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Biomedical subjects

D Remzi

Publications and source records attributed to D Remzi.

At least 37 records · Page 2Linked to original sources

Should radical nephrectomy include ipsilateral adrenalectomy?

We reevaluated 46 patients with histopathologically proven stage A and B renal cell carcinoma, who underwent radical nephrectomy for the presence of ipsilateral adrenal gland in the surgical specimens. It turned out that 23 specimens included ipsilateral adrenals. Two patients without adrenalectomy relapsed locally, whereas no local recurrence was noted in patients whose adrenals were removed. Three years' disease-free survival rates (DFS) for patients with and without adrenalectomy were 100% and 78%, respectively. Although no statistical difference was found in terms of DFS between patients with and without adrenalectomy, we suggest the removal of the ipsilateral adrenal gland if technically feasible.

Adrenal Gland Neoplasms↗

Methotrexate, vinblastine, adriamycin and cisplatin (MVAC) chemotherapy for the treatment of advanced bladder carcinoma.

Thirteen patients with advanced urothelial transitional cell carcinoma were treated with methotrexate, vinblastine, adriamycin and cisplatin combination. No complete remissions were achieved in patients with disseminated diseases; only three out of five patients (60%) with localized tumours in the bladder or perivesical space responded completely. Localized tumour recurrences in the bladder occurred in two of three complete responders at the ninth and tenth months after chemotherapy. Four patients died during or after chemotherapy: one from disease progression and the remainder from chemotherapy complications. Authors conclude that, although 23% complete and 30.8% partial remissions were achieved with the MVAC chemotherapy, strict toxicity monitoring and careful selection of patients are essential because of its non-negligible complications.

Aged↗

Genital infections in men associated with Chlamydia trachomatis.

The advent of new diagnostic procedures has made it possible for urologists to detect chlamydial presence in genital infections. Many studies have shown chlamydial association with urethritis. However, its presence in prostatitis and epididymitis has not been clearly defined yet. In this study we investigated the presence of Chlamydia trachomatis using enzyme linked immuno assay (ELISA) antigen and antibody detection method in sexually active men with different genital infections. We have found that in 32.1% of patients with non-gonococcal urethritis chlamydial antigen is detectable. We also have been able to detect chlamydial antigen in two patients with chronic non-bacterial prostatitis, but in no patients with epididymitis. We conclude that besides its presence in urethritis, there is an association between chlamydia and chronic prostatitis. Yet, further studies are needed to delineate this association more clearly.

Adult↗

Dual radioisotopic study: a technique for the evaluation of vasculogenic impotence.

Arterial and venous systems are the main points for the evaluation of vasculogenic impotence. To evaluate both of these systems in the same study we propose a dual radioisotopic study in which 99mtechnetium (99mTc) and 133xenon (133Xe) were used. The changes in 99mTc and 133Xe radioactivities administered intravenously and intracavernously, respectively, were monitored before and after intracavernous papaverine injection. These changes were determined as time activity curves, which were generated from the region of interest over the penis. A 99mTc penogram index derived from the 99mTc time activity curve was significantly different in the control and arteriogenic impotence groups (131.67 +/- 74.6 versus 62.94 +/- 51.6, p less than 0.01). A meaningful correlation between 99mTc penogram index results and duplex ultrasonographic findings were observed (r = 0.905). 133Xe penogram index, derived from the 133Xe washout curve was significantly different in the control and venogenic impotence groups (-25.65 +/- 24.9 versus -56.09 +/- 13.4, p less than 0.01). Also, a meaningful correlation was obtained between pharmacocavernosometry and 133Xe penogram index results of venogenic impotent patients (r = 0.86). These findings suggest that the dual radioisotopic study will be a useful technique in the evaluation of the entire vascular system of the penis, since it is a noninvasive method.

Adult↗

[Effects of prostatic massage on serum levels of prostatic acid phosphatase and specific antigen].

We studied the influence of prostatic massage on the seric levels of acid prostatic phosphatase (PAP) and prostatic specific antigen (PSA) before and 1, 24 and 48 h after the examination. Three groups of patients were studied: 13 patients with prostatic benign hypertrophy (PBH), six patients with metastatic prostate carcinoma and 10 control patients (urinary lithiasis). We observed a significant elevation of both seric markers 1 h after prostatic massage in the PBH and control groups. In both groups, seric marker levels returned to normal values within 24 h with PAP and 48 h with PSA. We recommend to assay serum PSA and PAP with an interval of at least 48 h after rectal digital examination.

Acid Phosphatase↗

Immunohistochemical detection of beta-human chorionic gonadotropin in urothelial carcinoma.

Histologic sections from the specimens of 60 patients with urothelial carcinoma were stained immunohistochemically to search for beta-human chorionic gonadotropin (B-HCG) production. There were 6 doubtful, 5 weak and 1 strong positive B-HCG stainings among 65 sections from 60 patients. De novo acquisition of B-HCG production capability of tumour cells seemed to be predictive for early haematogenous dissemination of the disease, but the data obtained in this particular study were insufficient to suggest B-HCG as a routine prognostic marker.

Biomarkers, Tumor↗

Dynamic cavernosography in the evaluation of impotence.

