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Biomedical subjects

David Ben Meir

Publications and source records attributed to David Ben Meir.

5 recordsLinked to original sources

Mucinous adenocarcinoma of posterior urethra. Report of a case.

Primary carcinoma of the male urethra accounts for less than 1% of malignancies in males. Mucinous adenocarcinoma of the urethra is extremely rare, and its biologic behavior is not well known. We report a case of mucinous adenocarcinoma showing the histologic features of colloid adenocarcinoma that appears to have evolved either by neoplastic degeneration of goblet cells found in the urethral epithelium or by malignant degeneration of persistent glandular elements of uretheritis cystica and glandularis.

Adenocarcinoma, Mucinous↗

Is prophylactic antimicrobial treatment necessary after hypospadias repair?

PURPOSE: We evaluate the complication rate after hypospadias repair with and without the use of antimicrobial prophylaxis. MATERIALS AND METHODS: A total of 101 boys who underwent tubularized incised plate urethroplasty with urethral catheter placement during a 16-month period were randomly divided into group 1-52 treated with cephalexin from day 1 after surgery to 2 days after catheter removal and group 2-49 who did not receive prophylaxis. All children received cefonicid before surgery. RESULTS: Average patient age was 2.3 years (range 11 months to 6.5 years). Hypospadias was coronal in 54 boys, penile in 33, glanular in 9 and penoscrotal in 5, the distribution of which was similar in both groups. Median time to urethral catheter removal was 8.6 days in group 1 and 8.3 in group 2. Overall bacteriuria was noted in 11 children in group 1 and 25 in group 2. The most common pathogen was Pseudomonas aeruginosa in group 1 and Klebsiella pneumoniae in group 2. Urethrocutaneous fistula developed in 3 boys in group 1 and 9 in group 2, meatal stenosis occurred in 1 boy in group 1 and 4 in group 2, and 1 boy in group 1 had meatal regression. Three boys in group 1 and 12 in group 2 had a complicated urinary tract infection (p <0.05). There was no difference in the number of surgical complications between boys for whom this was the first operation or a repeat hypospadias repair. CONCLUSIONS: A broad-spectrum antibiotic is recommended before and antimicrobial prophylaxis after hypospadias repair. This protocol may decrease the risk of complicated urinary tract infections after surgery, and probably reduce meatal stenosis and urethrocutaneous rates.

Antibiotic Prophylaxis↗

Expression of protein kinase C isoenzymes in benign hyperplasia and carcinoma of prostate.

Protein kinase C family consists of 11 isoforms, classified into 3 categories according to their structure and mechanisms of activation. These isoenzymes are involved in processes, which maintain intracellular homeostasis. Alterations in activity, amount or distribution of protein kinase C (PKC) isoenzymes may cause cellular proliferation or induce apoptosis. We have studied and compared the expression levels of several PKC isoforms in benign prostatic hyperplasia (BPH) and prostate cancer (PCa). These are PKCs alpha (alpha), beta (beta), delta (delta), epsilon (epsilon), zeta (zeta), eta (eta), which have been detected as major isoforms in prostate tissue. Paraffin sections of 25 benign prostatic hyperplasia (BPH) and 25 of prostatic carcinoma (PCa) were examined for expression of PKC alpha, beta, delta, epsilon, zeta, and eta. Expression of PKC beta was examined in additional 3 BPH and 3 PCa using Western blot analysis. We found a significant high level of expression of PKC isoforms alpha, beta, epsilon and eta in PCa compared to BPH (p<0.01). Using backward logistic regression, we found changes in PKC epsilon expression to be most significant between malignant compared to benign tumor tissue specimens. Immunostaining for PKCs alpha, beta and eta in addition to PKC epsilon may aid in distinguishing between benign and malignant prostatic disease.

Aged↗

Intrarenal foreign body presenting as a solid tumor.

A 45-year-old man underwent radical nephrectomy for an asymptomatic solid renal mass radiographically interpreted as a tumor. The pathologic examination revealed an intrarenal sponge forgotten during nephrolithotomy performed 5 years previously. The sponge was surrounded by a thick fibrous capsule. This case suggests that foreign body should be included in the differential diagnosis of a suspected renal mass in patients with a history of previous surgery.

Diagnosis, Differential↗

Prolapsed ureterocele after upper pole heminephrectomy.

Prolapse of a ureterocele through the external meatus is uncommon, and a prolapsed ureterocele occurring after upper pole heminephrectomy is extremely rare. We describe such a case, occurring 2 months after surgery. The ureterocele was excised with the upper pole ureteral stump, and the lower pole ureter was reimplanted with a good outcome.

Female↗