PubMed Health⌕ Search

Biomedical subjects

A S Kibel

Publications and source records attributed to A S Kibel.

7 recordsLinked to original sources
PubMed1997

Late venous thromboembolic disease after radical prostatectomy: effect of risk factors, warfarin and early discharge.

PURPOSE: We determined the incidence of late venous thromboembolic disease after radical prostatectomy, and the influence of risk factors, length of hospital stay and warfarin anticoagulation. MATERIALS AND METHODS: Patients undergoing radical prostatectomy received routine deep vein thrombosis prophylaxis that consisted of intermittent pneumatic compression stockings, early ambulation and warfarin administration during hospitalization with the goal of achieving a prothrombin time international normalized ratio of 1.5 or greater. When patients returned to the hospital for postoperative evaluation, venous duplex ultrasonography of the lower extremities was done. All patients were contacted at 2 months to ensure that they did not suffer a clinical thromboembolic event. RESULTS: One of 158 patients consenting to the study had a symptomatic thromboembolic event for a clinical incidence of 0.6% (95% confidence interval 0.0 to 3.5). Duplex ultrasonography was performed 21.4 +/- 7.8 days postoperatively and 3 of the 106 patients who completed the study had a positive ultrasound for an incidence of 2.8% (95% confidence interval 0.6 to 8.1). None of these patients suffered a symptomatic thromboembolic event. Age, body mass index, length of hospital stay, operative time, estimated blood loss, prostate specific antigen and Gleason score were evaluated for a statistical relationship with thromboembolic events. Only higher body mass index and length of hospitalization approached statistical significance. CONCLUSIONS: Late deep vein thrombosis can occur after radical retropubic prostatectomy. Shorter prophylaxis period, secondary to shorter periods of hospitalization, did not increase the risk of thromboembolic events. The combination of intermittent pneumatic compression stockings and warfarin anticoagulation may be contributing to the relatively low deep vein thrombosis rate in our study compared to previous studies.

Aged↗
PubMed1997

Immunostaining of the von Hippel-Lindau gene product in normal and neoplastic human tissues.

Alterations in the von Hippel-Lindau (VHL) gene are correlated with a diverse group of neoplasms including hemangioblastoma, clear cell renal carcinoma (RCC), and pheochromocytoma. Molecular genetic studies suggest that VHL is a tumor-suppressor gene; correspondingly, reintroduction of a VHL complementary DNA (cDNA) into RCC cells inhibits their ability to form tumors in nude mice. Recently, it was discovered that the VHL gene product (pVHL) binds to two subunits of the transcription elongation complex Elongin (SIII), resulting in decreased activity of this complex in vitro. It is proposed that pVHL functions in vivo as a negative regulator of transcription elongation; however, the intracellular localization of pVHL has not been clearly delineated. Epitope-tagged pVHL has been observed in either the nucleus or the cytoplasm of cultured cells, depending on the density of the cell culture. In this article, the cellular localization of pVHL in normal and neoplastic human tissues is documented using three different monoclonal antibodies. Strong expression of pVHL was observed in the epithelial cells of all organs examined, particularly in renal tubules, and was exclusively cytoplasmic. Lesser degrees of staining, also cytoplasmic, were observed in other cell types. A variety of carcinomas (lung, prostate, colon, breast, bladder, and thyroid) showed strong cytoplasmic staining for pVHL including four of five sporadic clear cell RCC. Of the nonepithelial neoplasms examined, only one tumor, an embryonal rhabdomyosarcoma, failed to stain for pVHL. The findings establish wide-spread expression of VHL at the protein level and provide strong evidence that most, if not all, pVHL is localized to the cytoplasm of cells in vivo.

Carcinoma↗
PubMed1997

Primary lymphoma of the bladder: a unique cystoscopic appearance.

Primary lymphoma of the bladder is a rare disorder that occurs in the fifth to seventh decades, with a female preponderance. Although computed tomographic scanning is the best diagnostic imaging study, cystoscopic biopsy and immunoperoxidase staining are needed to make the diagnosis. Primary lymphoma of the bladder has a good prognosis and responds to a variety of therapeutic modalities. Throughout the literature, authors have described primary lymphoma of the bladder as a submucosal tumor, smooth, nonulcerative, edematous, friable, or even hemorrhagic. We present what we believe to be the first photographic image of the cystoscopic appearance of primary lymphoma of the bladder.

Aged↗
PubMed1996

Constitutive expression of high levels of prostate-specific antigen in the absence of prostate carcinoma.

OBJECTIVES: To identify distinguishing serologic features in patients with stable marked elevation in prostate-specific antigen (PSA) and multiple negative biopsies. METHODS: The study population consisted of 7 patients with a stable PSA level of greater than 20 ng/mL (average 27.0), followed for at least 34 months (average 56), and with two or more negative prostatic biopsies including transition zone biopsies. The PSA density (PSAD), rate of change in PSA, reverse transcriptase/polymerase chain reaction (RT/PCR), and free/total PSA were obtained. RESULTS: Rate of change in PSA level was stable (0.18 +/- 1.2 ng/mL/yr), suggesting that there was no occult cancer; PSAD was high (0.34 +/- 0.5 ng/mL/cc), indicating that prostate size was not the sole cause of the elevation. The RT/PCR was negative in 6 of 7 patients, further decreasing the likelihood of an occult malignancy. Free versus total PSA was not consistent, averaging 16.8%, but with a range of 6% to 34%. CONCLUSIONS: Novel PSA tests were not found to be useful in this cohort of patients with multiple negative biopsies and PSA elevations greater than 20 ng/mL. Additional studies with larger sample size are required to confirm this finding.

Adult↗
PubMed1995

Intraperitoneal bladder rupture after normal vaginal delivery.

To our knowledge we report the first case of bladder perforation in a patient with no history of pelvic surgery or delivery. The patient presented 3 days post partum with renal failure and ascites. Paracentesis and cystography confirmed urinary ascites and bladder rupture. After open bladder repair convalescence was uneventful. The literature on intraperitoneal bladder rupture and urinary ascites is reviewed.

Adult↗