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Yoram Mor

Publications and source records attributed to Yoram Mor.

29 records · Page 2Linked to original sources
PubMed2003

Molecular analysis of transitional cell carcinoma using cDNA microarray.

The incidence of transitional cell carcinoma (TCC), the fourth most common neoplasm diagnosed in men, is rising. Despite the development of several noninvasive diagnostic tests, none have gained full recognition by the clinicians. Gene expression profiling of tumors can identify new molecular markers for early diagnosis and disease follow-up. It also allows the classification of tumors into subclasses assisting in disease diagnosis and prognosis, as well as in treatment selection. In this paper, we employed expression profiling for molecular analysis of TCC. A TCC-derived cDNA microarray was constructed and hybridized with 19 probes from normal urothelium and TCC tissues. Hierarchical clustering analysis identified all normal urothelium samples to be tightly clustered and separated from the TCC samples, with 29 of the genes significantly induced (t-test, P<10(-5)) in noninvasive TCC compared to normal urothelium. The identified genes are involved in epithelial cells' functions, tumorigenesis or apoptosis, and could become molecular tools for noninvasive TCC diagnosis. Principal components analysis of the noninvasive and invasive TCC expression profiles further revealed sets of genes that are specifically induced in different tumor subsets, thus providing molecular fingerprints that expand the information gained from classical staging and grading.

Adult↗
PubMed2003

Late post-reimplantation ureteral obstruction during pregnancy: a transient phenomenon?

PURPOSE: Patients with a history of surgical correction of vesicoureteral reflux warrant surveillance for long-term complications. However, there are little data on long-term outcome, based mainly on small series and insufficient followup. Close followup is particularly indicated during pregnancy since these patients tend to have a dilated collecting system and frequent urinary tract infections. As part of a long-term postoperative assessment of patients who underwent ureteral reimplantations in childhood, we focused on late pregnancy related obstructive dilatation associated with renal failure. MATERIALS AND METHODS: Between 1970 and 1979, 322 children underwent ureteral reimplantation at our institution. A comprehensive retrospective study done to evaluate the long-term postoperative outcome, detected 2 cases of late gestational ureteral obstruction. Subsequently 2 additional cases were identified elsewhere. RESULTS: All 4 patients underwent successful Politano-Leadbetter ureteral reimplantation at ages 4 to 12 years. They presented during pregnancy 17 to 22 years postoperatively with progressive hydroureteronephrosis and renal failure, which required urinary drainage by percutaneous nephrostomies. Antegrade studies performed during pregnancy and in the early post-delivery period revealed severe obstruction of the distal ureters, which gradually subsided. CONCLUSIONS: Ureteral obstruction during pregnancy, in women who previously underwent Politano-Leadbetter ureteral reimplantation, may be attributed to high reimplantation syndrome and is likely to be a transient phenomenon. Awareness of this late and rare complication may enable us to detect this situation early, provide temporary adequate urinary drainage and prevent unnecessary surgical procedures.

Adult↗
PubMed2002

Comparison of voiding cystourethrography and double-balloon urethrography in the diagnosis of complex female urethral diverticula.

The preoperative work-up of female urethral diverticula should provide the surgeon with maximum data regarding the anatomy and structure of the diverticulum. Preoperatively, the number of diverticula, as well as the location, size, configuration, and communication to the urethra need to be clearly depicted. The objective of this study was to compare the information gained by voiding cystourethrography (VCUG) and positive-pressure double-balloon urethrography (DBU), and to verify which imaging modality can better delineate the features of the diverticula. Twelve women with a presumptive clinical diagnosis of a urethral diverticulum underwent VCUG followed by DBU, and the radiological data from each modality were compared. In 4 of 12 patients (33.3%) VCUG completely failed in demonstrating the diverticulum, whereas DBU showed a large complex diverticulum in 2 patients and a distinct mid-urethral diverticulum in 2 patients. In the remaining 8 women (66.7%) VCUG delineated only the lower part of the diverticulum, whereas DBU depicted a large diverticulum extending beneath the bladder neck in 3 patients and multiple diverticula in 5 patients. The sensitivity of DBU and VCUG, in our series, was therefore 100 and 66.7%, respectively. The DBU supplied excellent documentation regarding the location, size, configuration, and communication of the diverticula to the urethra in every case, which markedly facilitated surgical excision of the diverticula in 9 of 12 patients. Three patients refused surgery and elected conservative treatment. In our experience, VCUG had a low sensitivity as a screening test for the diagnosis of female urethral diverticula, and failed to demonstrate properly the major structural characteristics of the diverticula, whereas DBU was highly sensitive as a diagnostic tool and supplied excellent anatomical delineation of the diverticula.

Adult↗
PubMed2002

The diagnosis and management of postoperative chylous ascites.

