Dan Richter Levin

Cancer of the Prostate: Is There a Need for Aggressive Treatment?

Adenocarcinoma of the prostate constitutes 18 % of all cancers in men, and is a major cause of neoplastic death second only to carcinoma of lungs and large bowel. In spite of the high incidence of the disease, there is still disagreement as to the right treatment. In our study we reviewed 101 patients in stages T0b, T1 + T2, T3 (N₀M₀) who were treated by nonradical prostatectomy and no other treatment. The follow-up of these patients was 58 months. The actuarial 5- and 10-year survival according to stage was respectively: 91.30 and 64.62% in stage T0b; 60.61 and 34.11 % in stage T1 + T2, and 41.67% in stage T3. Survival rates resembled those quoted in the literature. Our results justify a less aggressive approch to carcinoma of the prostate.

Lich-Gregoir anti-reflux operation: a surgical experience and 5-20 years of follow-up in 149 ureters

The surgical management of vesicoureteral reflux and the choice between the many good procedures available continue to be debated by urologists. The goal of each procedure is to achieve as normal a function of the urinary system as possible, to eliminate urinary tract infections, and thus to prevent further kidney damage. We present our experience in 149 antireflux repair operations with a technique first described by Lich and Gregoir in 1961. The follow-up in this study is 5-20 years, throughout which recurrent infections, reflux and other operative complications have carefully been considered. The success rate of this operation was 92.5%, with an additional 3.75% success in repair operations. Discussion and evaluation of other repair methods are reviewed but, in our opinion the Lich-Gregoir technique, because of its simplicity, should be the method of choice and should be used more by urologists.

An operation for incisional lumbar hernia.

To date, no standard technique for incisional lumbar hernia repair can be recommended since it depends on the size of the defect in the transversalis fascia. A new technique for this purpose, by using plication of the normal fascia, is described.

Obstructive jaundice caused by metastatic renal cell carcinoma.

We report the first instance of extrahepatic obstructive jaundice caused by renal cell carcinoma metastasis to ampulla of Vater

Effect of diclofenac sodium (Voltaren) and prostaglandin E2 on spermatogenesis in mature dogs

The effect of the prostaglandin-synthesis inhibitor, diclofenac sodium (Voltaren), and of prostaglandin E2 (PGE2) on spermatogenesis in mature dogs has been studied. Diclofenac sodium at 2.0 mg/kg was given subcutaneously once a day for 42 days. The testes were biopsied every 7 days, and spermatogenesis was quantified showing a marked and statistically significant increase (p less than 0.001). Administration of PGE2 in doses of 2.0 mg/kg subcutaneously, once a day for 15 days, produced a marked and statistically significant decrease in spermatogenesis (p less than 0.001), and an increase in the numbers of exfoliated immature germ cells in the seminiferous tubule lumens.

Metastatic Renal Cell Carcinoma to the Bladder

We report a case of metastatic renal cell carcinoma to the bladder. Our patient presented gross hematuria 6 months after treatment of the primary lesion. The possible routes and treatment regimens of metastasis of this site of lesion are discussed and a review of the literature is presented.

Dual-hologram shearing interferometry with regulated sensitivity.

A novel optical diagnostic technique, namely, dual-hologram shearing interferometry with regulated sensitivity, is proposed for visualization and measuring of the density gradients of compressible flows in wind tunnels. It is superior to conventional shearing interferometry in both accuracy and sensitivity. The method is especially useful for strong turbulent or unsteady regions of the flows, including shock flows. The interferometer has proved to be insensitive to mechanical vibrations and has allowed us to record holograms during the noisy wind-tunnel run. The proposed approach is demonstrated by application to a supersonic flow over spherically blunted and sharp nose-cone–cylinder models. We believe that the technique will become an effective tool for receiving optical data in many flow facilities.

Effect of extracorporeal piezoelectric lithotripsy shock waves on renal function measured by Tc-99m-DMSA using spect

Extracorporeal shock-wave lithotripsy has altered the therapeutic approach to urinary stone disease. Recently, a method was developed in which shock-wave generation is obtained piezoelectrically. To evaluate the effect of extracorporeal piezoelectric lithotripsy (EPL) on renal function, 20 patients were studied prior to and after EPL of renal calculi. Renal cortical function was evaluated by using a previously described and validated quantitative single photon emission computerized tomography (SPECT) method to measure individual absolute uptake of technetium-99m dimercaptosuccinic acid (Tc-99m-DMSA). Twenty kidneys were treated, and the 19 contralateral kidneys were without stone disease (1 patient had a single kidney). The absolute kidney uptake of Tc-DMSA in the normal kidneys was 21.4% +/- 6.2% before and 22.2% +/- 6.4% after EPL. For the treated kidneys the absolute update was 16.8% +/- 5.3% and 16.8% +/- 4.7% before and after, respectively. There was no statistical significant difference between pre- and post-treatment values. The absolute kidney uptake was significantly lower (p less than 0.01) in the treated than in the normal kidneys. This study indicates that the EPL procedure did not cause any damage to cortical function detectable by the DMSA uptake.

Paratesticular Papillary Mesothelioma

A case of uncommon paratesticular mesothelioma in a young patient is presented. Its questionable malignancy, as well as the method of treatment are discussed.

Effect of diclofenac sodium (Voltaren) on spermatogenesis of infertile oligospermic patients

The effect of the prostaglandin synthesis inhibitor diclofenac sodium (Voltaren) on spermatogenesis in infertile oligospermic patients has been studied. Diclofenac sodium was given orally at a daily dose of 100 mg for 30 days. Seminal fluid parameters were evaluated. Group II with high levels of seminal prostaglandin showed a statistically significant increase in the number and motility of spermatozoa (p less than 0.01), whilst no significant variations were observed in patients of group I with normal values of seminal prostaglandin.