Synthesis and cardiotonic activity of novel biimidazoles.

A series of substituted 2,2'-bi-1H-imidazoles and related analogues was synthesized and evaluated for inotropic activity. Structure-activity relationship studies based on a nonclassical bioisosteric approach indicated the necessity of a cyano group on one of the imidazole rings to obtain the desired pharmacological profile. 4(5)-Cyano-2,2'-bi-1H-imidazole (15a) was the most potent inotropic agent in the series.

Permeability of apical barriers.

The purpose of this work was to measure the permeability (hydraulic conductance) of root canal apical barriers in vitro. In 30 extracted teeth, the pulp tissue was removed and the apical opening standardized and enlarged using endodontic files. One-millimeter thick barriers of either autogenous dentin chips, calcium hydroxide powder, or durapatite particles were placed just inside the apical opening.

Specific genetic change in tumors associated with von Hippel-Lindau disease.

Previous reports showed that the loss of DNA sequences on the short arm of chromosome 3 (3p) is consistently found in sporadic renal cell carcinomas. To evaluate the significance of this genetic change, we looked for the loss of 3p alleles in hereditary renal cell carcinomas and other tumors from patients with von Hippel-Lindau disease. Specific loss of alleles from chromosome 3p was detected with polymorphic DNA markers in 11 renal cell carcinomas, one pheochromocytoma, two spinal hemangioblastomas and one cerebellar hemangioblastoma from von Hippel-Lindau patients.

Enhanced anti-tumor effects of recombinant human tumor necrosis factor plus VP-16 on metastatic renal cell carcinoma in a xenograft model.

A nude mouse renal subcapsular and subcutaneous implantation xenograft model utilizing the SN12C human renal carcinoma cell line was investigated. In the absence of treatment, renal subcapsular implantation of SN12C resulted in metastatic spread (lung, liver and lymph nodes) and death of all animals. Radical nephrectomy of the tumor-bearing kidney after various periods of tumor implantation demonstrated that surgery alone after 18 days of tumor growth resulted in no statistically significant increase in survival with 100% of the nephrectomized animals succumbing to local recurrence and distant metastases.

Endoscopic reconstruction of traumatic urethral transections.

Total traumatic urethral transections can be reconstructed endoscopically if the obliterated segment is short (less than 3 cm). A small trocar is passed under radiographic control, and balloon dilatation is performed over a guidewire. Scar is resected, and triamcinolone is injected.

A comparison of two post systems under applied compressive-shear loads.

This study compared a new parallel-tapering, threaded, split-shank post with a well-accepted parallel serrated post under applied compressive-shear loads. The posts were placed in paired, contralateral human teeth to attempt to minimize variation in the tooth model. Both initial and ultimate failure modes were observed, and the clinical significance reported.

Effects of distance from the pulp and thickness on the hydraulic conductance of human radicular dentin.

The purposes of this study were: (1) to measure the effect of distance from the pulp on the hydraulic conductance of human radicular dentin; (2) to determine the influence of dentin thickness on the rates of fluid flow; and (3) to attempt to correlate dentinal tubule densities and diameters with root dentin hydraulic conductance. Dentin slabs prepared from extracted, unerupted, human third molar teeth were placed in a split-chamber device to permit quantitation of fluid filtration rate (hydraulic conductance). In the SEM portion of the study, dentinal tubule numbers and diameters were recorded.

Evidence for cyclophosphamide-induced transitional cell carcinoma in a renal transplant patient.

Cyclophosphamide treatment has been associated with bladder cancer in a number of case reports but no causal relationship has been proved since nearly all of these patients were treated with the drug for malignant disease. We describe a patient who received cyclophosphamide after cadaveric renal transplantation to prevent rejection. Transitional cell carcinoma developed in the native bladder and in the donor transplanted ureter (20-year-old donor) 13 years later despite no identifiable risk factors.

A prototype device for nonimmersion shock wave lithotripsy using ultrasonography for calculus localization.

