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Current Urology Reports Sep 2016Bladder cancer is the second commonest urinary tract malignancy with 70-80 % being non-muscle invasive (NMIBC) at diagnosis. Patients with high-risk NMIBC (T1/Tis, with... (Review)
Review
Bladder cancer is the second commonest urinary tract malignancy with 70-80 % being non-muscle invasive (NMIBC) at diagnosis. Patients with high-risk NMIBC (T1/Tis, with high grade/G3, or CIS) represent a challenging group as they are at greater risk of recurrence and progression. Intravesical Bacilli Calmette-Guerin (BCG) is commonly used as first line therapy in this patient group but there is a current worldwide shortage. BCG has been shown to reduce recurrence in high-risk NMIBC and is more effective that other intravesical agents including mitomycin C, epirubicin, interferon-alpha and gemcitabine. Primary cystectomy offers a high change of cure in this cohort (80-90 %) and is a more radical treatment option which patients need to be counselled carefully about. Bladder thermotherapy and electromotive drug administration with mitomycin C are alternative therapies with promising short-term results although long-term follow-up data are lacking.
Topics: Antineoplastic Agents; BCG Vaccine; Cystectomy; Humans; Hyperthermia, Induced; Immunotherapy; Mitomycin; Urinary Bladder Neoplasms
PubMed: 27492610
DOI: 10.1007/s11934-016-0625-z -
International Journal of Environmental... Sep 2022The search for the "gold standard" in the surgical treatment of pterygium has been ongoing for over two decades. Despite the development of various surgical techniques,... (Review)
Review
The search for the "gold standard" in the surgical treatment of pterygium has been ongoing for over two decades. Despite the development of various surgical techniques, recurrence rates range from 6.7% to 88% depending on the method used. This review discusses the latest and most commonly used methods for the surgical removal of pterygium, primarily focusing on efficacy and safety. Moreover, this review includes articles that either evaluated or compared surgical methods and clinical trials for primary and recurrent pterygium. Limited data are available on combined methods as well as on the efficacy of adjuvant treatment. The use of adjuvant intraoperative mitomycin C (MMC) and conjunctival autografting (CAU) are the two most highly recommended options, as they have the lowest rates of postoperative recurrence.
Topics: Conjunctiva; Follow-Up Studies; Humans; Mitomycin; Pterygium; Recurrence; Treatment Outcome
PubMed: 36141628
DOI: 10.3390/ijerph191811357 -
BMC Ophthalmology Mar 2023The aim of this study was to compare trabeculectomy outcomes in patients with and without post-operative serous choroidal detachment (CD) and establish an association...
BACKGROUND
The aim of this study was to compare trabeculectomy outcomes in patients with and without post-operative serous choroidal detachment (CD) and establish an association between CD and trabeculectomy outcomes.
METHODS
In this 4-year retrospective cohort study, medical records of glaucoma patients older than 18 who underwent primary trabeculectomy with Mitomycin-C between 2012 and 2020 were reviewed. Phakic eyes without history of any other intraocular surgery and with at least one year of follow-up were included in the study. Postoperative CD was defined as clinically visible CD developed within the first postoperative week. Cases were categorized into with and without CD and trabeculectomy outcomes were compared. Comparison was carried out using postoperative intraocular pressure (IOP), glaucoma medications and surgery success. Two levels of success were defined regardless of glaucoma medications; criteria A) 5 < IOP < 19 mmHg and criteria B) 5 < IOP < 16 mmHg. In addition to the defined IOP ranges, IOP reduction less than 20% from baseline and further glaucoma surgery were also counted as surgery failures.
RESULTS
Total of 183 patients including 153 without CD (mean age 58.73 ± 11.40 years, mean IOP 23.7 ± 6.63 mmHg) and 30 with CD (59.00 ± 12.59 years, mean IOP 22.2 ± 3.83 mmHg) entered the study. Post-trabeculectomy mean IOPs were significantly higher in the CD group at all follow-up visits at year 1 through 4 (14.70, and 14.82 mmHg vs. 11.03, and 12.59 mmHg; p-value < 0.05). Similarly mean number of glaucoma medications was higher in the CD group at all follow-up visits (p-value > 0.001). Based on success criteria A, cumulative probability of success for patients with CD wasn't significantly different compared to those without CD at years 1 through 4 (80.0%, and 69.6% vs. 88.2%, and 74.1% respectively; p-value > 0.05, log-rank). However, based on success criteria B, patients with CD had significantly lower cumulative probability of success at years 1 through 4 (50.0% and 8.9% vs. 79.7% and 59.8%, p-value < 0.001).
CONCLUSION
We established that early post-trabeculectomy serous choroidal detachment is associated with adverse surgery outcomes. Lower rate of surgery success and higher mean postoperative IOP and glaucoma medications were observed in patients with post-trabeculectomy choroidal detachment and this was more pronounced in patients who required more stringent IOP control (success definition 5 < IOP < 16 mmHg).
