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Biomedical subjects

J C Manivel

Publications and source records attributed to J C Manivel.

At least 55 records · Page 3Linked to original sources
PubMed1994

Intraureteral metallic self-expanding endoprosthesis (Wallstent) in the treatment of difficult ureteral strictures.

Intractable and recurrent ureteral stricture presents a continuous challenge to the urologist. We report on 5 patients with severe ureteral stricture who were successfully treated with self-expanding metallic stents. Ureteral stricture occurred at ureteroileal anastomotic sites after neoplasm resection in 2 cases, multiple upper ureteral strictures were related to multiple surgical procedures for correction of bladder exstrophy in 1 and a ureteral kink developed in 1. Treatment with transluminal balloon dilation provided poor results but self-expanding metallic stents were used successfully with no major complications. In the last patient the stent and the overlying ureter were removed due to recurrent reflux; the gross and histological ureteral changes are discussed in detail. The technical approach is described, alternative therapeutic options are considered and pertinent literature is reviewed.

Adult↗
PubMed1994

Seromuscular colocystoplasty lined with urothelium: experimental study.

OBJECTIVES: Enterocystoplasty without bowel mucosa would be useful to prevent most complications related to the presence of bowel in the urinary tract. However, past attempts to remove the mucosa from intestinal segments have resulted in fibrosis and contraction of the patch. We designed this study to test the hypothesis that such contraction can be prevented by combining the principle of detrusorectomy and seromuscular colocystoplasty, covering the denuded urothelium with a de-epithelialized colonic segment, a procedure we named seromuscular colocystoplasty lined with urothelium (SCLU). METHODS: SCLU was performed in 14 female mongrel dogs weighing 20 to 25 kg. We performed the procedure with and without preservation of the intestinal submucosa and in animals with intact and previously reduced bladders. We describe a new animal model of reduced bladder capacity. Bladder capacity and histology were evaluated 1 to 6 months after the procedure. RESULTS: Twelve bladder specimens were available for analysis. In all cases, the seromuscular patches remained viable and well vascularized. When the intestinal submucosa was not preserved in the patch, there was moderate contraction of the patch with subepithelial fibrosis and the bladder capacity was not preserved. In contrast, when the submucosa was preserved, there was no fibrosis and the capacity was preserved. In animals with previously reduced bladder capacity by either subtotal cystectomy or talc-induced fibrosis, SCLU effectively augmented bladder capacity. CONCLUSIONS: The results suggest that the contraction of the intestinal patch in seromuscular enterocystoplasty can be avoided by the preservation of both the bladder urothelium and lamina propria, together with the submucosa and muscularis mucosa of the intestinal patch.

Animals↗
PubMed1994

Expression of clusterin in human renal diseases.

Clusterin, a glycoprotein with potent cohesive properties, is induced in a wide variety of acute and chronic experimental renal diseases. The purpose of this study was to examine clusterin expression in human renal diseases. Clusterin immunostaining was examined in nephrectomy specimens from patients with autosomal-dominant polycystic kidney disease (N = 5), autosomal-recessive polycystic kidney disease (N = 3), multilocular cyst of the kidney (N = 2), renal hypoplasia/dysplasia (N = 7), Wilms' tumor (nephroblastoma) (N = 6), renal cell carcinoma (N = 9), and acute and/or chronic renal transplant rejection (N = 15). No clusterin staining was detected in normal renal tissue distant from renal cell carcinomas. Increased expression of clusterin was found in epithelial cells lining cysts in all of the cystic disorders studied. Clusterin expression was found in some immature tubules in hypoplastic/dysplastic kidneys and in tubules of rejected renal allografts, but was not a prominent finding in renal neoplasms, although some renal cell carcinomas expressed clusterin in a focal manner. Common features of clusterin induction included exclusively epithelial production of clusterin in cysts, immature nephrons, and injured tubules, heterogeneity of clusterin expression, with only some tubules and/or cysts in a given area staining for clusterin, and uniform clusterin staining of epithelial cells in a given tubule or cyst in most cases. Based on its cohesive properties, we speculate clusterin functions to maintain cell-cell and cell-substratum interactions which become perturbed in the setting of renal injury and cystic diseases.

Adolescent↗
PubMed1994

Inclusion body fibromatosis of the breast. Two cases with immunohistochemical and ultrastructural findings.

