Biomedical subjects
O Nativ
Publications and source records attributed to O Nativ.
Cellular dysplasia in acquired cystic renal disease: comparison of histomorphometrically gauged nuclear parameters in normal kidneys, renal cell carcinomas and acquired cystic kidneys.
Nuclear parameters were assessed by computer-assisted image analysis in the cells of abnormal epithelial formations in the acquired cystic kidneys of two dialysis patients, the proximal and distal tubules of a normal kidney and two well differentiated renal cell carcinomas. One acquired cystic kidney contained many small clear celled foci and am 0.9 cm-size clear celled lesion and the second one a papillary microadenoma. The clear celled lesion was cytologically indistinguishable from the carcinomas. The histomorphometrically gauged nuclear parameters were maximal and minimal ferret diameters, averaged ferret diameter, aspect ratio, shape factor, area, volume and specific length and width. Statistical evaluation evidenced that the nuclear area, volume, aspect ration and shape factor allowed for the distinction between benign and malignant epithelial structures. The medians of the nuclear parameters of atrophic tubules, cysts, clear celled foci, papillary adenoma and clear celled lesion in the two acquired cystic kidneys deviation from those of normal renal tubules and in, increasing order of disparity, approached those of the carcinomas.
[Transthoracic approach for removing adrenal masses].
Early results with the transthoracic approach for removing adrenal tumors were evaluated. Between May 1994 and December 1995, 8 women and 5 men (aged 18-74) with adrenal masses underwent transthoracic adrenalectomy. All were excised successfully with short operation times (mean: 86 min), minimal blood loss (151 ml), limited use of parenteral analgesics (1.3 days), early ambulation (1.7 days post operation) and a short period of parenteral nutrition (1.7 days), resulting in reduced hospital stay (mean 6.7 days). With the transthoracic approach procedures are quick and safe even for large, malignant, and hormone-producing tumors. Recovery is easy with brief hospitalization. It provides excellent exposure of the adrenals, enables good control of bleeding vessels and is therefore our preferred method for removing adrenal masses.
[Diagnostic and therapeutic approach to sexually transmitted diseases].
In an ongoing study we evaluated 71 males and 32 females attending our sexually transmitted diseases (STD) clinic. Intraurethral or endocervical swab specimens were cultured for Neisseria gonorrhea (NG), Ureaplasma urealyticum (UU), Mycoplasma homines (MH), Herpes simplex virus (HSV) and Chlamydia trachomatis (CT), using an ELISA technique and the polymerase chain reaction (PCR). HIV antigen, hepatitis B (HBV) and Treponema pallidum (TP) seropositivity were tested by ELISA. Mean age was 33.4 and range 15-72 years. 83 patients (81%) used condoms only rarely, 35 (35%) had multiple sexual partners and 83 (81%) were treated empirically prior to evaluation. Dysuria and urethral discharge were found in 47 (45.6%), of whom 34 (33%) were males; the majority of females were asymptomatic. A specific etiology for STD was found in 53 patients (51.4%) and 1/3 had more than 1 pathogen. CT, UU, MH, HSV, NG and TV were found in 27, 24, 5, 3, 2 and 1, respectively. 8 patients were seropositive for HBV and 1 for TP; all were seronegative for HIV. CT was the most prevalent pathogen found. All patients with STD symptoms should be screened for all sexually transmitted pathogens, since many of them have more than 1 pathogen. STD clinics in Israel should be developed in conjunction with microbiology laboratories for better management of STD in the community.
Anuria and acute renal failure caused by multiple bladder calculi.
A rare case of multiple bladder stones (more than 300) is described. Acute renal failure and anuria complicated by urosepsis were the presenting symptoms.
Increased renal function in kidneys with ureteropelvic junction obstruction: fact or artifact? Assessment by quantitative single photon emission computerized tomography of dimercapto-succinic acid uptake by the kidneys.
PURPOSE: We evaluated whether increased differential renal function on the pentetic acid (DTPA) renogram represents elevated renal function in obstructed kidneys. MATERIALS AND METHODS: In 10 patients with unilateral ureteropelvic junction obstruction and a differential function of 53% or greater on the DTPA renogram of the obstructed kidney we performed quantitative single photon emission computerized tomography of dimercapto-succinic acid uptake by the kidneys. RESULTS: The absolute uptake of dimercapto-succinic acid was significantly higher in the obstructed kidneys compared to the contralateral normal kidneys (30.0% +/- 7.8 versus 25.3% +/- 8.2, t = 3.6, p < 0.01, respectively). The elevated absolute uptake in the obstructed kidneys was due to an increased functional volume compared to the contralateral normal kidneys (126.0 +/- 69.7 cc versus 102.3 +/- 59.2 cc, t = 4.4, p < 0.01, respectively). CONCLUSIONS: The results suggest that increased relative renal function in hydronephrotic kidneys due to ureteropelvic junction obstruction is not an artifact of the DTPA renogram. It may represent a compensatory mechanism that sometimes may overcompensate resulting in a paradoxical hyperfunctioning kidney.
