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1.
Plant Dis ; 98(5): 703, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-30708522

RESUMO

Severe plant stunting, chlorosis, and extensive root galling were observed on sunflower (Helianthus annus Pioneer Hi-bred PR64LE19, Dupont) in a commercial field at Agios Athanasios, Drama Province, northeastern Greece at the end of May 2013. Disease symptoms were observed about 1.5 months after planting, and were distributed in patches that covered approximately 2% of the whole cultivated area. Examination of the soil and root samples from selected infected plants revealed the presence of abundant root-knot nematodes. Juveniles, males, and females were extracted by sieving, decanting, and root dissection for identification using morphological traits. Nematode population densities ranging from 100 to 150 J2s per 100 cm3 of soil, and 150 to 3,000 eggs per g of fresh sunflower roots were observed. Identification was confirmed by perineal patterns of females and by sequencing of the D2-D3 expansion segments of 28S ribosomal RNA gene (1,3,4). All identification methods were consistent with typical Meloidogyne hispanica. Morphology of perineal patterns of females and measurements of the second-stage juveniles (J2s) matched those of the original description of M. hispanica (3). Alignment indicated that the D2-D3 sequence (GenBank Accession No. KF501128) was 99% homologous to other sequences of M. hispanica deposited in GenBank from Brazil, Portugal, and Spain (EU443606, EU443608, and GQ375158, respectively), differing in only one nucleotide. Phylogenetic analyses using maximum likelihood of this sequence placed the Meloidogyne sp. in a highly supported (100%) clade that included all M. hispanica sequences available from the GenBank database (4). Root-knot nematodes in general have been reported to cause economic losses in sunflower in Europe (2), but there are no reports of M. hispanica. M. hispanica was first found in Seville Province, southern Spain, infecting rootstocks of Prunus spp. (3). Its distribution has been confirmed worldwide on different agricultural crops. However, to our knowledge, this is the first report of M. hispanica infecting sunflower in Europe and the first report of this species on any crop for Greece. The identification of M. hispanica in sunflower is relevant because it may represent a threat for sunflower production in Greece. Research to develop sunflower varieties resistant to root-knot nematodes should now also consider M. hispanica along with other species of Meloidogyne. References: (1) K. R. Barker. Page 19 in: An Advanced Treatise on Meloidogyne. Vol. II, Methodology. K. R. Barker et al., eds. North Carolina State University Graphics, Raleigh, NC, 1985. (2) M. Di Vito et al. Nematol. Mediterr. 24:109, 1996. (3) H. Hirschmann. J. Nematol. 18:520, 1986. (4) B. B. Landa et al. Plant Dis. 92:1104, 2008.

2.
World J Urol ; 31(2): 377-82, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22130650

RESUMO

PURPOSE: To study microscopic patterns of remaining peripheral nerves (PN) after nerve-sparing (NS) radical prostatectomy (RP) and possible consequences for nerve preparation. METHODS: Specimens from 27 patients (7 = non-NSRP, 20 = unilateral NS) were examined. Sections were investigated for PN content by immunoassaying. 120 whole-mounted slides were divided into four sectors, and extracapsular nerves were counted; the mean posterior/anterior ratio was calculated. Calculated ratios were correlated with the respective volumes of prostatic tissue (PV). After dividing the patient cohort into two subgroups, shared by the median value of the posterior/anterior nerve ratios, the absolute PN contents on the anterior surface of the NS sides were compared. RESULTS: Anatomical posterior nerve percentage in non-NS aspects ranged from 0.0-100.0 to 26.7-94.6% with a mean of 66.60 ± 25.4% and 68.83 ± 16.0% (>/<200 µm, respectively). Individual ratios from two nerve categories showed significant correlation (P < 0.008). Mean posterior ratios were 83.04/79.68 and 39.21/56.00, respectively. After unilateral NS, 3.17-fold (2.25 vs. 0.71 nerves, P = 0.05) and 2.26-fold (21.54 vs. 9.53, P = 0.08) nerve fibers were resected in the anterior area in comparison with type A. After unilateral NS, the variation impact on the anterior nerve content of the NS side could be demonstrated. CONCLUSIONS: The amounts of nerves localized on the anterior prostate after RP vary interindividually. Saving only a minor part of the anterior areas may have an impact on the quantity of excised nerves adjacent to the specimen and impair postoperative functional results. Especially for those patients without a major posterolateral bundle distribution, surgeons should adapt the procedure and start nerve preservation more anteriorly to maximize the probability of satisfactory postoperative functional results.


