Biomedical subjects

A Cranidis

Publications and source records attributed to A Cranidis.

At least 19 recordsLinked to original sources

PubMed2001

Intraureteral metallic endoprosthesis in the treatment of ureteral strictures.

OBJECTIVE: We report our experience on intraureteral metallic stents placement for the treatment of malignant and benign ureteral strictures. METHODS: Eight patients (six men and two women) with inoperable malignant or benign ureteral strictures, underwent insertion of metallic stents through percutaneous tracts. Six lesions (three malignant, three benign) involved ureterointestinal anastomoses after cystectomy for bladder cancer and ureteroileal urinary diversion or bladder substitution, and two malignant lesions involved the midureter. Self-expandable stents were used in seven cases and a balloon-expandable stent in the remaining one case. One stent was sufficient in seven ureters, and in one ureter, two overlapping stents were placed. RESULTS: Metallic stents were inserted without technical difficulties in all obstructed ureters and patency was achieved in all patients. Ultrasonography revealed resolution of pre-existing hydronephrosis. The duration of follow-up was 6-17 months (mean, 9 months). One ureter was occluded 8 months after stent placement because of ingrowth of tumor and granulation tissue. The other ureters showed no signs of obstruction during follow-up. No major complications directly attributable to the metallic stent occurred. CONCLUSIONS: Our results suggest that insertion of a metallic stent in the ureter is feasible and safe for the treatment of benign or malignant ureteral strictures. However, more work needs to be done to establish the use of these stents for the treatment of ureteral obstruction.

Female↗

PubMed2001

Long-term results after percutaneous minimally invasive procedure treatment of symptomatic simple renal cysts.

OBJECTIVE: To assess the effectiveness and long-term results of two repeated ethanol injections in the treatment of symptomatic renal cysts. METHODS: Sixty-eight patients 47 to 75 years old with 77 large (6.3-14.8 cm; mean 8.62 cm) symptomatic cysts were included in this study. Of the 68 patients, in 4 cases there were renal cysts associated with renal calculi. An 8FR Pigtail catheter was inserted into the cyst under ultrasound guidance followed by aspiration of cystic fluid. Two repeated ethanol 95% injections were performed every 24 hours. Patients were followed-up by ultrasonography for a period of 12-48 months (mean 30). RESULTS: In two patients the cyst puncture was not feasible because of poor visualization of puncture site while in one patient there was communication of cystic cavity with the pelvocaliceal system. In these patients surgical resection of cysts was performed. Complete and partial regression rates were 57/68 (83.82%) and 8/68 (11.76%) respectively. In four patients with renal stones and renal cysts, extracorporeal shock wave lithotripsy (ESWL) was successfully executed I month after sclerotherapy. CONCLUSION: Our results suggest that percutaneous aspiration followed by two repeated ethanol injections is highly effective on reducing recurrence of simple renal cysts.

Aged↗

PubMed2001

The impact of norfloxacin, ciprofloxacin and ofloxacin on human gut colonization by Candida albicans.

We studied gastrointestinal (GI) colonization by Candida albicans in patients receiving oral norfloxacin, ciprofloxacin or ofloxacin as monotherapy for urinary tract infections. Quantitative stool cultures for C. albicans were performed before, at the end and 1 week after the end of treatment. All 3 quinolones increased GI colonization by C. albicans. Ciprofloxacin caused the highest increase, which was not statistically significant.

Adult↗

PubMed2001

Management of ureteral stones in pediatric patients.

PURPOSE: We report our 5-year experience in the management of ureteral stones in pediatric patients using shockwave lithotripsy (SWL) in combination with ureteroscopy. PATIENTS AND METHODS: A total of 25 children (age range 12 months-14 years; mean 8.7 years) underwent SWL for ureteral lithiasis. Stones were located in the upper ureter in 6 children (24%), the middle ureter in 8 (32%), and the lower ureter in 11 (44%). Their size ranged from 5 to 14 mm (mean 10.9 mm). The children who failed SWL underwent ureteroscopic treatment. RESULTS: In the SWL-only group, the overall stone clearance rate at 3 months was 84% (21 of 25 children). Four children (16%) who failed SWL underwent successful ureteroscopic treatment. Complications were infrequent and generally minor in both groups. CONCLUSIONS: Shockwave lithotripsy is a safe and efficient treatment modality for ureteral stones in pediatric patients. In expert hands, ureteroscopy can be successfully applied in case of SWL failure.

Adolescent↗

PubMed2001

Genetic detection of bladder cancer by microsatellite analysis of p16, RB1 and p53 tumor suppressor genes.

