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Biomedical subjects

I Nissenkorn

Publications and source records attributed to I Nissenkorn.

At least 19 recordsLinked to original sources
PubMed1995

Multicentricity in renal cell carcinoma.

In the era of ultrasound and computerized tomography, when more than 50% of renal cell carcinomas are detected incidently, with a high proportion of small tumors, the standard treatment of radical nephrectomy in the presence of a normal contralateral kidney should be questioned. The main objection against conservative surgery for renal cell carcinoma has been the concern about satellite small renal cell carcinomas, which have been reported in 7% and 19.7% of 100 and 66 kidneys, respectively. We studied the incidence of multicentric neoplasms in 50 kidneys: 27 with renal cell carcinoma and 23 autopsied normal kidneys. The incidence of small renal cell carcinoma in the kidneys with a tumor was 11.1% and that of small nodules in normal autopsied kidneys was 13% (none of them was malignant). The incidence of satellite malignant nodules in patients with renal cell carcinoma 3 cm. or smaller was 3.7% in our series, and 0% and 3% in other series. Therefore, patients who undergo nephrectomy for tumors up to 3 cm. in diameter may be considered as overtreated in 96 to 100% of the cases. We conclude cautiously that partial nephrectomy should be widely accepted in patients with small renal carcinoma and in the presence of a normal contralateral kidney.

Carcinoma, Renal Cell↗
PubMed1995

Late visual field changes following cryotherapy for retinopathy of prematurity stage 3.

AIMS: The correlation between cryoscars and visual field defects following cryoablation was studied. METHODS: A Humphrey 120 full field screening test was performed in 10 children (15 eyes) who were treated by cryotherapy between 10 and 14 years previously for retinopathy of prematurity (ROP) stage 3. RESULTS: In eight eyes treated by cryoablation through 360 degrees in zone I or II, a moderate circumferential peripheral visual field constriction was found. In seven other eyes, cryotreated up to 180 degrees only in the temporal retina (zone III), a nasal field constriction was noted. There was no evidence of late development of retinal tears or retinal detachment. The correlation between the primary cryoapplications, late chorioretinal cryoscars, and the visual field changes was evaluated. CONCLUSION: Late chorioretinal scars following cryotherapy for ROP stage 3 are associated with visual field defects, but as these defects are at the periphery of the visual field they do not cause any subjective derangements 10-14 years after treatment.

Adolescent↗
PubMed1995

A simple nonmetal stent for treatment of urethral strictures: a preliminary report.

PURPOSE: A polyurethane temporary stent has been designed for urethral strictures in patients who are unfit or unwilling to undergo surgery. MATERIALS AND METHODS: The stent resembles a Malecot catheter and is inserted easily through the urethrotome sheath immediately after urethrotomy. The stent was used in 22 patients with recurrent urethral strictures and was left in the urethra for 3 to 24 months. RESULTS: Mean followup was 11.2 months. All patients were treated successfully and had improved urine flow rates (maximum 15 to 21 ml. per second). In no patient was the stent obstructed by incrustation for up to 2 years. CONCLUSIONS: This simple stent may offer effective treatment for many urethral strictures.

Adult↗
PubMed1993

Efficacy of transurethral hyperthermia in benign prostatic hyperplasia.

From February 1990 through May 1991, 37 patients with benign prostatic hyperplasia were treated by transurethral hyperthermia according to two different protocols. In group I, 10 patients with an indwelling catheter underwent six one-hour sessions twice a week for three weeks, at a temperature of 43 degrees C. The 27 patients from group II (11 with indwelling catheter) had two sessions of two hours each for one week, at a temperature of 44.5 degrees C. Prostatic volume, Madsen symptom score, two estimates of peak flow, average flow, and residual urine measurements were recorded before treatment and one week, one month, six months, and one year after completing the sessions. Hyperthermia was applied through a metal ring, which was used both for heating and temperature control, mounted on a 16-F Foley-Tieman-like catheter. The follow-up period was five to fifteen months. From those who had an indwelling catheter, 5 of 10 patients (50%) from group I and 8 of 11 patients (72.7%) from group II regained spontaneous micturition and continued to void satisfactorily throughout the follow-up period. Nine of 16 patients without catheter (56.3%), showed objective and subjective improvement. Transurethral hyperthermia is a new, simple, noninvasive, and well-tolerated method for the treatment of benign prostatic hyperplasia.