The use of an ultrasonic assisted lipectomy device for the treatment of obstructive pelvic lipomatosis.
Pelvic lipomatosis is a rare disease of unknown etiology characterized by overgrowth of pelvic fat. We describe a 60-year-old man with pelvic and retroperitoneal lipomatosis causing severe urinary obstruction with massive hydroureteronephrosis. The diagnostic procedure and the management of the patient is described, emphasizing the value of the Ultrasonic Assisted Lipectomy device in performing ureterolysis.
Treatment of experimental mouse bladder tumour by LPS-induced epithelial cell shedding.
The purpose of the present study was to explore the therapeutic potential of serial administration of shedding-inducing endotoxin in a mouse tumour bladder model. The studies were conducted with two variants derived from the MBT-2 tumour namely, T5 and T50, the latter being far more aggressive than the former. It was found that T5 tumours responded to intravesical lipopolysaccharides (LPS) instillation by a considerable reduction in their pace of growth (P < 0.0001) when treatment was initiated 3 days after tumour implantation, but not when started after 7 days. The T50 variant did not respond to LPS when treated 3 days after implantation, but a considerable reduction in rate of growth occurred when treatment was started after 1-2 days. Shedding induced by intravesically instilled LPS was found to retard considerably the progression rate of experimental bladder tumour.
A comparison between histological grade and nuclear morphometry for predicting the clinical outcome of localized renal cell carcinoma.
OBJECTIVES: To determine the interrelationship of histological grade and nuclear morphometry and to compare their prognostic significance in patients with localized renal cell carcinoma (RCC). PATIENTS AND METHODS: A retrospective prognostic study of 39 patients with localized (pT1, pT2) RCC was performed. Conventional histological grade and nuclear morphometry were assessed independently and the correlation between these grading systems and their impact on the patients' outcome were evaluated. RESULTS: Histological grade and the nuclear morphometric variables were significantly correlated: the strongest association was that between grade and the nuclear regularity factor. The best predictor of disease-free interval and survival (by univariate analysis) was the combination of nuclear area and nuclear elongation factor, followed by conventional tumour grade, nuclear elongation factor, nuclear regularity factor and nuclear area. However, a multivariate analysis showed that the only independent prognosticator for survival was the combination of nuclear area and nuclear elongation factor. CONCLUSIONS: This study indicates that nuclear morphometry is prognostically superior to histological grade in patients with localized RCC.
Three-dimensional imaging using spiral computerized tomography prior to tumor enucleation in a patient with a solitary kidney.
The authors present a case of renal cell carcinoma in a man with a solitary kidney. Three-dimensional computerized tomography instead a selective renal angiography was used preoperatively as a noninvasive technique for visualization of the renal tumor and renal vascularization.
Sublingual buprenorphine compared to morphine delivered by a patient-controlled analgesia system as postoperative analgesia after prostatectomy.
After open prostatectomy, 52 patients were randomly allocated to two treatment groups. Group A (26 patients) received buprenorphine sublingually, and in group B (26 patients) the analgesia was induced using a patient-controlled analgesia system with morphine. The total dose of morphine given during the first 24 h was 72 +/- 8 mg compared to 1.6 +/- 0.45 mg of buprenorphine. The total dose of buprenorphine on days 2 and 3 was significantly lower than the total dose of morphine (p < 0.01). There were no significant differences in visual pain scores, side effects, mean arterial blood pressure, pulse rate and respiration rate between the two groups. Sublingual application of buprenorphine offers an effective and easy alternative to the parenteral route of morphine for the management of postoperative pain.
Transthoracal approach for the removal of adrenal tumors. Early experience with 10 cases.
OBJECTIVES: To evaluate the early results of a transthoracal approach for the removal of various adrenal tumors. METHODS: Between May 1994 and March 1995, 10 patients with adrenal masses underwent transthoracal adrenalectomy. Operation time, blood loss, the use of parenteral analgesia, duration of thoracal drainage, time to oral intake, ambulation and hospitalization period were assessed. RESULTS: All tumors were excised successfully, with a short operation time (mean 91.5 min), minimal blood loss (mean 35 ml), limited use of parenteral analgesics (mean 1.4 days), early ambulation (mean 1.9 days to ambulation) and shorter period of parenteral nutrition (mean 2 days) leading to a reduced hospital stay (mean 6.7 days). CONCLUSIONS: The transthoracal approach provided excellent exposure and is a quick and safe procedure even for large, malignant and hormone-producing tumors. At present this is our preferred method for the removal of adrenal masses.
[Comparison of polymerase chain reaction and ELISA in the diagnosis of Chlamydia trachomatis infection].