Two cases of fibromatosis of the breast, characterized by a proliferation of spindle cells containing intracytoplasmic, spherical, eosinophilic inclusion bodies, are reported. The light and electron microscopic features, as well as the immunohistochemical features, are indistinguishable from those found in infantile digital fibromatosis. The proliferating spindle cells are characterized as myofibroblasts, whereas the inclusion bodies show an immunohistochemically nonreactive, hollow-like pattern with peripheral reactivity for actin filaments. This lesion, observed for the first time in the breast, expands the number of extradigital inclusion body fibromatoses.

Adult↗
PubMed1994

Induction of clusterin in acute and chronic oxidative renal disease in the rat and its dissociation from cell injury.

BACKGROUND: Clusterin is a glycoprotein incriminated in diverse biologic processes including complement regulation, cell death, and tissue remodelling. Induction of clusterin occurs in renal and other tissue injuries. EXPERIMENTAL DESIGN: The purpose of this study was to determine the effect of prooxidant states, one acute (glycerol-induced acute renal failure) and the other chronic (vitamin E and selenium deficiency) on renal clusterin expression, and to attempt to delineate the signals which in these in vivo models can elicit expression of clusterin in vitro. RESULTS: In glycerol-induced acute renal failure, a model of rhabdomyolysis, clusterin mRNA was markedly increased 24 hours after injection of glycerol (control 97 +/- 21 versus glycerol 3644 +/- 134 optical density units; p < 0.001). Immunohistochemical clusterin was also increased in glycerol-treated rats with tubules in both cortex and medulla staining for clusterin. In vitamin E and selenium deficiency, clusterin mRNA was increased 9 weeks after initiation of the deficient diet (control 97 +/- 13 versus deficient 1137 +/- 403 optical density units; p < 0.04) as were the number of tubules staining for clusterin. Since renal injury is instigated in the glycerol model by muscle damage, we tested the effect of muscle extract on clusterin expression in vitro. A homogenate of skeletal muscle induced clusterin mRNA and this induction was not associated with disruption of cell membranes and was not inhibited by cycloheximide treatment, but was blocked by actinomycin D. Since increased generation of hydrogen peroxide is a pivotal biochemical lesion in both in vivo models, we tested the effect of peroxide to induce clusterin in vitro; no such induction occurred. CONCLUSIONS: Renal tubular clusterin expression was increased in both acute glycerol-induced renal failure and chronic vitamin E and selenium deficiency, two in vivo models of oxidant injury to the kidney. In vitro induction of clusterin can occur and can be dissociated from cell injury.

Acute Disease↗
PubMed1994

Immunohistochemical characterization of teratomatous and fetal neuroendocrine pancreas.

Six extragonadal teratomas that contained pancreatic tissue were retrieved from archival material at the University of Minnesota Hospital, Minneapolis. The neuroendocrine cells were studied immunohistochemically for insulin, glucagon, somatostatin, pancreatic polypeptide, vasoactive intestinal polypeptide, gastrin, chromogranin, and synaptophysin. Pancreatic tissue from autopsies of 10 stillbirths (20 to 40 weeks' gestational age) was evaluated similarly. The features of the teratomatous pancreatic tissue were compared with those of the fetal pancreata and with data from previous studies of normal pancreatic development and adult pancreata. The pancreatic tissue in all six teratomas contained abundant mature islets that contained beta, alpha, delta, and pancreatic polypeptide cells; however, they also showed widespread nesidioblastosis with the same cell types, resembling third-trimester fetal and neonatal pancreata. Increased proportions of alpha and delta cells were observed in three and five cases (relative to those of adult tissue), respectively, providing further evidence of immaturity. Two cases showed a lack of alpha cells. None of the teratomas contained pancreatic cells that were positive for vasoactive intestinal polypeptide or gastrin. Mechanisms that regulate neuroendocrine cell differentiation in the normal pancreas also seem to operate in the teratomatous pancreas; they may eventuate in features similar to those of the late fetal and neonatal pancreas. Abnormal differentiation in teratomas may result in deficient hormone production.

Adolescent↗
PubMed1993

Benign and malignant neoplasms of myoepithelial cells: cytologic findings.

We report two myoepithelial cell neoplasms; a salivary gland tumor was malignant and a breast neoplasm was benign. Both were studied histologically, immunohistochemically, cytologically, and ultrastructurally. The malignant myoepithelioma recurred twice and metastasized to one regional lymph node. This tumor was infiltrative with areas of necrosis and hemorrhage. It was composed of malignant-appearing spindle and plasmacytoid cells. Both types of cells were immunoreactive to muscle specific actin, S-100 protein, cytokeratin, vimentin, and neuron-specific enolase. Ultrastructurally, features of myoepithelial cells were seen. Fine-needle aspirate smears showed spindle and plasmacytoid cells, numerous mitoses, and malignant-appearing nuclei. Spindle-cell adenomyoepithelioma of the breast, a small well-circumscribed firm nodule, featured multiple lobules of spindle cells associated with clear-cell glands at the lobular periphery. Histologically and cytologically, the lesion was cellular but appeared benign. The differential diagnosis of myoepithelial neoplasms is discussed.