PURPOSE: We investigated the incidence of genetic alterations in urine specimens from patients with bladder cancer. MATERIALS AND METHODS: A total of 28 cytological urine specimens were assessed for microsatellite alternations, and 15 microsatellite markers were located on p53, RB1 and p16 regions. In 15 patients DNA from tumor specimens was also available. RESULTS: Loss of heterozygosity was detected in 26 of 28 patients (93%) in at least 1 microsatellite marker. Allelic losses were found in 18 patients (64%) for the p16 locus, in 8 (29%) for the RB1 locus and in 17 (61%) for the p53 region. In contrast, no microsatellite alterations were found in the normal group without evidence of bladder cancer. In 11 cases genetic alterations in the cytological urine specimens were not detectable in the corresponding tumor specimen, suggesting heterogeneity of bladder cancer. CONCLUSIONS: The detection of loss of heterozygosity in cytological urine specimens may be a prognostic indicator of early detection of bladder cancer. Our results suggest that microsatellite analysis of urine specimens represents a novel, potentially useful, noninvasive clinical tool to detect bladder cancer.

Aged↗

PubMed2001

Finasteride: a long-term follow-up in the treatment of recurrent hematuria associated with benign prostatic hyperplasia.

OBJECTIVES: To assess the effectiveness and long-term results after finasteride treatment of recurrent hematuria associated with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: The study comprised 80 patients, aged 62-86 (mean 74) years, of whom 50 received finasteride 5 mg once daily for 4 years and 30 were used as controls. Patients with malignancy, severe hepatic or renal failure and hematologic disorders were excluded. Patients were divided into 3 groups according to the severity of hematuria (minor, moderate, severe). All patients were followed up at 3, 12, 24 and 48 months. RESULTS: The follow-up ranged from 8 to 48 (mean 22) months in the finasteride group and 3-42 (mean 23) months in the control group. Hematuria recurrence rates were 6/50 (12%) and 23/30 (77%) in the finasteride and control groups, respectively. Surgical treatment was needed in 6 patients of the finasteride group and 19 of the control group. Patients with minor hematuria experienced no recurrence of symptoms in the finasteride group in contrast to 13 of 17 patients in the control group. For the patients with moderate hematuria, recurrence of symptoms was observed in 3 of 13 in the finasteride group and 3 of 5 in the control group. Three of six patients with severe hematuria had a recurrence of symptoms after finasteride treatment in contrast to 7 of 8 in the control group. CONCLUSION: Finasteride has proved to be a safe, well tolerable and effective medication in reducing or preventing recurrent hematuria related to BPH.

Aged↗

PubMed2000

Bladder augmentation.

This paper reviews bladder augmentation, which has been proved to be an effective way of providing a well functioning urine reservoir that protects the upper urinary tract and allows patients to have a good quality of life. Good results have been achieved with the use of all types of bowel segments. Lifetime follow-up and recognition of the complications is mandatory. Very careful patient selection is essential in order to achieve better long-term results. The principle of urothelial preservation, introduced by autoaugmentation, is very promising in the effort to create a compliant urinary reservoir without metabolic disturbance and without the risk of cancer.

Humans↗

PubMed2000

Urinary incontinence, the hidden health problem of Cretan women: report from a primary care survey in Greece.

OBJECTIVE: The prevalence of urine leakage and care-seeking rates of women 35-75 years of age who visited GPs in two rural areas of Crete were investigated. PARTICIPANTS: All the women who visited their family physician in two primary care units during the period of August to November 1997 (N = 251) were asked if they had experienced symptoms of involuntary urine leakage. A set of questions was addressed to the women who replied positively. RESULTS: Sixty-nine of the 251 women (27.5%) reported symptoms of involuntary urine leakage, and among the incontinent women 11 (15.9%) had previously contacted the health services about their problem. Only six out of thirty (20%) of the incontinent women who report effects on household activities, social and sexual life had contacted a physician about urinary incontinence (UI). The most common reason reported for not consulting the physicians was that the symptoms were not considered serious (35 women out of 58, 60.3%). CONCLUSION: This study points out the need for further awareness programs for both women and healthcare professionals to be set up in countries like Greece, in which a low care-seeking rate of incontinent women has been reported.

Adult↗

PubMed2000

Ureteral drainage by double-J-catheters during pregnancy.

PURPOSE: To access the safety and effectiveness of Double-J-stents in treating symptomatic hydronephrosis during pregnancy. MATERIAL AND METHODS: From 1994 to 1999, 21 women were hospitalized in the Urology Clinic at the University Hospital of Crete. Fourteen patients presented acute pyelonephritis, six painful hydronephrosis and one spontaneous renal rupture. In four cases the hydronephrosis was caused by calculus in the upper 3rd quadrant of the ureters. In 13 out of 14 cases of urinary febrile infection and one with spontaneous renal rupture, the dilatation resulted from direct compression of the ureters by the gravid uterus. Using ultrasound guidance, 21 ureteral stents were successfully placed under local ane- sthesia. RESULTS: In 14 out of 21 patients with urinary infection, we observed remission of fever during the first 24 hours after the placement of the ureteral stents. In the patient with spontaneous renal rupture the remission of symptoms was observed a few hours after the ureteral drainage. Complications were reported in six cases, such as, voiding symptoms and discomfort. CONCLUSION: Double-J-ureteral stenting is an effective, simple and safe method in treating symptomatic hydronephrosis during pregnancy.

