Search PubMed⌕ Search

Biomedical subjects

K A Hanash

Publications and source records attributed to K A Hanash.

At least 19 recordsLinked to original sources
PubMed2000

Radical cystectomy: minimizing operative blood loss with a "stapling technique".

We describe our experience with a surgical technique using the multiple fire Endo-GIA-30-3.5 stapler to control the vascular pedicles during radical cystectomy. This technique was performed in 16 radical cystectomies, including three pelvic anterior exenterations for female invasive bladder carcinoma, and compared with 23 cases treated with the conventional method. It was associated with a significant decrease in the intraoperative and postoperative blood loss and a shorter operative time.

Blood Loss, Surgical↗
PubMed2000

Prostatic carcinoma: a nutritional disease? Conflicting data from the Kingdom of Saudi Arabia.

PURPOSE: The incidence of prostate cancer in Saudi Arabia has been reported to be low at 1.4 to 2.1/100,000 person-years. We prospectively evaluated the true incidence of this disease and its association with dietary factors. MATERIALS AND METHODS: From 1994 to 1997 inclusive Saudi men older than 50 years treated at our institution for various presenting symptoms and diseases were randomly selected from various departments. They were examined prospectively with digital rectal examination, and total and free prostate specific antigen measurement. Transrectal ultrasound and prostatic biopsy were performed when either test was abnormal. Nutrition questionnaires and detailed interviews with a nutritionist were completed to assess the type of diet, and amount of saturated and polyunsaturated fat consumption of patients with prostatic carcinoma and controls. RESULTS: For the 2,270 Saudi men screened we noted an incidence of 3.1/100,000 person-years. Our nutritional survey revealed that recent fat consumption was greater than 120 gm. per person daily, of which about 40% was from meat and dairy products. Saturated fat comprised about 50% of the total fat intake. There was no difference in the amount of fat in the diet of men with and without prostatic carcinoma. CONCLUSIONS: The incidence of prostatic carcinoma in the Kingdom of Saudi Arabia is low despite a high saturated fat diet in recent years. This finding contradicts most western clinical studies, which indicate a positive association of a high fat diet with prostatic carcinoma.

Adolescent↗
PubMed1998

Feasibility of adrenalectomy with radical nephrectomy.

OBJECTIVES: To evaluate the justification of routine removal of ipsilateral adrenal gland as part of radical nephrectomy for renal cell carcinoma (RCC). METHODS: The medical records, pathologic specimens, and computed tomographic (CT) scans of 77 patients who underwent radical nephrectomy and ipsilateral adrenalectomy for RCC were reviewed. Comparison was made between radiologic analysis and pathologic findings regarding involvement of the adrenal gland. RESULTS: The size of the renal tumor varied between 3.5 and 19 cm (mean 8.5). The upper pole was involved in 45%, the lower pole in 28%, and the midpole in 18% of the patients, and in 9% the whole kidney was involved by the tumor. Histologic findings showed that 72 (94%) of the 77 adrenal glands were normal and 70 of these were normal on CT as well. Two adrenal glands involved by metastases showed heterogeneous contrast entrancement on CT. The benign lesions of three adrenal glands were also picked up as abnormal on CT. In 2 patients adrenal glands could not be visualized on CT because of a paucity of retroperitoneal fat. CONCLUSIONS: Adrenalectomy with nephrectomy may not be performed in patients with RCC in whom CT demonstrates normal adrenal glands. In patients with adrenal abnormality on CT, magnetic resonance imaging can separate metastases from incidental benign adrenal adenoma, further reducing the number of patients requiring removal of the adrenal gland.

Adrenalectomy↗
PubMed1997

Comparative results of goal oriented therapy for erectile dysfunction.