Extracorporeal shock wave lithotripsy has revolutionized the clinical treatment of renal calculi. A device was constructed with a spark gap for shock wave generation and a water-filled ellipsoidal reflector to focus the shock wave energy. A membrane coupled the device to the pig and an ultrasonic transducer was used for stone visualization.

Grazing incidence technique to obtain spatially resolved spectra from laser heated plasmas.

An experimental method is described in which a grazing incidence spectrograph is used to obtain spatially resolved spectra of laser heated plasmas in the 6-370-A region. In the experiment, small target spheres were irradiated by tightly focused laser beams. A tilted grazing incidence elliptical mirror placed 1.

Creation of an ileocolic bladder after cystectomy.

A divided segment of ileum and colon is used to create a neobladder after cystectomy with a cecourethral anastomosis to provide volitional voiding with continence. Such a bladder provides for good sensation with a large low pressure reservoir and an antireflux ureteral anastomosis. The standard nerve-sparing cystoprostatectomy is performed and no segment of the bladder or prostate is left to compromise the cancer operation.

Surgical management of renal cell carcinoma with intracaval neoplastic extension above the hepatic veins.

Cardiopulmonary bypass, hypothermia, temporary cardiac arrest and exsanguination represent the next logical step in the evolutionary management of intracaval neoplastic extension with renal cell carcinoma. This method of management provides control of the circulation of the entire body and allows for careful dissection in a bloodless field with less risk of embolization. From 1981 to 1986, 15 patients were treated with intracaval neoplastic extension of renal cell carcinoma above the level of the most inferior hepatic veins.

Synchronous and metachronous transitional cell carcinoma of the urinary tract: prevalence, incidence, and radiographic detection.

Six hundred forty-five cases of transitional cell carcinoma (TCC) of the bladder, ureter, and/or kidney were reviewed retrospectively to determine the frequency of synchronous and metachronous lesions elsewhere in the urinary tract. Among 597 patients with TCC of the bladder, 23 (3.9%) developed an upper-tract lesion, after an average delay of 61 months.

Cystine calculi: clinical management and in vitro observations.

Although cystine stones account for 1 to 3 per cent of renal calculi, many of these patients are difficult to manage because of recurrent urolithiasis. Seven cases of homozygous cystinuria are summarized. The evolution to the present treatment of percutaneous extraction and chemolysis appears to be the preferred form of treatment although extracorporeal shock wave lithotripsy (ESWL) may also be utilized.

Renal cell carcinoma: surgical management of regional lymph nodes and inferior vena-caval tumor thrombus.

Aggressive surgical management is the primary effective treatment of renal cell carcinoma, even with regional spread to lymph nodes or the vena cava. The extent of regional lymphadenectomy with radical nephrectomy and excision of vena-caval tumor thrombi are defined. In the future, with increasingly effective adjuvant therapy, these adjuncts to radical nephrectomy will continue to be important in the treatment of renal cell carcinoma.

Radical cystectomy for transitional cell carcinoma of the bladder. Long-term survival in high risk patients.

Debilitated, sometimes old, previously radiated patients with transitional cell carcinoma of the bladder may present with many poor prognostic features including: high grade, diffuse, carcinoma; invasion of perivesical tissue; ureteral obstruction; a fixed pelvic mass, and vascular and lymphatic invasion. Improvements in anesthesia, medical management, and nutrition have allowed radical cystectomy and long-term survival in 4 such high risk patients with locally advanced transitional cell carcinoma of the bladder, including 1 patient who had excision of his urinary tract.

Microsurgical vasoepididymostomy to corpus epididymidis in treatment of inflammatory obstructive azoospermia.

A unilateral microsurgical vasoepididymostomy utilizing 35 mm of epididymis was performed in a patient with postinflammatory epididymal obstruction. Success was verified with multiple semen analyses, the hamster egg penetration test, and a pregnancy. These results demonstrate that surgical bypass of inflammatory tubal obstruction in the distal epididymis can result in the return of normal epididymal function and fertility.