RESUMO
The objective of this randomized clinical trial was to compare the effect of revaccination in primiparous dairy cows with modified live viral (MLV) or killed viral (KV) vaccines containing bovine viral diarrhea virus (BVDV) and bovine herpesvirus-1 (BoHV-1) on (1) pregnancy rate following estrus synchronization-timed artificial insemination (TAI), (2) serum progesterone concentrations, and (3) serum neutralizing antibody titers at revaccination and at TAI. Primiparous dairy cows (n=692) that had been previously vaccinated with 4 doses of MLV vaccine as calves or heifers were randomized to receive either an MLV or a KV vaccine between 21 and 28 d in milk and 17 d before initiation of a double-Ovsynch-TAI protocol. Serum was collected within the double-Ovsynch protocol for determination of progesterone concentrations, and at vaccination and TAI for serum neutralizing antibody titers. Ultrasound pregnancy determinations were made at 30 and 60 d after TAI. No differences in pregnancy rates were observed between cows receiving MLV vaccine (44%; n=326) or KV vaccine (43%; n=336). No differences were observed in serum progesterone concentrations during a double-Ovsynch-TAI protocol between cows receiving MLV and KV vaccines. No differences were observed in BVDV 1 or BVDV 2 antibody titers at vaccination and TAI between cows receiving MLV or KV vaccine; however, BoHV-1 antibody titers were greater at TAI in cows receiving KV vaccine. Overall response to vaccination-defined as the percent of all individual cows that had any detectable increase in antibody titer from vaccination to TAI-was 39% for BVDV 1, 45% for BVDV 2, and 61% for BoHV-1. In this research, use of an MLV vaccine did not impede reproduction when revaccination was performed between 21 and 28 DIM and just before enrollment in an estrus synchronization-TAI program in primiparous dairy cows; however, response to vaccination as defined by increases in virus-specific antibody titers could be considered less than ideal for this population of cattle.
Assuntos
Lactação/fisiologia , Vacinação/veterinária , Vacinas Virais/efeitos adversos , Animais , Anticorpos Antivirais/sangue , Bovinos , Vírus da Diarreia Viral Bovina Tipo 1/imunologia , Vírus da Diarreia Viral Bovina Tipo 2/imunologia , Vírus da Diarreia Viral Bovina , Sincronização do Estro/métodos , Feminino , Herpesvirus Bovino 1/imunologia , Imunização Secundária , Inseminação Artificial/veterinária , Leite/imunologia , Paridade , Gravidez , Taxa de Gravidez , Progesterona/sangue , Reprodução , Vacinas Atenuadas/efeitos adversos , Vacinas de Produtos Inativados/efeitos adversos , Vacinas Virais/imunologiaRESUMO
The objectives were to vaccinate peri-pubertal bulls with a modified-live vaccine consisting of cytopathic BVDV strains Singer and 296 and evaluate the resulting: (a) transient shed of modified-live, cytopathic BVDV in semen; (b) risk of prolonged testicular infection; and (c) protection against subsequent testicular infection due to viral challenge. Seronegative, peri-pubertal bulls were vaccinated subcutaneously with a standard dose of vaccine (n=11) or were maintained as unvaccinated controls (n=11). Forty-nine days after vaccination, all bulls were intranasally inoculated with a noncytopathic field strain of BVDV. Semen and testicular biopsies collected after vaccination and challenge were assayed for BVDV using virus isolation, reverse transcription-nested PCR, or immunohistochemistry, and the identity of viral strains was determined by nucleotide sequencing of PCR products. Vaccination of peri-pubertal bulls with this vaccine caused a short-term, transient shed of only the type 1a strain of modified-live, cytopathic BVDV in semen for up to 10d after vaccination. The vaccine did not cause prolonged testicular infection. Vaccination with this product prevented development of prolonged testicular infections after subsequent exposure to a field strain of BVDV.