Adult↗
PubMed1993

Silicone shedding from artificial urinary sphincter in children.

Silicone is an inert material used in all genitourinary prosthetic devices. Silicone particle shedding has been documented in adults with penile prostheses and artificial urinary sphincters. We searched prospectively for silicone particles in the peri-prosthetic tissue and regional lymph nodes in 6 children who underwent removal or exchange of an artificial urinary sphincter. The peri-prosthetic fibrous capsule was biopsied and examined by light and polarizing microscopy. Regional lymph nodes were biopsied if clinically enlarged and evaluated in a similar manner. Lymph nodes from 2 children without an artificial urinary sphincter served as controls. An artificial urinary sphincter was in place from 3 to 10 years (mean 4.3 years) and none of the sphincters demonstrated infection or erosion. Silicone particles were found in the peri-sphincteric tissue of 3 patients, which induced foreign body giant cell reaction in 2 and eosinophilic infiltrate in 1. Focal histiocytic proliferation around the cuff was seen in another case without silicone migration. There was fibrosis around the sphincter in all cases. No silicone was found in the regional lymph nodes. Silicone shedding was documented in 50% of our patients. X-ray energy dispersive spectroscopy was not performed, raising the possibility that it was under-detected. Long-term effects of silicone in children with an artificial urinary sphincter are unknown and warrant further study.

Child↗
PubMed1993

The development of tumors in experimental gastroenterocystoplasty.

Bladder augmentation with segments of the gastrointestinal tract is commonly used to treat patients with small or noncompliant bladders. Reliable data on the incidence of tumors in patients with enterocystoplasty are not available. In the small number of cases reported in the literature the mean latency period is approximately 18 years. We designed a study in Sprague Dawley rats to try to determine the risk of carcinogenesis in different types of augmentation cystoplasty and its possible relationship with infected urine, and to investigate the possibility of detecting the tumors by cytological analysis. We performed 30 gastrocystoplasties, 35 sigmoid cystoplasties, 30 ileocystoplasties and 10 sham operations, and used 10 nonoperated animals as controls. The animals were sacrificed upon completing 1 year of followup and bladder urine samples were collected at the time of sacrifice. Of 115 animals 86 were available for histological evaluation (26 gastrocystoplasty, 22 sigmoid cystoplasty, 18 ileocystoplasty, and all sham and control animals). Mean followup was 11.2 months in the gastrocystoplasty, 11.8 months in the sigmoid cystoplasty, and 12 months in the ileocystoplasty, sham and control groups. Multifocal or superficial transitional metaplasia was found in 65.4% of the gastrocystoplasty, 50% of the sigmoid cystoplasty and 55.5% of the ileocystoplasty animals. Proliferations that we classified as papillary hyperplasia were present in 53.8% of the gastrocystoplasty, 40.9% of the sigmoid cystoplasty and none of the ileocystoplasty rats. The proliferations occurred either at or close to the anastomosis between the bladder and the gastric or colonic patch, or in areas of transitional metaplasia. Cytological urinalysis was negative for neoplastic cells in all cases. No correlation was found between the occurrence of papillary hyperplasia and urinary infection. These data indicate that in rats transitional metaplasia is common in gastrocystoplasty, sigmoid cystoplasty and ileocystoplasty, and that papillary hyperplasia may occur near or at the anastomosis, or in areas of transitional metaplasia in either gastrocytoplasty or sigmoid cystoplasty. In contrast to other studies, we observed no examples of papillary hyperplasia in the ileocystoplasty group in this series. No transitional cell carcinomas or adenocarcinomas were identified in this study. It is not known if these papillary lesions have an increased malignant potential, thus further studies with longer followup are warranted.

Animals↗
PubMed1993

Urological aspects of sacrococcygeal teratoma in children.

Sacrococcygeal teratoma is the most common extragonadal germ cell tumor of infancy. Associated urological complications, most of which are reported in children with malignancy, include vesicoureteral reflux, ureteral and urethral obstruction, and neurogenic bladder. To evaluate the influence of tumor grade and type on adverse urological outcome we reviewed the charts of 29 children with sacrococcygeal teratoma and correlated urological problems to lesion type and grade. No correlation was noted between tumor grade and the incidence of urological complications. The most common urological complications were neurogenic bladder in 12% of the patients, ureteral obstruction in 10% and vesicoureteral reflux in 7%. The highest incidence of urological complications (81%) was seen in patients with type IV (presacral) disease. We recommend early radiographic and neurourodynamic evaluation in all children with sacrococcygeal teratoma.

