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Biomedical subjects

W E Price

Publications and source records attributed to W E Price.

17 recordsLinked to original sources

Fatal hemorrhagic cystitis induced by pelvic irradiation and cyclophosphamide therapy. Case reports and review.

The potent cytotoxic drug cyclophosphamide has been used extensively for neoplastic and non-neoplastic diseases. Patients taking this drug may have received or may be receiving pelvic irradiation concurrently. This report describes two patients who developed fatal hemorrhagic cystitis induced by pelvic irradiation and cyclophosphamide therapy. Etiology, incidence, pathologic descriptions, and diagnostic and therapeutic aspects of this entity are described. The incidence and risk of serious, life-threatening bladder hemorrhage from cyclophosphamide therapy is increased by prior or concurrent pelvic irradiation. Alternative cytotoxic, non-urotoxic chemotherapy should be used in these high-risk patients.

Aged

The urethral syndrome: myth or reality? A commentary.

Although most urologists will agree that dealing with patients suffering from the multiple symptom complex commonly called the urethral syndrome is often time consuming, its origin and treatment continue to generate debate. This essay proposes that entrapment of sensory nerves in the wall of the urethra by fibrosis leads to an abnormal response of Barrington's reflex II, which, in turn, leads to the urethral syndrome. Periurethral fibrosis occurs following trauma, infections, and pelvic irradiation therapy. The urethral syndrome, the author concludes, is therefore based on recognized anatomical factors. The recommended treatment is urethral dilation accompanied by hot sits baths and short courses of Sulfamethoxazole-Trimethoprim. Long-term drug therapy is to be avoided.

Cystoscopy

Quantitative glomerular morphology of the normal and diabetic baboon kidney.

This is a study of quantitative glomerular morphology in 14 normal and 6 long-term diabetic female baboons between 3 and 25 years of age. In the normal female baboon, peripheral glomerular capillary basement membrane thickness increased until around 10 years of age, reached a plateau between 10 and 20 years of age, and possibly decreased at 25 years of age. Mean value for young (3 to 7 years of age) and older (10 to 25 years of age) controls were 266 nm and 329 nm respectively. Fractional volumes of mesangial matrix (8.9%) and mesangial cells (6.8%) were not affected by age. Glomerular basement membrane thickness and the volume of mesangial matrix increased progressively in female baboons with poorly controlled pancreatectomy-induced diabetes, while the volume of mesangial cells remained unchanged. After 106 to 145 months of diabetes, glomerular basement membrane thickness and the volume of mesangial matrix were 558 nm and 18.7% respectively. These values were significantly greater than those of the age-matched controlled (p = less than 0.05). By light and electron microscopy, the normal baboon glomerular morphology, morphometric measurements and changes with age were similar to those in man. The renal changes in diabetic baboons were also similar in morphology and rate of development to those of mild to moderate diffuse diabetic glomerulosclerosis in humans, indicating that the baboon is an ideal model for the long-term study of diabetic glomerulosclerosis. The presence of considerable interanimal variability in the degree of glomerulosclerosis attained after prolonged diabetes suggested that glomerulosclerosis progressed at different rates in these models. The reason for this was not apparent.

Aging

Propranolol in hypertensive dialysis patients: efficacy and compliance.

The effect of propranolol therapy on plasma renin activity and blood pressure control was evaluated in 35 uremic patients receiving intermittent center-based outpatient hemodialysis. Patients were determined to be either compliant or noncompliant with therapy based on the steady-state predialysis plasma propranolol concentration. Noncompliance occurred with remarkable frequency and was associated with persistent hyperreninemia and poorly controlled hypertension. Blood pressure control was significantly better in compliant patients, in whom plasma renin activity was generally, but not universally, suppressed. Propranolol can be effectively used in the management of hypertensive dialysis patients, but steady-state plasma propranolol levels should be measured to assess compliance in patients apparently refractory to treatment.

Adolescent