Assuntos
Vírus da Diarreia Viral Bovina/imunologia , Vacinação/veterinária , Animais , Antígenos Virais/análise , Doença das Mucosas por Vírus da Diarreia Viral Bovina/prevenção & controle , Bovinos , Doenças dos Bovinos/virologia , Efeito Citopatogênico Viral , Vírus da Diarreia Viral Bovina/isolamento & purificação , Vírus da Diarreia Viral Bovina/fisiologia , Imuno-Histoquímica , Masculino , RNA Viral/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sêmen/virologia , Doenças Testiculares/patologia , Doenças Testiculares/veterinária , Doenças Testiculares/virologia , Testículo/patologia , Testículo/virologia , Vacinas Virais/efeitos adversos , Vacinas Virais/imunologiaRESUMO
Voriconazole is a new antifungal drug that has shown effectiveness in treating serious fungal infections and has the potential for being used in large animal veterinary medicine. The objective of this study was to determine the plasma concentrations and pharmacokinetic parameters of voriconazole after single-dose intravenous (i.v.) and oral administration to alpacas. Four alpacas were treated with single 4 mg/kg i.v. and oral administrations of voriconazole. Plasma voriconazole concentrations were measured by a high-performance liquid chromatography method. The terminal half-lives following i.v. and oral administration were 8.01 +/- 2.88 and 8.75 +/- 4.31 h, respectively; observed maximum plasma concentrations were 5.93 +/- 1.13 and 1.70 +/- 2.71 microg/mL, respectively; and areas under the plasma concentration vs. time curve were 38.5 +/- 11.1 and 9.48 +/- 6.98 mg.h/L, respectively. The apparent systemic oral availability was low with a value of 22.7 +/- 9.5%. The drug plasma concentrations remained above 0.1 microg/mL for at least 24 h after single i.v. dosing. The i.v. administration of 4 mg/kg/day voriconazole may be a safe and appropriate option for antifungal treatment of alpacas. Due to the low extent of absorption in alpacas, oral voriconazole doses of 20.4 to 33.9 mg/kg/day may be needed.
Assuntos
Antifúngicos/farmacocinética , Camelídeos Americanos/metabolismo , Pirimidinas/farmacocinética , Triazóis/farmacocinética , Administração Oral , Animais , Antifúngicos/administração & dosagem , Antifúngicos/sangue , Camelídeos Americanos/sangue , Cromatografia Líquida de Alta Pressão/veterinária , Feminino , Injeções Intravenosas/veterinária , Modelos Lineares , Masculino , Pirimidinas/administração & dosagem , Pirimidinas/sangue , Triazóis/administração & dosagem , Triazóis/sangue , VoriconazolRESUMO
Bovine viral diarrhea viruses (BVDV), segregated in BVDV-1 and BVDV-2 species, lead to substantial economic losses to the cattle industry worldwide. It has been hypothesized that there could be differences in level of replication, pathogenesis and tissue tropism between BVDV-1 and BVDV-2 strains. Thus, this study developed an in vitro method to evaluate virus competition between BVDV-1 and BVDV-2 strains. To this end the competitive dynamics of BVDV-1a, BVDV-1b, and BVDV-2a strains in cell cultures was evaluated by a PrimeFlow RNA assay. Similar results were observed in this study, as was observed in an earlier in vivo transmission study. Competitive exclusion was observed as the BVDV-2a strains dominated and excluded the BVDV-1a and BVDV-1b strains. The in vitro model developed can be used to identify viral variations that result in differences in frequency of subgenotypes detected in the field, vaccine failure, pathogenesis, and strain dependent variation in immune responses.