Aged↗
PubMed1993

Temperature measurements and histology of the canine prostate during transurethral hyperthermia.

Intraprostatic temperature measurements during transurethral hyperthermia at 44.5C were obtained in 5 dogs. Temperatures were also recorded in the bladder neck wall and the rectal wall. After completion of the temperature measurements, hyperthermia was continued for 3 hours. The prostates were then removed and taken for histologic examination immediately after hyperthermia and 1 week and 1 month later. The mean temperatures obtained in the 5 canine prostates were 44.5 +/- 0.4C at the heating electrode; 43.8 +/- 0.4C at a distance of 3 mm. from the electrode; 42.6 +/- 0.5C, 40.8 +/- 0.4C and 39.4 +/- 0.5C, 6, 9 and 12 mm. from the heating electrode, respectively, in the right, prostatic lobe. Similar temperatures were measured in the left lobe. The thermal gradient in the prostatic tissue was therefore about 4C per 1 cm. On histology, hemorrhagic necrosis of the prostatic tissue adjacent to the urethra was found. These histologic changes were found as much as 5 mm. from the heating antenna (where the temperatures measured were above 43C). The findings of our study may have major clinical importance. We found that thermal energy above 43C provides enough penetration to cause tissue damage and be clinically effective in most patients, while the thermal gradient around the heating electrode of 4C per 1 cm. is steep enough to confine histologic damage within the prostate.

Animals↗
PubMed1993

The intraurethral catheter--three years of experience.

Ninety-four patients with benign prostatic hyperplasia who had anesthetic contraindications to surgery were treated by insertion of 130 intraurethral catheters (IUC). Of the 130 IUCs inserted, 80.8% were successful and in 19.2% the IUC had to be removed earlier than intended: improper placement, displacement of the stent and residual urine were the main reasons for failure. All patients with a successfully inserted IUC were continent. Fifty-three IUCs were left for 1-6 months and 52 stents remained in place for over 6 up to 19 months. Bacteriuria was found in 13% of the patients with IUCs, but only 2.4% of the patients had clinical urinary tract infection. The IUC may be used as an alternative to surgery in high risk patients and as an alternative to an indwelling catheter.

Aged↗
PubMed1993

Connection between the length of the heating antenna and volume of the prostate in transurethral thermotherapy for benign prostatic hyperplasia.

From June 1990 to June 1991, 79 poor surgical risk patients with benign prostatic hyperplasia (BPH) were treated with transurethral hyperthermia. The patients were divided into 2 treatment groups. In group I, 40 patients were treated by two 2-hour sessions at 44.5 degrees C and a heating antenna of 1 cm long. In group II, 39 patients received one 3-hour treatment session at a temperature of 46 degrees C and a 2-cm-long heating antenna. The mean follow-up period was 7.9 months for group I and 8.4 months for group II patients. In group I, 22 of 40 patients (55%) showed subjective and objective improvement. In group-II patients a major improvement was noted in 25 of 39 patients (64%). The patients in both groups were subdivided into those with prostates smaller or larger than 50 ml. Significantly better treatment results were obtained in patients with prostates smaller than 50 ml in group-I and group-II patients. The mean Madsen-Iversen score, residual urine and maximum flow rate improved significantly in 47% of groups-I patients with larger prostates and 62% of those with prostates < 50 ml (p < 0.05), and in 50% of group-II patients with prostates > 50 ml and 82% of those with prostates < 50 ml (p < 0.01). A temperature of 46 degrees C with a 2-cm-long heating antenna in patients with prostates < 50 ml gave the best treatment results (82%).

Aged↗
PubMed1993

[The intraurethral catheter. A 3-year experience].

One hundred and thirty prostatic stents were inserted in 94 patients with benign prostatic hyperplasia. Seventy eight of these patients (83%) had an indwelling catheter because of chronic urinary retention. The other 16 patients had severe obstructive symptoms. Of the 130 IUCs inserted, 80.8% were successful. Fifty three stents were left for 1 to 6 months and 52 remained in place for 6 to 19 months. All patients were continent. The IUC may be an alternative to surgery in patients with a high risk for prostatectomy, or may replace an indwelling catheter until surgery is possible.

