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Nativ O, Shefler A, Bejar J, Peschansky S, Lavi A, Michael C, Nativ O. Performance of standard systematic biopsy versus MRI/TRUS fusion biopsy using the Navigo® system in contemporary cohort. Urol Oncol 2024; 42:159.e1-159.e7. [PMID: 38431487 DOI: 10.1016/j.urolonc.2024.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/10/2024] [Accepted: 01/25/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION The introduction of multi parameter magnetic resonance imaging (mpMRI) of the prostate in combination with MRI/TRUS fusion and systematic biopsy resulted in improved detection of prostate cancer. The aim of the current study was to document the performance of MRI/TRUS fusion biopsy of the prostate using the Navigo™ software in a contemporary cohort of patients from nonreferral centers. MATERIAL AND METHODS We performed a two centers prospective data collection (2014-2020) for men with clinically suspected Pca and patients on active surveillance for low-risk Pca that were referred for TRUS biopsy after performing mpMRI of the prostate with a visible lesion. The primary outcome was detection of clinically significant cancer (csPca) defined as ISUP grade group ≥2. Patients were stratified according to biopsy technique and PI-RADS category. RESULTS The study group included 236 patients of whom 129 (54.9%) were diagnosed with Pca and 82 (34.7%) with csPca (GG ≥ 2) on combined biopsy. The overall detection of csPca was 31% for targeted vs. 25.4% for systematic biopsy with an absolute difference of 5.6% in favor of the fusion technique. No significant difference between the two techniques was observed for detection of benign prostate or GG1 disease. The improved performance of the targeted approach was noted only in patients with PI-RADS 4 and 5 lesions. Of the patients with csPca 10 (12%) were diagnosed only by the systematic biopsy while 20 (24%) were detected only in the fusion biopsy. Systematic biopsy of prostate lobe without MRI lesion detected only 2 cases (∼1%) with high grade disease. CONCLUSIONS Detection of csPca by mpMRI/TRUS fusion biopsy using the 3D Navigo™ system is feasible. The targeted approach outperforms the systematic one, however the later technique also detects high risk disease and should be included in the biopsy procedure. The overall detection rate (34.9%) of clinically significant prostate cancer by both targeted and systematic sampling is relatively low.
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Affiliation(s)
- Omri Nativ
- Department of Urology, Rambam Medical, Haifa, Israel.
| | | | - Jacob Bejar
- Department of Pathology, Bnai Zion Medical Center, Haifa, Israel
| | | | - Arnon Lavi
- Department of Urology, Hemek Medical Center, Afula, Israel
| | - Cohen Michael
- Department of Urology, Hemek Medical Center, Afula, Israel
| | - Ofer Nativ
- Department of Surgery, Elisha Medical Center, Haifa, Israel
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Cohen-Segev R, Nativ O, Kinaneh S, Aronson D, Kabala A, Hamoud S, Karram T, Abassi Z. Effects of Angiotensin 1-7 and Mas Receptor Agonist on Renal System in a Rat Model of Heart Failure. Int J Mol Sci 2023; 24:11470. [PMID: 37511227 PMCID: PMC10380355 DOI: 10.3390/ijms241411470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/09/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Congestive heart failure (CHF) is often associated with impaired kidney function. Over- activation of the renin-angiotensin-aldosterone system (RAAS) contributes to avid salt/water retention and cardiac hypertrophy in CHF. While the deleterious effects of angiotensin II (Ang II) in CHF are well established, the biological actions of angiotensin 1-7 (Ang 1-7) are not fully characterized. In this study, we assessed the acute effects of Ang 1-7 (0.3, 3, 30 and 300 ng/kg/min, IV) on urinary flow (UF), urinary Na+ excretion (UNaV), glomerular filtration rate (GFR) and renal plasma flow )RPF) in rats with CHF induced by the placement of aortocaval fistula. Additionally, the chronic effects of Ang 1-7 (24 µg/kg/h, via intra-peritoneally implanted osmotic minipumps) on kidney function, cardiac hypertrophy and neurohormonal status were studied. Acute infusion of either Ang 1-7 or its agonist, AVE 0991, into sham controls, but not CHF rats, increased UF, UNaV, GFR, RPF and urinary cGMP. In the chronic protocols, untreated CHF rats displayed lower cumulative UF and UNaV than their sham controls. Chronic administration of Ang 1-7 and AVE 0991 exerted significant diuretic, natriuretic and kaliuretic effects in CHF rats, but not in sham controls. Serum creatinine and aldosterone levels were significantly higher in vehicle-treated CHF rats as compared with controls. Treatment with Ang 1-7 and AVE 0991 reduced these parameters to comparable levels observed in sham controls. Notably, chronic administration of Ang 1-7 to CHF rats reduced cardiac hypertrophy. In conclusion, Ang 1-7 exerts beneficial renal and cardiac effects in rats with CHF. Thus, we postulate that ACE2/Ang 1-7 axis represents a compensatory response to over-activity of ACE/AngII/AT1R system characterizing CHF and suggest that Ang 1-7 may be a potential therapeutic agent in this disease state.
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Affiliation(s)
- Ravit Cohen-Segev
- Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 31096, Israel
| | - Omri Nativ
- Department of Urology, Rambam Health Center, Haifa 3109601, Israel
| | - Safa Kinaneh
- Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 31096, Israel
| | - Doron Aronson
- Cardiology, Rambam Health Care Campus, Haifa 3109601, Israel
| | - Aviva Kabala
- Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 31096, Israel
| | - Shadi Hamoud
- Department of Internal Medicine E, Rambam Health Care Campus, Haifa 3109601, Israel
| | - Tony Karram
- Vascular Surgery, Rambam Health Care Campus, Haifa 3109601, Israel
| | - Zaid Abassi
- Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 31096, Israel
- Laboratory Medicine, Rambam Health Care Campus, Haifa 31096, Israel
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Nativ O, Livne P, Zu'bi F, Steinberg R, Hoffman A, Assalia A, Eisenstein I, Assadi A. Simultaneous Renal Transplantation With Bilateral Nephrectomy and Ureterocystoplasty. Urology 2023; 173:164-167. [PMID: 36455677 DOI: 10.1016/j.urology.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 11/29/2022]
Abstract
Bladder augmentation (BA) may be required before renal transplantation in children with end stage renal disease (ESRD). Herein we report a case of a 7-year-old boy with ESRD, contracted bladder and severe bilateral reflux secondary to posterior urethral valve (PUV), successfully managed by simultaneous bilateral nephrectomy, bilateral ureterocystoplasty and renal transplantation.
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Affiliation(s)
- Omri Nativ
- Urology Department, Rambam Medical Center, Haifa, Israel.; Urology Department, Meir Medical Center, Kfar Saba, Israel; Pediatric Surgery Department, Rambam Medical Center, Haifa, Israel.; Vascular surgery Department, HaEmek Hospital, Afula, Israel; General Surgery Department, Rambam Medical Center, Haifa, Israel.; Pediatric Nephrology Department, Rambam Medical Center, Haifa, Israel..
| | - Pinhas Livne
- Urology Department, Rambam Medical Center, Haifa, Israel.; Urology Department, Meir Medical Center, Kfar Saba, Israel; Pediatric Surgery Department, Rambam Medical Center, Haifa, Israel.; Vascular surgery Department, HaEmek Hospital, Afula, Israel; General Surgery Department, Rambam Medical Center, Haifa, Israel.; Pediatric Nephrology Department, Rambam Medical Center, Haifa, Israel
| | - Fadi Zu'bi
- Urology Department, Rambam Medical Center, Haifa, Israel.; Urology Department, Meir Medical Center, Kfar Saba, Israel; Pediatric Surgery Department, Rambam Medical Center, Haifa, Israel.; Vascular surgery Department, HaEmek Hospital, Afula, Israel; General Surgery Department, Rambam Medical Center, Haifa, Israel.; Pediatric Nephrology Department, Rambam Medical Center, Haifa, Israel
| | - Ran Steinberg
- Urology Department, Rambam Medical Center, Haifa, Israel.; Urology Department, Meir Medical Center, Kfar Saba, Israel; Pediatric Surgery Department, Rambam Medical Center, Haifa, Israel.; Vascular surgery Department, HaEmek Hospital, Afula, Israel; General Surgery Department, Rambam Medical Center, Haifa, Israel.; Pediatric Nephrology Department, Rambam Medical Center, Haifa, Israel
| | - Aaron Hoffman
- Urology Department, Rambam Medical Center, Haifa, Israel.; Urology Department, Meir Medical Center, Kfar Saba, Israel; Pediatric Surgery Department, Rambam Medical Center, Haifa, Israel.; Vascular surgery Department, HaEmek Hospital, Afula, Israel; General Surgery Department, Rambam Medical Center, Haifa, Israel.; Pediatric Nephrology Department, Rambam Medical Center, Haifa, Israel
| | - Ahmad Assalia
- Urology Department, Rambam Medical Center, Haifa, Israel.; Urology Department, Meir Medical Center, Kfar Saba, Israel; Pediatric Surgery Department, Rambam Medical Center, Haifa, Israel.; Vascular surgery Department, HaEmek Hospital, Afula, Israel; General Surgery Department, Rambam Medical Center, Haifa, Israel.; Pediatric Nephrology Department, Rambam Medical Center, Haifa, Israel
| | - Israel Eisenstein
- Urology Department, Rambam Medical Center, Haifa, Israel.; Urology Department, Meir Medical Center, Kfar Saba, Israel; Pediatric Surgery Department, Rambam Medical Center, Haifa, Israel.; Vascular surgery Department, HaEmek Hospital, Afula, Israel; General Surgery Department, Rambam Medical Center, Haifa, Israel.; Pediatric Nephrology Department, Rambam Medical Center, Haifa, Israel
| | - Akram Assadi
- Urology Department, Rambam Medical Center, Haifa, Israel.; Urology Department, Meir Medical Center, Kfar Saba, Israel; Pediatric Surgery Department, Rambam Medical Center, Haifa, Israel.; Vascular surgery Department, HaEmek Hospital, Afula, Israel; General Surgery Department, Rambam Medical Center, Haifa, Israel.; Pediatric Nephrology Department, Rambam Medical Center, Haifa, Israel
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Nativ O, Berger E, Fazza N, Zu’Bi F, Kassis I, Dabaja-Younis H, Salame G, Ilivitzki A, Assadi A. Comparison between contrast enhanced voiding urosonography (CEVUS) with standard cystography under fluoroscopy (VCUG) for detection of vesicoureteral reflux in pediatric patients. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00251-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Zisman A, Assadi A, Goldin O, Malshy K, Nativ O, Meretyk S, Amiel GE, Mullerad M, Livne PM. Shock Wave Lithotripsy in Pediatric Stone Disease: A 15-Year Single-Center Experience with 2 Types of Lithotripters. Urol Int 2022; 106:1260-1264. [PMID: 35172318 PMCID: PMC9811415 DOI: 10.1159/000522079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 01/12/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION AND OBJECTIVES We report our experience with pediatric shock wave lithotripsy (SWL) using two types of lithotripters: Dornier HM3 (HM3) and Dornier Lithotripter SII (DLS). STUDY DESIGN We retrospectively reviewed the charts of children who underwent SWL between 2002 and 2016. Patients were divided into two groups based on the type of the lithotripter: during 2002-2009, we used the electrohydraulic HM3 lithotripter which was replaced in 2009 with the DLS electromagnetic lithotripter. Clinical and perioperative parameters were compared. RESULTS Our cohort included 107 children who underwent SWL. Average age was 11.5 ± 5.1 years. Average stone size was 10.6 ± 4.9 mm. HM3 was used in 38% of children and DLS2 in 62% (n = 41 and 66, respectively). There were no significant differences in age, gender, stone size, or location between the groups. The total SFR did not differ statistically between HM3 and DLS (83% vs. 74%, p = 0.35). SFR after one SWL was higher with the HM3 (78% vs. 62%, p = 0.093). Re-treatment rate was 22% and 17% (HM3 vs. DLS, p = 0.61). Complication rates were low, with renal colic being the most common (HM3 10%, DLS 20%, NS). CONCLUSIONS SWL in the pediatric population using the DLS showed good results with low complication rates that are equivalent to the gold standard HM3.