Assuntos
Próstata/inervação , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Idoso , Variação Anatômica , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Tratamentos com Preservação do Órgão , Complicações Pós-Operatórias/prevenção & controle , Próstata/anatomia & histologia , Próstata/cirurgia , Neoplasias da Próstata/patologia
3.
Eur J Gynaecol Oncol ; 34(1): 31-5, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23589996

RESUMO

INTRODUCTION: Decreased expression of E-cadherin has been associated with poorly differentiated endometrial carcinomas and poorer outcomes. AIM: The purpose of this study was to examine the distribution of E-cadherin immunohistochemical expression in specimens from primary endometrial carcinomas and its relation to classical clinicopathological prognostic factors. MATERIALS AND METHODS: Surgically-resected tissues of 30 patients with primary endometrial carcinomas were studied. Histological type and grade, depth of myometrial invasion, lymph-vascular space invasion, fallopian tube or ovarian invasion, and the presence of tumoral necrosis were evaluated. Immunohistochemical examination was performed on deparaffinized four-microm-thick sections. RESULTS: The mean age of patients was 65 years (+/- 11.41). The 63.54% of carcinomas were moderately/poorly differentiated. No statistical correlation was found between the score or intensity of E-cadherin immunohistochemical staining (strong or moderate positive expression) and the clinicopathological factors tested. CONCLUSIONS: The association of E-cadherin immunoreactivity with the standard clinicopathological factors seemed to be contradictory. The classical clinicopathological factors remain the most important prognostic parameters.


Assuntos
Caderinas/análise , Neoplasias do Endométrio/patologia , Idoso , Caderinas/fisiologia , Neoplasias do Endométrio/química , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Prognóstico
4.
Arch Esp Urol ; 66(1): 41-53, 2013.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-23406799

RESUMO

OBJECTIVES: To provide an up-to-date review of the available literature on laparoscopic cryotherapy for small renal masses (SRMs) including technique description, indications and outcomes. METHODS: A systematic literature search was conducted in March 2012, using MEDLINE and EMBASE via Ovid databases, to identify studies on laparoscopic cryotherapy for SRMs published during the last 10 years. Only English-language and human-based full manuscripts reporting case series studies with >20 participants, patient characteristics, efficacy and safety data were included. RESULTS: No randomised controlled trials (RCTs)were identified. In total, 27 full reports addressing laparoscopic cryoablation (LCA) for SRMs were selected. The number of patients per study ranged from 20 to 144. Mean age of treated patients across the series ranged from 62 to 73 years. Mean size of renal tumors ranged from 2.7 to 4 cm, being in most cases <3 cm. The number of cryoprobes used for cryoablation ranged from 1 to 6, and only 10 series described the use of 17-gauge (1.47 mm) third-generation needles. Overall, more than 55% of all ablated lesions were pathologically confirmed RCC. Mean follow-up ranged from 9 to 93 months. Only 7 series presented a long-term follow-up of more than 36 months. Most studies were limited by a relatively short follow-up. At least four urologic groups reported intermediate- and long-term outcomes. Persistence rates ranged from 0% to 17% and recurrence rates ranged from 0% to 14%. Overall complication rates ranged from 0% to 40%. CONCLUSIONS: Retrospective observational data and a few prospective series on LCA of SRMs show acceptable oncological 3- to 5-year outcomes with a low recurrence rate. It has proven to be a safe procedure with an overall low complication rate. It is mainly indicated for SRMs in elderly patients affected by co-morbidity and high surgical risk bearing tumours in the anterior valve of the kidney or in contact with the ureter or neighbouring organs.


