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M Lykourinas

Publications and source records attributed to M Lykourinas.

14 recordsLinked to original sources
PubMed2004

The presence of microscopic hematuria detected by urine dipstick test in the evaluation of patients with renal colic.

Urolithiasis is a common diagnosis in patients presenting at our hospital with flank pain. One of the most important steps in the diagnostic algorithm of renal colic is the presence of hematuria, but this fact has been challenged by authors reporting a negative urinalysis for microscopic hematuria in about 9-18% of such patients. Our aim was to investigate whether the same results are obtained when a sample of urine is tested with a urine dipstick test (UDT) at the time of the initial examination. Data from patients with the clinical diagnosis of renal colic examined at the emergency department of our hospital were reviewed, and the sensitivity of hematuria in urine samples tested by UDT was recorded in a group consisting of patients for whom imaging showed evidence of a stone >3 mm in size. In cases in which UDT was negative, or showed only traces of red blood cells (RBCs), a formal urinalysis was performed. A total of 609 patients were finally included in the study, with a mean age of 49.2 years. Average stone size was 5.8 mm, located mainly in the lower part of the ureter. Dipstick analysis was positive for hematuria in 92.9%. A urinalysis, with a cut-off point of less than three red blood cells per high power field, was used as a means to verify the results of the UDT in 17.8% of cases: in 7.1% of UDT negative patients and 10.7% of patients with traces of blood. The urinalysis was negative in 5.1% of patients, adding only 2% to the diagnostic accuracy of UDT. Therefore, our findings suggest that the sensitivity of a UDT for hematuria in cases of suspected renal colic has a high degree of accuracy when performed at the emergency department, and can be used as a first-line, low cost examination. A microscopic analysis may be useful when the UDT is negative or not clear enough, to verify the results.

Adult↗
PubMed2003

Detection of human telomerase reverse transcriptase mRNA in urine of patients with bladder cancer: evaluation of an emerging tumor marker.

OBJECTIVES: To assess the value of the telomerase enzyme as a bladder cancer detection marker, we investigated the expression of the catalytic subunit of the complex (human telomerase reverse transcriptase [hTERT]) in the urine of patients with malignant or benign urinary lesions, as well as of healthy individuals, and compared the results with urine cytology. METHODS: Spontaneously voided samples were obtained from two groups of subjects: group 1, 146 previously untreated patients with a histologic diagnosis of transitional cell carcinoma or other urothelial neoplasm; and group 2, 128 control individuals, either healthy or with a nonmalignant bladder disease. Total RNA extracts from sedimented urothelial cells were analyzed by a reverse transcriptase-polymerase chain reaction assay for the presence of a 146-bp hTERT transcript. Urine samples were also examined by standard cytology. RESULTS: Expression of hTERT was detected in 134 (92%) of 146 patients with bladder cancer, and only 64 (44%) yielded a positive result by cytology (P <0.001). The sensitivity advantage of the former technique became particularly evident in the detection of low-grade transitional cell carcinoma (93% versus 28%, P <0.001). Accordingly, the negative predictive value of the molecular assay was markedly greater than the one calculated for cytologic screening (91% versus 60%). On the other hand, both methods were at least 96% specific, with their positive predictive indexes exceeding 94%. CONCLUSIONS: Our findings suggest that the assessment of hTERT expression in urine sediments represents a reliable tool for the detection of primary urothelial neoplasms, equally specific, yet far more sensitive, than conventional cytology.

Adenocarcinoma↗
PubMed2002

Multicentricity in renal cell carcinoma: can primary tumor location serve as a co-determinant of surgical treatment?

