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Biomedical subjects

T M Turk

Publications and source records attributed to T M Turk.

11 recordsLinked to original sources
PubMed2001

Effects of fibrin glue on injured rabbit ureter.

BACKGROUND AND OBJECTIVE: Fibrin glue is used as a hemostatic agent, has potential as a tissue adhesive, and may promote tissue healing. The histologic effects of fibrin glue on the ureter have not yet been fully investigated. We studied the effect of fibrin glue on the thickness of various layers of injured and uninjured ureters and its effect on vessel density in the rabbit model. MATERIALS AND METHODS: Rabbits were divided into two groups. The ureters were exposed using a midline abdominal incision. In the study group, one of the ureters was crushed, and fibrin glue was instilled around both ureters. In the control group, one of the ureters was crushed, but no fibrin glue was instilled. The animals were sacrificed at 6 weeks and the ureters examined histologically. Using NIH Image Analysis solftware, the thickness of the urothelium, muscular, and adventitial layers and the cross-sectional area of the ureters were measured. The vessel density of the ureters was also assessed. RESULTS: Whereas the thickness of the epithelium was increased in the crushed ureters treated with fibrin glue (20.7 microm v 15.3 microm), the thickness was reduced in the uncrushed ureters treated with fibrin glue compared with controls (16.3 microm v 19.8 microm). There was no statistically significant difference in the thickness of the muscular or adventitial layers in the study and control groups. There was a reduction in the cross-sectional area of the uncrushed ureters treated with fibrin glue compared with controls (7,095 microm2 v 9,409 microm2). In addition, the vessel density in the crushed ureters was reduced in ureters treated with fibrin glue compared with controls (0.00067/microm2 v 0.00108/micro2). In the uncrushed ureters, the difference was not statistically significant. CONCLUSIONS: Fibrin glue has potential as an adhesive agent in the ureter and may promote healing. It may affect epithelial layer thickness and vessel density of the ureter, but these effects were variable. Fibrin glue does not appear to have significant effects on the ureteral muscular and adventitial layers or on the overall cross-sectional area of all three layers. These results indicate that fibrin glue does not appear to have a detrimental effect on the ureter.

Animals↗
PubMed2000

Use of epidermal growth factor and collagen synthesis inhibition as adjuvant to healing of ureteroureteral anastomosis.

BACKGROUND AND PURPOSE: When treating a ureteral narrowing by endopyelotomy or endoureterotomy, the urologist hopes that after the narrowed area is cut, it will heal with a patent lumen. A ureteral stent is usually left in place to provide a framework for healing. In cases of failure, histologic examination shows a predominance of collagen. We evaluated the effects of epidermal growth factor (EGF) and a collagen synthesis inhibitor, halofuginone, as adjuncts to ureteral healing. MATERIALS AND METHODS: Ten female pigs underwent ureteroureteral anastomosis bilaterally, with the left side being stented. They were then randomized to receive EGF (N = 4), halofunginone (N = 3), or saline (control; N = 3). On postoperative day 30, the ureters were examined grossly and histologically. RESULTS: The lumens of the ureters were significantly larger in the animals that received either EGF or funginone than in the control animals. The epithelium was significantly thicker in the animals that received halofunginone than in the controls or animals receiving EGF. The thickness of the smooth muscle and adventitia was similar in the three groups. Stenting improved the results. CONCLUSION: Both EGF and halofuginone show promise as adjuncts to endopyelotomy and endoureterotomy.

Adjuvants, Pharmaceutic↗
PubMed2000

Periurethral transurethral microwave thermotherapy for the treatment of benign prostatic hyperplasia: an interim 1-year safety and efficacy analysis using the thermatrx TMx-2000.