Assuntos
Carcinoma de Células Renais/cirurgia , Crioterapia/métodos , Neoplasias Renais/cirurgia , Laparoscopia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Crioterapia/efeitos adversos , Feminino , Humanos , Laparoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
5.
World J Urol ; 30(5): 619-24, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22820621

RESUMO

INTRODUCTION: As could be demonstrated for simple and radical nephrectomy, single-incision triangulated umbilical surgery (SITUS) is an interesting alternative to laparoscopic single-site surgery. We present our initial experience with the SITUS technique in radical cystectomy. MATERIALS AND METHODS: Between September 2010 and September 2011, eight patients underwent SITUS radical cystectomy (SITUS Cx), pelvic lymph node dissection and extracorporeal urinary diversion. A cutaneous ureterostomy was performed in three, an ileum conduit in one and an ileal neobladder in four patients. Data were collected prospectively, including patients' characteristics, intraoperative parameters, pathological stage and postoperative outcome. RESULTS: Mean age of the patients was 67 years and the mean body mass index 24 kg/m(2). SITUS Cx was successfully completed in all patients without conversion to conventional laparoscopic or open surgery. Mean surgical time was 434 min and mean estimated blood loss 643 ml. No major intra- or postoperative surgical complications occurred. All patients recovered quickly reporting low postoperative pain levels. Mean hospital stay was 16 (7-24 days). Histopathological evaluation revealed a mean of 16 (6-33) retrieved lymph nodes and no positive margins. CONCLUSION: In the present experience, SITUS Cx proved to be feasible with surgical outcome comparable to conventional techniques. Because SITUS Cx combines the advantages of traditional laparoscopy (straight instruments and triangulation) with those of single-port surgery (superior cosmesis and minimal invasiveness), it presents an attractive alternative to other minimally invasive techniques.


Assuntos
Cistectomia/métodos , Laparoscopia/métodos , Neoplasias da Bexiga Urinária/cirurgia , Derivação Urinária/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Excisão de Linfonodo/métodos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Prospectivos , Resultado do Tratamento , Umbigo/cirurgia , Ureter/cirurgia , Bexiga Urinária/cirurgia
6.
World J Urol ; 30(2): 213-8, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21512807

RESUMO

PURPOSE: To investigate the positive biopsy rate of MRI-guided biopsy (MR-GB) in a routine clinical setting, identify factors predictive for positive biopsy findings and to report about the clinical significance of the diagnosed tumors. METHODS: Patients with at least one negative trans-rectal-ultrasound-guided biopsy (TRUS-GB), persistently elevated or rising serum prostate specific antigen (PSA) and at least one lesion suspicious for PCa on diagnostic 1.5 Tesla endorectal coil MRI (eMR) were included. Biopsies were carried out using a 1.5 Tesla MRI and an 18 G biopsy gun. Clinical information and biopsy results were collected; logistic regression analysis was carried out. Definite pathology reports of patients with diagnosis of PCa and subsequent radical prostatectomy (RP) were analyzed for criteria of clinical significance. RESULTS: One hundred patients were included, mean number of previous biopsies was 2 (range 1-9), mean PSA at time of biopsy was 11.7 ng/ml (1.0-65.0), and mean prostate volume was 46.7 ccm (range 13-183). In 52/100 (52.0%) patients, PCa was detected. Out of 52 patients, 27 patients with a positive biopsy underwent RP, 20 patients radiation therapy, and 5 patients active surveillance. In total, 80.8% of the patients revealed a clinically significant PCa. In univariate regression analysis, only serum PSA levels were predictive for a positive biopsy result. Number of preceding negative biopsies was not associated with the likelihood of a positive biopsy result. CONCLUSIONS: MR-GB shows a high detection rate of clinically significant PCa in patients with previous negative TRUS-GB and persisting suspicion for PCa.


Assuntos
Carcinoma/patologia , Imagem por Ressonância Magnética Intervencionista/métodos , Neoplasias da Próstata/patologia , Ultrassonografia de Intervenção/métodos , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha/métodos , Carcinoma/sangue , Carcinoma/diagnóstico por imagem , Estudos de Coortes , Reações Falso-Negativas , Humanos , Masculino , Pessoa de Meia-Idade , Próstata/diagnóstico por imagem , Próstata/patologia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico por imagem
7.
Eur J Gynaecol Oncol ; 33(2): 214-6, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22611967

RESUMO

A case of peritonitis as an unusual complication of LLETZ (large loop excision of the transformation zone) for the treatment of CIN III associated with unrecognized iatrogenic posterior colpotomy is presented. After the procedure, the patient developed fever 38.3 degrees C and diffused severe pelvic pain. The contributing factors, prevention and management of this complication are discussed. Also, the complications of cold knife cervical conization and LLETZ procedure are reviewed.


