Search PubMed⌕ Search

Biomedical subjects

C Deliveliotis

Publications and source records attributed to C Deliveliotis.

At least 55 records · Page 3Linked to original sources
PubMed1996

Distal ureteral calculi: ureteroscopy vs. ESWL. A prospective analysis.

Two groups of 50 consecutive patients each, with distal ureteric calculi, were treated by ureteroscopy or in situ ESWL (Dornier HM-4 lithotriptor) in order to establish the effectiveness of ESWL at the distal portion of the ureter. In comparison to ureteroscopy, ESWL for distal ureteral calculi was performed on an outpatient basis, required less time, patients had more rapid convalescence and the procedure was simpler and safer. The overall success rate was 100% for ureteroscopy and 92% for ESWL. Our observations showed that in situ ESWL with the Dornier HM-4 lithotriptor is the method of choice for the treatment of distal ureteral calculi.

Adult↗
PubMed1996

Deoxyribonucleic acid measurements in transitional cell carcinomas: comparison of flow and image cytometry techniques.

PURPOSE: We compared the results of deoxyribonucleic acid (DNA) ploidy determinations performed by flow cytometry and image cytometry in transitional cell carcinomas of the bladder. MATERIALS AND METHODS: In 81 cases of transitional cell carcinoma of the bladder DNA indexes were measured by flow cytometry of bladder washings and tumor tissue samples, and by image cytometry of imprints from tumor tissue samples. RESULTS: There was good correlation between bladder washings and tissue samples analyzed by flow cytometry in 68 cases but aneuploidy was missed with bladder washings in 13 (16%). There was also good correlation between flow and image cytometry in 75 cases (92.59%) regarding the detection of aneuploidy. There was agreement between detection of aneuploidy and DNA index in 45 cases (55.5%), while both methods detected an aneuploid population in 30 (37%) but there was disagreement regarding DNA index. Aneuploid populations were missed by flow cytometry in 6 cases (7.4%). Furthermore, in 10 cases peridiploid peaks were found on the image cytometry histograms, which were not visible on flow cytometry. However, it was not possible to assess accurately if these were true peridiploid populations. CONCLUSIONS: There is good overall correlation between DNA content measured by flow and image cytometry but image cytometry has the advantage of visual discrimination, permitting preferential selection and analysis of tumor cells. However, certain problems remain with image cytometry, particularly in the case of peridiploid peaks, which cannot be classified accurately as showing true peridiploid or right shifted diploid populations.

Carcinoma, Transitional Cell↗
PubMed1996

Primary renal lymphoma: a clinical and radiological study.

PURPOSE: We assessed the incidence, clinical and radiological features, and prognosis of patients with renal lymphoma. MATERIALS AND METHODS: We studied 210 patients with symptoms, signs and and radiological findings suggestive of renal cell carcinoma. RESULTS: Final diagnosis in 6 of 210 patients (3%) was primary renal lymphoma. Radiological features were similar to those of renal cell carcinoma. Five of the 6 patients had an International Prognostic Index score of greater than 1. Despite appropriate chemotherapy, only 2 patients remain with complete remission. CONCLUSIONS: Primary renal lymphoma is unusual but not rare. The relatively poor prognosis in our patients could be attributed to the adverse prognostic factors associated with aggressive nodal lymphomas.

Aged↗
PubMed1996

Does free to total ratio of prostate-specific antigen alter decision-making on prostatic biopsy?

