ABSTRACT
BACKGROUND: Neuroendocrine differentiation has been demonstrated by immunohistochemical preparations in many cases of acinar type prostatic adenocarcinoma (CAP). Some studies have suggested that this differentiation may indicate an adverse prognosis. METHODS: Tissue samples from 38 consecutive patients with clinical Stage II (AJCC) CAP who underwent radical retropubic prostatectomy (RRP) were studied after preparations were made with antichromogranin (ChA) and neuron-specific enolase (NSE). All patients were followed for at least 4 years post-RRP or until disease progression was documented by rising serum prostate specific antigen concentration, X-ray evidence of recurrence, or a positive tissue biopsy. RESULTS: Nine of the 38 RRP specimens (24%) were positive for NSE, and 11 (29%) were positive for ChA. Neither of these neuroendocrine markers showed a significant correlation with tumor progression. Neuroendocrine differentiation in needle biopsy specimens from these same patients (when available) did not correlate with tumor progression either. Of the patients with tumor progression, 9 of 11 (82%) had pathologic Stage III disease after RRP; of those with no progression of CAP, only 7 of 27 (26%) had pathologic Stage III disease. CONCLUSIONS: Neuroendocrine differentiation, as demonstrated by NSE and ChA preparations, was not helpful in predicting tumor progression of CAP.
Subject(s)
Biomarkers, Tumor/analysis , Chromogranins/analysis , Phosphopyruvate Hydratase/analysis , Prostate/chemistry , Prostatic Neoplasms/chemistry , Follow-Up Studies , Humans , Male , Neoplasm Staging , Prostate/pathology , Prostatectomy , Prostatic Neoplasms/pathologyABSTRACT
Holistic ethics involves a basic underlying concept of the unity and integral wholeness of all people and of all nature that is identified and pursued by finding unity and wholeness within the self. Within this framework, acts are not performed for the sake of law, precedent, or social norms, but rather out of a sense of doing good freely in order to witness, identify, and contribute to unity. The development of holistic ethics involves elements of both the masculine and feminine concepts interacting and relating to one another and encompassing traditional ethical views. It is characterized in the yin-yang mode of the monad of the East and the Western concept of masculine and feminine. Holistic ethics is not an ethics that is grounded or judged either in the act performed or in the distant consequences of the act, but rather in the conscious evolution of an enlightened individual of raised consciousness who performs the act. The concern is the effect of the act primarily on the individual and his or her larger Self (that unity of which he or she is a part).
Subject(s)
Ethics, Professional , Health Occupations , Holistic Health , Consciousness , Human Development , HumansABSTRACT
We report a case of eosinophilic cystitis that was responsive to prednisone but that recurred when the drug was withdrawn. The cause of eosinophilic cystitis remains an enigma but it probably represents a form of allergy. Investigation of etiology and therapeutic options are discussed.
Subject(s)
Cystitis/drug therapy , Eosinophilia/drug therapy , Prednisone/therapeutic use , Cystitis/complications , Eosinophilia/complications , Humans , Male , Middle Aged , RecurrenceSubject(s)
Prostatic Neoplasms , Testicular Neoplasms , Urinary Bladder Neoplasms , Combined Modality Therapy , Humans , Male , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , Testicular Neoplasms/diagnosis , Testicular Neoplasms/therapy , Texas , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/therapyABSTRACT
A comprehensive practical approach to the diagnosis, staging, and treatment of carcinoma of the prostate is presented. Prostatic cancer in the elderly patient is not a benign clinical condition. The approach is designed to minimize the morbidity of the disease process and to allow the patient to live as normal a life as possible.
Subject(s)
Prostatic Neoplasms/therapy , Aged , Combined Modality Therapy , Estradiol Congeners/therapeutic use , Humans , Male , Neoplasm Staging/methods , Orchiectomy , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/pathology , Prostatic Neoplasms/radiotherapy , Prostatic Neoplasms/surgeryABSTRACT
PIP: The occurrence of ureteral fistulas as a complication of obstetrics is very rare, mostly occurring in developing countries. Only 2 cases of ureterouterine fistulas following dilation and curettage (D & C) have been reported. A 3rd case is reported in this paper. Diagnosis was made by an excretory urogram (IVP). After D & C the patient had hemorrhaged profusely and the IVP showed prominent calicectasis with hydronephrosis in the right kidney. After clinical stabilization, treatment of the pyelonephritis and evaluation of the bleeding disorder, a right percutaneous nephrostomy tube was inserted and vaginal drainage of urine ceased. Later the patient was hospitalized for an elective repair of the ureterouterine fistula. Right ureteroneocystosomy with a psoas hitch was performed to bridge th gap of the ureter to the bladder.^ieng
Subject(s)
Abortion, Therapeutic/adverse effects , Ureteral Diseases/etiology , Urinary Fistula/etiology , Uterine Diseases/etiology , Adult , Female , Humans , PregnancyABSTRACT
In essence, incontinence in the elderly should be managed by careful elucidation of the underlying causes and specific treatment aimed at those problems that are remediable. When specific treatment fails, external collecting devices may be helpful. Indwelling catheters should be either temporary, intermittently used, or a last resort. Finally, elderly patients with incontinence should not be treated as pariahs; they require an empathetic and investigative approach to their problem. Continence in the elderly is a goal to be achieved rather than a disease to be treated.
Subject(s)
Urinary Incontinence , Aged , Aging , Electromyography , Female , Humans , Male , Medical History Taking , Muscle Contraction , Physical Examination , Urethra/physiopathology , Urinary Bladder/physiopathology , Urinary Bladder, Neurogenic/etiology , Urinary Incontinence/drug therapy , Urinary Incontinence/etiology , Urinary Incontinence/surgery , UrodynamicsABSTRACT
A case of a cystic partially differentiated nephroblastoma treated with combined chemotherapy after removal in a 2-month old newborn is reported. Cystic partially differentiated nephroblastoma is a newly described clinicopathologic entity, involving elements of a nephroblastoma and cystic disease, and it is believed to be a pathologic derivative of the metanephric blastema and not related to renal dysplasia. Cystic partially differentiated nephroblastoma is distinguished from multilocular cysts of the kidney by the presence of partially differentiated renal elements in the septa of cysts. The aggressive appearance of the cells led to the treatment of this tumor as potentially malignant.
Subject(s)
Kidney Neoplasms/pathology , Wilms Tumor/pathology , Dactinomycin/therapeutic use , Humans , Infant , Kidney Neoplasms/drug therapy , Male , Vincristine/therapeutic use , Wilms Tumor/drug therapyABSTRACT
A case of Cushing's syndrome occurring during the eighth month of pregnancy was presented. Steroid values and the results of dexamethasone suppression tests were markedly abnormal. Urinary steroid excretion reverted toward normal following delivery and prior to the removal of a large adrenal cortical adenoma.
Subject(s)
Adenoma/complications , Adrenal Cortex Neoplasms/complications , Adrenal Gland Neoplasms/complications , Cushing Syndrome/complications , Pregnancy Complications , Adenoma/pathology , Adenoma/surgery , Adrenal Cortex Neoplasms/pathology , Adrenal Cortex Neoplasms/surgery , Adult , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy Trimester, ThirdABSTRACT
A case of a large renal cyst of the right kidney suggesting a nephroblastoma is reported. Preoperative differentiation was diffucult.