Assuntos
Peritonite/etiologia , Complicações Pós-Operatórias/etiologia , Displasia do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/cirurgia , Vagina/lesões , Adulto , Feminino , Humanos , Adulto Jovem
8.
Acta Haematol ; 126(1): 54-62, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21474922

RESUMO

BACKGROUND/AIMS: Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) share the same acquired lesion JAK2(V617F) and may exhibit substantial overlap. Variability in JAK activation and allele burden, complemented by host, genetic and non-genetic modifiers, determine the phenotype. The aim of this study was to investigate the presence of the JAK2 mutation in association with the ratio of metallopeptidases inhibitors (TIMPs) to tissue metallopeptidases (MMPs) in MPNs, where inhibitory rather than proteolytic activity in marrow microenvironment appears to predominate. METHODS: 94 patients with polycythemia vera, essential thrombocythemia and primary myelofibrosis, and 102 healthy individuals were evaluated. Allele-specific PCR and RFLP were used to detect JAK2 and genomic status. Serum concentrations of MMP and TIMP were measured by ELISA. The parameters were assessed with covariance analysis, and adjusted for gender, age and co-morbidity. RESULTS: Mutation frequency was 81.91%. Abnormal TIMP/MMP ratios were identified in all three diseases. JAK2 mutation was correlated with significant changes in TIMP concentrations. CONCLUSIONS: Identification of an abnormal TIMP/MMP ratio in all three diseases, regardless of the JAK2 status, indicates invariable marrow remodeling. In this particular group of patients, presence of a JAK2(V617F) mutation, being associated with even higher ratios, appears to be a concurring participant in bone marrow-reforming processes. Additional research may delineate correlates with the JAK2 allelic burden.


Assuntos
Genes abl , Janus Quinase 2/genética , Metaloproteinases da Matriz/metabolismo , Mutação , Transtornos Mieloproliferativos/metabolismo , Inibidores de Proteases/farmacologia , Idoso , Feminino , Humanos , Hidrólise , Masculino , Inibidores de Metaloproteinases de Matriz , Pessoa de Meia-Idade , Transtornos Mieloproliferativos/enzimologia , Transtornos Mieloproliferativos/genética
9.
Leuk Res ; 32(10): 1593-6, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18321571

RESUMO

Approximately half of essential thrombocythemia (ET) patients and almost all with polycythemia vera (PV) bear the activating JAK2617V>F point mutation, which arises at the multipotent haemopoietic progenitor cell level. Although ET is mainly characterized by megacaryocyte proliferation, the cases that are positive for the JAK2617V>F mutation also show increased bone marrow cellularity and higher erythrocyte and granulocyte counts. After establishing short- and long-term bone marrow cultures we found that the frequency of committed haemopoietic progenitors in the bone marrow, was not increased in JAK2617V>F positive ET compared to the negative ones, whereas in long-term cultures (LTBMC) JAK2617V>F positive ET display a growth pattern more similar to that observed in LTBMC produced by PV marrow cells. Our data support the notion that JAK2617V>F positive ET and PV represents a continuum spectrum of alterations within the same disease.


Assuntos
Hematopoese/genética , Janus Quinase 2/genética , Mutação Puntual , Trombocitemia Essencial/genética , Substituição de Aminoácidos , Células Cultivadas , Células-Tronco Hematopoéticas/patologia , Humanos , Policitemia Vera/patologia , Trombocitemia Essencial/patologia
10.
Rofo ; 180(7): 621-30, 2008 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-18561065

RESUMO

PURPOSE: To describe typical morphological patterns of abacterial prostatitis using magnetic resonance imagine (MRI) in chronic pelvic pain syndrome patients including spectroscopy. MATERIALS AND METHODS: 18 patients (age range between 25 and 67 years, average 46.2 years) with recurrent chronic pelvic pain syndrome for at least 3 months were evaluated clinically in the urological department and included if there were no suspicious findings from endorectal digital palpation and if their PSA values were < 5 ng/ml. A retrospective analysis of these 18 patients with 30 contrast-enhanced MRI investigations with endorectal coils in 28 of 30 cases was performed with a 1.5T MRI. T 2w signal intensity (SI) and spectroscopy data (9 / 18 patients) were acquired for the normal peripheral zone, the central zone, for the peripheral zone suspected of inflammation and for the muscle including SI ratios for the unaltered and the suspicious inflammatory peripheral zone. RESULTS: Typical MR patterns of signal alterations suspected of inflammation of CPPS patients were able to be detected as T 2w hypointense triangular, stringy (n = 12, 66.6 %) contrast-enhancing signal alterations without a nodular shape with well circumscribed margins of the capsula and without pericapsular signal alterations. In 6 patients changes also had a triangular but more homogeneous aspect (33.3 %). Three patients had an additional periurethral uptake (16.6 %). T 2w SI measurements and T 2w SI ratios showed much lower values for the peripheral zone suspected of inflammation as compared to the normal peripheral zone of the prostate (277.29 STD 77.5 to 432.9 STD 112.02 and 4.94 STD 1.47 to 7.58 STD 2.01 respectively). The spectroscopic analysis of the signal alterations suspected of inflammation showed normal Cholin+Creatin/Citrate SI ratio values in 3 patients (SI < 0.5), ratios suspected of low grade cancer in 3 patients (SI 0.5 and < 0.7) and ratios suspected of intermediate grade prostate cancer in 3 patients (SI > 0.7 and < 3.0). CONCLUSIONS: We saw typical MR patterns in CPPS patients. However, spectroscopy can mimic findings of cancer so that the knowledge of typical morphological patterns and a solid clinical evaluation play a major role in the diagnosis of CPPS.