Adult↗

PubMed1998

Experience with the Dornier lithotriptor MPL 9000-X for the treatment of vesical lithiasis.

Between February 1994 and March 1995, 52 patients (48 men and 4 women) with vesical lithiasis were treated by extracorporeal shock wave lithotripsy (ESWL), using the MPL 9000-X Dornier lithotriptor. Twenty-five patients showed bladder outlet obstruction. In 9 patients, there was evidence of associated bladder neuropathy. In 6 patients, calculi presented idiopathically in normal bladders. Two patients had silent migration of ureteral calculi and increase in bladder volume, 8 were high risk and 2 others refused other methods of up to date treatment. Vesical stone sizes ranged from 10 to 22 mm in greatest diameter (mean 15 mm). The treatments were performed without the use of anaesthesia and on an outpatient basis. Complete fragmentation was achieved after a single session in 46 patients and 3 required 2 sessions. Postoperative adjunctive endourological procedures included cystoscopy in 9 patients and urethroscopy in 1 patient for evacuation of stone fragments. The overall stone-free rate was 94.2% (49 out of 52 patients) with ESWL and adjunctive measures as needed. No major complications were noted. We find ESWL with the MPL 9000-X lithotriptor to be a simple, effective and safe modality for the treatment of most patients with vesical lithiasis, especially in high risk patients.

Adult↗

PubMed1998

MRI and CT features in two unusual cases of xanthogranulomatous pyelonephritis.

Two unusual cases of xanthogranulomatous pyelonephritis studied by both magnetic resonance imaging and computed tomography, are presented. Extension of the disease depicted by both computed tomography and magnetic resonance imaging was compatible with the findings at surgery. Computed tomography seems to be sufficient for xanthogranulomatous pyelonephritis imaging evaluation, while magnetic resonance imaging is not recommended on a routine basis, since no additional valuable information is yielded.

Aged↗

PubMed1998

Bladder autoaugmentation in the rabbit using de-epithelialized segments of small intestine, stomach and lyophilized human dura mater.

OBJECTIVE: To develop an animal model of partial detrusorectomy (autoaugmentation) and thus avoid the consequences of the direct contact of intestinal mucosa with the urinary tract in bladder augmentation. MATERIALS AND METHODS: A diverticular urothelial bulge was created and patched with demucosalized segments of small bowel (group A), stomach (group B) and with lyophilized human dura mater (group C). The surgery was performed on 50 New Zealand rabbits which were compared with 10 control animals and killed at 2, 4 and 6 weeks after surgery. Urodynamic studies and cystography were performed before operation and at death, and the augmented bladders examined histologically. RESULTS: Six weeks after the procedure, the mean (SD) bladder compliance was 22.7 (5.7) in group A (intestinal patch. n = 6). 2.3 (0.5) in group B (stomach patch, n = 3). 3.1 (1.9) in group C (lyophilized human dura, n = 3) and 9.4 (0.4) in the control group (n = 4). Histological studies showed residual enteric and gastric mucosa but an intact urothelium under the intestinal patch. CONCLUSION: The results of this experimental study suggest that a demucosalized segment of small bowel is the best material to increase bladder compliance in detrusorectomy (autoaugmentation) as applied in this animal model.

Animals↗

PubMed1998

Genetic instability in renal cell carcinoma.

OBJECTIVE: To investigate the incidence of loss of heterozygosity (LOH) and microsatellite instability (MI) in human renal cell carcinoma (RCC), and to determine a possible activation of H-ras oncogene in these tumours via implication of its polymorphic regions within the first intron and 3' ends. METHODS: In the present study, we investigated the incidence of MI and LOH in 22 RCCs, using a bank of 8 microsatellite markers located on chromosomes 2 (IL1A), 3 (D3S1234), 8 (MYC), 14 (D14S51) and 17 (THRA1, D17S250, D17S579). We also studied the microsatellite DNA of the H-ras oncogene within the first intron (HRM) and the minisatellite DNA of the variable tandem repeat (VTR), which is located 1,000 bp downstream of the H-ras gene and possesses enhancer activity, for genetic instability. Alterations of the 28-bp repetition core were studied employing restriction fragment length polymorphism analysis. RESULTS: MI and LOH were observed in 8 (4 MI and 4 LOH) out of 22 (18%) specimens at 3p21.1-p14.2 and 17q21, indicating the presence of putative tumour suppressor genes (TSGs) at these loci. Alterations of the 28-bp repetition core of H-ras VTR were found in 2 out of 22 cases (9%), while point mutations of the same repetition core were detected in only 1 case (5%). Additionally, 1 case (5%), showed LOH. CONCLUSIONS: Our results indicate that genetic instability is a detectable phenomenon in human RCC and it might be associated with the development of the disease. LOH at 3p21.1-p14.2 and 17q21 suggests that important TSGs may be located on these chromosomal regions involved in the tumorigenesis or progression of RCC. Considering the fact that the DNA sequence of this VTR region contains a target area for transcription and other regulation factors of H-ras gene expression, these findings could be of importance as regards the involvement of this gene in the process of carcinogenesis in RCC.

