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S Altarac

Publications and source records attributed to S Altarac.

18 recordsLinked to original sources
PubMed2001

Experimental and clinical study in the treatment of sigmoid volvulus.

The aim of the study was to introduce an alternative surgical procedure for the treatment of primary volvuius of the sigmoid colon. Sigmoid colon plication was performed in 42 dogs, and afterwards in six patients. The procedure consists of systematic plaiting the sigmoid colon wall with interrupted serosubmucosal 3/0 Vicryl sutures along the whole circumference, except on the mesenteric border. Five parallel circular folds were done in dogs, and 20-30 folds in patients, with appropriate bowel length reduction. In the experimental study, dogs were randomly divided into three experimental and one control group of 14 animals each. The group 1 dogs were sacrificed on day 8, group 2 dogs on day 15, and group 3 and control group dogs on day 30 postoperatively. On exploration, sigmold colon adhesions were found in 6 (14.3%) animals. Intestinal wall and lumen were normal. In the clinical study, six patients with sigmoid volvulus were operated on within 6-8 hours of admission. A viable colon was a prerequisite for the sigmoid plication procedure. The operating time was 60-90 minutes. Recovery was uneventful, with average hospitalization 11 (range 8-15) days. No volvulus recurrence was recorded during the three-year follow-up. Based on our experimental and clinical data, we believe that the plication procedure could be appropriate treatment in some selected patients with volvulus of the sigmold colon.

Adult↗
PubMed2001

Flail chest stabilization with palacos prosthesis.

The approach and management of patients with post-traumatic flail chest continue to be a controversial issue. A method of surgical stabilization of flail chest using palacos, a cement-like material is described. A ready-made prosthesis is placed on the external side of the ribs vertically bridging the flailed chest segment, and fixed to the first upper and first lower intact rib as well as to the mobile segments of the affected ribs. Surgical fixation was carried out in 56 patients. The results proved the method to be a simple and effective procedure.

Adolescent↗
PubMed1998

Obstruction score of ureteropelvic junction investigated by modified F-15 diuresis renography.

AIM: Introduction and assessment of an obstruction score in patients with obstructive uropathy, based on a diuresis renography time-activity curve. METHODS: Twenty-eight adults with unilateral pelviureteric junction obstruction were assessed by ultrasound scan, furosemide-enhanced intravenous urography and modified (F-15) 99mTc-DTPA diuresis renography. Renal unit drainage pattern was assessed by the obstruction score (sum of the time to peak, the index of excretion, and the tracer washout 40 min after furosemide administration). Renal units were classified as normal (0-3), equivocal (4-7) or obstructed (8-10). Renal function was determined by a split renal function and individual kidney glomerular filtration rate. The whole kidney minimum transit time was assessed as an interval on time scale between tracer input and output curve. RESULTS: After a 28-month mean follow-up, ultrasound findings were improved in 23 and unchanged in 5 patients. Regarding the response to furosemide, intravenous urography showed improvement in 19, no change in 8, and deterioration in 1 patient. The upper urinary tract on the affected side was obstructed in 26 and equivocal in 2 patients. Postpyeloplasty outcome was normal in 12 and equivocal in 16 cases. Overall drainage function was improved in 27 and unchanged in 1 patient. Parenchymal function was improved in 20, unchanged in 2, and deteriorated in 6 patients. Whole kidney minimum transit time was significantly reduced (5.55 +/- 1.56 to 4.41 +/- 0.83 min; p<0.001). CONCLUSION: The F-15 diuresis renography supplemented with the obstruction score system may be used for assessing the upper urinary tract urodynamics as initial diagnosis and in long-term follow-ups.

Adolescent↗
PubMed1997

Retroperitoneoscopic cutaneous ureterostomy.

A 56-year-old woman presented with bilateral ureteral stenosis and a vesicovaginal fistula secondary to advanced cervical carcinoma. Due to the long-standing obstruction she had a non-functioning right kidney. As a first step the function of the contralateral kidney was restored by percutaneous nephrostomy; two months later endoscopic cutaneous ureterostomy was performed using a four-port retroperitoneal approach. The ureter was mobilized, transected and pulled out through a 10-mm trocar in the mid-clavicular line. The total operative time was 165 min with an estimated intraoperative blood loss of less than 30 ml. Convalescence was short.

Female↗
PubMed1996

Laparoscopic and retroperitoneoscopic repair of ureteropelvic junction obstruction.