Assuntos
Bioensaio , Vírus da Diarreia Viral Bovina Tipo 1/genética , Vírus da Diarreia Viral Bovina Tipo 2/genética , Células Epiteliais/virologia , RNA Viral/genética , Animais , Doença das Mucosas por Vírus da Diarreia Viral Bovina/diagnóstico , Doença das Mucosas por Vírus da Diarreia Viral Bovina/virologia , Bovinos , Linhagem Celular , Coinfecção , Vírus da Diarreia Viral Bovina Tipo 1/classificação , Vírus da Diarreia Viral Bovina Tipo 1/isolamento & purificação , Vírus da Diarreia Viral Bovina Tipo 1/metabolismo , Vírus da Diarreia Viral Bovina Tipo 2/classificação , Vírus da Diarreia Viral Bovina Tipo 2/isolamento & purificação , Vírus da Diarreia Viral Bovina Tipo 2/metabolismo , Cães , Células Epiteliais/patologia , Feminino , Células Madin Darby de Rim Canino , Gravidez , RNA/genética , RNA/metabolismo , Sondas RNA/genética , Sondas RNA/metabolismo , RNA Viral/metabolismo , Tropismo Viral , Replicação ViralRESUMO
Estracyt (EMP) has been used for the treatment of hormone refractory prostate cancer for many years. Recently, new data from combination studies have given rise to new interest in this old drug. Explanations for the synergy found in the clinic are many, but one major factor may be the previous indication that the drug accumulates in the prostate tumor. We have, therefore, examined the level of the four metabolites, estromustine (EoM), estramustine (EaM), estrone, and estradiol in the tumor and serum of 14 patients with T2 and T3 prostate cancer receiving a single i.v. dose of 600 mg of EMP, about 12 h before radical prostatectomy. Because it has been suggested that the uptake into the prostate tumor is due to binding to the estramustine binding protein (EMBP), we have in addition measured the level of EMBP in the prostate tumor tissue. The main serum and tissue metabolite in all patients was EoM followed by EaM, estrone, and estradiol. The levels for EoM ranged from 63.8-162.8 ng/ml in the serum and from 64.8-1209 ng/ml in the prostate tumor, resulting in a mean ratio for serum to tumor of 1:5. The levels for EaM ranged from 8.3-51.4 ng/ml in the serum and 73.9-563.4 ng/ml in the tumor, giving a mean ratio for serum to tumor of 1:13. The levels of EMBP were higher in T3 tumors than in T2 tumors, 54.1 and 40.7 ng/g tissue, respectively. A significant correlation was found between the levels of EaM (r = 0.60) and the levels of EMBP in the tumor. These data demonstrate that 12 h after a single i.v. dose of 600 mg of EMP the levels of the cytotoxic metabolites EoM and EaM are substantially higher in the tumor than in the serum of the same patient and that a correlation exists between the levels of EaM in the tumor and the levels of EMBP. Thus, this supports the hypothesis that the EMBP is responsible for the retention of EoM and EaM in the prostate tumor.
Assuntos
Proteínas de Transporte/metabolismo , Estramustina/metabolismo , Neoplasias da Próstata/metabolismo , Proteínas Secretadas pela Próstata , Idoso , Antineoplásicos Hormonais/uso terapêutico , Proteínas de Transporte/sangue , Estradiol/sangue , Estradiol/metabolismo , Estramustina/sangue , Estramustina/uso terapêutico , Estrona/sangue , Estrona/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Fosfatos/sangue , Fosfatos/metabolismo , Prostatectomia , Neoplasias da Próstata/sangue , Neoplasias da Próstata/terapiaRESUMO
Mycoplasma bovis was isolated from the tympanic bullae of dairy calves with an exudative otitis media. The history, clinical signs, gross and histologic lesions, and bacteriologic findings are described for 5 preweaned Holstein calves with otitis media from a 600-cow dairy in Michigan. Clinical findings consisted of unilateral or bilateral ear droop, epiphora, head tilt, and recumbency in severely affected calves. Postmortem examination revealed unilateral or bilateral fibrinosuppurative to caseous exudate in the tympanic bullae. Histologically, a marked fibrinosuppurative to caseous exudate filled the tympanic air spaces. The partially ulcerated tympanic mucosa was markedly thickened with mononuclear cell infiltration and proliferation of fibrous connective tissue. Bone remodeling and periosteal hyperostosis were present in some osseous septa. Mycoplasma bovis was isolated from the tympanic bullae of all 5 calves and from the lungs of 2 calves and the frontal sinus of 1 calf. Mycoplasma bovis was isolated at > 100,000 colony forming units/ml from the bulk milk tank of the farm of origin. The isolation of M. bovis from the bulk milk tank, indicating subclinical mycoplasmal mastitis coupled with the feeding of waste milk from mastitic cows to calves is suggestive of a possible source of the infection resulting in otitis media in preweaned dairy calves.
