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M Shabtai

Publications and source records attributed to M Shabtai.

72 records · Page 4Linked to original sources
PubMed1989

Malakoplakia in renal transplantation: an expression of altered tissue reactivity under immunosuppression.

This report describes the successful treatment in a transplant recipient of a case of MK originating from the native urinary tract. As demonstrated, MK may pursue unexpected patterns to which conventional therapeutic guidelines may not be applicable. The type of surgical intervention used must be dictated by the extent and location of the disease and its complications. Withdrawal of immunosuppressive medication was useful in improving the patient's prognosis.

Adult↗
PubMed1988

Decompensated ureteropelvic junction obstruction in renal allograft.

We report a case of complete obstruction at the ureteropelvic junction in a renal allograft 6 months after related kidney transplantation. Surgical treatment consisted of a Foley nondismembered Y-V pyeloplasty. Although the donor harbored undetected bilateral, mild, ureteropelvic junction stenosis, as established by review of the excretory urogram that was performed before nephrectomy, the remaining kidney functioned well, as confirmed by renal function and morphological appearance on a repeat excretory urogram. The possible mechanisms of ureteropelvic junction decompensation, the most crucial of which appears to be autonomic denervation of the allograft, are discussed.

Adult↗
PubMed1985

Severe pulmonary nocardiosis in a kidney allograft recipient with a low immunological response.

A patient with severe pulmonary nocardiosis occurring in the early posttransplant period is presented. Three outstanding features characterized this case: 1) the failure to diagnose this rare opportunitistic pathogen by conventional detection methods necessitated open lung biopsy; 2) the initiation of trimethoprim-sulphamethoxazole therapy resulted in a dramatic clinical response; and 3) an allograft recipient with a low immunological response contracted nocardiosis. His immune status became apparent following pretransplant donor-specific blood transfusion tests, unresponsiveness to third-party transfusion and graft tolerance permitting the permanent withdrawal of azathioprine without graft function impairment.

Adult↗
PubMedDate not supplied

Postoperative pneumoperitoneum as detected by CT: prevalence, duration, and relevant factors affecting its possible significance.

BACKGROUND: To determine the prevalence and duration of postoperative pneumoperitoneum as detected on computed tomography (CT) and to evaluate factors that influence postoperative pneumoperitoneum. METHODS: One hundred three CT examinations of 89 patients performed after abdominal surgery for various indications were prospectively collected and reviewed. The presence and volume of free air were noted and correlated with patients' sex, age, and habitus, with the time interval between surgery and CT, with the type of surgery, and with the presence of drains. RESULTS: Pneumoperitoneum was seen in 44% of examinations performed in the first 3 days after surgery and in 30% between the 4th and 18th postoperative days. The prevalence and volume of free air decreased with the time interval between surgery and CT. It was not detected in any of the 11 examinations performed beyond the 18th postoperative day. The volume of free air in the majority of examinations did not exceed 10 mL and ranged from 0.2 to 10 mL in 19 patients (66% of patients with free air). Larger volumes of free air, ranging from 10 to 20 mL and from 20 to 40 mL, were observed in 5 (17%) and 4 (14%) patients, respectively, and only one patient had more than 40 mL of free air. Free air was found significantly more often in male and in asthenic patients; age had no significant effect. Free air was more prevalent in the presence of drains. The type of surgery did not significantly influence the prevalence of postoperative pneumoperitoneum, although it was noted slightly less often after laparoscopic surgery than after open laparotomy. CONCLUSIONS: Pneumoperitoneum is a common phenomenon after abdominal surgery, decreasing in frequency with time. The air is most often residual and not a sign of disruption of the gastrointestinal tract. Obesity, female sex, and occurrence of free air several weeks after surgery are factors suggestive of a leak, but the significance of a postoperative pneumoperitoneum on CT should be determined mainly by the clinical setting.

Abdomen↗
PubMedDate not supplied

Computer-assisted image analysis of small cell lymphoma of the thyroid gland. Comparison of nuclear parameters of small lymphocytes in lymphomas and Hashimoto's thyroiditis.

