent of the patients. Although reflux was seen in 40 of 55 patients who had cystograms 39 (97.5 per cent) were considered to be treated successfully. Indications for and results of the operation are discussed. The procedure is recommended as optimal therapy for carefully selected situations when the normal urinary tract cannot be used.

Carcinoma↗
PubMed1977

Condylomata acuminata and squamous cell carcinoma.

Until recently, condyloma acuminatum has been considered to be a benign growth with no malignant potential. The histologically similar, yet clinically different, giant condyloma acuminatum (Buschke-Lowenstein tumor) has been defined as a mass with downward growth that has no histologic malignant changes, although the clinical course may be malignant. A review of the literature yielded 65 cases of malignant degeneration of this type of tumor and supports the concept that either condyloma acuminatum or the Buschke-Lowenstein tumor may precede or be associated with squamous cell carcinoma. A patient presenting with condyloma acuminatum in whom invasive squamous carcinoma of the penis developed exemplifies the transitory character of the disease.

Adult↗
PubMed1977

Radical prostatectomy for carcinoma of the prostate: 1951-1976. A review of 329 patients.

Surgical therapy for early adenocarcinoma of the prostate has been an effective mode of cure since it was described by Young in 1905. The retropubic and perineal approaches of radical prostatectomy have been used at our hospitals for 25 years. Herein we examine 329 cases at the 2 hospitals. Although there were only 2 deaths (0.61 per cent) immediately attributable to the operation the surgical morbidity was significant. Patients of the attending staff had a 46 per cent complication rate while that of patients of the resident staff was 59 per cent. The 5 and 10-year survival rates of patients with stages A and B prostatic adenocarcinoma were 82 and 63 per cent, respectively, and the 5 and 10-year survival rates of patients who had stage C prostatic adenocarcinoma were 67 and 29 per cent, respectively. Our survival rates compare favorably to the national average survival for patients of all ages with localized or regional adenocarcinoma of the prostate. We believe that these data support the position of urologists who believe in radical surgical treatment of prostatic cancer.

Adenocarcinoma↗
PubMed1976

Penile reconstruction in irradiated patient.

Reconstruction of a penis using a modified Gillies technique was performed on a forty-one-year-old man who had a total penectomy, inguinal node dissection, and 6,000 rads of cobalt-60 irradiation for carcinoma of the penis. The three different surgical techniques for reconstructing the penis are discussed in detail. It is our belief that reconstruction of a urethra and placement of a baculum in penile reconstruction after radiation therapy have more disadvantages than advantages. The literature is reviewed.

Adult↗
PubMed1975

Reconstruction of the male external genitalia.

Congenital malformation, infection, lymphatic obstruction, trauma and carcinoma all have common denominator, the loss of tissue. This loss necessitates the surgeon's use of various techniques in reconstructing the male external genitalia. The stretching of remaining skin, split thickness grafts, flaps and pedicle tube grafts are used to cover the denuded area or reconstruct the penis and scrotum. These methods have been used recently in transsexual operations, combining the expertise of the plastic surgeon, urologist, endocrinologist and psychiatrist. Further improvement upon the preceding approaches is sought to maintain sensation, achieve acceptable cosmesis, create a sexual organ as well as a urinary conduit and prevent severe postoperative complications.

Elephantiasis↗