Transurethral microwave thermotherapy (TUMT) represents an accepted minimally invasive approach to the management of patients with benign prostatic hyperplasia (BPH). The TherMatrx TMx-2000 represents a further evolution in TUMT technique. This device uses periurethral transurethral microwave thermotherapy (P-TUMT) technology to directly target the BPH tissue adjacent to the prostatic urethra by using a catheter without a urethral-cooling surface. This article provides a technical review of the device and describes the results of a randomized, controlled multicenter study of P-TUMT for the treatment of symptomatic BPH. A discussion of the physiologic effects of P-TUMT is presented and compared to conventional TUMT. A comparison of P-TUMT to contemporary TUMT series in relation to efficacy and complications is also described. This study concludes that P-TUMT using the TherMatrx TMx-2000 device represents a minimally invasive, efficacious, and well-tolerated treatment for symptomatic BPH.

Aged↗
PubMed1999

Determination of optimal freezing parameters of human prostate cancer in a nude mouse model.

BACKGROUND: We sought to determine whether more than one freeze/thaw cycle is required and what minimum temperature reliably kills prostate cancer in vivo. METHODS: Two human prostate cancer cell lines (LNCaP and PC3) were implanted subcutaneously in male nude BALB/c mice. Tumors were frozen with contemporary cryosurgery equipment and monitored for temperature, size, and serum prostate-specific antigen (PSA) measurements. The tumors were subjected to one or two freeze/thaw cycles through a wide range of temperatures from 0 - -80 degrees C. RESULTS: These experiments show that a single freeze/thaw to a temperature < -40 degrees C is adequate to kill most tumor cells in this mouse model of prostate cancer. CONCLUSIONS: Freezing prostate cancer to < -40 degrees C and ensuring that the entire tumor is frozen is more important than additional freeze/thaw cycles in this experimental model.

Animals↗
PubMed1999

Incidence of urolithiasis in cystectomy patients after intestinal conduit or continent urinary diversion.

The purpose of this study was to determine the incidence of nephrolithiasis in radical cystectomy patients treated with either intestinal conduit or continent urinary diversion. The charts from 94 patients who had undergone radical cystectomy with urinary diversion at our institution from 1988 to 1998 were reviewed retrospectively for this study. Charts and radiographs from all patients were examined for renal function and evidence or urinary tract calculi. Two groups were compared: group I patients had undergone diversion with an intestinal conduit, and group II patients had received a continent diversion (primarily involving an Indiana pouch). Conduit diversions were typically done with a freely refluxing anastomosis (Bricker), whereas continent diversions were done with a nonrefluxing ureteral-intestinal anastomosis. Group I consisted of 54 patients who had undergone ileal conduit (50) or colon conduit (4) diversion with a mean follow-up of 2.5 years (range 0.6-7.0 years). Group II consisted of 40 patients who had undergone continent diversion (33 Indiana pouches, 7 orthotopic diversions) with a mean follow-up of 3.1 years (range 0.5-10.5 years). Laboratory studies of serum blood urea nitrogen, creatinine, and CO(2) were similar between the two groups. Six patients in group I developed urolithiasis, all in the upper tract. Stones developed at a mean of 3.1 years after urinary diversion. Three patients required operative intervention, whereas the others were managed expectantly. One patient in group II had an upper tract stone at the time of presentation for his bladder cancer, but no patient developed new upper tract stones during the present study period. Two patients in group II developed pouch calculi at a mean of 5 years after diversion; both required surgical intervention. In our study the risk for upper tract urolithiasis seemed higher in the intestinal conduit group (group I), with 11% of the patients developing stones. In the continent diversion group, no patient developed upper tract stones, although two patients (5%) developed pouch stones. Refluxing urine may contribute to an increased risk for stone formation after urinary diversion, whereas pouch stasis may contribute to stone formation in the continent diversion group.

Aged↗
PubMed1999

Carcinosarcoma of the prostate.

We present a rare case of carcinosarcoma of the prostate occurring in a 60-year-old white male. This diagnosis was initially missed after a transurethral resection of the prostate (TURP) had been performed to alleviate the patient's urinary obstructive symptoms. After recurrence of symptoms within a short period, another TURP was performed and the diagnosis of carcinosarcoma was then established. The patient then underwent a radical cystourethroprostatectomy with bilateral lymphadenectomy and ileal conduit diversion. Carcinosarcoma of the prostate is a very aggressive disease that often has a poor prognosis, especially when it has spread out of the prostate. Surgical removal of the prostate seems to be the best option for treatment in the select group of patients in which the disease remains confined to the prostate.