The nuclear parameters of the small lymphocytes in nine cases of small cell lymphomas of the thyroid gland and 17 cases of Hashimoto's thyroiditis were assessed by computer-assisted image analysis. The nuclear area, maximal, minimal and averaged Ferret diameters, perimeter, regularity factor and elongation factor were gauged. Statistically, the nuclear area was ascertained to be the optimum descriptor discriminating between small neoplastic and reactive lymphocytes. Application of a novel variable, combining a nuclear area cut-off value of 14 microm2 with a nuclear averaged Ferret diameter cut-off value of 4.5 micron, allows for the distinction - with a high degree of sensitivity and specificity - between small neoplastic lymphocytes in thyroidal lymphomas and the reactive lymphocytes in Hashimoto's thyroiditis.

Adult↗
PubMedDate not supplied

Immune inhibitory effects of renal cell carcinoma extract on lectin and alloantigen-induced peripheral blood and tumor infiltrating lymphocyte blastogenesis.

The presence of tumor infiltrating lymphocytes (TIL) has been attributed to the host cell mediated immune response against the evolving malignancy. However, due to specific evasive and escape mechanisms, the immune competent cells are rendered ineffective. One such mechanism may be the production of immune suppressor substance(s), inhibiting lymphocyte proliferation, and subsequently, their transformation into effector cells. To evaluate a possible impact of RCC extract on lectin and alloantigen-induced proliferation of TIL and peripheral blood lymphocytes (PBL) from renal cell carcinoma (RCC) patients and from healthy control human subjects. Tumor extract and TIL were derived from 13 patients with RCC undergoing radical nephrectomy. Tumor infiltrating lymphocytes and PBL from these patients were activated with Concanavalin A (Con-A), Phytohemoglutinine (PHA) or Pokeweed (PW) and the rate of blastogenesis was measured by (3)H Thymidine incorporation. The same procedure was used in assay with PBL from control healthy blood donors. There was a significant reduction (88.6%) in the proliferative response to ConA of TIL compared to PBL from the same patients (P = 0.007). A similar decrease was seen following stimulation by PHA (85.8%, P = 0.01) and PW mitogen (78.5%, P = 0.001). A 79.5% decrease in response level of TIL to alloantigens compared to PBL from RCC patients (P = 0.021), was observed. Lectin induced proliferative response of RCC patients was significantly lower in the presence of RCC extract (82.9%) compared to normal kidney extract (P = 0.008). Alloantigenic stimulation of healthy individual PBL was also decreased significantly in the presence of RCC extract (92.9%, P = 0.0001) compared to normal kidney extract. Similarly, lectin induced stimulation of healthy control PBL in the presence of RCC extract was significantly lower (83.2%, P = 0.003). Our data suggest that RCC extract contains an immune suppressive substance(s), capable of inhibiting lymphocyte proliferative response of tumor infiltrating lymphocytes as well as of PBL from patients and healthy individuals alike. This may be one of the mechanisms by which the tumor evades the transformation of lymphocytes into effector killer cells, and thus affects the biological inter-relationship between tumor and host. Identification of this substance and its gene may provide an effective anti-tumoral treatment modality.

Adenocarcinoma, Clear Cell↗
PubMedDate not supplied

Intraperitoneal bupivacaine does not attenuate pain following laparoscopic cholecystectomy.

BACKGROUND: Laparoscopic cholecystectomy is characterized by a short hospital stay. Hence, pain control on the day of surgery is increasingly important. The aim of this study was to evaluate the effect of intraperitoneal bupivacaine on pain relief following laparoscopic cholecystectomy. METHODS: Sixty patients undergoing elective laparoscopic cholecystectomy were prospectively randomized into 2 groups. Following removal of the gallbladder, group A received 100 mg of bupivacaine in 50 cc of saline, installed into the gallbladder bed and right subphrenic space. Group B received saline without bupivacaine. Pain was assessed using a visual/analog scale at fixed-time intervals. RESULTS: No significant difference occurred in the average pain levels between the groups at 1, 2, 4, and 14 hours postsurgery. The average analgesic requirement was lower in the bupivacaine group, but this did not reach statistical significance. CONCLUSION: Application of intraperitoneal bupivacaine did not attenuate pain following laparoscopic cholecystectomy, and no role exists for its routine use.

Adult↗