PubMed Health⌕ Search

Biomedical subjects

A Savir

Publications and source records attributed to A Savir.

17 recordsLinked to original sources
PubMed1999

Dendritic cells are resistant to apoptosis through the Fas (CD95/APO-1) pathway.

Immunoregulation of lymphocytes and macrophages in the peripheral immune system is achieved in part by activation-induced cell death. Members of the TNF receptor family including Fas (CD95) are involved in the regulation of activation-induced cell death. To determine whether activation-induced cell death plays a role in regulation of dendritic cells (DCs), we examined interactions between Ag-presenting murine DCs and Ag-specific Th1 CD4+ T cells. Whereas mature bone marrow- or spleen-derived DCs expressed high levels of Fas, these DCs were relatively insensitive to Fas-mediated killing by the agonist mAb, Jo-2, as well as authentic Fas ligand expressed on the CD4+ T cell line, A.E7. The insensitivity to Fas-mediated apoptosis was not affected by priming with IFN-gamma and/or TNF-alpha or by blocking the DC survival signals TNF-related activation-induced cytokine and CD40L. However, apoptosis could be induced with C2-ceramide, suggesting that signals proximal to the generation of ceramide might mediate resistance to Fas. Analysis of protein expression of several anti-apoptotic mediators revealed that expression of the intracellular inhibitor of apoptosis Fas-associated death domain-like IL-1-converting enzyme-inhibitory protein was significantly higher in Fas-resistant DCs than in Fas-sensitive macrophages, suggesting a possible role for Fas-associated death domain-like IL-1-converting enzyme-inhibitory protein in DC resistance to Fas-mediated apoptosis. Our results demonstrate that murine DCs differ significantly from other APC populations in susceptibility to Fas-mediated apoptosis during cognate presentation of Ag. Because DCs are most notable for initiation of an immune response, resistance to apoptosis may contribute to this function.

Animals↗
PubMed1996

Dismembered pyeloplasty in children with and without stents.

OBJECTIVES: To assess the benefit of performing nonstented pyeloplasty in infants. METHODS: Forty-eight consecutive pyeloplasties were performed by two surgeons using different techniques, from 1987 to 1992. One used stents in all cases (23) and the other performed a nonstented anastomosis with external drainage (25 cases). Patients with specific indications for internal drainage, i.e. poor renal function, extreme pyelocaliectasis, were excluded from the study. Parameters of cost and complications were assessed. RESULTS: The group with stents had more febrile episodes, needed more antibiotics and were hospitalized twice as long as the nonstented group. Pre- and postoperative renal function was similar in both groups. CONCLUSIONS: Performing pyeloplasties in children without stenting the anastomosis is safe and cost-effective.

Adolescent↗
PubMed1990

Re-orchiopexy: advantages and disadvantages.

Re-orchiopexy was performed in 33 boys (42 testes) in order to place an undescended testis in the scrotum after failure of the initial operation. Success was achieved in 80.9%. Seven of the 10 testes, reported to have short spermatic vessels at the first surgery, had no elongation of the vessels and only 1 of these resulted in a high scrotal location of the testis. It appears that most orchiopexy failures are the result of technical failures of the initial procedure. Standard orchiopexy with extensive mobilization of the spermatic vessels and testis can successfully correct most of the undescended testes. However, the preferred management for the intra-abdominal testis with short vessels may be transection of the spermatic vessels rather than a planned two-stage technique.

Adolescent↗
PubMed1990

Long-term follow-up of patients after pyeloplasty for ureteropelvic junction obstruction.

Between the years 1976 and 1986, 94 patients ranging in age from 2 weeks to 60 years were referred for treatment of ureteropelvic junction obstruction. A dismembered pyeloplasty was performed in 85 patients, ureterocalycostomy in 4 patients and primary nephrectomy in 5 patients. Apart from aberrant vessels found in 14 patients and associated calculi in 12, clinical results were satisfactory in most of the patients (96.2%). The calyceal appearance on the postoperative excretory urogram showed diminution with good drainage in 53.8%, improvement of drainage in 42.3%, and deterioration in 3.8%.

Adolescent↗
PubMed1989

Phenol sclerotherapy for hydrocele: a study in 55 patients.

Sclerotherapy with 2.5% phenol solution was used to treat 63 hydroceles in 55 patients with a mean age of 69 years. In 51.6% of the patients (32 hydroceles) 1 treatment was sufficient, while 2 treatments were necessary in 25.8% (16 hydroceles), 3 in 13% (8 hydroceles) and 4 in 8% (5 hydroceles). One patient required 7 injections. Treatment was unsuccessful in 1 patient in whom a local allergic reaction developed. Only 1 patient complained of pain, and other complications were rare and mild. On the basis of this experience we concluded that sclerotherapy with phenol 2.5% is a painless, highly effective, safe and economical procedure that permits one to avoid an operation, anesthesia and hospitalization. Its use is warranted in adults and particularly in the elderly.

Adult↗
PubMed1989

Results and relevance of urodynamic studies in the management of urinary incontinence in women over eighty.

