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Biomedical subjects

R K Babayan

Publications and source records attributed to R K Babayan.

53 records · Page 3Linked to original sources
PubMed1987

The role of ammonia toxicity in the post transurethral prostatectomy syndrome.

To investigate the aetiology of altered mental status following transurethral prostatectomy (TURP), serum electrolyte and blood ammonia levels were measured in 33 patients before and immediately after TURP. The irrigating fluid was 3% sorbitol in 12 patients and 1.5% glycine in 21. Serum electrolyte changes were similar in both groups. Elevated blood ammonia levels were observed in eight of the 21 patients receiving glycine irrigation. Three of these eight patients demonstrated clinical signs of encephalopathy. Absorption of glycine during transurethral prostatectomy appears to produce hyerammonaemia in some patients and may contribute to the encephalopathy.

Aged↗
PubMed1986

Vasectomy: what are community standards?

Vasectomy has become an increasingly popular mode of contraception in our society. It is also a procedure which places the urologist at an uncommonly high risk for litigation. To better assess the manner in which urologists within a geographical region treat their vasectomy patients, a survey was conducted of the members of the New England Section, American Urological Association. The results of that survey are presented.

Adult↗
PubMed1986

Transplant ureteral obstruction masquerading as recurrent rejection episodes: management by percutaneous antegrade balloon dilatation.

We report a 52-year-old male renal transplant recipient who had three "rejection episodes." The first of these responded to conventional antirejection therapy; however, the next two episodes showed incomplete responses to treatment for rejection. At subsequent presentation with deteriorating renal function, ureteral obstruction was evident and was relieved with percutaneous antegrade balloon dilatation with a return of his plasma creatinine to normal. Obstruction of the ureter was a major component in our patient's course given the lack of response to conventional antirejection therapy and the normalization of renal function with relief of the documented ureteral stenosis. This case illustrates that ureteral obstruction can mimic rejection in the renal transplant recipient. Management of ureteral stenosis in transplant patients with percutaneous antegrade balloon dilatation appears to be an effective procedure and can supplant the need for open surgical procedures.

Catheterization↗
PubMed1984

Radiation-associated impotence. A clinical study of its mechanism.

External beam pelvic irradiation in men is frequently complicated by erectile dysfunction. We tested the erectile function in 23 patients (mean age, 65 years) who received radiation therapy for prostate cancer. Fifteen patients experienced changes in erectile potency following radiotherapy. Neurological, endocrine, and vascular testing revealed abnormalities in 0, 5, and 15 of these patients, respectively. In two, arteriography revealed bilateral occlusive disease in the distal internal pudendal and penile arteries overlying the pelvic radiation field. A significant difference with cigarette smoking was found among the 15 patients whose erectile capacity decreased and the four patients whose capacity remained unchanged. Vasculogenic impotence is the most consistent organic erectile abnormality in RAI.

Aged↗
PubMed1984

Hematuria and the use of nonsteroidal anti-inflammatory drugs.

We reviewed 116 consecutive adults hospitalized for hematuria (92 with gross and 24 with microscopic hematuria). The cause of hematuria (that is neoplasia, stones, infection and inflammation) was recognized in approximately 79 per cent of the 116 patients (group 1), while 21 per cent (group 2) had idiopathic hematuria. Review of drug history in these 2 groups revealed that nonsteroidal anti-inflammatory drugs were used in 1 per cent of the patients in group 1 compared to 54 per cent in group 2. To confirm these findings we reviewed a control group of 60 patients without hematuria hospitalized for benign prostatic hyperplasia and followup of bladder tumors, and found a 3.3 per cent prevalence of nonsteroidal anti-inflammatory drugs. These findings implicate nonsteroidal anti-inflammatory drug use as a potential cause of idiopathic hematuria.

Adolescent↗
PubMed1984

Alteration of lipid metabolism associated with renal adenocarcinoma in the Wistar-Lewis rat.

Tumor bearing has been associated with a number of metabolic and biochemical alterations in man and animals. Recent studies have shown that Fischer rats bearing methylcholanthrene-induced sarcomas display elevations of plasma cholesterol and triglyceride levels. We investigated Wistar-Lewis rats bearing a transplantable, spontaneously arising renal adenocarcinoma histologically similar to human clear cell carcinoma of the kidney to determine whether similar metabolic derangements could be demonstrated. Baseline fasting levels of triglyceride and cholesterol were established in nontumor-bearing control rats. The presence of tumor implanted either subcutaneously in the flank or grown subcapsularly within the kidney resulted in a 20 to 25-fold elevation in circulating triglyceride. Following complete excision of implanted tumor, triglyceride levels returned to baseline.