OBJECTIVES: The aim of this study was to evaluate laparoscopic and retroperitoneoscopic pyeloplasty and to compare the efficacy of dismembered and nondismembered techniques. METHODS: Since May 1993, a modified laparoscopic transperitoneal (14 patients) and a retroperitoneoscopic approach (3 patients) have been used for the management of ureteropelvic junction obstruction. In 7 patients aberrant vessels were encountered; 1 patient had a horseshoe kidney. Surgical repair was achieved by dismembered pyeloplasty (8 patients), nondismembered Fenger-plasty (longitudinal incision, transverse closure; 3 patients), transaction and reanastomosis of the renal pelvis (1 patient), ureterolysis and displacement of crossing vessels (4 patients). RESULTS: In 1 patient dismembered pyeloplasty could not be scheduled because of cardiovascular problems. A minimal transient lesion of the sympathetic nerve was observed postoperatively in 1 patient and pulmonary embolism in another. The operative time in dismembered pyeloplasty was between 240 and 360 minutes (mean, 280); the results were good in all patients. Equally good results were obtained with nondismembered Fenger-plasty, and the operating time was shorter (120 to 180 minutes). Ureterolysis was found to have a failure rate of 50%. CONCLUSIONS: Laparoscopic dismembered pyeloplasty yielded good results but it is too complicated to become a standard procedure. Nondismembered Fenger-plasty, which also showed good results, is more suitable for laparoscopy and retroperitoneoscopy. The indications for this technique should be defined more precisely as more experience is being collected. The results of ureterolysis when used as a single measure were poor, and, therefore, this technique should be abandoned.

Adolescent↗
PubMed1996

Pneumothorax complicating laparoscopic ureterolysis.

In a 71-year-old female marked left-sided ureteral stenosis secondary to retroperitoneal fibrosis was diagnosed. Since conservative therapy with cortisone had failed, laparoscopic ureterolysis was performed. Following tracheal intubation the lungs were ventilated with 40 vol% O2 in air and isoflurane 0.5-2%, using a positive end-expiratory pressure of 6 cm H2O. A CO2 pneumoperitoneum was established with a pressure-controlled high-flow insufflator; the intraabdominal pressure during the procedure was 14 mm Hg. Two hours after gas instillation, the peak airway pressure increased from 22 to 40 cm H2O, and the PaCO2 from 45 to 70 mm Hg. Breath sounds over the right lung were no longer heard, and subcutaneous emphysema was noted over the neck and face. An intraoperative chest X-ray confirmed a right pneumothorax. Following peritoneal gas evacuation, the PaCO2 returned to 35 mm Hg, the subcutaneous emphysema diminished, and a repeat chest X-ray showed complete resolution of the pneumothorax. The course of this event led us to the conclusion that the pneumothorax was due to diffusion of CO2 from the peritoneal to the pleural cavity through congenital defects in the diaphragm. Ureterolysis could be continued by laparotomy.

Aged↗
PubMed1996

Technique and results of laparoscopic adrenalectomy.

OBJECTIVES: Our technique of laparoscopic adrenalectomy as well as the results of this method are presented. METHODS: Transperitoneal laparoscopic adrenalectomy was performed in 18 consecutive patients (10 right side, 8 left side) for Conn's disease (7 patients), pheochromocytoma (6 patients), Cushing's syndrome (1 patient), and large inactive adenoma (4 patients). The tumor size ranged between 1 and 8 cm (mean 4.2). One of the patients, who presented with Conn's disease and bilateral adenoma, underwent enucleation of the larger adenoma on the right side leaving the uninvolved portion of the adrenal gland intact. RESULTS: The mean operative time was below 3 h; blood loss was minimal in all cases except 2. Hypertensive crisis was not encountered in this series. The only postoperative complication seen was transient diabetes insipidus which occurred in 1 patient. Analgesics were required only on the first 2 postoperative days. Oral intake and ambulation were resumed within 24 h. Mean postoperative hospitalization was 4.6 days. CONCLUSIONS: In our hands, laparoscopic adrenalectomy proved to be associated with a low morbidity and few complications. In addition, it is one of the few procedures where laparoscopy can compete with open surgery in terms of operative time.

Adrenal Gland Neoplasms↗
PubMed1994

Management of 53 cases of testicular trauma.

Fifty-three patients with testicular injury were investigated. Four (8%) had bilateral testicular injury and 15 (28%) had associated injuries, such as penile, spermatic cord, epididymal disruption, thigh, urethral, perineal skin avulsion, femoral vessel disruption and axillary venous injury. The mode of testicle trauma was blunt in 36 (63%) and penetrating in 21 (37%) cases. Early exploration was done in 43 (81%) patients including 4 with bilateral testicular injury: hematoma evacuation in 23 (49%), partial orchiectomy in 16 (34%) and total orchiectomy in 8 (17%) cases, respectively. Otherwise, delayed exploration, due to the late presentation of more than 3 days after trauma, was done in the remaining 10 (19%) patients: hematoma evacuation in 6 (60%) and partial orchiectomy in 4 (40%) cases. The testicle salvage rate was 49/57 (86%), depending on the nature of testicular trauma. Hospitalization for uncomplicated cases was 4.82 +/- 1.85 days, with prolongation to 10.79 +/- 3.64 days (p < 0.05) for patients having associated injuries. Exploration is advocated in all cases of hematocele, irrespective of testicle contusion or rupture. As minimal, the blood-clot from the tunica vaginalis sac should be evacuated, which would relieve disability and hasten recovery.

