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Biomedical subjects

J Miskowiak

Publications and source records attributed to J Miskowiak.

At least 19 recordsLinked to original sources
PubMed1995

[Semirigid and flexible uretero-nephroscopy].

Thirty-seven ureteronephroscopies with the modern ureteroscope were attempted in 30 patients (median age of 60 years) because of radiographic filling defects, tumours, stenoses, stones, broken double "J" stent, unilateral haematuria and surveillance. Only one ureteronephroscopy (3%) could not be performed. The radiographic filling defects represented tumour (ten), stones (three) and a torn-off papilla (one). The ureteric stenoses could be classified as congenital (one), secondary to a vascular graft (1), tumour (1) or inflammation (two). In nine patients the stones were removed, and in four fragmented and the fragments passed during the next two to four weeks while treated with a stent. One ureteric tumour and two pelvis/calyx tumours were coagulated. One broken stent was removed, and one displaced nefrostomy catheter was caught in the calyx and pulled into the pelvis. There were three cases with transient fever, all in patients with infected nefrostomies. The modern ureteronephroscopy is a valuable method with only few complications.

Adult↗
PubMed1995

Expression and characterization of preproVIP derived peptides in the human male urogenital tract.

Expression of the gene sequence encoding vasoactive intestinal polypeptide (VIP) leads to the synthesis of a 170 amino acid precursor molecule which can be processed to five fragments: preproVIP 22-79, peptide histidine methionine (PHM), or peptide histidine valine (PHV), preproVIP 111-122, VIP and preproVIP 156-170. Using region specific radioimmunoassays and antisera against the functional domains of the VIP precursor in combination with immunocytochemistry and chromatography, the localization, distribution and identity of the preproVIP derived peptides within the human male urogenital tract were investigated. Postmortem as well as fresh tissue specimens were used. All the preproVIP derived peptides were expressed and could be demonstrated in nerve fibres throughout the urogenital tract in close relation to the epithelial lining and in vascular as well as non-vascular smooth muscle. The VIP-related peptide containing fibres were most abundant in the prostate parenchyma and the seminal vesicle. Using double immunostaining, co-localization of the various preproVIP derived peptides could be evidenced. The fact that all preproVIP derived peptides are present in the urogenital tract, should be taken into consideration when the regulatory aspects of neuropeptides in physiological and pathophysiological functions are discussed.

Adult↗
PubMed1995

Results of radiotherapy on ureteric obstruction in muscle-invasive bladder cancer.

OBJECTIVE: To evaluate the effect of radiotherapy on ureteric obstruction due to muscle-invasive bladder cancer. PATIENTS AND METHODS: Retrospective evaluation of the records of 574 patients with muscle-invasive bladder cancer revealed 90 patients (16%) with ureteric obstruction; the obstruction was bilateral in 24%. The effect of radiotherapy was assessed in 55 patients with 68 obstructed kidneys. Six patients with eight obstructed kidneys required percutaneous nephrostomy or ureteric catheters in addition to radiotherapy. RESULTS: Drainage improved in 20% of kidneys and the diverting catheter was withdrawn permanently in one (17%) of the diverted patients. The median survival was 11 months. Irradiation was followed by significant complications in 37 patients (67%). CONCLUSION: The results of this study raise doubts about the assumed beneficial effect of irradiation on ureteric obstruction due to muscle-invasive bladder cancer. The short median survival of 11 months confirms that ureteric obstruction is a poor prognostic factor in muscle-invasive bladder cancer.

Adenocarcinoma↗
PubMed1992

[Treatment of superficial bladder tumors with intravesical BCG].

Thirty three patients with carcinoma in situ (CIS) or/and numerous recurrences of superficial bladder tumor were treated with intravesical BCG after transurethral resection. 63% of patients with CIS were free of recurrence after two years, two underwent cystectomy and one died because of progression. Patients with Ta and concomitant CIS responded well to BCG, while the patient with T1 tumor and CIS was free from recurrence for 15 months. Dysplasia of grade II disappeared after BCG. 62% of patients with Ta tumor were without recurrence after one year, but after two years 86% of the patients had recurrences. Patients with T1 tumor were free from recurrence for eight months, after which 25% had progression. The side effects of BCG were transient: urinary frequency in 48%, malaise in 39%, dysuria in 36%, haematuria, bladder pain and fever in 24%. 15% of the patients required isoniazid treatment. It is concluded that intravesical BCG is beneficial in CIS and superficial bladder tumors.

Administration, Intravesical↗
PubMed1992

Local anesthesia for extracorporeal shock wave lithotripsy: a study comparing eutetic mixture of local anesthetics cream and lidocaine infiltration.

A study of the anesthetic efficacy of a eutetic mixture of local anesthetics (EMLA cream) versus lidocaine infiltration in extracorporeal shock wave lithotripsy (ESWL) was done. A total of 46 patients had 30 gm. of EMLA cream applied to the skin over the kidney and 45 had subcutaneous infiltration anesthesia with 20 ml. 1% lidocaine with epinephrine. All patients received an intravenous dose of morphine just before ESWL. The patients were comparable with regard to age, sex, weight, morphine dosage, number of shock waves given and duration of treatment. Median pain score and the amount of supplementary analgesics were not significantly different between the 2 groups. There were no significant differences between the groups with regard to post-ESWL skin changes. Therefore, EMLA cream can be recommended for ESWL provided it is applied correctly.

