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Biomedical subjects

M Many

Publications and source records attributed to M Many.

At least 19 recordsLinked to original sources

Long-term results of simple and radical nephrectomy for renal cell carcinoma.

From 1974 to 1983, simple and radical nephrectomies were performed at the Chaim Sheba Medical Center (Tel Hashomer, Israel) for renal cell carcinoma. The authors reviewed 109 cases that were followed for a period ranging from 5 to 14 years. Simple nephrectomy was performed in 55 patients, and 54 patients underwent radical nephrectomy. The selection of the surgical procedure was based on the surgeon's preference and not on the basis of clinical stage, age, or sex. The surgical results and survival rates were assessed according to the pathologic stage of the tumors. Among patients with Stage I tumor, radical nephrectomy produced better survival rates at 5 and 10 years (P = 0.03); however, when the non-cancer deaths were excluded, the difference in survival was not statistically significant. For Stage I tumors the survival free of disease at 5 years was better for the radical nephrectomy group, but this difference was not statistically significant. No difference was noticed in the local recurrence rate between the two groups. Nephrectomy in patients with Stage IV disease did not alter survival regardless of the type of operation.

Aged

Leiomyosarcoma of the ureter.

Primary ureteral tumors occur relatively infrequently compared to tumors of the kidney and bladder. Smooth muscle tumors of the ureter are very rare and only 9 cases of leiomyosarcoma have been reported in the literature. The treatment of choice is total nephroureterectomy with en bloc excision of the tumor. Prognosis is unfavorable as indicated by the short survival of the reported cases.

Adult

Vesicoureteral reflux in adults: a review of 95 patients.

Ninety-five adult patients with primary vesicoureteral reflux were reviewed concerning the presenting symptoms, radiological findings, associated renal damage, treatment and results of follow-up. We found a relatively high incidence of reflux in adult males. Although urinary tract infection and flank pain were the most common presentation, others had a wide variety of complaints not directly attributable to reflux. Renal anomalies were present in 37 patients. We found surgical correction of reflux useful in preventing infection, and recommend it especially in young women who may become pregnant.

Adolescent

Treatment of patients with transitional cell carcinoma of the urinary bladder with intravesical poly I: poly C effects on natural killer function.

Considerable interest has been focused on the use of interferon (IFN) and IFN-inducers as antineoplastic agents in humans. The current report will focus on the effect of intravesical administration of Poly I: Poly C on NK activity in patients with TCC of the urinary bladder. NK cytotoxicity was measured in 14 patients with primary TCC, 8 patients received Poly I: Poly C and 5 other patients received intravesical thiotepa. Blood samples were obtained prior to and 48 h following each drug treatment. A variation in the initial NK level determined prior to treatment was observed in the different TCC patients: 5 patients treated with Poly I: Poly C and 5 patients treated with thiotepa exhibited low NK activity prior to treatment, whereas the other 3 patients who were treated with Poly I: Poly C had high initial NK levels. Following drug treatment it was shown that a significant elevation in the NK cytotoxicity was only observed in patients treated by intravesical Poly I: Poly C who had low NK activity prior to treatment. No such effect was observed in patients treated with thiotepa or in patients treated with Poly I: Poly C who exhibited a high NK activity prior to treatment.

Adult

Ureterocutaneous fistulas secondary to urinary calculous disease.

Fistulas of the ureter are uncommon and are usually secondary to trauma or iatrogenic in nature. Spontaneous rupture of the ureter is rare, usually ending in a periureteral abscess. Two cases of spontaneous rupture of the ureter secondary to calculous disease resulting in ureterocutaneous fistulas are described.

Aged

Primary chondrosarcoma of the kidney.

Primary chondrosarcoma of the extraskeletal soft tissue is rare, usually occurring in the upper and lower extremities. We report the first case of this neoplasm arising in the kidney.

Chondrosarcoma

Examination of the urinary potential of hyperuricosuric patients to retard calcium oxalate precipitation.

In the present study it has been found that hyperuricosuric calcium oxalate (CaOx) stone formers do not differ from idiopathic CaOx stone formers in their urines' potential to retard in vitro precipitation of CaOx. On the other hand, urines of hyperuricosuric patients with no history of CaOx stone formation have the same potential to inhibit CaOx precipitation as those of normal controls. Reduction of urinary uric acid concentrations by either incubation of specimens with sodium urate or by treatment of hyperuricosuric patients with allopurinol had no effect on the urines' potential to retard CaOx precipitation.

Allopurinol

Change in inhibitory potential in urine of hyperuricosuric calcium oxalate stone formers effected by allopurinol and orthophosphates.