Female↗
PubMed1993

Male donor-derived cells in the brains of female sex-mismatched bone marrow transplant recipients: a Y-chromosome specific in situ hybridization study.

In five female bone marrow transplant (BMT) recipients of sex-mismatched donor marrow, Y-chromosome specific in situ hybridization was performed on formalin-fixed, paraffin-embedded sections of the medulla to detect the male donor marrow-derived cells. Y-chromosome-bearing cells (Y-cells), thereby donor-derived, were matched with leukocyte common antigen (LCA)-reactive cells in adjacent sections immunostained with anti-LCA antibody. Y-cells included mononuclear leukocytes (MNL) within the vessel lumen and infiltrating the perivascular space and parenchyma, and "perivascular cells." We have, therefore, concluded that donor marrow-derived MNL, though limited in number, do enter the normal-appearing brain and can transform to "perivascular cells" in human BMT recipients. It remains, however, to be confirmed whether MNL entering the normal adult CNS parenchyma transform to ramified microglia.

Adolescent↗
PubMed1993

Organophosphate sensitizes the human pancreas to acinar cell injury: an ultrastructural study.

Viable pancreas fragments from five human donors were incubated in oxygenated buffered Eagle Medium. The preparation and incubation conditions were based on the method of Scheele and Palade. In Group 1 there was 1-h preincubation with echothiophate (10(-4) M); then, acetylcholine (10(-5) M) was added. After 2 h tissues were prepared for electron microscopy. Acinar injury with vacuole formation was apparent. Many of these changes were observed in fragments incubated only with acetylcholine (10(-5) M) (Group 2) and in incubates with echothiophate only (10(-4) M) (Group 3); only minor changes were seen in controls with Eagle's Medium (Group 4). Large vacuoles were significantly more numerous in Group 1 than in Control Group 4 (p < 0.05). Zymogen granules were depleted in Groups 1, 2, and 3. This depletion was significant in Group 1 when compared with Group 4 (p < 0.02). These results extend previous in vitro results that showed increased amylase release after echothiophate treatment in human pancreas and a left shift in response to acetylcholine.

Acetylcholine↗
PubMed1993

A guinea pig model for Lyme disease.

We report that outbred Hartley guinea pigs are susceptible to Borrelia burgdorferi. We recovered spirochetes from 57 of 60 (95%) guinea pigs inoculated when < or = 3 months of age. In contrast, animals inoculated when > or = 6 months of age were resistant to infection as defined by recovery of organisms at > or = 4 weeks postinoculation. Infection was widely disseminated: B. burgdorferi was recovered from 83% of bladders, 64% of knee joints, 57% of hearts, 48% of spleens, and 38% of spinal cords examined within 4 weeks of inoculation. Histopathologic changes were common in the heart (88%) (preferential involvement of perineural tissues near the annulus fibrosus) and bladder (76%) and were also noted in a minority of spinal cords (13%) and knee joints (9%). Western immunoblots demonstrated an immunoglobulin G response to B. burgdorferi, particularly to the 24-, 31- (OspA), 39-, and 41-kDa (flagellin) antigens. Infection was cleared from most tissues with the passage of time; spirochetes were recovered from 63% of tissues removed from guinea pigs at < or = 4 weeks after inoculation but from only 32% at > or = 8 weeks postinoculation (P < 0.001). An exception was the failure to clear spirochetes from infected knees, 90% of which were culture positive even when evaluated at > or = 8 weeks postinoculation. The guinea pig provides a new model useful for studying host-spirochete interactions in Lyme disease.

Animals↗
PubMed1993

Disseminated malignant histiocytosis in a golden retriever: clinicopathologic, ultrastructural, and immunohistochemical findings.

