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M Shalev

Publications and source records attributed to M Shalev.

At least 19 recordsLinked to original sources
PubMed1998

Bupivacaine infiltration into the neurovascular bundle of the prostatic nerve does not improve postoperative pain or recovery following transvesical prostatectomy.

PURPOSE: We assessed the effect of intraoperative bupivacaine infiltration into the neurovascular bundle of the prostatic nerve on postoperative pain and patient outcome. MATERIALS AND METHODS: The study included 40 American Society of Anesthesiologists physical status I to III patients undergoing transvesical prostatectomy. Following surgical resection of the prostate the neurovascular bundle of the prostatic nerve was infiltrated with either 10 ml. bupivacaine 0.5% or saline. Postoperative pain intensity was assessed using a patient generated 100 mm. visual analog scale and a patient controlled analgesia device. Additional analgesic requirements, time to ambulation, length of hospitalization and return to normal activity were also recorded. RESULTS: There were no differences in visual analog scale for pain, patient controlled analgesia demands or actual morphine delivered. Similarly, saline versus bupivacaine infiltration did not influence ambulation time (21.3 +/- 2.7 versus 25.0 +/- 11.8 hours, respectively), length of hospitalization (7.06 +/- 0.8 versus 7.11 +/- 0.6 days, respectively), return to normal activity (14.4 +/- 8.8 versus 14.2 +/- 8.2 days, respectively) or patient satisfaction. On postoperative days 1 and 2 more patients in the saline treatment group requested additional oral analgesia compared to the bupivacaine treatment group. However, no statistical difference was demonstrated. CONCLUSIONS: Following transvesical prostatectomy, prostatic nerve blockade has no beneficial effects on postoperative pain or patient outcome.

Aged↗
PubMed1996

A case of myospherulosis occurring in the perirenal adipose tissue.

The authors report a case of spontaneous myospherulosis that developed in the right perirenal adipose tissue, presented like an abscess, in an 82-year old man of the A, Rh+ blood group. The patient had a history of chronic lymphocytic leukaemia. Fine needle aspiration and histological examination of the renal cyst allowed the observation of 4- to 7-micron spherules (or endobodies) enclosed in saccular structures (or parent bodies) and accompanied by a foreign body-type response. The walls of the parent bodies were negative for PAS, Gomori's methenamine silver and Giemsa's stain. Immunohistochemical study was positive with anti A antibody specific of A1/A2 blood group and with anti glycophorin A antibody. The authors reviewed the literature concerning this rare lesion: it usually occurs in subcutaneous fat or in the paranasal sinuses, nose and middle ear but, up to now, no previous case has ever been reported in the urinary tract. The only case of visceral myospherulosis previously reported occurred in a cystic teratoma of the ovary. The reported case is also peculiar by the unusual thickness of the parent bodies. The authors also discuss the mechanism of the disease and suggest that, in the present observation, myospherulosis could have been induced by the rupture of a preexisting cyst in the perirenal adipose tissue.

Adipose Tissue↗
PubMed1996

Use of an intraurethral catheter instead of a Foley catheter after laser treatment of benign prostatic hyperplasia.

OBJECTIVE: Our study describes the results obtained in 15 patients in whom an intraurethral catheter (IUC) instead of an indwelling catheter was used after visual laser ablation of the prostate (VLAP). METHODS: The 15 patients were treated by VLAP for benign prostatic hyperplasia. The IUC was inserted through the cytoscope sheath immediately after completion of surgery, and left in the prostatic urethra for 3 weeks. RESULTS: Twelve of the 15 patients (80%) voided through the urethra without need of an indwelling catheter. In the remaining 3 patients the IUC had to be removed and a Foley catheter inserted. CONCLUSION: Our results reveal that the IUC stent may be used as an alternative for an indwelling catheter in patients treated by VLAP.

Aged↗
PubMed1996

Correction of congenital or acquired penile curvature through a simple corporoplication technique.