PURPOSE: Goal oriented therapy for erectile dysfunction, based on a complete education of the couple, was offered to 460 patients. The short-term and long-term results of the first and second treatments selected were compared. MATERIALS AND METHODS: From September 1991 to March 1995, 460 patients with erectile dysfunction were evaluated and treated prospectively. The success of treatment, selected by the patient or couple, was defined as the ability to achieve and maintain good erections for successful coitus for at least 1 year after the start of therapy. Sexual satisfaction of the couple was required to confirm a successful outcome. RESULTS: The preferred first line of treatment by 322 patients was pharmacotherapy, with intracavernous injections being the second most selected therapy (80% success rate). However, there was a high long-term dropout rate for intracavernous injections. Approximately 70% of the patients were lost to followup or refused further treatment. CONCLUSIONS: Overall, this prospective study showed that goal oriented therapy is initially highly successful. However, the long-term high dropout rate and dissatisfaction of the couple cast doubt about the efficacy of the present treatment options.

Adult↗
PubMed1995

Ureterosigmoidostomy: is it a viable procedure in the age of continent urinary diversion and bladder substitution?

Between January 1977 and June 1985, 63 patients requiring supravesical diversion underwent ureterosigmoidostomy with an antireflux technique. Of the patients 49 had bladder cancer and 14 had other conditions. Two patients died in the postoperative period. Postoperatively, all patients were instructed to empty the rectum frequently, and received bicarbonate and potassium supplementation. Median followup was 41 months (range 3 to 70). Renal function remained stable in 92% of the patients. Radiographic deterioration occurred in 23% of the renal units, which was severe in 7%. These results indicate that the short and intermediate followup results with ureterosigmoidostomy are comparable to those of an ileal conduit. The method has the added advantage of being a form of continent diversion. We believe that ureterosigmoidostomy remains a viable and convenient alternative in select patients with bladder cancer who are not suitable for other forms of continent diversion or bladder substitution.

Adolescent↗
PubMed1992

Androgen effect on prostate specific antigen secretion.

Prolonged parenteral androgen therapy for 1 year resulted in the hypersecretion of prostate specific antigen (PSA) in a patient with no clinical evidence of prostate carcinoma, who had been treated with diethylstilbestrol (DES) for 9 years. The PSA level declined to normal values upon temporary discontinuation of androgen therapy and increased again upon resumption of treatment. This case seems to confirm the regulatory effect of androgens of PSA secretion and to suggest a possible "rebound" elevation of PSA in patients with androgen deprivation treated with testosterone replacement. The estrogen suppressed prostatic epithelial cells were able to respond to androgen stimulation with a steady increase in the PSA secretion and positive immunohistochemical PSA staining.

Aged↗
PubMed1989

Neurologic complications of ketoconazole therapy for advanced prostatic cancer.

Ketoconazole, an antifungal agent, has been recently used for the treatment of metastatic (Stage D) prostatic carcinoma. It acts by blocking the synthesis of androgens in the tests and adrenal glands. Its major side effects are gastrointestinal and hepatic. We describe a patient in whom severe mental disturbances developed following ketoconazole treatment. Symptoms improved after withdrawal of the drug.

Adenocarcinoma↗
PubMed1989

Recent advances in the surgical treatment of bilateral Wilms' tumor.

Definite progress has been made in the treatment of bilateral Wilms' tumor with marked improvement in the prognosis. Past aggressive surgical therapy has been recently replaced by a more conservative approach. Double or triple drug chemotherapy combined with conservative nephron sparing surgery is indicated for tumors with "favorable" histology. More aggressive ablative surgical therapy combined with chemotherapy and low dose radiation therapy are reserved for tumors with "unfavorable" histology. Fine needle aspiration biopsy, by both smears and cell block, combining light and electron microscopy approach, is an accurate method in establishing the diagnosis. It has some limitation in the precise histologic differentiation between "favorable and unfavorable" tumors. Treatment should be individualized according to clinical, histologic and morphologic factors. A multispecialty team effort undoubtedly, constitutes the most important element in the successful treatment of these tumors.

Child, Preschool↗
PubMed1987

Surgical treatment of bilateral synchronous Wilms' tumors.