Dynamic cavernosography before and after papaverine injection into the corpus cavernosum of 6 sexually normal volunteers and 44 impotent patients was performed with digital subtracting angiography technique. The average infusion rates in 26 patients with venous leakage were 325.5 ml/min for induction of erection and 161 ml/min for maintenance. The results for the remaining 18 impotent patients without venous leakage were 128.8 ml/min for induction and 56.9 ml/min for induction and 58.3 ml/min for maintenance. After papaverine injection the average infusion rates decreased to 131 ml/min (induction) and 59 ml/min (maintenance) in patients with venous leakage, 38.4 ml/min and 14.6 ml/min in the impotent patients without venous leakage and 35 ml/min and 14.1 ml/min in the control group, respectively. It was also noticed that in the control group filling of the superficial and deep veins may occur during the flaccid phase which disappeared with induced erection. Therefore we suggest intracavernous papaverine injection with dynamic cavernosography. The digital subtracting technique eliminates unnecessary images, providing a more accurate diagnosis of venous incompetence.

Adult↗

Diclofenac sodium and spasmolytic drugs in the treatment of ureteral colic: a comparative study.

Forty-nine patients with ureteral colic were included in this prospective double-blind study investigating the analgesic efficacy and side effects of a prostaglandin synthetase inhibitor Diclofenac sodium (Voltaren) versus a spasmolytic drug Tropenzilium bromide (Palerol). The analgesic efficacy and side effects of the calcium antagonist Nifedipine (Nidilat) applied sublingually in ureteral colic were also investigated. It was concluded that diclofenac sodium was more efficient for relieving pain due to acute ureteral obstruction and had fewer side effects than spasmolytic drugs. Nifedipine proved to have an analgesic effect equivalent to that of Tropenzilium bromide.

Adult↗

Screening of asymptomatic siblings of patients with vesicoureteral reflux.

Familial trait in vesicoureteral reflux (VUR) has been revealed in many studies. This paper reports on 36 siblings of 25 patients operated for vesicoureteral reflux at our Department. Siblings aged 2 to 21 years were evaluated by urine examination, urine culture and voiding cystourethrogram (VCU) for VUR. All of the siblings were asymptomatic and VUR was found in only 4 of them (11%), unilateral in 3 cases and bilateral in one case. It is concluded that evaluation of siblings for VUR will be suitable for revealing the presence of urinary infection, and assessing them by VCU at the time they are first seen.

Adolescent↗

Correlation between intracavernous papaverine injection, Doppler analysis and cavernosography in impotent patients.

Forty-four patients with impotence were evaluated by intracavernous papaverine injection, penile brachial index (PBI) determination and dynamic cavernosography. The correlation between these diagnostic procedures and their diagnostic value were investigated. It was concluded that the papaverine test is an efficient diagnostic procedure and can be used as the first step for the routine work-up of impotent patients.

Erectile Dysfunction↗

Histopathological changes in adult cryptorchid testes.

The histological specimens of 73 patients who presented with undescended testes after puberty were re-evaluated. None of the specimens revealed carcinoma in situ but in the specimens of 5 patients severe atypia was detected. None of the patients, including 5 with severe atypia, has shown any evidence of invasive testicular tumour during follow-up.

Adolescent↗

Primary carcinoma of the renal pelvis and ureter. A collective review.

During an 18-year period, 17 patients with renal pelvic and 8 with ureteral carcinoma were seen in our clinic. The lesion was transitional cell carcinoma in 23 patients, and epidermoid and anaplastic carcinoma, respectively, in 2 others. Because of frequent tumour recurrence in the lower tract, we recommend total nephroureterectomy including a cuff of the bladder as the treatment of choice for renal pelvic neoplasms. For ureteral tumours, less aggressive and conservative procedures can be considered.

Adult↗

Significance of scrotal violation in the prognosis of patients with testicular tumours.

Thirty-five patients with testicular cancer who had scrotal contamination during or prior to their primary treatment were compared with 70 patients who had undergone radical inguinal orchiectomy. The survival curves, disease-free intervals and 2-year survival rates of the two groups did not differ significantly and we do not advocate additional aggressive surgical treatment to the scrotum and superficial inguinal lymph nodes in these patients.

Dysgerminoma↗

[Fournier's gangrene: report of 6 cases].

6 patients with Fournier's gangrene a rare but life threatening disease, who were successfully managed are presented. Mortality rates between 17-45 percent have been reported for this disease, but through the use of broad-spectrum antibiotics, aggressive surgical debridement and when possible with multiple drainage incisions to avoid skin defects, the mortality rate has been reduced to 0 percent. We have found an association with diabetes mellitus in 2 cases, which is one of the serious predisposition factors and should not be forgotten.

Adolescent↗

Tissue alpha-fetoprotein and human chorionic gonadotrophin in non-seminomatous testicular tumours. A comparative study with serum levels.

The correlation between tissue localisation and serum levels of alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG) was studied in 20 tissue samples from 18 patients with non-seminomatous testicular tumours. Specific immunoperoxidase stains were used for tissue staining and serum measurements were made by radioimmunoassay. There was a close correlation between the tissue demonstration of AFP and HCG and elevated levels of serum markers. The cellular localisations of AFP and HCG were different and no cell stained concomitantly for both AFP and HCG. From these results and from the demonstration of tumour markers in the tissue of some patients with normal serum marker levels, it was concluded that immunocytochemical localisation of the tumour markers was more sensitive than serum measurements.

Choriocarcinoma↗

Association between HLA antigens and bladder tumors.

HLA antigen type was studied in 55 patients with transitional cell carcinoma of the bladder. The results showed high HLA-B5 and low HLA-BW35 frequencies. Histological grade, stage, and recurrence rate of tumors were also evaluated separately. The results were more significant in recurrent tumors.

Adult↗