Assuntos
Doenças dos Bovinos , Orelha Média/microbiologia , Infecções por Mycoplasma/veterinária , Mycoplasma/isolamento & purificação , Otite Média/veterinária , Animais , Bovinos , Orelha Média/patologia , Feminino , Masculino , Michigan , Infecções por Mycoplasma/microbiologia , Infecções por Mycoplasma/patologia , Otite Média/microbiologia , Otite Média/patologiaRESUMO
Thrombocytopenia has been associated with type II bovine viral diarrhea virus (BVDV) infection in immunocompetent cattle, but the mechanism is unknown. The purpose of the present study was to develop and characterize a model of type II BVDV-induced thrombocytopenia. Colostrum-deprived Holstein calves were obtained immediately after birth, given a BVDV-negative and BVDV antibody-negative plasma transfusion, housed in an isolation facility, and randomly assigned to either control (n = 4) or infected (n = 5) groups. Infected calves were inoculated by intranasal instillation on day 3 of age with 10(7) TCID50 of the prototype type II isolate, BVDV 890, whereas control calves were sham inoculated. Blood counts and virus isolations from serum, white blood cells, and platelets were performed daily until day 12 after infection, at which time all experimental calves were euthanatized, and pathologic, virologic, and immunohistochemical examinations were performed. On physical examination, the control calves remained normal, but the infected calves developed pyrexia and diarrhea characteristic of type II BVDV infection. The platelet count decreased in all infected calves, and a statistically significant difference in the platelet count between control and infected calves was observed on days 7-12 after infection. In addition, the mean platelet volume and white blood cell counts also decreased. Examination of the bone marrow from the infected calves revealed immunohistochemical staining for BVDV antigen in megakaryocytes and evidence of concurrent megakaryocyte necrosis and hyperplasia.
Assuntos
Doenças dos Bovinos/patologia , Vírus da Diarreia Viral Bovina Tipo 2/patogenicidade , Síndrome Hemorrágica Bovina/complicações , Trombocitopenia/veterinária , Animais , Animais Recém-Nascidos , Bovinos , Doenças dos Bovinos/virologia , Síndrome Hemorrágica Bovina/virologia , Imuno-Histoquímica , Masculino , Trombocitopenia/etiologiaRESUMO
Some isolates of type II bovine viral diarrhea virus (BVDV) are capable of causing severe clinical disease in cattle. Bovine viral diarrhea virus infection has been reported in pigs, but the ability of these more virulent isolates of type II BVDV to induce severe clinical disease in pigs is unknown. It was our objective to compare clinical, virologic, and pathologic findings between type I and type II BVDV infection in pigs. Noninfected control and BVDV-infected 2-month-old pigs were used. A noncytopathic type I and a noncytopathic type II BVDV isolate were chosen for evaluation in feeder age swine based upon preliminary in vitro and in vivo experiments. A dose titration study was performed using 4 groups of 4 pigs for each viral isolate. The groups were inoculated intranasally with either sham (control), 10(3), 10(5), or 10(7) TCID50 of virus. The pigs were examined daily and clinical findings were recorded. Antemortem and postmortem samples were collected for virus isolation. Neither the type I nor type II BVDV isolates resulted in clinical signs of disease in pigs. Bovine viral diarrhea virus was isolated from antemortem and postmortem samples from groups of pigs receiving the 10(5) and the 10(7) TCID50 dose of the type I BVDV isolate. In contrast, BVDV was only isolated from postmortem samples in the group of pigs receiving the 10(7) TCID50 dose of the type II BVDV isolate. Type I BVDV was able to establish infection in pigs at lower doses by intranasal instillation than type II BVDV. Infection of pigs with a type II isolate of BVDV known to cause severe disease in calves did not result in clinically apparent disease in pigs.