OBJECTIVE: To assess the incidence of multicentricity in our series of renal cell carcinoma (RCC) patients and to investigate whether certain clinicopathological parameters could assist the selection of the appropriate surgical modality. METHODS: We performed a retrospective analysis of 235 RCC specimens that had been resected by radical nephrectomy at our institution from June 1995 to 2001. RESULTS: Twenty-six (11%) kidneys contained at least one small accompanying nodule. Fourteen (6%) kidneys exhibited satellite tumors that were histologically consistent with the adenomas, while "true" multicentricity was detected in 12 (5%) specimens. In the latter, the number of concomitant foci was independent of the size of the primary tumor. No correlation was observed between histological pattern and multifocality. In five out of seven (71%) specimens that contained the main tumor mass within the upper or middle portion of the kidney, satellite lesions were found to be located at the mid-kidney, whereas specimens with lower-pole RCC demonstrated no restriction in the distribution of accompanying nodules. All patients had been screened pre-operatively by ultrasonography and CT scanning. CONCLUSIONS: Our findings may be suggestive of a putative link between primary tumor location and multicentricity, although this relation could not be statistically confirmed. The 5% incidence of multicentricity renders the biological significance of satellite adenomas and/or adenocarcinomas unclear.

Carcinoma, Renal Cell↗
PubMed2001

Laparoscopic versus open ureterolithotomy. A comparative study.

OBJECTIVE: The aim of this study is to compare the transperitoneal laparoscopic ureterolithotomy versus conventional open surgery in cases of ureteric stones which failed to be treated endoscopically. MATERIALS AND METHODS: In this study, the clinical results of 18 transperitoneal laparoscopic ureterolithotomies (TLU) are compared with 18 open ureterolithotomies (OU) for impacted or large stones of the upper and middle portion of the ureter that were unable to be disintegrated with extracorporeal shock wave lithotripsy (SWL) or endoscopically. In the analysis of the clinical data are included the operative time and the post-operative morbidity, length of analgesia needed, hospital stay and convalescence period. RESULTS: All our laparoscopic procedures were accomplished successfully. The mean operation time was 130 min for TLU and 85 min for OU. Analgesic medication requirement per patient was 1 day for TLU and 4 days for OU while the postoperative hospital stay averaged 3 days for TLU and 8 days for OU and the time of convalescence was12 days for TLU and 22 days for OU. No patient required a blood transfusion and postoperative complications included urinary leak, subcutaneous hematoma, subcutaneous emphysema in the TLU group and wound cellulitis and urinary tact infections in the OU group. CONCLUSION: While most patients with ureteric calculi can be rendered stone-free with SWL and endourological procedures, open stone surgery continues to represent a reasonable alternative for a small segment of the urinary stone population. However, our results reveal distinct benefits of TLU when compared to OU and thus laparoscopy instead of open surgery should be preferred.

Adult↗
PubMed2000

The use of betamethasone and hyaluronidase injections in the treatment of Peyronie's disease.

OBJECTIVE: The aim of this study was to assess the effect of local injections of betamethasone, hyaluronidase and lidocaine in patients with Peyronie's disease. MATERIAL AND METHODS: A total of 112 men who had a palpable plaque at the penis and suffered from painful erection and bending of penis was treated with a total of 12 injections containing betamethasone, hyaluronidase and lidocaine. Patients were classified into groups according to the duration of the disease (<6 months, 6-12 months or >12 months) as well as the size of the plaque (<10 mm, 10-20 mm or >20 mm). Pretreatment evaluation of patients and assessment of outcome were based on subjective criteria as well as measurement of the size of the plaque by means of ultrasound. Results were correlated to patients' characteristics. RESULTS: The overall response rate was 86%. Cure or improvement was noticed in 31% and 55% of patients respectively. Most of the patients (83%) had a duration of disease less than 12 months. Painful erection, bending of penis and plaque were absent in 97%, 32% and 31% of patients, respectively, after treatment. No severe complications were observed. The effect of treatment was strongly related to the duration of disease and the size of the plaque. CONCLUSIONS: The method is safe, well tolerated by patients and characterized by a high response rate in patients with a history of less than 12 months and a plaque not exceeding 20 mm.

Adult↗
PubMed1999

MR urography in the diagnosis of urinary tract obstruction.