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Rosenzweig B, Haramaty R, Davidson T, Lazarovich A, Shvero A, Haifler M, Gal J, Golan S, Shpitzer S, Hoffman A, Nativ O, Freifeld Y, Zreik R, Dotan ZA. Reply to Veerman et al. Comment on “Rosenzweig et al. Very Low Prostate PET/CT PSMA Uptake May Be Misleading in Staging Radical Prostatectomy Candidates. J. Pers. Med. 2022, 12, 410”. J Pers Med 2022; 12:jpm12060861. [PMID: 35743645 PMCID: PMC9225530 DOI: 10.3390/jpm12060861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/14/2022] [Indexed: 02/01/2023] Open
Affiliation(s)
- Barak Rosenzweig
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Correspondence: ; Tel.: +972-3-5302221
| | - Rennen Haramaty
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
| | - Tima Davidson
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Department of Nuclear Medicine, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel
| | - Alon Lazarovich
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
| | - Asaf Shvero
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
| | - Miki Haifler
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Department of Urology, Shamir Medical Center, Tzrifin 6093000, Israel;
| | - Jonathan Gal
- Department of Urology, Shamir Medical Center, Tzrifin 6093000, Israel;
| | - Shay Golan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Section of Urology, Rabin Medical Center, Petah Tikva 4941492, Israel;
| | - Sagi Shpitzer
- Section of Urology, Rabin Medical Center, Petah Tikva 4941492, Israel;
| | - Azik Hoffman
- Department of Urology, Rambam Health Center, Haifa 3109601, Israel; (A.H.); (O.N.)
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel; (Y.F.); (R.Z.)
| | - Omri Nativ
- Department of Urology, Rambam Health Center, Haifa 3109601, Israel; (A.H.); (O.N.)
| | - Yuval Freifeld
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel; (Y.F.); (R.Z.)
- Department of Urology, Carmel Medical Center, Haifa 3436212, Israel
| | - Rani Zreik
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel; (Y.F.); (R.Z.)
| | - Zohar A. Dotan
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
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Rosenzweig B, Haramaty R, Davidson T, Lazarovich A, Shvero A, Haifler M, Gal J, Golan S, Shpitzer S, Hoffman A, Nativ O, Freifeld Y, Zreik R, Dotan ZA. Very Low Prostate PET/CT PSMA Uptake May Be Misleading in Staging Radical Prostatectomy Candidates. J Pers Med 2022; 12:jpm12030410. [PMID: 35330410 PMCID: PMC8951096 DOI: 10.3390/jpm12030410] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 02/05/2023] Open
Abstract
Purpose: to evaluate a unique subpopulation of radical prostatectomy (RP) candidates with “negative” prostate 68Ga-labeled prostate-specific membrane antigen (PSMA) positron emission tomography (PET) computed tomography (CT) imaging scans and to characterize the clinical implications of misleading findings. Materials and Methods: This case-control retrospective study compared the final histological outcomes of patients with “negative” pre-RP PSMA PET/CT prostate scans (with a prostate maximal standardized uptake value [SUVmax] below the physiologic uptake) to those with an “intense” prostatic tracer uptake (with a SUVmax above the physiologic uptake). The patients underwent an RP between March 2015 and July 2019 in five academic centers. Data on the demographics, comorbidities, prostate-specific antigen (PSA) and rectal exam findings, prior biopsies, imaging results, biopsies, and RP histology results were collected. Results: Ninety-seven of the 392 patients who underwent an RP had PSMA PET/CT imaging preoperatively. Fifty-two (54%) had a “negative” uptake (in the study group), and 45 (46%) had a “positive” uptake (in the control group). Only the lesion size and SUVmax values on the PSMA PET/CT differed between the groups preoperatively. On the histological analysis, only the ISUP score, seminal vesicles invasion, T stage, and positive margin rates differed between the groups (p < 0.05), while 50 (96%) study group patients harbored clinically significant disease (ISUP ≥ 2), with an extra-prostatic disease in 24 (46%), perineural invasion in 35 (67%), and positive lymph nodes in 4 (8%). Conclusions: Disease aggressiveness generally correlated with an intense PSMA uptake on the preoperative PSMA PET/CT, but a subpopulation of patients with clinically significant cancer and aggressive characteristics showed a deceptively weak PSMA uptake. These data raise a concern about the unqualified application of PSMA PET/CT for staging RP candidates.
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Affiliation(s)
- Barak Rosenzweig
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Correspondence: ; Tel.: +972-3-5302221
| | - Rennen Haramaty
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
| | - Tima Davidson
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Department of Nuclear Medicine, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel
| | - Alon Lazarovich
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
| | - Asaf Shvero
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
| | - Miki Haifler
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Department of Urology, Shamir Medical Center, Tzrifin 6093000, Israel;
| | - Jonathan Gal
- Department of Urology, Shamir Medical Center, Tzrifin 6093000, Israel;
| | - Shay Golan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
- Section of Urology, Rabin Medical Center, Petah Tikva 4941492, Israel;
| | - Sagi Shpitzer
- Section of Urology, Rabin Medical Center, Petah Tikva 4941492, Israel;
| | - Azik Hoffman
- Department of Urology, Rambam Health Center, Haifa 3109601, Israel; (A.H.); (O.N.)
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel; (Y.F.); (R.Z.)
| | - Omri Nativ
- Department of Urology, Rambam Health Center, Haifa 3109601, Israel; (A.H.); (O.N.)
| | - Yuval Freifeld
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel; (Y.F.); (R.Z.)
- Department of Urology, Carmel Medical Center, Haifa 3436212, Israel
| | - Rani Zreik
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3200003, Israel; (Y.F.); (R.Z.)
| | - Zohar A. Dotan
- Department of Urology, Chaim Sheba Medical Center, Ramat Gan 5211401, Israel; (R.H.); (A.L.); (A.S.); (Z.A.D.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (T.D.); (M.H.); (S.G.)
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Malshy K, Nativ O, Zisman A, Sadeh O, Hoffman A, Amiel GE, Mullerad M. Can Endoscopic Appearance, Selective Cytology, and Pathological Sampling During Ureteroscopy Accurately Predict Tumor Grade of Upper-Tract Urothelial Carcinoma? Rambam Maimonides Med J 2022; 13:RMMJ.10459. [PMID: 35089121 PMCID: PMC8798584 DOI: 10.5041/rmmj.10459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study examined the reliability of the various parameters obtained in diagnostic ureteroscopy for upper-tract urothelial carcinoma (UTUC) in predicting the degree of differentiation in the final pathological report after radical nephroureterectomy (RNU). METHODS We conducted a retrospective review of patients undergoing RNU at a single tertiary hospital between 2000 and 2020. Only patients who underwent preoperative diagnostic ureteroscopy (URS) were included. The results of urine selective cytology, endoscopic appearance of the tumor, and biopsy taken during ureteroscopy were compared to the final pathological report. RESULTS In total, 111 patients underwent RNU. A preliminary URS was performed in 54. According to endoscopic appearance, 40% of the "solid"-looking tumors were high grade (HG), while 52% of those with a papillary appearance were low grade (LG). Positive cytology predicted HG tumors in 86% of cases. However, 42% of patients with negative cytology had HG disease. The biopsies acquired during URS showed that HG disease findings matched the final pathology in 75% of cases. However, 25% of patients noted as being HG, based on URS biopsies, were noted to have LG disease based on nephroureterectomy biopsies. Full analyses revealed that 40% of the cases diagnosed as LG based on the URS biopsies actually had HG disease. CONCLUSIONS Direct tumor observation of papillary lesions, negative cytology, and biopsies indicating LG disease are of low predictive value for classifying the actual degree of tumor differentiation. No single test can accurately rule out HG disease. In light of the rising use of neo-adjuvant chemotherapy in UTUC, a reliable predictive model should be developed that accurately discriminates between HG and LG disease.
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Affiliation(s)
- Kamil Malshy
- To whom correspondence should be addressed. E-mail:
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Haramaty R, Lazarovich A, Shvero A, Haifler M, Gal J, Golan S, Shpitzer S, Hoffman A, Nativ O, Freifeld Y, Zreik R, Dotan Z, Rosenzweig B. MP11-14 VERY LOW PROSTATE PET CT PSMA EXPRESSION MAY BE MISLEADING IN STAGING PROSTATECTOMY CANDIDATES. J Urol 2021. [DOI: 10.1097/ju.0000000000001984.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nativ O, Badaan S, Artool S, Safouri A, Hoffman A, Zohar Y, Abdo S, Merytek S, Zu’bi F. Idiopathic granulomatous orchitis: how can we avoid unnecessary orchiectomy? Journal of Clinical Urology 2021. [DOI: 10.1177/20514158211032824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Omri Nativ
- Department of Urology, Rambam Health Care Campus, Israel
| | - Shadi Badaan
- Department of Urology, Rambam Health Care Campus, Israel
- Department of Urology, The Nazareth Hospital EMMS, Israel
| | - Suheil Artool
- Department of Radiology, The Nazareth Hospital EMMS, Israel
| | - Amer Safouri
- Department of Internal Medicine, The Nazareth Hospital EMMS, Israel
| | - Azik Hoffman
- Department of Urology, Rambam Health Care Campus, Israel
| | - Yaniv Zohar
- Department of Pathology, Rambam Health Care Campus, Israel
| | - Samir Abdo
- Department of Urology, The Nazareth Hospital EMMS, Israel
| | - Shimon Merytek
- Department of Urology, The Nazareth Hospital EMMS, Israel
| | - Fadi Zu’bi
- Department of Urology, Rambam Health Care Campus, Israel
- Department of Urology, The Nazareth Hospital EMMS, Israel
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Goltsman I, Khoury EE, Aronson D, Nativ O, Feuerstein GZ, Winaver J, Abassi Z. Rosiglitazone treatment restores renal responsiveness to atrial natriuretic peptide in rats with congestive heart failure. J Cell Mol Med 2019; 23:4779-4794. [PMID: 31087547 PMCID: PMC6584517 DOI: 10.1111/jcmm.14366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/24/2019] [Accepted: 04/01/2019] [Indexed: 12/28/2022] Open
Abstract
The thiazolidinedione (TZD) class of Peroxisome proliferator‐activated receptor gamma agonists has restricted clinical use for diabetes mellitus due to fluid retention and potential cardiovascular risks. These side effects are attributed in part to direct salt‐retaining effect of TZDs at the renal collecting duct. A recent study from our group revealed that prolonged rosiglitazone (RGZ) treatment caused no Na+/H2O retention or up‐regulation of Na+ transport‐linked channels/transporters in experimental congestive heart failure (CHF) induced by surgical aorto‐caval fistula (ACF). The present study examines the effects of RGZ on renal and cardiac responses to atrial natriuretic peptide (ANP), Acetylcholine (Ach) and S‐Nitroso‐N‐acetylpenicillamine (SNAP‐NO donor). Furthermore, we assessed the impact of RGZ on gene expression related to the ANP signalling pathway in animals with ACF. Rats subjected to ACF (or sham) were treated with either RGZ (30 mg/kg/day) or vehicle for 4 weeks. Cardiac chambers pressures and volumes were assessed invasively via Miller catheter. Kidney excretory and renal hemodynamic in response to ANP, Ach and SNAP were examined. Renal clearance along with cyclic guanosine monophosphate (cGMP), gene expression of renal CHF‐related genes and ANP signalling in the kidney were determined. RGZ‐treated CHF rats exhibited significant improvement in the natriuretic responses to ANP infusion. This ‘sensitization’ to ANP was not associated with increases in neither urinary cGMP nor in vitro cGMP production. However, RGZ caused down‐regulation of several genes in the renal cortex (Ace, Nos3 and Npr1) and up‐regulation of ACE2, Agtrla, Mme and Cftr along down‐regulation of Avpr2, Npr1,2, Nos3 and Pde3 in the medulla. In conclusion, CHF+RGZ rats exhibited significant enhancement in the natriuretic responses to ANP infusion, which are known to be blunted in CHF. This ‘sensitization’ to ANP is independent of cGMP signalling, yet may involve post‐cGMP signalling target genes such as ACE2, CFTR and V2 receptor. The possibility that TZD treatment in uncomplicated CHF may be less detrimental than thought before deserves additional investigations.