OBJECTIVES: For patients with prostate specific antigen (PSA) values of 4-10 ng/mL, some urologists perform prostatic biopsies depending upon the findings of digital rectal examination (DRE) and transrectal ultrasonography (TRUS), and others perform biopsies on most of these men regardless of the findings of DRE and TRUS. The purpose of this study was to examine whether the information given by the measurement of the ratio of free to total (F/T) PSA can alter decision-making on prostatic biopsy. METHODS: One hundred and two (102) men with PSA values between 4 and 10 ng/mL, were included in this study. All men were examined with DRE and TRUS; a F/T PSA ratio was also measured, and six prostatic biopsies were taken from each patient. RESULTS: In 102 men who were biopsied, 22 (21.5%) prostatic carcinomas were identified. Among these 22 cancer patients, 13 had abnormal findings in DRE and/or TRUS and would have been biopsied and diagnosed anyway. If we use only the F/T PSA ratio (cut-off value 0.20) to decide whom to biopsy, we would have diagnosed 16/22 cancers; the difference between these two procedures was not statistically significant (P = 0.17). If we decide to biopsy those patients who have abnormal findings in DRE and/or TRUS and those who have a F/T PSA ratio < 0.20, we would diagnose 20/22 cancers (P = 0.05) and at the same time, reduce the unnecessary biopsies from 80 to 41 (48%). With a PSA value between 4 and 10 ng/mL and no findings in DRE and TRUS and at the same time with a F/T PSA ratio > or = 0.20, we would have to perform biopsies in 20.5 men to find one cancer. On the other hand, in patients with suspicious findings in DRE and/or TRUS and a F/T PSA ratio < 0.20, in every two men that we biopsy we would find one cancer. CONCLUSION: We believe that among patients with PSA values between 4 and 10 ng/mL after performing DRE and TRUS, the additional information of F/T PSA ratio can help since it increases the number of cancers detected and reduces the number of unnecessary biopsies.

Adult↗
PubMed1996

Extracorporeal shock wave lithotripsy of middle ureteral calculi: ventral shock wave application.

A total of 150 patients presenting with stone in the middle iliac ureter were treated with extracorporeal shock wave lithotripsy using a Dornier HM-4 lithotriptor. For adequate radiological stone visualization and excellent fragmentation, the prone position was used in all patients. In 45 patients (30%) an ureteral stent was placed before treatment. The overall success rate was 82% (123 of 150 patients). All patients were treated on an outpatient basis without anesthesia.

Adult↗
PubMed1996

Extracorporeal shock wave lithotripsy for renal stones in children.

The aim of our study is to determine the efficacy and safety of extracorporeal shock wave lithotripsy (ESWL) as a method of treatment of nephrolithiasis in childhood. Between 1986 and 1994, 50 children with renal calculi were treated by ESWL in our department. The age of the children ranged from 8 months to 14 years. Thirty-three of them were boys and 17 girls. The stone location was in the renal pelvis in 38 cases, in the upper renal calyx in 4 cases, in the lower calyx in 2, while 6 children had staghorn calculi. The stone size ranged between 3 and 39 mm. All treatments were performed with Dornier HM4 except 12 children, all older than 10 years, who underwent ESWL with Dornier HM3. All ESWL procedures took place under general anesthesia or sedation with ketamine. The number of shock waves varied between 400 and 2,000 per treatment and the standard maximum generator voltage was 18 kV. The overall stone clearance rate at 1 month was 66%. Fourteen children with large residual fragments underwent a second ESWL procedure 3 months later. With a mean follow-up of 33 months, 41 children (82%) are stone-free. Ten children developed urinary tract infection and 5 Steinstrasse. Twelve children had a pre- and post-ESWL DMSA scan and no permanent impairment of renal function was observed. We conclude that ESWL is the treatment of choice for urinary tract lithiasis in childhood. It is a low-risk method, without serious complications, which yields as high a success rate in children as in adults. We believe that as the stone fragmentation and clearance is much higher in children that in adults, the method must be the initial approach and may be the monotherapy even in staghorn or complex stones.

Adolescent↗
PubMed1996

Management of lithiasis in medullary sponge kidneys.

Twenty-four patients with medullary sponge kidneys (MSKs), diagnosed on a recent IVU, and renal lithiasis were treated by extracorporeal shock wave lithotripsy (ESWL). A detailed history regarding frequency of renal colic and urinary tract infection (UTI) was recorded and compared to the post-ESWL frequency of the symptoms. Our results show that the stone clearance rate is similar to that of non-MSK patients but there is a great reduction in the frequency of renal colic and UTI.

Adult↗
PubMed1996

Double-pigtail stents for distal ureteral calculi: an alternative form of definitive treatment.

