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Biomedical subjects

E Mukamel

Publications and source records attributed to E Mukamel.

72 records · Page 4Linked to original sources
PubMed1982

Unanticipated vesicoureteral reflux: a possible sequela of long-term thio-tepa instillations to the bladder.

Vesicoureteral reflux was studied by retrograde cystograms in 75 patients with recurrent transitional cell carcinoma of the bladder. Unilateral reflux was detected in 6 of the 14 patients (42.8 per cent) treated by transurethral resection of the bladder tumors. Five of these cases of reflux were anticipated and 1 was unanticipated. Among 61 patients treated by tumor resection and adjuvant instillations of thio-tepa reflux was found in 33 ureters of 25 patients (41.0 per cent). Of the 33 cases of reflux 15 were anticipated, while 18 were unanticipated. All the anticipated cases of reflux resulted from the direct effect of tumor resection on the ureteral orifice. The effect of thio-tepa on bladder mucosa and the ureteral orifices is suggested as a possible cause of the unanticipated cases of reflux.

Carcinoma, Transitional Cell↗
PubMed1982

Immunological profile of patients with transitional cell carcinoma of the bladder.

The immunological profile of 58 patients with various stages of transitional cell carcinoma of the bladder was determined by using the local xenogeneic graft versus host reaction (GVHR) test, by skin testing with 3 recall antigens (candida, trichophyton, streptokinase-streptodornase) and by quantification of T-lymphocytes. Thirty-two patients with low grade low stage tumours (Group A) showed only a slight impairment of the immunological profile with a slight decrease in T-lymphocytes, 4.4% negative GVHR tests and 31.2% negative skin tests. Ten patients with highly invasive inoperable tumours (Group B) showed a severe impairment of the immunological profile with a significant decrease in T-lymphocytes, 100% negative GVHR and 80% negative skin tests. A marked improvement in the immunological profile was noted while comparing 9 patients who were examined within 6 months after cystectomy (Group CI) (severe decrease in T-lymphocytes 44.4% negative GVHR tests and 66.6% negative skin tests) with 7 patients who were examined 18 months or more after operation (Group CII) (slight decrease in T-lymphocytes 0% negative GVHR and 42.8% negative skin tests). Incubation of T-lymphocytes with a thymic hormone (THF) caused an increase in the extent of the graft versus host reaction in 10 out of 14 patients with low grade low stage bladder tumours. This may represent an improvement in the functional activity of the T-lymphocytes with a possible therapeutic use in the future.

Adult↗
PubMed1980

Early combined hormonal and chemotherapy for metastatic carcinoma of prostate.

Twenty-five patients with confirmed Stage D carcinoma of the prostate were treated by a combination of bilateral orchiectomy, estrogen, and chemotherapy soon after diagnosis was established. Patients were given diethylstilbestrol (DES) 3 mg. daily, and a weekly intravenous injection of 5-fluorouracil (5-FU) 10 mg./Kg. and cyclophosphamide 10 mg./Kg. They were followed up for between sixteen and forty-two months. The majority of patients reported a subjective improvement. Objectively, the primary tumor shrunk by more than 50 per cent in 84 per cent of the patients, while in 64 per cent there was improvement in the lesions shown on bone scan. The cumulative survival rate during three and one-half years was 76.5 per cent. These encouraging preliminary results appear to justify the early initiation of combined therapy in larger numbers of patients with Stage D prostatic carcinoma.

Aged↗
PubMed1979

Widespread dissemination of gelfoam particles complicating occlusion of renal circulation.

Embolization of renal circulation by Gelfoam particles in a thirty-two-year-old man with renal carcinoma was followed by retrograde regurgitation of the injected particles upstream, with resultant occlusion of the celiac trunk and the superior mesenteric artery. This was followed by a stormy clinical course, which the patient survived. Several possible explanations are offered for the occurrence of this complication.

Adult↗
PubMed1979

Spontaneous rupture of renal and ureteral tumors presenting as acute abdominal condition.

We report on 3 patients who presented with an acute onset of abdominal pain, a palpable abdominal mass and a rapid decrease in hemoglobin. In 2 patients a spontaneously ruptured hypernephroma was found and the other patient had a squamous cell carcinoma of the ureter with bleeding into the tumor. Although in all 3 cases the tumors were at an advanced stage of development, the patients had been entirely free of urological symptoms until shortly before hospitalization. The importance of considering the possibility of spontaneous rupture of such a tumor in the evaluation of cases of an acute abdomen is stressed.

Abdomen, Acute↗
PubMed1979

Benign cholestatic jaundice after nephrectomy for pyonephrosis and sepsis.