Urinary incontinence among the elderly is a major problem that is often neglected. The results of urodynamic studies in a group of 32 women greater than 80 years old with incontinence revealed that detrusor instability was the primary cause of incontinence in 23 (72%), while 9 (28%) patients demonstrated signs of sphincter incompetence. Urodynamic study results were normal in four patients. Medical treatment on a self-regulated dose and bladder training were effective in controlling incontinence in 25 (78%) of the study group. It is suggested that, although detrusor instability is the major cause of incontinence in elderly women, urodynamic studies should be performed for accurate diagnosis to ensure optimal therapeutic results.

Aged↗
PubMed1985

The use of the portal system for the transplantation of a neonate kidney graft in a child with Wilms' tumor.

A single an-encephalus neonate kidney graft was transplanted into the portal system of a 6-year-old recipient who had previously undergone removal of the right kidney and inferior vena cava because of Wilms tumor. The left kidney ceased to function shortly thereafter. The child was supported very poorly on hemodialysis, and showed repeated very high levels of cytotoxic antibodies in her serum. The first cross-negative kidney graft that was available harbored two main arteries and duplicate collecting system with two very thin ureters. These vascular anatomic and pathologic variations of both donor graft and recipient necessitated the use of the portal system for renal graft venous drainage and the aorta for the graft revascularization. The ureters that had pinpoint-like lumen were inserted together into the lumen of the native ureter stump and fixated. One year after the transplantation the serum creatinine level is 1.8 mg/dL.

Aorta↗
PubMed1983

Human chorionic gonadotropin (hCG) treatment in cryptorchidism.

One hundred twenty-eight prepubertal boys, ages 1-12 years, were referred to our institute because of uni- or bilateral cryptorchidism. Patients with mobile (retractile) testes were not included in the study. They were treated with human chorionic gonadotrophin (hCG, Pregnyl-Teva) twice weekly for five consecutive weeks by the following doses; 1-4 years (n = 53) - 250 U X 10; 4-7 years (n = 51) - 500 U X 10; 7-12 years (n = 24) - 1000 U X 10;i.m. Plasma testosterone (T) levels were measured before and once weekly during the treatment period. A good clinical response (a complete descent of the testes into the scrotum) was obtained in 32 (25%), a partial response (a distal movement of the testes towards the scrotum) - in 41 (32%) of the boys. The basal plasma T levels were within the normal range for prepuberty in all the patients (18 +/- 9 ng/dl) and a significant increase during hCG treatment was found in all (peak of 344 +/- 185 to 640 +/- 288 ng/dl). These values were not significantly different between the "responders", "partial responders". The result of these studies, indicate the use of hCG for the initial treatment of boys with cryptorchidism, the minimal effective dose being 500 U twice weekly for five consecutive weeks.

Aging↗
PubMed1980

Malignant mesodermal (mesenchymal) tumors of bladder.

Malignant mesodermal tumors originating in the bladder are rare. Only a few cases could be found in large series of autopsies or in gathered series of primary retroperitoneal space tumors. Sarcomas originating in the bladder wall grow rapidly and usually infiltrate into neighboring tissues. Two cass of such rare tumors are presented. The polar discrepancy between the clinical situation and the histopathologic findings are emphasized. Therapeutic outlines for these rare cases are suggested.

Fibrosarcoma↗
PubMed1980

Dissolution of cystine calculi by pelviocaliceal irrigation with D-penicillamine.

We report on a cystinuric patient in whom unilateral hydronephrosis developed as a result of massive renal stone formation owing to non-compliance of systemic penicillamine therapy. At operation a large number of calculi could not be removed for technical reasons. After successful in vitro dissolution of 1 calculus using a 0.5 per cent solution of D-penicillamine at pH 8.0 the same solution was used to irrigate the renal collecting system via a nephrostomy tube. After 2 months of daily irrigations, which were decreased to 2 times a week for another 2 months, all the stones appeared radiographically to have disappeared. At followup 2 years after removal of the nephrostomy tube the patient is on regular systemic therapy with no evidence of residual or recurrent stone formation.

Adolescent↗
PubMed1975

Inflammatory processes mimicking bladder tumors in children.

Tumor-like proliferative lesions were discovered on cystourethrography and cystoscopy in two children, one with severe bacterial urinary tract infection and the other with painless terminal hematuria. Histologically, these lesions were characterized by inflammatory infiltration and proliferative changes of the bladder epithelium. Appropriate treatment, including antibiotics, resulted in complete disappearance of the bladder lesions in both patients. The development of such lesions is related to the potential for nonneoplastic proliferation and metaplasia of the bladder epithelium and is considered to be the result of irritation associated with infection or other chemical and physical factors. The known malignant potential of such bladder pathology indicates a need for careful, long-term follow-up in such patients, including children.

Child, Preschool↗
PubMedDate not supplied

Current experience with hypospadias repair.

Current experience with hypospadias repair in 77 boys during a 1-year period is presented. Thirty-nine with distal hypospadias underwent meatal advancement and glanuloplasty (MAGPI), 18 with more proximal lesion were repaired by Mathieu's flip-flap technique, and in 5 boys with severe chordee and proximal hypospadias, the transverse prepucial island flap repair was employed. Second-stage repair was performed in 10 children, and another 5 boys underwent release of chordee. The complication rate of the group was 18%, most of them fistulae. The current approaches to hypospadias repair are discussed and are supported by them.

Adolescent↗