In this study, we treated patients with a solitary distal ureteral stone of less than 10 mm in maximum diameter by placing a double-pigtail stent and subsequently removing it allowing the calculus to pass spontaneously. A total of 40 patients were enrolled in the study with a mean stone size of 5.1 x 3.5 mm (range 2-8 mm in length and 2-7 mm in width). The indication for intervention was intractable pain in 5 patients, infection due to obstruction in 2, highly obstructed urinary tract in 10, absence of progression for 30 days in 21 and desire of the patient to be free of stone in 2. A double-pigtail stent was inserted in the involved ureter under local anesthesia and left in place for 2 weeks. After stent removal, 34 patients succeeded in passing the stone within an average time of 5.8 days. The overall success rate was 85%. We suggest this method as an alternative form of treatment for distal ureteral calculi to extracorporeal shockwave lithotripsy of ureterolithotripsy under selected clinical circumstances.

Adult↗
PubMed1995

Transrectal needle aspiration versus transperineal needle biopsy in diagnosis of prostatic carcinoma.

Fine-needle aspiration of the prostate was compared to transperineal biopsy in 86 patients with suspected prostatic carcinoma. Aspiration was found to have a sensitivity of 98.6% while no complications were seen. Initial core needle biopsy compared to the final histological diagnosis in this study showed a sensitivity of 84.5%. Fine-needle aspiration of the prostate is a safe, inexpensive and accurate diagnostic method in prostatic carcinoma. Our findings suggest that prostatic aspiration should be used more widely as an initial diagnostic procedure for suspected prostatic cancer.

Biopsy, Needle↗
PubMed1995

Stimulation of the obturator nerve during extracorporeal shock wave lithotripsy.

This paper presents eigth patients with lithiasis of the lower third of the ureter that were treated by extracorporeal shock wave lithotripsy (ESWL). All the procedures were performed with a Dornier HM4 lithotriptor in the sitting position. In all cases clinical signs of stimulation of the obturator nerve were presented. Because of the continuing movement of the patient and the possibility of damage to the obturator nerve, the lithotripsy was interrupted in the sitting position and was performed successfully with patients in the prone position. One possible explanation for the above phenomenon is that the increased abdominal pressure in the sitting position pushes the ureter with the stone towards the side walls of the pelvis and the obturator nerve. In this way, both obturator nerve and stone were included either in the zone of the high concentration of the shock waves, or in the secondary focal point, with the final result of stimulation of the nerve. By placing the patient into the prone position, the abdominal pressure is reduced, the ureter moves towards the center line, the obturator nerve gets away from the shock waves and the ESWL is completed freely without stimulation of the nerve.

Adult↗
PubMed1995

The value of prostatic specific antigen in the early diagnosis of prostatic cancer: a Greek view.

OBJECTIVE: To assess whether it is worthwhile to screen asymptomatic men for prostate cancer using serum prostate specific antigen (PSA) and to determine how many patients could be cured of prostatic carcinoma if detected by screening. PATIENTS AND METHODS: Between June 1992 and January 1994 the serum PSA level of 1400 asymptomatic men over 50-years-old was assessed. Those men with PSA levels < 4 ng/mL were not evaluated further. Those men with PSA levels of 4-10 ng/mL underwent digital rectal examination (DRE) and transrectal ultrasonography (TRUS) and biopsies were taken when there were significant findings on DRE and/or TRUS. If the PSA levels were > 10 ng/mL patients were submitted for DRE and TRUS and, even if both examinations were negative, random biopsies were taken. Where cancer was detected the tumour was staged and if it was a clinically confined tumour a radical retropubic prostatectomy was performed. The pathological and clinical stages of the disease were then compared. RESULTS: The majority of patients (95%) had PSA levels of < 4 ng/mL. Forty-nine men had PSA levels of 4-10 ng/mL and of these 28 were biopsied, which detected 12 (24.5%) carcinomas. There were 20 men with PSA levels > 10 ng/mL and among them 11 (55%) were found to have carcinomas. Combining these figures, among the 1400 men there were 69 cases with PSA levels > 4 ng/mL and, using DRE and TRUS, 23 patients (33%) were diagnosed as having prostatic adenocarcinomas. Among these, one had metastatic disease, three had lymph node micrometastases during surgical exploration and 19 underwent radical prostatectomies. The pathological and clinical stages agreed in only eight patients. CONCLUSION: Only eight patients can be considered as cured because of the screening protocol and even this result is overoptimistic, as the future biological behaviour of these tumours is unknown. Therefore we cannot recommend screening for prostatic carcinoma among asymptomatic men in Greece.

