Biomedical subjects
Publications and source records attributed to B Moskovitz.
A case of the rare squamous carcinoma of the prostate is herein presented. Squamous cancer accounts for 0.5-1% of prostatic malignancies. The patient died of systemic metastases 5 months after diagnosis. Review of the literature suggests that such a cancer is highly aggressive and responds poorly to any mode of therapy, perhaps because of a different cell of origin.
The incidence of second primary cancer (SPC) was determined in 64 irradiated stage I testicular seminoma patients, treated and followed at the Northern Israel Oncology Center from 1968 to 1988. Seven (11%) patients developed a total of eight second cancers. The cumulative risk for developing second primary cancer at ten, 15 and 20 years following the diagnosis of seminoma was 2.5%, 5.1% and 8.9%, respectively. Two patients developed SPC within the radiation field (urinary bladder, sigmoid colon) and four patients outside the radiation field (bronchogenic cancer, thymoma, malignant melanoma, thyroid cancer). In two patients, who developed lung cancer and testicular seminoma, respectively, scatter dose from the main radiation field could not be excluded as one of the factors contributing to the SPC. Three patients died as a direct result of their SPC. It is concluded that there is a low, but significant risk of solid SPC among patients apparently cured of early stage seminoma. It will be important in future surveillance studies of stage I seminoma to assess the risk of SPC in the non-irradiated patients.
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A rare case of abscess of the corpus cavernosum is described. Culture of the abscess yielded beta-hemolytic streptococcus. Ultrasound scan and cavernosography confirmed the physical examination findings of involvement of the corpus cavernosum. The patient was treated successfully by percutaneous ultrasound-guided aspiration drainage and systemic antibiotic therapy.
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During 1968-1988, 6 patients with Stage I spermatocytic seminoma were registered at this oncology center. They represent 7% of a total of 83 patients referred for testicular seminoma (mean age 41 years, range 30-75). All 6 underwent high inguinal orchiectomy and 5 received postoperative radiotherapy. 1 refused any postoperative treatment. In a mean follow-up of 64 months (range 25-204), 4 patients were alive with no evidence of disease, 1 had died of ischemic heart disease without evidence of recurrence of the seminoma, and 1 was lost to follow-up after no evidence of disease was found 90 months after radiotherapy. In the light of our experience and reports in the literature, spermatocytic seminoma has a very good prognosis, although metastatic potential cannot be ruled out. Decision as to treatment should be based mainly on the stage of the disease.
The authors describe an uncommon case of a huge perinephric abscess with a gas-fluid level occupying the upper left abdomen. A rational sequence of radiological diagnostic methods such as plain film, ultrasound, CT, and combined retrograde urogram with contrast filling of percutaneous drainage led to correct management.
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Extracorporeal shock-wave lithotripsy has altered the therapeutic approach to urinary stone disease. Recently, a method was developed in which shock-wave generation is obtained piezoelectrically. To evaluate the effect of extracorporeal piezoelectric lithotripsy (EPL) on renal function, 20 patients were studied prior to and after EPL of renal calculi. Renal cortical function was evaluated by using a previously described and validated quantitative single photon emission computerized tomography (SPECT) method to measure individual absolute uptake of technetium-99m dimercaptosuccinic acid (Tc-99m-DMSA). Twenty kidneys were treated, and the 19 contralateral kidneys were without stone disease (1 patient had a single kidney). The absolute kidney uptake of Tc-DMSA in the normal kidneys was 21.4% +/- 6.2% before and 22.2% +/- 6.4% after EPL. For the treated kidneys the absolute update was 16.8% +/- 5.3% and 16.8% +/- 4.7% before and after, respectively. There was no statistical significant difference between pre- and post-treatment values. The absolute kidney uptake was significantly lower (p less than 0.01) in the treated than in the normal kidneys. This study indicates that the EPL procedure did not cause any damage to cortical function detectable by the DMSA uptake.
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To date, no standard technique for incisional lumbar hernia repair can be recommended since it depends on the size of the defect in the transversalis fascia. A new technique for this purpose, by using plication of the normal fascia, is described.
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We describe here the first case of an exceptional anomaly consisting of an incomplete quadruplication of the urinary tract in a solitary left kidney. A review of the English literature failed to document such a case.
The effect of distilled water on exfoliated tumor cells from transitional bladder carcinoma was compared to the effect of bacillus Calmette-Guérin (BCG; a nonspecific immunotherapeutic agent) dissolved in either saline or distilled water. The experiment was controlled by comparison to the effect of saline on tumor cells under the same conditions. Distilled water proved as effective as BCG in distilled water (p less than 0.001) and much more destructive than BCG in saline within the 2-hour time limit of the experiment (p less than 0.001).
We report a 63-year-old woman who presented with anemia and a left kidney mass. Guided fine-needle aspiration of the mass revealed extramedullary hematopoiesis and enabled avoiding an unnecessary operation. Subsequent bone marrow biopsy demonstrated myelofibrosis. Twenty-four months later the mass remained stable.
Impotence affects about 10% of all men. During the past decade it has been treated with self-injection of vasoactive drugs into the erectile tissue. In 1982 Virag reported experience with intracavernous injection of papaverine. Since then other vasoactive drugs, such as prostaglandin E1 (PGE1), have been used successfully, and self-injection has been advised. Between 1987-1989 we evaluated 550 patients with erectile dysfunction and 95 aged 21-79, mean 53.7, were found suitable for this treatment, of whom 80 were entered into an autoinjection protocol, of 74 were treated with a mixture of papaverine and regitine and 6 with PGE1. The volume of the injections ranged from 0.1 to 1.0 ml, and erections lasted from 15 minutes to 8 hours. 72% of the patients continued autoinjection during a mean follow-up of 9.9 months and were satisfied with the results. There were 5 cases of corporal fibrosis, and 3 cases had prolonged erections, usually after the papaverine test. The method is simple and inexpensive, and allows many impotent men to resume sexual life. It is a good alternative to the insertion of a penile prosthesis.
A rare case of carcinoma of female urethra from transitional cell origin is reported. The occurrence of primary transitional cell carcinoma in the urethra is being discussed, with review of the literature.
Injuries constitute one of the major disease categories in infancy and childhood. Child abuse is a significant portion of this. A rare case of battered child presenting with acute renal artery occlusion is reviewed.