Assuntos
Doença das Mucosas por Vírus da Diarreia Viral Bovina/fisiopatologia , Vírus da Diarreia Viral Bovina/classificação , Animais , Doença das Mucosas por Vírus da Diarreia Viral Bovina/patologia , Bovinos , Vírus da Diarreia Viral Bovina/genética , Vírus da Diarreia Viral Bovina/isolamento & purificação , Genótipo , Íleo/patologia , Íleo/virologia , Pulmão/patologia , Pulmão/virologia , Linfonodos/patologia , Linfonodos/virologia , Tonsila Palatina/patologia , Tonsila Palatina/virologia , Baço/patologia , Baço/virologia , SuínosRESUMO
Altered platelet function has been reported in calves experimentally infected with type II bovine viral diarrhea virus (BVDV). The purpose of the present study was to further evaluate the ability of BVDV isolates to alter platelet function and to examine for the presence of a virus-platelet interaction during BVDV infection. Colostrum-deprived Holstein calves were obtained immediately after birth, housed in isolation, and assigned to 1 of 4 groups (1 control and 3 treatment groups). Control calves (n = 4) were sham inoculated, while calves in the infected groups (n = 4 for each group) were inoculated by intranasal instillation with 10(7) TCID50 of either BVDV 890 (type II), BVDV 7937 (type II), or BVDV TGAN (type I). Whole blood was collected prior to inoculation (day 0) and on days 4, 6, 8, 10, and 12 after inoculation for platelet function testing by optical aggregometry by using adenosine diphosphate and platelet activating factor. The maximum percentage aggregation and the slope of the aggregation curve decreased over time in BVDV-infected calves; however, statistically significant differences (Freidman repeated measures ANOVA on ranks, P < 0.05) were only observed in calves infected with the type II BVDV isolates. Bovine viral diarrhea virus was not isolated from control calves, but was isolated from all calves infected with both type II BVDV isolates from days 4 through 12 after inoculation. In calves infected with type I BVDV, virus was isolated from 1 of 4 calves on days 4 and 12 after inoculation and from all calves on days 6 and 8 after inoculation. Altered platelet function was observed in calves infected with both type II BVDV isolates, but was not observed in calves infected with type I BVDV. Altered platelet function may be important as a difference in virulence between type I and type II BVDV infection.
Assuntos
Plaquetas/virologia , Doença das Mucosas por Vírus da Diarreia Viral Bovina/sangue , Vírus da Diarreia Viral Bovina Tipo 1/patogenicidade , Vírus da Diarreia Viral Bovina Tipo 2/patogenicidade , Agregação Plaquetária , Difosfato de Adenosina/farmacologia , Animais , Animais Recém-Nascidos , Plaquetas/efeitos dos fármacos , Plaquetas/fisiologia , Bovinos , Vírus da Diarreia Viral Bovina Tipo 1/isolamento & purificação , Vírus da Diarreia Viral Bovina Tipo 2/isolamento & purificação , Masculino , Agregação Plaquetária/efeitos dos fármacos , VirulênciaRESUMO
OBJECTIVE: To evaluate platelet aggregation responses in calves experimentally infected with a thrombocytopenia-inducing type II bovine viral diarrhea virus (BVDV) isolate (BVDV 890). ANIMALS: 9 neonatal male Holstein calves. PROCEDURE: 5 calves were inoculated with BVDV 890, and 4 were used as controls. Platelet aggregation studies and attempts to isolate BVDV from platelets were performed 2 days before, the day of, and every 2 days for 12 days after inoculation. Platelet function was assessed by means of optical aggregometry, using adenosine diphosphate and platelet-activating factor as agonists. Bovine viral diarrhea virus was isolated from purified platelet preparations by use of an immunoperoxidase monolayer assay. RESULTS: Maximum percentage aggregation and slope of the aggregation curve decreased over time in calves infected with BVDV. Bovine viral diarrhea virus was not isolated from platelets from control calves, but it was isolated from infected calves from 4 through 12 days after inoculation. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that platelet function may be depressed in calves infected with type II BVDV. Although the mechanism for altered platelet function was not determined, it likely involved an increase in the percentage of aged platelets in the circulation, a direct virus-platelet interaction, or an indirect virus-platelet interaction. Platelet dysfunction, in addition to thrombocytopenia, may contribute to the hemorrhagic syndrome associated with acute type II BVDV infection in calves.