Allopurinol and orthophosphates were used in the treatment of 25 hyperuricosuric calcium oxalate stone formers. Their urines were tested by the Discriminating Index method, which measures the potential of a urine to retard calcium oxalate precipitation in vitro. The tests were performed before any treatment was begun and about 10 days after the commencement of drug intake. An insignificant effect by allopurinol and a markedly significant effect of orthophosphates on Discriminating Index were found. In a few of the patients, allopurinol seemed to cause a decrease in the urine's potential to retard calcium oxalate precipitation. Therefore the effect of allopurinol in 11 hyperuricosuric patients with no history of calcium oxalate stone formation was tested. In 5 of the 11 patients, the urine's potential to retard calcium oxalate precipitation decreased to levels similar to those of calcium oxalate stone formers. The results of this study suggest that hyperuricosuric calcium oxalate stone formers suffer from the same yet-undefined etiology of stone formation as other calcium oxalate stone formers. The results also question the role of uric acid in calcium oxalate stone formation and the efficacy of allopurinol in preventing this disease. It is suggested that allopurinol may even be related to stone formation in some patients.

Allopurinol

Solcoderm in the treatment of genital and perianal condylomata acuminata.

Solcoderm, a new topical agent, was used in the treatment of genital and anal cutaneous condylomata in 11 patients. This is a relatively inexpensive form of treatment, which may be used in any office practice setting with no need for anesthesia and very few side effects. The success rate of 100% warrants its further use in the treatment of this disease entity.

Acetates

HLA-A and HLA-B antigens in transitional cell carcinoma of the bladder.

A possible association between HLA-A and HLA-B loci alleles and bladder carcinoma has been investigated in 44 patients with biopsy proved transitional cell carcinoma of the bladder. The patients were compared to 400 healthy controls and matched for ethnic origin. Typing was done by the standard National Institutes of Health microlymphocytotoxicity technique. Comparison between the HLA-A and HLA-B series of the patients and the controls, and the different stages of disease did not yield any significant difference.

Carcinoma, Transitional Cell

Familial renal hypouricaemia: two additional cases with uric acid lithiasis.

Two families are reported affected with hereditary renal hypouricaemia associated with uric acid lithiasis. The propositi of both families were found also to have hyperabsorptive hypercalciuria. Based on the study of the effect of pyrazinamide and probenecid on uric acid excretion in both propositi, it is suggested that the defect in uric acid reabsorption is most probably at the pre-secretory site.

Adult

Anuria in childhood due to bilateral urolithiasis. A report of four cases.

Four children with anuria due to occlusion of both ureters by calculi are presented. A plain film of the abdomen revealed faintly radiopaque urinary calculi bilaterally in three patients. In the fourth case, one calculus was visualized in the right ureter, but further contralateral exploration showed an obstructing ureteral calculus in the left ureter as well. It is concluded that in children with acute anuria, the possibility of bilateral ureteral obstruction due to calculi should be the physician's first consideration.

Acute Disease

Factor XI deficiency: detection and management during urological surgery.

Hereditary factor XI deficiency may remain undiagnosed until severe bleeding is observed after an operation or trauma. Two such cases were encountered and, therefore, a regular screening test for coagulation disorders among urological patients was initiated. During 2 years (1975 and 1976) 10 additional cases of factor XI deficiency were detected: 5 severe and 5 partial. All patients were Ashkenazic Jews of Eastern European origin. The 5 patients with severe factor XI deficiency underwent an operation without any complications. They were transfused with 5 to 20 ml./kg./day of fresh frozen plasma from the day before the operation until 10 to 14 days postoperatively. Of the 5 patients with partial XI deficiency 4 underwent an operation. In 1 of 3 patients who did not receive transfusions postoperative bleeding was observed. A minimal level of 0.3 U./ml. (30 per cent) factor XI was found necessary to ensure good hemostasis during and after an operation. In view of a recent finding of relatively high gene frequency of factor XI deficiency in Ashkenazic Jews it seems warranted to do a partial thromboplastin time in such patients who need an operation.

Adult

The metabolic effects of excess noradrenaline secretion from a pheochromocytoma.

We report a 14-year-old boy with severe hypertension who was cured by surgical removal of a pheochromocytoma. The tumor was shown biochemically and morphologically to secrete predominantly noradrenaline. The metabolic effects noted in this patient were raised free fatty acid levels and depressed insulin levels, hyperreninemia, hypercalcemia, and hypercalciuria with normal parathyroid function. All these abnormalities returned to normal after removal of the tumor. It is suggested that these effects were mediated via beta-adrenergic stimulation of the excess noradrenaline.

Adolescent

A unique combination of congenital genitourinary anomalies in a child.

A case of solitary crossed renal ectopia with concomitant, severe vesicoureteral reflux and a rudimentary ipsilateral ectopic ureter draining into the vas deferens is presented. In addition to these anomalies the patient had complete urethral duplication and right cryptorchidism, as well as right congenital dislocation of the hip. To our knowledge this is the first such case to be documented in the medical literature.

Abnormalities, Multiple