Adult↗

PubMed1997

Extracorporeal shockwave lithotripsy for urinary calculi in autosomal dominant polycystic kidney disease.

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited systemic disorder. Renal stones have a high rate of occurrence among patients with ADPKD and are a significant cause of morbidity in this disorder. Thirteen patients with ADPKD and symptomatic or obstructive renal stones presented to our hospital for evaluation and treatment with extracorporeal shockwave lithotripsy (SWL). A total of 16 renal units were treated. The auxiliary procedures included placement of a double-J stent in nine kidneys when the stone was larger than 8 mm in diameter. Eleven patients (85%) were stone free 3 months after lithotripsy; a second treatment was necessary in two patients. We conclude that SWL can be used as a primary management tool for renal stones in patients with ADPKD.

Adult↗

PubMed1997

Effect of norfloxacin, trimethoprim-sulfamethoxazole and nitrofurantoin on fecal flora of women with recurrent urinary tract infections.

The effects of antibiotics used for prophylaxis in women with recurrent urinary tract infections (UTIs) on the aerobic intestinal flora were investigated. Twenty-one patients with recurrent UTIs were randomly divided into three groups. The patients of each group received monotherapy with oral norfloxacin, trimethoprim-sulfamethoxazole or nitrofurantoin for one month. Urine and stool quantitative aerobic cultures were performed before prophylaxis, 2 and 4 weeks after the initiation of therapy, and 2 weeks after antibiotics were discontinued. The gram-negative aerobic flora was strongly suppressed during the administration of norfloxacin and trimethoprim-sulfamethoxazole, while Enterococcus spp. were not affected. Resistant strains of Escherichia coli were detected in two patients, one in the norfloxacin and one in the trimethoprim-sulfamethoxazole group. The aerobic intestinal flora was not affected by nitrofurantoin. These findings help in the selection of the most appropriate antimicrobial agent for prophylaxis in recurrent UTIs, so as to reduce the possibility of emergence of resistant bacterial strains.

Adult↗

PubMed1996

Transcriptional activation of H-ras, K-ras and N-ras proto-oncogenes in human bladder tumors.

In this study we demonstrate the involvement of ras oncogenes in bladder cancer at the level of RNA overexpression. We examined 26 bladder specimens, consisting of paired tumor and adjacent normal tissue and found that H-ras transcripts were overexpressed in 39% of the specimens while K-ras and N-ras in 58% of total specimens. Each tumor specimen had a unique pattern of overexpression for the three ras genes. A competitive-RT-PCR was employed for H-ras and a beta-actin control gene was co-amplified with K-ras or N-ras genes. These results indicate that the involvement of ras oncogenes in bladder cancer could be relative to overexpression of these genes.

Genes, ras↗

PubMed1996

Congenital ectopic vas deferens inserting into the bladder with ipsilateral renal agenesis.

Vas deferens ectopia is a rare congenital anomaly which is frequently associated with anorectal abnormalities. There have been 20 cases up to date with an ectopic vas deferens inserting into the ureter. Out of these 6 had a bilateral insertion and another 4 cases with an ectopic vas deferens inserting directly into the bladder, out of which 1 had a bilateral insertion. There is an embryological hypothesis which may explain this rare condition that may result from a possible underlying defect of the proximal vas precursor segment of the Wolffian duct. Herein, we present a case of an ectopic vas deferens terminating in the urinary bladder and accompanied by ipsilateral renal agenesis. This is the second case report in the world literature.

Abnormalities, Multiple↗

PubMed1996

Coexisting non-functioning pheochromocytoma and renal oncocytoma: a case report and review of the literature.

We report a case of an oncocytoma, coexisting with a non-functioning pheochromocytoma in a patient who was operated on for suspicion of a renal tumor with metastases to the ipsilateral adrenal gland. As oncocytoma is a relatively rare lesion of the kidney, estimated to account for approximately 3-5% of renal neoplasms, its coexistence with non-functioning pheochromocytoma, to the best of our knowledge, has not hitherto been described in the medical literature.

Adenoma, Oxyphilic↗