Serum prostate-specific antigen concentration is a powerful predictor of acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. PLESS Study Group.

Objectives: Prostate-specific antigen (PSA) is produced exclusively in the prostate gland and is currently the most useful clinical marker for the detection of prostate cancer. In this report, we examine whether serum PSA is also a predictor of important benign prostatic hyperplasia (BPH)-related outcomes, acute urinary retention (AUR), and the need for BPH-related surgery.

Methods: Three thousand forty men were treated with either placebo or finasteride in a double-blind, randomized study of 4-year duration.

Characteristics of bladder leiomyoma as noted on magnetic resonance imaging.

Leiomyoma of the bladder is a rare benign mesenchymal tumor that can be evaluated preoperatively with magnetic resonance imaging. Small tumors that appear to be leiomyomas on magnetic resonance imaging can be treated conservatively with transurethral resection.

An effective technique to facilitate radiographic stone visualization with an internal stent during shock wave lithotripsy.

Purpose: We describe a simple method to assist stone localization during shock wave lithotripsy in the presence of a Double J stent.

Materials And Methods: A 4F whistle tip ureteral catheter is passed alongside a previously inserted 6F Double J stent. The tip of the ureteral stent is positioned in the lower or mid third of the ureter.

Extracorporeal shock wave lithotripsy: a comprehensive review.

Extracorporeal shock wave lithotripsy (ESWL) has revolutionized treatment of urolithiasis since its introduction in the 1980s. The great majority of renal and ureteral stones can be successfully treated with ESWL. Complications can be minimized with maximal efficacy if patient selection is optimum.

Redistribution of renal blood flow after SWL evaluated by Gd-DTPA-enhanced magnetic resonance imaging.

Extracorporeal shockwave lithotripsy (SWL) is currently accepted as an effective noninvasive treatment for a wide variety of urinary tract calculi. However, the bioeffects of high-energy shockwaves on renal parenchyma have yet to be fully elucidated. The objective of this study was to measure the acute changes in regional renal hemodynamics associated with SWL utilizing dynamic gadolinium-DTPA-enhanced magnetic resonance imaging (MRI).

Accurate determination of chemical composition of urinary calculi by spiral computerized tomography.

Purpose: Choice of efficacious clinical management of symptomatic renal calculi can be facilitated by ascertaining the precise chemical composition of the calculus. Spiral computerized tomography (CT) is becoming a frequently used radiographic examination to establish the diagnosis and severity of calculus disease. Our objective for this study was to determine the precision of spiral CT in identifying the chemical composition of 6 different types of urinary calculi with region of interest measurements using spiral CT.

Health risk assessment of fluctuating concentrations using lognormal models.

A mathematical model is proposed for assessing health risk rates of fluctuating concentrations. Each time-averaged concentration may be regarded as a dose that, when applied to the dose-response curve, produces a risk of an adverse effect. A theoretical derivation shows that the dose-response pattern is a cumulative lognormal curve because of the diversity of the individuals in the exposed population.

Evaluation of a new self-screening chart for cytomegalovirus retinitis in patients with AIDS.

AIDS patients often present without visual symptoms despite severe vision-threatening cytomegalovirus (CMV) retinitis. A new self-examination chart, the Teich Target (copyright 1993, Steven A. Teich, pat.

Assessment of health effects of fluctuating concentrations using simplified pharmacokinetic algorithms.

The purpose of this study was to develop a simple, practical method to improve the accuracy of assessing health effects by determining the concentration patterns inside the body resulting from fluctuating external pollutant concentrations. Linear pharmacokinetic processes were assumed, and the attenuations of the high- and low-frequency components of the external pattern when entering through the "biological window" were determined. Similar attenuations also were determined for the "time-averaged sampling window.

Finasteride therapy does not alter bone turnover in men with benign prostatic hyperplasia--a Clinical Research Center study.

Benign prostatic hyperplasia is often treated with finasteride, which inhibits the conversion of testosterone to dihydrotestosterone (DHT). Aside from the prostate, other androgen-dependent tissues seem to be unaffected by selective DHT deficiency, but the effect on bone density in humans has not yet been defined. To study this question, we compared indices of bone turnover and bone mineral density in 35 men treated with finasteride with controls.

Urine toxicology screens in drivers suspected of driving while impaired from drugs.

Objective: Police departments, in conjunction with the National Highway Traffic Safety Administration, have developed a standardized evaluation aimed at identifying drivers impaired by drugs other than ethanol. These evaluations are performed by specially trained police officers known as Drug Recognition Experts.

Methods: We retrospectively reviewed the evaluations of 242 drivers detained for driving while impaired in the City and County of Denver from January 1, 1988 to June 30, 1990.

The pathophysiology of ureteral obstruction.

Ureteral obstruction can have a variety of causes intrinsic or extrinsic to the kidney. The effects of obstruction are examined from the perspectives of duration, severity, totality, and the presence of complicating factors. There is a difference in the postobstructive pathophysiology depending on whether one or both ureters were obstructed.

Stent use with extracorporeal shock wave lithotripsy.

Since the advantages of using ureteral stents in conjunction with extracorporeal shock wave lithotripsy were first recognized, the growing demand for outpatient stone treatment has made stent use much more frequent. However, prophylactic stent placement must be judicious to maximize success and minimize associated morbidity. Recent controlled retrospective studies and randomized trials showed that ureteral stenting does not increase the stone-free rate or reduce the complication rate for stones less than 2 cm in size, yet in such cases, there are increased morbidities such as urinary urgency, frequency, stent migration, and encrustation.

Pyomyositis in patients with the human immunodeficiency virus: an unusual form of disseminated bacterial infection.

Purpose And Patients: Pyomyositis, a common disease in the tropics, is rare in the continental United States, with approximately 83 cases described in the literature in the past two decades. The occurrence of pyomyositis complicating human immunodeficiency virus (HIV) infection has been reported in 10 patients since 1986. We report six cases of this entity in patients with advanced HIV disease seen in our institution over a 20-month period.

Identifying risk factors in development of clinically significant post-shock-wave lithotripsy subcapsular hematomas.

A retrospective study of 1,012 shock-wave lithotripsy treatments was performed to identify and analyze the risk factors for the development of six clinically significant post-extracorporeal shock-wave lithotripsy (ESWL) subcapsular hematomas. The patients studied had clinical signs and symptoms that on evaluation were confirmed as originating from a subcapsular hematoma. Common factors identified which we believe may put patients at increased risk for the development of subcapsular hematoma included hypertension, diabetes mellitus, coronary artery disease, and obesity.