A national imperative.
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Centers for Medicare and Medicaid Services, U.S.↗
Biomedical subjects
M Augusti
Publications and source records attributed to M Augusti.
Renal cell carcinoma: recent progress.
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Animals↗
Interleukin-6 and TNF alpha production in human renal cell carcinoma.
Several clinical and biological features suggest that cytokines implicated in the inflammatory response are produced by renal cell carcinoma (RCC). To define if alterations of tumor necrosis factor alpha (TNF alpha), interleukin 1 alpha (IL-1 alpha), IL-1 beta and IL-6 gene expression are present in this malignancy, samples from 19 tumors as well as samples from seven paired normal renal tissue were examined using Northern blot and immunohistochemical analysis. In addition, the expression of these cytokines was evaluated in seven RCC-derived cell cultures using Northern blot or RT-PCR. TNF alpha and IL-6 proteins were measured in culture supernatants using specific bio- and immunoassays. Consistent levels of IL-6 mRNA were detected in 17 of the 19 tested tumors whereas TNF alpha specific transcripts were present in seven of eight available RNA samples. TNF alpha and IL-6 mRNA were also detected in five of the seven paired normal kidneys. By immunolabeling, IL-6 antigen was not detected in RCC cells in any of the 19 studied samples. In contrast, using anti-TNF alpha antibody a strong labeling of stromal endothelia and macrophage cells was detected in all the 19 cases, and evident TNF alpha staining of the carcinoma cells themselves was observed in eight cases. Spontaneous IL-6 mRNA expression was detected in five RCC cell cultures and TNF alpha mRNA in four. The cultured cells exhibited positive TNF alpha immunolabeling in six of seven cases but were always IL-6 negative. Bioactive IL-6 was detected in all culture supernatants while bioactive TNF alpha was not detected.(ABSTRACT TRUNCATED AT 250 WORDS)
Carcinoma, Renal Cell↗
Prostatic epithelial polyp of the urethra.
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Adult↗
[A silica urinary calculus secondary to the absorption of gelopectose in a child].
The authors report a case of silica-containing urinary stones in a child. This drug-induced urinary stone was secondary to absorption of Gelopectose and its composition was confirmed by infrared spectrophotometry. Other cases have been diagnosed but have not yet been published. Patients with such urinary stones should be investigated for possible hypercalciuria or a disorder of H+ metabolism in the context of distal tubular acidosis, which may be incomplete and/or transient.
Feeding Behavior↗
[Renal Doppler ultrasonography in the diagnosis of acute obstructions of the upper urinary tract].
A comparative study of the resistivity indices (RI) obtained in both kidneys has been carried out in 30 controls and 60 patients with suspected unilateral acute obstruction of the upper urinary tract. Doppler findings (difference in the mean RI of both kidneys, delta RI) in the pathologic population have been systematically correlated to the data yielded by intravenous pyelography (IVP). In the control population delta RI was always < or = 0.03 (mean delta RI = 0.01, SD = 0.01). Considering that an increase in delta RI > or = 0.05 (> mean RI + 3 SD) is significant, 93% sensitivity and 100% specificity are obtained for the diagnosis of unilateral acute obstruction. Comparison of the resistivity indices of both kidneys is more specific and more sensitive than the assessment of the index on the obstructed side only; it improves the performance of ultrasonography in the initial diagnosis of acute urinary tract obstruction.
Acute Kidney Injury↗
Extracorporeal lithotripsy of ureteric calculi using the Dornier HM-3 lithotriptor.
Over a 5-year period (November 1984-November 1989), we treated 356 patients with ureteric calculi; 170 were treated by extracorporeal shock wave lithotripsy (ESWL) on a Dornier HM-3 lithotriptor. The calculi (n = 176) were uniformly distributed along the length of the ureter: 44 were just below the pelviureteric junction, 59 were lumbo-iliac, 42 were in the upper bony pelvis and 32 in the lower bony pelvis. The mean diameter of the upper ureteric calculi was 10 mm and for the others it was 8 mm. Thirty-four patients with acute obstructive pyelonephritis required pre-ESWL drainage of the urine. X-ray localisation required intravenous urography during lithotripsy in 52 cases (30%). On plain X-ray the following day 170 stones (96%) were judged to have disintegrated. The 6 patients whose stones were not fragmented received further treatment (ureterotomy (4) and ureteroscopy (2)). Five patients required additional treatment because of pain or fever (catheterisation (3) and ureterotomy (2)) and 2 patients had a second lithotripsy owing to insufficient fragmentation. Four patients were lost to follow-up. In 153 patients (90%) the fragments were eliminated completely, 146 in the first month and the remainder before the sixth month. No serious sequelae were observed. In addition to the 5 patients who required supplementary treatment. 11 patients with pain or fever needed medical treatment. We recommend first intention in situ ESWL for all ureteric calculi.