Aged↗
PubMed1995

Epithelial differentiation antigens and epidermal growth factor receptors in transitional cell bladder carcinoma: correlation with prognosis.

Epithelial differentiation antigens have been correlated with morphologic differentiation of neoplastic urothelium. Moreover, epidermal growth factor, which is a polypeptide regulating growth and differentiation of normal and neoplastic cells, is found in high concentrations in the urine while its receptors (EGFR) have been identified in bladder tumors. The aim of this study was to investigate the immunohistochemical expression of cytokeratin, epithelial membrane antigen (EMA), CEA and EGFR in transitional cell bladder carcinomas (TCC) and to define any correlation of their expression with tumor grade, stage and patient survival. Twenty-four biopsy specimens obtained from patients with TCC were studied retrospectively. There were 23 men and 1 woman with a mean follow-up of 64 months. Eight biopsy specimens, which represented tumor recurrences of 4 patients, were also included in our material. The immunohistochemical avidin-biotin complex method was performed on paraffin sections for the detection of cytokeratin and EGFR with monoclonal antibodies as well as CEA with a polyclonal antibody. Cytokeratin was detected in 83.5% of the TCC, EMA in 62% and CEA in 70%. The expression of the epithelial differentiation antigens in TCCs was heterogenous, showing an increased incidence in high-grade and high-stage TCC. The CEA expression in TCC demonstrated a statistically significant correlation with patient survival (p < 0.02). EGFR was detected in 50% of the TCC. Although not statistically significant, a trend was found for a higher percentage of EGFR detection in high-grade TCC. EGFR expression was significantly associated with tumor stage and patient survival (p < 0.01 and p < 0.04, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

The Swiss lithoclast: an ideal intracorporeal lithotripter.

We report our early experience with a new device for endoscopic stone disintegration: the Swiss lithoclast. This device was used to treat 200 patients with stones in kidney, ureter, and bladder. Its effectiveness was 100% when the stone could be approached irrespective of size or composition, and no complication was encountered.

Adolescent↗
PubMed1995

Subcapsular hematoma due to ESWL: risk factors. A study of 4,247 patients.

A study of 4,247 shockwave lithotripsy treatment was performed to identify and analyze the risk factors for the development of post-extracorporeal shock-wave lithotropsy hematomas. The Dornier HM-3 and HM-4 lithotriptors were used. We recognized 23 hematomas in 23 patients (0.54%). Various factors were examined to identify the certain predisposing risk factors. There was no correlation of sex, age, stone number, stone size, stone location, number of shock waves and voltage used with the occurrence rate of hematoma. We found that patients with pre-existing hypertension and especially those with poor control of it had a significantly increased incidence of perinephric hematoma.

Female↗
PubMed1995

T-lymphocyte subsets in the peripheral blood of patients with renal cell carcinoma.

We analyzed the phenotypic distribution of the major T-lymphocyte subsets in the peripheral blood of 22 renal cell carcinoma patients before and after nephrectomy. We also compared these distributions to those of healthy controls and related them to tumor spread. The lymphocyte subsets were analyzed by means of flow cytometry. The CD4+ subset was the only one which was significantly decreased (x +/- SD: 36.2 +/- 6.4 vs 41.4 +/- 2.2 in healthy controls, P < 0.05), this contributing to a significant decrease in the CD4/CD8 ration (x +/- SD: 102 +/- 0.56 vs 1.42 +/- 0.28, P < 0.05). The decrease was more apparent with advanced stage. Helper cell activity increased significantly after nephrectomy in the higher stage patients (x +/- SD: 41.1 +/- 4.6 vs 36.4 +/-3.1 and 38.2 +/- 3.9 vs 30.1 +/- 4.2 for stage T3 and T4 patients respectively). Knowledge of peripheral blood lymphocyte patterns that correlate with various tumor stages and therapies could provide information in host-tumor relationship and predict the clinical outcome and response to therapy.

Adult↗