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Affiliation(s)
- Ilia Goltsman
- Department of Physiology, Bruce Rappaport Faculty of Medicine, Technion-IIT, Haifa, Israel
| | - Emad E Khoury
- Department of Physiology, Bruce Rappaport Faculty of Medicine, Technion-IIT, Haifa, Israel
| | - Doron Aronson
- Department of Cardiology, Rambam Health Care Campus, Haifa, Israel
| | - Omri Nativ
- Department of Physiology, Bruce Rappaport Faculty of Medicine, Technion-IIT, Haifa, Israel
| | - Giora Z Feuerstein
- Department of Cardiology, Rambam Health Care Campus, Haifa, Israel.,FARMACON LLC, Translational Medicine Company, Bryn Mawr, Pennsylvania
| | - Joseph Winaver
- Department of Physiology, Bruce Rappaport Faculty of Medicine, Technion-IIT, Haifa, Israel
| | - Zaid Abassi
- Department of Physiology, Bruce Rappaport Faculty of Medicine, Technion-IIT, Haifa, Israel.,Department of Laboratory Medicine, Rambam Health Care Campus, Haifa, Israel
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Sukhotnik I, Nativ O, Ben-Shahar Y, Bejar IN, Pollak Y, Coran AG, Gorenberg M. Antioxidant treatment ameliorates germ cell apoptosis induced by a high-dose ionizing irradiation in rats. Pediatr Surg Int 2019; 35:137-143. [PMID: 30386894 DOI: 10.1007/s00383-018-4385-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Exposure to ionizing radiation results in cytotoxic and genotoxic effects caused mainly by the oxidative damage. In the present study, we investigated the radioprotective effect of novel antioxidant cocktail on germ cell apoptosis and spermatogenesis in rats subjected to whole body radiation (WBIR). METHODS Adult male rats weighing 250-270 g were divided into four groups, eight rats each. Group 1 served as untreated control, group 2 received an IP single dose of antioxidant cocktail (1 ml). Group 3 was exposed to a WBIR (6 Gy). Group 4 received antioxidant cocktail before WBIR. Rats from each group were killed after 48 h. MDA levels were measured in serum (TBARS assay). Johnsen's criteria and the number of germinal cell layers were used to categorize spermatogenesis. TUNEL assay was used to determine germ cell apoptosis. Statistical analysis was performed using one-way ANOVA test. RESULTS WBIR resulted in histological testicular damage (decrease in Johnsen's criteria, p < 0.05) that was accompanied by a significant increase in germ cell apoptosis, expressed as the number of apoptotic cells per 100 tubules (AI-1 apoptotic index) and the number of positive tubules per 100 tubules (AI-2 apoptotic index). Treatment with antioxidant cocktail resulted in a significant decrease in germ cell apoptosis (33% decrease in AI-1, p < 0.05 and 34% decrease in AI-2, p < 0.05) that was accompanied by an improved spermatogenesis (increase in Johnsen's criteria, p < 0.05). CONCLUSIONS In a rat model of WBIR, antioxidant treatment ameliorates oxidative stress-induced testicular damage, decreases germ cell apoptosis and improves spermatogenesis.
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Affiliation(s)
- Igor Sukhotnik
- Laboratory of intestinal adaptation and recovery, The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. .,Department of Pediatric Surgery, Bnai Zion Medical Center, 47 Golomb St., P.O.B. 4940, Haifa, 31048, Israel.
| | - O Nativ
- Laboratory of intestinal adaptation and recovery, The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Pediatric Surgery, Bnai Zion Medical Center, 47 Golomb St., P.O.B. 4940, Haifa, 31048, Israel.,Department of Urology, Bnai Zion Medical Center, Haifa, Israel
| | - Y Ben-Shahar
- Laboratory of intestinal adaptation and recovery, The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Pediatric Surgery, Bnai Zion Medical Center, 47 Golomb St., P.O.B. 4940, Haifa, 31048, Israel
| | - I N Bejar
- Laboratory of intestinal adaptation and recovery, The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Pediatric Surgery, Bnai Zion Medical Center, 47 Golomb St., P.O.B. 4940, Haifa, 31048, Israel
| | - Y Pollak
- Laboratory of intestinal adaptation and recovery, The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - A G Coran
- Section of Pediatric Surgery, C. S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, Michigan, US
| | - M Gorenberg
- Department of Nuclear Medicine, Bnai Zion Medical Center, Haifa, Israel
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Nativ O, Bahouth Z, Sabo E, Halachmi S, Moskovitz B, Hellou EG, Abassi Z, Nativ O. Method Used for Tumor Bed Closure (Suture vs. Sealant), Ischemia Time and Duration of Surgery are Independent Predictors of Post-Nephron Sparing Surgery Acute Kidney Injury. Urol Int 2018; 101:184-189. [PMID: 30025391 DOI: 10.1159/000490107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/16/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of our study was to examine the influence of tumor complexity and operative variables on the degree and rate of post-nephron sparing surgery (NSS) acute kidney injury (AKI). METHODS We retrospectively reviewed the records of 477 patients who underwent NSS for enhancing renal masses in our institution. AKI was determined using the latest definition by AKIN and RIFLE criteria. Serum creatinine was assessed daily starting from day 1 post-surgery and until discharge (usually on postoperative day 3). Estimated glomerular filtration was determined using the Modification of Diet in Renal Disease equation. RESULTS Overall, 191 patients (40%) developed postoperative AKI, and most of them (88%) were grade 1. Multivariate analysis revealed that the most significant and independent variables associated with AKI were operation time (p = 0.02), ischemia time (p = 0.02), and the use of tissue adhesive for tumor bed closure (p = 0.02). Other important factors (by univariate analysis) were the need for blood transfusion (p = 0.003) and estimated blood loss (p = 0.007). CONCLUSIONS Operative time, ischemia, and tumor bed closure method are independent predictors of post-NSS AKI. Efforts should be made to limit prolonged ischemia and to reduce viable parenchymal loss. Further studies concerning the functional impact of AKI in these patients will be required.
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Affiliation(s)
- Omri Nativ
- Department of Urology, Bnai-Zion Hospital, Haifa, Israel
| | - Zaher Bahouth
- Department of pathology, Rambam Health Care Campus, Haifa, Israel
| | - Edmond Sabo
- Department of pathology, Rambam Health Care Campus, Haifa, Israel
| | - Sarel Halachmi
- Department of Urology, Bnai-Zion Hospital, Haifa, Israel
| | - Boaz Moskovitz
- Department of Urology, Bnai-Zion Hospital, Haifa, Israel
| | - Elias G Hellou
- Galilee Faculty of Medicine, Bar Ilan University, Zafed, Israel
| | - Zaid Abassi
- Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Ofer Nativ
- Department of Urology, Bnai-Zion Hospital, Haifa, Israel
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Abassi Z, Hamoud S, Hassan A, Khamaysi I, Nativ O, Heyman SN, Muhammad RS, Ilan N, Singh P, Hammond E, Zaza G, Lupo A, Onisto M, Bellin G, Masola V, Vlodavsky I, Gambaro G. Involvement of heparanase in the pathogenesis of acute kidney injury: nephroprotective effect of PG545. Oncotarget 2018; 8:34191-34204. [PMID: 28388547 PMCID: PMC5470960 DOI: 10.18632/oncotarget.16573] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 03/16/2017] [Indexed: 11/29/2022] Open
Abstract
Despite the high prevalence of acute kidney injury (AKI) and its association with increased morbidity and mortality, therapeutic approaches for AKI are disappointing. This is largely attributed to poor understanding of the pathogenesis of AKI. Heparanase, an endoglycosidase that cleaves heparan sulfate, is involved in extracellular matrix turnover, inflammation, kidney dysfunction, diabetes, fibrosis, angiogenesis and cancer progression. The current study examined the involvement of heparanase in the pathogenesis of ischemic reperfusion (I/R) AKI in a mouse model and the protective effect of PG545, a potent heparanase inhibitor. I/R induced tubular damage and elevation in serum creatinine and blood urea nitrogen to a higher extent in heparanase over-expressing transgenic mice vs. wild type mice. Moreover, TGF-β, vimentin, fibronectin and α-smooth muscle actin, biomarkers of fibrosis, and TNFα, IL6 and endothelin-1, biomarkers of inflammation, were upregulated in I/R induced AKI, primarily in heparanase transgenic mice, suggesting an adverse role of heparanase in the pathogenesis of AKI. Remarkably, pretreatment of mice with PG545 abolished kidney dysfunction and the up-regulation of heparanase, pro-inflammatory (i.e., IL-6) and pro-fibrotic (i.e., TGF-β) genes induced by I/R. The present study provides new insights into the involvement of heparanase in the pathogenesis of ischemic AKI. Our results demonstrate that heparanase plays a deleterious role in the development of renal injury and kidney dysfunction, attesting heparanase inhibition as a promising therapeutic approach for AKI.