Assuntos
Imageamento por Ressonância Magnética/métodos , Dor Pélvica/diagnóstico , Próstata/patologia , Prostatite/patologia , Adulto , Idoso , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
11.
Orthopade ; 37(12): 1210-6, 2008 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-18806997

RESUMO

BACKGROUND: The efficacy and tolerability of oral controlled-release oxycodone in the therapy of musculoskeletal pain were analyzed in this observational study. PATIENTS AND METHODS: A total of 843 patients with severe to most severe pain in the musculoskeletal system were treated with controlled-released oxycodone for 4 weeks or up to a maximum of 6 months. Severity of pain, impairment in quality of life, and mobility associated with the pain were assessed before and during therapy with controlled-release oxycodone by a numerical rating scale (NRS 0-10). RESULTS: Pain intensity fell by an average of 65% within the first 4 weeks. Physical therapy was practicable in many patients only after implementation of a therapy regime with controlled-release oxycodone. Quality of life improved significantly under therapy with oxycodone, and the impairment of different aspects of life decreased by 50%. CONCLUSION: The therapy of pain of the musculoskeletal system with controlled-release oxycodone is efficient. An effective pain relief makes physical therapy practicable, reduces the impairment in different parts of life, and increases quality of life.


Assuntos
Analgésicos Opioides/administração & dosagem , Fraturas Espontâneas/reabilitação , Osteoartrite da Coluna Vertebral/reabilitação , Osteoartrite/reabilitação , Osteoporose/reabilitação , Oxicodona/administração & dosagem , Dor/tratamento farmacológico , Modalidades de Fisioterapia , Fraturas da Coluna Vertebral/reabilitação , Estenose Espinal/reabilitação , Analgésicos Opioides/efeitos adversos , Descompressão Cirúrgica/reabilitação , Preparações de Ação Retardada , Discotomia/reabilitação , Relação Dose-Resposta a Droga , Seguimentos , Humanos , Oxicodona/efeitos adversos , Medição da Dor , Dor Pós-Operatória/tratamento farmacológico , Fusão Vertebral/reabilitação
12.
Urologe A ; 47(5): 601-7, 2008 May.
Artigo em Alemão | MEDLINE | ID: mdl-18311555

RESUMO

BACKGROUND: The spectrum of percutaneous stone treatment was significantly widened following the introduction of the miniaturized percutaneous nephrolitholapaxy. At the end of the procedure usually a nephrostomy tube was placed to avoid urine paravasation and prolonged bleeding. In this work the tube-less mini-PCNL with direct closure of the access tract was compared to traditional mini-PCNL with placement of the nephrostomy tube. PATIENTS AND METHODS: Twenty consecutive patients undergoing mini-PCNL with placement of a nephrostomy tube at the end of the procedure were compared to 20 consecutive patients with direct closure of the access tracts following percutaneous stone removal. Clinical data like decrease in Hb, complications, need for analgesics and duration of hospital stay were compared. RESULTS: Both groups underwent the procedure without complications. There was no need for blood transfusions. The difference in total analgetic dose was not statistically significant; however, patients in the nephrostomy group needed analgetics for a longer period of time. There was no difference in duration of hospital stay (3.2 days in the tube-less group versus 3.4 days in the nephrostomy group). The primary stone-free rate was higher in the group with direct closure of the access tract (95 versus 85%). CONCLUSIONS: Closure of the percutaneous access following mini-PCNL with a gelatine-thrombin-haemostatic sealant is a safe alternative to the commonly used nephrostomy tube and can help to reduce postoperative pain and patient discomfort.