Adult↗
PubMed1993

A case of testicle replantation.

A case is reported of amputation of the testis, which was reattached to the stump of the severed spermatic cord using a microsurgical technique and local hypothermia. Total ischemia time was 4 hours and 20 minutes, including 3 hours for warm ischemia. Ultrasonography of the replanted testis 6 months postoperatively showed a homogeneous parenchymal echo pattern and color-coded duplex sonography confirmed normal blood flow. Semen analysis and serum testosterone level were normal. A biopsy of the replanted testicle revealed active spermatogenesis and a normal number of Leydig cells.

Adult↗
PubMed1993

Numerical quadruplet code of human cervical carcinoma tissue proteins.

Proteins were extracted from cervical cancer tissue at 100,000 g supernatant. The four most abundant extracted tissue proteins form a "numerical quadruplet code", by which tissues can be distinguished from each other. Proteins that are specific for cervical cancer were a protein with a relative migration rate of 0.5, obtained by disc-electrophoresis, and a small protein, p 35, obtained by SDS-PAGE. This shows that, in a malignant process, the expression of a new protein may occur or, more probably, an already existing protein is better expressed.

Carcinoma, Squamous Cell↗
PubMed1993

Testicular trauma sustained during football.

Three patients having testicle injury received while playing football are reported. Two of them received a blow with a ball. Surgical findings revealed spermatic cord injury with scrotal haemorrhage in one patient, and intratesticular hematoma in another one. After hematoma evacuation and arrest of haemorrhage achieved by ligature, the testicle appeared normal. In the third case with testicle rupture after scrotal kick, early exploration finished with adequate debridement and approximation of the tunica albuginea laceration. Postoperative ultrasonography showed a homogeneous echo pattern of the remaining two-thirds of the parenchyma.

Adolescent↗
PubMed1993

Cancer-associated serum globulin determined in patients with cervical, endometrial and ovarian cancer.

By using polyacrylamide gel electrophoresis, sera were tested on cancer-associated globulin from female patients bearing gynaecological cancers: 45 cervical, 21 endometrial and 38 ovarian. As a control, normal sera were taken from 97 healthy women. Sera were also taken from patients with benign neoplasias: 59 cervical dysplasias, 72 endometrial fibromyomas and 47 ovarian cystadenomas. The cancer-associated globulin was evaluated, as an antibody to a cancer antigen that consists of ceramide-lactoside conjugated to a protein integrated in a tumor cell membrane. This serum globulin can be shown densitometrically as the fourth post-transferrin peak (PTP 4). It was found in 69% cervical cancer patients, 52% of the endometrial cancer patients and 89% of the ovarian cancer patients. False positive results were detected in 11% of the normal sera and 25% of the sera from patients with benign neoplasias.

Electrophoresis, Polyacrylamide Gel↗
PubMed1992

Two new human cholangiocarcinoma cell lines and their cytogenetics and responses to growth factors, hormones, cytokines or immunologic effector cells.

Two new human cholangiocarcinoma (CC) cell lines (CC-SW-I and CC-LP-I) were established and maintained in culture for 2 years. Histologically, both original liver tumors were adenocarcinomas, and the cell lines exhibited morphologic features of moderately differentiated adenocarcinoma. Immunohistochemistry showed that both cell lines were strongly positive for cytokeratin AEI but negative for carbohydrate tumor-associated antigen, CA19-9. Ultrastructural analysis of both cell lines showed the presence of tight junctional complexes and focally formed microvilli. Both CC cell lines were tumorigenic in nude mice. Cytogenetic analysis showed that both cell lines expressed highly aneuploid karyotypes with numerous structural and numerical deviations. CC-SW-I was hypodiploid with numerous chromosome losses and structural rearrangements, while CC-LP-I was hyperdiploid and displayed multiple additional chromosomes. Doubling times for the CC-SW-I and CC-LP-I cell lines in the presence of 15% fetal bovine serum were 72 hr and 180 hr, respectively. Growth of the CC-SW-I cell line was significantly stimulated in the presence of insulin, while that of the CC-LP-I cell line was significantly augmented by epidermal growth factor (EGF). In contrast, dexamethasone strongly inhibited proliferation of both cell lines in a dose-dependent manner. Among various recombinant cytokines examined for effects on growth or surface antigen expression on CC cell lines, only interleukin I-beta (ILI-beta) strongly inhibited growth of the CC-LP-I cell line, while interferons (IFNs) or tumor necrosis factor-alpha (TNF-alpha) were mildly inhibitory. Both tumor cell lines were resistant to natural killer (NK) cells but sensitive to lymphokine-activated killer (LAK) cells. Preincubation of tumor cells with IFN-gamma, IFN-alpha or TNF-alpha significantly decreased the susceptibility of each tumor cell line to lysis by LAK cells, and the change in sensitivity did not correlate with the expression of HLA antigens or intercellular adhesion molecule-I (ICAM-I) on the surface of tumor cells. These 2 CC cell lines are expected to provide valuable information about cell biology of human CC.

