Sava Micic

Survival of patients with transitional cell carcinoma of the ureter and renal pelvis in Balkan endemic nephropathy and non-endemic areas of Serbia

An interesting reminder about TCC of the ureter and renal pelvis in Serbia is presented, comparing endemic and non‐endemic areas. The authors found similarities between the areas, but also that survival was influenced by female sex, and tumour size, grade and stage.

Chromosomal constitution of infertile men

Mitotic chromosome analyses performed on 820 infertile men revealed 60 (7.3%) men with some kind of chromosomal abnormality. Sex chromosomal abnormalities were detected in 28 (3.4%) and autosomal translocations in 9 (1.0%). Pericentric inversions of chromosome 9, with possible adverse effect on reproduction, was found in 23 (2.8%). Chromosome variants comprised a group of 77 (9.3%) subjects. We suggest that men with severe oligozoospermia and azoospermia should be considered for cytogenetical evaluation.

Comparison of Open Nephroureterectomy and Open Conservative Management of Upper Urinary Tract Transitional Cell Carcinoma

Introduction: The treatment preserving the kidney for upper urinary tract (UUT) transitional cell carcinoma (TCC) is still controversial. We aimed to elucidate the results of open conservative surgery and compare them with the results of radical nephroureterectomy (RNU). Patients and Methods: The study included 107 patients with UUT TCC treated by open conservative surgery (21 patients) or nephroureterectomy (86 patients). Epidemiological, clinical and pathological characteristics of patients as well as 5-year survival rates were compared between groups. Results: Patients treated by conservative surgery had a significantly higher rate of bilateral tumors (38% vs. 3%, p = 0.0001) and smaller tumor size than those treated by radical operations (2.60 ± 1.24 vs. 3.99 ± 3.94 cm, p = 0.060). Five-year survival rates for patients treated by conservative and radical surgery were 59 and 55%, respectively. Within the group of patients treated by conservative surgery, 5-year overall survival rates of patients operated due to imperative and elective indications were 41 and 75%, respectively. In univariate analysis, RNU was a statistically significant predictor of poorer outcome of the disease in comparison with conservative surgery (HR = 2.2, 95% CI 1.1–4.6, p = 0.030). Conclusions: The mode of operation affects the outcome of UUT TCC patients, in addition to factors such as tumor grade, stage and size.

Phenotype of two males with abnormal Y chromosomes

Two infertile males with sex chromosomal abnormalities and mosaic karyotype, 45,X/ 46,X,dic(Yq) and 45,X/46,X,ring(Y), had considerably changed physical findings, including tooth sizes and craniofacial dimensions. Spermatogenesis was preserved with abnormal meiotic chromosomal behaviour. Mosaic karyotype and structurally changed Y chromosome in both cases had an influence on physical parameters. Testes were normally developed and spermatogenesis was preserved but depressed in later stages.

Low chiasma frequency as an aetiological factor in male infertility.

Among 120 meiotic analyses of infertile men there were three cases with a particular meiotic anomaly: low chiasma count at diakinesis and spermatogenic arrest. All clinical findings, hormonal analyses and karyotypes from peripheral blood were normal. Meiotic studies showed that pachytene pairing was complete, but in diakinesis the mean number of chiasmata per cell was significantly lowered, chromosomes were fragmented and univalents could frequently be found. In all three cases azoospermia was the consequence of spermatogenic arrest, which occurred after diakinesis‐metaphase I.

Testis sparing surgery in the treatment of bilateral testicular germ cell tumors and solitary testicle tumors: A single institution experience.

To assess the oncologic and functional outcomes of testicular sparing surgery (TSS) based on a single institution experience.

Seminal antisperm antibodies and genitourinary infection

A total of 326 infertile men, 126 with genitourinary tract infection, and 200 without infection, were compared with 60 fertile men. Seminal plasma antisperm antibody with other clinical and microbiologic investigations were performed in all. Infertile men with genitourinary tract infection had antisperm antibody in 11.9 percent, infertile men without infection in 14.5 percent, and fertile men in 5 percent; these differences were not significant. The most common causes of these infections were gram-negative organisms and Chlamydia. Comparison of the levels of the titers of seminal plasma antisperm antibodies showed no significant difference between infertile and fertile men. This study shows no significant relationship between genitourinary tract infection and formation of the seminal antisperm antibody.

Double minute chromosomes in an invasive adenocarcinoma of the prostate

Cytogenetic analysis of an uncultured, primary and invasive adenocarcinoma of the prostate showed several clonal abnormalities in a hyperdiploid karyotype, including double minute (dmin) chromosomes. The latter, although sporadic in this type of tumor, were previously reported in two cases of invasive prostatic cancer. This anomaly may therefore be associated with increased malignant properties.

Meiotic studies in two infertile males with autosomal translocations.

SummaryMeiotic studies were performed in two infertile male carriers of balanced reciprocal translocations between chromosomes 3;5 and 6;10. The first patient had severe oligozoospermia with all stages of meiosis present. The other patient was azzospermic with meiotic breakdown after the first meiotic division. A ring quadrivalent configuration was found in diakinesis in both cases.

Solitary Kidney Stone Treatment by Extracorporeal Shock Wave Lithotripsy

OBJECTIVES To determine if solitary kidney stones can be successfully treated with ESWL. METHODS 38 patients were examined, 34 stones were treated on a Dornier lithotripter HM-3, and 4 on a Siemens Lithostar. 17 stones were larger than 400 mm2, 11 were incomplete and 6 complete staghorn calculi. In 26 patients a catheter was placed before lithotripsy, double-J and ureteral stents in 14 and 12, respectively. RESULTS Successful outcome of lithotripsy was achieved in 34 patients (89%). Complete fragment elimination was recorded in 23 patients (60%), and in 11 (29%) a negligible residuum was noticed. Treatment failure was recorded in 4 patients. In 3 patients fragment elimination was poor, and in 1 patient 3 ESWL sessions were not sufficient to commence stone destruction and we decided to operate on this patient. Anuria occurred in 4 patients (10%). CONCLUSIONS Our results suggest that ESWL can be successfully used in the treatment of urolithiasis in a solitary kidney. Even in cases of staghorn stones, the obligatory placement of a double-J catheter, and strategic lithotripsy in several sessions result in a high success rate with a tolerable risk of complications.