Assuntos
Esponja de Gelatina Absorvível/uso terapêutico , Hemostasia Cirúrgica/métodos , Cálculos Renais/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Nefrostomia Percutânea/métodos , Adolescente , Adulto , Idoso , Desenho de Equipamento , Feminino , Hemoglobinometria , Humanos , Cálices Renais/diagnóstico por imagem , Cálices Renais/cirurgia , Pelve Renal/diagnóstico por imagem , Pelve Renal/cirurgia , Masculino , Pessoa de Meia-Idade , Miniaturização/instrumentação , Nefrostomia Percutânea/instrumentação , Medição da Dor , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Urografia
13.
Urologe A ; 47(9): 1066, 1068-73, 2008 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-18709351

RESUMO

Minimally invasive percutaneous nephrolithopaxy (MIP) was developed to combine the excellent stone-free rates of the conventional percutaneous nephrolithopaxy (PCNL) technique with the low morbidity of the miniaturized PCNL (Mini-Perc) and, at the same time, achieve a high level of patient comfort. The procedure is characterized not only by the diameter of the miniaturized 18-Fr Amplatz sheath that was adopted from the Mini-Perc but also by the following features: ultrasound-guided puncture of the kidney; single-step dilatation of the access tract; ballistic lithotripsy; a low-pressure irrigation system together with stone retraction by irrigation with a specially designed nephroscope sheath, for the so-called vacuum cleaner effect; and a sealed and tubeless access tract with primary closure of the channel independent of hemorrhage and without a second-look procedure.The results of the first 57 patients demonstrate primary stone-free rates of 92.9% with operating times averaging 62 (25-123) min. Severe complications, such as sepsis or bleeding requiring blood transfusion, did not occur. The high and predictable stone-free rate and a low morbidity comparable to that of ureteroscopy and extracorporeal shock-wave lithotripsy make MIP an attractive option for patients and urologists. The "vacuum cleaner effect" with quick removal of stone fragments reduces operating time and prevents new stone formation by avoiding residual fragments. The direct and primary closure of the access tract increases patient comfort and is justified by the reintervention rate of less than 8% in the presented cohort.The lack of a need for second-look nephroscopies, the vacuum cleaner effect, improved patient comfort without nephrostomy tubes, as well as surgery times comparable to that of traditional PCNL demonstrate a consequent evolution of the Mini-Perc. MIP therefore represents a promising and future-oriented module in modern stone therapy.


Assuntos
Cálculos Renais/cirurgia , Litotripsia/instrumentação , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Nefrostomia Percutânea/instrumentação , Adolescente , Adulto , Idoso , Criança , Desenho de Equipamento , Feminino , Hemostasia Cirúrgica/instrumentação , Humanos , Masculino , Pessoa de Meia-Idade , Miniaturização/instrumentação , Hemorragia Pós-Operatória/diagnóstico por imagem , Hemorragia Pós-Operatória/prevenção & controle , Tomografia Computadorizada por Raios X , Adulto Jovem
14.
Nuklearmedizin ; 46(5): 161-8; quiz N47-8, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17938748

RESUMO

UNLABELLED: Aim of this study was to compare the diagnostic accuracy of positron emission tomography and computed tomography with (11)C-Choline (Cho-PET/CT) and whole body magnetic resonance imaging (WB-MRI) for diagnostic work-up of prostate cancer. PATIENTS, METHODS: We evaluated retrospectively 42 patients with untreated prostate cancer (n = 17), or increasing levels of prostate-specific antigen (PSA) after curative therapy (n = 25) who had been investigated by both Cho-PET/CT and WB-MRI. MRI, CT, and PET images were separately analyzed by experienced radiologists or nuclear medicine experts, followed by consensus reading. Validation was established by histology, follow-up, or consensus reading. RESULTS: 88/103 detected lesions were considered as malignant: 44 bone metastases, 22 local tumor, 15 lymph node metastases, 3 lung, and 3 brain metastases. One further lesion was located in the adrenal gland, which was a second tumor. Overall sensitivity, specificity and accuracy for Cho-PET/CT were 96.6%, 76.5%, and 93.3%, resp., and for WB-MRI 78.4%, 94.1%, and 81.0%, resp. 3 vertebral metastases had initially been missed by Cho-PET/CT and were found retrospectively. MRI identified 2 bone metastases and 1 lymph node metastasis after being informed about the results of Cho-PET/CT. CONCLUSIONS: Cho-PET/CT and WB-MRI both presented high accuracy in the detection of bone and lymph node metastases. The strength of MRI is excellent image quality providing detailed anatomical information whereas the advantage of Cho-PET/CT is high image contrast of pathological foci.