Severe benign postoperative intrahepatic cholestatic jaundice appeared immediately after nephrectomy in a patient with nephrolithiasis and septicemia. Convalescence was uneventful and no treatment was necessary. This diagnostic possibility should be considered whenever jaundice appears postoperatively for pyonephrosis and septicemia.

Cholestasis↗
PubMed1979

Occult progressive renal damage in the elderly male due to benign prostatic hypertrophy.

A review of the case histories of 345 patients who underwent protatectomy showed that 1.7 percent (6 patients) had "occult and progessive renal damage" secondary to prostatic hypertrophy. All these men were over the age of 60 and the disturbances in micturition were so mild that the patients were unaware of, or chose to ignore them. The presenting symptoms were nonspecific and included generalized weakness, anorexia, nausea, constipation, and weight loss. Investigation revealed impaired renal function of varying degrees. Prostatectomy was associated with a dramatic improvement in all 6 patients. Physicians should be aware of the clinical entity of occult and progressive renal damage secondary to obstruction of the bladder outlet, especially in the elderly male. Uremia can develop with minimal urinary symptoms. Elderly men often suppress or deny their symptoms because of the fear of operation.

Age Factors↗
PubMedDate not supplied

Human prostatic tissue constituents respond differently to thermal injury induced by Nd-YAG laser ITT fiber applied ex-situ.

BACKGROUND AND OBJECTIVE: The human prostate is a glandular organ that has intervening fibromuscular elements. The objective of this study was to evaluate the thermocoagulative effect on the different components of the organ exposed to Nd-YAG laser irradiation using a new ITT optic fiber design (Interstitial Thermal Therapy). STUDY DESIGN/PATIENTS AND METHODS: Twelve fresh transvesical prostatectomy specimens were irradiated ex-situ at 4 to 6 sites using an ITT fiber with laser energies ranging from 900 to 4500 joules (J) applied at times ranging from 60 to 300 seconds corresponding to 10 to 15 watts. The specimens were serially sectioned to include the proximal, mid and distal regions of the centrally coagulated channel. An ocular grid was utilized to measure the radius (r) of thermal injury from the margin of the centrally coagulated channel to the furthermost detectable area of thermally induced changes. RESULTS: The maximal extent of thermal injury was seen at the mid-length of the irradiated channel at energy of 2700 J (15w/180 sec). The fibromuscular compartment of the prostate was more affected (r = 855 microm) and showed more interstitial vacuolization and charring than the adenomatous one (r = 495 microm). Utilization of higher energy doses did not significantly alter the depth of injury but did reduce the extent of interstitial vacuolization of both components. CONCLUSION: The study indicates that the extent of laser induced coagulative necrosis depends on the histologic architecture of the prostate and also varies in extent along the length of the channel surrounding the fiber.

Dose-Response Relationship, Radiation↗
PubMedDate not supplied

Upper gastrointestinal bleeding from uncommon causes in patients with concomitant peptic ulcer: a clinical, diagnostic and therapeutic pitfall.

In the majority of cases, massivm a peptic ulcer arises from the ulcer. On rare occasions, the bleeding emanates from other sites in the gastrointestinal tract. Four patients, all of whom had suffered from peptic ulceration for lengthy periods, and who were referred to hospital with severe bleeding from sources other than peptic ulcer, are presented. This group of patients poses particular diagnostic and therapeutic problems, which are discussed. The need for performing emergency gastroscopy and/or selective angiography, in an attempt to localize the source of bleeding preoperatively, is stressed. In doing so, one is taking into consideration the many difficulties sometimes encountered during operation in locating a bleeding point in a bowel filled with blood clots. In those patients in whom the source of the hemorrhage cannot be ascertained, early surgical intervention is advised, because the bleeding may possibly be coming from a tumor of the small bowel.

Adult↗
PubMedDate not supplied

Prophylactic effect of triethylenethiophosphoramide on the recurrence rate of superficial bladder tumors.

The prophylactic effect of triethylenethiophosphoramide (thio-TEPA) on the recurrence rate of superficial transitional cell carcinoma of the bladder was examined in three groups of patients. Patients in group 1 had been treated by transurethral resection of the tumor before the study began; thereafter, topical thio-TEPA was added to the therapeutic regimen. The mean recurrence rate in this group dropped from 1 in 11.1 months before treatment with thio-TEPA to 1 in 28.6 months during treatment. Group 2 included patients treated by transurethral resection, with the addition of thio-TEPA instillation as soon as a diagnosis of transitional cell carcinoma of the bladder was established. In this group, the recurrence rate was 1 in 34.6 months. The control group for group 2 (group 3) was treated by transurethral resection of the tumor with no thio-TEPA instillation, and in this group, the recurrence rate was 1 in 11.6 months. These results justify the prophylactic use of thio-TEPA in patients with transitional cell carcinoma of the bladder.

Aged↗