Assuntos
Plaquetas/fisiologia , Doença das Mucosas por Vírus da Diarreia Viral Bovina/sangue , Vírus da Diarreia Viral Bovina/isolamento & purificação , Agregação Plaquetária , Difosfato de Adenosina/farmacologia , Animais , Animais Recém-Nascidos , Plaquetas/virologia , Bovinos , Técnicas In Vitro , Cinética , Masculino , Agregação Plaquetária/efeitos dos fármacosRESUMO
OBJECTIVE: To compare degree of viremia and disease manifestations in calves with type-I and -II bovine viral diarrhea virus (BVDV) infection. ANIMALS: 16 calves. PROCEDURE: Colostrum-deprived calves obtained immediately after birth were assigned to 1 control and 3 treatment groups (4 calves/group). Calves in treatment groups were inoculated (day 0) by intranasal instillation of 10(7) median tissue culture infective dose BVDV 890 (type II), BVDV 7937 (type II), or BVDV TGAN (type I). Blood cell counts and virus isolation from serum and leukocytes were performed daily, whereas degree of viremia was determined immediately before and 4, 6, 8, and 12 days after inoculation. Calves were euthanatized on day 12, and pathologic, virologic, and immunohistochemical examinations were performed. RESULTS: Type-II BVDV 890 induced the highest degree of viremia, and type-I BVDV TGAN induced the lowest. Virus was isolated more frequently and for a longer duration in calves inoculated with BVDV 890. A parallel relationship between degree of viremia and rectal temperature and an inverse relationship between degree of viremia and blood cell counts was observed. Pathologic and immunohistochemical examinations revealed more pronounced lesions and more extensive distribution of viral antigen in calves inoculated with type-II BVDV. CONCLUSIONS AND CLINICAL RELEVANCE: Degree of viremia induced during BVDV infection is associated with severity of clinical disease. Isolates of BVDV that induce a high degree of viremia may be more capable of inducing clinical signs of disease. Strategies (eg, vaccination) that reduce viremia may control clinical signs of acute infection with BVDV.
Assuntos
Doença das Mucosas por Vírus da Diarreia Viral Bovina/patologia , Vírus da Diarreia Viral Bovina/patogenicidade , Viremia/veterinária , Animais , Animais Recém-Nascidos , Antígenos Virais/análise , Temperatura Corporal , Medula Óssea/patologia , Medula Óssea/virologia , Doença das Mucosas por Vírus da Diarreia Viral Bovina/sangue , Doença das Mucosas por Vírus da Diarreia Viral Bovina/virologia , Bovinos , Imuno-Histoquímica/veterinária , Contagem de Leucócitos/veterinária , Masculino , Contagem de Plaquetas/veterinária , Timo/patologia , Timo/virologia , Viremia/patologia , Viremia/virologiaRESUMO
OBJECTIVE: To determine whether cattle persistently infected with bovine viral diarrhea virus (BVDV) that lack virus detectable in serum by use of the immunoperoxidase microtiter assay (IPMA) can transmit the virus to susceptible herdmates and determine prevalence of these cattle. DESIGN: Clinical trial and serologic survey. SAMPLE POPULATION: 2 cattle and 1,952 blood samples. PROCEDURE: A persistently infected cow in which virus could not be detected in serum was housed with a BVDV-seronegative steer. Blood and nasal swab specimens were tested via virus isolation and serum virus neutralization. Parallel WBC preparations and sera from blood samples of 1,952 adult cows were screened for BVDV by use of IPMA. RESULTS: The steer seroconverted to BVDV within 4 weeks of contact with the cow. Virus was detected in sera and WBC of 5 adult cows that were verified as persistently infected by retest 3 weeks later. Cattle persistently infected with BVDV in which virus could not be detected in both serum and WBC by use of IPMA were not found. CONCLUSION AND CLINICAL RELEVANCE: Cattle persistently infected with BVDV in which virus cannot be detected in serum by use of IPMA may serve as virus reservoirs for infecting susceptible cattle. Persistent infection was detected at a prevalence of 0.26%. Screening adult cattle by use of IPMA on serum samples appears to be a reliable means of detecting persistent infection with BVDV. Prevalence of cattle persistently infected with BVDV that have negative results of IPMA on serum is extremely low.