Adenocarcinoma↗
PubMed1992

Role of cytokines in the adoptive immunotherapy of an experimental model of human head and neck cancer by human IL-2-activated natural killer cells.

Peritumoral injection of human IL-2-activated natural killer cells into nude mice consistently induced regression of xenografts of human squamous cell carcinoma of the head and neck (SCCHN). To determine the mechanisms responsible for the tumor regression, the lymphoid cells infiltrating the tumor stroma at 24 to 48 h after adoptive immunotherapy were examined by in situ hybridization for the presence of mRNA for cytokines or IL-2R. Numerous lymphoid cells expressing cytokine or IL-2R genes were observed in these tumors, whereas the cultured IL-2-activated NK cells used for therapy were negative. Thus, it appeared that the transferred NK cells became activated in situ after coming into proximity with the tumor cells. To analyze this phenomenon, fresh or cultured human NK cells were coincubated in vitro with irradiated human SCCHN cell line, PCI-1, with or without the presence of IL-2. Expression of mRNA for IL-2R, perforin, and various cytokines was observed within 5 h. Contact with the tumor cells stimulated NK cells to proliferate, secrete IFN-gamma, TNF-alpha, and soluble IL-2R, up-regulate cell surface expression of IL2R p55 and p75 as well as CD16 Ag, and mediate higher levels of antitumor activity in 51Cr-release assays. In addition, supernatants of in vitro-activated NK cells significantly inhibited proliferation of SCCHN cell lines. By examining the effects of neutralizing mAb to various cytokines, this inhibitory activity was shown to be partially attributable to IFN-gamma. To determine the possible in vivo role of soluble factors produced by activated human NK cells, the supernatants (0.2 ml) or rIFN-gamma (10(5) U) were injected perilesionally each day for 2 wk into 3-day SCCHN established in immunosuppressed nude mice. These treatments caused significant (p less than 0.02) inhibition of tumor growth. The results of our studies indicate that human NK cells are strongly activated by SCCHN cells and that the consequent release of cytokines contribute to the regression of SCCHN growing in nude mice.

Animals↗
PubMed1991

Protein parameters of differential gene activation during development and tumorigenesis.

Various models of normal and abnormal developmental systems were addressed to get an insight into molecular parameters of cell differentiation at the level of protein gene products. Electrophoretic analysis of heterogeneous protein mixtures permitted qualitative analysis of developing systems, particularly during organogenesis in mammals, as well as of neoplastic growth in the animal and plant kingdoms. From our earlier findings indicating that the definite protein patterns characteristic of adult organs are acquired long after the adult morphological and histological characteristics of these tissues have developed, it has been repeatedly proven that quantitative changes in whole proteins is not a dependable indicator of cell differentiation.

Animals↗
PubMed1991

[Cytoplasmic proteins in the uterine cervix].

The uterine cervical tissue was homogenized in STM buffer (0.25 M sucrose, 10 mM MgCl2, 10 mM Tris, pH 7.5). A soluble fraction with cytoplasmic proteins was obtained in the supernatant by centrifugation at 100,000 g for 40 minutes. According to the Davis method, there was almost no difference between the most abundant native cytoplasmic proteins (0.8/0.4/0.1/0.3) and the control serum proteins (0.8/0.1/0.4/0.3). Otherwise, according to the Laemmli method, the third and the fourth number of the "four-part numerical code" were strongly different for cytoplasmic proteins (67, 41, 186, 294) toward serum proteins (67, 41, 112, 235). Those data confirm Irwin's suggestion about the specificity of the "tissue codes".

Cervix Uteri↗
PubMedDate not supplied

[Conservative surgical procedures in transitional cell carcinoma of the kidney and ureter].

Conservative surgical procedure in selected patients with transitional cell carcinoma of upper urinary tract is alternative to radical surgery. Generally, a conservative surgical procedure is indicated in solitary low-stage lesions, particularly impaired renal function and bilaterality. At our Institute, conservative surgical procedure was performed in patients with solitary kidney and significant renal function damage. Survival after conservative and radical surgery was similar, extending the scope of indications for conservative surgical procedure in cases of low-grade low stage tumors.

Adult↗