Risk management and pollution prevention: thinking outside the box.

The Medical University of South Carolina's risk management department received a 12-month grant from South Carolina's General Assembly "Hazardous Waste Management Research Fund" for the purpose of identifying pollution prevention opportunities within South Carolina healthcare facilities. One hundred and one healthcare facilities were invited to participate in this study. Facilities ranged in size from zero-licensed beds (clinics) to more than 300 beds.

Efficacy and safety of luteinizing hormone-releasing hormone antagonist cetrorelix in the treatment of symptomatic benign prostatic hyperplasia.

As the life expectancy for men increases, more cases of benign prostatic hyperplasia (BPH) will be expected. Symptomatic BPH causes morbidity and can lower the quality of life. We investigated whether short term administration of the LH-releasing hormone antagonist cetrorelix could provide an improved treatment for men with BPH.

The effect of age, ethnicity and geographical location on impotence and quality of life.

Objective: To estimate the prevalence of impotence in men over 40 years of age and correlate impotence to age, geographical location, ethnicity and quality of life.

Subjects And Methods: While attending 'The Prostate Cancer Awareness Week' in Madison, WI, USA, New Orleans, LA, USA and New York, NY, USA, 1680 men were asked to complete a questionnaire regarding impotence, age, geographical location, ethnicity and quality of life.

Results: Impotence was found to be significantly associated with age, was less associated with geographical location but independent of ethnicity.

Effect of age, educational status, ethnicity and geographic location on prostate symptom scores.

We evaluated the effect of patient age, educational status, ethnicity and geographic location upon the American Urological Association benign prostatic hyperplasia symptom scores. Using patients attending Prostate Cancer Awareness Week, we collected additional data on the symptom score and also on education received. A total of 2,245 records was obtained from 4 different centers.

One-stage laparoscopic pelvic lymphadenectomy and radical perineal prostatectomy.

Laparoscopic pelvic lymph node dissection is currently an accepted procedure for staging adenocarcinoma of the prostate. To assess the feasibility and efficacy of performing laparoscopic pelvic lymph node dissection and radical perineal prostatectomy during the same anesthesia, we retrospectively analyzed 98 patients with clinically localized adenocarcinoma of the prostate who were candidates for radical prostatectomy. Of the patients 12 (12%) underwent laparoscopic pelvic lymph node dissection only since they had metastatic disease to the pelvic lymph nodes on frozen section evaluation (the Gleason pathological grade was 2 to 4 in 2 patients, 5 to 7 in 8 and 8 in 2).

Single-dose regimen of cefonicid for the treatment of uncomplicated infections of the lower urinary tract.

Fifty-three women with symptoms of lower urinary tract infection were randomly assigned to treatment with cefonicid administered intramuscularly in a single 1-g dose or to treatment with 500 mg of amoxicillin administered orally three times a day for five to seven days. Urine cultures were obtained before therapy and again at five to 18 days and six to seven weeks after termination of therapy. Forty-one patients had greater than or equal to 2 X 10(4) colony-forming units (cfu)/ml of catheterized urine or greater than or equal to 10(5) cfu/ml of midstream urine.

Renal cell carcinoma: the Ochsner Medical Institution experience (1945-1978).

We reviewed 161 patients operated upon for renal cell carcinoma between 1945 and 1978. Life table and survival analyses were computed to compare the effects of stage, tumor differentiation, cell type, surgical technique, renal vein involvement and sex on the years of survival. Patients with stage I and well differentiated tumors had the best prognosis.

Critical evaluation of 1-stage cystectomy--reducing morbidity and mortality.

Although it is a major surgical effort removal of the bladder can be done with reasonable safety. In our opinion cystectomy and urinary diversion by an ileal conduit can be performed as a conjoined procedure without need for staging to reduce risks. Mortality up to 3 months postoperatively was 3.

Treatment of condylomata acuminata with carbon dioxide laser.

Ten patients with condyloma acuminatum were treated successfully with carbon dioxide laser photocoagulation. There are no side effects, damage to the surrounding tissue is minimal, and, in our experience, the lesions have not recurred. It is particularly useful for lesions which are recalcitrant to other types of therapy.

Simple cyst arising in a transplanted kidney: a case report.

A 17-year-old girl was hospitalized for evaluation of gradually decreasing function of a kidney transplanted 8 years earlier. A plain film of the abdomen showed a possible renal calculus. Excretory urography proved that this calcification was slightly anterior to the kidney but in the upper pole a well rounded mass was discovered.

Adenocarcinoma of the bladder as seen at Ochsner Medical Institutions.

Adenocarcinoma of the bladder is an uncommon malignancy comprising less than 2% of all bladder tumors. Eleven cases of adenocarcinoma of the bladder were seen from 1947 to 1977 at the Ochsner Medical Institutions. Six of the tumors were urachal in origin, and five involved the base and lateral walls of the bladder.

Partial cystectomy in the treatment of transitional cell carcinoma of the bladder.

Between 1950 and 1974, 35 men and 10 women underwent partial cystectomy for transitional cell carcinoma of the bladder. Indications, contraindications and the principles of technique for partial cystectomy as therapy for transitional cell tumors of the bladder are discussed. All patients were evaluated postoperatively, with cystoscopic examination every 3 months for 1 year, every 6 months for 3 years and then at yearly intervals if no tumors had been detected.

Congenital giant hydronephrosis in adults.

Giant hydronephrosis is the term designating the presence of more than 1,000 ml. of fluid in the collecting system. Of 4 cases of congenital hydronephrosis found over a three-year period at the Ochsner Medical Institutions, 2 were associated with unsuspected carcinomas.

Partial cystectomy in the treatment of transitional cell carcinoma of the bladder.

Between 1950 and 1974, 35 men and 10 women underwent partial cystectomy for transitional cell carcinoma of the bladder. Indications, contraindications and the principles of technique for partial cystectomy as therapy for transitional cell tumors of the bladder are discussed. All patients were evaluated postoperatively, with cystoscopic examination every 3 months for 1 year, every 6 months for 3 years and then at yearly intervals if no tumors had been detected.

Free full thickness skin graft urethroplasty for urethral stricture: experience with 66 patients.

The free, full thickness skin graft urethroplasty, which has been used successfully for 20 years, was first adopted for anterior urethral strictures at our hospital in 1969. Presently, 66 cases of urethral stricture have been treated, 5 of them for posterior urethral strictures. The free, full thickness tube graft technique is discussed and 3 cases are reported.

Medical therapy in idiopathic retroperitoneal fibrosis.

Except for its linkage with the ergot derivatives retroperitoneal fibrosis is a disease of unknown etiology. Two cases in which the traditional surgical approach was used but with the subsequent use of steroids are presented. The third patient was treated with steroids alone.

Treatment of chronic prostatitis. Comparison of Minocycline and Doxycycline.

The results of minocycline and doxycycline therapy in 41 patients with chronic prostatitis and minocycline therapy in 6 patients with acute prostatitis were evaluated. In the comparative study of chronic prostatitis, minocycline and doxycycline were given on the same dosage schedule, milligram for milligram: a loading dose of 200 mg. followed by 100 mg.