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Affiliation(s)
- Zaid Abassi
- Department of Physiology, The Rappaport Faculty of Medicine, Technion, Haifa, Israel.,Department of Laboratory Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Shadi Hamoud
- Department of Internal Medicine E, Rambam Health Care Campus, Haifa, Israel
| | - Ahmad Hassan
- Department of Internal Medicine A, Rambam Health Care Campus, Haifa, Israel
| | - Iyad Khamaysi
- Department of Gastroenterology, Rambam Health Care Campus, Haifa, Israel
| | - Omri Nativ
- Department of Physiology, The Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Samuel N Heyman
- Department of Internal Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | | | - Neta Ilan
- Department of Cancer and Vascular Biology Research Center, The Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Preeti Singh
- Department of Cancer and Vascular Biology Research Center, The Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | | | | | - Antonio Lupo
- Department of Medicine, Renal Unit, Verona, Italy
| | - Maurizio Onisto
- Department of Biomedical Sciences, University of Padova, Catholic University of the Sacred Heart, Roma, Italy
| | | | | | - Israel Vlodavsky
- Department of Cancer and Vascular Biology Research Center, The Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Giovani Gambaro
- Department of Medicine, Columbus-Gemelli Hospital, Catholic University of the Sacred Heart, Roma, Italy
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Bahouth Z, Halachmi S, Shprits S, Burbara Y, Avitan O, Masarwa I, Moskovitz B, Nativ O. The use of bovine serum albumin-glutaraldehyde tissue adhesive (BioGlue ®) for tumor bed closure following open partial nephrectomy. Actas Urol Esp 2017; 41:511-515. [PMID: 28283215 DOI: 10.1016/j.acuro.2016.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/16/2016] [Accepted: 12/21/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To report the results of the use of Bovine Serum Albumin-Glutaraldehyde tissue adhesive (BioGlue®) for tumor bed closure in open nephron-sparing surgery (NSS). MATERIALS AND METHODS The cohort included 255 patients with enhancing renal mass who underwent open NSS. We used open flank approach, with in-situ hypothermia and enucleation of the tumor. For tumor bed closure, we used the BioGlue® sealant for tumor bed filling, without suturing the edges. RESULTS Mean patients' age was 65.4 years. 5.1% of patients had pre-operative chronic renal failure. Mean renal mass diameter was 4.2±1.6cm and mean R.E.N.A.L nephrometry score was 8.0±1.6. Mean ischemia time was 21.8±7.6. Mean estimated blood loss was 42±82ml and only two patients required blood transfusion. Urine leak and pseudo-aneurysm were recorded in two and one patient, respectively. None of the operations were converted to radical nephrectomy. The average change between post-operative and pre-operative eGFR (Δ=-1.7ml/min) was insignificant in a mean follow-up of 30.1±29.6 months. The 10-year recurrence-free survival rate was 99% and the 10-year overall survival rate was 85%. CONCLUSIONS The use of BioGlue® alone for hemostasis after NSS is a feasible and safe alternative to classical suturing. Its use enables satisfactory functional outcome and could potentially reduce ischemia time.
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Bahouth Z, Meyer G, Yildiz G, Nativ O, Moskovitz B. Update in urethral stents. ARCH ESP UROL 2016; 69:601-606. [PMID: 27725336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Urethral stents were first introduced in 1988, and since then, they have undergone significant improvements. However, they did not gain a wide popularity and their use is limited to a small number of centers around the world. Urethral stents can be used in the entire urethra and for various and diverse indications. In the anterior urethra, it can be used to treat urethral strictures. In the prostatic urethra, they can be used for the treatment of prostatic obstruction, including benign, malignant and iatrogenic prostatic obstruction. Moreover, although not widely used, it can be also applied for the treatment of posterior urethral stricture and bladder neck contracture, usually resulting in urinary incontinence and the need for subsequent procedures. Our main experience are with Allium urethral stents, and as such, we provide the latest updates in urethral stents with special emphasis on the various types of Allium urethral stents: bulbar, prostatic and bladder neck stents.
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Affiliation(s)
- Z Bahouth
- Department of Urology. Bnai-Zion Medical Center and Faculty of Medicine, Technion. Hafia. Israel
| | - G Meyer
- Department of Urology. Bnai-Zion Medical Center and Faculty of Medicine, Technion. Hafia. Israel
| | - G Yildiz
- Department of Urology. Dr. Suat Seren Chest Diseases and Surgery Teaching and Research Hospital. Izmir. Turkey
| | - O Nativ
- Department of Urology. Bnai-Zion Medical Center and Faculty of Medicine, Technion. Hafia. Israel
| | - B Moskovitz
- Department of Urology. Bnai-Zion Medical Center and Faculty of Medicine, Technion. Hafia. Israel
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Masola V, Zaza G, Gambaro G, Onisto M, Bellin G, Vischini G, Khamaysi I, Hassan A, Hamoud S, Nativ O, N. Heyman S, Lupo A, Vlodavsky I, Abassi Z. Heparanase: A Potential New Factor Involved in the Renal Epithelial Mesenchymal Transition (EMT) Induced by Ischemia/Reperfusion (I/R) Injury. PLoS One 2016; 11:e0160074. [PMID: 27467172 PMCID: PMC4965068 DOI: 10.1371/journal.pone.0160074] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 07/13/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Ischemia/reperfusion (I/R) is an important cause of acute renal failure and delayed graft function, and it may induce chronic renal damage by activating epithelial to mesenchymal transition (EMT) of renal tubular cells. Heparanase (HPSE), an endoglycosidase that regulates FGF-2 and TGFβ-induced EMT, may have an important role. Therefore, aim of this study was to evaluate its role in the I/R-induced renal pro-fibrotic machinery by employing in vitro and in vivo models. METHODS Wild type (WT) and HPSE-silenced renal tubular cells were subjected to hypoxia and reoxygenation in the presence or absence of SST0001, an inhibitor of HPSE. In vivo, I/R injury was induced by bilateral clamping of renal arteries for 30 min in transgenic mice over-expressing HPSE (HPA-tg) and in their WT littermates. Mice were sacrificed 48 and 72 h after I/R. Gene and protein EMT markers (α-SMA, VIM and FN) were evaluated by bio-molecular and histological methodologies. RESULTS In vitro: hypoxia/reoxygenation (H/R) significantly increased the expression of EMT-markers in WT, but not in HPSE-silenced tubular cells. Notably, EMT was prevented in WT cells by SST0001 treatment. In vivo: I/R induced a remarkable up-regulation of EMT markers in HPA-tg mice after 48-72 h. Noteworthy, these effects were absent in WT animals. CONCLUSIONS In conclusion, our results add new insights towards understanding the renal biological mechanisms activated by I/R and they demonstrate, for the first time, that HPSE is a pivotal factor involved in the onset and development of I/R-induced EMT. It is plausible that in future the inhibition of this endoglycosidase may represent a new therapeutic approach to minimize/prevent fibrosis and slow down chronic renal disease progression in native and transplanted kidneys.
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Affiliation(s)
| | - Gianluigi Zaza
- Renal Unit, Department of Medicine, Verona, Italy
- * E-mail:
| | - Giovanni Gambaro
- Renal Unit, Columbus-Gemelli Hospital, Catholic University of the Sacred Heart, Roma, Italy
| | - Maurizio Onisto
- University of Padova, Department of Biomedical Sciences Padova, Padova, Italy
| | | | - Gisella Vischini
- Renal Unit, Columbus-Gemelli Hospital, Catholic University of the Sacred Heart, Roma, Italy
| | - Iyad Khamaysi
- Gastroenterology, Rambam Health Care Campus, Haifa, Israel
| | - Ahmad Hassan
- Internal Medicine A, Rambam Health Care Campus, Haifa, Israel
| | - Shadi Hamoud
- Internal Medicine E, Rambam Health Care Campus, Haifa, Israel
| | - Omri Nativ
- Department of Physiology and Biophysics, The Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Samuel N. Heyman
- Department of Internal Medicine, Hadassah Medical Center, Jerusalem, Israel
| | - Antonio Lupo
- Renal Unit, Department of Medicine, Verona, Italy
| | - Israel Vlodavsky
- Cancer and Vascular Biology Research Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Zaid Abassi
- Department of Physiology and Biophysics, The Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
- Research Unit, Rambam Health Care Campus, Haifa, Israel
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Masola V, Zaza G, Gambaro G, Onisto M, Bellin G, Vischini G, Khamaysi I, Hassan A, Hamoud S, Nativ O, Heyman SN, Lupo A, Vlodavsky I, Abassi Z. MP079HEPARANASE: A POTENTIAL NEW FACTOR INVOLVED IN THE PRO-FIBROTIC RENAL BIOLOGICAL MACHINERY ACTIVATED BY THE ISCHEMIA-REPERFUSION INJURY. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw183.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Arends T, Nativ O, Maffezzini M, De Cobelli O, Van Der Heijden A, Witjes J. 944 Results of the first randomized controlled trial comparing intravesical radiofrequency induced chemohyperthermia with mitomycin-C versus BCG for adjuvant treatment of patients with intermediate- and high-risk non-muscle invasive bladder cancer. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/s1569-9056(15)60932-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lüdecke G, Schäfer L, Nativ O, Witzsch U, Hanitzsch H, Hasner F, Issa R, Witjes F, Weidner W. 949 Radiofrequence induced hyperthermia chemotherapy (RIHTC) in high-risk non-muscle invasive bladder cancer (NMIBC): Multiinstitutional, international outcome analysis of 271 treated patients with a follow-up time of more than 2 years. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/s1569-9056(15)60937-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lai CF, Lin SL, Chiang WC, Chen YM, Kuo ML, Tsai TJ, Hwang HS, Choi YA, Park KC, Yang KJ, Choi HS, Kim SH, Lee SJ, Chang YK, Kim SY, Yang CW, Xiujuan Z, Yoshimura R, Matsuyama M, Chargui J, Touraine JL, Yoshimura N, Zulkarnaev AB, Vasilenko IA, Artemov DV, Vatazin AV, Park SK, Kang KP, Lee S, Kim W, Schneider R, Betz B, Moller-Ehrlich K, Wanner C, Sauvant C, Yang KJ, Park KC, Choi HS, Kim SH, Choi YA, Chang YK, Park CW, Kim SY, Lee SJ, Yang CW, Hwang HS, Sohotnik R, Nativ O, Abbasi A, Awad H, Frajewicki V, Armaly Z, Heyman SN, Nativ O, Abassi Z, Chen PY, Chen BL, Yang CC, Chiang CK, Liu SH, Abozahra AE, Abd-Elkhabir AA, Shokeir A, Hussein A, Awadalla A, Barakat N, Abdelaziz A, Yamaguchi J, Tanaka T, Eto N, Nangaku M, Quiros Y, Lopez-Hernandez FJ, Perez de Obanos MP, Ruiz J, Lopez-Novoa JM, Shin HS, Kim MJ, Choi YJ, Ryu ES, Choi HS, Kang DH, Jankauskas SS, Pevzner IB, Zorova LD, Babenko VA, Morosanova MA, Plotnikov EY, Zorov DB, Huang CY, Huang TM, Wu VC, Young GH, Plotnikov EY, Pevzner IB, Zorova LD, Chupyrkina AA, Zorov SD, Zorov DB, Grande JP, Hartono SP, Knudsen BE, Mederle K, Castrop H, Hocherl K, Iwakura T, Fujikura T, Ohashi N, Yasuda H, Fujigaki Y, Matsui I, Hamano T, Inoue K, Obi Y, Nakano C, Kusunoki Y, Tsubakihara Y, Rakugi H, Isaka Y, Shimomura A, Wallentin Guron C, Nguy L, Lundgren J, Grimberg E, Kashioulis P, Guron G, Guron G, DiBona GF, Nguy L, Grimberg E, Lundgren J, Nedergaard Mikkelsen M, Marcussen N, Saeed A, Edvardsson K, Lindberg K, Larsson T, Ito K, Nakashima H, Watanabe M, Abe Y, Ogahara S, Saito T, Albertoni G, Borges F, Schor N, Beresneva ON, Parastayeva MM, Kucher AG, Ivanova GT, Shved N, Rybakova MG, Kayukov IG, Smirnov AV, Chen JF, Ni HF, Pan MM, Liu H, Xu M, Zhang MH, Liu BC, Kim Y, Choi BS, Kim YS, Han JS, Reis LA, Christo JS, Simoes MDJ, Schor N, Mulay SR, Santhosh Kumar VR, Kulkarni OP, Darisipudi M, Lech M, Anders HJ, Zorov DB, Plotnikov EY, Silachev DN, Jankauskas SS, Pevzner IB, Zorova LD, Zorov SD, Morosanova MA, Sola A, Jung M, Ventayol M, Mastora C, Buenestado S, Hotter G, Rong S, Shushakova N, Wensvoort G, Haller H, Gueler F, Pan MM, Zhang MH, Ni HF, Chen JF, Xu M, Liu BC, Morais C, Vesey DA, Johnson DW, Gobe GC, Godo M, Kaucsar T, Revesz C, Hamar P, Cheng Q, Wen J, Ma Q, Zhao J, Castellano G, Stasi A, Di Palma AM, Gigante M, Netti GS, Curci C, Intini A, Divella C, Prattichizzo C, Fiaccadori E, Pertosa G, Grandaliano G, Gesualdo L, Wei QW, Jing QQ, Ying NJ, Dong QZ, Yong G, Choi YJ, Kim MJ, Shin HS, Ryu ES, Choi HS, Kang DH, Pevzner IB, Pulkova NV, Plotnikov EY, Zorova LD, Silachev DN, Morosanova MA, Sukhikh GT, Zorov DB, Kim S, Lee J, Nam NJ, Na KY, Han JS, Ma SK, Joo SY, Kim CS, Choi JS, Bae EH, Lee J, Kim SW, Cernaro V, Medici MA, Donato V, Trimboli D, Lorenzano G, Santoro D, Montalto G, Buemi M, Longo V, Segreto HRC, Almeida W, Schor N, Ramos MF, Gomes L, Razvickas C, Schor N, Gueler F, Rong S, Gutberlet M, Meier M, Mengel M, Wacker D, Haller H, Hueper K, Uzum A, Ersoy R, Cakalagaoglu F, Karaman M, Kolatan E, Sahin O, Yilmaz O, Cirit M, Inal S, Koc E, Okyay GU, Pasaoglu O, Gonul I, Oyar E, Pasaoglu H, Guz G, Sabbatini M, Rossano R, Andreucci M, Pisani A, Riccio E, Choi DE, Jeong JY, Kim SS, Chang YK, Na KR, Lee KW, Shin YT, Silva AF, Teixeira VC, Schor N, Meszaros K, Koleganova-Gut N, Schaefer F, Ritz E, Walacides D, Ruskamp N, Rong S, Hueper K, Meier M, Haller H, Schiffer M, Gueler F, Marom O, Haick H, Nakhoul F, Chen JF, Liu H, Ni HF, Lv LL, Zhang MH, Tang RN, Zhang JD, Ma KL, Chen PS, Liu BC, Wu VC, Young GH, Chen YM, Ko WJ, Misiara GP, Coimbra TM, Silva GEB, Costa RS, Francescato HDC, Neto MM, Dantas M, Lindberg K, Olauson H, Amin R, Ponnusamy A, Goetz R, Mohammadi M, Canfield A, Kublickiene K, Larsson T, Rodriguez J, Reyes EP, Cortes PP, Fernandez R, Yoon HE, Koh ES, Chung S, Shin SJ, Pazzano D, Montalto G, Cernaro V, Lupica R, Torre F, Costantino G, Buemi M, Prieto M, Gonzalez-Buitrago JM, Lopez-Hernandez F, Lopez-Novoa JM, Morales AI, Vicente-Vicente L, Ferreira L, Christo JS, Reis LA, Simoes MJ, Passos CD, Schor NS, Shimizu MHM, Canale D, de Braganca AC, Andrade L, Luchi WM, Seguro AC, Canale D, de Braganca AC, Goncalves J, Shimizu MHM, Volpini RA, Andrade L, Seguro AC, Garrido P, Fernandes J, Ribeiro S, Vala H, Parada B, Alves R, Belo L, Costa E, Santos-Silva A, Reis F. AKI - experimental models. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nativ O, Suhotnik R, Nativ O, Sukhotnik I, Awad H, Abassi Z. 605 THE NEPHROPROTECTIVE EFFECT OF PHOSPHODIESTERASE-5- INHIBITION (PDE5-I) IN ISCHEMIA REPERFUSION (I/R) RAT MODEL. J Urol 2013. [DOI: 10.1016/j.juro.2013.02.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abassi Z, Shalabi A, Sohotnik R, Nativ O, Awad H, Bishara B, Frajewicki V, Sukhotnik I, Abbasi A, Nativ O. Urinary NGAL and KIM-1: Biomarkers for Assessment of Acute Ischemic Kidney Injury Following Nephron Sparing Surgery. J Urol 2013; 189:1559-66. [DOI: 10.1016/j.juro.2012.10.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2012] [Indexed: 01/20/2023]
Affiliation(s)
- Zaid Abassi
- Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Haifa, Israel
- Rambam Research Unit, Haifa, Israel
| | - Amjad Shalabi
- Department of General Surgery, Rambam Medical Center, Haifa, Israel
| | - Rima Sohotnik
- Department of Nephrology, Carmel Hospital, Haifa, Israel
| | - Omri Nativ
- Department of Urology, Bnai Zion Hospital, Haifa, Israel
| | - Hoda Awad
- Department of Physiology and Biophysics, Rappaport Faculty of Medicine, Haifa, Israel
| | - Bishara Bishara
- Department of General Surgery, Rambam Medical Center, Haifa, Israel
| | | | - Igor Sukhotnik
- Department of Pediatric Surgery, Bnai Zion Hospital, Haifa, Israel
| | - Abeer Abbasi
- Department of Urology, Bnai Zion Hospital, Haifa, Israel
| | - Ofer Nativ
- Department of Urology, Bnai Zion Hospital, Haifa, Israel
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Sukhotnik I, Nativ O, Roitburt A, Bejar D, Coran AG, Mogilner JG, Nativ O. Methotrexate induces germ cell apoptosis and impairs spermatogenesis in a rat. Pediatr Surg Int 2013; 29:179-84. [PMID: 23224566 DOI: 10.1007/s00383-012-3197-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE The primary toxic effects of methotrexate (MTX) are myelosuppression and/or intestinal mucositis. The objective of the present study is to investigate the effect of MTX on germ cell apoptosis and spermatogenesis in a rat. METHODS Male Sprague-Dawley rats were divided into three experimental groups: control rats treated with vehicle; MTX-2 rats treated with one dose (20 μg/kg) of MTX given IP and killed on the second day; and MTX rats treated with IP MTX (20 μg/kg) and killed on day 4. Johnsen's criteria and the number of germinal cell layers in the testes were used to categorize the spermatogenesis. TUNEL assay was used to determine germ cell apoptosis. Western blotting was used to determine Bax and Bcl-2 protein levels. Statistical analysis was performed using the non-parametric Kruskal-Wallis ANOVA test, with p less than 0.05 considered statistically significant. RESULTS On day 2, MTX-treated animals demonstrated minimal changes in the histological parameters of spermatogenesis, but germ cell apoptosis increased significantly (threefold increase, p = 0.002) compared to control rats. On day 4, MTX-treated rats demonstrated a trend toward a decrease in germ cell apoptosis, compared to day 2, and showed histological signs of impaired spermatogenesis (decreased number of germ cell layers and Johnsen's criteria). A significant increase in cell apoptosis in MTX-treated rats was correlated with higher Bax/Bcl-2 protein levels. CONCLUSIONS MTX induced germ cell apoptosis and impaired spermatogenesis in rat testes.
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Affiliation(s)
- Igor Sukhotnik
- The Bruce Rappaport Faculty of Medicine, Laboratory of Intestinal Adaptation and Recovery, Technion-Israel Institute of Technology, Haifa, Israel.
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Sohotnik R, Nativ O, Abbasi A, Awad H, Frajewicki V, Bishara B, Sukhotnik I, Armaly Z, Aronson D, Heyman SN, Nativ O, Abassi Z. Phosphodiesterase-5 inhibition attenuates early renal ischemia-reperfusion-induced acute kidney injury: assessment by quantitative measurement of urinary NGAL and KIM-1. Am J Physiol Renal Physiol 2013; 304:F1099-104. [PMID: 23364806 DOI: 10.1152/ajprenal.00649.2012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Acute kidney injury (AKI) is a common clinical problem that still lacks effective treatment. Phosphodiesterase-5 (PDE5) inhibitors possess anti-apoptotic and anti-oxidant properties, making it a promising therapy for ischemia-reperfusion (I/R) injury of various organs. The present study evaluated the early nephroprotective effects of Tadalafil, a PDE5 inhibitor, in an experimental model of renal I/R. Sprague-Dawley rats were divided into two groups: vehicle-treated I/R (n = 10), and Tadalafil (10 mg/kg po)-treated I/R group (n = 11). After removal of the right kidney and collection of two baseline urine samples, the left renal artery was clamped for 45 min followed by reperfusion for 60, 120, 180, and 240 min. Functional and histological parameters of the kidneys from the various groups were determined. In the vehicle-treated I/R group, glomerular filtration rate was significantly reduced compared with that in normal kidneys. In addition, the ischemic kidney showed remarkable cast formation, necrosis, and congestion, a consistent pattern of acute tubular necrosis. Furthermore, urinary excretion of NGAL and KIM-1, two novel biomarkers of kidney injury, substantially increased following I/R insult. In contrast, Tadalafil treatment resulted in a significant improvement in kidney function and amelioration of the adverse histological alterations of the ischemic kidney. Noteworthy, the urinary excretion of NGAL and KIM-1 markedly decreased in the Tadalafil-treated I/R group. These findings demonstrate that Tadalafil possesses early nephroprotective effects in rat kidneys subjected to I/R insult. This approach may suggest a prophylactic therapy for patients with ischemic AKI.
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Affiliation(s)
- Rima Sohotnik
- Department of Nephrology and Hypertension, Carmel Medical Center, Haifa, Israel
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Dotan ZA, Fridman E, Lindner A, Ramon J, Pode D, Bejar J, Kopolovic J, Pizov G, Sandbank J, Katz R, Shapiro A, Shilo Y, Nativ O. Detection of prostate cancer by radio-frequency near-field spectroscopy in radical prostatectomy ex vivo specimens. Prostate Cancer Prostatic Dis 2012; 16:73-8. [PMID: 22964689 DOI: 10.1038/pcan.2012.34] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of radical prostatectomy (RP) is the complete removal of the prostate gland with negative surgical margins. The presence of cancer at the surgical margin is associated with higher probability of disease progression. Current methods of intraoperative margin assessment are inaccurate or time-consuming.The study goal was to evaluate the ability of a novel device (Dune Medical Devices) to differentiate between cancer and BPH. METHODS A total of 49 patients undergoing RP in four medical centers between November 2007 and May 2008 were enrolled in this study.The device was applied to numerous intra- and extra-capsular sites of freshly excised RP specimens. Measurement sites were accurately marked and analyzed histologically. The ability of the device to differentiate between malignant and nonmalignant sites was assessed. RESULTS A total of 15,156 measurements from 45 patients were analyzed. Differentiation of the intra-capsular malignant sites from extra-capsular nonmalignant sites (bladder neck and apex regions) depends on the cancer feature size. Differentiation was achieved with sensitivity and specificity of 93.6 (95% confidence interval (CI): 88-98) and 94.1 (95% CI: 93-95), respectively, at feature sizes at or >0.8 mm in diameter. The device was able to discriminate between all intra-capsular malignant (with feature sizes down to a few cells) and nonmalignant measurement sites, with sensitivity and specificity of 80.8 (95% CI: 73-87) and 68.4 (95% CI: 67-69), respectively. CONCLUSIONS First results from a radio-frequency near-field spectroscopy sensor look promising for differentiation between cancer and benign prostate tissue. The sensor's dimensions (radius of ~ 1 mm) and design enable use in open, laparoscopic and robotic RP to evaluate the surgical margins intraoperatively.