Assuntos
Doença das Mucosas por Vírus da Diarreia Viral Bovina/sangue , Doença das Mucosas por Vírus da Diarreia Viral Bovina/transmissão , Vírus da Diarreia Viral Bovina/isolamento & purificação , Animais , Anticorpos Antivirais/sangue , Bioensaio/métodos , Doença das Mucosas por Vírus da Diarreia Viral Bovina/epidemiologia , Bovinos , Vírus da Diarreia Viral Bovina/imunologia , Reservatórios de Doenças/veterinária , Feminino , Técnicas Imunoenzimáticas/veterinária , Masculino , Prevalência , Estudos SoroepidemiológicosRESUMO
Fifty-two children with 63 renoureteral units were treated for primary megaureter (p.m.) and 62 children with 102 renoureteral units for secondary megaureter (s.m.) due to infravesical obstruction. The changing concepts of diagnosis and therapy in 3 periods influenced both the indication for ureteroneocystostomy (p.m.: 79%, 63%, 58%; s.m.: 71%, 30%, 31%) and the rate of good results of operation (p.m.: 63%, 80%, 76%; s.m.: 44%, 78%, 81%), the criteria for good results being no infection, no reflux, no dilatation. Extensive diagnostic studies are necessary to avoid false indications with consequent poor therapeutic results. In cases of incidentally diagnosed primary megaureter without symptoms conservative treatment or "watchful waiting" is justified.
Assuntos
Doenças Ureterais/cirurgia , Obstrução do Colo da Bexiga Urinária/complicações , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Ultrassonografia , Doenças Ureterais/diagnóstico , Doenças Ureterais/etiologia , Obstrução do Colo da Bexiga Urinária/cirurgia , Refluxo Vesicoureteral/cirurgiaRESUMO
Forty-five adult patients underwent surgical treatment for complications of double malformations of the upper urinary tract. Compared with children, the percentage of incomplete duplications rose from 3--43%, and nephrectomy was necessary in 25% instead of 0 to 8%. The possible effect of the yo-yo phenomenon is discussed. Early surgical intervention might improve the possibilities of saving the organ.
Assuntos
Anormalidades Múltiplas/complicações , Ureter/anormalidades , Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/cirurgia , Adolescente , Adulto , Fatores Etários , Feminino , Alemanha Ocidental , Humanos , Masculino , Métodos , Estudos Retrospectivos , Doenças Ureterais/cirurgiaRESUMO
Both giant hydronephrosis and blind-ending ureteral bud are rare conditions. We report on a patient with an impacted ureteral stone leading to giant pyohydronephrosis (6.51) on the right side, which in turn caused displacement of the ureter containing the stone to the left. An asymptomatic blind-ending ureteral bud initially complicated the diagnosis. After nephrectomy, a unsuspected transitional cell carcinoma of the right renal pelvis and the ureter was found.
Assuntos
Hidronefrose/diagnóstico por imagem , Pielonefrite/diagnóstico por imagem , Ureter/anormalidades , Carcinoma de Células de Transição/diagnóstico por imagem , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/cirurgia , Diagnóstico Diferencial , Humanos , Hidronefrose/patologia , Hidronefrose/cirurgia , Cálculos Renais/diagnóstico por imagem , Cálculos Renais/patologia , Cálculos Renais/cirurgia , Cálices Renais/diagnóstico por imagem , Cálices Renais/patologia , Cálices Renais/cirurgia , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Masculino , Pessoa de Meia-Idade , Nefrectomia , Pielonefrite/patologia , Pielonefrite/cirurgia , Tomografia Computadorizada por Raios X , Ureter/patologia , Ureter/cirurgia , Cálculos Ureterais/diagnóstico por imagem , Cálculos Ureterais/patologia , Cálculos Ureterais/cirurgia , Neoplasias Ureterais/diagnóstico por imagem , Neoplasias Ureterais/patologia , Neoplasias Ureterais/cirurgia , UrografiaRESUMO
The most common causes of an 'acute scrotum' in childhood are testicular torsion, torsion of an appendix testis, epididyoorchitis, idiopathic edema, and hematoma. In rare cases a scrotal hematoma can originate from an extra- or intraperitoneal adrenal bleeding. 12 such cases have been described in the literature, yet. We report on 3 further cases, that occurred in our institution between 1992 and 1997. In the first case we performed a scrotal exploration due to a suspected testicular torsion, but only a normal testicle and liquid hematoma were seen. Postoperatively we discovered an ipsilateral adrenal hemorrhage by sonography. In the latter two cases the adrenal bleeding was recognized primarily as causal for the scrotal mass and operation remained undone. In newborns adrenal hemorrhage is mostly due to birth-trauma, large birth-weight, hypoxia, and asphyxia. This was present as well with our 3 children. If the clinical situation of the child is stable, complete restitution under conservative therapy can be expected.