Assuntos
Estadiamento de Neoplasias/métodos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias Ósseas/secundário , Radioisótopos de Carbono , Humanos , Metástase Linfática/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Metástase Neoplásica/diagnóstico por imagem , Metástase Neoplásica/patologia , Tomografia por Emissão de Pósitrons , Neoplasias da Próstata/patologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X
15.
Clin Exp Obstet Gynecol ; 34(3): 154-8, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17937090

RESUMO

OBJECTIVE: To measure the incidence of preeclampsia-eclampsia and its perinatal mortality as they appear in the two major ethnic groups in Thrace: Christian Orthodox and Muslims. STUDY DESIGN: Incidence and perinatal mortality of preeclampsia-eclampsia were studied retrospectively on all women managed in our clinic for hypertensive disorders in pregnancy who were delivered of a stillborn or healthy neonate between 1986 and 1999. We also compared the prevalence of certain risk factors of the disease as they appear in the above-mentioned distinct ethnic groups. RESULTS: The total incidence of preeclampsia-eclampsia in Thrace was 2.3% and the total perinatal mortality 6.4%. Both variables presented higher values and severe preeclampsia-eclampsia had greater prevalence in the Muslim population. Most risk factors presented statistically significant differences between Christians and Muslims (chi2 test, p < 0.05). CONCLUSIONS: There was an ethnic variation in most epidemiologic variables of hypertensive disorders in Thrace between Christians and Muslims.


Assuntos
Mortalidade Fetal/etnologia , Mortalidade Infantil/etnologia , Pré-Eclâmpsia/etnologia , Pré-Eclâmpsia/epidemiologia , Adolescente , Adulto , Ortodoxia Oriental , Feminino , Grécia/epidemiologia , Humanos , Incidência , Recém-Nascido , Islamismo , Gravidez , Estudos Retrospectivos , Fatores de Risco
16.
Clin Exp Obstet Gynecol ; 34(1): 42-6, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17447637

RESUMO

This is a report on our experience in the application of biomagnetism in perinatal medicine. We provide a brief description of our research work in fetal magnetoencephalography and fetal magnetocardiography in normal, preeclamptic and IUGR pregnancies, together with hemodynamics of the umbilical cord and uterine arteries, providing a new approach to biomagnetism as a non invasive imaging modality in the investigation of perinatal complications.


Assuntos
Retardo do Crescimento Fetal/fisiopatologia , Feto/fisiologia , Magnetocardiografia/métodos , Magnetoencefalografia/métodos , Pré-Eclâmpsia/fisiopatologia , Diagnóstico Pré-Natal/métodos , Cordão Umbilical/fisiologia , Feminino , Retardo do Crescimento Fetal/diagnóstico , Grécia , Humanos , Pré-Eclâmpsia/diagnóstico , Gravidez , Cordão Umbilical/irrigação sanguínea , Útero/irrigação sanguínea
17.
Urologe A ; 46(9): 1104-12, 2007 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-17701393

RESUMO

BACKGROUND: After sufficient oncological treatment of prostate cancer the life quality becomes most important. A multi disciplinary research network aims to optimize the diagnostics and the resulting treatment of prostate cancer. METHODS: Main characteristics of the interdisciplinary cooperation are the interlocked individual projects. A major research field is investigation of the whole mounted prostate sections to study the peripheral nerves and the comparison of histological tumor locations with the MRI. Using serial sections of prostate specimens, three-dimensional computer-animated models are created illustrating the tumors histological and immunohistochemical distributions. For nodal staging, a new methodology is investigated to demonstrate single tumor cells in lymphatic tissue lysates. A retrospective evaluation of life quality including the functional outcome is performed by using questionnaire surveys. RESULTS: Anatomical studies gave new insights into the exact localizations of peripheral nerves which may lead to an improvement of the surgical approach in nerve-sparing radical prostatectomy. For the preoperative planning the MRI imaging might need a different interpretation in relation to the topographic location. Studies using molecular markers and their relation and distribution patterns gave new insights regarding interpretation of histological biopsy results concerning the tumor extension. Numerical quantification of tumor cells in each lymph node demonstrated micro metastases in histological negative nodes contributing to the nodal staging. A close connection of the nerve-sparing technique was demonstrated with quality of life aspects and functional results. CONCLUSION: An interdisciplinary approach is mandatory for translational prostate cancer research. As a result, individualized diagnostic and therapeutic approaches improve oncological results and at the same time provide the best quality of life in these patients.