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Affiliation(s)
- Z A Dotan
- Department of Urology, Uro-Oncology Service, Chaim Sheba Medical Center, Tel Hashomer, Israel.
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Moskovitz B, Halachmi S, Moskovitz M, Nativ O, Nativ O. 10-year single-center experience of combined intravesical chemohyperthermia for nonmuscle invasive bladder cancer. Future Oncol 2012; 8:1041-9. [DOI: 10.2217/fon.12.90] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Owing to the limited efficacy and significant toxicity of most topical intravesical agents for the management of nonmuscle invasive bladder cancer (NMIBC), a search for new therapeutic modalities continues. This study evaluates the safety and efficacy of a relatively new modality, combined intravesical chemotherapy and hyperthermia, using the intravesical chemohyperthermia system. Methods: The data summarize our 10 years of experience in the Department of Urology at Bnai Zion Medical Center, Israel. Ninety two patients with NMIBC (88 evaluable) were treated according to the adjuvant (66 patients) and the neoadjuvant (26 patients) protocols, with up to 7 years follow-up. Results: Over the follow-up period, 56 out of 64 patients (72%) treated according to the adjuvant protocol remained free from recurrences. The progression rate was 4.7% (three out of 64 patients). An initial complete response was documented in 19 out of 24 patients (79%) treated according to the neoadjuvant protocol. During the follow-up period, 16 out of these 19 patients (84%) remained free from recurrences. All of the recurrences in this group had stage Ta grade 1 tumors. Conclusion: Microwave-induced chemohyperthermia is a safe and effective treatment option for patients with NMIBC, both in the adjuvant and neoadjuvant settings. The use of this treatment modality did not expose the patients to an increased risk of progression.
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Affiliation(s)
- Boaz Moskovitz
- The Department of Urology, Bnai Zion Medical Center, 47 Golomb St, Haifa 31048, Israel
- The Faculty of Medicine, Technion Israeli Institute of Technology, 47 Golomb St, Haifa 31048, Israel
| | - Sarel Halachmi
- The Department of Urology, Bnai Zion Medical Center, 47 Golomb St, Haifa 31048, Israel
| | - Michal Moskovitz
- The Department of Urology, Bnai Zion Medical Center, 47 Golomb St, Haifa 31048, Israel
| | - Omri Nativ
- The Department of Urology, Bnai Zion Medical Center, 47 Golomb St, Haifa 31048, Israel
| | - Ofer Nativ
- The Department of Urology, Bnai Zion Medical Center, 47 Golomb St, Haifa 31048, Israel
- The Faculty of Medicine, Technion Israeli Institute of Technology, 47 Golomb St, Haifa 31048, Israel
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Alfred Witjes J, Hendricksen K, Gofrit O, Risi O, Nativ O. Intravesical hyperthermia and mitomycin-C for carcinoma in situ of the urinary bladder: experience of the European Synergo working party. World J Urol 2009; 27:319-24. [PMID: 19234857 PMCID: PMC2694311 DOI: 10.1007/s00345-009-0384-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Accepted: 01/26/2009] [Indexed: 11/05/2022] Open
Abstract
Objectives To study the results of chemotherapy combined with intravesical hyperthermia in patients with mainly BCG-failing carcinoma in situ (CIS). Methods Patients with histologically confirmed CIS were included retrospectively. Outpatient thermochemotherapy treatment was done with mitomycin-C (MMC) and the Synergo® system SB-TS 101 (temperature range between 41 and 44°C), weekly for 6–8 weeks, followed by 4–6 sessions every 6–8 weeks. Results Fifty-one patients were treated between 1997 and 2005 from 15 European centers. Thirty-four were pre-treated with BCG. Mean age was 69.9 years. Twenty-four patients had concomitant papillary tumors. The mean number of hyperthermia/MMC treatments per patient was 10.0. Of the 49 evaluable patients 45 had a biopsy and cytology proven complete response. In two patients CIS disappeared, but they had persistent papillary tumors. Follow-up of 45 complete responders showed 22 recurrences after a mean of 27 months (median 22): T2 (4), T1 (4), T1/CIS (1), CIS (5), Ta/CIS (2), Ta (5) and Tx (1). Side effects (bladder complaints) were generally mild and transient. Conclusions In patients with primary or BCG-failing CIS, treatment with intravesical hyperthermia and MMC appears a safe and effective treatment. The initial complete response rate is 92%, which remains approximately 50% after 2 years.
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Affiliation(s)
- J Alfred Witjes
- Department of Urology, Radboud University Nijmegen Medical Centre, PO Box 9101, Nijmegen 6500 HB, The Netherlands.
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Witjes J, Hendricksen K, Gofrit O, Risi O, Nativ O. 150 INTRAVESICAL HYPERTHERMIA AND MITOMYCIN-C FOR (BCG REFRACTORY) CARCINOMA IN SITU OF THE URINARY BLADDER. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s1569-9056(07)60149-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Meyer G, Gross M, Mullerad M, Kravtsov A, Moskovitz B, Nativ O. MP-03.01. Urology 2006. [DOI: 10.1016/j.urology.2006.08.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kravtsov A, Sabo E, Mullerad M, Meyer G, Gross M, Issaq E, Moskovitz B, Nativ O. MP-12.08. Urology 2006. [DOI: 10.1016/j.urology.2006.08.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Moskovitz B, Halachmi S, Sopov V, Burbara J, Horev N, Groshar D, Nativ O. Effect of percutaneous nephrolithotripsy on renal function: assessment with quantitative SPECT of (99m)Tc-DMSA renal scintigraphy. J Endourol 2006; 20:102-6. [PMID: 16509791 DOI: 10.1089/end.2006.20.102] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To measure the effect of PCNL on global and regional renal function using quantitative single-photon emission CT (SPECT) measurement of Tc-dimercaptosuccinic acid (DMSA) uptake by the kidneys (QDMSA). PATIENTS AND METHODS A series of 47 male and 41 female patients with a mean age of 47 +/- 16 years were studied by sequential QDMSA examinations before and 1.5 to 24 months after PCNL. Among the 67 patients (76%) in whom PCNL was performed using upper- or lower-pole access, the function of the affected and nonaffected poles of the treated kidney was calculated separately. RESULTS There was no statistically significant difference in the uptake by the treated kidneys before versus after PCNL (11.9% +/- 5% v 11.6% +/- 5%; t = 0.9; P = 0.368). The total functional volume of the treated kidney was slightly decreased, from 235 cc +/- 62 cc to 224 cc +/- 59 cc (t = 2.7; P = 0.011). The percent of the injected isotope dose per cubic centimeter of tissue of the treated kidney was not affected (0.051 +/- 0.02 v 0.053 +/- 0.02; t = 0.86; P = 0.296). Regional assessment revealed a statistically significant decrease in the functional volume at the PCNL port of entry (91 cc +/- 30 cc v 82 cc +/- 27 cc; t = 2.64; P = 0.013). Regarding the percent of the injected dose per cubic centimeter of renal tissue, no statistically significant difference was found between the area of the kidney that underwent PCNL and the untreated area of the same kidney (0.049 +/- 0.02 v 0.05 +/- 0.02; t = 0.693; P = 0.494). The function of the contralateral kidneys remained unchanged (13.4% +/- 5.2% v 13.6% +/- 4.8%; t = 0.68; P = 0.5). CONCLUSIONS Despite the statistically significant decrease in the functional volume of the surgically treated region, neither total percent uptake nor percent of injected dose were reduced significantly. Further studies with long-term follow-up of treated kidneys are required.
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Affiliation(s)
- B Moskovitz
- Department of Urology, Bnai Zion Medical Center, Technion, Institute of Technology, Haifa, Israel.
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Hidas G, Kastin A, Mullerad M, Shental J, Moskovitz B, Nativ O. Sutureless nephron-sparing surgery: Use of albumin glutaraldehyde tissue adhesive (BioGlue). Urology 2006; 67:697-700; discussion 700. [PMID: 16566976 DOI: 10.1016/j.urology.2005.10.064] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2005] [Revised: 09/10/2005] [Accepted: 10/05/2005] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the feasibility of using serum albumin glutaraldehyde tissue adhesive (BioGlue) to achieve hemostasis and prevent urine leakage during nephron-sparing surgery (NSS). METHODS From February 1993 to April 2005, 174 NSS operations were performed for renal cell carcinoma at our institute. A total of 143 patients underwent NSS with the traditional suturing technique (suture group) and 31 patients underwent a sutureless BioGlue sealing-only procedure (BioGlue group). We compared the two groups for clinical and tumor characteristics and surgical outcome. RESULTS The patient and tumor characteristics were similar in both groups. The average maximal tumor diameter was 4.21 cm (range 2.2 to 7) for the suture group and 3.67 cm (range 2 to 6.8) for the BioGlue group. The use of BioGlue reduced the mean warm ischemic time by 8.8 minutes (17.2 versus 26 minutes, P = 0.002). The mean estimated blood loss was 45.1 mL in the BioGlue group and 111.7 mL in the suture group (P = 0.001). Blood transfusion was required in 1 patient (3.2%) of the BioGlue group and 24 (17%) in the suture group (P = 0.014). None of the patients treated with BioGlue developed urinary fistula compared with three (2%) in the suture group. CONCLUSIONS Albumin glutaraldehyde tissue adhesive (BioGlue) alone provided adequate hemostasis during NSS, significantly decreasing the blood loss and transfusion rate, as well as the renal ischemic and operative times. BioGlue was easy to use and safe for sealing the kidney during partial nephrectomy. Future prospective clinical trials are necessary to validate its role during renal surgery.
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Affiliation(s)
- G Hidas
- Department of Urology, Bnai-Zion and Medical Center, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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Moskovitz B, Segev Y, Sopov V, Horev N, Groshar D, Nativ O. [Does percutaneous nephrolithotripsy (PCNL) affect renal function: assessment with quantitative spect of Tc 99M-DMSA (QDMSA) renal scintigraphy]. Harefuah 2005; 144:626-9, 677, 676. [PMID: 16218533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
PURPOSE The study aimed to quantitatively investigate the effect of PCNL on global and regional function using quantitative single photon emission computerized tomography (SPECT) measurement of Tc-dimercaptosuccinic acid (DMSA) uptake by the kidneys (QDMSA). METHODS Seventy nine patients with nephrolithiasis undergoing PCNL were studied by sequential QDMSA examination. There were 42 (53%) males and 37 (47%) females with mean age of 47 +/- 16 years. The initial study was conducted before PCNL procedure and the follow-up studies were performed 1.5-24 months after PCNL. Among 60 of the 79 (76%) patients, in whom PCNL was performed using upper or lower pole access, regional renal function of affected and non-affected pole of operated kidney was calculated separately. RESULTS There was no statistically significant difference between the uptake of treated kidney before and after PCNL procedure (11.9% +/- 5% vs 11.6% +/- 5%; t = 0.9, p = 0.368). The total renal functional volume of treated kidney was to be slightly decreased from 235cc +/- 62cc to 224cc +/- 59cc (t = 2.7; p = 0.011). The percent of injected dose per ml.. of renal tissue of treated kidney was not affected statistically (0.051 +/- 0.02 vs 0.053 +/- 0.02; t = 0.86, p = 0.296). In the assessment of the regional renal function of treated kidney, a statistically significant decrease in the functional renal volume was revealed at the part which underwent PCNL procedure (91cc +/- 30cc vs 82cc +/- 27cc; t = 2.64, p = 0.013). Regarding percent of injected dose per ml. of renal tissue, no statistically significant difference was found between the part of treated kidney, which underwent PCNL and non-affected area of the same kidney (0.049 +/- 0.02 vs 0.05 +/- 0.02; t = 0.693, p = 0.494). The function of contralateral kidney remained unchanged (13.4% +/- 5.2% vs 13.6% +/- 4.8%; t = 0.68, p = 0.5). Function volume, neither total percent uptake, nor percent of injected dose per ml. of renal tissue were reduced significantly. Further studies with long term follow-up of treated kidney are required.