Definite progress has been made in the treatment of bilateral Wilms' tumors with marked improvement in the prognosis. This is confirmed in our series of 6 consecutive patients with synchronous tumors. The recent trend toward more conservative surgery, double or triple drug chemotherapy, and avoidance of high-dose radiation therapy has yielded good results.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Testicular seminomas in Saudi Arabia: clinical characteristics, prognostic indicators, and recommendations for management.

Thirty Saudi patients with pure testicular seminoma were treated at King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia, between January 1977 and June 1983. Disease characteristics in Saudi Arabia including clinical findings, response to therapy, and prognosis are described and compared to those in other populations reported in the literature. Symptom durations were 3 to 42 months. Many of the patients presented with an extensive tumor burden and a poor performance status. There was a higher incidence of anaplastic seminoma and of cryptorchidism than in other series and a relatively high incidence of elevated betahuman chorionic gonadotropin (B-HCG). Patients initially underwent funiculo-orchiectomy. Twenty-two patients received radiation therapy and four received chemotherapy. Patients with limited disease responded well to orchiectomy and radiation therapy. However, those with extensive tumor burden had an unsatisfactory response to radiation therapy. Preradiation chemotherapy is recommended for patients with massive retroperitoneal metastases, nodal disease above the diaphragm, or extranodal disease and patients with minimal or moderate sized retroperitoneal nodal disease associated with an elevated B-HCG.

Chorionic Gonadotropin↗
PubMed1986

One-stage plastic reconstruction of a totally amputated cancerous penis using a unilateral myocutaneous gracilis flap.

A 36-year-old Saudi underwent a total penectomy for cancer involving the penile shaft with no corporeal invasion or distant metastases. One year postoperatively and in the absence of tumor recurrence or metastasis, a penile reconstruction using a right myocutaneous gracilis flap was performed. The result two years later was satisfactory, with preservation of deep penile sensation and successful weekly sexual intercourse. To our knowledge, no similar case has been reported previously.

Adult↗
PubMed1985

Pattern of calcium metabolism in normo- and hypercalciuric patients with calcium urolithiasis in Saudi Arabia.

Urinary calcium excretion was measured in 100 consecutive normocalcemic patients with calcium urolithiasis and 12 Saudi Arabian controls while the patients and the controls were eating their usual diet of unknown calcium content. Only 16 patients were hypercalciuric using the definition of twenty-four-hour urinary calcium of more than 300 mg for males and more than 250 mg for females, and one of these patients was subsequently found to have hyperparathyroidism. The twenty-four-hour urine calcium was less than 200 mg in 60 per cent of male patients and in all the male controls. Since the dietary intake of calcium during the twenty-four-hour urinary collection was unknown, a 1,000-mg calcium loading test was performed in an attempt to differentiate various patterns of abnormal calcium excretion. Of the twenty-four-hour normocalciuric patients 10 (18%) had "absorptive hypercalciuria" and 16 patients (29%) demonstrated a "renal hypercalciuria" pattern. Thirty-nine patients (57%) and all 12 controls had normocalciuria before and after calcium loading.

Adolescent↗
PubMed1985

Metastatic tumors to the testicles.

Metastatic tumors to the testicles are rare. The most common primary sites are the prostate, the lung, the kidney, the gastrointestinal tract and the skin (melanomas). The majority of these tumors are diagnosed at autopsy or at orchiectomy for metastatic prostatic carcinoma. Their clinical manifestations can antedate the clinical discovery of the primary tumor and the correct pathologic diagnosis of the testicular tissue may result in the identification of an "occult" carcinoma. Although they commonly occur in old patients with a peak incidence in the fifth and sixth decade, they may also involve younger patients and should be differentiated from primary testicular tumors. The most common routes of metastasis to the testes are the lymphatics, the vas deferens, the spermatic veins and the hematogeneous (arterial) pathways. Their diagnosis, although suspected by the patient's age and clinical symptoms should be confirmed histologically. Their treatment which includes a high inguinal orchiectomy is directed to the primary neoplasm. The prognosis depends on the site, type, grade and extent of the original tumors.

Adult↗