Topics: Humans; Middle Aged; Aged; Trabeculectomy; Retrospective Studies; Glaucoma; Intraocular Pressure; Eye; Mitomycin; Treatment Outcome; Follow-Up Studies
PubMed: 36932410
DOI: 10.1186/s12886-023-02860-1 -
Ophthalmology. Glaucoma 2021Intra-Tenon or subconjunctival injection of a solution of mitomycin C (MMC) and 1% preservative-free lidocaine (as an anesthetic) has gained popularity for its use in...
PURPOSE
Intra-Tenon or subconjunctival injection of a solution of mitomycin C (MMC) and 1% preservative-free lidocaine (as an anesthetic) has gained popularity for its use in trabeculectomy, a filtering surgery for glaucoma. To our knowledge, no studies have analyzed the impact of lidocaine on the cytotoxic effects of MMC in this setting. This study was conducted to evaluate in vitro fibroblast cytotoxicity to a solution of MMC (0.2 mg/ml) and 1% preservative-free lidocaine.
DESIGN
Experimental study.
PARTICIPANTS
Nonhuman subject research.
METHODS
Cultured human conjunctival fibroblasts were incubated in phosphate-buffered saline (PBS) (control), MMC (0.2 mg/ml), a mixture of 0.2 mg/ml MMC + 1% preservative-free lidocaine, or 1% preservative-free lidocaine. Samples were taken at 2, 5, 10, 30, and 60 minutes, and a 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay with photoabsorbance testing was used to assess conjunctival cell viability.
MAIN OUTCOME MEASURE
Mean photoabsorbance.
RESULTS
Mean photoabsorbance across all time intervals was 0.680 for solutions incubated in PBS, 0.642 for MMC, 0.612 for MMC + 1% preservative-free lidocaine, and 0.605 for 1% preservative-free lidocaine. A 2-way analysis of variance analyzing solution, time, and solution-time interaction on photoabsorbance showed that PBS was least cytotoxic and an optimal control for this study. Tukey post hoc comparisons showed that MMC was more cytotoxic than PBS (P < 0.001). However, both MMC + 1% preservative-free lidocaine and 1% preservative-free lidocaine were more cytotoxic than MMC and PBS (P < 0.01 for all). No significant differences in cytotoxicity comparing lidocaine-containing solutions were observed.
CONCLUSIONS
In this in vitro study, we found an increase in cytotoxicity when MMC (0.2 mg/ml) was combined with 1% preservative-free lidocaine. We note that lidocaine did not inhibit MMC cytotoxicity and exhibited a significant cytotoxic effect on its own.
Topics: Glaucoma; Humans; Lidocaine; Mitomycin; Tetrazolium Salts; Trabeculectomy
PubMed: 33080409
DOI: 10.1016/j.ogla.2020.10.011 -
Der Ophthalmologe : Zeitschrift Der... Jul 2021The pterygium is a frequent ultraviolet (UV) light-induced focal fibrovascular proliferation of the conjunctival tissue onto the cornea. Surgical excision should be...
The pterygium is a frequent ultraviolet (UV) light-induced focal fibrovascular proliferation of the conjunctival tissue onto the cornea. Surgical excision should be performed in the case of reduced visual acuity, progressive astigmatism, impending invasion of the optical axis and ocular surface complaints. The main factors in preventing recurrence include optimal surgical treatment by an excision combined with a free conjunctival autograft, consistent postoperative treatment with preservative-free artificial tears and topical steroids as well as long-term UV protection.
Topics: Astigmatism; Conjunctiva; Humans; Mitomycin; Pterygium; Recurrence; Transplantation, Autologous
PubMed: 33782734
DOI: 10.1007/s00347-021-01366-9 -
The Journal of Urology Nov 2015
Topics: Female; Humans; Hyperthermia, Induced; Male; Mitomycin; Urinary Bladder Neoplasms
PubMed: 26239496
DOI: 10.1016/j.juro.2015.05.107 -
Methods in Molecular Biology (Clifton,... 2020To date, only three bacteriophages of leptospires-leptophages-are known. Nonetheless, numerous prophages have been found in the genus, especially in the genomes of...
To date, only three bacteriophages of leptospires-leptophages-are known. Nonetheless, numerous prophages have been found in the genus, especially in the genomes of pathogenic species. Thus, some laboratories attempt to isolate leptophage particles from environmental samples or following mitomycin C induction of bacterial cultures. Here, we propose multiple procedures to isolate, purify, and characterize bacteriophages, based on protocols used for LE3 and LE4 characterization.