PURPOSE: Postoperative chylous ascites is a rare complication of retroperitoneal and mediastinal surgery that represents a difficult management problem due to the serious mechanical, nutritional and immunological consequences of the constant loss of protein and lymphocytes. We reviewed the topic of postoperative chylous ascites with special emphasis on the relevant diagnostic and imaging modalities. We propose a novel management algorithm. MATERIALS AND METHODS: We performed a MEDLINE search of the literature on chylous ascites using chyloperitoneum as the subject heading and chylous ascites as an additional key word. The search yielded 651 articles. We focused on 102 series, collective reviews and mainly case reports related to the issue of postoperative chylous ascites. RESULTS: We propose a novel algorithm based on a step-up approach aimed at promoting decreased lymph production and flow as well as maintaining nutritional balance. The management algorithm integrates repeat palliative paracentesis, dietary measures, total parenteral nutrition therapy, peritoneovenous shunting and surgical closure of the lymphoperitoneal fistula. Due to the remarkable effectiveness of somatostatin therapy for the closure of lymphatic fistula somatostatin therapy should be attempted with or without total parenteral nutrition early in the course of treatment of chylous ascites before any invasive steps are taken. CONCLUSIONS: Various management modalities may be used successfully to treat chylous ascites. Therefore, treatment should be individualized and adjusted to the severity of lymphatic leakage and its consequences. The outcome mostly depends on the underlying pathological condition. Thus, in the absence of malignant or congenital underlying pathology the prognosis in cases of postoperative chylous ascites is good with the majority responding to conservative measures.

Adult↗
PubMed2002

Chylous ascites after radical nephrectomy and inferior vena cava thrombectomy. Successful conservative management with somatostatin analogue.

Postoperative chylous ascites is a rare complication of retroperitoneal surgery. The treatment of postoperative chylous ascites is primarily conservative, consisting of repeated paraceteses, medium chain triglyceride (MCT) diet, salt restriction, diuretics and bowel rest with total parenteral nutrition. Occasionally, chylous ascites may take a protracted course which may necessitate insertion of peritoneo-venous shunts or direct surgical lymphostasis. Recently, Somatostatin was shown to be highly effective in closure of refractory lymphatic fistulas. We present a case of refractory chylous ascites following radical nephrectomy with inferior vena caval thrombectomy that failed to respond to conventional conservative measures and resolved rapidly following the administration of Somatostatin.

Chylous Ascites↗
PubMed2002

Neurofibromatosis diagnosed on CT with MR correlation.

We report a young man with asymptomatic neurofibromatosis type-1 initially diagnosed on CT. CT demonstrated the typical lesions of this disorder: extensive cervical, thoracic, abdominal and pelvic masses and spinal alterations. The symmetrical distribution and the location of the lesions as well as their attenuation are characteristic of NF-1 and may be considered diagnostic for this disease.

Adult↗
PubMed2002

Epidermoid cyst of the testis in an adolescent: Case report and review of the evolution of the surgical management.

Epidermoid cyst, a tumorlike lesion, is a rare benign testicular tumor with typical, distinctive ultrasonographic appearance. When the preoperative features are highly suggestive of epidermoid cyst, testicular sparing surgery after strict oncologic guidelines is warranted. The authors report a case of a preoperatively suspected epidermoid cyst in an adolescent and review the literature concerning the changing paradigm of management.

Adolescent↗
PubMed2002

The efficacy and safety of perioperative low molecular weight heparin substitution in patients on chronic oral anticoagulant therapy undergoing transurethral prostatectomy for bladder outlet obstruction.

PURPOSE: Candidates for prostatectomy who require chronic anticoagulant therapy present a major perioperative management problem due to the threat of significant hemorrhage associated with surgery and the risk of thromboembolism associated with discontinuation of the anticoagulants. We evaluated prospectively a perioperative routine using low molecular weight heparin substitution to allow safe discontinuation of prophylactic oral anticoagulants in patients undergoing transurethral resection of the prostate. MATERIALS AND METHODS: We treated 20 patients on chronic oral anticoagulant therapy who required prostatectomy for bladder outlet obstruction according to a prospective protocol based on exchange of the oral anticoagulants with perioperative injections of low molecular weight heparin and resumption of oral anticoagulants early postoperatively. The safety and efficacy of this regimen were assessed in comparison to a control group comprised of 20 randomly selected nonwarfarin treated patients who underwent prostatectomy during the same period. RESULTS: The need for blood transfusions and mean number of units transfused did not significantly differ between the 2 groups. Due to persistent hematuria routine removal of the catheter was possible only in 9 of 20 patients (45%) in the heparin group compared to 18 of 20 (90%) in the control group. Average catheterization and hospitalization period in the heparin group was 3.2 days and 4.2 days respectively, compared to 2.1 and 2.1 days in the control group, respectively (p <0.01). No long-term hemorrhagic or thromboembolic complications were noted at 3 months postoperatively. CONCLUSIONS: Despite longer hospitalization in the heparin treated group, our substitution protocol is safe and effective.

Administration, Oral↗