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Affiliation(s)
- B Moskovitz
- Department of Urology, Bnai Zion Medical Center, Israel
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Moskovitz B, Meyer G, Kravtzov A, Gross M, Kastin A, Biton K, Nativ O. Thermo-chemotherapy for intermediate or high-risk recurrent superficial bladder cancer patients. Ann Oncol 2005; 16:585-9. [PMID: 15734775 DOI: 10.1093/annonc/mdi124] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the efficacy of combined local hyperthermia and intravesical mitomycin-C (MMC) in a selected group of patients with intermediate or high-risk recurrent transitional cell carcinoma (TCC) of bladder. PATIENTS AND METHODS Forty-seven patients with multiple or recurrent Ta or T1 TCC of the bladder were treated with intravesical MMC and local hyperthermia of the bladder wall. Patients were treated with either a prophylactic protocol (40 mg MMC) after complete transurethral resection of all tumours or with an ablative protocol (80 mg MMC) in patients with viable tumours. RESULTS Thirty-two patients were eligible for analysis. The prophylactic protocol was administered to 22 patients. After a mean follow-up of 289 days, 20 patients (91%) were recurrence free. Two patients (9%) had tumour recurrence after a mean period of 431 days. The ablative protocol was administered to 10 patients. Complete tumour ablation was achieved in eight patients (80%) after a mean follow up of 104.5 days. CONCLUSIONS Our efficacy and safety results confirm those reported in previously published studies, suggesting the promising value of this combined treatment modality for both prophylactic and ablative patients. The ablative protocol offers an alternative therapy for a selected patient population for whom no other treatment option exists.
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Affiliation(s)
- B Moskovitz
- Department of Urology Bnai Zion Medical Center, Technion, Institute of Technology, Haifa, Israel.
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Moskovitz B, Halachmi S, Mullerad M, Sopov V, Burbara J, Horev N, Groshar D, Nativ O. 781Does renal function change following percutaneous nephrolithotripsy (PCNL)? assessment with quantitative spect of Tc 99M-DSMA (QDMSA) renal scintigraphy. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/s1569-9056(05)80785-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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van der Heijden AG, Kiemeney LA, Gofrit ON, Nativ O, Sidi A, Leib Z, Colombo R, Naspro R, Pavone M, Baniel J, Hasner F, Witjes JA. Preliminary European results of local microwave hyperthermia and chemotherapy treatment in intermediate or high risk superficial transitional cell carcinoma of the bladder. Eur Urol 2004; 46:65-71; discussion 71-2. [PMID: 15183549 DOI: 10.1016/j.eururo.2004.01.019] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2004] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Superficial bladder cancer can be treated by transurethral resection (TUR) and adjuvant intravesical therapy. Intravesical bacillus Calmette-Guérin (BCG) has been proven to be more efficacious with respect to recurrence prevention than intravesical chemotherapy, although at the cost of more severe side effects. There is a need for a new treatment modality with higher efficacy and less toxicity. The subject of this study is the efficacy of local microwave hyperthermia and chemotherapy treatment in intermediate or high risk superficial transitional cell carcinoma (TCC) of the bladder. PATIENTS AND METHODS Ninety eligible patients received adjuvant treatment with a combination of mitomycin-C (MMC) and local microwave hyperthermia. All patients had multiple or recurrent Ta or T1 TCC of the bladder and were classified as intermediate or high risk according to EAU criteria. In total, 41 patients were BCG failures. The treatment regimen included 6 to 8 weekly sessions followed by 4 to 6 monthly sessions. Follow-up consisted of video-cystoscopy and urine cytology every 3 months. All patients were observed for 2 years. RESULTS Kaplan-Meier analyses of the total group (N = 90) indicated that 1 year after treatment only 14.3% (SE 4.5%) of all patients experienced a recurrence. After 2 years of follow-up the risk of recurrence was 24.6% (SE 5.9%). No progression in stage and grade was observed. CONCLUSION Microwave induced hyperthermia combined with MMC has promising value in intermediate or high risk superficial bladder cancer patients compared to literature data of BCG and/or intravesical chemotherapy, particularly where other treatments, i.e. BCG, have failed.
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Affiliation(s)
- A G van der Heijden
- Department of Urology, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands
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Nativ O, Thorpe A, Laufer M, Matzkin H, Salzberg M, Yarkoni S, Dezube B, Harris A. Safety and tolerability of oral halofuginone hydrobromide in refractory recurrent transitional cell carcinoma of the bladder. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- O. Nativ
- Bnei Zion Medical Center, Haifa, Israel; Freeman Hospital, Newcastle, United Kingdom; Sheba Medical Center, Tel Hashomer, Israel; Ichilov Medical Center, Tel Aviv, Israel; PBS Ltd, Basel, Switzerland; Collgard Biopharmaceuticals, Petach Tikva, Israel; Beth Israel Deaconess Medical Center, Boston, MA; The Churchill Hospital, Oxford, United Kingdom
| | - A. Thorpe
- Bnei Zion Medical Center, Haifa, Israel; Freeman Hospital, Newcastle, United Kingdom; Sheba Medical Center, Tel Hashomer, Israel; Ichilov Medical Center, Tel Aviv, Israel; PBS Ltd, Basel, Switzerland; Collgard Biopharmaceuticals, Petach Tikva, Israel; Beth Israel Deaconess Medical Center, Boston, MA; The Churchill Hospital, Oxford, United Kingdom
| | - M. Laufer
- Bnei Zion Medical Center, Haifa, Israel; Freeman Hospital, Newcastle, United Kingdom; Sheba Medical Center, Tel Hashomer, Israel; Ichilov Medical Center, Tel Aviv, Israel; PBS Ltd, Basel, Switzerland; Collgard Biopharmaceuticals, Petach Tikva, Israel; Beth Israel Deaconess Medical Center, Boston, MA; The Churchill Hospital, Oxford, United Kingdom
| | - H. Matzkin
- Bnei Zion Medical Center, Haifa, Israel; Freeman Hospital, Newcastle, United Kingdom; Sheba Medical Center, Tel Hashomer, Israel; Ichilov Medical Center, Tel Aviv, Israel; PBS Ltd, Basel, Switzerland; Collgard Biopharmaceuticals, Petach Tikva, Israel; Beth Israel Deaconess Medical Center, Boston, MA; The Churchill Hospital, Oxford, United Kingdom
| | - M. Salzberg
- Bnei Zion Medical Center, Haifa, Israel; Freeman Hospital, Newcastle, United Kingdom; Sheba Medical Center, Tel Hashomer, Israel; Ichilov Medical Center, Tel Aviv, Israel; PBS Ltd, Basel, Switzerland; Collgard Biopharmaceuticals, Petach Tikva, Israel; Beth Israel Deaconess Medical Center, Boston, MA; The Churchill Hospital, Oxford, United Kingdom
| | - S. Yarkoni
- Bnei Zion Medical Center, Haifa, Israel; Freeman Hospital, Newcastle, United Kingdom; Sheba Medical Center, Tel Hashomer, Israel; Ichilov Medical Center, Tel Aviv, Israel; PBS Ltd, Basel, Switzerland; Collgard Biopharmaceuticals, Petach Tikva, Israel; Beth Israel Deaconess Medical Center, Boston, MA; The Churchill Hospital, Oxford, United Kingdom
| | - B. Dezube
- Bnei Zion Medical Center, Haifa, Israel; Freeman Hospital, Newcastle, United Kingdom; Sheba Medical Center, Tel Hashomer, Israel; Ichilov Medical Center, Tel Aviv, Israel; PBS Ltd, Basel, Switzerland; Collgard Biopharmaceuticals, Petach Tikva, Israel; Beth Israel Deaconess Medical Center, Boston, MA; The Churchill Hospital, Oxford, United Kingdom
| | - A. Harris
- Bnei Zion Medical Center, Haifa, Israel; Freeman Hospital, Newcastle, United Kingdom; Sheba Medical Center, Tel Hashomer, Israel; Ichilov Medical Center, Tel Aviv, Israel; PBS Ltd, Basel, Switzerland; Collgard Biopharmaceuticals, Petach Tikva, Israel; Beth Israel Deaconess Medical Center, Boston, MA; The Churchill Hospital, Oxford, United Kingdom
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Gofrit ON, Shapiro A, Pode D, Sidi A, Nativ O, Leib Z, Witjes JA, van der Heijden AG, Naspro R, Colombo R. Combined local bladder hyperthermia and intravesical chemotherapy for the treatment of high-grade superficial bladder cancer. Urology 2004; 63:466-71. [PMID: 15028439 DOI: 10.1016/j.urology.2003.10.036] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2003] [Accepted: 10/08/2003] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of combined local bladder hyperthermia and intravesical chemotherapy for the treatment of patients with high-grade (G3) superficial bladder cancer. METHODS Patients with G3 bladder tumors (Stage Ta or T1) were treated with combined intravesical chemotherapy with mitomycin-C and local radiofrequency hyperthermia of the bladder wall. The patients were treated with either a prophylactic protocol (40 mg mitomycin-C) after complete transurethral resection of all tumors or with an ablative protocol (80 mg mitomycin-C) when visible tumor was seen on video-cystoscopy or bladder biopsies were positive for carcinoma in situ. RESULTS Combined chemo-thermotherapy was administered to 52 patients with high-grade superficial bladder cancer (40 patients with Stage T1 tumor, 11 with Ta, and 3 with concomitant or isolated carcinoma in situ). At a median follow-up of 15.2 months (mean 23, range 6 to 90), no stage progression to T2 or disease-related mortality had occurred. The bladder preservation rate was 86.5%. The prophylactic protocol was administered to 24 patients. After a mean follow-up of 35.3 months, 15 patients (62.5%) were recurrence free. The bladder preservation rate was 95.8%. The ablative protocol was administered to 28 patients. Complete ablation of the tumor was accomplished in 21 patients (75%). After a mean follow-up of 20 months, 80.9% of these patients were recurrence free. The bladder preservation rate for the ablative group was 78.6%. CONCLUSIONS Combined local bladder hyperthermia and intravesical chemotherapy has a beneficial prophylactic effect in patients with G3 superficial bladder cancer. Ablation of high-grade bladder tumors is feasible, achieving a complete response in about three quarters of the patients.