Topics: Bacteriophages; Clinical Laboratory Techniques; Leptospira; Mitomycin
PubMed: 32632860
DOI: 10.1007/978-1-0716-0459-5_7 -
Der Ophthalmologe : Zeitschrift Der... Jun 2018Trabeculectomy is the most proven method for the treatment of open angle glaucoma. The long-term results of this method show an 80% success rate in lowering intraocular... (Review)
Review
Trabeculectomy is the most proven method for the treatment of open angle glaucoma. The long-term results of this method show an 80% success rate in lowering intraocular pressure over 20 years. The surgical technique is demonstrated in detail with the help of a video of the operation and which is available online. For more than 15 years trabeculectomy has been performed with the use of antifibrotic substances, such as mitomycin C. Long-term treatment with antiglaucoma eyedrops leads to a proven inflammation of the conjunctiva and the ocular surface with an increase in lymphocytes, mast cells, and fibroblasts. Discontinuation of antiglaucoma therapy in turn allows regeneration of the ocular surface. From the knowledge gained from these histopathological studies it has been recommended to stop glaucoma treatment prior to glaucoma surgery and to pretreat the conjunctiva with eyedrops containing cortisone. Administration of nonsteroidal antiphlogistic substances or local steroids to the conjunctiva 4 weeks prior to surgery increases long-term success of the filtering bleb function.
Topics: Conjunctiva; Intraocular Pressure; Mitomycin; Tonometry, Ocular; Trabeculectomy; Treatment Outcome
PubMed: 29589148
DOI: 10.1007/s00347-018-0685-1 -
Journal of Glaucoma Sep 2023Repeat trabeculectomy is associated with similar postoperative intraocular pressure (IOP), a lower complication rate, and a lower need for medications when compared with... (Review)
Review
PRCIS
Repeat trabeculectomy is associated with similar postoperative intraocular pressure (IOP), a lower complication rate, and a lower need for medications when compared with Ahmed valve implantation (AVI) when performed after initially failed trabeculectomy.
OBJECTIVE
The goal of this study was to compare the efficacy of repeat trabeculectomies and AVI after an initial failed trabeculectomy.
METHODS
All studies that investigated the postoperative success of patients who underwent AVI or repeat trabeculectomy with mitomycin- C after a prior failed trabeculectomy with mitomycin- C found in PubMed, Cochrane Library, Scopus, and CINAHL were included. Mean preoperative and postoperative IOP, proportions of complete and qualified successes, and proportions of complications were extracted from each study. Meta-analyses were performed to compare the differences between the two surgical approaches. Methods of measuring complete and qualified success were too heterogeneous among the included studies to allow for meta-analysis.
RESULTS
The literature search yielded 1305 studies, and 14 studies were included in the final analysis. Mean IOP was not significantly different between the two groups preoperatively and then after 1, 2, and 3 years. Mean number of medications between the two groups was similar preoperatively. After 1 and 2 years, the mean amount of glaucoma medications in the AVI group was approximately twice that of the trabeculectomy group; however, this relationship was only significant at 1 year of follow-up ( P = 0.042). In addition, the cumulative proportion of overall and sight-threatening complications was significantly higher in the AVI group.
CONCLUSION
Repeat trabeculectomy with mitomycin- C and AVI may both be considered after failed primary trabeculectomy. However, our analysis suggests that repeat trabeculectomy may be the preferred method as it provides similar efficacy with fewer disadvantages.
Topics: Humans; Follow-Up Studies; Glaucoma Drainage Implants; Intraocular Pressure; Mitomycin; Retrospective Studies; Trabeculectomy; Treatment Outcome
PubMed: 37311016
DOI: 10.1097/IJG.0000000000002240 -
Pediatric Nephrology (Berlin, Germany) Feb 2018Refinement of immunosuppressive strategies has led to further improvement of kidney graft survival in recent years. Currently, the main limitations to long-term graft... (Review)
Review
Refinement of immunosuppressive strategies has led to further improvement of kidney graft survival in recent years. Currently, the main limitations to long-term graft survival are life-threatening side effects of immunosuppression and chronic allograft injury, emphasizing the need for innovative immunosuppressive regimens that resolve this therapeutic dilemma. Several cell therapeutic approaches to immunosuppression and donor-specific unresponsiveness have been tested in early phase I and phase II clinical trials in kidney transplantation. The aim of this overview is to summarize current cell therapeutic approaches to immunosuppression in clinical kidney transplantation with a focus on myeloid suppressor cell therapy by mitomycin C-induced cells (MICs). MICs show great promise as a therapeutic agent to achieve the rapid and durable establishment of donor-unresponsiveness in living-donor kidney transplantation. Cell-based therapeutic approaches may eventually revolutionize immunosuppression in kidney transplantation in the near future.
Topics: Humans; Immunosuppression Therapy; Kidney Transplantation; Mitomycin; Myeloid-Derived Suppressor Cells; Nucleic Acid Synthesis Inhibitors; Transplantation Tolerance
PubMed: 28229281
DOI: 10.1007/s00467-017-3599-2