Assuntos
Doenças das Glândulas Suprarrenais/complicações , Hematoma/etiologia , Hemorragia/complicações , Escroto , Doença Aguda , Doenças das Glândulas Suprarrenais/diagnóstico , Doenças das Glândulas Suprarrenais/cirurgia , Diagnóstico Diferencial , Seguimentos , Hematoma/diagnóstico , Hematoma/cirurgia , Hemorragia/diagnóstico , Hemorragia/cirurgia , Humanos , Lactente , Recém-Nascido , Masculino , UltrassonografiaRESUMO
A radical nephrectomy of a left-sided renal cell carcinoma with extension of the tumor thrombus into the vena cava as far up as the right atrium is described. The right kidney has no venous collateral system, therefore ligation of the right renal vein and resection of the tumor-invaded vena cava is not possible. A left radical extended nephrectomy, if necessary, with interposition of a vessel prosthesis, increases the prognosis and must be considered the therapy of choice.
Assuntos
Adenocarcinoma/complicações , Neoplasias Renais/complicações , Trombose/etiologia , Veia Cava Inferior , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/cirurgia , Feminino , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Pessoa de Meia-Idade , Prognóstico , Radiografia , Veia Cava Inferior/cirurgiaRESUMO
Between 1967 and 1986 185 children (246 renoureteral units) and 21 adults (25 renoureteral units) with megaureters have been treated surgically in our department. 85 of the children had primary obstructive megaureters, 77 children showed secondary megaureters, whereas 23 others showed either a gross ureteral dilatation due to an ureterocele or gross reflux. All of the adult patients presented with primary obstructive megaureters. 122 children (65.9%) and 15 adults (71.4%) underwent ureterocystoneostomy (UCN) using various techniques, the Psoas Hitch technique being exclusively the method of choice since 1977 with markedly better results. The indication for ureteral tapering was considered extremely conservatively. In the rest of the patients the elimination of the infravesical obstruction alone was sufficient or a nephrectomy/nephroureterectomy had to be performed due to a non-functioning kidney. The percentage of UCN in primary obstructive megaureters throughout the years (79% in 1967-1971 and 63% in 1977-1986) and its significant decrease in secondary megaureters from 71% to 39% during the same time period displays the conceptional changes in the therapy regimen. The majority of children and adults with primary obstructive megaureters can be treated conservatively. UCN should be indicated for cases with synchronous reflux and/or recurrent febrile urinary tract infections. The indication for ureteral tapering should be considered very carefully. Especially in secondary megaureters the indication for ureteral tapering and reimplantation is rare since the adequate relief of the infravesical obstruction may be sufficient alone in many of the cases.
Assuntos
Doenças Ureterais/cirurgia , Adulto , Criança , Dilatação Patológica/cirurgia , Seguimentos , Humanos , Técnicas de Sutura , Doenças Ureterais/congênito , Obstrução Ureteral/cirurgia , Ureterocele/cirurgia , Refluxo Vesicoureteral/cirurgiaRESUMO
We report on the eighth known case of a mature metastasis of a mature teratoma of the testis. In a 19-year-old patient who had undergone a pyeloplasty of the left renal pelvis 6 years before, a mature metastasis of an occult mature teratoma of the testis was found at the former operation site. This case--in addition to those published previously--emphasizes the fact that a mature teratoma of the testis has to be regarded as a malignant tumor in adults. It is supposed that the mature teratoma originates, as other testicular tumors, from carcinoma-in-situ-cells, which are responsible for metastasize and are not detected after lysis.