Sexual dysfunction resulting from penile deformity is amenable to surgical correction. Thirty-five cases of penile deformity either 29 congenital or six secondary to Peyronie's disease were treated by simple plication of the tunica albuginea with non-absorbable sutures through a small skin incision made on the convex side of the curved penis. Postoperative complications such as impaired erection or loss of sensitivity of the glans were not reported. After an average follow-up of 36 months (range 12-60 months) all patients have straight erections and retain normal erectile function.

Adolescent↗
PubMed1995

Is ipsilateral adrenalectomy a necessary component of radical nephrectomy?

Due to the increased use of modern imaging systems during the last few years, kidney tumors are often diagnosed at an earlier and less advanced stage. This fact implies a reevaluation of the operative technique of radical nephrectomy that was recommended 30 years ago. The ipsilateral adrenal involvement during radical nephrectomy for renal cell carcinoma is assessed and the necessity of its extirpation is discussed. Between September 1987 and September 1993, we performed 299 radical nephrectomies for renal cell carcinoma and removed 285 ipsilateral adrenal glands. Eleven adrenal glands (3.8%) were involved with the kidney tumor and 274 (96.2%) were free of disease. In 7 of the adrenal gland involved cases (63.6%) the tumor invaded the gland by direct extension from the superior pole of the kidney. In the other 4 cases the ipsilateral adrenal gland was affected by a metastatic lesion. In all 11 adrenal gland involved cases the tumors were at an advanced stage (the lowest was stage pT3N1). Our results led us to recommend adrenalectomy during radical nephrectomy only when direct extension of the kidney tumor into the gland is suspected (upper pole or large tumors) or when the adrenal is the site of a single metastasis. Macroscopically normal adrenal glands at radical nephrectomy should not be routinely extirpated. Metastatic renal cell carcinoma (not by contiguity) in the ipsilateral adrenal gland should be regarded as a stage M+ (distant metastasis) tumor.

Adrenal Gland Neoplasms↗
PubMed1993

Does detubularization improve continence in bladder replacement?

Camey in the seventies promoted bladder replacement. In 1987, the French Association of Urology gave us the opportunity to review 729 Tubularized Ileocystoplasty (Camey operation) [1]. The day time continence was excellent or acceptable (mild stress incontinence) on 91% of the patients, the night time continence was excellent (no pads, no leakage) or acceptable (one pad or less than 3 wakes at night) for 44% of the patients (56% had to use a device). Since 1985, the detubularization attempted to improve the continence rate. Today, the review of the literature shows that day time continence has not changed and the night time continence improved less than 20% arising from 44% to 60%. Bladder replacement after prostatocystectomy has been proved to be superior to continent urinary diversion in patients whose urethral and external sphincter can be preserved. Day time continence is excellent in tubularized and detubularized bowel reservoirs. Night time continence, in 30 to 50% of patients, remains an unresolved problem also in detubularized low pressure reservoirs, even if they are of great capacity. The literature is therefore too optimistic when describing night time continence in 85% of the patients. These results are stated in spite of the absence of sensitivity in the neobladder, the loss of reflexic increase in sphincteric activity during bladder filling, and the low sphincteric tonus during sleeping. These optimistic results are due to lack of unanimous criteria for evaluating continence after bladder replacement and not taking into consideration as continence failure the abundant although not frequent nighttime incontinence. In order to improve continence, muscle reeducation and artificial sphincter implantation are the most adequate solutions.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1992

Use of computerized interactive morphometry in the diagnosis of mammary adenoma and adenocarcinoma in dogs.

We attempted to define quantitative objective criteria for diagnosis of mammary adenoma and adenocarcinoma in dogs. To that end, correlation between diagnosis made by conventional histologic examination and morphometric descriptors, obtained by computerized histologic analysis, was assessed in biopsy specimens of mammary tissue from 63 dogs. We used 2 interactive computer procedures: one assessed mean nuclear perimeter, mean nuclear area, and circularity factor; and the other evaluated nuclear stratification and cell crowding. A data base was generated with 11 specimens from normal mammary tissue, 17 specimens from mammary adenoma, 18 specimens from low-grade mammary adenocarcinoma, and 15 specimens from mammary adenocarcinoma. The mean values of nuclear perimeter, nuclear area, nuclei per millimeter of basement membrane, and minimal distances from cells to basement membrane gradually increased from normal to high-grade malignancy. Distributions of nuclear areas and of minimal distances from cells to basement membrane were shifted in specimens from malignant tumors. Multivariate analysis confirmed the homogeneity of the diagnostic groups.