Carcinosarcoma↗
PubMed1999

Splenosis as a cause of testicular pain: laparoscopic management.

This is a case report of a 37-year-old man with severe testicular pain unresolved after conventional investigative and therapeutic methods. On the basis of his history of abdominal trauma followed by emergency splenectomy and evidence of functioning splenic tissue on a radionuclide scan, the diagnosis of splenosis was established. Laparoscopic exploration was done, and the initial diagnosis confirmed. Splenic tissue located at the right inguinal ring was removed. Testicular pain abated after the procedure.

Adult↗
PubMed1999

A comparison of ureteroscopy to in situ extracorporeal shock wave lithotripsy for the treatment of distal ureteral calculi.

PURPOSE: The optimal treatment for distal ureteral calculi remains controversial. Most urologists offer extracorporeal shock wave lithotripsy (ESWL) or ureteroscopy for stones that require intervention. We present data from our institution on these modalities since 1990. MATERIALS AND METHODS: We treated 187 distal ureteral calculi with ESWL (91 cases) on a Dornier HM3 or MFL 5000 lithotriptor, or with ureteroscopy (96 cases) using basket extraction with or without pulsed dye laser lithotripsy. RESULTS: Fragmentation and stone-free rates for ESWL were 80 and 73%, respectively, with no complications. For ureteroscopy the stone-free rate was 95% with a 5.2% short-term complication rate and no long-term complications. CONCLUSIONS: At our institution ureteroscopy is more efficacious than ESWL for the treatment of distal ureteral calculi.

Adult↗
PubMed1990

Cyclophosphamide and abrogation of tumor-induced suppressor T cell activity.

Previously we have demonstrated that the in vitro generation of P815-specific anti-tumor cytotoxic T lymphocytes (CTL) was suppressed by splenic suppressor T cells from late tumor-bearing hosts (TBH). Suppression is not caused by in vitro growth of P815 from splenic metastases, since suppression was also seen with spleen cells from late TBH mice bearing a hypoxanthine/aminopterin/thymidine-sensitive subline (PHS-5) of P815 in the presence of HAT. Cyclophosphamide has been shown to inhibit the induction of suppressor cells selectively in a number of immune responses, but evidence that it can inhibit active tumor-induced suppressor T cells is limited. We have found that suppressor T cells already induced by P815 in syngeneic late TBH are sensitive to low doses of cyclophosphamide (50 mg/kg) given 1 day before spleen harvest, but the in vitro CTL response of late TBH spleen cells could not be restored by pretreating the mice with cyclophosphamide, even when exogenous interleukin-2 was added to the cultures. Although 50 mg/kg cyclophosphamide did not inhibit the CTL response of spleen cells from mice immunized with P815 + Corynebacterium parvum, the same dose of cyclophosphamide eliminated the CTL response of spleen cells from early TBH. Interleukin-2 (IL-2) did not overcome this effect of cyclophosphamide, suggesting a direct effect on CTL. "Ultra-low" -dose cyclophosphamide (10 mg/kg) did not adversely effect early TBH CTL but was still able to eliminate suppressor T cell activity from late TBH. Nevertheless, late TBH CTL remained unresponsive after pretreatment of mice with ultra-low-dose cyclophosphamide, even when exogenous IL-2 was added in vitro. CTL precursor frequency analyses demonstrated that cyclophosphamide pretreatment had little or no effect on the numbers of CTL precursors from early TBH. Late TBH CTL precursor cells were not detectable in these studies, with or without suppressor T cell inhibition by cyclophosphamide pretreatment. Thus, it appears that most CTL precursor cells may be lost or irretrievably inactivated in the spleens of late TBH mice.

Animals↗