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MESH Headings
- Administration, Intravesical
- Aged
- Aged, 80 and over
- Antineoplastic Agents, Alkylating/administration & dosage
- Antineoplastic Agents, Alkylating/adverse effects
- Antineoplastic Agents, Alkylating/therapeutic use
- Carcinoma in Situ/drug therapy
- Carcinoma in Situ/pathology
- Carcinoma in Situ/therapy
- Carcinoma, Transitional Cell/drug therapy
- Carcinoma, Transitional Cell/pathology
- Carcinoma, Transitional Cell/surgery
- Carcinoma, Transitional Cell/therapy
- Combined Modality Therapy
- Cystectomy
- Cystoscopy
- Disease Progression
- Disease-Free Survival
- Female
- Follow-Up Studies
- Humans
- Hyperthermia, Induced/adverse effects
- Male
- Middle Aged
- Mitomycin/administration & dosage
- Mitomycin/adverse effects
- Mitomycin/therapeutic use
- Neoplasm Recurrence, Local/surgery
- Neoplasm Staging
- Urinary Bladder Neoplasms/drug therapy
- Urinary Bladder Neoplasms/pathology
- Urinary Bladder Neoplasms/surgery
- Urinary Bladder Neoplasms/therapy
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Affiliation(s)
- O N Gofrit
- Department of Urology, Hadassah University Hospital, Jerusalem, Israel
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Abstract
The aim of this study was to evaluate the accuracy of tumor size measurement on CT studies of renal tumors. Sixteen patients with tumors of the kidneys were imaged by helical CT prior to surgery. Assessment of tumor volume was made by two radiologists on the CT images with the summation of area method, then compared with the resected specimen water displacement volume. Intra- and interobserver agreement for CT measurements were also assessed. There were substantial differences between the CT volume measurement compared with the tumor post-operative volume (mean of differences 30.05+/-91.6, 95%CI: 31.45-91.55). The inter- and intraobservation agreements for tumor measurement by CT was found to be satisfactory (ANOVA: p < 0.0001; t-test: p < 0.05). The CT volumetric measurement by area summation is a method with good inter- and intraexamination reproducibility but not an accurate technique for tumor volume assessment.
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Affiliation(s)
- M Tann
- Department of Radiology, Bnai-Zion Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.
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Mullerad M, Falik T, Madeb R, Nativ O. Hereditary prostate cancer--the search for the gene. Isr Med Assoc J 2001; 3:523-7. [PMID: 11791421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- M Mullerad
- Department of Urology, Bnai Zion Medical Center, Haifa, Israel.
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Mullerad M, Dickstein G, Nativ O. [Adrenal mass in patients with previous history malignancy: a diagnostic and patient managing challenge]. Harefuah 2001; 140:409-12. [PMID: 11419064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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Abstract
OBJECTIVE To evaluate the impact of nuclear DNA content on outcome of patients with testicular seminoma. METHODS Formalin-fixed paraffin-embedded blocks taken from 111 patients with primary testicular seminoma were studied by flow cytometry for nuclear DNA content. The results of ploidy status were correlated with histopathologic features, tumor progression and patients' survival. RESULTS 48% of the tumors were DNA diploid and 52% were DNA aneuploid. None of the patients with DNA diploid seminoma had an advanced stage seminoma at the time of diagnosis. Progression after therapy or cancer-related death occurred only in patients who had DNA aneuploid testicular tumors. CONCLUSIONS Nuclear DNA ploidy pattern provides important prognostic information for patients with testicular seminoma.
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Affiliation(s)
- O Nativ
- Department of Urology, Mayo Clinic, Rochester, Minn., USA
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Nativ O, Sabo E, Madeb R, Halachmi S, Madjar S, Moskovitz B. Prognostic score for patients with localized renal cell carcinoma treated by nephrectomy. Isr Med Assoc J 2001; 3:24-7. [PMID: 11344796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
OBJECTIVE To evaluate the feasibility of using combined clinical and histomorphometric features to construct a prognostic score for the individual patient with localized renal cell carcinoma. PATIENTS AND METHODS We studied 39 patients with pT1 and pT2 RCC who underwent radical nephrectomy between 1974 and 1983. Univariate and multivariate analyses were used to determine the association between various prognostic features and patient survival. RESULTS The most important and independent predictors of survival were tumor angiogenesis (P = 0.009), nuclear DNA ploidy (P = 0.0071), mean nuclear area (P = 0.013), and mean elongation factor (P = 0.0346). Combination of these variables enabled prediction of outcome for the individual patient at a sensitivity and specificity of 78% and 89%, respectively. CONCLUSION Our results indicate that no single parameter can accurately predict the outcome for patients with localized RCC. Combination of neovascularity, DNA content and morphometric shape descriptors enabled a more precise stratification of the patients into different risk categories.
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Affiliation(s)
- O Nativ
- Department of Urology, Bnai Zion Medical Center, Lady Davis Carmel Medical Center, Haifa, Israel.
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Madjar S, Jacoby K, Giberti C, Wald M, Halachmi S, Issaq E, Moskovitz B, Beyar M, Nativ O. Bone anchored sling for the treatment of post-prostatectomy incontinence. J Urol 2001; 165:72-6. [PMID: 11125367 DOI: 10.1097/00005392-200101000-00018] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This ongoing study evaluates the safety and efficacy of a new minimally invasive sling procedure for treating post-prostatectomy incontinence. MATERIALS AND METHODS A total of 16 men 56 to 74 years old (mean age 67) underwent the procedure using the Straight-In bone anchoring system. Time after prostatectomy was 1.5 to 5 years (mean 2.5). Of the 16 patients 14 had urodynamically confirmed stress urinary incontinence, while 2 had mixed incontinence with stress incontinence and detrusor instability. The procedure is performed with the patient in the lithotomy position using a perineal approach. Four miniature bone screws with pre-attached pairs of No. 1 polypropylene sutures are placed directly into the medial aspect of the inferior rami of the pubic bone. A pair of bone anchors is placed just below the symphysis on each side, and the second pair is inserted 3 to 4 cm. lower. To support the bulbar urethra a gelatin coated polyethylene terephthalate trapezoid shaped sling or cadaveric fascia lata is tied to the pubic bone using the 4 pairs of sutures attached to the bone anchors. Urethral resistance is increased to 30 to 50 cm. water above baseline pressure. RESULTS Followup was 4 to 20 months (mean 12.2). Of the 14 men with the preoperative urodynamic diagnosis of genuine stress incontinence 12 were cured of incontinence, defined as subjectively dry with no or only 1 pad used daily for security without any episode of leakage, while 2 were improved subjectively with a decrease of 50% or more in pads daily. Two other patients with the preoperative diagnosis of mixed urinary incontinence were improved. Postoperatively urodynamic study in these patients revealed resolved stress incontinence but persistent urge urinary incontinence. They responded to anticholinergics and are completely dry. Intraoperative and postoperative complications were minimal with no erosion, infection or osseous complications. CONCLUSIONS This new minimally invasive male sling procedure is safe and efficacious. Adjusting sling tension by measuring urethral resistance results in a low rate of over correction and failure. Further experience is needed to establish this procedure as treatment for post-prostatectomy incontinence.
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Affiliation(s)
- S Madjar
- Bnai-Zion Medical Center, Haifa, Israel, Northwest Hospital, Seattle, Washington, and San Paolo Hospital, Savona, Italy
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Halachmi S, Madeb R, Kravtsov A, Moskovitz B, Halachmi N, Nativ O. Bladder cancer--genetic overview. Med Sci Monit 2001; 7:164-8. [PMID: 11208514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND This article review the serial genetic changes which are responsible to the initiation and progression of bladder cancer. Knowledge of the exact genetic alteration has a direct implication on the development of knew more sensitive and specific tool for an early diagnosis and better prognosis calculations. CONCLUSION Bladder cancer develop and progress through a series of genetic alterations. Understanding of the genetic mechanisms which lead to malignant transformation gave rise to the development of various genetic mechanisms which lead to malignant transformation gave rise to the development of various genetic tools providing better ability of early detection and more accurate prognosis prediction.
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Affiliation(s)
- S Halachmi
- Department of Urology, Bnai Zion Medical Center, 47 Golomb St., Haifa, Israel
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Nativ O, Sabo E, Wald M, Halachmi S, Moskovitz B. Relationship between prostate size and percent free prostate-specific antigen in patients with operable prostate cancer. Isr Med Assoc J 2000; 2:889-91. [PMID: 11344767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND The free-to-total prostate-specific antigen ratio is the best marker for optimizing prostate cancer detection. The main problem with studies of percent free PSA is the variability of reported cutoff values. OBJECTIVES To evaluate the influence of prostate size on the ratio of free to total PSA. METHODS The study group included 58 patients (mean age 66.4 years) with clinically localized prostate cancer treated surgically at our institution. Total PSA and free PSA levels were measured by a solid phase enzyme immunoassay test (Hoffman-La Roche, Basel, Switzerland). The percent free PSA was compared with prostate size as determined from the surgical specimen. RESULTS A direct relation was noted between prostate size and the percent free PSA value (r = 0.49, P = 0.0001). Mean percentage free PSA was 9% +/- 0.004 in men with normal-sized gland while in men with large prostate (> 60 g) the average percent free PSA was 15.9 +/- 0.09 (P = 0.001). CONCLUSIONS In patients with prostate cancer the percent free PSA level is influenced by the gland size. The larger the prostate the higher the proportion of the free PSA. Such information may have influence on the recommendation for prostate biopsy in screening programs for early detection of prostate cancer.
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Affiliation(s)
- O Nativ
- Department of Urology, Bnai Zion Medical Center, Haifa, Israel.
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Nativ O, Sabo E, Raviv G, Halachmi S, Moskovitz B. Value of nuclear morphometry for differentiating localized from metastatic renal cell carcinoma. Eur Urol 2000; 33:186-9. [PMID: 9519362 DOI: 10.1159/000019553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the feasibility of using nuclear morphometry of primary renal cell carcinoma to differentiate cases with localized tumors from those with metastases. METHODS Using an interactive image analysis system, nuclear morphometry was performed on hematoxylin- and eosin-stained slides of 40 primary renal tumors. There were 18 cases with organ-confined disease and 22 with advanced stage. RESULTS The most significant shape descriptor to differentiate between the two groups was mean nuclear regularity factor (889.5 +/- 24.4 vs. 701.1 +/- 157.3, p = 0.00015). The combination of mean nuclear area and mean nuclear regularity factor enabled accurate prediction of metastatic potential in 36 (85%) cases. CONCLUSION Nuclear morphometry measured by image analysis provides prognostic information on patients with renal cell carcinoma.
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Affiliation(s)
- O Nativ
- Department of Urology, Bnai Zion Medical Center, Haifa, Israel
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Abstract
Ureterocele is a common disorder characterized by cystic dilatation of the terminal submucosal portion of 1 or both ureters. Conventional imaging modalities for the diagnosis of ureterocele include intravenous urography and voiding cystourethrography; gray-scale sonography, augmented by color Doppler and spectral analysis studies, can be useful in diagnosing and managing this condition as well. We describe the diagnosis of ureterocele using transvaginal gray-scale and color Doppler sonography with spectral analysis in 2 women. Color Doppler sonography demonstrated urine flow into the bladder, and spectral analysis was used to measure the flow velocity. Together, these modalities can provide additional information about urinary flow dynamics, aid in implementing treatment for patients with ureterocele, and eliminate the need for invasive diagnostic procedures.
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Affiliation(s)
- R Madeb
- Department of Urology, Bnai Zion Medical Center, P.O. Box 4940, Haifa 31048, Israel
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Madjar S, Beyar M, Nativ O. Die im Knochen verankerte Schlingenplastik zu der Therapie der Stressinkontinenz. Aktuelle Urol 2000. [DOI: 10.1055/s-2000-7202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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