Adenocarcinoma↗
PubMed1991

[Chylous ascites imitating acute appendicitis].

Acute accumulation of chyle in the peritoneal cavity is rare. It is usually idiopathic and the diagnosis is made at laparotomy, when indicated because of signs of acute peritonitis. Drainage is the only treatment required and the prognosis is excellent. A 33 year-old man who was operated on for signs of acute peritonitis is described. There was more than a liter of chyle, but no underlying pathological condition was found. 3 months after discharge, physical and laboratory examinations were normal, with no evidence of chylomicron retention disease.

Adult↗
PubMed1990

[Intracavernous pharmacotherapy for organic impotence in the elderly].

Vasoactive intracavernous pharmacotherapy (VIP) has become an important tool for the treatment of erectile impotence. The average age of patients treated has been only 59 years and the oldest, 79. We describe the results of VIP in the oldest group of patients described. 28 men, 65-84 years old (average 70), were treated for organic impotence with intracavernous injections of a mixture containing 25 mg/ml papaverine HCl and 0.83 mg/ml phentolamine. Treatment was started with an injection of 0.25 ml of the mixture, with increments of 0.25 ml until there was functional erection, or untip a total of 1.5 ml was injected. Full erection was obtained in 46.5%, while in 40.0% there was a mild nonfunctional erection and in 13.4% no reaction to treatment. The response to the injection was similar in the different etiologic groups. There were no complications, such as prolonged erections or adverse reactions to the drugs injected. We conclude that elderly men seek help in order to have normal sexual function. We therefore think that VIP has a definite place in the treatment of impotence of the elderly.

Aged↗
PubMed1986

Acute reversible cataract induced by xylazine and by ketamine-xylazine anesthesia in rats and mice.

Combined administration of ketamine and xylazine is used increasingly for safe, effective anesthesia of small laboratory animals. We found that rats injected systemically with ketamine and xylazine at doses recommended for effective anesthesia developed acute reversible lens opacities. Mice given the same drug doses were similarly affected. Testing of each drug alone demonstrated that xylazine was the causative agent. The appearance of cataract was associated to varying degree with proptosis, suppression of the blink reflex, corneal surface drying, and mydriasis. All of these ocular effects, including cataract also could be induced locally by topical application of xylazine to one eye, with untreated contralateral eyes showing no drug effects. A possible cause of xylazine-induced transient lens opacification is trans-corneal water loss and alteration of aqueous humor composition due to corneal exposure. Additional action on aqueous humor formation and the lens itself may be due to the alpha-2-adrenoceptor nature of xylazine. Whatever the cause of cataract induction, the occurrence of this phenomenon during ketamine-xylazine anesthesia appears to be associated with marked changes in the physiological state of the eye. Therefore, the side-effects of anesthetic drug combination should be considered prior to its use on animals for studies of ocular physiology.

Acute Disease↗
PubMed1980

Myxoma of bone in a nonhuman primate.

A myxoma of the mandibles in an adult female Macaca mulatta is described. The left mandible was markedly enlarged by the tumor, which extended from the symphysis to the temporomandibular joint. The tumor had extended a short distance across the symphysis into the right mandible. It was composed of a glistening mucinous material. Radiographs of the tumor showed a large expansile radiolucent lesion of the left mandible without soft tissue involvement. Light microscopy demonstrated capillaries, stellate shaped cells with processes up to 15 mu long, very few other cell types, and an amorphous ground substance. Electron microscopic examination revealed similarity to the myxoma of bone of man. The oxytalan fibers discovered in this myxoma have not been found in myxomas before and suggest the tumor is odontogenic in origin. The incidence of spontaneous neoplasia in general and that of spontaneous oral tumors in particular in nonhuman primates are reviewed.

Animals↗