Chlamydia trachomatis (CT) is the most frequent cause of sexually transmitted disease in the western world. However, only a few cases have been reported from Israel. Because of the frequent absence of symptoms, its high prevalence, rapid spread, and the seriousness of complications, the quality of the diagnostic test for this microorganism is very important. Cell culture has always been regarded as the "gold standard" in diagnosis. However, factors such as collection, transport time and storage can negatively influence the sensitivity of culturing. We evaluated a polymerase chain reaction (PCR) assay (Amplicor CT, Roche Molecular Systems) for the detection of CT. CT-PCR was compared with a non-culture method (ELISA) in cervical, urethral and first-void urine specimens in 30 patients attending our sexually transmitted disease clinic. There were 16 males and 14 females; in 16 of them (53%) CT-PCR was positive. However, in only 6 of the latter (38%) was CT-ELISA also positive. 7 urine specimens from males with non-specific urethritis had a positive CT-PCR and a negative CT-ELISA. There were discrepancies between ELISA and the PCR test in 10 (3 females) of the 30. We confirm other studies indicating the PCR to be a highly sensitive assay for detecting CT infection from urogenital specimens. CT-PCR from first-void urine provides a noninvasive technique for routine screening of CT infection in both symptomatic and asymptomatic males and females.
Benign and malignant eccrine poroma--a flow cytometric comparison.
Eccrine poroma is a benign, slow growing, solitary adnexal tumor. Malignant degeneration may take place in longstanding solitary lesions; in such cases cutaneous and fatal visceral metastases have occurred. Our goal was to determine whether flow cytometry yields useful diagnostic and prognostic information on benign and malignant eccrine poroma. Flow cytometric analysis of the nuclear DNA ploidy pattern was performed on four samples of eccrine poroma and five samples of malignant eccrine poroma. All the histograms of the eccrine poromas were diploid. Two of five specimens (40%) of the eccrine porocarcinoma were aneuploid, and the other three (60%) were diploid. The diploid pattern represents another expression of the benignancy of eccrine poroma. Since abnormal DNA content is often correlated with tumor grade, the aneuploid DNA histogram of 40% of the patients with malignant eccrine poroma is not a surprising finding in this cytologically malignant neoplasm.
Percutaneous ablation of malignant liver tumor in rabbits using low radio frequency energy.
Radio frequency (RF) current has been used successfully to ablate normal human tissue. To further investigate the clinical application of this modality in tumors we studied the potential of using RF percutaneously to destroy experimental liver tumors. Thirty five outbred albino rabbits underwent liver VX2 tumor direct-implantation during open surgery. After 21 days ultrasonography was performed revealing tumor presence and size. A shielded RF needle was designed so that it could be inserted percutaneously through an introducing needle, and an electrical insulation shield covering the RF needle could be retracted to control the length of the exposed RF needle inside the tissue. Twenty two days after tumor implantation RF was applied via the aforementioned needle using a ZoMed International RF generator. In one group of rabbits the procedure was performed under direct vision during open surgery and on the other group treatment was applied percutaneously, guiding the needle by tumor palpation. Rabbits were killed 3 days later and pathology revealed 4 to 25 mm intratumoral RF induced lesions. A direct relation was found between lesion size, power and duration of RF application (At 7.5 W, r = 0.48, p = 0.032). Based on our preliminary results we may conclude that RF may have clinical application in the near future for percutaneous local tumor control in parenchymal organs.
[Nonmalignant proliferative lesions of the urinary bladder].
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The role of nuclear morphometry for predicting disease outcome in patients with localized renal cell carcinoma.
BACKGROUND: More than one-third of patients with localized renal cell carcinoma (RCC) will have disease progression after nephrectomy. Present histopathologic variables cannot accurately predict the outcome of individual patients. METHODS: Nuclear morphometry was performed by an image analyzer on histologic sections from 39 specimens of pathologic T1 and T2 classification RCC. All patients underwent radical nephrectomy and were followed for a mean of 7.6 years. A univariate analysis and then a multivariate stepwise regression method were used to correlate results with patients' outcome. RESULTS: The best predictors of disease free interval were mean nuclear elongation factor (MNEF) (P = 0.023), mean nuclear regularity factor (MNRF) (P = 0.034), and mean nuclear area (MNA) (N = 0.038). Univariate analysis identified a significant correlation between patient survival and MNEF (P = 0.009), MNRF (P = 0.020) and MNA (P = 0.023). Combination of MNEF and MNA was even more strongly associated with survival (P = 0.0013). Multivariate analysis revealed that MNA (P = 0.044) and MNEF (P = 0.045) correlated independently with survival. CONCLUSION: These results suggest that nuclear morphometry provides objective independent prognostic information for patients with localized RCC.
[Prostatic carcinoma: prognostic importance of nuclear DNA ploidy].
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