Adenocarcinoma↗
PubMed1983

The relationship of histamine H2 receptor-bearing suppressor cells with the growth and metastasis of FANFT-induced bladder cancer.

A poorly differentiated transitional cell carcinoma in C3H/He mice results from the oral ingestion of the urinary tract carcinogen FANFT. This model, designated MBT2, is readily transplantable into syngeneic animals and has proven to be very useful in the development of chemotherapy. Prior to the use of this model for the testing of potential immunotherapeutic strategies, we have attempted to characterize the immunobiology of this tumor line. We report that the primary growth of this tumor in the footpad and its metastasis to lung are correlated with the development of increased numbers of suppressor cells, characterized by the expression of a surface histamine H2 receptor. These cells are originally evident in spleen and become maximal approximately 4 weeks after tumor implantation. This is followed by the migration of these cells from spleen to peripheral blood, an event that parallels the growth and eventual metastasis of this implanted transitional cell carcinoma. These events may have important significance for the development of immunomodulating therapy against bladder cancer.

Animals↗
PubMed1983

Adjuvant chemotherapy for stage D1 adenocarcinoma of prostate.

In a series of 112 patients undergoing pelvic lymphadenectomy for clinically localized prostate cancer, 37 were found to have pelvic lymph node metastases. After prostatic irradiation, these 37 patients were divided into groups receiving adjunctive chemotherapy versus no additional treatment. The patients were followed for a period ranging from twelve to sixty-five months for evidence of disease progression. Of the 12 patients administered chemotherapy, disease progression was documented in 4 (average time to progression was fifteen months). In contrast, of the 25 patients receiving no additional treatment, 12 exhibited evidence of gross metastatic disease within an average interval of 11.6 months. One death has been recorded in the chemotherapy group at twenty-nine months after diagnosis; 4 deaths have occurred in patients receiving no systemic therapy (average time to death was eighteen months).

Adenocarcinoma↗
PubMed1983

Urologic complications of hip arthroplasty.

Significant intrapelvic injuries from routine hip surgery are rare but may result in long-term urologic morbidity. Two illustrative cases are presented with attention given to the close anatomic proximity of the intrapelvic structures to the hip joint and their potential for injury after hip surgery. A review of similar cases with their management is presented.

Adult↗
PubMed1983

Vincristine-induced bladder neuropathy.

We report a case of detrusor areflexia caused by vincristine neurotoxicity and documented by urodynamic testing. Vincristine commonly induces peripheral neuropathy but rarely causes voiding dysfunction. Neurourological evaluation aided in monitoring and understanding this problem.

Drug Therapy, Combination↗
PubMed1983

Inguinal node metastases from testicular tumors in patients with prior orchiopexy.

Testicular tumors in patients who have had the lymphatics disrupted by prior scrotal or inguinal surgery can metastasize primarily to the ipsilateral inguinal nodes in addition to the usual retroperitoneal pattern. Whether routine inguinal node dissection along with retroperitoneal node dissection is warranted in patients with testicular tumors and prior scrotal surgery is controversial due to the small numbers of such cases reported in the literature. We report on 2 patients who had undergone previous orchiopexy and who presented with inguinal and testicular masses. Both patients underwent retroperitoneal lymph node dissection and inguinal node dissection with hemiscrotectomy and metastatic tumor was in each lymphatic area. Ipsilateral inguinal along with bilateral retroperitoneal node dissection should be considered in the primary therapy of any patient with a nonseminomatous testicular tumor who has had prior scrotal and certain inguinal procedures.

Adult↗
PubMed1979

The catch-22's of cost containment.

While exploring the problem of escalation of health care expenditures in urology and analyzing various means to curtail this escalation, we noted a recurrent problem relating to the negative incentives inherent in presently used reimbursement mechanisms. Proposed solutions to a particular problem usually are accompanied by new economic difficulties arising from the solution. A series of Catch-22's are encountered in many different problems concerning economic health care delivery. We herein elucidate a number of these problems and propose a novel reimbursement system in which there are positive incentives provided to those urologists who make an honest effort at cost containment.

Budgets↗