Aged↗
PubMed1992

Systemic candidiasis in babies with retinopathy of prematurity.

Fifteen premature babies developed systemic candidiasis during the administration of intravenous hyperalimentation in the Beilinson Neonatal Intensive Care Unit. Candida albicans was found in the blood cultures of all the babies and in the urine cultures of 66.7% of them. Repeated funduscopic examinations revealed no evidence of septic embolization in the retinal or choroidal circulation. It should be noted that acute retinopathy of prematurity (ROP) grade 2 or 3 was found in all the babies.

Candida albicans↗
PubMed1992

Safety of transrectal prostatic biopsy through double-glove technique without antibiotic prophylaxis.

We studied 143 men who underwent transrectal prostatic biopsies using the double-glove technique. No patient received any antimicrobial therapy before the procedure. Clean catch urine cultures were obtained at admission and two, four, and twenty-four hours, and two weeks after biopsy. Aerobic and anaerobic blood cultures were performed at admission, and at thirty minutes and four hours after the procedure. In addition, clinical parameters were monitored closely in the hospital for twenty-four hours after the biopsy. A total of 132 patients were considered evaluable. Temperatures of 37.6 degrees C or higher occurred in 3.8 percent of the patients. In no case was rigors recorded. In 4 of the patients studied (3%) post-biopsy urine cultures were infected with Escherichia coli. All post-biopsy blood cultures, both aerobic and anaerobic, were negative. Our data indicate that with the use of the double-glove technique, prophylactic administration of antibiotics is not necessary to prevent the infectious complications following transrectal biopsy of the prostate.

Aged↗
PubMed1992

Treatment of benign prostatic hyperplasia causing complete urinary retention through local transurethral hyperthermia.

A new technique is described for the treatment of benign prostatic hyperplasia with local hyperthermia applied transurethrally by an electromagnetic wave generator. A series of 72 treatment sessions given to 16 patients sustaining an indwelling catheter is reported. The patients were divided into two groups. Group 1 consisted of 10 patients who received 60 treatment sessions (six 60-min sessions each with 43 degrees C during 3 weeks). In group 2 there were 6 patients who received a total of 12 treatment sessions (two 120-min sessions each with a temperature of up to 44.5 degrees C for 1 week). Five of the 10 patients from group 1 (50%) and 4 of 6 patients from group 2 (67%) were relieved of the catheter and have been able to void satisfactorily during the 7- to 14-month (mean 10.1 +/- 2.8) follow-up period. The overall success rate in this series of 16 patients was 56.3%.

Aged↗
PubMed1992

The effect of light on oxygen-induced vasoproliferative retinopathy in newborn kittens.

The effect of bright fluorescent light (115 fc) on oxygen-induced retinopathy in newborn kittens was compared with that of complete darkness and cyclic illumination of 12 hr of bright light (115 fc) and 12 hr of complete darkness. No significant difference was found in the extent of preretinal vasoproliferation and retinal ultrastructural findings among the three groups of kittens reared in different levels of illumination and a control group raised in a standard laboratory illumination level of 40 fc. These results confirmed that light is not a required factor for the development of oxygen-induced retinopathy in kittens.

Animals↗
PubMed1991

Transperineal ultrasound examination in the evaluation of prostatic size.

Eighty patients with benign prostatic hyperplasia underwent transperineal ultrasonographic evaluation of prostatic size and calculation of prostatic volume. In 10 patients transabdominal prostatic ultrasonography was also performed and the findings compared with those of transperineal examination. The estimated prostatic volume measured by transperineal ultrasonography was compared to the actual weight of the surgically removed gland. The correlation coefficient was 0.89 (P less than 0.0001). The transperineal and transabdominal ultrasonographic estimated volumes were also compared. The correlation coefficient was 0.92 (P less than 0.0001). No pain or discomfort were reported by the patients. Transperineal ultrasonography appears to be an accurate, fast and easy method to evaluate prostatic volume.

Humans↗
PubMed1991

Single preoperative bladder instillation of povidone-iodine for the prevention of postprostatectomy bacteriuria and wound infection.