Adolescent↗
PubMed1992

Topical anesthesia with eutetic mixture of local anesthetics cream in vasectomy: 2 randomized trials.

Two paired randomized trials testing topical anesthesia with a eutetic mixture of local anesthetics (EMLA cream*) in vasectomy were performed. In 1 trial EMLA cream was applied on 1 side of the scrotum, while infiltration anesthesia into the skin and subcutaneous tissue with mepivacaine was used on the contralateral side. All but 1 of the 13 patients (p less than 0.05) preferred infiltration anesthesia because of pain as the incision reached the subcutaneous tissue. In the other trial 29 patients received EMLA cream on 1 side of the scrotum before bilateral mepivacaine infiltration. There was significantly less pain on the sides with the anesthetic cream (p less than 0.001). Many patients would pay the price of the cream. In conclusion, EMLA cream cannot replace but it can supplement infiltration anesthesia during vasectomy.

Adult↗
PubMed1991

Ultrasonic diagnosis and transurethral incision of ureterocele with hydronephrosis.

In a 65-year-old woman with right-sided loin pain, ultrasonography revealed a grossly dilated and obstructed right pyelogram due to a 50-mm ureterocele. After transurethral lateral incision of the ureterocele, there was complete recovery without vesicoureteric reflux. Ultrasonography is advantageous in diagnosing acute urinary-tract obstruction, and transurethral incision is useful in the acute treatment of ureterocele.

Aged↗
PubMed1991

Continuous intestinal dialysis for uraemia by intermittent oral intake of non-absorbable solutions. An experimental study.

A new approach to intestinal dialysis was investigated in a normal person and in a patient with chronic uraemia and a renal creatinine clearance of 10 ml/min. Both subjects drank 1-1.5 l non-absorbable solutions of polyethylene glycol or mannitol every fourth hour. The solutions stayed in the intestines for about four hours in the normal person and for 1.5 to 3 hours in the patient. The patient's intestinal clearances were 6-10.4 ml/min for creatinine, 4 ml/min for uric acid and 10.7-15.4 ml/min for phosphate, which compares favourably to those from 12 hours weekly haemodialysis. Continuous intestinal dialysis was well tolerated and the results indicate that this might be a useful way of treating uraemia if conventional methods are unavailable.

Administration, Oral↗
PubMed1990

[Urethral stricture].

The incidence of urethral stricture has increased since the introduction of gonorrhoea to Europe in the 15th century. Nowadays, transurethral instrumentations and catheterisations are responsible for the majority of the urethral strictures. The mechanism is inflammatory or traumatic lesion of the urethral epithelium causing extravasation of urine and fibrosis. The symptoms often suggest to infravesical obstruction. The diagnosis is made from the patient's history in combination with flowmetry, ante- and/or retrograde urethrography, external ultrasound examination or urethral calibration and is verified at urethroscopy. Dilatation is relatively simple but seldom curative and carries a considerable morbidity. Urethrotomy is very common but also hampered with a high rate of recurrence. A technique where urethrotomy is followed by intermittent self-catheterisation or implantation of a selfexpanding wire netting seems promising but needs further investigation. Reconstructive operations in form of a free or pedicled skin island patch, skin tube graft, endourethral free split skin graft, multistaged urethroplasty, meatoplasty and excision of prostatomebraneous stricture are followed by cure in 50-95% of the cases.

Humans↗
PubMed1990

Long-term results of carbon dioxide laser treatment of meatal condylomata acuminata.

A group of 74 men who underwent carbon dioxide laser treatment of meatal condylomata were observed for an average of 18 months. The cure rate after 1 treatment of isolated meatal lesions was 78%; the presence of external lesions lowered the rate to 32% and additional external and urethral warts to 25%. Following multiple treatments all but 6 patients were cured; 83% of the recurrences developed within 3 months. One urethral and 6 meatal strictures occurred more than 3 months after treatment; 9 patients had a spraying stream many years after treatment and 2 complained of frequency.

Adult↗
PubMed1989

[Esophageal varices: physiopathology and treatment. The role of the lower esophageal sphincter].

Development of esophageal varices depends on local esophageal factors and portal gradient, vascular resistance in the azygos vein or presence of other portosystemic collaterals. Esophageal varices are found in the lamina propria of lower esophageal sphincter (LES), the pressure of which exceeds the normal portal pressure. Factors reducing LES pressure promote development of varices and enlarge these. Contraction of LES leads to reduction of the variceal and azygos flows, decrease in the pressure gradient across the varix wall and diminishes the varices. Pharmacological contraction of LES arrests the endoscopically proved bleeding from esophageal varices. Manipulation of LES pressure appears to be a genuine alternative to the current methods of treatment of the bleeding esophageal varices.

Esophageal and Gastric Varices↗
PubMed1988

Treatment of hydrocele testis by injection of tetracycline.

In a prospective study 27 hydroceles were treated with single aspiration and injection of 500 mg tetracycline. The median observation period was 6 months (range 3-15 months). One month after therapy 9 recurrences were observed; but 5 disappeared spontaneously during the next 2 months, giving an overall success rate of 85% (95% confidence limits 66-96%). No serious complications occurred. Dilution of tetracycline in lidocaine prevented acute scrotal pain. Sclerotherapy with tetracycline is efficient, easy and inexpensive and, therefore, economical and beneficial for the patient.

Adult↗