Diagnosis of malignant histiocytosis (MH), a disorder characterized by systemic proliferation of morphologically atypical histiocytes and their precursors, in an 8-year-old neutered female Golden Retriever was based on light and electron microscopic and immunohistochemical findings. Clinically, the dog presented with unilateral forelimb lameness. Eight days after surgical exploration of a swollen brachium, the dog developed sudden onset of posterior paresis, fecal and urinary incontinence, and a flaccid tail. Necropsy revealed infiltrative and nodular lesions in the right forelimb and regional lymph nodes, thoracic and abdominal cavities, and lumbar epidural space. Gross lesions were not found in the lungs or integument. Histopathologic examination showed infiltrates of atypical histiocytes in skeletal muscle, joint, and regional lymph nodes of the right forelimb; intercostal muscle; lung; liver; spleen; pancreas; kidneys; and spinal dura. Most tumor infiltrates were nodular and composed of loosely aggregated cells that were 10-30 microns in diameter with abundant eosinophilic to foamy cytoplasm, had central or eccentric nuclei, and were periodic acid-Schiff negative. Many binucleated cells, multinucleated giant cells, and mitotic figures were seen. Tumor cells contained phagocytosed erythrocytes, mononuclear cells, and some leukocytes. Ultrastructural features of tumor cells included cytoplasmic lipid droplets, lysosomes, and phagolysosomes. Immunohistochemical studies on paraffin-embedded sections showed positive reactivity to human T-cell Ag (clone UCHL-1) and for lysozyme, alpha-1-antitrypsin, and cathespin B. Polyclonal intracellular immunoglobulin reactivity and lectin binding (peanut, soybean, and wheat germ agglutinins and concanavalin A) were also demonstrated. Criteria for diagnosis of malignant histiocytic tumors and differential diagnosis are discussed.

Animals↗
PubMed1993

Tumor necrosis factor induces enzymatic changes in liver comparable to those in extrahepatic cancer.

Human recombinant tumor necrosis factor was administered to rats in small doses to determine whether it causes changes in the activity of liver enzymes similar to those observed in cancer growing extrahepatically. Intraperitoneal injection of increasing doses of tumor necrosis factor (20-100 micrograms/kg/day for 5 days) resulted in a 20-50% decrease in hepatic alanine aminotransferase (P < or = 0.05), a 10-20% decrease in aspartate aminotransferase (P < or = 0.04), and a 50-200% increase in alkaline phosphatase (P < or = 0.02). The activity of hepatic 5'-nucleotidase was unchanged. In the serum, there was no significant change in the activity of any of the enzymes. Histologically, there was no damage detectable by light or electron microscopic examination of the liver, and no evidence of biliary obstruction. However, in frozen liver sections stained histochemically for alkaline phosphatase, there was a dramatic increase in the activity of this enzyme in hepatocytes, which was confined to the bile canaliculi. There was also a 3- to 9-fold increase in the mitotic activity of hepatocytes. Comparable changes have been reported in the tumor-free liver of animals with cancer.

5'-Nucleotidase↗
PubMed1993

Investigation of a fatality from nonoccupational aluminum phosphide exposure: measurement of aluminum in tissue and body fluids as a marker of exposure.

This case study reports our clinical and laboratory investigation of the accidental death of a pregnant rural woman related to phosphine exposure from stored grain fumigated with aluminum phosphide (AIP3) pellets. Environmental data (housing proximity to fumigated grain and meteorologic conditions at the time) coupled with clinical data (tachycardia and the rapid development of pulmonary edema with no antecedent clinical abnormalities) suggested possible toxicant effects. Gross and microscopic autopsy findings demonstrated pulmonary edema. Because phosphine generated from the phosphide is highly reactive and unstable, our laboratory strategy for this investigation focused on the quantitative analysis of aluminum (AI) in blood, gastric contents, and in lung tissue to test the possibility of fumigant intoxication. We recovered 713 ng/ml Al from blood (normal laboratory range 2 to 42 ng/ml). Laser mass spectral analysis of lung tissue demonstrated high concentrations of Al in alveolar macrophages (> 200 ppm) with little or no Al in adjacent lung tissue. Control lung tissue from an urban autopsy case matched by age, sex, and smoking habits showed no demonstrable Al. We conclude that Al may be a useful marker for AIP3 exposure.

Adult↗
PubMed1992

Transurethral resection of prostate immediately after renal transplantation.

The subject of transurethral resection of the prostate (TURP) after renal transplantation has not been evaluated in the urologic literature. We retrospectively compared the outcome of renal transplantation in 8 patients who underwent transurethral resection of the prostate within ten days of renal transplantation with 8 patients who did not undergo prostate surgery. Patients were computer-matched for seven parameters. There was no statistically significant difference in patient survival (6 vs 7) and graft survival (56% vs 88%) between the two groups. However, there was a 25 percent incidence of major perioperative complications (including one mortality) in the TURP group directly attributable to the procedure. Transurethral resection of the prostate can be safely performed immediately after renal transplantation only if urine is sterile, antibiotics and steroids are carefully administered perioperatively, low-gravity irrigation is used, and hemostasis is meticulous.

Aged↗