OBJECTIVE: To evaluate the efficiency of MR urography in depicting the urinary tract. METHODS: 33 patients with urinary tract abnormalities were additionally evaluated with MR urography. 25 had dilated upper urinary tracts because of urinary obstruction and 8 had normal tracts. MR urography was performed with a 1,5T magnet using a heavy T2w sequence (3D-IR-TSE) in the coronal plane. Images were post-processed using the MIP algorithm. Both reconstructed and source images were evaluated. The results of MR urography were compared with the final diagnosis, which was established surgically in 23 cases, and with multimodality imaging workup in 10 cases. RESULTS: MR urography correctly depicted the level of obstruction and the degree of dilatation of the urinary tract in all 25 patients with hydronephrotic kidneys (sensitivity 100%). Additionally, it succeeded in suggesting the underlying pathology in 25 cases (48%). Concerning the 8 patients without dilatation of the urinary tract, there was either no depiction or depiction was bad. CONCLUSION: MR urography, a new noninvasive technique, demonstrates 100% sensitivity in diagnosing urinary tract obstruction and also suggests the underlying pathology in many cases. In nondilated systems it is not possible to get good images because MR urography only depicts fluid in the urinary tract. Thus we believe that MR urography can provide a reliable alternative in selected cases as opposed to other more invasive modalities, such as retrograde or antegrade urography, and is without the risk of contrast media and radiation exposure.

Adult↗
PubMed1994

Immunotargeting of urothelial cell carcinoma with intravesically administered Tc-99m labeled HMFG1 monoclonal antibody.

Ten patients with transitional cell carcinoma (TCC) of the bladder received 3-6 mCi of HMFG1 monoclonal antibody (MAb) intravesically. The antibody was labeled with Tc-99m using the 2-Iminothiolane method. All patients underwent transurethral resection of the bladder tumor within 12-20 h following intravesical administration of 99m-Tc-HMFG1. The presence of the radiolabeled MAb in the circulation was studied by measuring the radioactivity in the serum for a period up to 20 h. Three of 10 patients underwent immunoscintigraphy (SPECT) 2-3 h postadministration and cancerous areas could be easily localized. Biopsies were taken from the tumor sites as well as from normal bladder mucosa. Absolute uptake of the administered MAb expressed as percent administered dose/kg of tissue could be evaluated only in eight patients. Multiple specimen taken from various tumor sites in every patient gave a wide range of uptake values ranging from 0 to 9.29% adm. dose/kg, whereas normal tissue uptake values ranged from 0 to 1.63, respectively.

Administration, Intravesical↗
PubMed1982

The role of acid and alkaline DNases as tumour markers in cancer of the genitourinary tract.

The levels of Acid and Alkaline DNases were measured in the serum of patients with: (a) Cancer of the Genitourinary Tract (confirmed by biopsy), (b) with inflammatory diseases and non-malignant tumours of the Genitourinary tract, (c) healthy blood donors. In the first group the results showed that the Acid DNase level was raised in 62% and Alkaline DNase in 43%. In the second group acid DNase was increased in 30% and Alkaline DNase in 13%. In the third group Acid and Alkaline DNase levels were normal. These results suggest that the measurement of Acid and Alkaline DNases could be considered as malignant diseases markers, in spite of false positive and false negative results in some cases.

Deoxyribonucleases↗
PubMedDate not supplied

Fine needle aspiration of the testis. Correlation between cytology and histology.

OBJECTIVE: To determine the diagnostic value, reliability, safety and patient discomfort of testicular fine needle aspiration (FNA) as a cytologic sampling technique. All cases were divided into three groups: group A (control group), 15 patients with normal testes undergoing orchiectomy for prostatic carcinoma treatment; group B, 17 cases who had presented with oligoazoospermia for evaluation of male infertility; group C, 20 cases who had presented mainly with scrotal swelling with or without pain. The patients' ages ranged between 22 and 83 years. Older patients entered group A. Younger patients entered group B. A wide range in age occurred in group C. STUDY DESIGN: Fine needle aspirates from 98 testes in 52 patients, 46 bilaterally punctured, were assessed. RESULTS: All fine needle results on group A and most on B and C were correlated with histologic results of biopsy specimens. In 88.5% of cases an excellent correlation was found between the results of the two methods, and the cytologic diagnosis was absolutely precise. The specificity and sensitivity of the method were 100% in this series. CONCLUSION: The procedure was well tolerated, reliable and simple, with no serious complications. Testicular FNA is a useful and safe investigative modality in the evaluation of testicular function and disease.

Adult↗