Assuntos
Comportamento Cooperativo , Disfunção Erétil/prevenção & controle , Microcirurgia/métodos , Equipe de Assistência ao Paciente , Complicações Pós-Operatórias/prevenção & controle , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Garantia da Qualidade dos Cuidados de Saúde , Incontinência Urinária/prevenção & controle , Disfunção Erétil/psicologia , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Excisão de Linfonodo/métodos , Imageamento por Ressonância Magnética , Masculino , Microcirurgia/psicologia , Estadiamento de Neoplasias , Nervos Periféricos/patologia , Complicações Pós-Operatórias/psicologia , Próstata/inervação , Próstata/patologia , Prostatectomia/psicologia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/psicologia , Qualidade de Vida/psicologia , Incontinência Urinária/patologia , Incontinência Urinária/psicologia
18.
Eur J Gynaecol Oncol ; 27(6): 594-6, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17290589

RESUMO

Our experience in the application of biomagnetism in gynaecologic oncology is presented. We provide a brief description of our research work in the investigation of biomagnetic activity in benign and malignant ovarian and breast diseases, and an evaluation of uterine myomas, providing a new approach of biomagnetism as a non invasive imaging modality for assessing gynaecologic tumours.


Assuntos
Leiomioma/diagnóstico , Magnetismo , Neoplasias Ovarianas/diagnóstico , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Feminino , Grécia , Humanos , Leiomioma/patologia , Magnetismo/instrumentação , Neoplasias Ovarianas/patologia
19.
Clin Exp Obstet Gynecol ; 33(4): 229-32, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17211972

RESUMO

This study reports our experience in the application of magnetoencephalography (MEG) and magnetocardiography (MCG) in neonates. Results gained from our studies, lead us to believe that MEG and MCG could provide clinical practice with non-invasive, rapid and easy to perform methods, which could be adjuncts to conventional methods for the evaluation of neonatal brain and heart function.


Assuntos
Recém-Nascido/fisiologia , Magnetocardiografia , Magnetoencefalografia , Triagem Neonatal/métodos , Adolescente , Adulto , Feminino , Grécia , Humanos , Gravidez
20.
J Cancer Res Clin Oncol ; 131(7): 407-19, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15887028

RESUMO

INTRODUCTION: Radical prostatectomy and radiotherapy are currently accepted treatment modalities for localized prostate cancer. Regarding radiotherapy, current evidence suggests that favorable treatment outcome critically depends on adequate radiation doses. However, the exact role of dose in relation to the individual risk profile is complex. In order to evaluate available data on radiation dose response relationships, in prostate cancer, a thorough and critical literature analysis was performed. MATERIAL AND METHODS: Studies on dose response relationships from randomized trials, dose escalation trials, retrospective subgroup analyses and pooled data were identified by Pubmed and ISI web of sciences searches and were critically reviewed. RESULTS AND CONCLUSION: All available data suggest a clear dose response relationship for radiotherapy for localized prostate cancer. In low risk cases, most studies suggest that doses of 70-72 Gy are adequate. Dose escalations up to 78-80 Gy seem to be beneficial for intermediate risk patients. Due to confounding variables, the dose response curves for high-risk patients are less steep. The integration of dose escalation into a more comprehensive treatment protocol is difficult, since trials on the relative impact of either hormonal ablation or inclusion of adjuvant nodal regions on dose escalation are missing.


Assuntos
Neoplasias da Próstata/radioterapia , Ensaios Clínicos como Assunto , Humanos , Masculino , Antígeno Prostático Específico/análise , Neoplasias da Próstata/sangue , Neoplasias da Próstata/mortalidade , Dosagem Radioterapêutica , Taxa de Sobrevida , Resultado do Tratamento
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