Adolescent↗
[Epididymitis disclosing an idiopathic urethroseminal reflux in children].
Idiopathic urethroseminal reflux is exceptional in children. In both of our cases, it presented in the form of epididymitis and was confirmed by suprapubic cystography, which also eliminated an obstructive cause and any associated malformations. Long-term antiseptic treatment prevented recurrent infections.
Child↗
[Extracorporeal lithotripsy of ureteral calculi using the Dormier HM3 device. A series of 176 calculi].
In a series gathered over 5 years (November 1984 to November 1989), we have treated 356 patients with ureteral lithiasis. Out of these, 170 (134 men and 36 women) were treated with extracorporeal shock-wave lithotrity with a Dornier HM3 system, in situ and as a first intention. The calculi (176 stones) were regularly distributed along the ureter: their location was subpyelic in 44 cases, lumboiliac in 59, upper pelvic in 42 and lower pelvic in 32. The average diameter of the calculi was 10 mm for subpyelic stones and 8 mm for the others. A preliminary urine drainage was required for 24 calculi causing acute obstructive pyelonephritis (32 ureteral drains surrounding the stone, and 2 percutaneous nephrostomies). Radioscopic localization required intravenous pyelography during lithotrity in 52 cases (30%). On radiographs without preparation taken the next day, 170 stones were regarded as fragmented (96%). After some time the 6 patients whose calculus had not been fragmented underwent another treatment (4 ureterotomies and 2 ureteroscopies). Five patients had an additional treatment because of a painful and/or febrile episode (3 drain insertions and 2 ureterotomies) and 2 patients required a second session of lithotrity because fragmentation was not sufficient; 4 patients were lost to follow-up. A total of 153 patients (90%) got rid of their fragments, 146 during the first months and the remaining 7 before the sixth month. No severe complication was noted. Besides the 5 patients who had required additional treatment, 11 patients suffering from pain and/or fever had a medical treatment. These treatments lead us to proposing first-intention "in situ" extracorporeal shock wave lithotrity for all ureteral lithiases requiring a treatment.
Adolescent↗
Protective effect of oestrogen in pancreatic cancer.
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Adenocarcinoma↗
[Ectopic opening of the ureter in the urethra in adult women. Radiological diagnosis apropos of 17 sites].
PURPOSE: To study diagnostic problems encountered by physicians and radiologists in adult females with ureteral ectopia into the urethra. CASE MATERIAL AND METHODS: Retrospective study of 17 localizations in 16 women, 15 to 65 years of age at the time of the definitive diagnosis of duplication of the ipsilateral urinary tract, the ectopia being connected to the upper pelvicalyceal system. RESULTS: Radiological confirmation of the diagnosis had been obtained in 14 cases. The ectopic ureter was thin in 11 cases. In 5 of 6 cases with megaureter, the distension involved only the distal intrapelvic part of the ureter. The ectopic meatus was juxta-cervical in 5 cases, much lower in the other cases. Of the 11 cases investigated by intravenous urography, 8 exhibited severe monocalyceal hydronephrosis of the upper pelvis whereas 6 upper pelvicalyceal systems were dysplastic. The lower pelvicalyceal system was congenitally normal in all cases. CONCLUSION: Most of the false negative diagnoses of intra-urethral ectopic ureter in adult female result from technically inadequate permicturating urethrocystography. The diagnosis should be evoked, especially in women with recurrent cystitis, on the urographic association of: duplication of the upper urinary tract, dysplastic or chronically distended atrophied upper pelvicalyceal system, pseudo-normal architecture of the lower pelvicalyceal system because of the unusually developed "upper" calyx.
Adolescent↗
[Sarcomatoid cancer of the kidney in the adult. 7 case reports].
Based on a retrospective series of 7 patients (6 men and 1 woman) with a mean age of 56.5 years, the authors describe the clinical, radiological and pathological features and the clinical course of sarcomatoid renal cancers in adults. They stress the severity of this type of tumour, due to the fact that the lesion is usually very advanced at the time of diagnosis (3 cases of Robson's stage III tumours and 4 stage IV tumours). Radiological assessment frequently reveals calcifications within the mass (4 out of 7 patients). Surgical excision is sometimes impossible and, when it can be performed, it has little influence on the prognosis or the survival.
Adenocarcinoma↗