The treatment of varicocele by microsurgical techniques

We performed an extensive bibliographic search, and review the alternatives for surgical treatment of varicocele, especially microsurgical techniques. The surgical techniques for varicocele have not suffered much variation over the last years, being their use generalized among urologists. The lower incidence of relapse and secondary hydrocele to lymphatic lesion make retroperitoneal techniques be used less frequently in favour of inguinal or subinguinal techniques, microsurgical or not. For better understanding of the surgical indications and development of techniques we offer some short anatomical and physiopathological comments about varicocele.     

Endoscopic treatment of colorectal polyps in a digestive endoscopy outpatient department

The aim of this report was to evaluate the effectiveness of the endoscopic treatment of colonic polyps to allow secondary prophylaxis in order to prevent the onset of cancer arising from adenomas. From October 2002 to January 2004 we performed 487 colonoscopies on a patient group with the following indications: screening prior to kidney transplant; screening for colorectal cancer (patients positive at faecal occult blood testing); follow-up of patients who had undergone colonic resections for colorectal cancer; patients with other diseases. Colorectal polyps were diagnosed in 15 males and 15 females, with a mean age of 63 years. All the neoplasms were resected during colonoscopy and specimens sent for histological study. The histological examinations yielded the following results: 4 hyperplastic polyps; 9 tubular adenomas (6 with mild, 2 with mild-to-moderate, and 1 with severe dysplasia); 8 tubulo-villous adenomas (3 with mild, 1 with mild-to-moderate, and 4 with moderate dysplasia); 4 villous adenomas (3 with mild and 1 with severe dysplasia); 1 adenocarcinoma; 1 inflammatory polyp; in 3 cases we were unable to retrieve the polyps after polypectomy. Colonoscopic detection of a neoplasm allows us to remove it and send to the pathology laboratory for definitive histological diagnosis. Moreover, snare polypectomy can be a radical treatment for dysplastic polyps without stromal axis and basal membrane infiltration. We therefore conclude that colonoscopy allows not only early diagnosis of colonic neoplasms, but also radical curative treatment in the early stages.     

Microdensitometry of T2-weighted magnetic resonance (MR) images from patients with advanced neoplasias in a phase I clinical trial of an infrared pulsed laser device (IPLD)

BACKGROUND AND OBJECTIVE: The aim of this study was to determine whether an infrared pulsed laser device (IPLD)-induced pathophysiologic changes could be identified before measurable modifications in tumor volume. STUDY DESIGN/PATIENTS AND METHODS: Pre-and post-IPLD treatment magnetic resonance (MR) images of tumor heterogeneities and peritumoral tissues were digitized and a linear transformation was performed to convert images to 256 intensity levels. Data were analyzed by using the Student's t-test and the Kolmogorov-Sminov test (alpha = 0.05). RESULTS: The post-treatment mean intensity values of tumor heterogeneities increased significantly (P < 0.001) for all of the seven patients (n = 7) evaluated. For peritumoral tissues, a significant increase (P < 0.001) was measured in four patients (n = 4). The Kolmogorov-Sminov test showed significant values for the tumor tissue of six (n = 6) patients. CONCLUSION: This is the first study of early evidence of anti-cancer activity of a novel IPLD showing a significant increase in the water content of tumor heterogeneities before measurable changes in tumor volume.