OBJECTIVE: To study the effectiveness of preoperative bladder washing with povidone-iodine to prevent postprostatectomy wound infection. DESIGN: Patients with an indwelling catheter and scheduled for prostatectomy were divided into two groups. In patients in group 1 (n = 76) the indwelling catheter was simply removed without bladder irrigation. Patients in group 2 (n = 80) had their bladder washed with a nondiluted solution of povidone-iodine before surgery. PATIENTS: One hundred fifty-six consecutive patients with an indwelling catheter and bacteriuria. Mean age was 64 years. All patients had an open prostatectomy during the 12-month study period. Patients undergoing open prostatectomy during the first 6 months of the study had no bladder irrigation and served as the control group. Patients undergoing open prostatectomy during the following 6 months had a bladder instillation with povidone-iodine. RESULTS: Wound infection appeared in 17 of 76 patients (22.4%) without bladder washing and in 4 of 80 patients (5%) when 50 to 60 ml of the solution was retained in the bladder for 10 to 13 minutes (p = .001). The incidence of postoperative bacteriuria remained unchanged in the control group (100%) but was reduced to 22.5% in the treated group (p = .001). Statistical comparisons of incidence were done using the chi square test. CONCLUSIONS: It has been demonstrated that the use of preoperative bladder instillation of povidone-iodine may be highly effective in the prevention of postprostatectomy wound infection and in reducing the incidence of bacteriuria in patients with an indwelling catheter and urine colonization.

Administration, Intravesical↗
PubMed1991

Infected urine as a risk factor for postprostatectomy wound infection.

OBJECTIVE: To study the relation of preoperative infected urine and postprostatectomy wound infection in patients with and without indwelling bladder catheters. DESIGN: Patients undergoing prostatectomy were evaluated for the presence of infected urine prior to prostatectomy and postoperative wound infection. They were further divided into patients with indwelling urinary catheter and catheter-free patients. All had received antibiotic prophylaxis. PATIENTS: One hundred fifty consecutive patients undergoing open prostatectomy--mean age was 67 years; 100 patients with an indwelling catheter for a mean period of 50 days; 50 catheter-free patients. RESULTS: Wound infection was found in 19 of 81 (23.5%) and in 6 of 69 (8.7%) patients with infected and sterile urine, respectively (p = .028). In patients with indwelling catheters prior to operation, wound infection was 22.4% when urine was infected and 8.3% when it was not. In patients without catheters, infected urine was associated with 40% of wound infections, as compared with 8.9% of wound infections in patients with sterile urine. Organisms obtained from infected wound and urine were identical in 84% of cases. These results were obtained despite antibiotic prophylaxis. CONCLUSIONS: Wound infection has been demonstrated to be a postprostatectomy complication directly related to the presence of urinary infection at surgery; thus, elective prostatectomy should be deferred until urine becomes sterile.

Aged↗
PubMed1991

The intraurethral catheter: long-term follow-up in patients with urinary retention due to infravesical obstruction.

Insertion of 43 intraurethral catheters (IUC) was performed on 31 patients in order to replace an indwelling catheter for urinary retention due to benign prostatic hyperplasia. The insertion of the IUC was done under local anaesthesia with lignocaine jelly in the out-patient clinic. The device has been in place for 3 to 14 months (mean 7), in 14 cases for greater than 3 months and in 29 cases for greater than 6 months. In 7 of the 43 inserted IUCs the device had to be removed earlier than intended (after 4.2-8 months) for reasons related to the device. Of the remaining 36 devices which were functioning well, 6 were removed at prostatectomy 3.5 to 8 months after insertion and an additional 6 IUCs had to be removed for reasons not related to the device; 24 IUCs are still in place and functioning satisfactorily. The mean maximal flow rate in these patients is 13.9 ml/s. Of the 31 patients, 27 had a positive urine culture before IUC insertion. None of the patients with the IUC had a clinically evident urinary tract infection, although in 7 cases the urine culture was positive during the follow-up period. All patients were in a better psychological state, and those who were able to perform sexually before they had the indwelling catheter were also able to perform sexually with the device in place. After long-term follow-up, the IUC has proved to be a cost-effective, successful alternative to an indwelling catheter and can be used as an alternative to prostatectomy in patients who are at high risk for surgery.

Catheters, Indwelling↗