Pathologic pattern of invasive bladder carcinoma: impact of bilharziasis

To describe the pathologic pattern of invasive bladder carcinoma in cystectomy specimens in relation to bilharziasis. Between April 2002 and October 2006, 148 consecutive patients with invasive bladder cancer were subjected to radical cystectomy and orthotopic sigmoid bladder substitution at Al-Azhar Urology Department, Cairo, Egypt. A retrospective computerized data- base analysis of the pathologic features of the cystectomy specimens was done focusing on the impact of bilharziasis on the pathology of bladder carcinoma. The tumor cell type, stage, grade and gross features in addition to lymph node involvement were particularly noted. Bilharzial bladder pathology [lesions or ova] was present in 105 [70.9%] of 148 cystectomy specimens. Tumor histology included transitional cell carcinoma [TCC] in 84 [56.7%], squamous cell carcinoma [SCC] in 51 [34.5%], adenocarcinoma in 9 [6.1%] and anaplastic tumor in 4 [2.7%] of these specimens. Most tumors associated with bilharziasis were bulky and appeared fungating or ulcerative. The pathologic tumor stage was pT2 in 23%, pT3 in 70.9% and pT4a involving the prostate or seminal vesicles in 6.1%. None of these pT4a tumors were SCC. The tumor grade was described as low grade in 72 [48.6%] and high grade in 76 [51.4%] specimens. Regional lymph node involvement was detected in 31 [20.9%] specimens irrespective of bilharzial infestation. Invasive bladder carcinoma associated with bilharzial pathology is mainly stage pT3, low-grade SCC and commonly appears as an ulcerative, bulky, fungating or verrucous mass. On the other hand, bladder carcinoma not associated with bilharziasis is mainly high-grade TCC and commonly appears as nodular or fungating lesions. Positive surgical margin and lymph node involvement are unrelated to bilharzial infestation

Monopolar electrocautery, an alternative novel method of hemostasis during radical cystectomy: preliminary report

During radical cystectomy, local hemostasis is a critical factor for surgical success. It can be accomplished with a variety of techniques including mechanical compression, ligatures, auterization and laser. The aim of this work was to evaluate monopolar electrocautery alone for achieving hemostasis during radical cystectomy. In this prospective study 30 patients were scheduled for radical cystectomy over a period of 2 years at Al-Azhar University Hospitals using monopolar electrocautery as the only hemostatic tool. The parameters studied were: operative time, estimated blood loss and incidence of complications. The data were analyzed clinically and statistically. Monopolar electrocautery as the only hemostatic tool during radical cystectomy resulted in a short operative time [35 +/- 5 minutes]. The mean estimated blood loss was 150 +/- 50 ml. Intraoperative bleeding was encountered in 2 patients only and they received blood transfusion. The overall post-operative early [within the fi rst month] complication rate was low [13.3%] and all complications were managed conservatively. Monopolar electrocauterization is a safe method for achieving hemostasis during radical cystectomy, with a signifi cantly short operative time, low cost, low blood loss, a low cystectomy-related complication rate and a short hospital stay

Micelle formation in water-ethylene glycol mixtures

Critical micelle concentrations [cmc's] of the ionic surfactant dodecyltriethanolammonium iodide have been studied spectrophotometrically in water-ethylene glycol [EG] mixtures [XEG = 0.0, 0.093, 0.120, 0.290, 0.552 and 1 at 25, 35 and 45C]. The equilibrium model of micelle formation is selected to determine the thermodynamic parameters delta G, delta H and delta S. An interpretation of structural changes in H2O-EG system has been suggested

Experimental study in scleroma

Kl.rhinoscleromatis was inoculated intranasally together with subcutaneous or intradermal inoculation in a group of nude mice and normal mice. Histopathological examination for the nude mouse that survived the experiment revealed granulomatous reaction with a Mikulicz cell like appearance in lungs, in orbit and liver. Normal mice showed granulomatous reaction only in lungs and was lesser in extent and in number of Mikulicz like cells. Kl rhinoscleromatis was isolated from lung tissue of all animals. The results showed that Kl rhinoscleromatis is responsible for the disease as it fulfilled Koch's postulates and that it is an organism with low virulence that can be potentiated by depressed cell mediated immunity. The significance of the findings in relation to scleroma in humans is discussed